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Results for “Conservatism”

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At least 145 records · Page 8Linked to original sources
PubMed1986

Use of sodium nitroprusside in post-coronary bypass surgery. A plea for conservatism.

In 292 patients who underwent coronary artery bypass graft (CABG) surgery, seven patients developed sodium nitroprusside (SNP) toxicity in the postoperative period. Duration of infusion varied between 26 to 160 hrs and total SNP dose ranged from 1.8 to 12 mg/kg body weight. All patients were critically ill and required ventilatory support in the postoperative period. Tachyphylaxis to SNP requiring increase of SNP dose for control of hypertension, and loss of consciousness were the major signs of toxicity. Other commonly described signs of SNP toxicity were absent in those patients. Discontinuation of SNP therapy and treatment with sodium thiosulfate was followed by improvement in four patients. Three patients who failed to regain consciousness later died because of hemodynamic, pulmonary and/or renal complications. Our observation suggests that recommended doses of SNP may be toxic in unstable post-CABG patients. We recommend that the dose and duration of SNP infusion be minimized in critically ill patients.

Aged↗
PubMed1997

World Bank education policy: market liberalism meets ideological conservatism.

Neoliberalism does not consider education a strategic investment. World Bank discourse for Latin America lacks a medium- and long-term view and is based on a short-term cost-benefit analysis. The Bank's education policy is determined by "adjustment" of countries economies so that they can go on paying their external debts. The goal is to eliminate educational expenses for the states by keeping education for elites, breaking up and privatizing the large public education systems, and nullifying teachers' contracts. To justify its policy, the Bank argues that governments should stop financing secondary and higher education and instead focus on primary education, where investments would be more efficient. But at the same time, governments should shift the financing of primary education to the private sector. Teachers' unions are now at the forefront of opposition to the World Bank's education reforms.

Education↗
PubMedDate not supplied

Conservatism, innovation and old age.

The onset of old age can be understood as a sequence of losses--of relationships, physical abilities, functions--which must be grieved. It represents a kind of psycho-social transition, whose generic characteristic is a breakdown in the structure of meaning by which we interpret events and which forces us to re-interpret that structure before we can assimilate the events that have provoked the breakdown. The better we understand such transitions as retirement, and loss of health, the more likely we can find ways to create the social and psychological conditions in which to work through the grief. The attitudes of American society towards old age tend to make these transitions harder than they need be.

Aged↗
PubMed1983

Blaming the aged victim: the politics of scapegoating in times of fiscal conservatism.

The ideology and process of victim blaming have undergone profound changes as a consequence of recent sociopolitical developments. This paper examines a newer and more pernicious form of victim blaming, with particular attention to the ways it has been directed at the elderly in American society. Several contexts are presented within which we may view recent budget cuts affecting the elderly in order to analyze the scapegoating of the aged as a primary "cause" of the fiscal crisis. These contexts include the cyclical nature of social problems, which expand or contract in accordance with the dominant needs of the economy; the "fiscal crisis mentality"; the philosophy and tactics of decentralization; and the Reagan Administration's move toward an "ideological definition of reality." Each of these contexts is seen as fitting within the overarching context of the current economic crisis and the intensified class conflict and related outcomes which it has generated. Unlike the victim blaming of the 1960s and early 70s, which defined "the elderly" as a social problem and devised solutions (e.g. expanded Social Security benefits, Medicare and Medicaid) for dealing with that problem, the victim blaming of the 1980s is seen as defining these earlier "solutions" as part of the problem. Not only are the aged problematic, but ameliorative programs are seen as "busting the federal budget" and in need of dismantling and/or shifting to other levels of government and the private sector. Education grounded in political-economic analyses of the "aging problem," aimed in part at overcoming structurally induced divisiveness among oppressed groups, is suggested as an important deterrent to the increased polarization which the current fiscal crisis mentality has nurtured.

Aged↗
PubMed1999

Therapeutic substitution and therapeutic conservatism as cost-containment strategies in primary care: a study of fundholders and non-fundholders.

BACKGROUND: General practice (GP) fundholders contained prescribing costs by restricting the rise in volume of prescribing and by increasing generic prescribing. It is uncertain whether they used more sophisticated approaches to medicine choice in attempts to contain costs. AIM: To examine whether fundholding practices have adopted medicine-specific strategies to contain prescribing costs--i.e. switching to less expensive but equally effective medicines or resisting the uptake of newer more expensive medicines--by examination of the prescribing of ulcer-healing and antidepressant medicines in the period before and after practices became fundholders. METHOD: Comparison of prescribing data of 52 fundholding practices before fundholding and after fundholding with that of matched non-fundholding practices. Measures examined were prescribing costs (net ingredient cost in each therapeutic area per ASTRO-pu); prescribing volume (defined daily doses per ASTRO-pu); the proportion of all ulcer-healing medicines prescribed as cimetidine, ranitidine, nizatidine, and as proton pump inhibitors; and the proportion of all antidepressant medicines prescribed as selective serotonin re-uptake inhibitors. RESULTS: In comparison with non-fundholding practices, fundholders increasingly prescribed less expensive medicines (cimetidine and nizatidine) within the class of histamine2 receptor antagonists. However, fundholders adopted proton pump inhibitors or selective serotonin re-uptake inhibitors at the same rate as non-fundholders. CONCLUSION: Fundholders have used therapeutic substitution with medicines of equal effectiveness to contain prescribing costs. There is no evidence that fundholders have been slower than non-fundholders to use newer, more expensive medicines.

Aged↗
PubMedDate not supplied

The management of forearm fractures in children: a plea for conservatism.

A retrospective review was undertaken to evaluate the efficacy of primary nonoperative treatment (closed reduction and long-arm casting) along with pins and plaster as a salvage technique for those reduction failures. A total of 730 closed fractures (1987-1993) was compiled, of which 300 required closed reductions and casting. Excluded from the study were teenagers whose growth plates were closed. Of the 300 fractures requiring closed reductions, 22 went on to require remanipulations, and 12 required the use of pins-and-plaster technique to obtain or maintain satisfactory reduction. Complications in the group treated in this manner included two superficial pin infections treated with antibiotics and two forearms with moderate loss of pronation/supination not requiring treatment. We believe that closed reduction of pediatric forearm fractures remains the accepted standard and the technique of pins and plaster should be considered a reliable alternative for the unstable injuries.

Adolescent↗