Monthly Archives: February 2010

Academia, Society

Ancient Suffragette City-State

I am a little disconcerted after reading Solomon and Higgins’ (2010, Chapter 10) discussion of sexual inequality throughout the ages. Though they are quick to point out many patriarchal societies and how they negatively effect the carriage of any woman’s philosophy through time, they fail to recognize societies that recognize the female and hold her in as high esteem as her male counterpart. Citing Aristotle, they are quick to point out the male-centric society of ancient Greece, but fail to educate us on the Spartan woman.

According to the historian Richard Monk (2006), “Sparta had an entirely different view of gender. Essentially, it ignored it” (para. 5). He continues to describe the Hellenistic age, post-Peloponnesian War, where the women of Sparta were on equal footing with men. This was also true, in fact, of Athens at the same time, though it is neglected by most historical scholars (Scott, 2009, p. 34). The fourth century (B.C.E.) was certainly a turning point for women’s rights in Greece (Scott, 2009, p. 39).

Two other key societies worth mentioning are the Norse and the Iriqouis (Vivante, 1999, p. xv; Ward, n.d., para. 9).

My thoughts on the importance of women in sociopolitical philosophy are the same as my thoughts for men. I do not distinguish between them. Any person with a stake in a society should be able to choose whether to have their voice heard or not. Sometimes, a message not spoken has the weight, if not more, than one that is. Speaking of women, specifically, I feel that they should be afforded the opportunity to enjoy the same rights, roles, and responsibilities of any person within their society. Unfortunately, societies throughout history seemed to not share my view.

Many early female philosophers have been lost to time and suppression by the patriarchal societies that failed to notice their worth. One stands out: Hypatia. Unfortunately, where she found freedom to express her views in public, she also found a horrible death in public.

“Fables should be taught as fables, myths as myths, and miracles as  poetic fancies.  To teach superstitions as truths is a most terrible  thing.  The child mind accepts and believes them, and only through  great pain and perhaps tragedy can he be in after years relieved of them.  In fact men will fight for a superstition quite as quickly as for a living truth often more so, since a superstition is so intangible you cannot get at it to refute it, but truth is a point of view, and so is changeable.” – Hypatia

 References

Monk, R. (2006, April 19). Greek civilization – What about the women? Retrieved February 25, 2010, from http://ezinearticles.com/?Greek-­Civilization-­%96-­What-­About-­The-­Women?&id=181596

Scott, M. (2009, November). The rise of women in ancient Greece. History Today, 59(11), 34-40. Retrieved from Academic Search Complete.

Solomon, R.C., & Higgins, K.M. (2010). The big questions: A short introduction to philosophy (8th ed.). Belmont, CA: Wadsworth, Cenrage Learning.

Vivante, B. (Ed.). (1999). Women’s roles in ancient civilizations: A reference guide. Westport, CT: Greenwood Press.

Ward, C. (n.d.). Sigríð stórráða Tóstadóttir: Queen Sigríð the Proud. The Viking Answer Lady. Retrieved from http://www.vikinganswerlady.com/SigridStorrada.shtml

Academia, Society

The Social Contracts of Hobbes, Locke, and Rousseau

Social contract theory indicates that we acquiesce to the demands of a society in order to benefit from membership within that society (Chafee, 2009; Solomon & Higgins, 2010). Some of these demands allow the formation of a power structure to guide the formation and growth of the society, while other demands cause the individual to relent to the values stipulated by the society. These values make up the morality of the society. Social contract theory was influenced, particularly, by Hobbes, Locke, and Rousseau (Solomon & Higgins, 2010, p. 291). Their theories are telling of the individual’s motivation for creating and belonging to a society, but I will explore how these theories relate to some of the constructs of society, namely morality and the roles and responsibilities of citizens within a society.

Before discussing societal constructs, it might be best to consider the ultimate nature of society and the power it holds over its citizens. The arguments appear to be two-sided: a) social contract, and b) entitled sovereignty (Chafee, 2009, p. 567). I argue that society is truly a social contract and any authority within society stems directly from this contract. Considering that the alternative is a rule by force, fear, and intimidation, one can only conclude that such a society is passively agreed with until a revolution is possible, which undermines the overreaching authority and replaces it.

This conflict arises between the populace (society) and government (a construct of society). Where there is no society, there can be no government, but in every society, there is a government (even an anarchist society has a form of governance, natural law). Hence, government is a by-product of society, which, by definition, is solely reliant on the social agreements of individuals indicating an equality within the creation of the contract, but not necessarily the execution of the contract. This is ideal in that it not only explains why uprisings and revolts occur when governments fail to work for the people, but it also explains why they should occur in these cases.

