Friday, August 23, 2019

Critical opinion about article Literature review

Critical opinion about article - Literature review Example Introduction While the function of drug coatings in medications are rarely considered by the consumer, they are vital to the function and efficacy of most modern medicines. By incorporating a drug into a polymer film, gel, or other encapsulating material, the hydrophobic molecules can be made to degrade much more slowly [1]. The use of an encapsulating membrane allows the chemical to circulate within the body, while also creating a hydrophilic shell that can pass through the cell membrane of the bacterial target [1, 2]. The coatings also may have the additional property of bioadhesion, keeping the drug at the target site for a longer period of time [3]. Niosomal membranes, non-ionic surfactant vesicles, are one common type of encapsulating material, especially for transdermal and ophthalmic topical use [4, 5]. Niosomes can also be made into a substance called proniosomes, a dehydrated powder formulation of niosomes, which can be transported further and stored longer, increasing their usefulness [6]. Niosomal Encapsulation and Hydrogen Bonding In their 2011 study, Hao and Li examined the efficacy of niosomal entrapment in solution, specifically on the rate of encapsulation when the niosomes were included in a solution that also contained the desired chemical for entrapment [7]. Niosomal encapsulation is achieved by coating a water-soluble pharmaceutical chemical with a lipid membrane, and this lipid coating will slow the release of the encased pharmaceutical chemical into the surrounding environment. This is usually made use of in such situations as a time-released or delayed-release medication [5]. Additionally, the use of a niosomal membrane around the pharmaceutical chemical is currently the only known method for achieving safe and efficient transdermal drug delivery. The ability of the niosomal membrane to help the pharmaceutical chemical cross the dermal and subdermal layers is dependent on the structural organization of niosomes, not simply on the properti es of the niosomal membrane. Other non-ionic surfactants do not produce the same successful results for transdermal permeation [4]. One of the chemical models in the Hao and Li study, p-hydroxyl benzoic acid, was found to form hydrogen bonds with the niosomal membrane being studied [7]. These hydrogen bonds caused an increase in the entrapment efficiency of the formulation. This can be seen in the fact that the second model used in their study, salicylic acid, showed lower rates of entrapment efficiency. Salicylic acid also did not form the same type of hydrogen bonds with the niosomal membrane, showing that the increased encapsulation efficiency seen in the p-hydroxyl benzoic acid solution was therefore related to the hydrogen bonding of the solute to the niosomal membrane. Figure 1 shows the changes in the UV absorption spectra of the solutions being studied which indicate the presence of hydrogen bonding between the niosomal coating and the p-hydroxyl benzoic acid. Conversely, th ese spectra also show the lack of such hydrogen bonding in the salicylic acid solution and the blank niosome solution. This study is the first to note the importance of those hydrogen bonds in the functioning of the niosomal membrane and the relation of those bonds to encapsulation efficiency [7]. Niosomes are able to form those hydrogen bonds by providing â€Å"a stable system that allows the self-assembly of hydrogen-bonded receptors to occur in contact with aqueous environments†

