Refusal Of Services Research Articles

Effects of multi-component programmes in preventing sales of alcohol to intoxicated patrons in nightlife settings in the United Kingdom

IntroductionAlcohol service to intoxicated patrons is common across nightlife settings and preventing such sales is a key priority globally. In England and Wales, three multi-component programmes have been implemented including: (1) community mobilisation, responsible beverage server (RBS) training and routine law enforcement; (2) community mobilisation and enhanced law enforcement; and, (3) community mobilisation, RBS training and enhanced law enforcement. This study estimates the association between sales of alcohol to pseudo-intoxicated patrons and implementation of three multi-component interventions in four nightlife settings. MethodsAlcohol test purchases by pseudo-intoxicated actors were implemented at pre (n = 206) and post-intervention (n = 224). Actors/observers recorded venue and test purchase characteristics. Logistic regression assessed service refusal by intervention type, adjusting for venue/test purchase characteristics. ResultsPre-intervention, 20.9% of sales were refused. Post-intervention, 42.1%, 68.8% and 74.0% of sales were refused in areas with intervention 1, 2, and 3 respectively. In adjusted analyses, compared to pre-intervention, the odds of service refusal were higher for all interventions, with the highest odds when the intervention included enhanced law enforcement (adjusted odds ratios, interventions 1, 2, 3: 2.6, 7.1, 14.4; p < 0.01). Service refusal was higher if the test purchase was implemented on a Saturday/Sunday night; and lower if implemented in a nightclub or if age verification was requested at the bar. ConclusionCommunity-based multi-component interventions were associated with significant increases in service refusal to pseudo-intoxicated actors in nightlife settings in England and Wales. Effects were stronger for interventions including enhanced law enforcement, and particularly if all intervention components were implemented.

Increasing Access to CBT for Psychosis: Development, Feasibility, and Acceptability of a Specialized Outpatient Service.

Despite the increasing demand for cognitive behavioural therapy for psychosis (CBTp), the existing literature is lacking in terms of models for sustainable implementation. The aims of this study were to: (a) describe the development of a specialized CBTp Service; (b) report demographic characteristics and referral patterns over 1year to examine feasibility; and (c) review feedback from participants in group-based CBTp to examine acceptability. Data were analyzed from 126 referrals (M = 35.52, SD = 13.06, 59.5% men) to an outpatient CBTp Service at the Centre for Addiction and Mental Health (Toronto, Ontario) between January 2019 to January 2020. Anonymous feedback was obtained from 54 individuals who completed group-based CBTp. Positive symptoms and distressing emotions were the main reasons for referral. Over half of eligible referrals scheduled an intake assessment and 70% of individuals who completed this assessment attended further treatment. Primary reasons for service refusal were scheduling conflicts and illness-related barriers. The total service wait-time was two months, with the longest delay between dates of referral and initial contact. Satisfaction with the quality of CBTp and its components was rated high among group members. Although variable wait-times and engagement levels were identified across stages of the referral process, the CBTp Service demonstrates preliminary feasibility and acceptability, and provides a model of service delivery to incorporate within future CBTp implementation efforts in Canada.

Magnitudes of Immunization Dropout Rate and Predictors for 12-23 Months Aged Children in Abobo District Southwest Ethiopia