Tyranny is the unilateral enforcement of values placed upon a society. Morality is the cumulative set of values of a society, and it adapts to the constant change in these societal values. Justice, the governmental means of regulating morality, must have the participation of the society, lest tyranny takes hold. It is the responsibility of the individuals within a society to participate in every process of government to ensure that morality is even and that justice prevails. This participation need not be direct. Voting, military service, holding public office, or simply criticizing governmental policy are all ways in which individuals can participate. Hobbes, Locke, and Rousseau would agree that enforcing the social contract is the responsibility of every individual within a society, not only to ensure the status quo, but to ensure positive growth and continuity.

As a libertarian, I can appreciate the social contract theories of Hobbes, Locke, and Rousseau. In my view, do what you will so long as you do not infringe on the rights of others. Though many aspects of this philosophy can be argued against, it remains as good as any starting point to maintain freedom and equality within a society while still demanding responsibility for the outcome.

References

Chafee, J. (2009). The philosopher’s way: Thinking critically about profound ideas (2nd ed.). Upper Saddle River, N.J.: Pearson Prentice Hall.

Solomon, R. C., & Higgins, K. M. (2010). The big questions: A short introduction to philosophy (8th ed.). Belmont, C.A.: Wadsworth, Cengage Learning.

Academia, Health Care, Public Health

Health Promotion: Workplace Health Screening

Cardiovascular disease (CVD), diabetes mellitus (DM), and colorectal cancer (CRC) are all significant health concerns facing us today (Anonymous, 2005; Bagai, Parsons, Malone, Fantino, Paszat, & Rabeneck, 2007; de Koning, 2009; Korhonen, Jaatinen, Aarnio, Kantola, & Saaresranta, 2008; Matthews, Nattinger, Venkatesan, & Shaker, 2007). In the U.S., CRC is estimated to kill 56,000 people per year, while, in the U.K., the numbers are around 16,000. (Anonymous, 2005). CVD is on the decline but is expected to continue to have a global impact, taking off the most years of life, and DM creates a 4-fold increase of dying from CVD (de Koenig, 2009).

Through efforts at targeting healthy lifestyle changes, the mortality of these diseases has decreased over the past few years, but the numbers remain high, and studies suggest that identifying those people with risk factors or early signs of disease helps to both treat for the disease effectively and decrease the overall incidence (Anonymous, 2005; Bagai et al., 2007; de Koning, 2009; Matthews et al., 2007).

As Bagai et al. (2007) point out, health promotion activities focused on screening are notably scarce within the workplace. Researchers, Hamashima and Yoshida, have shown that early detection of CRC is effective at decreasing overall morbidity (as cited in Bagai et al., 2009). Bagai et al. attempted to apply this reasoning within the confines of a typical Canadian work environment by introducing CRC screening to the men and women of the Toronto police force. With workplace screening programs being limited in Canada, Bagai et al. hoped to show the effectiveness of these screening programs, and they were successful, but unfortunately, the participation in the study was limited.

Another study (Matthews et al., 2007) aims at increasing CRC screening among the residents of the Midwestern States in the U.S. The literature seems to suggest that participation in screening procedures is contingent on education and insistence by the physician, specifically.

Not only does this correlate to the thought that the primary care physician has an important role in screening and detecting disease, but in order for workplace screening programs to be successful, the physicians need to make the recommendation that the patient uses the screening programs available to him or her.

Korhonen et al. (2008) used the waist circumference criteria (women: 88 cm; men: 102 cm) set forth by the American Heart Association and the National Heart, Lung, and Blood Institute to assess the effectiveness of at-home screening for CVD and DM risk by using a simple questionnaire and a tape measure. Taking very little time and requiring little expertise, this process could be incorporated with any workplace screening program to increase its efficacy.

Increasing these screening programs, particularly within the workplace, should target the population most at risk to CRC, CVD, and DM. Targeting specific risk groups to educate about these diseases should ultimately lead to a higher survivability, decreased incidence, and lower morbidity rates. More research should be aimed at studying the effects of more targeted workplace health screenings to understand how this tool could be best implemented to provide better screening for CVD, DM, CRC, and, perhaps, other pathological processes.

