Using Descriptive Inquiry to Make and Do Philosophy in School: Creating Shared Educational Principles at City-As-School during the Coronavirus Pandemic

This piece describes how the faculty of City-As-School used Descriptive Inquiry to generate shared educational principles during the 2020-21 school year during the coronavirus pandemic. City-As-School is a public experiential learning school in New York City serving older adolescents seeking an alternative to traditional high school. Descriptive Inquiry is an inquiry process developed by Patricia Carini and faculty at the Prospect School in Bennington, Vermont, that supports educators in understanding children and their own educational practice to teach for human dignity, ethical well-being, and holistic growth. The piece provides an introduction to City-As-School and briefly describes how faculty members have used Descriptive Inquiry to foster whole school professional learning and growth. The piece then details how the faculty used Descriptive Inquiry to surface and concretize shared educational principles during the 2020-21 school year, a poignant example of Patricia Carini's notion of "making and doing philosophy in a school."

Crisis politics of dehumanisation during COVID-19: A framework for mapping the social processes through which dehumanisation undermines human dignity

The COVID-19 global pandemic is understood to be a multidimensional crisis, and yet undertheorised is how it reinforced the politics of dehumanisation. This article proposes an original framework that explains how dehumanisation undermines the human dignity of individuals with minoritised socio-economic identities during the COVID-19 pandemic. The framework identifies four interrelated mechanisms of crisis-driven dehumanisation: threat construction, expanded state coercion, reinforcement of hierarchies, and normalisation of deaths. The article argues that an understanding of these mechanisms is crucial for capturing the complexity of human rights deterioration during the COVID-19 pandemic. The article uses the plausibility probe method to demonstrate macro-processes of dehumanisation, with illustrative empirical examples from diverse societies during COVID-19. It proposes a framework for understanding these dehumanisation processes that can apply to other transnational crises. [ FROM AUTHOR] Copyright of British Journal of Politics & International Relations is the property of Sage Publications Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

Looking in the Rearview Mirror and to the Road Ahead on Dementia & Living Well

The number of Americans living with Alzheimer's and all other dementias continues to increase. Most of them will need long-term and community-based services as the disease progresses. While medical research is making advances, there is more work to be done to ensure that every person receives care that is person-centered and allows them to live with dignity and respect.

Direito à moradia: as ações do Museu das Remoções durante a pandemia

A luta pelo direito à moradia no Brasil continuou existindo durante a pandemia de Covid-19 e precisou adotar novas estratégias diante das restrições sanitárias. Este artigo aborda as reivindicações do movimento do Museu das Remoções e sua atuação em defesa do direito à moradia. A pesquisa baseia-se em dados qualitativos da transcrição de debates realizados em 2020 e 2021 pelo Museu das Remoções com outros movimentos sociais na Internet. Os resultados revelam que os principais desafios enfrentados por movimentos sociais durante a pandemia foram a insuficiência do Estado brasileiro em assegurar o direito à moradia com dignidade nas cidades e a contínua violência nos despejos e nas remoções ocorridos mesmo diante das restrições sanitárias. A pesquisa mostra que a disputa por territórios nos centros urbanos atende fundamentalmente aos interesses do capitalismo imobiliário, capaz de inviabilizar inclusive o cumprimento de medidas sanitárias em saúde pública em meio a uma pandemia com elevada letalidade.Alternate :The struggle for the right to housing in Brazil continued to exist during the Covid-19 pandemic and had to adopt new strategies in the face of health restrictions. This article addresses the demands of the Museum of Removals movement and its performance in defense of the right to housing. The research is based on qualitative data from the transcript of debates held in 2020 and 2021 by the Removals Museum with other social movements on the internet. The results reveal that the main challenges faced by social movements during the pandemic were the failure of the Brazilian State to ensure the right to housing with dignity in cities and the continuous violence in evictions and removals that occurred even in the face of health restrictions. The research shows that the dispute over territories in urban centers fundamentally serves the interests of real estate capitalism, capable of even making it impossible to comply with sanitary measures in public health in the midst of a pandemic with high lethality.