Vaccination is the epicenter of preventive care for good children's health outcomes in each nation. Nevertheless, a number of factors have been hindering the attainment of targets from providing complete vaccination in different nations. This study aims to assess predictors of immunizations in 12-23 months aged children in Abobo District, Gambela regions southwest Ethiopia.&#x0D; Method: A community-based cross-sectional study was employed in 436 pairs of mothers to children aged 12–23 months from 12 marches---27 April 2019. The study participant was recruited by multistage-sampling were used for each kebele. Data were entered into Epi-Data version 3.1 after cleaning and coded, exported to STATA/SE-14/R logistic regression analysis. Variables with P-value &lt;0.25 in bivariate logistic regression were transported into multivariable logistic regression. A variable with 95%CI in AOR was used as claim predictors for the dropout rate.&#x0D; Results: The overall dropout rate of immunization from completion was found 25.8% (95%CI: 21.5--30.2). Factors like mothers did not attend ANC (AOR= 4.59, 95% CI: 2.58, 7.84), being home delivery (AOR=6.46, 95% CI: (3.5--- 11.4), postponed last immunization scheduled (AOR=3.44, 95% CI: 1.98---5.97), children ill during measles vaccine (AOR=1.83, 95% CI: (1.02---3.28), Mothers refused ≥30 minutes for vaccine service waiting (AOR=3.58, 95% CI: (1.99, 6.44) were significantly associated with immunization dropout out.&#x0D; Conclusion: The immunization dropout rate was unacceptable and higher compared to WHO reference (&lt;10%). Home delivery postponed measles vaccine, child illness, ANC status Service refusal ≥30 minutes waiting for the vaccine were independently associated with dropout.

Experiences of Violence Against Lesbian and Bisexual Women in Brazil.

BackgroundLesbophobia and biphobia are manifestations of homophobic violence directed at lesbian and bisexual women that results in daily violation of rights and social exclusion.AimTo describe experiences of the violence against lesbian and bisexual women in Brazil.MethodsSequential mixed methods study was carried out in 2 stages. In the first one, quantitative, an electronic questionnaire was applied to women from all regions, with questions about sociodemographic characteristics, self-identification and lesbophobic and biphobic events. In the second one, qualitative, lesbian, and bisexual women were interviewed face to face about the violence suffered.OutcomesThe chi-square test was applied to compare violence against lesbian and bisexual women (type of violence, place of aggression, gender and age range of the aggressor, bond with the aggressor, repetition of violence, and denunciation of violence) and the content analysis for qualitative data (main categories of analysis were events of violence, denunciation, and consequences of violence).ResultsThe report of violence was present in 65% of the answers. There was a predominance of psychological violence (39.8%), in the public environment (63%), practiced by men (73.2%), by strangers (66.2%) and repeatedly (82%). Lesbian women, compared to bisexuals, were more prone to violence in the public environment (59.5% vs 39.5%) and with repetition (84.3% vs 60.6%). The narratives explained intimidating experiences in the family environment (insults, threat of suicide or homicide and false imprisonment) and public (harassment, beatings, and rape). Discriminatory attitudes, insults, and refusal of service in restaurants and bars were recurrent.Clinical ImplicationsThe data provide information that can serve to improve policy initiatives to reduce these episodes.Strengths and LimitationsThis is the first study of mixed methods, with national coverage, on lesbophobia and biphobia events in Brazil. Future studies should include women underrepresented in this research as trans women, non-white, less educated, and from the most distant regions of the country.ConclusionLesbophobic or biphobic event has harmful repercussions for multiple aspects of these women's lives, including mental health.Rufino AC, Filho CEWBdeC, Madeiro A. Experiences of Violence Against Lesbian and Bisexual Women in Brazil. Sex Med 2022;10:100479.

RESEARCH TOOLS FOR PROTECTING INTERNET RESOURCES FROM DDOS-ATTACK DURING CYBERWAR

To date, information technologies have entered all the spheres of society. Due to the rapid development of scientific and technological progress, the traditional methods of introduction of wars, which are currently underway not only in the field of hostilities, but also in the cybernetic space of society, are also changing. The modern world is characterized by active wars in cyberspace, where one of the most common attacks is DDoS-attack, including critical infrastructure. This is primarily due to the extreme density of integration into the life and activities of the society of various gadgets, electronic devices and the Internet, the violation of which can cause significant damage - both psychological and significant damage to the enemy from the inside. One of the simplest and most popular methods for violating such normal functioning is the use of resource overload, which can even lead to their complete inaccessibility. One of the ways of overload is the use of DDoS-attacks in case of refusal of service. Mass sending external requests to the attacked resource leads to the fact that such a resource in a short period of time is trying to develop a significant number of requests, which will lead to a significant slowdown in its work or even lead to a complete stop of the resource. This work is devoted to the study of the methods by which DDoS-atack are carried out. The most common methods for their implementation and the main methods of protection against them are considered in detail. This work has examined in detail the technologies and methods of protection against DDoS attacks analyzed and relatively existing solutions of ready-made companies for protection. But since information technologies are developing rapidly, DDoS attacks will develop. Consequently, the problem of protection against them is relevant, especially in the conditions of cyber.

