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\"As chairman of the Federal Reserve (1979-1987), Paul Volcker slayed the inflation dragon that was consuming the American economy and restored the world's faith in central bankers. That extraordinary feat was just one pivotal episode in a decades-long career serving six presidents. His insight into world-changing events such as the end of the Bretton Woods system, the closing of the 'gold window,' and the financial crisis of 2008 provide enduring lessons about the critical importance of open, disciplined, and efficient government. Told with wit, humor, and down-to-earth erudition, the narrative of Volcker's career illuminates the changes that have taken place in American life, government, and the economy since World War II. He vibrantly illustrates the crises he managed alongside the world's leading politicians, central bankers, and financiers. Yet he first found his model for competent and ethical governance in his father, the town manager of Teaneck, NJ, who instilled Volcker's dedication to absolute integrity and his \"three verities\" of stable prices, sound finance, and good government.\"--Publisher's description.

The business ethics field contains a number of explanations for the imagination's influence on decision-making. This has benefited moral theorizing because approaches that utilize the imagination tend to acknowledge important biological and psychological forces that influence the way we understand situations, develop strategies for problem-solving, and choose courses of action. But, I argue, the broad range of approaches has also served as an obstacle to theory development in the field. Given the variety of theoretical and disciplinary approaches, coupled with the diversity of applications, it would be fair to judge the current state of theory as fractured. To bring focus to theory development, this conceptual study of the moral imagination is grounded in the work of one discipline, one theorist, one text: Plato's Republic. The primary outcome of this study is the demonstration of the conditions under which the imagination serves to augment and support rationality rather than serving as an impediment. The systematic nature of Plato's theory aids in the formation of more coherent conceptual grounding than currently available in the field. A final contribution of this study is the positioning of Plato as a proper beginning or foundation to any further theory development in the moral imagination.

Modernism is both a contested aesthetic category and a powerful political statement. Modernist music was condemned as degenerate by the Nazis and forcibly replaced by socialist realism under the Soviets. Sympathetic philosophers and critics have interpreted it as a vital intellectual defence against totalitarianism, yet some American critics consider it elitist, undemocratic, and even unnatural. Drawing extensively on the philosophy of Heidegger and Badiou, Quilting Points proposes a new dialectical theory of faithful, reactive, and obscure subjective responses to musical modernism, which embraces all the music of Western modernity.

This issue was initiated in a period of global tension and widespread corporate expressions of concern about racism. The articles presented here document the continued presence of disparate racialized experiences in a range of work environments. They provide deep insight into the ways that race shapes the lives of educators, researchers, students, employees, and managers. Such racialized experiences are widely unacknowledged by those whose lives and bodies insulate them. In the time since we initiated this special issue, the anxiety related to talking about race in schools and the workplace has become yet more virulent. In the United States, many municipalities have adopted laws constraining and controlling classroom conversations about race. Corporations continue to struggle with how to implement high-minded DEI policy statements without provoking backlash. We are hopeful that these articles provide greater awareness of racialized capitalism. Further, we aspire to open the door for business ethics research that recognizes the impact of race on institutional policies as well as formal and informal practices. Awareness, recognition, and acknowledgment of disparate impact are essential steps in creating more just work and educational environments.