Seeing the Patient as a Person: Reflections from the Implementation of the Meet My Loved One Project (Sch459)

Outcomes: 1. Utilizing a discussion-based approach, participants will self-report the ability to inject humanism and dignity into patient care by utilizing and incorporating initiatives like the MMLO into their practice. 2. Evaluate and analyze the impact of initiatives such as the MMLO project on patients' families and on healthcare workers. Purpose(s): As COVID-19 surged, patients and healthcare workers (HCWs) experienced diminished recognition of patient personhood and increased burnout. Adapted from the University of Alabama's MMLO initiative, the UNC palliative care team implemented the MMLO initiative in the early stages of the COVID-19 pandemic to elicit personhood, restore patient dignity, and provide patient-centered care. The team also aimed to understand the MMLO's effect on HCWs and patient care. Method(s): Primary teams identified candidates and made referrals. The MMLO team called patients' loved ones to explain the initiative and ask questions from the MMLO form. Respondents' answers were posted at patients' bedsides along with collected patient photos. Survey data were collected from participants immediately prior to and 2-7 days after form completion. Quantitative and qualitative data from HCWs' experiences with MMLO were also collected after implementation. Result(s): Using a Mann-Whitney test, there is a significant improvement in median satisfactory level between the pre- and post-MMLO surveys of patients' loved ones regarding their perception of the care provided. Of the 21 HCWs surveyed, 96% agreed they learned something about their patients, and 58% stated they learned something about themselves after taking care of patients with a completed MMLO. Additionally, 90% of the HCWs stated that the MMLO increased their connectedness to their patients, and 76% stated that this project will positively change their future care of patients. Implications: The MMLO revealed the importance of connectedness and reflection. For HCWs, the connectedness to patients at a time of heightened stress reinforced a sense of purpose. Reflections concluded that the MMLO "visualized that people care" and provided a new lens for how others see the medical profession. Given these positive outcomes, we hope to universally implement the MMLO throughout the UNC Health Care system and promote it more broadly.Copyright © 2023

The Rights Of The Dead And Their Rights To Have Dignity In Their Last Rites: A Study In India During The Covid-19 Pandemic

With the deadly COVID-19 claiming more than 1.3 lakh lives by November 2020 in India, a very pertinent thought comes to anyone's mind. That, is it illegal to deny last rites to a COVID-19 deceased in India? Various health and safety guidelines issued by international organizations like the World Health Organization and national organizations like the Ministry of Health and Family Welfare concerning the last rites of COVID-19 patients have failed to address the issue at hand. Numerous reports of inhumane treatment of the dead have raised concerns among human rights activists and the Indian Courts wherein it was stated that the rights of the dead to a decent funeral are enshrined in Article 21 and Article 25 of the Indian Constitution. The paper provides detailed insights into the chaos that have unfolded around the last rites of the dead, traces the human rights jurisprudence on this much-neglected topic and concludes with the recent judicial pronouncements in the subject area.Copyright © 2020 Ubiquity Press. All rights reserved.

The Resurrection of Art and Human Dignity MAGNETS Case Study

To overcome social isolation and complete art production standstill, during the Covid-19 outbreak we chose the "blue pill” (The Matrix, 1999) in favour of an artificial, digital space where we transferred most of our activities and practices. Building on the idea that participating in artistic endeavours has a positive impact on psychological well-being and health and is a very good model to tackle current social challenges, we ran MAGNETS a collaborative art project in the digital realm. Through online interviews with the artists who participated in the MAGNETS project, we have discovered a powerful link between art and human dignity. In this paper, we argue that participation in collaborative artistic creation through the digital realm is a process that restores and reaffirms human dignity and contributes to "social healing”. We also call for more exploration of collaborative art in the digital realm as it offers a safe space where aesthetics is experienced through the process of creation and as a functional solution to a specific social problem. © 2023, ICST Institute for Computer Sciences, Social Informatics and Telecommunications Engineering.

Allocating Hospital Beds in the Pandemic

The Covid-19 pandemic put the views of bioethicists on the allocation of scarce health care resources to the test. We consider positions taken by medical organizations and national ethics councils in Italy, Spain, United Kingdom, Germany and Sweden. In several statements from these bodies, the concept of human dignity plays a central role. We argue that the use of this concept does not stand up to ethical scrutiny, and instead defend the view that decisions on the allocation of scarce resources should be guided by the goal of maximizing the net benefits to those affected. We conclude by asking whether the fact that, in some regions, after vaccination became widely available, the scarcity of hospital beds was largely caused by members of the community choosing not to be vaccinated against the virus that causes Covid-19 should play a role in allocating resources to unvaccinated people who subsequently became ill from that virus. © 2022 Wydawnictwo Naukowe Uniwersytetu Szczecinskiego. All rights reserved.

