This paper describes a practice innovation: the addition of formal weekly discussions of patients with prolonged PICU stay to reduce healthcare providers’ moral distress and decrease length of stay for patients with life-threatening illnesses. We evaluated the innovation using a pre/post intervention design measuring provider moral distress and comparing patient outcomes using retrospective historical controls. Physicians and nurses on staff in our pediatric intensive care unit in a quaternary care children's hospital participated in the evaluation. There were 60 patients in (...) the interventional group and 66 patients in the historical control group. We evaluated the impact of weekly meetings to establish goals of care for patients with longer than 10 days length of stay in the ICU for a year. Moral distress was measured intermittently and reported moral distress thermometer scores fluctuated. "Clinical situations" represented the most frequent contributing factor to moral distress. Post intervention, overall moral distress scores, measured on the moral distress scale revised, were lower for respondents in all categories, and on three specific items. Patient outcomes before and after PEACE intervention showed a statistically significant decrease in PRISM indexed LOS, a statistically significant increase in both code status changes DNR, and in-hospital death, with no change in patient 30 or 365 day mortality. The addition of a clinical ethicist and senior intensivist to weekly inter-professional team meetings facilitated difficult conversations regarding realistic goals of care. The study demonstrated that the PEACE intervention had a positive impact on some factors that contribute to moral distress and can shorten PICU length of stay for some patients. (shrink)

Exhaustive study of concept of liberation of soul (Mokṣa) in six systems of Hindu philosophy and other schools.

Reserach work on Hindu doctrines and philosophy.

Relationships are an integral part of the design of a database. Comparing and integrating relationships from heterogeneous databases requires that the relationships be mapped to each other or to a common classification. Identifying similarities and resolving differences in relationships across large data sources is a resource-intensive task that could benefit greatly from semi-automated approaches. A prerequisite to developing such approaches is a clear understanding of the semantics of relationships used in database design. This research presents a layered ontology for classifying (...) the semantics of relationships. It consists of a core layer that captures the fundamental types of relationships between entities. A middle layer provides the internal context, obtained from entities surrounding the relationship, to interpret the fundamental types. The outer layer allows further interpretation using the external context, that is, the domain in which a relationship is being used. An initial assessment on relationships from a variety of application domains demonstrates that the ontology can be adequate and useful for comparing relationships across databases. (shrink)

Amid the action of the 2013 Super Bowl aired the usual array of high-priced advertisements. Most ads were original. Some were unusual. One regional ad, however, seemed distantly familiar. The 30-second commercial promoted the NJOY King electronic cigarette1 to at least 10 million viewers in several major markets. It featured an attractive male model taking a drag from what looks like a cigarette. He then slowly blows smoke to the tune of Foreigner’s “Feels Like the First Time.” Of course, the (...) “smoke” does not come from burning tobacco. Rather, it is the water vapor produced by an e-cigarette as part of its nicotine delivery process. This, however, was not evident from the imagery. For those watching the broadcast, including thousands of minors, NJOY’s advertisement depicted what tobacco companies have not portrayed on television for decades: a person engaged in smoking behavior. (shrink)

Public health law research reveals significant complexities underlying the use of law as an effective tool to improve health outcomes across populations. The challenges of applying public health law in practice are no easier. Attorneys, public health officials, and diverse partners in the public and private sectors collaborate on the front lines to forge pathways to advance population health through law. Meeting this objective amidst competing interests requires strong practice skills to shift through sensitive and sometimes urgent calls for action (...) to address known threats to the health of individuals and the community. It also necessitates objective, timely information and national and regional legal support. (shrink)