Intercultural Pragmatic Analysis of “Sorry” in In-flight Service Refusals by Flight Attendants: A Case Study of a Thai Airline

Intercultural Pragmatic Analysis of “Sorry” in In-flight Service Refusals by Flight Attendants: A Case Study of a Thai Airline

ПОЛУМАРКОВСКАЯ МОДЕЛЬ ТЕЛЕКОММУНИКАЦИОННОЙ СЕТИ С ДИНАМИЧЕСКИМ УПРАВЛЕНИЕМ

The paper proposes a semi-Markov model of telecommunication network. The variant of dynamictraffic control of queuing system as a special case of telecommunication network is considered.The main purpose of control is to minimize the average cost per unit of time to service theincoming flow of information (packets). This takes into account the different bandwidth of thechannels, the processing speed of information in the channel and the information capacity of thebuffers. The approach to the organization of dynamic control taking into account noise immunity(information reliability) and information security is discussed. The problem of dynamic control ofa telecommunication network is considered on the example of a simple single-channel structure ofthe “point-to-point” type, which is modeled as a linear unidirectional Markov chain. The parametersof the service tariff, the cost of the fine for refusal of service were introduced. The analysisallows us to make the following remarks that the distribution of the input information flow ofpackets is Poisson, the law of distribution of the length of packets and the speed of their arrival isexponential, which together characterizes the Markov process. However, there are concurrentservice delays relative to the timing of service requests, including buffer overflow delays. The proposedsemi-Markov model of a telecommunications network can be used for more complex networkstructures. In particular, for a telecommunication network, consisting not only of one singlechannelinformation transmission system (single-channel queuing system), but representing a setof several systems, that is, for multichannel telecommunication networks.

They Have the Ability to Say Yes or No: Providers' Perspectives on Veterans' Service Refusal as a Cause of Readmissions

Service refusal, where patients actively refuse clinicians’ recommendations for additional services needed to achieve safe and full recovery after discharge, is a key but often overlooked cause of readmissions. There is a dearth of literature on the extent of service refusal and providers’ (e.g. clinicians, nurses, social workers) observations regarding how to deal with these situations. As part of a larger, 10 VA site organizational case study of readmission, semi-structured interviews exploring causes of readmission were conducted with 21-41 staff members at each site (n=314). 41 providers identified Veteran service refusal and decision-making as causes of readmission. Providers acknowledged the need to honor patient autonomy/self-determination in decisions while at the same time worrying about potential adverse outcomes. Incongruence between Veterans’ and providers’ perceptions (especially for capacity for self-care), goals, and discharge plans was also cited as a factor in service refusal. Frustration was also raised about initial acceptance of service followed by refusal at time of service delivery. Providers also felt readmissions increased even further when combined with lack of or inadequate caregiving arrangements/family support, lack of cognitive capacity, homelessness, or home care affordability. Findings point to the need for interventions to evaluate congruence between provider and patient assessment of self-care capabilities and provide more in-depth goal setting and motivational interviewing techniques to help patients reach more realistic post-discharge care goals.

Understanding professionals' perspectives and experiences of elder self-neglect: A systematic review and meta-synthesis of qualitative studies.