Domestic Violence- A Crying Call for Change

Domestic violence or intimate partner violence, can be defined as a pattern of behaviors which could be physical, sexual, emotional, economic or psychological actions or threats of actions in any relationship that is used to gain or maintain power and control over an intimate weaker partner that influence another person. Domestic abuse can happen to anyone regardless of age, race, gender, sexual orientation, religion or socioeconomic background and education levels. It can occur within a range of relationships and not just those who live with us in our homes. These incidents are seldom isolated and escalate in frequency and severity if not opposed initial stage itself and may harm physically as well as emotionally and at times even endangers lives. Statistics for this is grave be it our country be it abroad and it became more grim covid times when staying home was not always safe. There are various factors involved from genesis to the maintainence of this menace medicolegal aspects and many more. Multidisciplinary approach for awareness that one needs to seek help, that one is not alone and various measures for curbing this grave issue is required at all levels. Domestic violence is the outcome of cumulative irresponsible behaviour which a section of society demonstrates. It is also important to note that solely the abuser is not just responsible but also those who allow this to happen and act as mere mute spectators. In this era of rights-based mental health services, such 'hidden shades' of mental wellbeing form potent challenges, which face unique conditions of demographics, prevalence of mental disorders and awareness related to this grave issue of domestic violence. Human rights are universal and are vital for promoting mental health and dignity. With this premise, this symposium intends to unfold the various factors involved and highlight the intersections of Domestic volence and approaches required to bring about and discuss strategies to curb it in light of the lessons learnt from experiences across the globe.

Dignity therapy effects by race: Chaplain and nurse implementation in pragmatic, multisite steppedwedge randomized control trial

Aim: As a brief psychotherapy for individuals facing mortal threat, Dignity Therapy (DT) effects on spiritual outcomes are unknown, especially as an intervention to support cancer health equity for racial minority patients. Our study aim was to compare usual outpatient palliative care and such care along with nurse-led or chaplain-led DT groups for main effects on dignity impact and the interaction of DT with race. Method(s): We conducted the 4-step, stepped-wedge randomized control trial at 4 NCI designated cancer centers and 2 academic cancer centers across the United States. Half of the sites were randomized to chaplain-led DT and half to nurse-led DT. Of the 645 recruited cancer patients (age >= 55 years) receiving outpatient palliative care, 579 (59% female, mean age 66.4+/-7.4 years, 78% White, 77% Christian religion, 62% stage 4 cancer) provided data for intent-totreat analysis. Over 6 weeks, patients completed pretest/posttest measures including the Dignity Impact Scale (DIS, primary outcome) ranging from low impact of 7 to highest impact of 35. In step 1-3, study procedures were completed in person. In step 4 (during the COVID-19 pandemic), when all sites were providing the intervention, study procedures were completed via Zoom. We used multiple imputation and regression analysis adjusting for pretest DIS, study site, and study step. Result(s): Of the 579 patients, 317 were in the DT group and 262 in the usual care group. The vast majority of the sample was White (n=448) along with 103 Blacks, 5 Asians, 2 Pacific Islanders, 1 Native American, 13 other races (all minorities were combined as Other Race), and 7 were missing race data. At pretest, the mean DIS score was 24.3+/-4.3 in the DT group and 25.9+/-4.3 in the usual care group. Adjusting for pretest DIS scores, study site, and study step, the chaplain-led (beta=1.7, p=.02) and nurse-led (beta=2.1, p=.005) groups reported significantly higher posttest DIS scores than the usual care groups. Adjusting for age, gender, race, education, and income, the effect on DIS scores remained significant for both DT groups. We then examined the interaction between race and DT with the entire sample and observed that the interaction was not significant (p=.73) and the sizes of DT effects were similar for White (beta=1.9, p=.005) and the Other Race (beta=1.6, p=.055) patients. Conclusion(s): Whether led by chaplains or nurses, DT was effective in improving dignity impact for older adult outpatient palliative care patients with cancer. DT, a patient-centered approach, has promise as an intervention to improve health equity in support of dignity for racial minorities. This rigorous trial of DT is a landmark step in gero-oncology palliative care and spiritual health services research focused on cancer health equity.

Safe management of COVID-19 dead bodies in sub-Saharan Africa: could families be allowed to bury their dead?.

