Ultimate Authority Research Articles

Antithrombotic therapy decision making in advanced cancer: Patients and clinicians' views, perspectives, and experiences

Abstract Background Decision-making regarding antithrombotic therapy (ATT) for patients with advanced cancer is highly challenging, given the competing risks and benefits of this treatment near the end of life. SERENITY is a Pan-European study aiming to develop and evaluate a shared decision-making support tool (SDMST), to facilitate ATT management with patients with advanced cancer, at the end of life (1). Purpose To explore patients’ and clinicians’ views, perspectives and experiences of ATT treatment and decision making. These data will form part of the evidence base to develop and evaluate a SDMST to support decision-making with patients with advanced cancer receiving ATT. Methods Semi-structured interviews were conducted with patients and clinicians involved in ATT treatment and management in the UK, Denmark, France and Spain. Data were analysed using Framework Analysis; the thematic framework was informed by concomitant SERENITY work packages, interview transcripts/summaries and patient and public representatives. Results Fifty-nine patients and 77 clinicians were interviewed across the four countries. Some patients expressed a preference not to be involved or informed, while others felt they should have the ultimate authority over ATT prescribing decisions. For many, there was little distinction between being informed about the decision and being involved in the decision regarding ATT; ultimately, many patients expressed the doctor should make the final decision. However, many patients did not perceive there to be a decision to make, either due to the complexities of the choice to be made, or that there are circumstances in which they should discontinue ATT. Similarly, while patients relied heavily on the doctors’ expertise, clinicians described significant reliance upon the patient perspective, due to the complexity of competing risks and benefits, and the context of advanced cancer/multi-comorbidities. Some patients reported being highly concerned about the risks of ATT deprescription, while others did not have a strong opinion on this treatment, deferring to their clinicians’ expertise. Thus, a discordance in decision-making perceptions between patients and clinicians was evident. Moreover, the decision is multifaceted in nature; the context of advanced cancer, coupled with the possibility that the clinician prescribing ATT may not serve as the primary clinician during the time when ATT decisions must be made, further complicated both the decision-making process and the opportunity for shared decision making. Conclusion There appears to be discordance in decision-making perceptions between patients and clinicians, which could negatively influence the co-decision making regarding ATT, contributing to prescribing inertia, and potentially impacting patient outcomes. A SDMST may help support the complexity around the decision, ensuring informed choices are made, and patients’ wishes and values are incorporated into the decision.

Ivan Illich perspective of deschooling society and the right of education

For over a century, schools have been able to institutionalize the value behind learning and “earning” an education. Ivan Illich argues that most learning was not the result of instruction, but of active engagement in a meaningful setting. He questions the system that encourages everyone to access an education that is guided by socio-economic relations, as pre-formatted product. This study aims to investigate if the theory of education proposed by Ivan Illich in Deschooling Society is feasible, legal, and how can it influence the creation of better models of education. The paper addresses the right to education according to the Universal Declaration of Human Rights and to what extent a parent has the ultimate authority to direct a child’s education. Using the review literature methodology, it investigates what is the role of school and what is the proposition of Ivan Illich for an alternative system of education. By reflecting on problems and contradictions of the tradition school system the paper discusses if schools contribute to a more democratic and egalitarian society, or if they reinforce inequalities. As a conclusion, Ivan Illich believes that the biggest obstacle to achieving a society that really educates is the existing imaginary that is conditioned to schooled thinking. Illich advocated for the decentralization of education and the empowerment of individuals to take control of their own learning processes. He promoted informal learning through community-based initiatives, apprenticeships, and self-directed study. This perspective has influenced alternative education movements and contributed to the development of concepts like homeschooling, unschooling, and self-directed learning. Alternative models of education can bring creativity and innovation to the learning process and should be encouraged and celebrated, especially if guided by an emancipatory approach and not by a neoliberal market logic that reinforces inequalities.