To systematically review and synthesize the findings on various professionals' perspectives of elder self-neglect (ESN) and/or their experiences with ESN. A systematic qualitative review was used. Primary qualitative studies published either in English or Chinese until August 2020 were systematically searched in the following databases: PubMed, Web of Science, Embase, CINAHL Plus, PsycINFO, Wanfang Data, and China National Knowledge Infrastructure (CNKI). Eleven studies were included. Five subthemes including retaining a sense of normalcy/identity, service refusal, isolation, contributing factors in ESN, and manifestations and consequences of ESN were included in the overarching theme of ESN features. Another two subthemes, emotional and ethical dilemmas in caring for self-neglecters and management strategies, were included under the second overarching theme of complicated experiences managing cases of ESN. This qualitative synthesis provides a deep and comprehensive insight into professionals' perspectives and experiences of self-neglect in older adults. Understanding professionals' perspectives of ESN can help with the knowledge and theory development pertinent to this particular phenomenon. Findings are valuable in informing the provision of funds and structural, informational, and emotional support systems development for professionals managing ESN cases. Establishing a strong link between ESN case management and improved outcomes in older self-neglecters is essential to establish a definite need for the provision of support, resource, and stardardized guidelines for these professionals.

Impact of expanded carrier screening on health care utilization.

To evaluate potential consequences of expanded carrier screening (ECS) for reproductive risk on health care utilization among women who are not at increased reproductive risk. Women planning pregnancy were randomized to usual care carrier screening or ECS to assess reproductive risks. Electronic health record (EHR) data were used to evaluate the effects of ECS on pregnancy-related utilization and general health care utilization among all study participants who did not receive positive ECS results of at least a 25% risk (ie, received negative [normal] ECSresults). EHR data were extracted through research-ready databases and extensive chart review for 304participants. We analyzed the effect of ECS for women who were not found to be at increased reproductive risk on (1)utilization of mental health services in the period between randomization and initial results disclosure; (2)utilization of general outpatient and inpatient services, specialty services, and mental health-related services in the year following randomization; and (3) utilization and refusal of pregnancy-related services among pregnant women (n = 129) prior to and following randomization. No significant differences in health care utilization were found between women randomized to receive ECS and those receiving usual care. Women who received negative ECS results did not refuse recommended screening for conditions that are not identified via ECS at a higher rate than women in the usual care arm. These results suggest that ECS does not have unintended negative impacts on the health care system for the majority of patients who are not at increased reproductive risk.

Using Randomization to Learn About Framing Effects on LGBTQ Rights Questions

In a survey that included the same question about refusing service to gay and lesbian people due to religious beliefs in two different batteries, some respondents offered different answers. We probe the framing issues inherent in each question battery and find that support for refusing service to gay and lesbian people declines when the question is in the context of other group service refusals that could be considered civil rights issues. Additionally, inconsistent responses are also related to question order. We posit that randomization can lead to what appear to be fluctuations in attitudes but may, in fact, also be capturing framing effects. This has implications for both the survey design process and substantive findings.

Travelling with a Guide Dog: Experiences of People with Vision Impairment

There is considerable research on people with vision impairment (PwVI) in the transport, travel and tourism sectors, which highlights the significance of real-time information and consistency in services to accessibility. Based on interviews with guide dog owners in the United Kingdom, this paper contributes an additional dimension to our understanding of transport accessibility for PwVI by focusing specifically on guide dog owners’ experiences in the travel and tourism sector. A guide dog is more than a mobility tool, but a human–dog partnership that improves the quality of life for PwVI; however, it also introduces constraints related to the dog’s welfare and safety. Further, lack of understanding of guide dog owners’ rights to reasonable accommodation leads to discrimination through service refusals and challenges to service access. This paper concludes that the limited and inconsistent public knowledge of disability diversity has serious ramifications for transport accessibility and suggests specific industry and legislative interventions in response.