Sub-Saharan African countries have been hit by the Coronavirus 2019 pandemic (COVID-19) since March 2020. Besides the resulting health and economic disasters is the psycho-socio-cultural problem related with the management of corpses of people dead from the disease, which might hinder the implementation of the response strategy. In Cameroon for instance, the current corpse management policy is very disputed. In fact, although they were recently made more flexible, the restrictions applied to burials still ban any transfer of dead bodies between cities. In light of the African cultural considerations of dead persons, the disputes observed between the families and the health personnel, the legislation and the available scientific evidence, this article analyses the risks and benefits of allowing families to bury their relatives. It thereafter suggests solutions that reconcile dignity (by allowing families to bury their dead relatives in their homes) and safety (by ensuring a sealed handling and the surveillance by a judiciary police officer). Applying these solutions could improve the population's trust towards the health system, and positively contribute to COVID-19 case prevention, identification and management. Copyright © 2020, African Field Epidemiology Network. All rights reserved.

Accès aux soins: l'âge comme critère d'exclusion? Les pleins et les déliés des recommandations éthiques au temps du Covid

Le sujet de l'allocation des ressources et des choix qu'elle implique se pose constamment en santé. La crise Covid l'a cependant rendue plus visible tout en l'exacerbant puisqu'elle a concerné l'accès à la réanimation avec, par conséquent, un enjeu vital. Dans la perspective d'un risque très sérieux de pénurie, le sort des patients âgés a immédiatement été interrogé. En particulier, la question a été soulevée de savoir si l'âge pouvait être un critère d'exclusion des services de réanimation. Au sein de l'hexagone, la réponse a paru clairement négative. Contrairement à d'autres pays, la France a en effet refusé de fixer un âge seuil pour cet accès. En ce sens, sociétés savantes et autorités administratives ont multiplié les recommandations réaffirmant les principes éthiques fondés notamment sur l'égalité, la dignité et la justice sociale. Ces textes ont ainsi donné l'impression d'une continuité malgré la crise. Revêtu d'une certaine portée normative (les recommandations entendaient toutes guider les comportements des différents acteurs de prise de décision médicale), ce corpus mérite d'être étudié sous l'angle juridique dans l'idée de révéler les principes en tension dans une telle situation de crise. Car si les textes prennent soin de rappeler l'interdiction de discriminer sur le critère de l'âge, il est possible d'y déceler en filigrane une discrimination indirecte fondée sur ce critère. Et, lorsque l'âge est conjugué à d'autres caractéristiques ou situations spécifiques – on pense ici aux résidents d'Ehpad –, ces textes conduisent même à une véritable exclusion des plus vulnérables du système de soins de droit commun.Alternate :The allocation of resources and the choices involved in such decisions is an ongoing issue in healthcare. But the COVID crisis boosted the visibility of this subject while exacerbating it, since a central concern of the epidemic was the vital issue of access to intensive care. With the prospect of a highly serious risk of shortage, the fate of elderly patients immediately became a key aspect. In particular, the question was asked if age could be a criterion from excluding individuals from intensive care units. In France, the answer to this question was overwhelmingly "No". Contrary to other countries, France refused to set a threshold age for access to intensive care. Supporting this decision, administrative authorities and learned societies issued numerous recommendations reasserting ethical principles based on equality, dignity and social justice. These texts gave the impression of continuity despite the crisis. Relating in varying degrees to the setting of standards – the recommendations all strove to guide the behaviour of the various medical decision-makers –, this corpus deserves to be studied from a legal standpoint with a view to identifying principles that come under pressure in crisis situations such as the COVID pandemic. Because while the texts conscientiously reminded readers that discriminating on the basis of age is forbidden, an indirect discrimination based on exactly that criterion can be read between the lines. And while age is combined with other specific situations or characteristics (with a thought for the residents of retirement homes), these texts can even lead to the true exclusion of the most vulnerable individuals from the general healthcare system.

