There is an ever-greater emphasis on the maintenance of professional standards in communication among medical professionals. Much of the focus to date revolves around discourse between patients and families in the clinical arena and reflects standards developed by accrediting agencies and the government. Little has been written about the communication among professionals occurring in the administrative milieu that is largely unseen by those not engaged in the direct provision of or receipt of medical care. That rumours are a part (...) of the interactive discourse is likely not unfamiliar to most in academia. Their potential for damage to the workplace and individuals is very real and requires recognition and in some situations, corporate action. There are options to reduce the likelihood of these kinds of communications and to manage them actively when they occur. What may result is an environment that leads to greater organisational confidence and individual productivity. (shrink)

The author tries to clarify the differences between the Conservative and Labor parties and to justify his preference for the latter. The argument, owing to its informality, makes little contribution to political theory. The earlier case for and against socialist egalitarianism is thoughtful and honest; later chapters on Communism and on America are of lesser merit.--R. G. S.

Ventricular Fibrillation is responsible for a majority of sudden cardiac death, but little is known about how ventricular tachycardia (VT) degenerates into ventricular fibrillation. Several clinical studies focused only on preventing VT with a class III antiarrhythmic drug resulted in many deaths. Our simulations investigate the interactions between an antiarrhythmic drug likely to suppress a VT and a Figure 8 reentry. A parameter AAR is introduced to increase the action potential duration and therefore simulate various Class III drugs. Simulations (...) are ran under several conditions (phases of the reentry, values of AAR, durations). They show that a VT can be suppressed whatever the phase of the reentry but it strongly depends on the duration of the effect. It confirms that a drug which can suppress a reentry can also worsen it. It also shows a great variety of activation patterns and thus the complexity of antiarrhythmic drugs effects. Simulations also demonstrate that suppressing VT is an increasing function of AAR. (shrink)

The unity of Plato's writings is discovered in their connection with Plato's life; they are parts of a "great confession." Wolff reconstructs Plato's life on the basis of his works and interprets his works in the light of his biography. The relevant facts of Plato's life, on Wolff's view, are the trial and death of Socrates, political movements and the study and criticism of other philosophers. These facts tend to throw light on Plato's development but contribute little to our (...) understanding of the internal unity of individual dialogues.--R. G. S. (shrink)

The MS. tradition of Prudentius is particularly interesting, since in the famous Codex Puteanus we have a MS. dating from the early sixth century—i.e. but little more than a hundred years after the publication of the collected poems in 405. Yet it has only been of late years that due consideration has been given to this ancient Codex, which is the actual MS. corrected by Vettius Mavortius' own hand. Mr. Winstedt has spoken of the neglect which it has suffered (...) for the most part from editors, and also of the similar lack of attention paid even by Dressel to its seventh-century companion at Milan—the Codex Ambrosianus; while, later, J. Bergman shewed himself enthusiastic in its praise . A confirmation is now available of a curious and generally discredited reading in this MS. , from that same Arma glossary of ‘saec. viii.-ix’ which bears witness to the readings of a lost Terence MS. of the δ-family, the best minuscule family, older than any extant MS., as I shewed in the April, 1925, number of this journal. At Prud. Apoth. 895 the reading of Puteanus is— Agenitus genitusque deus, pater et patre natus. (shrink)

Information can be public among a group. Whether or not information is public matters, for example, for accounts of interdependent rational choice, of communication, and of joint intention. A standard analysis of public information identifies it with (some variant of) common belief. The latter notion is stipulatively defined as an infinite conjunction: for p to be commonly believed is for it to believed by all members of a group, for all members to believe that all members believe it, and so (...) forth. This analysis is often presupposed without much argument in philosophy. Theoretical entrenchment or intuitions about cases might give some traction on the question, but give little insight about why the identification holds, if it does. The strategy of this paper is to characterize a practical-normative role for information being public, and show that the only things that play that role are (variants of) common belief as stipulatively characterized. In more detail: a functional role for “taking a proposition for granted” in non-isolated decision making is characterized. I then present some minimal conditions under which such an attitude is correctly held. The key assumption links this attitude to beliefs about what is public. From minimal a priori principles, we can argue that a proposition being public among a group entails common commitment to believe among that group. Later sections explore partial converses to this result, the factivity of publicity and publicity from the perspective of outsiders to the group, and objections to the aprioricity of the result deriving from a posteriori existential presuppositions. (shrink)

The Marxist theory of history and of the sources of cultural change is here applied to the Pre-Socratics. As a consequence, most of the book is devoted to pre-history and to the history of Greece from the Homeric Age on. The final portions discussing the Pre-Socratics show the economic sources of the different schools and the ways in which they anticipated confusedly the truths of Dialectical Materialism. The book contributes little either to Marxist theory or to philosophy, and is (...) interesting only as an application of Marxist theory to the history of philosophy.--R. G. S. (shrink)

If you wish to aid the student whose German is weak to begin reading Hegel, you should compose him a literal crib of the type so helpful to the struggling schoolboy; but you should tell him that he must as soon as possible improve his German and throw away his crutch. If, on the other hand, you are fired by the very different ambition of translating Hegel’s thought truly for the intelligent reader who has no German, then you must write (...) fluent idiomatic English which recalls German forms of speech as little as possible. You may now and then in a footnote or a bracket confess to a liberty taken, but you must always be readable and bold. You must of course know your German, and your Hegelian German, very well, but you must not only prune otiose expletives but not shrink even from metamorphosis. Apart from rash Phaethons like Osmaston who knew little German and less philosophy, too many English translators of Hegel have tried to compromise between the high road and the low road; but partly because they have been baffled by an obscure text, partly because they have clung with misplaced fidelity to the German, they have commonly produced dreary versions which crawl cribwise on the ground. They have forgotten that ineptitudes can be nearly as misleading as errors and far more tedious. (shrink)