Thursday, August 22, 2019

Feminism During the 50s Essay Example for Free

Feminism During the 50s Essay The book Revolutionary Road, written by Richard Yates, tells the reader a story about the life of Frank and April Wheeler. The Wheelers are a married couple with children who live in a 1950’s suburb. This essay shows the reader how characters in the book do not conform to typical gender roles during this time period and how these gender roles are switched between men and women. The story gives us a lot of insight in to gender roles during the 1950’s. However, Frank and April Wheeler do not abide to the typical gender roles of men and women during this time period in American society. The idea of this analysis is to show the reader how Feminism and Masculinity are tested in Revolutionary Road. Richard Yates switches gender roles in this novel and does a good job of showing us a different perspective from what was most common during the 1950’s. Revolutionary Road is about Frank and April Wheeler who live in a suburb called Revolutionary Estates with their two children Jennifer and Michael. They are viewed by their neighbors as your ideal husband and wife. They have a nosy real estate agent named Mrs. Giving’s who randomly shows up throughout the story and has a deranged son named John who ends up having some conflict with the Wheelers. Mrs. Giving’s also has a husband named Howard who seems not to care what she has to say most of the time because she is always gossiping or talking too much. There is also a couple, Milly and Shep Campbell who are family friends of the Wheelers and often hang out and drink together. Frank ends up having an affair with Maureen, a woman who works at Knox with him. He ends up feeling guilty about it because April does something special for him. She stops the argument they are in and has a surprise birthday plan for him and tells him about her plans of moving their family to Europe. Plans fail however when April realizes she is pregnant and Frank is satisfied that they won’t have to move. April ends up having an affair with Shep Campbell who is in love with her secretly. The story ends up with April killing herself attempting to do her own abortion from home. Frank lives on in distraught and agony. Richard Yates uses Feminism in the story to show the reader how Frank fits in with typical feminine role of this time and April fits in with the  typical masculine role. Frank is constantly emasculated throughout the story by April. When they realize April is pregnant, she wants to have an abortion. Frank is upset but he can’t do much about it because he doesn’t have any say in what she does. He tries to say, â€Å"Listen. Listen to me. You do this – you do this and I swear to God I’ll –† and she cuts him off and says, â€Å"Oh, you’ll what? You’ll leave me? What’s that supposed to be – a threat or a promise?† (Yates 52) testing his masculinity once again. April is not the typical woman of the 50’s and that’s why conflicting gender roles play such an important theme in this novel. Frank thrives off of the need to prove himself to April. He wants her to believe he is in control of every situat ion and is the man of the house. He tries to put off this image to April that he is a real man and leads their household. Frank has a lot of conflict throughout the book because of his constant need to prove his manhood and prove his masculinity to April. Richard Yates uses Frank Wheeler to show us just how this novel conflicts the typical gender roles during the 1950’s. Yates says about Frank, â€Å"Wasn’t it true, then, that everything in his life from that point on had been a succession of things he hadn’t really wanted to do? Taking a dull job to prove he could be as responsible as any other man†¦ Having another child to prove that the first one hadn’t been a mistake†¦ Proving, proving; and for no other reason than that he was married to a woman who put him forever on the defensive† (Yates 51). Yates shows the reader the true tenacity of Frank’s need to prove himself to April day after day. Having a job, having a family, and doing everything to provide for your family were all things men were expected to do during that time in America. Frank has an obsession with needing April to believe he is in control and fully providing for her and their children. He feels she will leave him or step up and provide for them herself is he cannot do it. Frank is trying to prove he is the man and holds the masculine gender role over April. April says in one scene to Frank, â€Å"Me. Me. Me. Oh, you poor, self-deluded – Look at you, Look at you, and tell me how by any stretch of imagination you can call yourself a man† ( Yates 28) which really test Franks masculinity. He is without a doubt upset about April’s actions and words. By receiving her approval, he feels his masculinity and feels he has accomplished what is important. Throughout the  story however, we see that Frank never truly gets the approval from April he is looking for. Yates intends for Frank to be weaker and less masculine than April. This is how Richard Yates uses conflicting gender roles in his characters. April is a very independent woman and she will take care of what she feels is necessary. She doesn’t look to Frank for guidance and leadership. The narrator points this out when April is mowing the lawn and Frank is watching her wishing he was doing it. The narrator states that Frank had â€Å"planned as soon as he’d had some coffee to go out there and take the lawnmower away from April, by force if it was necessary, so the he could restore as much balance to the morning as possible. But he was still in his bathrobe† (Yates 40). Frank cannot stand the fact that April is mowing the yard and not letting him do it. Yates gives us a description of April in the yard, he says, â€Å"It was April herself, stolidly pushing and hauling the old machine, wearing a man’s shirt and a pair of loss, flapping slacks† (Yates 35) This description of April really gives the reader a simple understanding that April doesn’t need Frank to mow the yard because she is capable and willing to do it herself. These are the things that really bother Frank because he wants a woman who needs him to do everything for her. That’s what Frank feels he is supposed to do; he wants to be the sole provider and â€Å"alpha† of his household. Another way we see Frank being emasculated is when April plans the move to Europe. She tells Frank about the plans to move at his surprise birthday get together, he had just got home from having an affair with Maureen from his office. The narrator gives us a good understanding of Frank’s inability to take control. He ends up agreeing with the plans even though he is not fully sure and confident that is what he wants. Frank says, â€Å"Darling? We are really going to do it, aren’t we? I mean it hasn’t just been a lot of talk or anything, has it?† (Yates 116) and they agree the move to Europe is a sure thing. Then they fall asleep and the chapter ends with April saying I love you to Frank. Frank is finally feeling a sense of assurance at this point because things are getting better between him and April. He is finally feeling that sense of satisfaction he thrives for. He and April are getting  along and things â€Å"seem† to be good. However, April ends up letting Frank in on some startling news. She is pregnant and when Frank finds out he is actually happy about the news because he has had a promotion offered to him at work and knows that having a baby will keep them from moving. When April realizes Frank is satisfied with not moving she threatens to abort the baby herself after Frank finds her abortion tools and she test Franks masculinity again by saying, â€Å"And what are you going to do? Do you think you’re going to stop me?† (Yates 209) when he questions her on what she is going to do with the tools. Frank has no control over any situations throughout this book. Especially in this situation because April has had her mind set on moving and she was not going to take no for an answer. She eventually kills herself trying to proceed in doing an abortion herself at their home. April had control of the situation the whole time. Furthermore, â€Å"Revolutionary Road† gives the reader a wide and detailed interpretation of very unusual gender roles for the 1950’s. The author’s use of feminism helps him to show how Frank is a man who feeds of his wife for satisfaction. Everything Frank does is mainly to get the approval and acceptance of his wife April. Feminism also helps us to take a look at how April Wheeler is portrayed. She is a very independent woman and for this time period that is very rare. Women typically depended on men and did not step up as leaders and sole providers of their family. However, April is much different. She wants Frank to know that she can take care of herself and her family without the help of a man. She is portrayed as being much more masculine and superior than her husband. She is in control of their relationship and she is in control of Frank’s life. Everything Frank does is based on what April thinks and getting her to notice and her to approve is what makes him feel like a man. Richard Yates did an amazing job in â€Å"Revolutionary Road† by showing the reader the conflicting gender roles of April and Frank Wheeler. Works Cited Yates, Richard. Revolutionary Road. 2nd. New York: Vintage Contemporaries, 2000. Print.