Women’s Rights in Le Dynasty’s “Quoc Trieu Hinh Luat”,Vietnam

Originating in the mid-15th century, the “Quoc Trieu Hinh Luat” legal law stands out for its remarkable value and achievements, featuring progressive attributes that surpass both preceding and succeeding legal laws. Throughout the extended period of Vietnamese subjugation by the North, the population endured significant influences from Chinese culture, operating within a feudal system that recognized the dominance of males over females. And Confucianism promoted a patriarchal system, a society where men have ultimate authority within the family unit and community. While the “Quoc Trieu Hinh Luat” could not entirely break free from this prevailing context, it introduced certain privileges for Vietnamese women that were absent in the contemporary Chinese setting. This article focuses on highlighted provisions safeguarding the dignity and rights of women in a society traditionally biased towards male superiority. Key aspects include right to decline marriage, the autonomy for women to enter voluntary marriages, the wife’s right to unilaterally leave her husband, and the right to divorce. Additionally, the “Quoc Trieu Hinh Luat” imposes stringent penalties for offenses against the physical and mental well-being of women. In some instances, female offenders receive relatively lenient punishments compared to their male counterparts. The primary aim of this article is to contribute to scholarly discussions on women’s rights within the socio-cultural milieu of the Le Dynasty’s “Quoc Trieu Hinh Luat”.

The Nature of the Administrative Relationships between the Shariʿah Board and the Stakeholders in Brunei Darussalam

Corporate governance involves a set of administrative relationships between a company and other stakeholders. The shareholders and management should take part in protecting the interests of all stakeholders by making decisions and building policy framework processes that fulfill the stakeholders’ needs. As far as Islamic corporate governance (ICG) is concerned, the institution of the Shari’ah board comes into the picture and plays a crucial role in favoring the interest of the stakeholders by ensuring that all corporation activities are in line with the Shari’ah principles. This paper attempts to examine the administrative relationships between the SB and other stakeholders by looking at the duties, roles, and responsibilities of the SB toward other stakeholders and vice versa in Brunei Darussalam. For this purpose, it relies on doctrinal and Islamic worldview methodologies and uses both content and legal analysis methods. After the discussion, it is concluded that the administrative relationship between the Shari’ah board and other stakeholders may take the form of imamah (ultimate authority), wilayah (specific authority), taʿlimiyah (educational), or istishariyah (consultative) relationship, depending on the type of relevant stakeholder. Nonetheless, to align the administrative relationship between SB and other stakeholders with these notions, further legal and regulatory amendments need to be made to the Bruneian Shariah governance framework.

"No sufro, estoy bien/I am not suffering, so I am doing OK": A mixed method exploration of individual and network-level factors and Type 2 Diabetes Mellitus (T2DM) among Mexican American adults in New York City.

The prevalence of type 2 Diabetes Mellitus (T2DM) is 2-3 times greater among Mexican Americans than non-Latino whites, and Mexican Americans are more likely to develop T2DM at younger ages and experience higher rates of complications. Social networks might play a crucial role in both T2DM etiology and management through social support, access to resources, social engagement, and health behavioral norms. To quantitatively identify the social network features associated with glycated hemoglobin (HbA1c) in a community sample of Mexican immigrants residing in New York City, and to explore the extent to which these quantitative findings converge with qualitative narratives of their lived experiences. This study used a convergent mixed methods design. To collect personal network data, we used EgoWeb, and obtained 1,400 personal network ties from 81 participants. HbA1c readings were collected using dried blood spots and categorized according to the laboratory criteria of the American Diabetes Association. Additional survey data were collected using Qualtrics software. To investigate the significance of the network-level factors after accounting for the socioeconomic and demographic individual-level factors that the literature indicates to be associated with T2DM, we used a multiple regression model on quantitative data sources. For the qualitative portion of the study, we selected a subset of individuals who participated in the quantitative portion, which represented 500 personal network ties from 25 participants. We conducted in-depth interviews guided by the visualization of these ties to explore who was helpful or difficult in managing their health and health behaviors. Individual-level indicators associated with lower HbA1c scores were body mass index (β = -0.07, p<0.05), and healthy eating index scores (β = -0.03, p<0.02). The network-level predictor associated with higher HbA1c levels was the percentage of diabetic alters in the network (β = 0.08, p <0.001, with a 25% increase in the percentages associated 2.0 change in HbA1c levels. The qualitative data highlighted that most of the diabetes-related information diffused through the social networks of our participants was related to dietary practices, such as reducing sugar and red meat consumption, eating out less, and reducing portion sizes. Notably, even among those with elevated levels and diabetes-related health complications, HbA1c was not considered a part of the lay descriptions of good health since they were not "suffering." Participants regarded doctors as the ultimate authority in diabetes care, even if they had supportive members in their personal networks. Our study provides quantitative evidence for the significant role of diabetic network members in the etiology and management of T2DM among Mexican Americans. Our qualitative findings suggest important ley terms for T2DM management and the importance of physicians, which could be included in in future social networks studies seeking to diffuse diabetes-related health information for T2DM prevention and management efforts in this population.