Health care professionals often face moral dilemmas. Not dealing constructively with moral dilemmas can cause moral distress and can negatively affect the quality of care. Little research has been documented with methodologies meant to support professionals in care for the homeless in dealing with their dilemmas. Moral case deliberation is a method for systematic reflection on moral dilemmas and is increasingly being used as ethics support for professionals in various health-care domains. This study deals with the question: What is (...) the contribution of MCD in helping professionals in an institution for care for the homeless to deal with their moral dilemmas? A mixed-methods responsive evaluation design was used to answer the research question. Five teams of professionals from a Dutch care institution for the homeless participated in MCD three times. Professionals in care for the homeless value MCD positively. They report that MCD helped them to identify the moral dilemma/question, and that they learned from other people’s perspectives while reflecting and deliberating on the values at stake in the dilemma or moral question. They became aware of the moral dimension of moral dilemmas, of related norms and values, of other perspectives, and learned to formulate a moral standpoint. Some experienced the influence of MCD in the way they dealt with moral dilemmas in daily practice. Half of the professionals expect MCD will influence the way they deal with moral dilemmas in the future. Most of them were in favour of further implementation of MCD in their organization. (shrink)

Quel bon vent, quel joli vent, ma vie m’appelle, ma vie m’attend French folk song 1. Presentists and Growing Block theorists appeal to ‘powerful intuitions’ when they defend their respective conceptions of time . Eternalists are prepared to go some length towards ‘reconciling’ the view from nowhen with at least some of these intuitions, or try to explain them away . Unaided intuitions may in fact underdetermine any particular metaphysical choice. One set of intuitions about time seems to have been (...) neglected, though, in spite of its power. These intuitions are the mirror image of those supporting the Growing Block theory , and they are modelled on a pre-reflective understanding of our own life. According to the intuitions, only the future and the present are real; the past isn’t. The present is the constantly eroding edge of the future, which thus shrinks incessantly. There is less and less future as the present proceeds. The obvious intuitive model of this view of time is our life; from which every day eats up a little bit. Smaller scale models are available in everyday life. As you are reading this text, you have less and less to read. You know it. You know that at some point you’ll finish, or stop, reading it. But a model is not enough to make a grand philosophical claim, and indeed the very existence of the model is the ground for a negative claim: a picture, it may be said, is holding you captive. The Future Shrinker has two tasks. The first is to show that the intuitive picture supporting the claim is robust and does not make implausible epistemological claims. The second task is to show that her theory is at least compatible with scientific lore, and at best a good way …. (shrink)

While across the animal kingdom offspring are born smaller than their parents, notable exceptions exist. Several dipteran species belonging to the Hippoboscoidea superfamily can produce offspring larger than themselves. In this essay, the blood‐feeding tsetse is focused on. It is suggested that the extreme reproductive strategy of this fly is enabled by feeding solely on highly nutritious blood, and producing larval offspring that are soft and malleable. This immense reproductive expenditure may have evolved to avoid competition with other biting flies. (...) Tsetse also transmit blood‐borne parasites that cause the fatal diseases called African trypanosomiases. It is discussed how tsetse life history and reproductive strategy profoundly influence the type of vector control interventions used to reduce fly populations. In closing, it is argued that the unusual life history of tsetse warrants their preservation in the areas where human and animal health is not threatened. (shrink)

This paper presents a theoretical elaboration of the ethical framework of classical capitalism as formulated by Adam Smith in reaction to the dominant mercantilism of his day. It is seen that Smith's project was profoundly ethical and designed to emancipate the consumer from a producer and state dominated economy. Over time, however, the various dysfunctions of a capitalist economy — e.g., concentration of wealth, market power — became manifest and the utilitarian ethical basis of the system eroded. Contemporary capitalism, dominated (...) as it is by large corporations, entrenched political interests and persistent social pathologies, bears little resemblance to the system which Smith envisioned would serve the common man. Most critiques of capitalism are launched from a Marxian-based perspective. We find, however, that by illustrating the wide gap between the reality of contemporary capitalism and the model of amoral political economy developed by Smith, the father of capitalism proves to be the most trenchant critic of the current order. (shrink)

I agree with Paul Lewis that mathematics has a valuable but not all-encompassing role in economics, that event regularities must be supplemented with a persuasive narrative, and that inferences can inform our understanding of economic behavior. However, Lewis's full-throated defense of critical realism does little to allay my original concerns. It is absurd to maintain, as critical realists do, that mainstream economics has nothing valuable to offer heterodox economists, as their critique of the quantity theory of money tries to (...) demonstrate. More crucially, critical realists—unlike Austrian economists—neglect to provide an epistemological explanation of economic actors’ perceptions, which is necessary if we are to bridge critical realism's own division of the social world into the “actual,” “empirical,” and “non-actual real.”. (shrink)

Quite rightly, philosophers of physics examine the theories of physics, theories like Quantum Mechanics, Quantum Field Theory, the Special and General Theories of Relativity, and Statistical Mechanics. Far fewer, however, examine how these theories are put to use; that is to say, little attention is paid to the practices of theoretical physicists. In the early 1950s David Bohm and David Pines published a sequence of four papers, collectively entitled, ‘A Collective Description of Electron Interaction.’ This essay uses that quartet (...) as a case study in theoretical practice. In Part One of the essay, each of the Bohm-Pines papers is summarized, and within each summary an overview is given, framing a more detailed account. In Part Two theoretical practice is broken into six elements: (a) the use of models, (b) the use of theory, (c) modes of description and narrative, (d) the use of approximations, (e) experiment and theory, (f) the varied steps employed in a deduction. The last element is the largest, drawing as it does from the earlier ones. Part Three enlarges on the concept of ‘theoretical practice,’ and briefly outlines the subsequent theoretical advances which rendered the practices of Bohm and Pines obsolete, if still respected. (shrink)

