Corollary Issues Research Articles

Ethical Leadership: Descriptive Literature Review of the Diverse Influence and Development of Ethics upon Public Sector and Military Leaders, Followers, and Organizations

Literature reviews are a significant tool for examining the breadth and depth of a selected body of literature. Although there are many types of literature reviews, ranging from narrative to meta-analysis, this article uses a descriptive review. Descriptive reviews are extremely useful for examining a body of literature, highlighting key areas of interest, particularly as it addresses a specific research question, or is directed toward a particular purpose. This article utilizes a descriptive review of ethical public leadership, both in civilian and military organizations, particularly focusing on two critical areas of interest: theme identification and issue development. Four key themes were identified: leadership trust, organizational environment, relationship between employee and workplace attitudes, and ethical competence. Our review elicited several key issues reflected in the ethical public leadership literature: leader behavior relationship, employee or follower behavior, education, development, and training, and organizational awareness. In addition, four corollary issues emerged: influence of military leadership behavior, geographic distribution of study populations, distinct array of leadership positions, and methodological diversity. Our primary conclusion is that ethical public leadership research, particularly focusing on our four key issue areas, is present in all public organizations, civilian or military, crosses organizational, cultural, and geographic boundaries, and utilizes multiple types of methodologies. In summary, while we recognize limitations to our review, and point out key areas for future research, we contend public leadership is and should continue to be a fertile and significant area for ethics research and development.

Premorbid functioning as a predictor of outcome in pediatric brain tumor: An initial examination of the normalcy assumption.

Research on neurodevelopmental outcome in survivors of pediatric brain tumor (BT) is often based on the assumption of normal development up to the onset of overt symptoms. We sought to verify the "normalcy assumption" and to investigate corollary issues including challenges inherent to the measurement of premorbid neurobehavioral functioning. The Brain Radiation Investigative Study Consortium (BRISC) is a prospective longitudinal multisite study of 58 children diagnosed with BT. Premorbid functioning was assessed via retrospective parent report on standardized rating scales and detailed questionnaires. Findings were examined for the sample as a whole and in patients grouped by tumor histology (embryonal and non-embryonal). Mean age at diagnosis was 9.84 years (range, 3-16). The overall sample showed low proportions of pre/postnatal risk factors and delays in development. The proportion of children with clinically significant premorbid attention (18%) problems based on the BASC-2 exceeded expectation of that in healthy children (6.68%). Similar findings were obtained for somatization (18%) and anxiety (14%). Delays in talking were significantly more common in children with embryonal than non-embryonal tumors (P=0.02). The non-embryonal tumor group had significantly higher overall rates of premorbid psychosocial problems than the embryonal tumor group (P<0.001). We describe a rigorous approach to estimating premorbid developmental status in pediatric BT. The findings suggest mixed support for the "normalcy assumption" and highlight the complexity of this concept and need for further investigation. Our results also suggest the need for further study of potential premorbid correlates with tumor histology.

How do you handle a colleague who regularly does not inform his or her patients of all needed treatment?

How do you handle a colleague who regularly does not inform his or her patients of all needed treatment?

Environmental rulemaking across states: Process, procedural access, and regulatory influence

Rulemaking is central to policymaking in the United States. Additionally, regulatory authority is devolved to the states in many instances. However, our knowledge of state-level rulemaking is not as advanced as that related to federal rulemaking. To advance the scholarship on state rulemaking, this study compares environmental rulemaking across three environmental issues (renewable portfolio standards, concentrated animal feeding operation regulations, and hydraulic fracturing disclosure rules) in five states (California, Colorado, Michigan, North Carolina, and Pennsylvania) to understand procedural and stakeholder participation commonalities among the cases. Using data from public rulemaking documents, stakeholder comment during rulemaking, and in-depth interviews with agency staff and stakeholders, the findings suggest that there are common patterns of pre-process informal stakeholder consultation, public comment and outreach mechanisms, and corollary issues related to stakeholder access across these cases. These findings advance our knowledge of state-level rulemaking as it relates to public input and procedural equity for stakeholders.

Futility: Another Way?