Does Disgust Drive Religious Freedom Attitudes? Experimental Results About the Context of Service Refusal Opinion

ObjectiveWhat factors shape public support for service refusals carried out in the name of the free exercise of religion? Existing analyses treat the businesses refusing to serve LGBT citizens as fungible. We hypothesize that the religious context does not matter and that reactions are consistent with the role of socialized disgust.MethodsWe engage the same experimental design in two 2019 samples, one of 800 Colorado adult residents and one of 1,010 Protestants. The 1 × 2 × 2 design enables a contrast between a control, conditions that vary the business between a florist and photographer, and conditions that vary the religious nature of the event.ResultsThe results suggest that the religious nature of the context is immaterial and that reactions generally conform with the role of disgust, especially for those socialized to feel it—high attending evangelicals.ConclusionWe affirm the importance of the context of service delivery for religious freedom attitudes and discuss the role of religion.

Ensuring Reproductive Rights of Women in Nepal: Law and Praxis

Reproductive rights are fundamental rights and freedoms relating to reproduction and reproductive health that vary amongst countries around the world, but have a commonality about the protection, preservation and promotion of a woman‘s reproductive health rights. Reproductive rights include the right to autonomy and self-determination , the right of everyone to make free and informed decisions and have full control over their body, sexuality, health, relationships, and if, when and with whom to partner, marry and have children , without any form of discrimination, stigma, coercion or violence. The access and availability of reproductive health services are limited due to geography and other issues, non-availability and refusal of reproductive health services may lead to serious consequences. The State need to ensure accessibility, availability, safe and quality reproductive health services and address the lifecycle needs of women and girls and provide access of every young women and girls to comprehensive sexuality education based on their evolving capacity as their human rights, through its inclusion and proper implementation in school curriculum, community-based awareness program and youth led mass media. It is necessary for strengthening compliance, in a time-bound manner, with international human rights standards that Nepal has ratified that protect, promote, and fulfill the basic human rights and reproductive health rights in Nepal and also need to review standards and conventions that Nepal has had reservations about or those that have been poorly implemented in the country.

Искупленный дважды: толмач Ставропольского войска Афанасий Шорин (опыт реконструкции нетипичной биографии крещеного калмыка второй трети XVIII в.)

Introduction. Religious policies of the Russian Empire in early modern history is a topical issue of historiography. An important (though poorly researched) aspect of this question is the role of Kalmyk Christian elites. Being part of the diverse ethnoreligious cluster, the latter served as a conductor of Russia’s influence on subject nomadic communities (Oirats, Turkic tribes) during the period under consideration across southeastern steppe peripheries and adjacent territories. The Stavropol Kalmyk host established in 1737, quartered next to the fortress of Stavropol-on-Volga, and since 1745 referred to as Stavropol Corps of Kalmyk Christians was one of such groups.Goals.The study seeks to reconstruct the biography of Afanasy Shorin, an interpreter socially representing army elites. His life journey may be instrumental in tracing the shaping (and details) of communication patterns between Russian authorities and steppe leaders during the mentioned period. Materials and Methods. The study analyses rich source materials from Russia’s central and local institutions that reflect certain phases of Afanasy Shorin’s biography. The research tools include those of source criticism and archaeography which provided a systematic insight into the documents. Special attention is paid to the collected indirect testimonies that would clarify separate aspects of the person’s life. Results.The biography reconstructed from the documents contains a number of milestones, such as birthright privileges, military career prospects, escape attempts and refusal of active service, two discharges from any liability for the offences by the Russian authorities as a tribute to the social status and merits of ancestors, admission to the Collegium of Foreign Affairs, civil service in Stavropol-onVolga, and an important political mission in 1757–1758. The article identifies how and why the life trajectory unusual for a representative of such background and status — a school teacher, interpreter but not a military officer — reflected the processes of interaction between Russia proper and steppe nomads. It also underlines the importance of the Oirat factor for the state before and after the fall of Dzungaria. In the meantime, the text describes sentiments of the Stavropol host leadership and emphasizes the dissatisfaction with restrictions to have resulted from social class policies of Russian authorities by the late 1760s. The article contains the idea that it was the discontent with his position, which was fully characteristic of many including Afanasy Shorin, that pushed the highest authorities of the host to participate in the Yemelyan Pugachev’s Rebellion. As a possible prospect, the departure was suggested, by the example of the Kalmyks of Ubashi Khan, who departed to China in 1771. The article proves first to reveal the mechanism of how service conditions, kinship and confessional contacts influenced the inclusion of Kalmyk Christian elites into the border Russian military-andpolitical system. The text gives arguments that essentially contradict the trend (previously expressed in historiography) to consider the anti-serfdom protest as the only reason why Stavropol Kalmyks supported Pugachev’s Rebellion. Conclusions. The paper concludes the Kalmyk Christian nobility and related elites of the Kalmyk community played a significant role in foreign and religious policies under Elizaveta Petrovna and in the early years of Catherine the Great’s reign, which explains the increased attention of the government towards them. However, their relevance within the established border system and, consequently, their positions were largely exhausted in the 1770s. This was also facilitated by the decline in the importance of the Oirats, and the rise of the Turkic direction in Russia’s foreign policy in the south and southeast.