Rapid developments in Artificial Intelligence are leading to an increasing human reliance on machine decision making. Even in collaborative efforts with Decision Support Systems (DSSs), where a human expert is expected to make the final decisions, it can be hard to keep the expert actively involved throughout the decision process. DSSs suggest their own solutions and thus invite passive decision making. To keep humans actively ‘on’ the decision-making loop and counter overreliance on machines, we propose a ‘reflection machine’ (RM). This (...) system asks users questions about their decision strategy and thereby prompts them to evaluate their own decisions critically. We discuss what forms RMs can take and present a proof-of-concept implementation of a RM that can produce feedback on users’ decisions in the medical and law domains. We show that the prototype requires very little domain knowledge to create reasonably intelligent critiquing questions. With this prototype, we demonstrate the technical feasibility to develop RMs and hope to pave the way for future research into their effectiveness and value. (shrink)

Health care professionals often face moral dilemmas. Not dealing constructively with moral dilemmas can cause moral distress and can negatively affect the quality of care. Little research has been documented with methodologies meant to support professionals in care for the homeless in dealing with their dilemmas. Moral case deliberation is a method for systematic reflection on moral dilemmas and is increasingly being used as ethics support for professionals in various health-care domains. This study deals with the question: What is (...) the contribution of MCD in helping professionals in an institution for care for the homeless to deal with their moral dilemmas? A mixed-methods responsive evaluation design was used to answer the research question. Five teams of professionals from a Dutch care institution for the homeless participated in MCD three times. Professionals in care for the homeless value MCD positively. They report that MCD helped them to identify the moral dilemma/question, and that they learned from other people’s perspectives while reflecting and deliberating on the values at stake in the dilemma or moral question. They became aware of the moral dimension of moral dilemmas, of related norms and values, of other perspectives, and learned to formulate a moral standpoint. Some experienced the influence of MCD in the way they dealt with moral dilemmas in daily practice. Half of the professionals expect MCD will influence the way they deal with moral dilemmas in the future. Most of them were in favour of further implementation of MCD in their organization. (shrink)

Cultural taboos and their sanctionshave helped to check abuse of the environmentat least among the local people. The disregardfor these traditional checks and balancesespecially among Christians has adverselyaffected their enforcement at this time. Theenvironment and culture preservation inAwka-South were investigated. The faithfulobservance of the traditional laws in the studyarea was attributed to the fact that Awka-Southarea had remained occupied by the same peoplefor centuries. The study showed that thepreserved forests and their shrines in Nibotown have largely remained intact. In Nisetown, (...) however, with nine shrines still inexistence, the rules have relaxed a little,mainly because they embraced modernization. Inthis town, the fringes of the forests may beused for farming but no felling of trees wouldbe allowed. The ``god'' of the shrine in Obunaguvillage was much revered until the advent ofChristianity. This religion has had an erodingeffect on the taboos, which were put in placeto protect their forests and streams. Theabandonment of traditional cultural practicesis doing harm that goes beyond the abrogationof traditional cultural practices to seriousthreat to natural environmental structures. Thecultures of the different tribes in Nigerianeed to be revisited for evaluation and studiesto enable their integration into modernpractices that will make the environment moresustainable. This will be more productive thanthe unilateral introduction of programs,execution, and maintenance methods that arecompletely new, or in many cases run contraryto the cultural practices of the local peopleand tribes of Nigeria. (shrink)

The aim of this article is to give more insight into what ethical challenges clinicians in mental healthcare experience and discuss with a Clinical Ethics Committee in psychiatry in the Region of Southern Denmark. Ethical considerations are an important part of the daily decision-making processes and thereby for the quality of care in mental healthcare. However, such ethical challenges have been given little systematic attention – both in research and in practices. A qualitative content analysis of 55 written case-reports (...) from the Clinical Ethics Committee. The Committee offers clinicians in mental healthcare structured ethical analyses of ethical challenges and makes a thorough written case-report. The ethical challenges are grouped into three overarching topics: 1. Clinicians and their relation to patients and relatives. 2. Clinicians and institutional aspects of mental healthcare 3. Clinicians and mental healthcare in a wider social context. Through presentation of illustrative examples the complexity of daily clinical life in mental healthcare becomes evident, as well as typical interests, values and arguments. This qualitative study indicates that difficult ethical challenges are an inherent part of mental healthcare that requires time, space and competence to be dealt with adequately. (shrink)

Eclipses are proverbially fraught with forebodings. The solar eclipse of 1919 was no exception. Seen in retrospect, that eclipse marked the end of an old era and the beginning of a new in the philosophy of science. Not in science itself, be it noted, for the scientific life is a life of patience and sobriety and continuity, knowing little of what the world calls ‘sensation’. But for the onlookers, the philosophers of science, the event was drama. The reign of (...) Newton, long tottering, was finally broken; Einstein took up the vacant chair. Men were not slow to learn the lesson: if king-making can be done once it can be done again. Philosophy of science must needs hereafter be a philosophy of revolutions—whether continuous revolution or spasmodic revolutions is still a subject of debate. (shrink)