Getting out of history: Levitation and paralysis in Sebald and Nabokov

Abstract Nabokov and Sebald confronted the dark sides of their national histories and tried to exempt themselves from them. Nabokov liberated himself from its burden by escaping into levitation, whereas Sebald’s willing exposure to its consequences ended in paralysis. Nabokov appears in his Emigrants as the equivocal figure of the ‘butterfly man’ who is simultaneously mobilizing and immobilizing. This is like the Russian writer himself, who used to adopt butterflies’ metamorphoses as a writer and paralyze them as a lepidopterist. Contrary to him, Sebald was horrified by their immobilization and sincerely empathized with them. Eluding the detached position of an ultimate authority and making his author deeply attached to all kinds of ‘nocturnal’ creatures, he created an unreliable but indispensable narrative agency. If Nabokov was at pains to deaden the uneasy memories of his past in order to relieve the present of their contamination, Sebald took the other way around, adhering to the most painful of them in order to enlighten their subterranean existence. He was committed to manifest these deeply buried remnants via his protagonists and narrators, however this amounted to the expulsion of those among them that had no other choice but to stick to life in darkness.

The positive impacts on employees and corporates’ benefits of the egalitarian corporation culture.

The essay will focus on the two words. The first word is Hierarchical. The belief is that power should be distributed hierarchically across society. Belief in ascribed or inherited ability with ultimate authority residing in institutions. Emphasis on organizing vertically and autocratic or centralized decision-making. Emphasis on who is in charge. Acceptance of authority; reluctance to question authority. The second word is Egalitarian. The belief is that power should be distributed relatively equally across society. Belief in shared or elected power with ultimate authority residing in the people. Emphasis on organizing horizontally and participatory or decentralized decision-making. Focus on who is best qualified.Rejection or skepticism of authority; willingness to question authority. There are many advantages of the egalitarian culture of the manufacturing industry. Alibaba via Twitter Dynamic digital technology, intelligent menu

Jesus and the Rapture Part 1: Matthew 24:40–41 Reconsidered

Is the doctrine of the pre-tribulation rapture authentically biblical? Many seek to answer this question by turning to the ultimate authority in all doctrinal matters, Jesus Christ. Did Jesus believe in and teach about the rapture? This two-part series maintains that He did. Unfortunately, many seek to discover Christ’s rapture teaching in the wrong place, which is Matthew 24:40–41. The first article in this two-part series contends that the rapture cannot be found here, given Matthew’s overall argument, the exegetical details of Matthew 24:40–41, and the inadequacy of the pro-rapture arguments concerning the passage. However, the second article will contend that John 14:1–4 represents far more fruitful ground for understanding Christ’s rapture teaching. This will be demonstrated through an examination of the position of the upper room discourse in John’s Gospel, the exegetical details of John 14:1–4, and by answering the anti-rapture arguments concerning the interpretation of the passage.

WHAT DO SHARIAH BOARDS THINK ABOUT AI?

This paper provides a critical discussion on the functions and capabilities of Shariah boards, considering their ultimate authority in delivering Shariah assurance to stakeholders of Islamic banks. The primary objective of this initiative is to enhance the proficiency of Islamic banking in the realm of digital finance advancement while ensuring rigorous adherence to Shariah principles. This paper discusses the significance of robo advisory in facilitating real-time Shariah counsel by Shariah boards. Additionally, it highlights the potential of blockchain management systems (BMS) in augmenting the monitoring function of Shariah boards, namely in conducting reviews and audit assessments to ensure Shariah compliance in Islamic banks.