HUMAN DIGNITY, DEMOCRACY AND OTHER CHALLENGES OF THE COVID-19 PANDEMIC

Human dignity has been a much-discussed topic in contemporary debate, and it has benefited from numerous approaches stemming from the fields of philosophy, politics, ethics, psychology or the legal, social and cultural domains. Yet, the meaning of the concept can vary in clarity, leading to ambiguity of usage and approach. The aim of this paper is to examine the concept of human dignity and to assess its potential as a fundamental value for contemporary democracies. A conceptual analysis of human dignity was conducted in the first part of the paper, embracing two essential coordinates of democracy, the political and the ethical approach. An extension of the notion of human dignity, with applications on the collective level rather than simply on the individual one, implies a set of obligations and responsibilities for the democratic state, a context that involves exploring the relationship between human dignity and human rights. In turn, democracy is a means for the constitutional state to provide both the opportunities and the adequate framework for the fullest affirmation and realisation of human dignity. The global challenges posed by the Covid-19 pandemic triggered a growing list of changes that highlighted new faces of democracy and respect for human dignity, aspects that were analysed in the final part of this paper. The author promotes the idea that human dignity emerges as a fundamental value of democracy and that recent global challenges call for a new momentum on debates of this concept. © 2022, Polish Academy of Sciences - Institute of Philosophy and Sociology. All rights reserved.

Exploring social determinants of health: COVID-19 vaccine challenges and solutions

The Coronavirus (COVID-19) pandemic has negatively shifted the foundations of human health and the well-being of humanity on a global scale. Its contagiousness and lethal symptoms pose a threat to everyone, especially seniors over 65 years, immunocompromised individuals, and people with preexisting health conditions. The factors of the social determinants of health had great influence on the vaccination status for Black and Brown communities. Access to life-saving treatment and resources was hindered by the poor social determinants and socioeconomic status, which led to slow vaccination numbers. This article examines that equitable vaccination access, distribution, and health literacy in Black and Brown communities are all supported by careful analysis of the notion of dignity.

IPA and WPA-SOAP Strategies to Promote the Human Rights in Mental Health Care of Older Adults

The number of persons with 60 years and more worldwide is estimated to triple by 2050. With the raising burden of the mental health conditions that accompany population ageing, mental health care for older adults has to be under pined by a dignity and human rights based approach. The extraordinary number of human rights violations of the older population during the COVID-19 pandemic has come to the forefront, as consequence of this population vulnerability, the lack of political will to give prior attention to this group needs and the disseminated ageistic attitudes. Discrimination based on age can lead to catastrophic social consequences such as elder abuse, neglect and all forms of violences. Their access to services become reduced, including health, social and justice services. These negative attitutdes, more than only morally unacceptable, are source of unnecessary suffering and increase morbidity and mortality rate. Intersecting across psychiatric diagnoses and interventions are the principles of dignity, autonomy, respect and equality which are all at the base of the call for an United Nations Convention of Rights of the Older People. Keeping all thes points in mind, the World Pschiatric Association Section of Old Age Psychiatry and the International Psychogeriatric Association are working together to promote the Human Rights of Older Adults. The presentation of a webinar, the publication of joint position statements, the organization of symposia in several international congress and the publication of a recent special issue of the America Jornal of Geriatric Psychiatry (October 2021 - https:// www.ajgponline.org/issue/S1064-7481(21)X0010-3) are some examples of this common effort.

Health emergency, Constitution, weak subjects: old and new rights to the test of the pandemic

The following contribution aims to deal with the delicate problem of the relationship between emergency and fundamental rights, with particular attention to vulnerable subjects – especially people with disabilities – in the prism of human dignity. Starting from a general premise, concerning the issue of the emergency – prodromal to a reconstruction of the impact of the pandemic on State-Regions relations, also in the light of sentence 37/2021 of the Constitutional Court, and on the exercise of fundamental rights, taking into account the restrictive measures taken and the introduction of the so-called Green Pass and of the compulsory vaccination – follows an examination of the principle of the person’s dignity as a "foundation of the constitutional foundations", necessary to specifically address, within the category of vulnerable people, the impact on the enjoyment of the rights of people with disabilities – with particular reference to right to education – and to (re)propose in a problematic way the question of the recognition of the right to Internet access, also analysed in a perspective of favor for the vulnerable people. The same general perspective, based on the recognition of the co-essential link between dignity and fundamental rights, both civil and social ones, allows us to introduce the theme of the relationship between the essential content of rights and essential levels of performance, clarifying the conceptual differences and offering considerations around the current issues affecting this theme. Finally – always electing the value of the dignity of the human person as the compass of the discussion – the examination focuses on the legal profiles of the "tragic choices" and the end-of-life of Covid patients, in order to configure – in the light of Articles 2-3-19-32 of the Constitution – a right to a dignified healthcare and a new “right to a dignified death” – with a different meaning from the common one – as a summary clause of the rights of the dying person. © 2022, Societa Editoriale Federalismi s.r.l.. All rights reserved.