Wednesday, August 21, 2019

Social Justice in India Essay Example for Free

Social Justice in India Essay An Inquiry into the Conditions of Social Justice in India [Note: 1 . This study of Justice concentrates on conditions of social Justice in India and will not include general issues of criminal Justice; the proposal refers mainly to social justice and popular ideas of Justice, as linked to, but distinct from rights. 2. This proposal is built on the insights drawn from the previous research programme on autonomy, and thus while this is a new proposal it is also a follow up on the earlier exercise. Similar to the preceding one, it has research, publications, and dialogue segments. 3. The current research plan has developed through a series of onsultations; its enunciation here is thus a product of the dialogic approach of our research work. 4. This statement is divided into three sections (a) Description of the theme, and its context; (b) approach of the study; (c) activities proposed ] A. The Context and the Theme of Social Justice 1 . Though the theme of Justice has occupied a high ground in philosophical discussions since the beginning of political philosophy, yet in terms of democracy and popular politics its exact meaning and implications have been nebulous, one of the reasons being the fact that Justice in reality is a meeting ground of many ideas, ituations, concepts, expectations, mechanisms, and practices. Many things intersect to form the context of social Justice ethical ideas of the people, laws, the evolving nature of claims, and the pattern of collective claim making politics, institutional issues relating to the delivery mechanisms of Justice, ideas about rights and entitlements, ideas among the citizens about responsibility of the rulers towards them, plus many situations generating many conditions of Justice. All these make the social context of Justice, also the social form and social site of Justice. By social Justice we therefore indicate as a beginning: (i) social context of Justice, (it) social content of justice, and (iii) social sites of Justice. We also indicate that as social, there can be many contexts, contents, and sites. 2. The point of plurality made in the last sentence is significant, because notions and ideas, claims and practices, and mechanisms of Justice have depended on varying situations. Thus we can witness various forms of social Justice in reality social claim as Justice, attainment and restoration of dignity as Justice, end to discrimination as ustice, retribution as Justice, conciliation of claims as Justice, social idea of minimal justice, positive discrimination as Justice, protection of the vulnerable sections of society as Justice, and finally autonomy as Justice. Social Justice can and does have strong gender implications. 3. Situations of marginality produce ideas of Justice. Lack of access to means of representation / resources / survival means such as education, health, etc. produces marginality. Similarly displacement creates marginal situations. Likewise minority status engenders marginal existence. Hereditary discriminations have the same ffect. Gender has the same role. These marginal situations have one thing in common they speak of power matrix. And they produce specific calls for Justice. Different marginalities generate different expectations and forms of Justice thus gender Justice, Justice for the indigenous people, Justice for those denied of dignity death or for people living below poverty line all of which mean Justice for those who cannot access the mechanisms for Justice. The thing to note here is that while constitution has provisions of Justice in its various articles and clauses, unlike in the ase of rights Justice does not have a compact formulation, even though the Preamble and earlier the Objectives Resolutions of the Constituent Assembly had justice as one of the founding provisions. 4. One of the implications of this manifold context is that while the issue of Justice is studied only or mostly closely in terms of governance, its delivery mechanisms, and the various governmental forms of Justice, social Justice as distinct and as the other of governmental Justice emerges as a distinct category of social reality to be inquired and appreciated in its ow n right. Such a study will have to concentrate on the forms f social Justice indicated above, the impact of public interest litigation as an avenue of ensuring social Justice and as a process contributing to the idea of social Justice, the Justiciability of social Justice, and the significance of the particular relation between rights, capabilities, claims, and law in terms of the idea of social Justice equally significantly, in terms of making this idea a reality. Finally, the significance of this has to be sought in the realisation of the notion of responsibility responsibility of the State, its various organs, various governmental institutions, and their national nd international commitments to provide Justice. In sum, the context of the research can be summed up as one that provides the background to the interrelation between Justice and society. 5. Given the significance of the idea of Justice in the Indian national movement and in its associated ideas and thoughts, and the wide demand for Justice from each of the underprivileged sections of the Indian society today, and the recurring incidents of communities assuming the responsibility of delivering direct Justice in the background of perceived delays and determining their own norms of Justice, the proposed inquiry assumes significance. During the national movement there were several articulations of the idea of Justice; similarly in the constituent assembly proceedings competing and complementary ideas of Justice emerged. Likewise in the writings of several thinkers Justice has been discussed from various angles. Apart from intellectual, theoretical, and literary exercises, other discursive and institutional exercises have been marked by popular thoughts and ideas. Various manifestos, leaflets, pamphlets, popular writings, sketches, songs, newspaper articles, speeches, etc. have been the other sites where ideas of Justice at the popular level have been rticulated. 6. Social Justice is an arena only partly covered by law; rest is covered by social and political ideas and practices. Ethical ideas about honour, right, respect, autonomy, claim, share, revenge, and shame also play significant role in determining mores of justice. A sense of entitlements also has a role to play. Justice thus propels variety of forms from social-economic rights, to the forms of Justiciability, forms of redistribution of wealth, the form of due process, subjective experiences of Justice, and as distinct from these experiences the objective tests of Justice. In this context ne has to note the parts played by social movements and social mobilisations in determining the popular concepts of Justice. . One can already sense in the preceding description of the theme of inquiry the approach likely to underlie the proposed programme References have been made already to the historical milieu of nationalist ideas, communitarian ideas, and the constituent assembly deliberations. We need to recall in this context that in colonial India, the idea of social Justice had formed the core of a politic al movement, as in Tamil Nadu and Maharashtra; and after an interregnum Justice again became the ore element of many movements and formations. Since mid 70s and early 80s of the last century one can observe in the country a significant trend in governance and the social and economic (SE) rights scenario in India. It was during this time that the government started shifting its focus from political declarations on civil and political rights to programmes, policies, legislations and Acts for delivering basic services to its citizens. In a way it began with 20-point programme of the Government in the mid-70s. At the same time due to a crisis in legitimacy of the state following the Emergency (1975-77), a host of peoples movements sprang up across the country demanding rights from the state, at the same time devising alternative models for ensuring basic services. We also began witnessing from that time the ideas and practices of committed administration, known by the phrase developmental bureaucracy, and committed Judiciary, that is to say a Judiciary, whose premise is valuing ideals of social Justice. Judicial activism too emerged in that context. This historical context provides the ground for research into the process by which Justice as a social and political programme took concrete shape in the country. This historical context has also propelled citizens bodies, and peoples movements to take stock of the condition of rights, and launch campaigns at all levels to demand the right for sustainable livelihood, which includes issues of access to food, clothing, and housing and extends to the right to a dignified life with access over utilisation and control of resources. These campaigns have become significant in making the SE rights of the people a crucial item in public agenda of social Justice, and in the emergence of public demand for transparency, accountability and efficiency from the tates and direct participation of society in matters of governance. Instances of the profound expression of such campaigns, which have resulted in legislations at state and national levels on various issues are not lacking. They have raised the level of legal arguments, Judicial awareness, and the quality of constitutionalism including constitutional interpretations. All in all, an inquiry into conditions of Justice will require an investigation of the historical milieu. 