Objectives—To evaluate a departmental computer system.Design—a. Direct comparison of the time taken to use a manual system with the time taken to use a computer system for lung function evaluation, loan of equipment and production of correspondence. b. Analysis of the accuracy of data capture before and after the introduction of the computer system. c. Analysis of the comparative running costs of the manual and computer systems.Setting—Within a department of respiratory medicine serving a hospital of 1323 beds.Main Outcome Measures—a. Time (...) taken to perform functions with the assistance of computerised methods, in comparison to the manual method used alone. b. Accuracy of data capture. c. Relative running costs.Results—a. The computer system was significantly faster than the manual system for lung function evaluation, loan of equipment, and checking for overdue equipment. The production of correspondence was slightly slower with the computer. b. All outpatient episodes, but only 43 of 65 of inpatient episodes, were captured. Lung function and managerial report data were accurate using both manual and computerised methods. The manual system for equipment loans was inefficient, and use of the computer resulted in the recovery of 221 nebulisers. c. Development costs for 1988–1990 were high. Only £1200 to £1845 per year was recovered directly from staff time saved by the computer but larger savings resulted from changes in work practice. After 10 years the projected deficit is £10 000 per annum in running costs.Conclusions—In comparison with the manual methods, the computer system has shown significant advantages which provide accurate information, with significant favourable effects on working practices. In evaluating computer systems used in clinical practice it is essential to ensure that the projected work practice benefits are achieved without unacceptable costs in staff time, inaccurate data and high financial outlay. (shrink)

Engaging, accessible, and up-to-date, this work introduces the central debates of English language philosophy since 1945. It begins with a brief description of philosophical debate during the first half of the twentieth century, offering fascinating discussions of writings by Wittgenstein, Ryle, Austin, Quine, and Sellars. It then describes several ensuing philosophical debates that have shaped philosophical discussions since the 1960s, addressing the Davidson/Dummett debate on language; the Kripke/Lewis debate on possible worlds; the Popper/Kuhn debate on the justification in epistemology; the (...) debates on materialism, functionalism, and dual-aspect theories of mind; and recent work in moral psychology, metaethics, and normative ethics. It also includes a critical discussion of Rorty's metaphilosophical skepticism and pays extensive attention to writings of Strawson, Putnam, Evans, McDowell, Williams, Nagel, and many other contemporary philosophers. (shrink)

This book explores the idea that we have two minds - one automatic, unconscious, and fast, the other controlled, conscious, and slow. It brings together leading researchers on dual-process theory to summarize the state of the art highlight key issues, present different perspectives, and provide a stimulus to further work.

Jacques Lacan's thinking revolutionised the theory and practice of psychoanalysis and had a major impact in fields as diverse as film studies, literary criticism, feminist theory and philosophy. Yet his writings are notorious for their complexity and idiosyncratic style. Emphasising the clinical basis of Lacan's work, _An Introductory Dictionary of Lacanian Psychoanalysis_ is an ideal companion to his ideas for readers in every discipline where his influence is felt. The _Dictionary _features: * over 200 entries, explaining Lacan's own terminology and (...) his use of common psychoanalytic expressions * details of the historical and institutional context of Lacan's work * reference to the origins of major concepts in the work of Freud, Saussure, Hegel and other key thinkers * a chronology of Lacan's life and works. (shrink)

This paper forms an introduction to this issue, the contents of which arose directly or indirectly from a conference in May 2001 on Corruption of scientific integrity? — The commercialisation of academic science. The introduction, in recent decades, of business culture and values into universities and research institutions is incompatible with the openness which scientific and all academic pursuit traditionally require. It has given rise to a web of problems over intellectual property and conflict of interest which has even led (...) to corporate sponsors’ suppressing unfavourable results of clinical trials, to the detriment of patients’ health. Although there are those who see the norms of science developing to recognise the importance of instrumental science aiming at specific goals and of knowledge judged by its value in a context of application, none justifies the covert manipulation of results by vested interest. Public awareness of these problems is growing and creating a climate of opinion where they may be addressed. We suggest a way forward by the introduction of nationally and internationally-accepted guidelines for industrial collaboration which contain proper protections of the core purposes of universities and of the independence of their research. Some codes suggested for this purpose are discussed. We note that some universities are moving to adopt such codes of conduct, but argue the need for strong support from the government through its funding bodies. (shrink)