References

Anonymous. (2005). Colorectal cancer: Not an embarrassing problem. Lancet, 366, 521. doi:10.1016/S0140-6736(05)67030-4

Bagai, A., Parsons, K., Malone, B., Fantino, J., Paszat, L., & Rabeneck, L. (2007). Workplace colorectal cancer–screening awareness programs: An adjunct to primary care practice? Journal of Community Health, 32(3), 157-167. doi:10.1007/s10900-006-9042-4

Cyranoski, D. & Williams, R. (2005). Health study sets sights on a million people. Nature, 434, 812. doi:10.1038/434812a

de Koning, H. J. (2009). Testing at home—the screening of the future? European Journal of Public Health, 19(1), 5–6. doi:10.1093/eurpub/ckn120

Geltman, P. L., & Cochran, J. (2005). A private-sector preferred provider network model for public health screening of newly resettled refugees. American Journal of Public Health, 95, 196-199. doi:10.2105/AJPH.2004.040311

Korhonen, P. E., Jaatinen, P. T., Aarnio, P. T., Kantola, I. M., & Saaresranta, T. (2008). Waist circumference home measurement – a device to find out patients in cardiovascular risk. European Journal of Public Health, 19(1), 95–99. doi:10.1093/eurpub/ckn090

Matthews, B. A., Nattinger, A. B., Venkatesan, T., & Shaker, R. (2007). Colorectal cancer screening among Midwestern community-based residents: Indicators of success. Journal of Community Health, 32(2), 103-120. doi:10.1007/s10900-006-9038-0

Smith, G. D., Ebrahim, S., Lewis, S., Hansell, A. L., Palmer, L. J., & Burton, P. R. (2005). Genetic epidemiology 7: Genetic epidemiology and public health: Hope, hype, and future prospects. Lancet, 366, 1484-1498. doi:10.1016/S0140-6736(05)67601-5

Academia, Society

The Nature of Truth

Truth transcends knowledge, and knowledge transcends belief. Too many people invert these values to claim that their beliefs are true. In order to understand truth, it makes sense to first explore knowledge and belief and how, as humans, we use these constructs.

In the search for truth and knowledge, we as humans develop a belief structure based on observation over time. As this belief system develops, we start to draw correlations and presume conclusions based on the perceived degree of believability for each new belief, a system of fuzzy logic (Hajek, 2009), and how each relates to another. It is only when beliefs correlate well with other beliefs regarding the same subject do we get to claim knowledge.

I define knowledge as the agreement of beliefs within the study of interrelated subjects. Science is the process used to attain knowledge (“Science”, 2010). However, science can be wrong. This has been proven throughout history, time and time again. Science can only prove “provisional truths[, or] answers that are the best explanation for things at the present time” (Jackson, 2006, 1). It is these provisional truths that I regard as knowledge.

Truth, in the ultimate terms, cannot be false to any degree. It is easy to create truth from knowledge by applying conditions confining it. Ergo, the belief that dogs are dangerous is not true, nor is it knowledge, though there is truth in the statement that some dogs can be dangerous. Likewise, any other broad and sweeping generalization could create a false, but widely held belief. It is much more difficult to attain a universal, or absolute, truth, such as the God of Christianity is the architect and creator of the universe and all life within it, or that life is just a natural process and has no dependent relationship with any singular intelligent being.

Some absolute truths, however, can be attained. One such truth is that mortal existence ceases upon death. Death, in fact, is the definition of the end of mortal existence. This definition has been formed by observation, the creation of beliefs, and acceptance of these beliefs as knowledge. Though, if our beliefs and knowledge about death were different, as they once were, it would not negate the truth.

Another absolute truth is that life is revolutionary, or cyclical. Otherwise, what is the point of attaining knowledge and understanding truth if it cannot be used to our benefit?

References

Hajek, P. (2009). Fuzzy Logic. In Edward N. Zalta (Ed.), The Stanford Encyclopedia of Philosophy [Spring ed.]. Retrieved from http://plato.stanford.edu/archives/spr2009/entries/logic-fuzzy/

Jackson, J. (2006). Science has been wrong before. UK-Skeptics. Retrieved from http://www.skeptics.org.uk/article.php?dir=articles&article=science_has_been_wrong_ before.php

Science. (2010). Merriam-Webster Online Dictionary. Retrieved from http://www.merriam-webster.com/dictionary/science

Academia, Health Care, Public Health

The Impact of Stages of Life on Health

During our lifetimes, we are met with all kinds of obstacles to overcome, whether in business, society, or in moral dilemmas. None as true as in our health and wellness. During each major stage of life, there are many health challenges and risks that must be met and overcome. The importance of identifying challenges in each developmental stage of life is crucial to the promotion and adoption of healthy changes in behavior (Green, 1984). I will explore how lifestyle and behavioral choices, as well as social determinants of health, can impact these health risks and challenges as they relate to the various life-stages. Kolbe (as cited in Green, 1984) indicates a number of “health-related types of behaviors” (p.218), some of which I will address for each life-stage and transition between life-stages. As we transcend each stage of our lives, new and evolving concerns obstruct our path to wellness. We tend to approach our health from the present, the here and now, but it starts before our birth and, with genetics, possibly before conception.