Shariah governance framework for Islamic banking in Pakistan: a critical review and comparison with AAOIFI

Purpose The study aims to critically review the Shariah governance framework for Islamic banking prevailing in Pakistan and provide a comparison with Accounting and Auditing Organization for Islamic Financial Institutions (AAOIFI). Design/methodology/approach It analyzes 16 circulars issued by the State Bank of Pakistan (SBP) since 2002, including three Shariah governance frameworks in 2014, 2015 and 2018. Additionally, the study compares the SBP and AAOIFI Shariah governance standards to evaluate the soundness of the SBP framework against international benchmarks. Findings Pakistan’s Shariah governance model is centralized, with the SBP’s Shariah board having ultimate authority. The SBP has provided a comprehensive Shariah framework, which includes among others, the criteria for the qualifications and conflict of interests of Shariah members. Both AAOIFI and SBP Shariah governance frameworks have similarities and differences in terms of the tenure of Shariah Supervisory Board (SSB) members, reporting line of SSB, number of SSB meetings, minimum experience of SSB members, primary duties of Shariah board, code of ethics and conduct for SSB and management and requirement of publication of SSB report in the annual report of Islamic banks. The frameworks differ in terms of the delegation of SSB powers, assessment and appraisal of SSB effectiveness and outsourcing of Shariah Compliance Department and Internal Shariah Audit Unit. Practical implications The study recommends expanding the qualification criteria for Shariah advisors to include additional degrees and qualifications, upholding stringent criteria for conflict of interests and promoting stakeholder consultation through exposure drafts. Originality/value To the best of the authors’ knowledge, this is the first of its kind which critically review and compare the Shariah governance framework prevailing in Pakistan.

Scripture's Authorisation of Concepts in Oliver O’Donovan's Ethics and Theology

A key aspect of Oliver O’Donovan's approach to ethics and theology is the notion of Scripture's ‘authorisation’ of concepts. Authorisation is an organic process of concepts and Scripture illuminating each other, where Scripture has ultimate authority over concepts. That is, while concepts from various disciplines can illuminate biblical texts, the biblical texts in return shape those concepts. Here concepts are formed organically guided by the Spirit. Such a notion of authorisation lies dormant in O’Donovan's earlier political theology, The Desire of the Nations, and comes to fuller expression in his relatively recent Ethics as Theology.

Neoliberal masculinity in the Ultimate Fighting Championship

ABSTRACT In this article, the author examines neoliberal masculinity in the Ultimate Fighting Championship (UFC) in the aftermath of Donald Trump’s election. She uses neoliberal masculinity as a framework for understanding how and why the UFC promotes diverse masculinities—including alt-right white masculinity—who can brand themselves for an array of domestic and international markets. She argues that neoliberal masculinity requires entrepreneurial subjects who view the market as the ultimate moral authority and discourage athletes from challenging the sports-media-complex's labor exploitation. The UFC ironically requires a docile athlete-worker that is incongruent with the sport’s reputation for hypermasculine performances of power.

Should the Board Have Control over Shareholder Proposals? Evidence from China

Abstract This Article empirically investigates the impacts of the board’s rejection of shareholder proposals on corporate value and the appropriate approach to regulation. The study utilizes a dataset of such incidents in China, where the board enjoys significant discretion in rejecting proposals due to the inadequacy of legal enforcement mechanisms. The findings provide suggestive evidence that the market reacts negatively to the announcement of proposal rejections, leading to a significant decline in a firm’s stock value. The most adverse effects are associated with rejections of director nomination proposals and blockholder-sponsored proposals. The inclusion of external legal opinions can help alleviate these adverse consequences. Additionally, the research uncovers that while the two stock exchanges in China demonstrate overall competence in identifying harmful rejection decisions, the effectiveness of their regulatory actions via comment letters is hindered by the inherent weakness of the soft law approach. Drawing upon these results, this study posits that the critical value of the shareholder proposal regime lies in providing a low-cost approach for dissident shareholders to replace poorly performing management and facilitating the constructive engagement of large shareholders and the management. Furthermore, it is recommended that China establish an SEC-style review process for board rejection decisions, with the exchanges as the ultimate authority permitting the exclusion of shareholder proposals.

