Challenges of Urban Mental Health Disaster Planning

Summary

Establishing disaster preparedness is an urgent matter, particularly with regard to mental health. This article examines the challenges of mental health disaster planning in the context of an urban setting, which may differ from those pertaining to rural areas. The need to better integrate public health disaster planning and mental health disaster planning is critical. This document particularly focuses on the challenges involved in leading, coordinating, and convening an urban mental health disaster response. With time, dedication, resources, and creation of effective policy, successful mental health response capability will evolve and endure.     

Neuroethics and National Security

This essay considers the potential role of bioethics in disaster response planning and preparedness. Bioethicists can make substantial contributions, by ensuring that decision-making and distribution of resources during crises is carried out in a fair and just manner, as well as by examining the assumptions upon which disaster planning are based. Bioethicists should also be aware of potential pitfalls of overly-hasty engagement with this new field.     

Planning Disaster Response Services: The Role of a Multi-Agency Steering Group

The tradition in UK emergency planning has been for responses to be taken at a local level. Local authorities prepare plans for dealing with any eventualities arising from a major incident. Many local-authority disaster plans have, however, lacked adequate provision for psychological services. Previous disaster responses are examined, and planning deficits identified. One of the factors considered important is active involvement of those concerned rather than the imposition of a plan designed by others. The stages necessary to develop an effective community mental health intervention are elaborated. Psychological input to future plans at both national and local levels is examined. The central requirement identified is for a Multi-Agency Steering Group, whose members have specified roles, to co-ordinate all aspects of the disaster response and support services.     

地方卫生立法现状及其问题评析

以法学基本理论为指导,采用实证分析方法,利用《中国法律法规信息检索系统》等检索系统,收集我国31个省、自治区、直辖市的地方卫生法规、规章、自治条例及单行条例,并以此为样本,以地方卫生法规、规章为主线,客观回顾了我国地方卫生立法的历史发展,就地方卫生立法的现状展开调查,深入分析存在的问题。     

Autonomy for nursing home residents: the role of regulations

The importance of autonomy and choice to nursing home residents' well-being has been well established. This paper examines the complex role of regulation as it affects the autonomy of nursing home residents. Nonstandardized interviews with residents, family members, nursing staff members, and administrators were conducted at three nursing homes in suburban Maryland. These anecdotal interviews identified the most problematic areas where regulations enforce barriers to autonomy and control. These areas include: scheduling of activities of daily living, food portions, physical environment, and documentation. Suggestions for possible improvements are discussed.     

Promoting Positive Adaptation in Adult Survivors of Natural Disasters

This article integrates the guidelines of American Red Cross and the Psychological First Aid: Field Operations Guide (Brymer et al., 2006) with adult development theories to demonstrate the promotion of adaptive functioning in adults after a disaster. Case examples and recommendations for counselors working in disaster situations are included.     

Laws, Ceteris Paribus Conditions, and the Dynamics of Belief

The characteristic difference between laws and accidental generalizations lies in our epistemic or inductive attitude towards them. This idea has taken various forms and dominated the discussion about lawlikeness in the last decades. Likewise, the issue about ceteris paribus conditions is essentially about how we epistemically deal with exceptions. Hence, ranking theory with its resources of defeasible reasoning seems ideally suited to explicate these points in a formal way. This is what the paper attempts to do. Thus it will turn out that a law is simply the deterministic analogue of a sequence of independent, identically distributed random variables. This entails that de Finetti's representation theorems can be directly transformed into an account of confirmation of laws thus conceived. This revised version was published online in July 2006 with corrections to the Cover Date.     

CETERIS PARIBUS,THERE IS NO PROBLEM OF PROVISOS

Much of the literature on ceteris paribus laws is based on a misguided egalitarianism about the sciences. For example, it is commonly held that the special sciences are riddled with ceteris paribus laws; from this many commentators conclude that if the special sciences are not to be accorded a second class status, it must be ceteris paribus all the way down to fundamental physics. We argue that the (purported) laws of fundamental physics are not hedged by ceteris paribus clauses and provisos. Furthermore, we show that not only is there no persuasive analysis of the truth conditions for ceteris paribus laws, there is not even an acceptable account of how they are to be saved from triviality or how they are to be melded with standard scientific methodology. Our way out of this unsatisfactory situation to reject the widespread notion that the achievements and the scientific status of the special sciences must be understood in terms of ceteris paribus laws. This revised version was published online in June 2006 with corrections to the Cover Date.     