ANALYSIS OF VIOLENCE AND THE CRIME OF FEMICIDE DURING THE COVID-19 PANDEMIC

Objective: The objective was to analyze violence against women and the proliferation of the crime of femicide during the COVID-19 pandemic from the perspective of lawyers in the judicial district of Lima Norte, 2020. Method: In this sense, the basic type was used, under the qualitative paradigm. And it responds to the non-experimental design by case study. The research technique implemented was that of observation and interview structure, with the participation of expert lawyers in cases of violence and femicide according to the Peruvian Criminal Law Code. Results: It was found that the COVID-19 pandemic has brought serious consequences of various kinds for society. In particular, there has been an increase in violence and the crime of femicide against women. As a result, confinement has caused many women to live with their aggressor. As a result, there have been more reports of physical and psychological violence and in some cases even the death of the woman, thus constituting the crime of femicide. Conclusion: Therefore, during the pandemic, femicide and violence against women has increased. And although there are special laws that regulate this type of crime and the penalties are severe for the femicide, it cannot be eradicated or controlled. The problem has to do with the social dimension such as machismo, jealousy of partners, mental illness, inadequate education of citizens, alcohol consumption, etc. And because most women in the country have overload of responsibility with the children, do not have job opportunities and are not educated to support themselves. © 2022, Centro Universitario Curitiba - UNICURITIBA. All rights reserved.

Le downsizing en temps de COVID-19 : la difficile conciliation entre le social et l’économique. Le cas des survivants d’un établissement hôtelier en Tunisie

L’objectif de cette recherche est de comprendre comment une entreprise peut mettre en place une stratégie de downsizing socialement responsable en temps de COVID-19. La visée de cette étude est de proposer une analyse fine des formes du downsizing en mettant l’accent sur son caractère distinctif dans les pays du Sud. Les résultats de l’étude qualitative, de nature exploratoire, menée au sein d’un établissement hôtelier en Tunisie mettent en exergue une série de mesures socialement responsables. Parmi ces pratiques à forte valeur ajoutée, figurent notamment la responsabilisation, la participation, l’accompagnement de proximité, la communication, la formation professionnelle, l’implication du syndicat et le respect de la législation sociale. Les conclusions soulignent que la mise en oeuvre d’un ensemble de préalables et de dispositifs avant, au cours et après le downsizing permet de limiter ses dégâts psychologiques et ses effets pervers. Aussi, elles révèlent que le déploiement de pratiques managériales bienveillantes, équitables et respectueuses de la dignité humaine, ainsi que l’adoption d’un agir éthique rendent le downsizing socialement toléré. Il est clair qu’il n’y a pas un modèle typique ou un « one best way » en matière de downsizing. Le recours à une approche ancrée dans les particularismes locaux est plus pertinent qu’un raisonnement en termes de meilleures pratiques universellement applicables. Le downsizing socialement responsable permet de concilier la rationalité psychosociale et la rationalité économique. Toutefois, il exige des concessions, des compromis parfois difficiles et s’appuie sur des équilibres précaires et des arrangements négociés. L’étude souligne qu’il est difficile d’enrayer les conséquences négatives du downsizing sur le plan humain, mais qu’il est nécessaire d’agir adéquatement et justement en faisant preuve de bienveillance et de responsabilité organisationnelle. Précis L’objectif de cette recherche est de comprendre comment l’entreprise peut mettre en place une stratégie de downsizing socialement responsable en temps de COVID-19. Les résultats de l’étude qualitative, de nature exploratoire, menée au sein d’un établissement hôtelier en Tunisie révèlent une série de pratiques socialement responsables qui confère un caractère distinctif à la stratégie de downsizing déployée. Les conclusions soulignent que la mise en oeuvre d’un ensemble de mesures avant, au cours et après le downsizing permet de limiter ses dégâts psychologiques et ses effets pervers. Aussi, elles révèlent que la mobilisation de pratiques managériales bienveillantes, équitables et respectueuses de la dignité humaine, ainsi que l’adoption d’un agir éthique et juste rendent le downsizing socialement toléré.Alternate :The objective of this research is to understand how the company can implement a socially responsible downsizing strategy in times of COVID-19. The aim of this study is to provide a detailed analysis of downsizing forms, emphasizing its distinctive character in southern countries. The results of our qualitative protocol, of an exploratory nature, carried out in a Tunisian hotel, revealed a mix of socially responsible measures. These high added-value practices include accountability, participation, local support, communication, professional training, union involvement and compliance with social legislation. The conclusions underlined that the implementation of a set of prerequisites and mechanisms before, during and after downsizing makes it possible to limit its psychological damage and its perverse effects. Also, they revealed that the deployment of benevolent managerial practices, fair and respectful of human dignity, as well as the adoption of an ethical guidelines have made downsizing socially tolerated. Clearly there is not a typical model or "one best way" when it comes to downsizing. The deployment of an approach rooted in local particularities is more relevant than reasoning in terms of universally applicable best practices. Socially responsible downsizing makes it possible to reconcile psychosocial rationality and economic rationality. However, it requires concessions, difficult compromises, and is based on precarious balances and negotiated arrangements. The study underscored that it is difficult to prevent the negative human consequences of downsizing, but that it is necessary to do things properly and fairly with kindness and organizational responsibility.