Once we are conceived, we are locked into the care of our parents to be. Whether a mother and father, a single working parent, a single drug-addicted parent, caring grandparents, foster care, the State, or a host of other possibilities, each is suggestive of the environment to which we will be born and/or raised. This environment will surely shape our health from within the womb and health professionals are tasked with providing directed education to the parents-to-be to give the child the best chance of a healthy development.

The importance of maternal health to the fetus has become a focus in public health over the last century, but emerging research is showing how best to approach this topic. “Two principal threats to infant health are low birth weight and congenital disorders including birth defects” (Green, 1984). Though technological advances are proving helpful in high-risk pregnancies (Blincoe, 2007), prevention and education is still key. A recent literature review (Slama et al., 2008) has identified some links between environmental toxins and neonatal health, calling for more specialized research in this area. Exposure by pregnant women to toxins, such as that from pharmaceuticals, cigarette smoke, and contaminated fish, pose significant threats to the fetus (Gwiazda, Campbell, & Smith, 2005; Landrigan, Kimmel, Correa, & Eskenazi, 2004). Family violence towards the mother-to-be also serves a significant threat to children in utero. A study by Amaro, Fried, Cabral and Zuckerman (1990) reveals that women who have a poor support structure, a history of depression, and current alcohol and illicit drug abuse are more prone to be victims of violence, which threatens the pregnancy.

Infancy is the most crucial of the developmental stages for cognitive, social, and emotional development (Centers for Disease Control, 2009). The environment in which the infant development takes place is a key determinant to the level of neonatal and infant health. Lead, as well as other environmental toxins and notwithstanding comprehensive abatement programs, still threatens the development of infants and young children (Gwiazda et al., 2005; Landrigan et al., 2004). As infants develop into toddlers and young children, the threat focus shifts from indirect toxin exposure to direct accidental poisoning and physical trauma.

As children start to walk and gain enough strength and ingenuity to open doors and containers, there is an increased risk of accidental poisoning by household goods (Hockey, Reith, & Miles, 2000). Though accidental poisoning has been mitigated to a degree by the “Mr. Yuck” campaign (Children’s Hospital of Pittsburgh, University of Pittsburgh Medical Center, 1971/2009) and the introduction of childproof containers, many poisonings still occur, some being purposeful by loved ones (Davis et al., 1998) but most are accidental. Poisoning included, trauma remains the leading cause of childhood death (Green, 1984, p. 225; Harkins, 2009).

The transition into puberty comes with a change in physiology, both in the body and in the brain. Adolescents must contend with a new found, and usually intense, libido. With this, the adolescent faces the threat of early pregnancy and a host of sexually transmitted diseases. Though public health education efforts seem to be effective on some levels, teenage pregnancy and STD’s remain a constant concern.

Green (1984) also finds that teenagers also find themselves expanding and exploring their environments with their increased autonomy. Increased risk-taking attitudes typically lead to a high likelihood of trauma, which, as is true for younger children, remains the leading cause of death for adolescents, though the associated poisoning is attributed more to recreational and experimental illicit drug use and abuse.

Transitioning into adulthood, the health focus begins to shift towards disease processes and away from trauma, except for, perhaps, motor vehicle and occupational incidents. Green (1984) supposes that this is from a “curtailed freedom [and] increased responsibility for lifestyle” along with “reduced parenting roles, changing bodily functions, [and] reduced activity” (Table 3). It is within these years that other responsibilities can seem to outweigh those of health, probably attributable to a high sense of health as active teenagers and a perceived need to be successful within their personal economy. This loss of health focus can certainly lead to disease processes, such as atherosclerosis, hypertension, and obesity, which can, in turn, lead to an early stroke or heart attack. It makes sense to consider that behavioral health changes within the early adult years can impact the later adult and senior adult years.

As we age towards our retirement, our picture of health tends to become more obvious. Many of us will suffer from hypertension, coronary artery disease, diabetes, and elevated cholesterol levels. Some of us will have already suffered a heart attack or stroke, and some others might soon. At this point in life, it is imperative to have frequent check ups with a physician who will probably attempt to control most of the underlying risk factor diseases mentioned above with pharmaceuticals. Though we can try to adopt healthier behaviors, by the time we reach our senior years, most of the physiologic damage is irreparable. There is some promise, however, as “the elderly are found in evaluative research studies to be as much if not more responsive to behavioral change supports than younger patients or subjects” (as cited in Green, 1984, p. 228).