2. The social Justice scenario is to be investigated in the context of two streams of entitlements: (a) sustainable livelihood, which means access to adequate means of iving, such as shelter, clothing, food, access to developmental means, employment; education, health, and resources; (b) social and political participation (enabling or empowering means), which is built on the guarantee of fundamental rights, and promotion and empowerment of the right to participation in the government, and access to all available means of Justice, and on the basis of which Justice as a political programme becomes a viable reality. We require therefore a study based on select illustrations of various issues relating to government policies on topics such as: a) the right to food and water; (b) housing, which includes resettlement and healthcare, (e) right to work, and (f) access to information and the right to communication. In short, one of the important ways in which the inquiry will proceed will be through taking stock of various forms that have occasioned the articulation of ideas of social Justice. 3. The all-important question however will be how are we to make sense of different notions and realities of Justice, which we have already noted? Governmental Justice consists of various welfare schemes, law, legal literacy, administrative forms of rbitration such as tribunals, boards, courts, public interest litigation, new legal education, plus the constitutional idea of protection of weaker sections of the society and introduction of positive discrimination. But this dominant governmental form cannot satisfy the requirements expressed in other forms of Justice, indicated above. The inquiry conducted through historical investigations into conditions of social justice, and select case studies, has to provide us an answer as to: What constitutes a just society or Just social relations? Or, how can people having conflicting interests nd values agree on principles of Justice? What constitutes in the main the world of social Justice in India? Where and how do the social-Justice-talks feature in Indian political and social discourse? People talk of lack of or inadequate access to legal justice; dalits talk of social Justice against the backdrop of discrimination, caste society and social and govt. nterventions; activists talk about how the peoples notion of social Justice is often trumped by economic rationality and growth and other powerful interest associated with them; women activists also talk about Justice in the ontext of discrimination, patriarchy and so on. For the sake of clarity then we can say that the project will be about critically examining the ways people/groups encompassing different contexts use the language of social Justice to advance their interests, to critique and to promote their values, and advance their claims in the context of their respective notions of what constitute injustices. . Thus, the inquiry will be conducted keeping its eyes on the various uses of the social Justice language in India; its multiple contexts, its myriad invocations and its varied renditions. One might say the ways in which people/groups/ activists use the social Justice language may not be coherent; may not even pass the standard set by political philosophers. But a critical examination of these usages will do an important job. As a result of the work, these discourses can become the elements of a new theoretical explanation of the dynamics of Justice and critique the existing ones. We can term thus the approach of the proposed study as part ethnographic, if it is part historical, part analytical. 5. In its analytic dimension, the study will remember that in its present form legal heory views liberty bearing provisions of a countrys basic text as negative rights, that is they do not require state resources; the actual obligation of the state is not to do something, i. e. not to subject an individual to torture or not to carry out arbitrary arrests. On the other hand, Justice bearing provisions are viewed as positive, require state resources since they are seen as obligations to do something, e. g. to provide free primary or secondary education or health care facilities. Presented in this manner, it is easy to see why states have been more receptive to implementing iberty-bearing provisions and why today the public attention is increasingly on a set are seen as benefits given by the state. They are also viewed as aspirations that the state would one day like to fulfil through a process of progressive realisation. The growing public opinion is however quite different from this perception. Justice in popular politics is seen as the congealed form of entitlements, and as a set of provisions inextricably linked to differential notions of rights and responsibilities, Since most of the governmental responses to these urgings for Justice have been uch more through executive policies, rather than through fundamental recognition of entitlements, the problem is that most of these policies operate in an ad-hoc basis. The government assumes that it knows about how to provide welfare, but ignores the fact that a welfare approach in order to be successful has to based on a consensus on the notion of Justice rather than be based on the benevolence of a mai-baap sarkar (benefactor government). The analytic dimension in this inquiry therefore has to take stock of public interest litigations in recent years fought on the terrain of justice. The process of analysing the legal dynamics of social Justice should include a study of various approaches undertaken by the government from time to time in guaranteeing Justice the welfare approach, equity in development approach, efficiency approach, empowerment approach, and the entitlements-approach. The attempt should be to find out how much these approaches have mixed with each other in activist, Juridical, and governmental discourses over the years, and have contributed to the development of the idea of Justice, which are marked by notions of (i) non-negotiability of Justice-centric provisions, (it) non-derogability of these rovisions, (iii) accommodation and harmonisation of various popular interests and claims on the basis of fairness, compensation, guarantee, Joint custodianship, and differential needs. 6. In sum, the approach of the inquiry will be part historical, part ethnographic, and part analytic. The purpose is composite consisting of the following aims: The inquiry will enormously enrich our ideas of responsibility, rights, entitlements, and claims, It will give an idea of the index of of social Justice in the light of rights and entitlements; The role of popular politics and the extent of articipation of the peoples organisations in programme and implementation of the welfare schemes towards ensuring provisions of social Justice; Debate between rights versus welfare based approaches to development; Shift in the governance agenda towards policies and programmes rather than enacting legislations, which would bestow rights on citizens; Impact of womens awareness on the Justice discourse in India; Similarly, the impact of the awareness about various marginal situations in a democracy which call for differential notions, dynamics, and institutional operations of Justice; ? The close relation between the idea of Justice and the political issue of the delivery mechanisms of Justic e; An investigation into the twin reality Justice as a strong idea in politics and Justice as practice; And therefore an investigation into two forms of social Justice Justice as a function of government, that is to say, governmental form of