In this paper we explore the practice of interdisciplinarity by examining how the UK research councils addressed the problem of the sustainable city during the 1990s. In developing their research programmes, the councils recognised that the problems of the sustainable city transcended conventional disciplinary boundaries and that an interdisciplinary approach was needed. In practice, however, initially radical proposals to research the city as a complex combination of science and technology and society contracted into more cognate collaborations that emphasised either science (...) or technology or society, with the result that interdisciplinarity came to be located within research councils rather than between them. This, in turn, led to the development of a third kind of interdisciplinarity as the responsibility for making the connections between the research programmes was outsourced to the user communities—the local authorities. Unfortunately, local authorities struggled to find the resources to conduct this work so that the radical interdisciplinarity recommended at the start of the decade remained unaccomplished at the end. In describing these events we emphasise roles of paradigms and epistemic cultures in shaping research approaches and the complications they raise for the triangulation between approaches that is assumed in the idea of interdisciplinarity. We do not wish to be entirely negative, however, and conclude by suggesting some ways in which the quality and success of this much-needed interdisciplinary work could be increased. (shrink)

What purpose is served by renovation or redesign of professionalism, and how successful a process is it likely to be? This article addresses these questions by examining the effectiveness as a professional development mechanism of the imposition of changes to policy and/or practice that require modification or renovation of professionalism. The 'new' professionalisms purported to have been fashioned over the last two or three decades across the spectrum of UK education sectors and contexts have been the subject of extensive analysis, (...) and this article avoids going over old ground and revisiting issues that have already been much debated. Nevertheless, the example of UK government education policy during this period is used as a basis for considering the pitfalls associated with mechanisms for modifying professionalism through a reform and standards agenda. The article's analysis incorporates redefinition and examination of the concept and substance of professionalism and offers new perspectives in the form of three distinct conceptions: demanded, prescribed and enacted professionalism. Exploring the existentialist status of 'new' or 'modified' professionalisms and the relationship between professionality, professional culture and professionalism, it examines how professionalism may be interpreted and utilised for the development of education professionals. (shrink)

M. Oaksford and N. Chater presented a Bayesian analysis of the Wason selection task in which they proposed that people choose cards in order to maximize expected information gain as measured by reduction in uncertainty in the Shannon-Weaver information theory sense. It is argued that the EIG measure is both psychologically implausible and normatively inadequate as a measure of epistemic utility. The article is also concerned with the descriptive account of findings in the selection task literature offered by Oaksford and (...) Chater. First, it is shown that their analysis data reported in the recent article of K. N. Kirby is unsound; second, an EIG analysis is presented of the experiments of P. Pollard and J. St. B. T. Evans that provides a strong empirical disconfirmation of the theory. (shrink)

BackgroundThis study aimed to determine what, how, and under what circumstances individual-focused interventions improve well-being and decrease burnout for critical care healthcare professionals.MethodThis realist approach, expert opinion interview, was guided by the Realist And Meta-narrative Evidence Synthesis: Evolving Standards II guidelines. Semi-structured interviews with critical care experts were conducted to ascertain current and nuanced information on a set of pre-defined individual interventions summarized from a previous umbrella review. The data were appraised, and relationships between context, mechanisms, and outcomes were extracted, (...) which created theory prepositions that refined the initial program theory.ResultsA total of 21 critical care experts were individually interviewed. By understanding the complex interplay between organizational and personal factors that influenced intervention uptake, it was possible to decipher the most likely implementable intervention for critical care healthcare professionals. The expert recommendation suggested that interventions should be evidence-based, accessible, inclusive, and collaborative, and promote knowledge and skill development. Unique mechanisms were also required to achieve the positive effects of the intervention due to the presence of contextual factors within critical care settings. Mechanisms identified in this study included the facilitation of self-awareness, self-regulation, autonomy, collaboration, acceptance, and inclusion.ConclusionThis validation of a theoretical understanding of intervention that addressed well-being and burnout in critical care healthcare professionals by expert opinion demonstrated essential mechanisms and contextual factors to consider when designing and implementing interventions. Future research would benefit by piloting individual interventions and integrating these new theoretical findings to understand better their effectiveness for future translation into the “real-world” setting. (shrink)

Horse racing has begun to enter an economic decline in many countries, notably represented by a decline in revenues in betting volumes. A number of reasons may be attributed to this: the success of...

The republic -- Knowledge -- Reality -- Dialectic -- Value -- Causality and change -- Politics, art and the fate of the soul.

It proposed that certain types of human resource (HR) practices can be both normatively rooted and also instrumental in achieving economic goals. Specifically,managers may perceive organizational justice HR practices and work-family conflict HR practices as a legitimate response to these seemingly conflicting interests. Legitimacy evaluations of HR practices by managers are also likely to impact managerial perceptions of organizational reputation.