Plato, in the Phaedrus, expressed forebodings about the written word. And the history of hermeneutics does little to dispel Plato’s prophecy of ills to come. At the present time, observes Professor Hirsch, we are, as regards literary criticism, in the high tide of subjectivism and scepticism. The meaning of Scripture is a new revelation to each generation; the meaning of a literary text is what it means to us today, and whatever meaning the author may have intended is irrelevant. (...) The magisterium of the teacher, as the preserver of a heritage and the conveyor of knowledge, has gone: his reading is no more valid than that of a pupil. On the other hand, to shift the focus of discussion from the text to the author is equally unsatisfactory. This course leads us into a search for influences and an enquiry into authorial habits and experiences. Literary criticism degenerates into futility. We must endeavour to fix on a point between these two extremes, a point where an objectively valid interpretation emerges, an interpretation which links the mind of the reader with the mind of the author. We must presume that the author, when he wrote, meant something determinate by his text. Our task is to discover from the text what he meant. How best to perform this task is the theme of the present book. (shrink)

Insight has been investigated under the assumption that participants solve insight problems with insight processes and/or experiences. A recent trend has involved presenting participants with the solution and analysing the resultant experience as if insight has taken place. We examined self-reports of the aha experience, a defining aspect of insight, before and after feedback, along with additional affective components of insight (e.g., pleasure, surprise, impasse). Classic insight problems, compound remote associates, and non-insight problems were randomly interleaved and presented to participants. (...) Solution feedback increased ratings of aha experience in both insight and non-insight problems, with this result being driven by responses to solutions that were initially incorrectly generated. Ratings of aha for correctly generated solutions decreased after the correct solution was presented. These findings have implications for insight research paradigms as well as informing teaching methods. (shrink)

BackgroundThe proper and ethical inclusion of PWLHIV and their young children in research is paramount to ensure valid evidence is generated to optimize treatment and care. Little empirical data exists to inform ethical considerations deemed most critical to these populations. Our study aimed to systematically review the empiric literature regarding ethical considerations for research participation of PWLHIV and their young children.MethodsWe conducted this systematic review in partnership with a medical librarian. A search strategy was designed and performed within the (...) following electronic databases: Ovid MEDLINE, Embase and CINAHL. We screened titles and abstracts using the following inclusion criteria: (1) a study population of PWLHIV or children under 5 years of age; and (2) collection of qualitative or quantitative data regarding ethics of research participation. Excluded were reviews, commentaries, policy statements, clinical care-related ethics concerns, abstracts, case studies, or studies unrelated to HIV research. Studies were appraised for quality, data were extracted, and studies were qualitatively analyzed using a principle-based ethical framework within the Belmont Report.ResultsOf the 7470 titles identified, 538 full-text articles were reviewed for eligibility and only three articles met full criteria for inclusion within this review. While we allowed for inclusion of studies involving young children born to mothers with HIV, only articles focused on PWLHIV were identified. Within the results of these studies, four themes emerged: (1) adequacy of informed consent; (2) consideration of paternal involvement; (3) balancing risks; and (4) access to research and treatment. A strength of this review is that it included perspectives of international research investigators, community leaders, and male partners. However, only two studies collected empiric data from PWLHIV regarding their experiences participating in researchConclusionResearchers and funding agencies should be aware of these considerations and appreciate the value of and critical need for formative research to ensure clinical trials involving PWLHIV promote ethical, well-informed research participation and, ultimately, improve care outcomes. More research is needed to create a comprehensive ethical framework for researchers when conducting studies with PWLHIV. (shrink)

Collaborative research and development (R&D) activities between public universities and industry are of importance for the sustainable development of the innovation ecosystem. However, policymakers especially in developing countries show little knowledge on the issues. In this paper, we analyse the level of university–industry collaboration in Malaysia. We further examine the fundamental conditions that hinder university–industry collaboration despite the government’s initiatives to improve such linkages. We show that the low collaboration is a result of an R&D gap between the entities. (...) While the universities engage in basic and fundamental R&D, the private sectors involved in incremental innovation that requires less R&D investments. The different nature of the industries’ R&D requires closer cooperation between firms namely buyers, suppliers and technical service providers and not the universities. Among others, the lack of an intermediary role, absorptive capacity and collaborative initiative by the industry also contribute to the problem. The study suggests that the collaborative activities can benefit both if deliberate and effective efforts on reducing the R&D mismatch are made between the universities and industry. Likewise, proper institutional arrangements in coordinating these activities are required. This result seems to reflect the nature of many developing countries’ national innovation systems, and therefore, lessons from Malaysia may serve as a good case study. (shrink)

Canada has a marked shortfall between the supply and demand for kidneys for transplantation. Median wait times for deceased donor kidney transplantation vary from 5.8 years in British Columbia, 5.2 years in Manitoba and 4.5 years in Ontario to a little over 2 years in Quebec and Nova Scotia. Living donation provides a viable option for some, but not all people. Consequently, a small number of people travel abroad to undergo kidney transplantation by commercial means. The extent to which (...) they are aware of the potential risks to their health and the health of the kidney vendors is unclear. Travel abroad to obtain a kidney commercially i.e. transplant tourism (TT), raises ethical issues which include the exploitation of the poor, uncertainty of donor informed consent to nephrectomy, poor clinical care and lack of follow up for the donor, commodification of the body and inequity of access to medical care for donors. Also, TT widens socioeconomic disparities in access to transplantation, differing from the Canadian system of universal coverage for healthcare. The Canadian transplant community has discussed how to respond to patients who plan to travel abroad for TT or return with a purchased kidney. Unease rests in the tension between the duty to care for legitimate Canadian residents and the unwillingness to enable TT. This paper discusses three anonymized cases and the Canadian responses to TT as recorded in academic literature and a formal statement by relevant professional bodies. (shrink)