Justice, and Justice as a product of dialogues in contested and differential situations, that is to say, dialogic Justice. C. Activities Proposed 1 . The programme will have two segments (a) research (b) dialogues. The research . The research will produce a series of status reports on Justice, and a comprehensive volume. The volume will be based on study papers based on the researches on the following themes: a. Historical investigation into the development of the idea of Justice as a fundamental element of popular politics in the colonial time, and different intellectual discourses on Justice b. Historical investigation into the succeeding constitutional deliberations on Justice c. Ethnographies of Justice I (dalits and Justice) d. Ethnographies of Justice II (indigenous people and Justice) e. Ethnographies of ustice Ill (survival rights, property notions, and Justice) f. Ethnographies of Justice IV (women and Justice) g. Justice as legal activity a review of the history of Public Interest Litigation (PIL) h. The literary site of Justice i. Justice and injustice: who are the victims and how do they perceive? J. Social justice in form of two binaries legalities and illegalities; and governmental Justice and dialogic Justice The volume will throw light on how the idea of Justice has played its part in refashioning democratic politics its relation to the popular discourse on rights, welfare, and law. . Since the study agenda as proposed here is strongly perched on an appreciation of differential circumstances and the marginalities producing the most immanent forms of Justice, a dialogue programme on the basis of the appreciation of differences and marginalities becomes an essential part of the study agenda. Such dialogue would include conversations with and among different actors in the arena of social Justice process who are marginally situated in the world of formal politics and governance, or are actors in propelling the idea of Justice as a political programme, or are critical n shaping a new politico-juridical discourse on Justice. As has always been the CRG practice, research will be combined with dialogue, will gather strength from the latter, and must go back in terms of its inputs to the dialogic partners. This was done in the preceding programme on autonomy; it is proposed that study and dialogue will be combined again. This dialogue will focus on social movements. Thus dalit activists, activists of social Justice, lawyers, sub-divisional and tehsil-level Judges, gender rights activists, people involved in water sharing movements and other nvironmental movements will become the dialogue partners. Similarly decentralisation and Justice will become another significant theme and site for dialogue. Dialogue with victims of injustice can become one of the most significant occasions for dialogue on Justice. Dialogues on Justice A series of three dialogues on Justice was carried out by the Calcutta Research Group (CRG), in 2006 where about seventy people took part from diverse backgrounds. These dialogues were combined with public lectures in Kolkata and Darjeeling. These dialogues are also part of the CRGs research programme on social Justice in India. They have immensely contributed to the collective knowledge on the state of social justice in the country, thrown up new ideas and questions, and have shed light on how collective struggles for Justice go on in this country with or without the help of law. At a fundamental level, they have been instrumental in clarifying various notions restitution, or rights and Justice. These dialogues have also helped us in gaining knowledge about various repositories of archival material on Justice, such as popular tracts, manifestos, legal materials, other popular writings, political declarations, and eportages that tell us lot about various perceptions on Justice. Dialogue has been an integral part of the research design of CRG. Our colleagues from various institutions participating in these discussions reinforced our belief and emphasis on this procedure. To say the least, no amount of scholarly paper presentation in seminars or philosophical treatise would have clarified the plural character of Justice, the historically predicated nature of it, or its contentious character, as these dialogues have done. Our fear is that we may not have been able to do Justice to the richness of the discussions on the three occasions. Several institutions came forward to assist us in holding these three dialogues: the Ford Foundation, the Lok Niti Centre for the Study of Developing Societies, the European Union and the International IDEA. The first dialogue was held in Kolkata on 5 June 2006 on the theme of Conditions of Social Justice in India. One of the aims in convening the dialogue in Kolkata was to take note of the two trends in the literature on social Justice. Of these two, one consists of existing writings focused on formulating or analyzing some normative principles of Justice, which states and other delivering agencies ought to follow in ourse of their administrative and welfare actions. The second trend is made up of ethnographic researches, which concentrate on how people negotiate their ways through different systems of Justice customary or modern existing in society, and make their own meanings of Justice. The highlights of this of this dialogue was Identifying themes and case studies with special reference to West Bengal and eastern India, and developing an appropriate research design; understanding in this context the complex relationship between theory and ethnography; preparing a comprehensive, annotated bibliography that will include a list of texts of relevant olicies, enactments, public interest litigations and relevant legal decisions, parliamentary and legislative assembly debates and material relating to popular demands for Justice, and popular tracts on Justice and finally, identifying the institutional locations, resources and individual researches in the country particularly in West Bengal and eastern India. The second dialogue was An inquiry into the Conditions of Social Justice in India and was held in Darjeeling, on 26-28 June 2006. Continuing from where the Kolkata deliberations left, it was once again noted that situations of marginality produce deas of Justice. Lack of access to means of representation/resources/ survival means such as education, health, etc. produces marginality. Similarly displacement creates marginal situations. Likewise minority status engenders marginal existence. Hereditary discriminations have the same effect. Gender has the same role. These marginal situations have one thing in common they speak of power matrix. Many things intersect to form the context of social Justice ethical ideas of the people, laws, the evolving nature of claims, and the pattern of collective claim making politics, nstitutional issues relating to the delivery mechanisms of Justice, ideas about rights we therefore indicate as a beginning: (i) social context of Justice, social content of justice, and (iii) social sites of Justice. The third dialogue took place in Bhubaneswar, on the specific theme of Justice and Democracy in Divided Societies. It was held on 20-22 November 2006. The main objectives of the dialogue in this context were: To explore the dynamics of social divisions in contemporary South Asian societies compounded by governmental operations, which transform divisions into marginalities; To propose a possible genda of social Justice in the context of divided societies an agenda that bases itself on marginalities and can address therefore the issues of Justice in a new way; To suggest policy alternatives in terms of their bearing on democracy. The legal fiction of a homogeneous public immune from the operations of power in the society is nowhere more sharply focused than in the writings of Jurgen Habermas, Axel Honneth and their associates. As the legal fiction subsumes governmentally produced social divisions mentioned above, issues of Justice get continuously sidetracked and pushed into the background. In other words, democracies of modern times bring into play a discourse where they produce injustice without being seen as such. Thus, it is not surprising that marginalities, livelihood crises and hunger deaths do not get constituted as public agenda in societies revisited by them. A post-colonial engagement with the issue of democracy helps demystify the fiction, and thus can seek to push democracy beyond the grids of governmentality by teasing out the implications of social divisions for issues of Justice and bring them to bear on the functioning of contemporary democracies in divided societies.

