A framework for rationing by clinical judgment

Although rationing by clinical judgment is controversial, its acceptability partly depends on how it is practiced. In this paper, rationing by clinical judgment is defined in three different circumstances that represent increasingly wider circles of resource pools in which the rationing decision takes place: triage during acute shortage, comparison to other potential patients in a context of limited but not immediately strained resources, and determination of whether expected benefit of an intervention is deemed sufficient to warrant its cost by reference to published population based thresholds. Notions of procedural justice are applied along with an analytical framework of six minimal requisites in order to facilitate fair bedside rationing: (1) a closed system that offers reciprocity, (2) attention to general concerns of justice, (3) respect for individual variations, (4) application of a consistent process, (5) explicitness, and (6) review of decisions. The process could be monitored for its applicability and appropriateness.     

The contributions of arousal and self-focused attention to avoidance in social anxiety

Abstract

Fear of blushing is a specific syndrome generally subsumed under the diagnostic category of social anxiety disorder (SAD). This study aims at gathering preliminary data about an intensive weekend intervention specifically designed for individuals with fear of blushing as the predominant complaint. Treatment consisted of a combination of attention training and behavioral therapy. Thirty-one blushing-fearful individuals meeting the criteria for SAD following the Diagnostic and Statistical Manual of Mental Disorders IV (DSM-IV) were treated in three groups. The study was conducted as an open trial. Full assessments were performed before treatment, six weeks after treatment, and at six-month follow-up. Only fear of blushing, the main outcome criterion, was assessed immediately before and after the treatment weekend. The intensive therapy program was well accepted. Fear of blushing and SAD were significantly reduced and reductions remained stable. At follow-up, nearly two-thirds of the participants achieved significant changes in fear of blushing. Despite the preliminary nature of this study, the condensed format of weekend therapy for treating fear of blushing calls for further investigation.     

Refashioning Islam: elite women and piety in Bangladesh

This paper attempts to explore the development of Islamic identity of a group of elite women in Dhaka, Bangladesh. These women constitute a significant group in the country where 10% of the rich control 40% of the national wealth, and the 10% of the poorest control 1.84% of the national wealth.* Socially, politically and economically, elite women and their families are powerful and have access to resources and political influence. Many of these women who did not grow up with a very strict religious orientation came to Islam and consolidated religious thoughts and practices through a weekly Quran reading class. This particular Quran class began in 2002. The classes were initiated by a foreign diplomat’s wife who was Muslim, and have continued even after her departure from the country in 2004. While Dhaka houses many meetings of Muslim men and women to discuss Islamic ideas and practices, this particular class was quite unique in its ability to attract and convert elite women whose lives were seemingly perfect. This urban elite phenomenon of Islamic revivalism has not been the subject of any in-depth research in Bangladesh, and this work therefore, is the first of its kind and largely introductory.     

Discussing the Bangladesh Rifles (BDR) rebellion: non-Islamist women and religious revival in urban Bangladesh

This article explores the piety/politics nexus by asking what it means when educated, urban Bangladeshi women who are embracing religion anew claim that their pursuit of piety, and the learning circles that inspire it, are apolitical. I explain this self-proclaimed apolitical stance through women’s own accounts of why and how they maintain political neutrality. The article demonstrates that organizers of many Islamic discussion circles in Dhaka consciously strive to attain a certain political neutrality, while allowing whoever is interested to attend, irrespective of the latter’s political affinities. This decision stems from an understanding of the lack of trust that accompanies organized religion in Bangladesh, and its alliance, in the national imaginary, with the explicit political agenda of the Jama’at-i Islami. The article provides an account of different discussion circle members’ varied articulation of political neutrality and how they draw from different ideas and discourses about being publicly religious in their molding of the ideal, pious, Bangladeshi woman. To exemplify the pious self-fashioning of urban, educated, Bangladeshi women, I will recount the ways in which several women discussed the March 2009 Bangladesh Rifles mutiny—a highly politically charged event. Women’s accounts of the mutiny serve to unify lesson attendees around the cultivation of piety. Contestations over national politics and political affinities are made secondary, as women focus on giving an ethical bend to the deeply personal, subjective and gendered experiences of being educated and upwardly-mobile in present day urban Bangladesh.