Pregnant women and their interests have been underrepresented in health research. Little is known about issues relevant to women considering research participation during pregnancy. We performed in-depth interviews with 22 women enrolled in either one of two trials sponsored by the National Institutes of Health to assess the safety and immunogenicity of the H1N1 vaccine during pregnancy. Three themes characterized women’s decisions to participate in research: they valued early access to the vaccine, they perceived a safety advantage when participating (...) in research, and they wanted to help advance scientific knowledge. However, there were also some considerations that would disincline them to participate in research—for instance, a significant risk of maternal or fetal harm, the presence of a placebo arm in a study, or a requirement to significantly change planned therapy or behavior. Pregnant women who participated in the H1N1 vaccine trials viewed research favorably, citing its advantages over standard clinical care. These findings emphasize that access to benefit should guide policy for including pregnant women in research. (shrink)

Objectives To conduct an independent evaluation of the first phase of the Health Foundation’s Safer Patients Initiative (SPI), and to identify the net additional effect of SPI and any differences in changes in participating and non-participating NHS hospitals. Design Mixed method evaluation involving five substudies, before and after design. Setting NHS hospitals in the United Kingdom. Participants Four hospitals (one in each country in the UK) participating in the first phase of the SPI (SPI1); 18 control hospitals. Intervention The SPI1 (...) was a compound (multi-component) organisational intervention delivered over 18 months that focused on improving the reliability of specific frontline care processes in designated clinical specialties and promoting organisational and cultural change. Results Senior staff members were knowledgeable and enthusiastic about SPI1. There was a small (0.08 points on a 5 point scale) but significant (P<0.01) effect in favour of the SPI1 hospitals in one of 11 dimensions of the staff questionnaire (organisational climate). Qualitative evidence showed only modest penetration of SPI1 at medical ward level. Although SPI1 was designed to engage staff from the bottom up, it did not usually feel like this to those working on the wards, and questions about legitimacy of some aspects of SPI1 were raised. Of the five components to identify patients at risk of deterioration—monitoring of vital signs (14 items); routine tests (three items); evidence based standards specific to certain diseases (three items); prescribing errors (multiple items from the British National Formulary); and medical history taking (11 items)—there was little net difference between control and SPI1 hospitals, except in relation to quality of monitoring of acute medical patients, which improved on average over time across all hospitals. Recording of respiratory rate increased to a greater degree in SPI1 than in control hospitals; in the second six hours after admission recording increased from 40% (93) to 69% (165) in control hospitals and from 37% (141) to 78% (296) in SPI1 hospitals (odds ratio for “difference in difference” 2.1, 99% confidence interval 1.0 to 4.3; P=0.008). Use of a formal scoring system for patients with pneumonia also increased over time (from 2% (102) to 23% (111) in control hospitals and from 2% (170) to 9% (189) in SPI1 hospitals), which favoured controls and was not significant (0.3, 0.02 to 3.4; P=0.173). There were no improvements in the proportion of prescription errors and no effects that could be attributed to SPI1 in non-targeted generic areas (such as enhanced safety culture). On some measures, the lack of effect could be because compliance was already high at baseline (such as use of steroids in over 85% of cases where indicated), but even when there was more room for improvement (such as in quality of medical history taking), there was no significant additional net effect of SPI1. There were no changes over time or between control and SPI1 hospitals in errors or rates of adverse events in patients in medical wards. Mortality increased from 11% (27) to 16% (39) among controls and decreased from 17% (63) to 13% (49) among SPI1 hospitals, but the risk adjusted difference was not significant (0.5, 0.2 to 1.4; P=0.085). Poor care was a contributing factor in four of the 178 deaths identified by review of case notes. The survey of patients showed no significant differences apart from an increase in perception of cleanliness in favour of SPI1 hospitals. Conclusions The introduction of SPI1 was associated with improvements in one of the types of clinical process studied (monitoring of vital signs) and one measure of staff perceptions of organisational climate. There was no additional effect of SPI1 on other targeted issues nor on other measures of generic organisational strengthening. (shrink)

Perceptual learning involves an improvement in perceptual judgment with practice, which is often specific to stimulus or task factors. Perceptual learning has been shown on a range of visual tasks but very little research has explored chromatic perceptual learning. Here, we use two low level perceptual threshold tasks and a supra-threshold target detection task to assess chromatic perceptual learning and category effects. Experiment 1 investigates whether chromatic thresholds reduce as a result of training and at what level of analysis (...) learning effects occur. Experiment 2 explores the effect of category training on chromatic thresholds, whether training of this nature is category specific and whether it can induce categorical responding. Experiment 3 investigates the effect of category training on a higher level, lateralized target detection task, previously found to be sensitive to category effects. The findings indicate that performance on a perceptual threshold task improves following training but improvements do not transfer across retinal location or hue. Therefore, chromatic perceptual learning is category specific and can occur at relatively early stages of visual analysis. Additionally, category training does not induce category effects on a low level perceptual threshold task, as indicated by comparable discrimination thresholds at the newly learned hue boundary and adjacent test points. However, category training does induce category effects on a supra-threshold target detection task. Whilst chromatic perceptual learning is possible, learnt category effects appear to be a product of left hemisphere processing, and may require the input of higher level linguistic coding processes in order to manifest. (shrink)

Objectives - To explore the wvay ethical principles develop during a medical education course for three groups of medical students - in their first year, at the beginning of their penultimate (fifth) year and towards the end of their final (sixth) year. Design - Survey questionnaire administered to medical students in their first, fifth and final (sixth) year. Setting - A large medical school in Queensland, Australia. Survey sample - Approximately half the students in each of three years (first, fifth (...) and sixth) provided data on a voluntary basis, a total of 385 students. Results - At the point of entry, minor differences were found between medical students and first year law and psychology students. More striking were differences between male and female medical students, suggesting early socialization had a substantial impact here. Conclusions - Results indicate that substantial changes in attitude have developed by the beginning of fifth year with little change thereafter. Gender difference persisted. Some difference in ethical attitudes were found when groups of different ethnic backgrounds were compared. The impact of a move to a graduate medical course, which gives high priority to ethics within a professional development domain, can now be evaluated. (shrink)