Tuesday, August 20, 2019

Clinical Decision Support Systems in Healthcare

Clinical Decision Support Systems in Healthcare Melchor Abejon One pressing public health problem and a threat to patient safety are medical errors. Written articles about such incidents have highlighted cases and the amount of money spent. According to the United States (US) News and World Report (2013), medical error is the third leading cause of death in the US after heart disease and cancer with an estimate number of 250,000 deaths annually. Clinical decision making in healthcare is a very crucial process. Though this process will always be flawed, for sure there are ways to make it better. With the advent of the Electronic Health Record (EHR) meaningful use incentive program and the development of Clinical Decision Support (CDS) tools, healthcare organizations along with clinicians are mandated to integrate CDS into their federally certified EHR systems. As the director of clinical decision support at a healthcare delivery system, the purpose of this paper is to: Describe the different approaches to be used that will ensure all aspects of patient care are considered in the development of a CDS system. Identify how the efforts of the CDS team would be prioritized in the development of CDS in the organizations focus areas. Approaches to Developing a CDS System Like in the implementation of any other health information systems, the development and implementation of a CDS system entails an equivalent complexity and hard work. It is an endeavor that requires significant planning and preparation.ÂÂ   Once implemented, it is essential to evaluate and measure its value as an additional asset of the organization. According to Nelson and Staggers (2014), the CDS as a valuable tool can prevent many clinical errors especially when coupled with a computerized information system that enables process improvement measures. Though it is mentioned in the given scenario that the organization has existing CDS, my plan is to re-evaluate the existing systems and processes, and I want to make sure that I would not be missing a single essential step in my project, and have everything taken into consideration as I create a new plan.ÂÂ   Health IT provides a systematic strategic plan for the implementation of CDS which I will adopt for the organization. The strategic plan is composed of five steps as listed and described below: Commence the project with a strong foundation. This initial step includes assessing the readiness of the organization to adopt a CDS intervention; assessing the interest of stakeholders in using CDS to improve outcomes, and as well as assessing the overall capacity of the organization to adapt to the change. My key steps to establishing a strong project foundation are: To identify the essential stakeholders who can contribute to a discussion about using CDS to improve the quality and safety goals of the organization. To establish goals for the CDS by collaborating with the stakeholders to highlight the benefits and barriers to implementation. To determine the readiness of the organization for a CDS initiative. This is a critical process. A key aspect of readiness is understanding how well the organization can adapt to the change. To develop a plan on how to proceed with the implementation. It includes identifying the core members of the implementation team, outlining and refining achievable quality goals, identifying strategic next steps toward achieving the goals, building a shared vision among the stakeholders, and identifying champions of the project. Assemble a CDS implementation team.ÂÂ   My key steps to assembling the implementation team are: To stress the roles of the stakeholders that are required for the success of the project. To seek a clinical champion who possesses the desired characteristics for the role. To collaborate with an outside source who may be able to assist and fill the gaps in expertise in the implementation of CDS. To call for the implementation team to start planning by holding a kick-off meeting. Plan for successful development of CDS, design and deployment. The following are my key steps to assist the organization achieve the capacity for CDS interventions: To select a clinical goal that suits best to the goals and needs of the organization. The end users should agree with the chosen goal. To consult Electronic Medical Record (EMR) vendors and designers about ways on how CDS can help improve the clinical goals and objectives of the organization. It is important to discuss with them and determine the ability of a given CDS intervention to be customized to support the needs of the end-users. To select a CDS intervention that can help achieve the clinical goals and objectives of the organization. Considerations are ease of implementation, effect on clinical quality reporting, implementation of financial incentives, and workflow. To develop clinical objectives and baseline measures for the goals to help measure improvements. Example of this is through the utilization of metrics to measure baseline performance and assess the effect of the intervention. To map out existing workflows and clinical processes affected by the interventions. To develop a system for keeping interventions and CDS clinical knowledge current. This includes identifying people and processes that are involved in the interventions update. To ensure the usability of the CDS intervention by understanding its limits of functionality and possibly request for customization if needed. To test for the CDS interventions usability and effect on workflows. Roll out effective CDS interventions. My key steps are: To create a roll out plan. This includes defining the clinical goals and having the selected interventions assessed and tested. Also, to determine how to implement the interventions in the best way. To communicate the roll out plan to the end-users and stakeholders. This can be accomplished by describing and disseminating to the stakeholders the expected changes to the organizations workflow and processes. To develop a training plan to train users with the new intervention. To ensure that support structures such as people and other resources are in place to provide support during and after deployment of the intervention. Measure the effects of the intervention. This pertains to measuring the impact of the intervention post-implementation and to ensure it is improving the organizations processes and outcomes, and that clinical goals and objectives are being met. My key steps are: To conduct an ongoing assessment of the CDS systems usability. This includes capturing feedback and assessing how well is the intervention being received by the end-users. To collect and report the performance of the intervention against the clinical goals and objectives. To use feedback and measurement results to continually improve the performance of the intervention. To have the end-users get involved in the refinement of the intervention by communicating back to them the changes and by showing them continued support. Bates et al. (2003) published the Ten Commandments for effective Clinical Decision Support Systems (CDSS). This is another important collective approach and consideration in developing and implementing a CDSS for the organization. Listed below are the ten commandments for CDSS: Speed is everything. Speed is what end-users value most and is a top priority. Anticipate needs and deliver in real time. Information should be delivered when needed. Fit into the users workflow. Suggestions are integrated with clinical practice. Little things can make a big difference. In order to do the right things, usability of the intervention should be improved. Recognize that physicians will strongly resist stopping. Rather than insist on stopping, alternatives should be offered. Changing direction is easier than stopping. Example is changing dose defaults; route or medication frequency can change behavior. Simple interventions work best. Guidelines can be simplified by reducing to a single computer screen. Additional information can be asked when you really need it. A guideline will less likely be implemented when more data elements are requested. Monitor impact, get feedback and respond. If some reminders are not followed, either readjust or completely remove the reminder. Maintain and manage the knowledge -bases system. Information and currency of information should be monitored. CDSS Team Efforts and Areas of Focus Payment rates tied to quality measures. A primary consideration when developing and implementing a CDSS is the cost savings for the total system. With the existing reimbursement scheme, the financial commitment to implement a CDSS has become one major consideration to many health care organizations. Insufficient documentation of patients diagnosis has always been the difficulty in maximizing and meeting compliance with reimbursement and external quality agencies. As the director of the clinical decision support, I will summon and coordinate with the team to create a CDS intervention that can improve compliance with billing directives by ensuring systems work harmoniously to capture the correct diagnosis. Having such efficient CDSS in harmonious work with the organizations information systems can ensure delivered care, coded care, and documented care to become the same, thus meeting the meaningful use criteria and aligning with the nations health outcome policy priorities. CDS interventions that meet meaningful use. The stage 2 of the EHR meaningful use requires hospitals and healthcare professionals to implement five CDS interventions that are directly linked to four or more of the Center for Medicare and Medicaid Services (CMS) quality measures. As the leader of the team, I will suggest and work with the team on the implementation of support measures that will monitor health conditions that are of high priority such as stroke, hypertension, cancer and diabetes. Also, the team will aim to develop a CDS intervention that will alert clinicians when a patient is a candidate for colorectal screening. This intervention directly corresponds with the NQF-0034 colorectal cancer screening clinical quality measure. Also, the team will ensure that the CDSS will meet meaningful use by considering the five rights of CDS which are (a) the right information, (b) to the right person, (c) in the right format of intervention, (d) through the right channel, (e) at the r ight time in workflow (Campbell, R., 2016). CDSS in appropriate care services such as congestive heart failure. The team will consider developing a CDS intervention that will assist providers adhere to medical care, practice guidelines and prescribing guidelines. The administration of B-blockers has been demonstrated effective in improving the chance of survival for heart failure patients. The deployment of electronic reminder interventions for the prescription of drugs and appropriate dosing can additionally improve the care and survival for congestive heart failure patients and also in the management of chronic diseases. Other areas for clinical improvement. CDSS has also been proven effective in preventive service processes. As the leader of the team, I will work with the team to implement computer-generated reminders for providers to improve the standard of care in preventive services such as hypertension and smoking cessation counseling, eye and diabetic foot examinations, measurement of lipid levels, and glycosylated hemoglobin and proteinuria testing for diabetic patients. Conclusion The CDSS when coupled with the organizations existing systems such as the EHR and Computerized Provider Order Entry (CPOE) can work harmoniously to provide an effective clinical decision support to improve the quality of care in a healthcare organization. Though challenges may seem formidable, coming up with an effective approach in the development and implementation of such systems can assure positive return in investment overtime. References Bates, D. W. et. al (2003). Ten commandments for effective clinical decision support: Making the practice of evidence-based medicine a reality. Retrieved January 29, 2017 from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC264429/ Campbell, R. (2016). The five rights of clinical decision support. CDS tools helpful for meaningful use. Retrieved January 29, 2017 from http://bok.ahima.org/doc?oid=300027#.WJC59_krLIV Gross, P.A., Bates, D.W. (2007). A pragmatic approach to implementing best practices for clinical decision support systems in computerized provider order entry systems. Retrieved January 29, 2017 from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2215068/#bib13 HealthIT.gov (n.d.). How-to guides for clinical decision support implementation. Retrieved January 29, 2017 from https://www.healthit.gov/policy-researchers-implementers/cds-implementation Murphy, E.V. (2014). Clinical decision support: Effectiveness in improving quality processes and clinical outcomes and factors that may influence success. Retrieved January 29, 2017 from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4031792/ Nelson, R., Staggers, N. (2014). Health informatics: An interprofessional approach. (1st Ed.). St. Louis, MO; Elsevier Mosby United States News and World Report (2016). Medical errors are third leading cause of death in the U.S. Retrieved January 29, 2017 from http://www.usnews.com/news/articles/2016-05-03/medical-errors-are-third-leading-cause-of-death-in-the-us