This essay addresses the violence of the digital world through its relationship to the visuality of noise and how it shapes the image of thought. Noting how deep and contemplative silence is integral to any creative and critical process, it fleshes out the ways the hyper-technologization of life is throwing us into an immersive abyss. This represents another indicator in the digital colonization of the human condition, through which the poetic is being completely appropriated by a technological vision for species (...) being. Calling for a revival in attentive silence, it draws upon literary thinkers and artists, to move beyond the mimetic understanding for art and reveal the violent depths of digitalization and its total noise seduction which ultimately devour its own content. Over-stimulation thus becomes an audible clamor for lives lost within a digital trace; lives which no longer find they are able to cast any meaningful shadow. (shrink)

The COVID-19 pandemic presents unprecedented challenges to public health decision-making. Specifically, the lack of evidence and the urgency with which a response is called for, raise the ethical challenge of assessing how much (and what kind of) evidence is required for the justification of interventions in response to the various threats we face. Here we discuss the intervention of introducing technology that aims to trace and alert contacts of infected persons—contact tracing (CT) technology. Determining whether such an intervention is proportional (...) is complicated by complex trade-offs and feedback loops. We suggest that the resulting uncertainties necessitate a precautionary approach. On the one hand, precautionary reasons support CT technology as a means to contribute to the prevention of harms caused by alternative interventions, or COVID-19 itself. On the other hand, however, both the extent to which such technology itself present risks of serious harm, as well as its effectiveness, remain unclear. We therefore argue that a precautionary approach should put reversibility of CT technology at the forefront. We outline several practical implications. (shrink)

“Run-in” and “washout” periods involving the withholding of medication are widely used in drug research trials in pursuit of both patient safety and scientific reliability. Such no-medication periods can be justified ethically provided that they are apparent to patients, who can thereby properly consent to undergoing them. Less widespread, but still common, is the practice of “single blinding” no-medication periods, concealing them from patients by means of placebo. Whilst all placebos involve a measure of concealment, their use is typically justified (...) in drug research trials by their preserving the uncertainty generated by the random allocation of different treatments within a drug trial; and by the researchers openly declaring both the randomisation process and the chances of receiving placebo. In the single blind placebo “run-in” or “washout”, neither of these conditions is met.This paper considers three possible defences of the practice of using single blind placebo “run-ins” or “washouts” and finds them all to fail; the practice appears ethically unjustified. (shrink)

The author read all of Maine's most important works & created this text which discusses the most valuable information to be gained from each work of Maine. The author believed that all the theories of Maine can now be found in this handy text, making it a valuable contribution to the student of the law.

Patients participating in the shared benefits of publicly funded health care enjoy the benefits of treatments tested on previous patients. Future patients similarly depend on treatments tested on present patients. Since properly designed research assumes that the treatments being studied are—so far as is known at the outset—equivalent in therapeutic value, no one is clinically disadvantaged merely by taking part in research, provided the research involves administering active treatments to all participants. This paper argues that, because no other practical or (...) moral considerations count decisively against so doing, we could and should oblige patients to agree to receive indicated treatment within the terms of any concurrent research protocols. This ensures their treatment will benefit not only themselves but also future patients through contributing to new knowledge. By analogy with the paying of income tax, patients should not be allowed to “veto” their social responsibility to take part in clinical research. (shrink)

Sir Austin Bradford Hill’s ‘aspects of causation’ represent some of the most influential thoughts on the subject of proximate causation in health and disease. Hill compiled a list of features that, when present and known, indicate an increasing likelihood that exposure to a factor causes—or contributes to the causation of—a disease. The items of Hill’s list were not labelled ‘criteria’, as this would have inferred every item being necessary for causation. Hence, criteria that are necessary for causation in health, disease (...) and intervention processes, whether known, knowable, or not, remain undetermined and deserve exploration. To move beyond this position, this paper aims to explore factors that are necessary in the constitution of causative relationships between health, disease processes, and intervention. To this end, disease is viewed as a causative pathway through the often overlapping stages of aetiology, pathology and patho-physiology. Intervention is viewed as a second, independent causative pathway, capable of causing changes in health for benefit or harm. For the natural course of a disease pathway to change, we argue that intervention must not only occupy the same time and space, but must also share a common form; the point at which the two pathways converge and interact. This improved conceptualisation may be used to facilitate the interpretation of clinical observations and inform future research, particularly enabling predictions of the mechanistic relationship between health, disease and intervention. (shrink)