Strange bedfellows? Reflections on bioethics' role in disaster response planning

This essay considers the potential role of bioethics in disaster response planning and preparedness. Bioethicists can make substantial contributions, by ensuring that decision-making and distribution of resources during crises is carried out in a fair and just manner, as well as by examining the assumptions upon which disaster planning are based. Bioethicists should also be aware of potential pitfalls of overly-hasty engagement with this new field.     

Pediatric Do-Not-Attempt-Resuscitation Orders and Public Schools: A National Assessment of Policies and Laws

Some children living with life-shortening medical conditions may wish to attend school without the threat of having resuscitation attempted in the event of cardiopulmonary arrest on the school premises. Despite recent attention to in-school do-not-attempt-resuscitation (DNAR) orders, no assessment of state laws or school policies has yet been made. We therefore sought to survey a national sample of prominent school districts and situate their policies in the context of relevant state laws. Most (80%) school districts sampled did not have policies, regulations, or protocols for dealing with student DNARs. A similar majority (76%) either would not honor student DNARs or were uncertain about whether they could. Frequent contradictions between school policies and state laws also exist. Consequently, children living with life-shortening conditions who have DNARs may not have these orders honored if cardiopulmonary arrest were to occur on school premises. Coordinated efforts are needed to harmonize school district, state, and federal approaches in order to support children and families' right to have important medical decisions honored.     

社会因素对剖宫产率的影响

近二三十年来,剖宫产率在世界范围内不断升高。究其原因,除了医学因素外,社会因素起着重要作用,从社会经济发展,社会科学文化水平、社会习俗观念、法律、医疗道德、国家计划生育政策、医学教育等多个角度分析了社会因素对剖宫产率的影响,并就如何发挥社会因素的积极作用,消除和避免其消极作用,使剖部率维持在合理的范围内进行了讨论。     

英国养老护理人员培训对我国的借鉴与启示

本文介绍了英国养老护理人员培训概况,分析了其培训特点,在此基础上思考了对我国养老护理人员培训的借鉴：满足老年人的疾病护理的需求,丰富护理内涵;不断壮大养老护理队伍,吸引高技能人才;借鉴NVQ制度,促进我国养老护理人员分层培训体系的建立;改善养老护理员工的福利与奖惩制度;完善养老机构的规章制度,确保持证上岗比例。     

Normische Gesetzeshypothesen und die wissenschaftsphilosophische Bedeutung des nichtmonotonen Schliessens

Normic Laws and the Significance of Nonmonotonic Reasoning for Philosophy of Science. Normic laws have the form ‘if A then normally B’. They have been discovered in the explanation debate, but were considered as empirically vacuous (§1). I argue that the prototypical (or ideal) normality of normic laws implies statistical normality (§2), whence normic laws have empirical content. In §3–4 I explain why reasoning from normic laws is nonmonotonic, and why the understanding of the individual case is so important here. After sketching some foundations of nonmonotonic reasoning as developed by AI-researchers (§5), Iargue that normic laws are also the best way to understand ceteris paribus laws (§6). §7 deals with the difference between physical and non-physical disciplines and §9 with the difference between normicity and approximation. In §8 it is shown how nonmonotonic reasoning provides a new understanding of the protection of theories against falsification by auxiliary hypotheses. §10, finally, gives a system- and evolution-theoretical explanation of the deeper reason for the omnipresence of normic laws in practice and science, and forthe connection between ideal and statistical normality. This revised version was published online in August 2006 with corrections to the Cover Date.     

Family participation in the care of patients in public health disasters

The ethical implications of disaster planning garner increasing scrutiny. The role of families in disaster efforts is a topic that requires additional ethical examination. This article reviews the potential roles for families before and during disasters, with particular attention to the impact on children and vulnerable elderly patients. The potential positive and negative impact of family participation in different aspects of healthcare and disaster efforts is assessed.     

Ceteris Paribus — An Inadequate Representation For Biological Contingency

It has been claimed that ceteris paribus laws, rather than strict laws are the proper aim of the special sciences. This is so because the causal regularities found in these domains are exception-ridden, being contingent on the presence of the appropriate conditions and the absence of interfering factors. I argue that the ceteris paribus strategy obscures rather than illuminates the important similarities and differences between representations of causal regularities in the exact and inexact sciences. In particular, a detailed account of the types and degrees of contingency found in the domain of biology permits a more adequate understanding of the relations among the sciences. This revised version was published online in July 2006 with corrections to the Cover Date.     