Letters17 June 2014Futility: Another Way?Samir K. Shah, MDSamir K. Shah, MDFrom Cleveland Clinic, Cleveland, Ohio.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/L14-5012-8 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:Thanks to Dr. Lynn and Dr. Radwany, who wrote to offer practical suggestions for the future or to simply share their experiences.I agree wholeheartedly with Dr. Kassabian's point that a 0% success or survivability rate is not a reasonable criterion that can be endorsed by physicians. It is important to note, however, that this criterion is used by patients and families on occasion, and I have seen it become the source of much conflict between the patient and treating physicians. The corollary issue of uncertainty in medicine, specifically in prognostication, is an important one that is beyond ... Author, Article, and Disclosure InformationAffiliations: From Cleveland Clinic, Cleveland, Ohio.Disclosures: Authors have disclosed no conflicts of interest. Forms can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=L14-0190. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoFutility Samir K. Shah Futility Samir K. Shah Futility: Another Way? Joanne Lynn Futility: Another Way? Steven M. Radwany Futility: Another Way? Simon Kassabian Futility: Another Way? Keyvan Ravakhah Futility: Another Way? Keyvan Ravakhah Futility: Another Way? Joanne Lynn Futility: Another Way? Simon Kassabian Futility: Another Way? Steven M. Radwany Metrics 17 June 2014Volume 160, Issue 12Page: 879KeywordsCardiac surgeryConflicts of interestDisclosureEmotionsForecastingPalliative careResidencySurgeons ePublished: 17 June 2014 Issue Published: 17 June 2014 Copyright & PermissionsCopyright © 2014 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...

Value and Cancer Care: Toward an Equitable Future

Health care expenses in the United States are increasing inexorably. At the current rate of growth, it is anticipated that 20% of the gross national product will consist of health-related expenditures within the next decade. Cancer is the second leading cause of death in the United States, and it is increasing in prevalence because of the aging of the population and the limited number of successful prevention strategies. As the biological characteristics of cancer come into sharper focus, targeted therapies are being developed that offer the promise of increased clinical benefit with fewer toxicities than are associated with conventional treatment. Although spectacular successes are infrequent with this approach, to date, the majority of targeted therapies are modestly effective at best, and extremely costly. This observation suggests that a broadly acceptable definition of value in a cancer therapeutic agent is not at hand, but is sorely needed from the vantage points of the patient and society. A corollary issue of enormous import is how to equitably distribute the health care dollar in the service of achieving the greatest good for the greatest number. Although cancer is responsible for only 5% of the health care budget, its cost is increasing and it can be viewed as paradigmatic when contemplating the problem of equity in health care. Here, a number of concepts are discussed that focus on this goal and its implications for the cancer patient and society at large.

Basic science focus on blood substitutes: a summary of the NHLBI Division of Blood Diseases and Resources Working Group Workshop, March 1, 2006

In March 2006, a workshop sponsored by the National Heart, Lung, and Blood Institute was convened to identify the role of basic science research in clarifying issues that are impeding progress in the development of hemoglobin-based oxygen carrying (HBOC) solutions. These discussions resulted in a consensus that, although HBOCs have shown clinical promise, various side effects have inhibited further development and regulatory approval, with cardiovascular events being of particular concern. As a consequence, workshop participants focused on formulating research recommendations to better understand and mitigate these side effects. In addition, several important corollary issues were identified, including better understanding of the impact of HBOC infusion on human physiology; the need for rapid, noninvasive methods for the measurement of tissue oxygenation in human patients to better inform transfusion decisions; further investigation of routes and consequences of hemoglobin metabolism; optimization of clinical protocols for HBOC use; and assessment of the impact of HBOC formulation excipients. Also discussed was the possibility and desirability of developing new HBOCs with improved characteristics, such as prolonged functional intravascular persistence, greater stability, and a decreased propensity to generate reactive oxygen species. One practical limitation in this area is the consistent availability of pure, well-characterized HBOC solutions for the research community. This communication summarizes the opinion of workshop participants on these issues and concludes with a list of specific recommended areas of research that could positively impact the development of blood substitutes.

Negotiating Limits

This paper reviews the origin of the concept of sadomasochism and its treatment by the American legal system. Relevant court cases and corollary issues such as the rights to privacy and sexual freedom, child custody, domestic violence, and employment discrimination are profiled. Organizations created by the gay, lesbian and heterosexual leather communities to create accurate public awareness of the SM subculture, and their programs of education and activism, are discussed and prospects for effective legislative change evaluated.

