Most donated organs in the United States come from brain dead donors, while a small percentage come from patients who die in “controlled,” or expected, circumstances, typically after the family or surrogate makes a decision to withdraw life support. The number of organs available for transplant could be substantially if donations were permitted in “uncontrolled” circumstances–that is, from people who die unexpectedly, often outside the hospital. According to projections from the Institute of Medicine, establishing programs permitting “uncontrolled donation after circulatory (...) determination of death,” or uDCDD, throughout the United States has the potential to provide 22,000 more donation opportunities annually. In contrast, U.S. controlled donation after circulatory determination of death, or cDCDD, cases have increased progressively over the past decade from 87 to 848 donors, but currently account for only 10.6 percent of all deceased donors. Following the IOM recommendations, several projects exploring the feasibility of uDCDD were funded by the federal government, including a grant from the Health Resources and Services Administration that supported a pilot project in New York City in which the authors of this article participated.A key feature of our protocol, and indeed of many uDCDD protocols, is the initiation of preservation methods such as chest compressions and extracorporeal membrane oxygenation shortly after death in order to perfuse and preserve the donor's organs. Critics of uDCDD argue that the means of determining death deviates from generally ascribed principles. They assert that reinstituting circulation in order to preserve organs has the effect of “undoing” the prior determination of death. The result is that cDCDD is widely accepted and practiced routinely even though it only marginally increases the number of organs available for transplantation, and uDCDD is widely considered unacceptable despite being ethically embraced and proven to significantly increase organ donation opportunities in other countries. This article explores the evolution of this counterintuitive state of affairs and calls for a policy that, in line with the IOM report, allows for both cDCDD and uDCDD protocols. (shrink)

Workplace spirituality has emerged as a remarkable area of study in the field of management and organizational behaviour over the past two decades. Researchers have extensively explored its impact on employee engagement, job satisfaction, organizational citizenship behaviour and performance. The present study employs bibliometric analysis to examine the existing literature on workplace spirituality. It analyses 400 relevant articles from the Scopus and Web of Science databases from 2003 to 2023. The research identifies influential authors, pertinent journals and key trends using (...) two analytical tools, that is, the R package and VOSviewer. It creates network diagrams and cluster visualizations representing connections and relationships among the authors and keywords. The findings reveal consistent publication growth, highlighting influential articles and key contributors. The study emphasizes the need for more empirical research on individual and organizational outcomes concerning workplace spirituality. It suggests incorporating diverse methodologies, such as qualitative and mixed-method approaches, to enhance understanding. The insights provided serve as valuable information for academics, professionals and organizational leaders, offering a comprehensive understanding of spirituality in the workplace and promoting the overall well-being of employees. (shrink)

Piliavsky, A, Nobody’s People: Hierarchy as Hope in a Society of Thieves. Stanford University Press, 2020, ₹1870, 253 pp.. ISBN: 978 1 503 60464 3.

This study examines the impact of food culture aspects such as taste, display, and preparation process on visitor satisfaction and motivation during food festivals. Data from 150 participants were analyzed utilizing SPSS 25 for data analysis. The study uses Spearman's Rank Correlation, Confirmatory Factor Analysis (CFA), and Chi-Square testing to investigate how these characteristics influence festival experiences. Significant positive correlations were found using Spearman's Rank Correlation, taste had a strong correlation with visitor satisfaction (ρ = 0.65,p = 0.01) and motivation (...) (ρ = 0.60,p = 0.02), while display also had a moderately positive correlation with both (ρ = 0.55,p = 0.05) satisfaction and motivation (ρ = 0.50,p = 0.04). The association for the preparation process, however, was not statistically significant and was much weaker. It was established that CFA had high dependability with estimates of 0.78 for taste, 0.85 for display, and 0.80 for the preparation procedure, all of which met high CR and AVE values. The relationships between aspects of food culture and visitor outcomes were evaluated using the Chi-Square Test. Taste was found to have significant correlations with motivation (χ² = 10.45, p = 0.05) and satisfaction. While the display was only significantly connected with satisfaction (χ² = 7.89, p = 0.10), the preparation process was strongly associated with satisfaction (χ² = 12.34, p = 0.03). These results emphasize how important taste is to improving visitor experiences and show how particular characteristics of food cultures can affect festivalgoers' motivation and level of satisfaction. The study found that taste has a substantial impact on both satisfaction and motivation, emphasizing its importance for good event planning and increased attendee involvement. (shrink)