Misophonia has been characterized as intense negative reactions to specific trigger sounds. However, recent research suggests high-level, contextual, and multisensory factors are also involved. We recently demonstrated that neurotypicals’ negative reactions to aversive sounds are attenuated when the sounds are synced with positive attributable video sources. To assess whether this effect generalizes to misophonic triggers, we developed a Sound-Swapped Video database for use in misophonia research. In Study 1, we created a set of 39 video clips depicting common trigger sounds (...) and a corresponding set of 39 PAVS temporally synchronized with the OVS videos. In Study 2, participants rated the 39 PAVS videos for their audiovisual match and pleasantness. We selected the 20 PAVS videos with best match scores for use in Study 3. In Study 3, a new group of participants observed the 20 selected PAVS and 20 corresponding OVS and judged the pleasantness or unpleasantness of each sound in the two contexts accompanying each video. Afterward, participants completed the Misophonia Questionnaire. The results of Study 3 show a robust attenuating effect of PAVS videos on the reported unpleasantness of trigger sounds: trigger sounds were rated as significantly less unpleasant when paired with PAVS with than OVS. Moreover, this attenuating effect was present in nearly every participant regardless of their score on the MQ. In fact, we found a moderate positive correlation between the PAVS-OVS difference and misophonia severity scores. Overall our results provide validation that the SSV database is a useful stimulus database to study how misophonic responses can be modulated by visual contexts. Here, we release the SSV database with the best 18 PAVS and 18 OVS videos used in Study 3 along with aggregate ratings of audio-video match and pleasantness. We also provide detailed instructions on how to produce these videos, with the hope that this database grows and improves through collaborations with the community of misophonia researchers. (shrink)

Study on the creation of the universe in the light of Vedas and science.

Study of Vedāntakaustubha of Śrīnivāsācārya, commentary on Brahmasūtra of Bādarāyaṇa, work on Vedanta philosophy.

Supercommentary on the Vedāntakalpataru of Amalānanda, 13th cent., commentary on the Bhāmatī of Vācaspatimiśra, fl. 976-1000; Advaita viewpoint.

Study of Vedāntasiddhāntamuktāvalī, work on Advaita Vedanta philosophy by Prakāśānanda, 16th cent.; includes Sanskrit text.

Supercommentary on Brahmasūtra of Bādarāyaṇa, aphoristic work on Vedanta philosophy and commentary on Vedāntapārijātasaurabha of Nimbārka and Vedāntakaustubha of Śrīnivāsācārya, disciple of Nimbārka; includes Hindi translation; includes Yamunastotra of Keśavakāśmīri Bhaṭṭācārya and study on the doctrines and religious leaders of Nimbarka Sect.

Contributed research papers presented at International seminar on scientific aspects of Vedas and Vedic literature; Volume 1 comprises 27 papers out of 72 papers on a wide-ranging topics.

Study with text of Vedāntakārikāvalī of Bucci Veṅkaṭācāryulu, 18th/19th cent., work on Viśiṣṭādvaita philosophy.

Study of Vedāntatattvaviveka, work on Advaita philosophy, by Nr̥siṃhāśrama.

K. Satchidananda Murty (1924-2011) was a vociferous writer and an iconoclast. This volume is a collection of his unpublished writings. It includes Murty's views on the Veda, its meaning, relevance, and study, and shows the significance of the Vedāntic vision to the modern world. Murty elucidates the basic tenets of Advaita Vedānta and expounds the Advaitic doctrine of the relationships between Brahman and God, Brahman and the individual self, as well as between God and the world. In his writings, (...) Murty contrasts empirical knowledge with transcendental wisdom and surveys the history of Indian science and scientific views in ancient times. The book also includes Murty's musings on the scholar Śankara's philosophy, authorship and religious life. An important contribution to Indian philosophy, the volume will be of great interest to scholars, teachers and students of Hindu philosophy, Vedāntic philosophy, Advaita Vedanta, comparative philosophy, religious studies, and South Asian studies. (shrink)

Upaniṣatsvadvaitabrahmavādaḥ.-Brahmasūtrāṇāmadvaitānuguṇyam.-Pūrvamīmāṁsānyāyānāṃ Vedāntārthanirṇayopayogaḥ.

Exhaustive study on Hindu sects, philosophy and doctrines according to Vedas, Hindu canonical texts.

Study of Vedāntakalpalatikā of Madhusūdana Sarasvatī, treatise on Advaita Vedanta.