Life-cycle Squeeze, Time Pressure, Daily Stress, and Leisure Participation: A Canadian perspective

This article addresses two corollary issues, namely, the relationship between life-cycle and chronic stress, and the effects of leisure participation on stress and health, controlled for life-cycle situation. Arguments have been made that levels of time pressure and perceived stress have risen in modern societies, but that these increases are unevenly distributed among different social demographic groups, in particular groups positioned at different stages of the life-course (Wilensky; 1981; Zuzanek, Robinson and Iwasaki, 1998). It has been also suggested that active life-styles, in particular participation in leisure activities, may serve as an effective tool for moderating negative health effects of stress. In the following analyses these two propositions are put to an empirical test. Data on stress, time pressure, health, and leisure participation, collected as part of the 1994 Canadian National Population Health Survey (n = 17,626), and the 1992 General Social (Time-Use) Survey (n = 9,815) are examined in an attempt to: (a) identify life-cycle groups most exposed to chronic and personal stress; (b) establish the relationship between daily stresses and time pressure; (c) assess the effects of participation in physically active leisure on respondents' stress levels and mental and physical health; and (d) determine how the relationships between life cycle, time pressure, daily stress, health, and leisure participation are affected by gender.

Big Texts: A Critique of Literary Economy

Who or what is the object of purchase here? 'Who is speaking thus?'2 Is it the book whose weight might sprain the wrists of the reader, or is it the author who sells himself at the cost of straining the purse (and the physical body) of the reader? These questions, at the start of Seth's lengthy text, raise important issues of value and material size or volume, as well as questions of cultural worth and somatic pleasure. The Voltairean epigraphs to Seth's text: 'The superfluous, that very necessary thing [.. .]'. 'The secret of being a bore is to say everything', suggest that the questions of material volume and evaluation are not new ones, and further make it clear that what is fundamentally at issue is a question of economics. I do not intend to write here of the direct financial concerns of publishing: rather, what I attend to is a question of'literary economy' or 'critical economy', though I accept that it has always to be recalled that lying behind these ostensibly less material issues which are my concern is the publishing apparatus which markets books, determines their price and print-run, and finds ways of shifting them as so many commodified units at the end of a balance-sheet. But none of this would make sense without the corollary issue of the reader's investment of time and energy as well as of money, nor without the author's sense of the 'proper' length of the narrative which she or he is making. My argument here makes a distinction between two kinds of such literary economy. The first of these, which I shall characterize as the product of a specifically modern order of things, is a 'just economy'. It is based on a principle of exchange, in which there is presumed to be an equivalence between the elements being exchanged; but I shall contend that such equivalence is merely formal or aesthetic, that the justice in question is prescriptive (and to the extent that it is prescriptive it is also, paradoxically, unjust), and that the subscription to such an economy is made in the

Two‐dimensional modeling of low‐angle backscatter from geologically realistic seafloors

The numerical scattering chamber has been used to quantitatively predict low‐angle backscatter coefficients for a suite of seafloor models. A number of issues have been addressed: (a) How finely does seafloor bathymetry need to be resolved in order to predict the backscattered field? Corollary issues in this area are (i) at what resolution can one go from a deterministic to a stochastic representation and (ii) how should one interpolate between bathymetric data points? (b) How important are shear (rigidity) properties of the sediment and basement in a predictive model of seafloor backscatter? (c) How important is intrinsic attenuation (anelasticity) in a predictive model of seafloor backscatter? (d) How do the magnitude and mechanisms of backscatter vary with increasing sediment cover? (e) How effective are isolated facets on the seafloor in generating strong backscatter? (f) Can realistic volume heterogeneities within the sediment and basement generate comparable backscatter levels to realistic seafloor roughness? These issues will be discussed by comparing backscatter coefficients for various seafloor representations.