Wicked Problems: An Exploration of Elder Mistreatment Complexity

Elder mistreatment (EM) complexity, while described anecdotally, lacks an empirical foundation for measurement. Improved knowledge on the range and nature of concurrent issues that complicate EM intervention would inform the development of more effective solutions and enable greater precision of evaluation research. The purpose of this qualitative study was to explore factors contributing to complexity in a sample of EM cases that was selected based on difficulty reaching resolution. The sample was drawn from those reviewed by an experienced EM Multidisciplinary team (MDT) and determined to require long-term case management (n=39) beyond the capacity of the MDT’s usual response. Case manager narrative documentation of ongoing assessment and social service records were qualitatively coded by two researchers. Inductive content analysis, with iterative code reconciliation, was used to identify issues and problems both related and concurrent to EM. Eighteen themes and 74 sub-themes emerged, with 93% initial coding agreement between researchers. The most frequent themes were problems with Caregiving (80%), Cognition (80%), Physical Health (80%), Behavioral Health (69%), Socialization (64%), and Finances (62%). Refusal of formal services was common (90%), yet all accepted visitation by the case manager, suggesting informal support may be effective. Diversity, interconnectedness, and emergence of issues along the duration of case management indicates a system approach to intervention design and evaluation is warranted. This research underscores the need for holistic intervention for highly complex EM, and lays the foundation for objective measure of complexity to standardize selection for specialized intervention.

With their children placed in kinship care, did parents get the services they needed?

This secondary analysis involved exclusively parents with children placed in kinship care by a child welfare agency. It examined associations between parents’ receipt of needed services and 6 sets of variables measuring parents’ needs, access to service providers, social structural factors, demographic factors, family resources, and child welfare interventions experienced. The sample of 731 parents was extracted from the National Survey of Child and Adolescent Well-Being II. Data were analyzed using generalized least squares random-effects modeling. Analysis showed an association in positive direction between the percentage of needed services parents received and 4 measures: Medicaid coverage, education, case plan’s specification of needed services, and racial/ethnic homogeneity of parent and child welfare caseworker. Association in negative direction was observed between the outcome and unavailability of services, difficulty accessing services, refusal of services, caseworker engagement perceived by parent, and physical maltreatment. Implications of results include the necessity that caseworkers list in case plans the accurately identified needs of parents for services, along with mandates for those services. Implications also include need for adequate training in building caseworker–parent working alliance and need for sustained focus on reunification.

Boston Violence Intervention Advocacy Program: Challenges and Opportunities for Client Engagement and Goal Achievement.

