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Present Era (present + era)
Selected AbstractsThe Expansion of Global Governance into the Third World: Altruism, Realism, or Constructivism?INTERNATIONAL STUDIES REVIEW, Issue 1 2004Yakub Halabi This essay examines the expansion of global governance into developing countries. Its central thesis is that in the present era of globalization, competitiveness has become a major concern for developed countries, in particular, those facing tough competition from the developing states that have improved their terms of trade through state-led development strategies and have become major exporters of manufactured products. Developed countries seek the expansion of global governance in order to regulate the behavior of these developing states, thereby opening their economies to foreign investment and augmenting their wealth. Yet, a successful expansion of global governance requires the creation of internal institutions in the developing countries that may alter their political cultures. Given the unique problems of the developing states, this task cannot be achieved simply by internationalizing the countries in the Global South. This essay relies on the theory of social constructivism and contends that the creation of internal institutions compatible with global governance has been achieved only when developing countries have become convinced that global regulations will benefit them, not just the more developed states. [source] From critical care to comfort care: the sustaining value of humourJOURNAL OF CLINICAL NURSING, Issue 8 2008Ruth Anne Kinsman Dean PhD Aims and objectives., To identify commonalities in the findings of two research studies on humour in diverse settings to illustrate the value of humour in team work and patient care, despite differing contexts. Background., Humour research in health care commonly identifies the value of humour for enabling communication, fostering relationships, easing tension and managing emotions. Other studies identify situations involving serious discussion, life-threatening circumstances and high anxiety as places where humour may not be appropriate. Our research demonstrates that humour is significant even where such circumstances are common place. Method., Clinical ethnography was the method for both studies. Each researcher conducted observational fieldwork in the cultural context of a healthcare setting, writing extensive fieldnotes after each period of observation. Additional data sources were informal conversations with patients and families and semi-structured interviews with members of the healthcare team. Data analysis involved line-by-line analysis of transcripts and fieldnotes with identification of codes and eventual collapse into categories and overarching themes. Results., Common themes from both studies included the value of humour for team work, emotion management and maintaining human connections. Humour served to enable co-operation, relieve tensions, develop emotional flexibility and to ,humanise' the healthcare experience for both caregivers and recipients of care. Conclusions., Humour is often considered trivial or unprofessional; this research verifies that it is neither. The value of humour resides, not in its capacity to alter physical reality, but in its capacity for affective or psychological change which enhances the humanity of an experience, for both care providers and recipients of care. Relevance to clinical practice., In the present era which emphasises technology, efficiency and outcomes, humour is crucial for promoting team relationships and for maintaining the human dimension of health care. Nurses should not be reluctant to use humour as a part of compassionate and personalised care, even in critical situations. [source] Rhinocerebral mucormycosis: the disease spectrum in 27 patientsMYCOSES, Issue 4 2007Sandeep Mohindra Summary The variable forms of clinical complaints, findings and time interval of presentation in 27 cases of mucormycosis have been described, which were encountered over a span of 8 years. The previous concept about this fungal infection attacking chronic, debilitated, immunocompromised patients does not appear to hold true. Seven of the 27 patients (22.2%) did not reveal any predisposing factors and their outcome of 42.9% survival seems to be poorer than the total outcome (66.7%). ,Chronic form' of disease presentation, the definition of which is still not delineated, was encountered in four patients (14.8%). Again, the outcome was not significantly different from the total survival. Burr-hole tap of an intracranial abscess revealing mucor in a 2-month-old infant has been described. Even in the present era, extranasal exenteration of sinuses along with disfiguring orbital exenteration is required to ensure satisfactory surgical debridement. Control of the underlying predisposing illness, along with the aggressive surgical debridement and the parenteral administration of amphotericin B, remains the treatment essentials even today. [source] Sovereignty, Migration and the Rule of Law in Global TimesTHE MODERN LAW REVIEW, Issue 4 2004Catherine Dauvergne This article argues that in the present era of globalisation, control over the movement of people has become the last bastion of sovereignty. This is important both to theoretical accounts of globalisation and to policy decisions by governments. Nation states threatened with loss of control in other realms are implementing a variety of ,crackdown' measures in questions of immigration. Issues of refugee law, illegal migration and skilled migration each challenge sovereignty in specific ways. While international human rights standards have made few inroads in questions of migration, recent decisions in England and Australia suggest that the rule of law may be emerging as a counter to traditional executive free reign in matters of migration law. [source] Ductal adenocarcinoma of the prostate diagnosed on transurethral biopsy or resection is not always indicative of aggressive disease: implications for clinical managementBJU INTERNATIONAL, Issue 4 2010Hakan Aydin Study Type , Prognosis (case series) Level of Evidence 4 OBJECTIVE To report the clinicopathological characteristics of 23 cases of ductal adenocarcinoma of the prostate (DCP) and discuss the implications for clinical management, as DCP is considered an aggressive subtype of prostate adenocarcinoma (PA). PATIENTS AND METHODS The presence of DCP in transrectal ultrasonography-guided prostate biopsy (TRUSB) is associated with adverse pathological findings at radical prostatectomy (RP) and clinical outcomes, and the significance of detecting DCP initially in transurethral biopsy (UB) or transurethral resection (TURP) in the present era of screening with prostate-specific antigen (PSA) is unclear. The study included 23 cases of pure DCP without acinar PA diagnosed on UB or TURP. Demographic information, serum PSA level, follow-up surgical procedures (RP, TURP or TRUSB) and outcome data were collected. RESULTS The mean age of the men was 67.5 years and the mean PSA level before the procedure was 12.5 ng/mL; 14 cases were detected on UB and nine were diagnosed on TURP. The mean (range) follow-up was 4 (1,23) months after the initial procedure. In all, 21 (89%) patients had DCP or PA in follow-up procedures. Two (11%) patients had no residual cancer, one on RP and the other on two repeat TURPs. DCP or PA was found in 12 RP cases; four patients had Gleason score 7 PA, three of which were organ-confined, and eight had Gleason score ,8 PA. Extraprostatic extension, seminal vesicle invasion and regional lymph node metastasis were present in seven, six and two cases, respectively. CONCLUSIONS Most DCP diagnosed on UB or TURP in this contemporary series was associated with aggressive PA, but a subset presented as a small periurethral tumour with no concomitant acinar PA, and was eradicated by the initial biopsy/TURP alone. We recommend that patients with a diagnosis of DCP on UB or TURP undergo follow-up TURP and TRUSB before radical surgery is offered. [source] | ||||||||||