A Surgeon With AIDS-Reply

In Reply.— My editorial concluded that it is acceptably safe, from the stand-point of HIV transmission risk, for HIV-infected surgeons to perform most operations. Dr Fulghum raises two of the most important corollary issues: What are the disclosure obligations of the HIV-infected surgeon? What are the implications of the physical and mental impairment that HIV infection ultimately produces? These issues are best considered in the context of other potential disclosure obligations and accommodations to physician impairment. The implications of HIV infection in health care workers are analyzed thoroughly in a position paper developed by the Association for Practitioners in Infection Control and the Society of Hospital Epidemiologists of America. 1 There are many situations that might lead patients to switch physicians but that produce no or virtually no increased risk and are not ordinarily disclosed to patients. Examples include past drug use, recent physical or mental illness, or a

The right of physicians to refuse versus the obligation of physicians to treat AIDS patients

Discussion of the right of healthcare professions to refuse and the obligation to care for AIDS patients have recently generated considerable interest and dialogue. One component of this issue faced by hospitals is whether or not physicians have the right to refuse to treat AIDS patients. The corollary issue is whether or not physicians and hospitals have the obligation to treat and provide care to AIDS patients. Recent American medical ethical statements may influence future Canadian medical ethical positions for the treatment of AIDS patients. Principles derived from the common law and legislation are also examined.

The Right of Physicians to Refuse versus the Obligation of Physicians to Treat AIDS Patients

Discussion of the right of healthcare professions to refuse and the obligation to care for AIDS patients have recently generated considerable interest and dialogue. One component of this issue faced by hospitals is whether or not physicians have the right to refuse to treat AIDS patients. The corollary issue is whether or not physicians and hospitals have the obligation to treat and provide care to AIDS patients. Recent American medical ethical statements may influence future Canadian medical ethical positions for the treatment of AIDS patients. Principles derived from the common law and legislation are also examined.

American Women Writing Fiction by Mickey Pearlman

284 Western American Literature Myth expresses “verities,” history only “manifest fictions” (88). It victimizes the past by “measuring an illusion of reality rather than feeling the pulse of a significant human event” (87). Thus the inability of historians to enter the Puritan mind or any unfamiliar territory. Not that feeling the pulse of the past is easy. It requires considerable groping, judging from Poulsen’s prose: “And yet some explanations seem insufficient to cope with, appreciate, the immense pervasiveness of certain folk, certain mythological images. It is one problem to be able to explain, prove, that animals. . .” etc. (60). This stylistic hesitancy, throat-clearing, is distracting, puzzling, given the author’s equal penchant for flat pronouncements. Those he disagrees with are wrong, even disgustingly so. And when he isnot lecturing historians for misrepresenting the past, he is lecturing the sources they use (the Donner Party survivors, for instance) for misunderstanding their own experiences. Yet all he offers are fortune cookie profundities: “facts are illusions of measurement which portray the mind of the researcher, not the condition of the thing observed” (86) ; “History is a divinity” (107) ; “Truth is the unending reflection of an image” (119); “Science is a system of measured prejudices” (120) ;“Chaos, like truth, is unbearable” (125) ; “Human life is a tissue of spaces” (135) ; “Satisfaction and greatness are antithetical” (147). One thinks of Herbert Spencer’s strain­ ing after a universal law. “Evolution,” he wrote, “is a change from an indefin­ ite, incoherent homogenity to a definite, coherent heterogeneity, through continuous differentiations and integrations.” A contemporary translated: “Evolution is a change from a nohowish, untalkaboutable, all-alikeness, to a somehowish and ingeneral-talk-aboutable not all-alikeness, by continuous something-elsefications and sticktogetherations.” Poulsen’s nihilation, in turn, translates as a subjectivity devoid of other than personal significance. Of course, this is the opinion of an historian. BRIAN W. DIPPIE University of Victoria, B.C. American Women Writing Fiction. Edited by Mickey Pearlman. (Lexington: The University Press of Kentucky, 1989. 236 pages, $20.00/$10.00.) In her seminal essay, “The Masculine Wilderness of the American Novel,” Carolyn G. Heilbrun writes of the standard, now even classical “texts” of American literature as exclusively male—that is to say, concerning man alone, the solitaryhero, an individual pitting strength and durability against society in an adventurous and mythic journey to knowledge. Whether or not the knowl­ edge readers have come to through reading this fiction is the same as the hero’s—existential, escapist, vindicating—the fact remains that for generations of readers this literature has defined “American character” and the corollary issues (social, political, religious, psychological) that apparently concern us. Reviews 285 Mickey Pearlman points out in his introduction to American Women Writing Fiction not only the now evident alternate view of women writers to this masculine perspective, but how identity is tied for women not in “lighting out for the territory,” but in memory and family. He notes, however, that the purpose of this collection is not to argue that women write about memory, identity, family, and space and that men do not. Rather, he notes that women writers as represented by the voices in this book are aware of the change in the lives of contemporary American women, the tension that provokes, and the resulting refocusing on the themes identified above. While feminist criticism records and explicates the growing awareness of American women writers the last forty years of their role as female artists, this volume avoids both social and biological explanations for this phenome­ non. The collection includes the work of ten critics, the essays written particu­ larly for this volume and published here for the first time. Bibliographies of the works of these authors, also original, as well as substantial bibliographies of criticism about them, are included. The choice of the writers Joyce Carol Oates, Mary Gordon, Joan Didion, Louise Erdrich, Alison Lurie, Susan Fromberg Schaeffer, Toni Cade Bambara, Gail Godwin, Jayne Anne Phillips, and Mary Lee Settle offers widely divergent considerations of regional, ethnic, generational perspectives. In this case, diversity also points to a complicated and commingling assembling of writers who more broadly reflect who we are. This volume isrecommended for critics, professors...