Monday, August 19, 2019

Never Lose Hope :: essays research papers

Never Lose Hope William Blake, born on November 28, 1757, in London is one of the greatest English poets. His work is studied today all over the world. One of Blake’s poems, â€Å"The Chimney Sweeper†, shows many signs of immortality. In this poem, immortality can only be reached by maintaining hope in a hopeless world and embracing happiness. An example of this is line 20: â€Å"He’d have God for his father, and never want joy†. Immortality is something people have chased for years and have never been able to capture. In Webster’s dictionary, immortality is stated as, â€Å"Not mortal, deathless, living or lasting forever.† In â€Å"The Chimney Sweeper†, Blake saw immortality in a different sense than Webster states. Blake saw immortality as happiness throughout life and the importance of hope.   Ã‚  Ã‚  Ã‚  Ã‚  Ã¢â‚¬Å"The Chimney Sweeper† is a great title for Blake’s poem. The title is a symbol representing the harsh life of a chimney sweeper and his life as a child. He states, â€Å"When my mother died I was very young, and my father sold me while yet my tongue†, (ln 1-2). This is saying that his mother died when he was young and his father gave him up. Blake’s unhappiness resembles being mortal in a sense that his unhappiness is like being dead. Blake has two meanings when he says, â€Å"So your chimney’s I sweep, and in soot I sleep†, (ln 4). This line denotes that he is an adult now with the responsibility of being a chimney sweeper. Blake is really saying that his childhood was terrible like the work of a chimney sweeper. Now Blake introduces a new character into the poem, which is Tom Dacre (ln 5). In the second stanza, Blake is stating the mortality, or unhappiness of Tom. The author’s tone changes for a moment in stanza two when he says â€Å"Hush, Tom! never mind it, for when your head’s bare, the soot cannot spoil your white hair†, (ln 7-8). The author has two meanings in these lines. The obvious is that he can’t have hair for the fact that his hair would be full of soot. The tone change comes in where the meaning is not so obvious. The tone up to line six is mournful. Lines seven and eight also have a mournful tone in the obvious state. They connote that Tom needs to keep his head up and not let his job get to him, or simply to keep hope alive.