One of these changes is osteoporosis, or a weakening of the calcium bone matrix. As we grow through childhood, our bones are formative and calcium is readily bonded within the bone structure providing the skeletal framework for the rest of our lives. The elderly suffer the most from any calcium deficiency, as the threat of simple fall can lead to a catastrophic injury requiring surgery for correction or a permanent fracture if the person does not have strong enough bones. This will most certainly result in the loss of the person’s ability to maintain his or her activities of daily living which can result in having to rely on residential nursing care. A lifetime of cigarette smoking, heart disease, or generally poor health can lead to the same degree of disability requiring the same type of care.

Skilled nursing facilities, though important for the continual care or rehabilitation of the elderly and infirm, have risks for the in-patient just as any other treatment might. Skilled nursing facilities are a vector of a number of nosocomial infections, usually medically resistant, which can and often does lead to a serious condition known as sepsis, a life-threatening infectious condition that overcomes the bodies ability to self-regulate. Sepsis is largely fatal. Confinement in a nursing facility is also associated with an increased incidence of depression and loss of constitution (Green, 1984).

As we have discussed some of the more prominent challenges that we face at each stage of our lives, we need to understand some of the determinants that affect our health. So long as we are aware of these, we can change our lifestyle and behaviors to minimize the impact of some of the negative determinants. In my opinion, the most important determinant of health is the availability of clean water, then perhaps, the availability of whole food and decent shelter. I feel that these are most important because they are the most difficult to correct as an individual. Following these, I feel that the availability of comprehensive health care is important.

This paper is based on research conducted primarily in developed Western society; therefore, it does not address the problem of extreme poverty and other determinants of health attributed to it. One example of this is provided by Kiapa-Iwa and Hart (2004) who show an increase risk of health with a prevalence of high-risk pregnancy and STD’s in the impoverished region of Uganda. Whether we are discussing Britain’s Liverpool, the Mid-west United States, or Uganda, we must admit that a focus on education and prevention, such as safe-sex programs, safe storage of medications and firearms, defensive driving, and others, seem to be the most effective means of mitigating some of the more controllable health determinants for parents and children, as well as adolescents. Older adults and seniors need to have a comprehensive program directed by their physician, including a healthy diet, exercise, and controlling medical problems such as hypertension and diabetes to increase their health status.

References

Amaro, H., Fried, L. E., Cabral, H., & Zuckerman, B. (1990). Violence during pregnancy and substance use [Abstract]. American Journal of Public Health, 80(5), 575-579. doi:10.2105/AJPH.80.5.575

Blincoe, A. J. (2007, October). Doppler sonography: Improving outcome in high risk pregnancy. British Journal of Midwifery, 15(10), 650-653. Retrieved from http://www.britishjournalofmidwifery.com/

Centers for Disease Control. (2009, May 7). Child development. Retrieved from http://www.cdc.gov/ncbddd/child/default.htm

Children’s Hospital of Pittsburgh, University of Pittsburgh Medical Center. (1971/2009). About Mr. Yuck. Retrieved from http://www.upmc.com/Services/poisoncenter/Pages/about-mryuk.aspx

Davis, P., McClure, R. J., Rolfe, K., Chessman, N., Pearson, S., Sibert, J. R., Meadow, R. (1998). Procedures, placement, and risks of further abuse after Munchausen syndrome by proxy, non-accidental poisoning, and non-accidental suffocation. Archives of Disease in Childhood, 78, 217-221. doi:10.1136/adc.78.3.217

Green, L. W. (1984). Modifying and developing health behavior. Annual Review of Public Health, 5, 215-236. doi:10.1146/annurev.pu.05.050184.001243

Gwiazda, R., Campbell, C., & Smith, D. (2005, January). A noninvasive isotopic approach to estimate the bone lead contribution to blood in children: Implications for assessing the efficacy of lead abatement. Environmental Health Perspectives, 113(1), 104-110. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1253718/pdf/ehp0113-000104.pdf

Hockey, R., Reith, D., Miles, E. (2000, July). Injury bulletin: Childhood poisoning and ingestion [Injury Bulletin No. 60]. Queensland Injury Surveillance Unit. Retrieved from http://www.qisu.org.au/modcore/PreviousBulliten/backend/upload_file/issue060.pdf