THEMES AND CHALLENGES OF END OF LIFE CARE FOR COVID-19 PATIENTS REQUIRING NON-INVASIVE RESPIRATORY SUPPORT

Introduction The COVID-19 pandemic created new challenges due to the high numbers and the high symptom burden of end-of-life patients on respiratory support. Methods We conducted an audit of end-of-life patients on the respiratory HDU wards at Whipps Cross Hospital between 17/09/2020-30/01/2021. Results 84 patients receiving respiratory support (in the form of CPAP and HFNT) died during that time at a mean age of 77 (95% CI 67-87) and median of 79 years. All but one death, which followed a cardiac arrest, were expected. The most common clinical indicator for a patient approaching end-of-life was hypoxia on respiratory support, which was documented in 36 (43%) patients, followed by terminal agitation in 27 (32%) patients. Objections to the medical assessment of terminal illness were raised by 3 families and in 1 case the patient had conflicting wishes. The average time between recognition of a terminal deterioration and death was 1.4 days with a median of 2 days. 29 (35%) patients did not have a specialist palliative care review primarily due to the rapid patient deterioration. 25 (30%) patients were not visited by a relative due to the infection risk. 72 (86%) patients were weaned off respiratory support and those who continued did so due to a medical or patient decision. Despite most patients (82%) receiving continuous subcutaneous infusions with an opiate and benzodiazepine most patients had persistent terminal symptoms: 51 (74%) on infusions had agitation and 38 (55%) were persistently breathlessness. Discussion This data highlights some of the major difficulties faced in caring for patients with COVID on respiratory support and approaching end of life. With the inevitably persisting nature of this pandemic and the possibility of future pandemics still present, it is vital to be able to offer guidance and multidisciplinary input to ensure comfort and dignity for these patients.

Digital aging and mental health deteriorations: Risk mitigation in the older people with liver disease in Indonesia

Objectives: Indonesia is entering an aging society with an older people population reaching 26.82 million people or 9.92% of the total population in 2020 and it is predicted that around one-fifth of Indonesia's population in 2045 will be older people. The senior citizen is the covid-19 most at risk due to comorbidities and low digital literacy. In Indonesia, the liver is one of the highest comorbid factors in increasing the risk of death by 13.5 times and increasing to 16.8 times in the elderly due to COVID-19. This condition increases the aging market in Indonesia but low digital literacy will affect the lower QoL. Materials and Methods: Using data from the 2014 Indonesia Family Life Survey (IFLS), this study aims to analyze mental health problems and mobile phone ownership in older adults (60) with Liver disease. Results: The analysis shows that the proportion of older people with liver disease reaches 4,07% and 59,18% are male. 57,5% of them experienced mental health problems and the percentage is higher in men. However, the percentage of elderly with liver disease experiencing mental health problems will decrease by 6,78% when they have a cellphone. The elderly SES in Indonesia has a fairly diverse distribution between provinces and 55,8% of them are still working. Nearly half of older people's education attainment is elementary school, which reaches 46.05 percent. In general, the elderly with higher digital literacy prefer to seek treatment at a formal health facility than traditional practitioners such as shamans. They tend to seek outpatient care treatment at a community health center or Puskesmas (44,11%), specialist (29,41%), and private hospital (11,76%). Conclusion: Increasing digital aging encourages elderly health literacy, as well as decreases mental health problems. Mainstreaming the digital aging issue can help various information and services needed by the elderly to be healthier, independent, and with dignity.