The Teaching of Cataloging

This paper examines library literature concerning the conflict in teaching cataloging, between education for librarianship and training for specific tasks performed in the library. The literature reflects fundamental trends in library education; balance between theory and practice, evolution from apprenticeship to graduate school and the role of cataloging in curricula. It has concerned six issues; practitioners as educators, differentiation of professional duties, centralization and cooperation, development of cataloging codes, technological change and anticipated professional functions. A more profound corollary issue is also addressed. Training prepares for the current environment; education prepares for change. The literature presents a dichotomous view, seeking resolution by balancing mutually exclusive elements. An historical perspective suggests a dialectical paradigm, a process of continuous interaction between opposing forces which produce a synthesis.

Should Psychotherapy be taught to Psychiatric Residents? A Debate.

Much of this discussion was inspired by a debate held at the 1984 APA Annual Meeting, entitled " Does Psychodynamic Theory Have Little Relevance to Contemporary Psychiatric Care?" We saw the need for a debate, resident generated, that would address a corollary issue in residency training.

Critical Considerations in Total Communication and an Environmental Intervention Model for the Developmentally Delayed

Total communication is gaining widespread acceptance as an alternative or supplemental form of communication for language delayed hearing children for whom oral language training alone is inadequate. The authors address several issues pertinent to designing environmentally based total communication assessment and training programs. Major issues discussed include (a) Who are the appropriate clients for total communication training? (b) What criteria are useful in selecting a sign system? (c) What linguistic model is appropriate for selecting valid language targets and designing generalization? (d) What adaptations in an oral language teaching program are necessary for a manual mode of communication training? These questions and corollary issues are addressed from theoretical and clinical perspectives.

Serial Order Revisited: A Reply to R. D. Kent

This paper examines two rule-based or non-associative alternatives to associative theories of serial order in behavior. Both rule-based models seemed superior to chain association, but one, the CV Organization model, was found to require further development to handle corollary issues associated with serial ordering eg. coarticulation phenomena, sequential plasticity and a parsimonious fit to speech rate data. The other rule-based model, Syllabic Recording, was shown to be compatible with these and several previously unexplored corollary issues, including the nature of sequential redundancy, production variability (word reduction) and the nature of errors in the acquisition of phonology by children.

Diagnostic Characteristics Related to Services in Psychiatric Clinics for Children

Tr _HE standard diagnostic nomenclature of mental disorders (1) has been applied to children since the initiation in 1954 of nationwide psychiatric clinic reporting (2). Much criticism has been evoked and numerous difficulties cited in the application of these standard classifications to children (3) (4). We have encountered a number of such problems but even with these limitations have been able to demonstrate large differences in the risk of clinic admission by diagnosis and by population groups (5). In this paper, we should like to consider a corollary issue: to what extent is the psychiatric classification an operationally important variable in determining the course of clinic service for the child patient? We shall use data from one state (Maryland) where an intensive educational effort with clinic professional and clerical personnel preceded and accompanied the collection of reports. Maryland is an eastern seaboard state of 10,000 square miles and three million population; its large urban center, Baltimore City, has approximately one million people. Four Maryland counties met the 1950 census definition of a metropolitan area-Baltimore and Anne Arundel counties, which are contiguous with Baltimore City, and Montgomery and Prince George's counties, adjacent to Washington, D.C. About a fourth of the population was classified as rural in the 1950