Harkins, D., (2009). Pediatric trauma in the spotlight. Journal of Trauma Nursing, 16(3), 123-125. Retrieved from http://content.ebscohost.com/pdf23_24/pdf/2009/39B/01Jul09/ 44454466.pdf

Kiapi-Iwa, L., & Hart, G. J. (2004). The sexual and reproductive health of young people in Adjumani district, Uganda: Qualitative study of the role of formal, informal and traditional health providers. AIDS Care, 16(3), 339-347. doi:10.1080/09540120410001665349

Landrigan, P. J., Kimmel, C. A., Correa, A., & Eskenazi, B. (2004, February). Children’s health and the environment: public health issues and challenges for risk assessment. Environmental Health Perspectives, 112(2), 257-265. doi:10.1289/ehp.6115

Slama, R., Darrow, L., Parker, J., Woodruff, T. J., Strickland, M., Nieuwenhuijsen, M., …Ritz, B. (2008). Meeting report: Atmospheric pollution and human reproduction. Environmental Health Perspectives, 1161(61), 791-798. doi:10.1289/ehp.11074

Academia, Health Care, Public Health, Society, Technology

Direct To Consumer Advertising: Patient Education

Today, we are familiar with mass-media marketing of prescription drugs not only to physicians but to patients as well, known as direct-to-consumer advertising (DTCA). Though, many argue that a better informed patient allows for more autonomy in physcian-directed care (Buckley, 2004; Lyles, 2002; Sumpradit, Fors, & McCormick, 2002), “the evidence for DTCA’s increase in pharmaceutical sales is as impressive as is the lack of evidence concerning its impact on the health of the public” (Lyles, 2002, p. 73). Concerns abound regarding the ability of the physician to direct the care of a patient driven by DTCA. Many researcher’s, including Buckley (2004) and Green (2007) believe that many physicians prescribe medications solely on the request of the patient without providing guidance or education to the patient.

As a paramedic, I hear the concerns of patient’s regarding physician refusals to prescribe name-brand drugs to patients. These patients are almost militant about their beliefs of their illness and that the physician should honor the requests of their patients. While these patients never seem to find a resolution, I also see many people who trust in their physicians’ role and, with education, discuss with their physicians the possibilities and concerns of advertised medications. As one secondary data analysis (Sumpradit et al, 2002) suggests, though there is no demographic difference in the propensity of patients to ask their doctor for a medication based on DTCA alone versus seeking more information from their doctor, those with chronic conditions and who have poorer perception of health status tend to engage their physicians more often to clarify information garnered from DTCA’s.

I feel that DTCA is can be an empowering tool for the patient as long as it is educational, honest, and forthcoming. Empowering the patient to take an active role in his or her medical care is very important, but this empowerment comes with responsibility to be as fully educated as possible, allowing the physician his or her role in the relationship as the ultimate patient advocate, which some physicians lack.

References

Buckley, J. (2004). Pharmaceutical marketing: Time for change. Electronic Journal of Business Ethics and Organization Studies, 9(2), 4-11.

Green, J. A. (2007). Pharmaceutical Marketing Research and the Prescribing Physician. Annals of Internal Medicine, 146(10), 742-748.

Lyles, A. (2002). Direct marketing of pharmaceuticals to consumers [Abstract]. Annual Review of Public Health, 23, 73-91.

Sumpradit, N., Fors, S. W., McCormick, L. (2002). Consumers’ attitudes and behavior toward prescription drug advertising. American Journal of Health Behavior, 26(1), 68-75.

Academia, Society

The Problem of Evil

There is a boding question about the “evils” of the world, and many people need to justify the necessity of evil through faith. I define faith as deduction, induction, or hope. With this definition, it only makes sense to me that so many people in the world, and throughout history, have faith in a supreme being and a just and rewarding afterlife. Solomon and Higgins (2010) present the discussion of evil in contrast to the goodness and how it relates to God. Chafee (2009), like Solomon and Higgins (2010), examines only the religious concepts of evil, but he does state one important truth, “the existence of evil in the world poses a serious threat to religion in general, and the concept of an all-loving, all-powerful God in particular” (p. 391). The argument that if evil exists then there can be no omnibenevolent, omnipotent, and omniscient God acknowledges the existence of evil and denies the existence of God. To me, the word evil seems to have too many religious connotations for academic consideration, as for those that do not believe in God, this contrast between good and bad loses meaning and application. For this same reason, it is difficult for me, I admit, to discuss evil in the context of God and religion. To do so would mean that I have suspended my faith and beliefs.