A better understanding of the factors affecting client engagement in hospital-based violence intervention programs (HVIPs), and which types of client needs prove most challenging to achieve, may be of key importance in developing novel, targeted strategies to violence intervention. In this study, we examined the demographics and injury characteristics of violently injured patients by their level of engagement with the Boston Violence Intervention Advocacy Program (VIAP) and determined the degree of client goal achievement through VIAP client services. This retrospective study was performed using a cohort of patients presenting to the Boston Medical Center emergency department for a violent penetrating injury due to community violence between 2013 and 2018. Data on client demographics, injury characteristics, and client needs were collected from the VIAP data repository. Cox proportional hazard regression models were used to estimate hazard ratios (HRs) and 95% confidence intervals to assess the difference in hazards of client goal achievement by need type. Of the 2,243 victims of violent injury, 839 (37.4%) patients engaged with VIAP. Significant predictors of client engagement include younger age, Black race, permanent home, existing mental health diagnosis, gunshot wound, and more severe injuries. Conversely, older age, homelessness, substance use, stab wound, and less severe injuries predicted refusal of VIAP services. For clients who chose to engage with VIAP, needs related to education (HR=0.47, 95% CI= 0.38 to 0.58), employment (HR=0.66, 95% CI= 0.57 to 0.77), and housing (HR=0.76, 95% CI= 0.68 to 0.86) were significantly less likely to be achieved compared to basic needs. This study demonstrates that VIAP is effectively engaging the client population that HVIPs have been designed to support. HVIPs should consider novel strategies to engage vulnerable populations not typically targeted by intervention programs. These results speak to the difficulties of program attrition and the complexities of altering the life course for victims of violence.

Scienza e coscienza ai tempi dell’emergenza sanitaria da Covid-19

SOMMARIO: 1. Il dilemma etico ai tempi della pandemia da Covid-19 -2. Le Raccomandazioni di etica clinica della SIIARTI del 6 marzo 2020 - 3. I criteri selettivi di accesso ai reparti di terapia intensiva in Svizzera, Quebec (Canada) e Alabama (USA) - 4. Triage in emergenza pandemica. Possibile contrasto di alcuni criteri selettivi con i valori religiosi ed etici del personale sanitario -5. Emergenza sanitaria e “clausola di coscienza” in Italia. Science and at the time of the Covid-19 health emergency ABASTRACT: The Covid-19 pandemic crisis and the saturation of the intensive care wards have made it necessary to prepare patient selection criteria in case of lack of available places. The spread of various selective criteria, in different regulatory realities, starting in Italy from the Ethical Recommendations of the SIIARTI (Italian Society of Anaesthesia, Analgesia, Resuscitation and Intensive Care) of March 6, 2020, as well as for reasons of distributive justice and appropriate allocation of limited health resources, was also necessary to relieve medical staff from part of the responsibility in the choices to be made, sometimes particularly onerous. The rationale behind the medicine of catastrophes documents, however, may conflict with the ethical values of medical personnel, undoubtedly capable of influencing their professional choices. The present contribution aims to verify the configurability of a space within which to give prominence, even in emergency conditions, to the ethical-religious beliefs of health personnel, in accordance with the rules of medical and nursing ethics that allow the individual operator to invoke the conscience clause to justify the refusal of services considered contrary to their or their technical-scientific beliefs, even in cases not recognized by laws that expressly provide for conscientious objection.

From overt to covert: Exploring discrimination against homosexual consumers in retail stores

This research examines discrimination against homosexual consumers in several stores located in a Colombian shopping mall. Further, this research assesses retail conditions in Colombia, which is dealing with conflicts arising from issues related to its legalization of same-sex marriage. In the past, homosexual consumers experienced overt discrimination from retail employees typically in the form of finger pointing, negative stares, laughing, and refusal of service. This research reveals that overt discrimination against homosexual consumers seems to have abated across several indices, primarily in terms of waiting time for assistance from employees. The data reveal that gay male and lesbian couples remain susceptible to covert discrimination by retail employees, compared with their heterosexual counterparts, typically in the form of negative glances, refusal of service, and laughter. This research reveals that homosexual consumers may not realize the full value potential of marketplace exchanges, despite the waning of overt discriminatory practices by retail employees.