Background In Sierra Leone (SL), a low-income country in West Africa, dental care is very limited, largely private, and with services focused in the capital Freetown. There is no formal dental education. Ten dentists supported by a similar number of dental care professionals (DCPs) serve a population of over 7.5 million people. The objective of this research was to estimate needs-led requirements for dental care and human resources for oral health to inform capacity building, based on a national survey of oral health in SL. Methods A dedicated operational research (OR) decision tool was constructed in Microsoft Excel to support this project. First, total treatment needs were estimated from our national epidemiological survey data for three key ages (6, 12 and 15 years), collected using the ‘International Caries Classification and Management System (ICCMS)’ tool. Second, oral health needs were extrapolated to whole population levels for each year-group, based on census demographic data. Third, full time equivalent (FTE) workforce capacity needs were estimated for mid-level providers in the form of Dental Therapists (DTs) and non-dental personnel based on current oral disease management approaches and clinical timings for treatment procedures. Fourth, informed by an expert panel, three oral disease management scenarios were explored for the national population: (1) Conventional care (CC) : comprising oral health promotion (including prevention), restorations and tooth extraction; (2) Surgical and Preventive care (S 5&6 P and S 6 P) : comprising oral health promotion (inc. prevention) and tooth extraction (D5 and D6 together, & at D6 level only); and (3) Prevention only (P) : consisting of oral health promotion (inc. prevention). Fifth, the findings were extrapolated to the whole population based on demography, assuming similar levels of treatment need. Results To meet the needs of a single year-group of childrens’ needs, an average of 163 DTs (range: 133–188) would be required to deliver Conventional care (CC) ; 39 DTs (range: 30–45) to deliver basic Surgical and Preventive care (S 6 P) ; 54 DTs for more extended Surgical and Preventive care (S 5&6 P) (range 38–68); and 27 DTs (range: 25–32) to deliver Prevention only (P) . When scaled up to the total population, an estimated 6,147 DTs (range: 5,565–6,870) would be required to deliver Conventional care (CC) ; 1,413 DTs (range: 1255–1438 DTs) to deliver basic Surgical and Preventive care (S 6 P) ; 2,000 DTs (range 1590–2236) for more extended Surgical and Preventive care (S 5&6 P) (range 1590–2236); and 1,028 DTs to deliver Prevention only (P) (range: 1016–1046). Furthermore, if oral health promotion activities, including individualised prevention, could be delivered by non-dental personnel, then the remaining surgical care could be delivered by 385 DTs (range: 251–488) for the S 6 P scenario which was deemed as the minimum basic baseline service involving extracting all teeth with extensive caries into dentine. More realistically, 972 DTs (range: 586–1179) would be needed for the S 5&6 P scenario in which all teeth with distinctive and extensive caries into dentine are extracted. Conclusion The study demonstrates the huge dental workforce needs required to deliver even minimal oral health care to the Sierra Leone population. The gap between the current workforce and the oral health needs of the population is stark and requires urgent action. The study also demonstrates the potential for contemporary epidemiological tools to predict dental treatment needs and inform workforce capacity building in a low-income country, exploring a range of solutions involving mid-level providers and non-dental personnel.

Background Pre-hospital and emergency services in Indonesia are still developing. Despite recent improvements in the Indonesian healthcare system, issues with the provision of pre-hospital and emergency services persist. The demand for pre-hospital and emergency services has not been the subject of previous research and, therefore, has not been fully understood. Our research explored the utilization of emergency medical services by patients attending hospital emergency departments in Jakarta, Indonesia. Methods The study used a cross-sectional survey design involving five general hospitals (four government-funded and one private). Each patient’s demographic profile, medical conditions, time to treatment, and mode of transport to reach the hospital were analysed using descriptive statistics. Results A total of 1964 (62%) patients were surveyed. The median age of patients was 44 years with an interquartile range (IQR) of 26 to 58 years. Life-threatening conditions such as trauma and cardiovascular disease were found in 8.6 and 6.6% of patients, respectively. The majority of patients with trauma travelled to the hospital using a motorcycle or car (59.8%). An ambulance was used by only 9.3% of all patients and 38% of patients reported that they were not aware of the availability of ambulances. Ambulance response time was longer as compared to other modes of transportation (median: 24 minutes and IQR: 12 to 54 minutes). The longest time to treatment was experienced by patients with neurological disease, with a median time of 120 minutes (IQR: 78 to 270 minutes). Patients who used ambulances incurred higher costs as compared to those patients who did not use ambulances. Conclusion The low utilization of emergency ambulances in Jakarta could be contributed to patients’ lack of awareness of medical symptoms and the existence of ambulance services, and patients’ disinclination to use ambulances due to high costs and long response times. The emergency ambulance services can be improved by increasing population awareness on symptoms that warrant the use of ambulances and reducing the cost burden related to ambulance use.