To discuss evil, I must remove the religious connotations and define it in acceptable terms. The word evil embodies all that is harmful, but what is harmful for one might be curative for another. For there to be good in the world, there must be equal bad to contrast, essentially giving the good its value in comparison to the bad. One might argue that good gives value to bad, also. This is commonly referred to as “the Contrast View” and is in direct disagreement with Martin Buber’s (1981) view of evil as inattention to moral ways. Things that have no morals (e.g. nature) can be perceived as evil, thereby providing an argument to Buber, though I believe that Buber’s views are that of some of the humanistic causes of evil.

Evil, or the bad in the world, is simply a lack of good, just as black is a lack of white, and cold, a lack of heat. Consider, though, that an unfortunate event can be viewed as evil to one person and can prove fortunate to another. Therefore, I consider evil to only be a perception of an individual grading fortune and misfortune on a scale of good and bad.

References

Buber, M. (1981). Good and evil. Upper Saddle River, N.J.: Prentice Hall.

Chafee, J. (2009). The philosopher’s way: Thinking critically about profound ideas (2nd ed.). Upper Saddle River, N.J.: Pearson Prentice Hall.

Solomon, R. C., & Higgins, K. M. (2010). The big questions: A short introduction to philosophy (8th ed.). Belmont, C.A.: Wadsworth, Cengage Learning.

Academia, Society

Perception is Reality

For Peyton Farquhar, belief acquiesed to knowledge the moment that he felt his neck break, the last of his mortal feelings (Bierce, 1909/1966, Chapter 3). While reading “An Occurence at Owl Creek Bridge”, I was taken in by the author’s use of the omniscient narrator’s descriptions of Farquhar’s perceptions. And, as I have stated before, perception is reality. In order to contrast what is real and what is not, we must acknowledge that there are separate realities for each perceiver, and each perception must be that of consequence. The old rhetoric asks, “If a tree falls in the wood and there is no one around to hear it, does it make a sound?” My reply is, “How do you know that the tree fell?” This, however, does not answer the question, but it starts us on a journey to find the meaning of reality and which reality we are defining.

In the question about the tree in the wood, there is a consequence of the falling action, which is a transfer of energy to the vegetation and ground which it strikes. There is also the vibration of the air around the tree agitated by the sudden separation. The question here is if it made a sound. Very simply, these vibrations are perceived as sound by using the ear as an antenna, the ear drum as a modulator, and the brain as a filter and recorder. If there is neither any living thing in audible proximity to the fall, nor an analog recording device capable of reproducing the sound as testimony, then I argue that the tree did not make a sound. Further, one could argue that only the brain makes the sound by interpretting the vibrations; therefore, falling trees do not make any sound and any recording is only a recording of vibrations of air. Is this just semantics? Because this argument depends largely on how “sound” is defined, I believe it is. The same is true for color.

By my statement that perception is reality, I mean that our reality is defined by our perceptions, though it does not mean that what is real to me must be real to anyone else. One could also say that life is defined through experiences, but again, it is truly the individual perception of these experiences that matter, nothing else. “A philosophy is the expression of a man’s intimate character, and all definitions of the universe are but the deliberately adopted reactions of human characters upon it” (James, 1909, p. 20).

In Bierce (1909/1966), Peyton Farquhar perceived an ordeal where he was spared a hanging because of chance. Consider my theory, both metaphysically and astrophysically, that the Universe is infinite and, thereby, everything that can happen does happen. The term “Universe” here is a misnomer. I am actually describing a Multiverse with an infinite number of Universes, each a separate and distinct realm based on a choice, decision, and consequence. Picture an infinite number of Universes that are, initially, exactly the same, then there comes a choice to be made: option A or option B. Half of the Universes take on the consequences of option A while the remaining half take on option B, then there is another choice to be made, and the Multiverse splits infinitely in half based on the infinite choices that are made. This theory would promote realms where the choices not made in our Universe may or may not be consequent. Did Peyton Farquhar get a glimpse of an alternate reality in which the supply sergeant failed to care for the rope appropriately? Though it might be possible, it does not matter. Peyton Farquhar perceived his death immediately after, subsequently defining his reality, and for a split second, giving him knowledge. Though, if he continued the experience of escaping his death even after his death is witnessed by the executioner and his peers, one could argue that reality had split and though Peyton was dead, perhaps he lived on in another reality. This, I believe, is the basis of the religious context of Heaven and Hell. You can believe in Heaven, Hell, or nothing in particular; until you experience it, you have no knowledge of it.

If we can never glimpse the alternate realities, then we cannot perceive them; therefore, they are not real.