“Tell me," Wittgenstein once asked a friend, "why do people always say, it was natural for man to assume that the sun went round the earth rather than that the earth was rotating?" His friend replied, "Well, obviously because it just looks as though the Sun is going round the Earth." Wittgenstein replied, "Well, what would it have looked like if it had looked as though the Earth was rotating?” What would it have looked like if we looked at all (...) sciences from the viewpoint of Wittgenstein’s philosophy? Wittgenstein is undoubtedly one of the most influential philosophers of the twentieth century. His complex body of work has been analysed by numerous scholars, from mathematicians and physicists, to philosophers, linguists, and beyond. This volume brings together some of his central perspectives as applied to the modern sciences and studies the influence they may have on the thought processes underlying science and on the world view it engenders. The contributions stem from leading scholars in philosophy, mathematics, physics, economics, psychology and human sciences; all of them have written in an accessible style that demands little specialist knowledge, whilst clearly portraying and discussing the deep issues at hand. (shrink)

The format of this book is unusual, especially for a book about linguistics. The book is meant primarily as a research monograph aimed at linguists who have some background in formal semantics, e. g. Montague Grammar. However, I have two other audiences in mind. Linguists who have little or no experience of formal semantics, but who have worked through a basic mathematics for linguists course (e. g. using Wall, 1972, or Partee, 1978), should, perhaps with the help of a (...) sympathetic Montague gramma rian, be able to discover enough of how I have adapted some of the basic ideas in formal semantics to make the developments that I undertake in the rest of the book accessible. Logicians and computer scientists who know about model theoretic semantics and formal systems should be able to glean enough from Chapters I and II about linguistic concerns and techniques to be able to read the remainder of the book, again possibly with the help of a sympathetic Montague grammarian. However, readers should beware. Chapter II is not meant as a general introduction either to formal semantics or to linguistics and while much of the presentation there is going over ground that is already well covered in the literature, the particular formulation and the emphases are very much oriented to the developments to be undertaken later in the book. (shrink)

Monica Colvin-Adams,1 Nonyelum Harcourt,1 Robert LeDuc,2 Ganesh Raveendran,1 Yassir Sonbol,3 Robert Wilson,1 Daniel Duprez11Cardiovascular Division, University of Minnesota, Minneapolis, MN, USA; 2Division of Biostatistics University of Minnesota, Minneapolis, MN, USA; 3Cardiovascular Division, St Luke's Hospital System, Sugar Land, TX, USAObjective: Arterial elasticity is a functional biomarker that has predictive value for cardiovascular morbidity and mortality in nontransplant populations. There is little information regarding arterial elasticity in heart transplant recipients. This study aimed to characterize small and large artery elasticity in (...) heart transplant recipients in comparison with an asymptomatic population free of overt cardiovascular disease. A second goal was to identify demographic and clinical factors associated with arterial elasticity in this unique population.Methods: Arterial pulse waveform was registered noninvasively at the radial artery in 71 heart transplant recipients between 2008 and 2010. SAEs and LAEs were derived from diastolic pulse contour analysis. Comparisons were made to a healthy cohort of 1,808 participants selected from our prevention clinic database. Multiple regression analyses were performed to evaluate associations between risk factors and SAE and LAE within the heart transplant recipients.Results: LAE and SAE were significantly lower in heart transplant recipients than in the normal cohort. Female sex and history of ischemic cardiomyopathy were significantly associated with reduced LAE and SAE. Older age and the presence of moderate cardiac allograft vasculopathy were also significantly associated with reduced SAE. Transplant duration was associated with increased SAE.Conclusion: Heart transplants are associated with peripheral endothelial dysfunction and arterial stiffness, as demonstrated by a significant reduction in SAE and LAE when compared with a healthy population. Furthermore, cardiac allograft vasculopathy is associated with a significant reduction in SAE, suggesting a potential use in screening heart transplant recipients at risk for developing this complication.Keywords: heart transplant, endothelial function, arterial elasticity, cardiac allograft vasculopathy. (shrink)