Violated Laws,Ceteris Paribus Clauses,and Capacities

It is often claimed that the bulk of the laws of physics –including such venerable laws as Universal Gravitation– are violated in many (or even all) circumstances because they havecounter-instances that result when a system is not isolated fromother systems. Various accounts of how one should interpretthese (apparently) violated laws have been provided. In thispaper, I examine two accounts of (apparently) violated laws, thatthey are merely ceteris paribus laws and that they aremanifestations of capacities. Through an examination of theprimary example that motivated these views, I show that given aproper understanding of the situation, neither view is optimalbecause the law is not even apparently violated. Along the way, Iam able to diagnose what has led to the mistaken belief: I showthat it originates from an element of the standard empiricistconception of laws. I then evaluate the suggestions of how tointerpret violated laws with respect to other examples and findthem wanting there too.     

Approximation,Idealization, and Laws of Nature

Traditional theories construe approximate truth or truthlikeness as a measure of closeness to facts, singular facts, and idealization as an act of either assuming zero of otherwise very small differences from facts or imagining ideal conditions under which scientific laws are either approximately true or will be so when the conditions are relaxed. I first explain the serious but not insurmountable difficulties for the theories of approximation, and then argue that more serious and perhaps insurmountable difficulties for the theory of idealization force us to sever its close tie to approximation. This leads to an appreciation of lawlikeness as a measure of closeness to laws, which I argue is the real measure of idealization whose main purpose is to carve nature at its joints. This revised version was published online in June 2006 with corrections to the Cover Date.     

Comparing public concern and support for drone regulation to the current legal framework

In this study we assess the extent to which the regulations governing the use of drones in the United States address the concerns held by the public they are meant to protect. In general, respondents were most supportive of those regulations that could be categorized as limiting one's exposure to an unwanted drone. The most popular policies were those that protected personal privacy, while the least popular were those that hampered drones used for public safety. The largest discrepancy was found to be respondents' preference for laws protecting personal privacy compared with the lack of regulatory constraints currently in place. Federal regulators have only begun to introduce regulations on how drones can be used in our national airspace, with additional regulations for other types and sizes of drones likely to be introduced in the future. The results of this study may be utilized by regulators and lawmakers to create a regulatory structure that effectively mitigates risk and supports the public interest.     

Being, Doing, and Knowing: Developing Ethical Competence in Health Care

There is a growing interest in ethical competence-building within nursing and health care practising. This tendency is accompanied by a remarkable growth of ethical guidelines. Ethical demands have also been laid down in laws. Present-day practitioners and researchers in health care are thereby left in a virtual cross-fire of various legislations, codes, and recommendations, all intended to guide behaviour. The aim of this paper was to investigate the role of ethical guidelines in the process of ethical competence-building within health care practice and medical research. A conceptual and critical philosophical analysis of some paragraphs of the Helsinki Declaration and of relevant literature was performed. Three major problems related to ethical guidelines were identified, namely, the interpretation problem (there is always a gap between the rule and the practice, which implies that ethical competence is needed for those who are to implement the guidelines); the multiplicity problem (the great number of codes, declarations, and laws might pull in different directions, which may confuse the health care providers who are to follow them); and the legalisation problem (ethics concerns may take on a legal form, where ethical reflection is replaced by a procedure of legal interpretations). Virtue ethics might be an alternative to a rule based approach. This position, however, can turn ethics into a tacit knowledge, leading to poorly reflected and inconsistent ethical decisions. Ethical competence must consist of both being (virtues) and doing (rules and principles), but also of knowing (critical reflection), and therefore a communicative based model is suggested.     

To Conceal and Carry or Not to Conceal and Carry on Higher Education Campuses, That is the Question

This article addresses conceal and carry laws on higher education campuses as ethical and social dilemmas. The Second Amendment reads, “A well regulated Militia, being necessary to the security of a Free State, the right of the people to keep and bear Arms, shall not be infringed” (U. S. Const. amend. II 1791). Proponents for conceal and carry laws on college and university campuses often interpret the Second Amendment as an overarching right to have weapons, regardless of location. Opponents of such legislation argue that allowing guns on campuses would be a mistake and student safety can be addressed in other ways. Throughout the 2010–2011 legislative sessions Arizona and Texas have been on the cusp of passing pro conceal and carry laws which would allow higher education students to carry weapons on campus. Over two decades states have increased access to weapons, while most in the U.S. have sentiments against their neighbors carrying arms (Kranz 2006). While the Second Amendment provides the right for individual to carry arms, higher education campuses are regarded as a subset of the population, a space for maturing adults and not a place for concealed weapons.