The Legendary Vision in the Novel "The Alchemist" written by Paulo Coelho

Objective: This study aims to analyze Paulo Coelho's novel "The Alchemist" through the lens of a mythical vision dominating the narrative formation. It explores how the writer conveys his vision and ideas about a world shaped by the mythical interpretation of cosmic phenomena, where religions and social values do not hold ultimate authority. Instead, aspirations, dreams, and subjective visions play a significant role in explaining the universe and its manifestations.&#x0D; Methods: The study employs an analytical methodology, encompassing a comprehensive examination of the novel's text and interconnecting the significance and meanings within the interpretive dimension of the events, characters, time, and location depicted in the story.&#x0D; Results: The study found that a mythical vision guides the fictional work, leading to the realization of what Coelho refers to as "the personal legend" or "the Language of the Universe." It identifies Coelho's use of mythical dimensions and magical elements as means to achieve the novel's central goal, the pursuit of life's purpose. The study perceives this approach as distinctly mythical in nature.&#x0D; Conclusion: This novel offers rich content, inspiring readers to explore its deeper meanings and implications carried by the text and its narrative.

Federalism as an institutional doctrine

Federalism as an institutional doctrine

Esports Cannot Defeat Homophobia With Capitalism

Esports, competitive video gaming, is an emerging media industry looking to legitimize itself on the global stage. Part of its efforts include addressing a culture widely perceived as toxic. Toxic gamer culture claims hegemonic masculinity by degrading any seen as feminine, such as women and queer men; while this problem is endemic to gaming, it is particularly virulent in esports due to its struggles to be recognized as a “real” sport. The methods esports authorities have deployed to combat patriarchal homophobia, however, are insufficient. They share much with an anti-queer respectability politics that reinscribes the market as the ultimate cultural authority. An alternative approach would be one based on the principles of transformative justice, which emphasizes the humanity of both perpetrators and victims while demanding perpetrators take responsibility for the harm they cause. Transformative justice has already proved viable in game live-streaming, as seen by AnyKey's GLHF initiative.

Xi Jinping’s Consolidation of Power at the 20th Party Congress: Implications for Chinese Foreign Policy

The 20th National Congress of the Chinese Communist Party (CCP) in October 2022 secured Xi Jinping’s third term as General Secretary and secured a team of supporters amid socioeconomic woes and increasingly hostile global circumstances. While leadership matters in all political systems, it matters much more in totalitarian and authoritarian ones. Political leaders in democracies are constrained by electoral cycles, term limits, and approval ratings, but the leaders of the PRC’s single-party system that emphasizes discipline, hierarchy, and democratic centralism operate relatively unchecked by bureaucracy, opposition forces, or public opinion. Its leaders possess the ultimate decision-making authority in national security and strategic policies (Zhao, 2022, p. 5).The consolidation of Xi’s power has far-reaching implications for China’s foreign policy. As a feared, sycophantically revered, and ruthless emperor confident in his country’s military power and economic clout, Xi feels equipped to accomplish his mission of making China great again. He has also inherited a pervasive insecurity of pushback from Western powers that threatens his authoritarian rule. He has therefore upheld the security of the regime beyond Deng Xiaoping and his decades of prioritizing growth. Proactively stifling any opposition to his rule and cracking down on any hint of a “color revolution” at home in connection with foreign forces, Xi has strengthened the military and reorganized the economy in preparation for a possible showdown with the United States. He has required Chinese diplomats to act as “wolf warriors” in diplomatic battles and fight criticisms of the regime even at the cost of escalating international tensions. While his team of supporters has maximized his power to implement his policies, this has also prevented his colleagues from counseling against any mistakes they may anticipate or discover. Intentionally or not, he has minimized opportunities to correct his mistakes and increased the stakes and the risks they present, raising the potential for his country to become embroiled in a foreign adventure of no return.

Against All Odds

Against All Odds

Teachers’ and students’ perceptions of a sense of community in blended education

Universities have renewed interest in blended learning in preparation for post-COVID education. However, unsatisfactory social interactions hinder the quality of blended learning, despite its potential for flexible and personalized learning. In this situation, a sense of community would provide essential academic and social benefits. To develop a sense of community among students, we need to further understand students' and teachers' perceptions concerning this subject by exploring their experiences in blended learning. Therefore, we investigated this for three blended courses using a qualitative case study approach. We conducted: (1) classroom observation; (2) document analysis of course content, assignments, and assessments; and (3) individual interviews with teachers (n = 3) and group interviews with students (n = 18). The results showed the main factors that appeared to contribute to sense of community: group learning activities within courses, non-academic and extracurricular activities across courses, and the campus as a physical place integrating academic and social life after COVID. Further, we identified two obstacles: students valued group learning but struggled to manage group dynamics, and despite teachers' efforts to encourage learning autonomy, students viewed teachers as the ultimate authority in the learning process, which strained the student–teacher relationship. Additionally, this study revealed the limitations that digital tools have for promoting sense of community, as students questioned whether these tools have added value for supporting intricate and in-depth conversations. Finally, based on these findings, we provided practical recommendations for the future development of sense of community in blended learning.