This anthology consists of a collection of papers on the nature of dis positions and the role of disposition concepts in scientific theories. I have tried to make the collection as representative as possible, except that problems specifically connected with dispositions in various special sciences are relatively little discussed. Most of these articles have been previously published. The papers by Mackie, Essler and Trapp, Fetzer (in Section 11), Levi, and Tuomela appear here for the first time, and are simultaneously (...) published in Synthese 34, No. 4, which is a special issue on dispositions. Of the previously published material it should be emphasized that the papers by Hempel and Fisk have been extensively revised specially for this anthology. The papers are grouped in four sections, partlyon the basis of their content. However, due to the complexity of the issues involved, there is considerable overlap in content between the different sections, especially between Sections land 11. I wish to thank Professors James Fetzer and Carl G. Hempel for helpful advicc in compiling this anthology. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:What Emotional Responding Is to Blame It Might Not Be to ResponsibilityR. J. R. Blair (bio)Keywordsblame, responsibility, emotional responses, psychopathyIn this interesting paper, Levy argues that by failing the moral/conventional distinction task (Blair 1995), individuals with psychopathy show a fundamental inability to categorize moral harms and as such their moral responsibility for their actions is reduced. He argues that, although we might still wish to incarcerate such individuals to (...) prevent them inflicting further harm on others, we should be less enthusiastic to blame them for their actions.In many respects, I agree with much of Levy's treatise. I certainly do not regard ascriptions of blame as useful in my own work with this population. I believe that our goal should be to fully understand the nature of their emotional deficit to be able to treat it similarly to other researchers who work to treat other emotional disorders. To me, Levy's argument appears sound.However, I offer three considerations and raise questions within these considerations that might further the debate. First, not all rules involve care-based emotional responses to victims. As Levy notes, this is the origin of the moral/conventional distinction. The problem here is that we do consider someone responsible if they break a conventional transgression. The student talking in class is generally considered blameworthy for this action as long as they knew that the rule of not talking during the lesson applied to that classroom. Yet, there is no victim and no care-based emotional response. Here, the only thing necessary to ascribe blame and responsibility is that the individual knew that a rule exists. Given this holds for conventional transgressions, why must we necessarily make a special case, with respect to responsibility, for moral transgressions?I believe that Levy is fully aware of this concern. He specifically makes reference to moral responsibility and writes that:the kind and degree of wrongness, and therefore blame, which attaches to infringements of the rules [against double parking or line-jumping] is very different, and usually much less significant, than the kind and degree attaching to moral wrongs. For psychopaths, all offences are merely conventional, and therefore—from their point of view—none of them are all that serious.(2007, p. 132)But the danger here is that issues of blame and responsibility may become highly relativistic and hinge on the strength of the emotional reaction. This is a problem because, although we might judge someone as more blameworthy if he intentionally [End Page 149] runs over five people rather than one, do we really consider that there is a distinction in moral responsibility between these two cases? If not, might not responsibility relate to factual knowledge of the existence of the rule against the transgression rather than the emotional response to the transgression?Second, there is considerable debate regarding whether psychopathy represents a taxon or a continuum (e.g., Vasey et al. 2005; Edens et al. 2006). Assuming it does represent a continuum, then we have an additional concern. How little of an emotional response to the transgression reduces one's moral responsibility and blame? Is it only the very reduced (although usually not absent) levels of emotional response that are shown by individuals with psychopathy? Or should we consider moral responsibility and blame proportional to the level of the emotional response? If this latter option is adopted, then what should we do about individuals who show heightened emotional responses, for example, patients with specific anxiety disorders (Rauch, Shin, and Wright 2003)? There are already some data that inhibited children (a developmental precursor to some anxiety disorders; Kagan and Snidman 1999) show heightened conscience development (Asendorpf and Nunner-Winkler 1992). If such children commit moral transgressions, should we regard them as more morally responsible and more blameworthy than regular folks?Third, the issue of intention received little attention in this paper. I have been considered to show a similar lack of attention to intention in the past (Nichols 2002) and, moreover, in some respects the issue was of limited concern given Levy's main goals. However, I mention it because so much of whether we consider someone responsible for their actions and... (shrink)

The relationship of consciousness to brain, which Schopenhauer grandly referred to as the "world knot," remains an unsolved problem within both philosophy and science. The central focus in what follows is the relevance of science---from psychoanalysis to neurophysiology and quantum physics-to the mind-brain puzzle. Many would argue that we have advanced little since the age of the Greek philosophers, and that the extraordinary accumulation of neuroscientific knowledge in this century has helped not at all. Increas- ingly, philosophers and scientists (...) have tended to go their separate ways in considering the issues, since they tend to differ in the questions that they ask, the data and ideas which are provided for consideration, their methods for answering these questions, and criteria for judging the acceptability of an answer. But it is our conviction that philosophers and scientists can usefully interchange, at least to the extent that they provide co~straints upon each other’s preferred strategies, and it may prove possible for more substantive progress to be made. Philosophers have said some rather naive things by ignoring the extraordinary advances in the neurosciences in the twentieth century. The skull is not filled with green cheese! On the other hand, the arrogance of many scientists toward philosophy and their faith in the scientific method is equally naive. Scientists clearly have much to learn from philosophy as an intellectual discipline. Manifestations of Mind: Some Conceptual and Empirical Issues Walter B. Weimer Pages 5-31 The Mysterious “Split‘: A Clinical Inquiry into Problems of Consciousness and Brain Peter H. Knapp Pages 37-69 Mind, Brain, and the Symbolic Consciousness Irwin Savodnik Pages 73-98 Brain and Free Will John C. Eccles Pages 101-121 An Old Ghost in a New Body C. Wade Savage Pages 125-153 How Dogmatic Can Materialism Be? John C. Eccles Pages 155-160 Mental Phenomena as Causal Determinants in Brain Function R. W. Sperry Pages 163-177 Consciousness as an Emergent Causal Agent in the Context of Control System Theory E. M. Dewan Pages 181-198 Reductionism, Levels of Organization, and the Mind-Body Problem William C. Wimsatt Pages 205-267 Mind, Structure, and Contradiction Gordon G. Globus Pages 271-293 Problems Concerning the Structure of Consciousness Karl H. Pribram Pages 297-313 The Role of Scientific Results in Theories of Mind and Brain: A Conversation among Philosophers and Scientists E. M. Dewan, John C. Eccles, Gordon G. Globus, Keith Gunderson, Peter H. Knapp, Grover Maxwell et al. Pages 317-328 Scientific Results and the Mind-Brain Issue: Some Afterthoughts Grover Maxwell Pages 329-358. (shrink)

The first three volumes of the Minnesota Studies have become recent classics. They contain some of the most important and philosophically suggestive papers published during the fifties and early sixties. Some of the discussions which are the basis of volume IV took place in 1966 and a number of the papers here seem "dated"--at least to the extent that discussion of the relevant issues has been superseded by publication in other places. There is still another tour de force by Paul (...) K. Feyerabend, who is becoming more strident and more anarchistic in his politics, epistemology, and philosophy of science. There is a brief paper by the late N. R. Hanson and a typically solid and balanced defense of the "standard conception" of scientific theories by Carl G. Hempel. Three papers by Paul E. Meehl are included which, as usual, excel in the care and clarity of argument--even though there seems to be little that is new here. And there is also an informed discussion of correspondence rules by a number of participants in a special conference dedicated to this subject. While the quality of the papers is high, this volume nevertheless lacks some of the excitement and novelty of the earlier volumes.--R. J. B. (shrink)

