School of Historical and Philosophical Studies - Research Publications

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    Artistic practices of the Bohol School of Painting: An analytical and archival study of nineteenth-century panel paintings in the Philippines
    Tse, N ; Jett, P ; Winter, J ; McCarthy, B (Archetype Publishing, 2005)
    In the center of the Philippines on the island of Bohol, a unique panel painting practice evolved linking western artistic methods introduced by the Spanish with Filipino knowledge of materials and techniques. The scientific analysis of five nineteenth century panel paintings belonging to the Baclayon Parish was undertaken and combined with an archival investigation of the Parish Archives to develop a better understanding of their provenance. Results illustrate the western construction methods used in the panel paintings with an oil medium as well as the utilization of local materials such as Kedondong wood for the panel support, cotton and bast fiber paper for a gap filler between the wood panels, and a transparent brown hydrocarbon for the ground layer. Some of the pigments identified correlate with the geological deposits from the region and others correspond with the archival church records. Other identified pigments were not referenced in the archives or found locally. The latter indicate the importation of high quality pigments, not of Filipino origin. Further, the good condition of the panels highlight their sound preparation and an environment suited for these particular works.
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    Cluster randomisation or randomised consent as an appropriate methodology for trials in palliative care: a feasibility study [ISRCTN60243484].
    Fowell, A ; Russell, I ; Johnstone, R ; Finlay, I ; Russell, D (Springer Science and Business Media LLC, 2004-04-27)
    BACKGROUND: Although guidelines for the care of the dying patient exist the evidence base to support the guidelines is poor. Some of the factors contributing to this include failure to recruit to trials, protective healthcare professionals and subsequent attrition from trials due to the death of the patients. Recent studies report favourably on the use of cluster randomisation as an appropriate methodology for use in this patient group. METHODS/DESIGN: A feasibility study, exploring two types of randomisation as appropriate methodology for trials involving dying patients. Cluster randomisation and randomised consent will be utilised following a crossover design at two sites, one oncology ward and one Macmillan unit within the Northwest Wales NHS Trust. All patients commencing on the Integrated Care Pathway (ICP) for the Last Days of Life will be eligible for inclusion in the study. Using the hypothesis that it is not necessary to prescribe an anti-emetic medication when setting up a syringe driver for the dying patient, the study will evaluate different models of research methodology. DISCUSSION: The identification of the most appropriate methodology for use in studies concerning this patient group will inform the development of future clinical studies. Furthermore, the outcomes of this feasibility study will inform the development, of a proposal seeking funding for Wales-wide trials in palliative care. The identification of an appropriate methodology will provide a starting point for the establishment of a robust evidence base for the care of the dying patient.
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    Health biotechnology in China -: reawakening of a giant
    Li, ZZ ; Zhang, JC ; Wen, K ; Thorsteinsdóttir, H ; Quach, U ; Singer, PA ; Daar, AS (NATURE PUBLISHING GROUP, 2004-12)
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    Conclusions:: promoting biotechnology innovation in developing countries
    Thorsteinsdóttir, H ; Quach, U ; Daar, AS ; Singer, PA (NATURE PORTFOLIO, 2004-12)
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    Strengthening the role of genomics in global health
    Acharya, T ; Daar, AS ; Thorsteinsdóttir, H ; Dowdeswell, E ; Singer, PA (PUBLIC LIBRARY SCIENCE, 2004-12)
    How genomics and related health biotechnologies can improve the health of the poor and contribute towards meeting the Millenium Development Goals
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    Harnessing genomics to improve health in the Eastern Mediterranean Region - an executive course in genomics policy.
    Acharya, T ; Rab, MA ; Singer, PA ; Daar, AS (Springer Science and Business Media LLC, 2005-01-21)
    BACKGROUND: While innovations in medicine, science and technology have resulted in improved health and quality of life for many people, the benefits of modern medicine continue to elude millions of people in many parts of the world. To assess the potential of genomics to address health needs in EMR, the World Health Organization's Eastern Mediterranean Regional Office and the University of Toronto Joint Centre for Bioethics jointly organized a Genomics and Public Health Policy Executive Course, held September 20th-23rd, 2003, in Muscat, Oman. The 4-day course was sponsored by WHO-EMRO with additional support from the Canadian Program in Genomics and Global Health. The overall objective of the course was to collectively explore how to best harness genomics to improve health in the region. This article presents the course findings and recommendations for genomics policy in EMR. METHODS: The course brought together senior representatives from academia, biotechnology companies, regulatory bodies, media, voluntary, and legal organizations to engage in discussion. Topics covered included scientific advances in genomics, followed by innovations in business models, public sector perspectives, ethics, legal issues and national innovation systems. RESULTS: A set of recommendations, summarized below, was formulated for the Regional Office, the Member States and for individuals.* Advocacy for genomics and biotechnology for political leadership;* Networking between member states to share information, expertise, training, and regional cooperation in biotechnology; coordination of national surveys for assessment of health biotechnology innovation systems, science capacity, government policies, legislation and regulations, intellectual property policies, private sector activity;* Creation in each member country of an effective National Body on genomics, biotechnology and health to:- formulate national biotechnology strategies- raise biotechnology awareness- encourage teaching and training of biotechnology- devise integration of biotechnology within national health systems. CONCLUSION: The recommendations provide the basis for a road map for EMR to take steps to harness biotechnology for better and more equitable health. As a result of these recommendations, health ministers from the region, at the 50th Regional Committee Meeting held in October 2003, have urged Member States to establish national bodies of biotechnology to formulate a strategic vision for developing biotechnology in the service of the region's health. These efforts promise to raise the profile of genomics in EMR and increase regional cooperation in this exciting new field.