The development of creative imagination across different school grades involves examining that students’ ability to think creatively and imaginatively evolves as they progress through their education journey. This study examines the development of imaginative creativity across a range of students' grades, emphasizing the roles that various factors play in students' creative growth, such as parental engagement, creative competition participation, innovative problem-solving skills, guidance from teachers, and visualization abilities. Information has been gathered from 150 teachers and 150 students who took part (...) in speech, storytelling, and art competitions. With the use of SPSS version 28, discriminant and factor analyses were carried out to examine how these variables differentiate students across grade levels and identify fundamental aspects of creativity. Also, the self-reported questionnaires were executed to explore the student's creative thinking level. The outcomes show that creative problem-solving skills and mentorship from trainers are important factors in enhancing students' creativity, parental involvement and visualization also have a significant impact. These results highlight the importance of parental and instructional guidance in supporting inventive growth throughout various school grades and provide insightful information about the elements influencing students' increased creativity. (shrink)

Several facets of learning, include imaginative writing transformed from digital technologies. Writing creatively fosters students' creativity and critical thinking abilities, an essential part of literacy education. The long-term effects of digital technologies on imaginative writing skills (IWS), despite the increasing usage. The potential of digital tools diversions might constitute the intended benefits and the application of these technologies utilized in educational institutions. The study aims to investigate how digital tool improve writing skills and develop innovative writing abilities by fostering creativity. (...) The research intends to identify which digital tools offer the most significant benefits and how integrated into educational practices to support imaginative writing development. This study included a total of 60 participants, including males (28) and females (32) for imaginative writing skills. Utilizing SPSS software, a statistical analysis of the data was carried out. The data was analyzed using a t-test, ANOVA, and regression analyses. These analyses demonstrated imaginative writing skills. The research findings demonstrated that digital tools greatly enhanced participant’s creative writing skills, vocabulary growth and story structure. The use of digital tools could significantly improve participant’s capacity for imaginative writing skill development. (shrink)

The ever‐increasing demand for organs led Spain, France, and other European countries to promote uncontrolled donation after circulatory determination of death (uDCDD). For the same reason, New York City has recently developed its own uDCDD protocol, which differs from European programs in some key ways. The New York protocol incorporates a series of technical and management improvements that address some practical problems identified in response to European uDCDD protocols. However, the more fundamental issue of whether uDCDD donors are dead when (...) organs are procured remains problematic for the New York City protocol and, indeed, for all uDCDD protocols. In the United States, two amendments to the legal criteria of death have been suggested to avoid a formal violation of the dead donor rule in DCDD protocols: first, replacing the requirement “irreversible” with the weaker term “permanent,” and second, using the term “circulatory” instead of “cardiac” to identify the key function that must be lost to declare death. While intended to facilitate controlled DCDD, these modifications create a problem for uDCDD protocols: if extracorporeal membrane oxygenation is introduced to preserve the organs, then circulation is restored after death is declared. In this issue of the Hastings Center Report, Kevin Munjal and colleagues call for a new ethical construct and policy so that uncontrolled and controlled DCDD can coexist. (shrink)

The most controversial issue in organ donation after the circulatory determination of death is whether the donor was truly dead at the moment death is declared. My colleagues and I further analyzed this issue by showing the relevance of the distinction between the “permanent” and the “irreversible” loss of circulatory functions. Permanent cessation means that circulatory function will not return because it will not be restored spontaneously and medical attempts to restore it will not be conducted. By contrast, irreversible cessation (...) means that circulatory function cannot be restored using currently available technology. In this issue of the Report, Kevin Munjal and colleagues criticize the unjustified application of the permanent‐irreversible distinction, which my colleagues and I developed for cDCDD, to their well‐designed and carefully conducted experimental protocol of uncontrolled DCDD (uDCDD) in New York City, for which our analysis was not targeted. They claimed that to determine a donor's death in uDCDD, it is unnecessary to show that permanence is a valid surrogate indicator of irreversibility because the unsuccessful attempt to resuscitate the patient comprises prima facie evidence of circulatory irreversibility. Ironically, that potent justification defending death determination in uDCDD yields limitations that are similar to those created when our permanent‐irreversible distinction is applied to death determination in cDCDD. (shrink)