In 1958, economist A. W. Phillips published an article describing what he observed to be the inverse relationship between inflation and unemployment; subsequently, the "Phillips curve" became a central concept in macroeconomic analysis and policymaking. But today's Phillips curve is not the same as the original one from fifty years ago; the economy, our understanding of price setting behavior, the determinants of inflation, and the role of monetary policy have evolved significantly since then. In this book, some of the top (...) economists working today reexamine the theoretical and empirical validity of the Phillips curve in its more recent specifications. The contributors consider such questions as what economists have learned about price and wage setting and inflation expectations that would improve the way we use and formulate the Phillips curve, what the Phillips curve approach can teach us about inflation dynamics, and how these lessons can be applied to improving the conduct of monetary policy. ContributorsLawrence Ball, Ben Bernanke, Oliver Blanchard, V. V. Chari, William T. Dickens, Stanley Fischer, Jeff Fuhrer, Jordi Gali, Michael T. Kiley, Robert G. King, Donald L. Kohn, Yolanda K. Kodrzycki, Jane Sneddon Little, Bartisz Mackowiak, N. Gregory Mankiw, Virgiliu Midrigan, Giovanni P. Olivei, Athanasios Orphanides, Adrian R. Pagan, Christopher A. Pissarides, Lucrezia Reichlin, Paul A. Samuelson, Christopher A. Sims, Frank R. Smets, Robert M. Solow, Jürgen Stark, James H. Stock, Lars E. O. Svensson, John B. Taylor, Mark W. Watson. (shrink)

The beginning of the seventy-sixth poem of Catullus appears to cause some modern readers considerable dismay. One may instance the reactions of R. O. A. M. Lyne: ‘Our first reaction to the beginning of this poem may be one of incredulity’ ; ‘The effect of such language is to imply an outrageous and implausible self-righteousness’ ; of K. Quinn: ‘a self-righteousness that makes us feel a little uncomfortable’ ; or of G. Williams: ‘this is sheer melodrama, a deft and (...) surprising reversal of “count your blessings”’; and, further down, on ‘si vitam puriter egi’: ‘This could be simply priggish or outrageous or both, but he does not mean it as a general statement’. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:94 HUME ON THE PERCEPTION OF CAUSALITY Introduction Few issues in philosophy have generated as much debate and as little agreement as Hume's controversial theory of causality. The theory itself has been notoriously difficult to pin down, and not surprisingly empirical evidence has played a very minor role in the issue of what is meant by 'cause'. This is not, however, due to the fact that empirical tests (...) of the theory are hard to devise, but rather because such tests have usually been undertaken by experimental psychologists addressing slightly different issues and unaware of the philosophical implications of their work. However, recent signs of agreement on the overall nature of the theory (reviewed in Beauchamp and Rosenberg, chapter 1) allow a profitable integration of the theory with psychological research on the nature and importance of the perception of causal relations in conditioning. The significance of some of these experiments will be discussed later, and it will be argued that the factors Hume cited as being the essential determinants of causality, when complemented by the additional factor of the degree of contingency between the cause and the effect, correspond exactly with the factors known to affect conditioning; and therefore, that the laws of conditioning specify the properties that define causal relationships. Hume's Theory of Causality Hume was well aware of the importance of causal connections between events as a source of associations in the mind: 95 'Tis sufficient to observe, that there is no relation, which produces a stronger connexion in the fancy, and makes one idea more readily recall another, than the relation of cause and effect betwixt their objects (T II).2 In other words, if we believe a causal relationship exists between two events, then one of these events, the cause, will readily recall the other, the effect. The problem comes, of course, when we ask how it is that we know that a causal relationship exists. Obviously, a distinction must be made between causation as a physical property and causality as a mental idea. Traditionally, the following definitions have been made: causation is the physical property of one event causing another, such as one ball colliding with and causing the movement of a second ball. This property is part of the realm of mechanics and physics. Causality, on the other hand, describes the attribution by an organism of an effect to a cause. Such a distinction is supported by dictionary definitions. These two ways of thinking of what is meant by the term 'cause' are explicitly discussed by Hume. On the notion of physical causation, he says: We may define a CAUSE to be 'An object precedent and contiguous to another, and where all the objects resembling the former are plac'd in like relations of precedency and contiguity to those objects, that resemble the latter.' Of the mental idea of a causal relationship, on the other hand, he says: A CAUSE is an object precedent and contiguous to another, and so united with it, that the idea of the one determines the mind to form the idea of the other, and the impression of the one to form a more lively idea of the other. (T 170) Unfortunately, Hume was never less than imprecise in maintaining this dissociation, and often 96 he plainly confused the two definitions. Hence the academic controversy, between those who, like Kemp Smith, believe that the second definition represents a misguided attempt by Hume to analyse the causal relation on a mental level, 3 and those who see both definitions as essential (e.g. Beauchamp and Rosenberg). But surely the first definition simply represents Hume's view of causality as a philosophical relation, while the second represents his view of it as a psychological fact. And it is as much his intention to explain this fact, that ideas do not simply come into our heads for no apparent reason, but on the contrary are summoned up by preceding thoughts which they are associated, as it is to elucidate the philosophical relation. The extent of Hume's commitment to a psychological explanation of causal attribution has been recognised by Beauchamp and Rosenberg: 5 Hume plainly did develop a theory of causal... (shrink)