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    What do hospital decision-makers in Ontario, Canada, have to say about the fairness of priority setting in their institutions?
    Reeleder, D ; Martin, DK ; Keresztes, C ; Singer, PA (BMC, 2005-01-21)
    BACKGROUND: Priority setting, also known as rationing or resource allocation, occurs at all levels of every health care system. Daniels and Sabin have proposed a framework for priority setting in health care institutions called 'accountability for reasonableness', which links priority setting to theories of democratic deliberation. Fairness is a key goal of priority setting. According to 'accountability for reasonableness', health care institutions engaged in priority setting have a claim to fairness if they satisfy four conditions of relevance, publicity, appeals/revision, and enforcement. This is the first study which has surveyed the views of hospital decision makers throughout an entire health system about the fairness of priority setting in their institutions. The purpose of this study is to elicit hospital decision-makers' self-report of the fairness of priority setting in their hospitals using an explicit conceptual framework, 'accountability for reasonableness'. METHODS: 160 Ontario hospital Chief Executive Officers, or their designates, were asked to complete a survey questionnaire concerning priority setting in their publicly funded institutions. Eight-six Ontario hospitals completed this survey, for a response rate of 54%. Six close-ended rating scale questions (e.g. Overall, how fair is priority setting at your hospital?), and 3 open-ended questions (e.g. What do you see as the goal(s) of priority setting in your hospital?) were used. RESULTS: Overall, 60.7% of respondents indicated their hospitals' priority setting was fair. With respect to the 'accountability for reasonableness' conditions, respondents indicated their hospitals performed best for the relevance (75.0%) condition, followed by appeals/revision (56.6%), publicity (56.0%), and enforcement (39.5%). CONCLUSIONS: For the first time hospital Chief Executive Officers within an entire health system were surveyed about the fairness of priority setting practices in their institutions using the conceptual framework 'accountability for reasonableness'. Although many hospital CEOs felt that their priority setting was fair, ample room for improvement was noted, especially for the enforcement condition.
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    Nanotechnology and the developing world.
    Salamanca-Buentello, F ; Persad, DL ; Court, EB ; Martin, DK ; Daar, AS ; Singer, PA (Public Library of Science (PLoS), 2005-05)
    How nanotechnology can be harnessed to address some of the world's most critical development problems
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    Global health challenges: The need for an expanded discourse on bioethics
    Benatar, SR ; Daar, AS ; Singer, PA (PUBLIC LIBRARY SCIENCE, 2005-07)
    Benatar and colleagues argue that the world has changed profoundly since the birth of modern bioethics in the 1960s, and that bioethics needs to address today's global health problems.
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    Setting priorities in health care organizations: criteria, processes, and parameters of success
    Gibson, JL ; Martin, DK ; Singer, PA (BMC, 2004-09-08)
    BACKGROUND: Hospitals and regional health authorities must set priorities in the face of resource constraints. Decision-makers seek practical ways to set priorities fairly in strategic planning, but find limited guidance from the literature. Very little has been reported from the perspective of Board members and senior managers about what criteria, processes and parameters of success they would use to set priorities fairly. DISCUSSION: We facilitated workshops for board members and senior leadership at three health care organizations to assist them in developing a strategy for fair priority setting. Workshop participants identified 8 priority setting criteria, 10 key priority setting process elements, and 6 parameters of success that they would use to set priorities in their organizations. Decision-makers in other organizations can draw lessons from these findings to enhance the fairness of their priority setting decision-making. SUMMARY: Lessons learned in three workshops fill an important gap in the literature about what criteria, processes, and parameters of success Board members and senior managers would use to set priorities fairly.