References

Bierce, A. (1966). An occurrence at Owl Creek Bridge. The collected works of Ambrose Bierce (Vol. 2, pp. 27-45). Retrieved from Project Gutenberg: http://www.gutenberg.org/files/13334/13334-h/13334-h.htm (Original work published 1909)

James, W. (1909). A pluralistic universe. Retrieved from http://books.google.com/books

Academia, Culture, Emergency Management, Emergency Medical Services, Health Care, Technology

Improving Traffic Safety for Emergency Responders

The Emergency Medical Services (EMS) is an occupational field wrought with opportunities for workers to become ill, injured, or succumb to death while performing the functions of their job (Maguire, Hunting, Smith, & Levick, 2002). In the mid-1980’s, Iglewicz, Rosenman, Iglewicz, O’Leary, and Hockmeier (1984) were among the first to perform research into the occupational health of EMS workers by uncovering unhealthy carbon monoxide levels in the work area. This appears to have been the impetus for further research into uncovering some of the causes and contributing factors of illness and injury incidents, as well as safer alternatives to current work practices.

One of the more recent efforts to protect EMS workers relates to traffic-related injuries and fatalities of EMS workers while responding to calls and working on the scenes of traffic accidents. As important it is for the EMS workers to be able to get to the scene of an emergency and work without threat of injury, the safety of the community is important to consider. Solomon (1990) realized the need to improve safety in this area and recommended changing the paint color of emergency apparatus to more visible lime-green. Emergency workers were continuing to fall victim to “secondary incidents” at roadway scenes (Cumberland Valley Volunteer Firemen’s Association, 1999). An analysis of EMS worker fatalities between 1992 and 1997 reveals an occupational fatality rate that continues to exceed that of the general population (Maguire, Hunting, Smith, & Levick, 2002).

Across the pond, in the United Kingdom, efforts were also underway to improve the visibility of police vehicles by considering various paint design schemes, including the Battenburg design: alternating blocks of contrasting colour (Harrison, 2004). Harrison concluded that the half-Battenburg design showed promise as it increased visibility and recognition of police cars in the United Kingdom, and the United States National Institute of Justice was considering research on the efficacy of the Battenburg design here in the United States to promote officer safety. EMS administrations are known for paying special attention to the bandwagon, that is they frequently make changes based on inconclusive and sporadic evidence. This is the case with recent ambulance designs.

Many ambulances in the New England, as well as other parts of the country, are being designed with the half-Battenburg markings applied to the sides of the vehicles in attempts to improve the safety of EMS workers. Unfortunately, we may find that these markings might have an unintended effect of confusing other drivers and causing more problems. A recent study found that Harrison (2004) was correct in that the Battenburg design assisted British drivers in quickly identifying British police vehicles, but the “effectiveness of the ‘Battenburg’ pattern in the UK appears primarily related to its association with police vehicles in that country” (Federal Emergency Management Agency, Department of Homeland Security, 2009, p. 6) having little effect on the recognition potential of American drivers.

Perhaps with the evolving data, we can begin using an evidence-based approach at helping the EMS worker perform his or her job safely at traffic scenes.

References

Cumberland Valley Volunteer Firemen’s Association. (1999). Protecting Emergency Responders on the Highways: A White Paper. Emmitsburg, MD: United States Fire Administration.

Federal Emergency Management Agency, Department of Homeland Security. (2009). Emergency vehicle visibility and conspicuity study [Catalog No. FEMA FA-323]. Emmittsburg, MD: United States Fire Administration.

Harrison, P. (2004). High-conspicuity livery for police vehicles [Publication No. 14/04]. Hertfordshire, U.K.: Home Office, Police Scientific Development Branch. Retrieved from http://scienceandresearch.homeoffice.gov.uk/hosdb/publications/road-policing-publications/14-04-High-Conspicuity-Li12835.pdf

Iglewicz, R., Rosenman, K.D., Iglewicz, B., O’Leary, K., & Hockmeier, R. (1984). Elevated levels of carbon monoxide in the patient compartment of ambulances. American Journal of Public Health, 74(5).

Maguire, B.J., Hunting, K.L., Smith, G.S., and Levick, N.R. (2002). Occupational fatalities in emergency medical services: A hidden crisis. Annals of Emergency Medicine, 40(6), 625-632. doi: 10.1067/mem.2002.128681

Solomon, S.S. (1990). Lime-yellow color as related to reduction of serious fire apparatus accidents: The case for visibility in emergency vehicle accident avoidance. Journal of the American Optometric Association, 61, 827-831.