We compared the transmission performances of 600 Gbit/s PM-64QAM WDM signals over 75.6 km of single-mode fibre (SMF) using EDFA, discrete Raman, hybrid Raman/EDFA, and first-order or second-order (dual-order) distributed Raman amplifiers. Our numerical simulations and experimental results showed that the simple first-order distributed Raman scheme with backward pumping delivered the best transmission performance among all the schemes, notably better than the expected second-order Raman scheme, which gave a flatter signal power variation along the fibre. Using the first-order backward Raman pumping scheme demonstrated a better balance between the ASE noise and fibre nonlinearity and gave an optimal transmission performance over a relatively short distance of 75 km SMF.

This paper presents a case study comparing text analysis approaches used to classify the current status of a patient to inform scheduling. It aims to help one of the UKs largest healthcare providers systematically capture patient outcome information following a clinic attendance, ensuring records are closed when a patient is discharged and follow-up appointments can be scheduled to occur within the time-scale required for safe, effective care. Analysing patient letters allows systematic extraction of discharge or follow-up information to automatically update a patient record. This clarifies the demand placed on the system, and whether current capacity is a barrier to timely access. Three approaches for systematic information capture are compared: phrase identification (using lexicons), word frequency analysis and supervised text mining. Approaches are evaluated according to their precision and stakeholder acceptability. Methodological lessons are presented to encourage project objectives to be considered alongside text classification methods for decision support tools.

Background There are few contemporary studies on the time taken to complete dental procedures, those most heavily relied on in the United Kingdom date back to 1999. Objectives This work aimed to establish how long members of the dental team took to complete specific dental procedures, relevant to their scope of practice. Methods Data were collected via a purposive sample of 96 dentists, dental hygienists/therapists and dental nurses. Via an online survey, participants were asked to state the mean, minimum and maximum time they estimated that they took to complete individual dental procedures. Results The mean time taken to complete procedures common to both dentists and dental hygienists/therapists ranged from 3.7 to 4 min respectively for clinical note reading prior to seeing patients to 30.1 and 28 min to undertake root surface debridement. There were no significant differences between the time taken by dentists and dental hygienists/therapists to treat adult patients. However, in all but one procedure, dental hygienists/therapists reported taking longer ( p  = 0.04) to treat child patients. Conclusions The data provided here represent an up to date assessment of the time taken to complete specific tasks by different members of the dental team. These data will be of value to service planners and commissioners interested in evolving a dental care system that employs a greater degree of skill-mix and preventively oriented care.

ObjectivesCurrent guidelines for screening for blunt cerebrovascular injury (BCVI) are commonly based on the expanded Denver criteria, a set of risk factors that identifies patients who require CT-angiographic (CTA) screening for these injuries. Based on previously published data from our center, we have adopted a more liberal screening guideline than those outlined in the expanded Denver criteria. This entails routine CTA of the neck for all blunt trauma patients already undergoing CT of the cervical spine and/or CTA of the chest. The aim of this study was to analyze the incidence of patients with BCVI who did not meet any of the risk factors included in the expanded Denver criteria.MethodsA retrospective review of all patients diagnosed with BCVI between June 2014 and December 2019 at a Level I Trauma Center were identified from the trauma registry. Medical records were reviewed for the presence or absence of risk factors as outlined in the expanded Denver criteria. Demographic data, time to CTA and treatment, BCVI grade, Glasgow Coma Scale and Injury Severity Score were collected.ResultsDuring the study period, 17 054 blunt trauma patients were evaluated, and 29% (4923) underwent CTA of the neck to screen for BCVI. 191 BCVIs were identified in 160 patients (0.94% of all blunt trauma patients, 3.25% of patients screened with CTA). 16% (25 of 160) of patients with BCVI had none of the risk factors outlined in the Denver criteria.ConclusionOur findings indicate that reliance on the expanded Denver criteria alone for BCVI screening will result in missed injuries. We recommend CTA screening in all patients with blunt trauma undergoing CT of the cervical spine and/or CTA of the chest to minimize this risk.Level of evidenceLevel III, therapeutic/care management.