Comparing Tolstoy’s novel, The Death of Ivan Ilyich and the Russian Sta

Comparing Tolstoy’s novel, The Death of Ivan Ilyich and the Russian State In Leo Tolstoy’s novel The Death of Ivan Ilyich, the title character’s life changes in several important ways during the course of the story. First, his relationships with the people in his life change. Secondly, he engages in different â€Å"forms of diversion† as his life goes through different stages. Thirdly, his attitude towards wealth and possessions changes near the end of his life. In addition, we also see a gradual realization and acceptance of death. One could draw interesting parallels between the progression of Ivan Ilyich’s character and the Russian state and leadership in the latter part of the Imperial period. The changes in Ivan’s relationships with other people are seen best with his friends and family. Through most of the story, we see that he chooses friends based on social standing. He even applies this to his family, as illustrated near the beginning. His younger brother, having only obtained an appointment in the Railway Division, is labeled a failure by his family and avoided at all costs. Ivan Ilyich’s relationship with his wife is also of particular interest. He seems fairly happy while a newlywed, but becomes quite annoyed with his wife for creating â€Å"distasteful and ill-mannered scenes† (Tolstoy 56; ch. 2) around the time of her pregnancy. At first he tries to ignore her by carrying on with his former social life, but eventually finds that his work is the only excuse that can get him away from her. He goes on avoiding his wife with varying success until the onset of his illness, being confined more and more to his home. During this last st age of his life, he purposely starts arguments with his family, ... ...was unable to control it any longer. The Duma which he had created instantiated a new provisional government and Nicholas finally abdicated the throne. As has been demonstrated, character changes in Tolstoy’s The Death of Ivan Ilyich find parallels in Russian power specifically through its rulers’ foreign and domestic policies. Though never expressly implied, one can assume that the author, having been quite politically involved, considered such things while writing his novella. We must not put biting social and political satire past a man who, among other things, was involved in the mass emigration of oppressed Russian Jews to the United States and Canada (Riasanovsky 397). Works Cited Riasanovsky, Nicholas V. A History of Russia. 6th ed. New York: Oxford, 2000. Tolstoy, Leo. The Death of Ivan Ilyich. Bantam Classic ed. New York: Bantam, 1981.

Sunday, August 18, 2019

Acid Base Extraction Essay -- essays research papers

Acid Base Extraction The purpose of this laboratory assignment was two-fold, first, we were to demonstrate the extraction of acids and bases, finally, determining what unknowns were present. Second, we were to extract caffeine from tea. These two assignment will be documented in two separate entities. Introduction: Acid/base extraction involves carrying out simple acid/base reactions in order to separate strong organic acids, weak organic acids neutral organic compounds and basic organic substances. The procedure for this laboratory assignment are on the following pages. 3) Separation of Carboxylic Acid, a Phenol and a Neutral Substance   Ã‚  Ã‚  Ã‚  Ã‚  The purpose of this acid/base extraction is to separate a mixture of equal parts of benzoic acid(strong acid) and 2-naphthanol(weak base) and 1,4- dimethoxybenzene(neutral) by extracting from tert-butylmethyl ether(very volatile).The goal of this experiment was to identify the three components in the mixture and to determine the percent recovery of each from the mixture. 4) Separation of a Neutral and Basic Substance   Ã‚  Ã‚  Ã‚  Ã‚  A mixture of equal parts of a neutral substance containing either naphthalene or benzoin and a basic substance containing either 4-chloroaniline or ethyl 4-aminobenzoate were to be separated by extraction from an ether solution. Once the separation took place, and crystallization was carried out, it became possible to determine what components were in the unknown mixture, by means of a melting point determination. Results Procedure Observations Inference Dissolve 3.05g Phenol Mixture was a golden-Neutral acid in 30ml brown/yellow color t-butyl methyl ether in Erlenmeyer flask and transfer mixture to 125ml separatory funnel using little ether to complete the transfer Add 10 ml of water  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Organic layer=mixture   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  aqueous layer=water(clear) Add 10 ml saturated aqueous   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Sodium bicarbonate  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  NaHCO3 dissolves in solution sodium bicarbonate  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  ... ...sp;  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Caffeine salicylate is a Pasteur pipette while the  Ã‚  Ã‚  Ã‚  Ã‚  isolated(white color)  Ã‚  Ã‚  Ã‚  Ã‚     Ã‚  Ã‚  Ã‚  Ã‚  formed. beaker is in the ice bath then vacuum filter. Caffeine beaker:  Ã‚  Ã‚  Ã‚  Ã‚  51.61g   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   -51.56g   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  .05g = 50mg % yield = .05g x 100% = 20%   Ã‚  Ã‚  Ã‚  Ã‚   .25g Caffeine salicylate:  Ã‚  Ã‚  Ã‚  Ã‚  17.198g   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   -17.036g   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   .062g % yield = .062g x 100% = 25%   Ã‚  Ã‚  Ã‚  Ã‚   .25g Conclusion   Ã‚  Ã‚  Ã‚  Ã‚  According to the HPLC graph that follows, my product was very pure. The actual melting point of caffeine salicylate is 137 degree(C), my product was found to have a melting point of 138 degrees (C). As before, of course this experiment was not done completely error-free, the error is due almost entirely on human error.