Warsaw Ghetto Police: The Jewish Order Service During the Nazi Occupation by Katarzyna Person (review)

Reviewed by: Warsaw Ghetto Police: The Jewish Order Service During the Nazi Occupation by Katarzyna Person Gary Bruce Person, Katarzyna–Warsaw Ghetto Police: The Jewish Order Service During the Nazi Occupation. Ithaca: Cornell University Press, 2021. 232 p. In the late summer of 1942, the Jewish Order Service of the Warsaw ghetto brought roughly 6,000 people a day to the Umschlagplatz, where German authorities then deported them to Treblinka. The Service was savage in their rounding up of adults and children alike, many of the latter from Janusz Korczak’s orphanage. Jozef Szmerling, who oversaw the Umschlagplatz, was bestial. How it came to pass that Jews ruthlessly helped to dispatch other Jews to their deaths is the central question of Warsaw Ghetto Police. The Warsaw ghetto police was established in September 1940 when Adam Czerniakow, chairman of the Warsaw ghetto Judenrat (Jewish council), received orders to form a Jewish police force to assist with keeping order in the ghetto. Although the Service had some room to maneuver, it was never fully independent, reporting to the Judenrat, Polish Blue Police, and, the ultimate authority, the German civil administration. Czerniakow appointed Jozef Szerynski, a Jew who had converted to Catholicism, to oversee the roughly 2,000 strong ghetto police. It became immediately evident to ghetto residents that a position in the new police force would be advantageous. The author, Katarzyna Person, makes [End Page 232] a compelling case that the Service did not represent a cross-section of Jewish society, but was tilted towards the wealthy. The majority of the force had been office workers, merchants, or industrialists, as they were able to bribe their way into an organization that allowed them to avoid the roundups to labour camps. Although historians refer to the ghetto “police” as a shorthand, many of its tasks were more mundane than those of a police force, typically involving sanitation. They maintained general cleanliness in the ghetto, removed debris from pavement and roadways, monitored carts for safety, ensured horses were not overburdened, checked the ghetto walls for holes made by smugglers, and the like. Significantly, they were forbidden from conducting criminal cases, which remained the purview of the Blue Police and the German authorities. As time passed, their duties evolved to become more expansive and grislier. They established checkpoints in front of Judenrat buildings, collected debts from shops, and dealt with children who lay in the streets abandoned or dead. During “typhoid checks” on random dwellings, they beat Jews mercilessly and stole their money. In the spring of 1941, they began to round up Jews for labour detail and even furnished some of the guards at the labour camps. Such actions earned them the derogatory nickname “catchers” by other Jews and comparisons to officers in tsarist Russia who delivered Jews to the Russian military authorities. A tipping point in their duties came in November and December 1941 when the Jewish Order Service was used as an auxiliary in the execution of other Jews being held in a German prison. “For many,” Person writes, “these executions became a symbol of the final moral collapse of the Jewish police” (p. 74). Because of incidents like this, the service’s excessive use of force, and its terrible corruption, the service was vilified by ghetto residents, who described the force as “a collection of smugglers, Gestapo informers, and war profiteers” (p. 76). Oneg Shabbat, the underground group that ran the Ringelblum Archive, denounced the force as collaborators and betrayers of their own people. Emanuel Ringelblum himself was very critical of the force as well. Person is careful to point out that the force was not an “outsider” force of Jews who had converted to Catholicism, as might be implied by the situation of the Service’s leader. It was primarily composed of unassimilated Jews. This book is driven by a strong chronological narrative, with the occasional pause for analysis. Because Person’s analysis is so thoughtful, readers would no doubt desire more of it. One of the most intriguing sections of the book, for example, is her discussion of the concept of violence. As much as the Jewish policemen hid behind the standard refrain that “round ups carried out...