Patient safety has only recently been subjected to wide-spread systematic study. Healthcare differs from other high risk industries in being more diverse and multi-contextual, and less certain and regulated. Also many patient safety problems are low-frequency events associated with many, varied contributing factors. The subject of this paper is the epistemology of patient safety (the science of the method of finding out about patient safety). Patient safety research is considered here on the background of a risk management framework which requires (...) researchers to: • Understand the context - as a subset of healthcare quality, services and systems research, with technical and human behavioural (cultural) components and a range of external and internal organisational influences, a wide range of research disciplines is necessary • Identify the risks - identify the things that go wrong and the frequency and nature of different types of incidents from sources such as medical record review, observational studies, audit, incident and medico-legal reports • Analyse the risks - deconstruct the things that go wrong, identifying contributing factors and trying to detect trends and patterns in contributing factors, detection, mitigation factors, ameliorating factors and actions taken to reduce risk • Evaluate the risks - decide on priorities, identifying preventive and corrective strategies and judging the risk- and cost-benefit of potential corrective strategies such as standardisation or simplification of a process or device • Manage the risk - evaluate and scope preventive and/or corrective strategies and then implement these, or place the problem on a risk register pending solution, or accept that what is needed is unaffordable • Communicate and consult - use interactive sessions, audit, on-going feedback, reminders and patient mediated prompts • Monitor and review the state of the problem - get baseline trends and patterns so that changes can be tracked and properly attributed to an intervention A hierarchy of levels of evidence has been proposed for clinical research and we argue that insufficient weighting has been given to lower ranked levels of research and to qualitative research, although critical interpretive synthesis is now gaining acceptance in mainstream thinking (e.g. by the Cochrane Collaboration). Fundamental challenges remain including how to grasp the elusive concept of patient safety, how to quantify, characterise and cost the problems, how to judge the extent to which harm can be attributed to errors, violations or system failures, how to identify contributing factors and the extent to which they can be implicated, how to judge whether incidents or their precursors are preventable, how to generate strong evidence to make healthcare safer and how to translate research into practice. Future directions include addressing the mundane as well as rare, dramatic events, and developing further research in non-hospital settings and in developing countries. In summary, a mixture of qualitative and quantitative methods, using information from all available data sources and combining retrospective, real time and prospective study designs, is necessary to address some of the more difficult patient safety problems. (shrink)

THE TITLE W. used the title 'Philosophische Untersuchungen, Versuch einer Umar- beitung' as the heading of his 1936 revision of Br. B. in Vol. ...

The world’s third largest producer of scientific research, Germany, is the origin of the research university and the independent, extra-university research institute. Its dual-pillar research policy differentiates these organizational forms functionally: universities specialize in advanced research-based teaching; institutes specialize intensely on research. Over the past decades this policy affected each sector differently: while universities suffered a lingering “legitimation crisis,” institutes enjoyed deepening “favored sponsorship”—financial and reputational advantages. Universities led the nation’s reestablishment of scientific prominence among the highly competitive European and (...) global science systems after WWII. But sectoral analysis of contributions to science, technology, engineering, mathematics, and medical and health journal publications finds that Germany’s small to medium-sized independent research institutes have made significant, growing contributions, particularly in publishing in higher impact journals proportionally more than their size. Simultaneously—despite dual-pillar policy implications—the university sector continues to be absolutely and relatively successful; not eclipsed by the institutes. Universities have consistently produced two-thirds of the nation’s publications in the highest quality journals since at least 1980 and have increased publications at a logarithmic rate; higher than the international mean. Indeed, they led Germany into the global mega-science style of production. Contrary to assumed benefits of functional differentiation, our results indicate that relative to their size, each sector has produced approximately similar publication records. While institutes have succeeded, the larger university sector, despite much less funding growth, has remained fundamental to German science production. Considering these findings, we discuss the future utility of the dual-pillar policy. (shrink)

This article surveys recent literature on Wittgenstein's "Rule-following considerations" most notably S. Kripke's, C. McGinn's, and G.P. Baker's and P.M.S. Hacker's contributions. I argue that the normativity requirement in rule-following is to be located not in transtemporal but interpersonal sameness of meaning, and that the community-view is false when viewed as a condition on correct rule-following, but true when viewed as providing criteria for the possibility of rule-following.

Reform of the federal income tax system has become a perennial item on the domestic policy agenda of the United States, although there is considerable uncertainty over specifics. Indeed the recent report of the President's Advisory Panel on Federal Tax Reform recommended not one but two divergent policy directions. In Fundamental Tax Reform, top experts in tax policy discuss a wide range of issues raised by the prospect of significant tax reform, identifying the most critical questions and considering whether the (...) answers are known, unknown--or unknowable. The debates over tax reform usually concern the advantages and disadvantages of income-based taxation as opposed to any of the several alternative forms of consumption-based taxation. The book opens with chapters that discuss the strengths, weaknesses, and political feasibility of these options. Other chapters consider the effect of tax reform on businesses, especially their investment behavior, and include a discussion of possible problems in any transition to a consumption-based tax; international taxation issues arising in an era of globalization; and individual behavioral response to tax reform, including a view of the topic from the perspective of the relatively new field of behavioral economics. ContributorsRosanne Altshuler, Alan J. Auerbach, John W. Diamond, Harry Grubert, Arnold C. Harberger, Kevin A. Hassett, Thomas J. Kniesner, Laurence J. Kotlikoff, Edward J. McCaffery, Kathryn Newmark, David Rapson, Daniel Shaviro, Joel Slemrod, James P. Ziliak, George R. ZodrowDiscussants James Alm, Henry J. Aaron, Charles L. Ballard, Leonard E. Burman, Robert S. Chirinko, Robert D. Dietz, Malcolm Gillis, Roger H. Gordon, Jane G. Gravelle, Timothy S. Gunning, James M. Poterba, Thomas S. Neubig, Alan Viard, George Yin John W. Diamond is Edward and Hermena Kelly Fellow in Tax Policy and Adjunct Professor of Economics at the Baker Institute for Public Policy, Rice University. George R. Zodrow is Professor of Economics and Rice Scholar at the Baker Institute and International Research Fellow at the Centre for Business Taxation, Oxford University. (shrink)

On Philosophy and Philosophers is a volume of unpublished philosophical papers by Richard Rorty, a central figure in late-twentieth-century intellectual debates and a primary force behind the resurgence of American pragmatism. The first collection of new work to appear since his death in 2007, these previously unseen papers advance novel views on metaphysics, ethics, epistemology, philosophical semantics and the social role of philosophy, critically engaging canonical and contemporary figures from Plato and Kant to Kripke and Brandom. This book's diverse offerings, (...) which include technical essays written for specialists and popular lectures, refine our understanding of Rorty's perspective and demonstrate the ongoing relevance of the iconoclastic American philosopher's ground-breaking thought. An introduction by the editors highlights the papers' original insights and contributions to contemporary debates. (shrink)

The author investigates how the conception of legal validity as a specific mode of existence, adopted by Kelsen in Allgemeine Theorie der Normen (General Theory of Norms), can be reconciled with a conception of the legal system in which conflicts of legal norms remain of logical concern. To this end he makes use of Ludwig Wittgenstein's picture theory of the proposition as set out in the Tractatus Logico-Philosophicus. The conclusion is that in order to reconcile the two conceptions, the legal (...) system itself must be conceived of as consisting of three sub-systems, namely, (i) a sub-system of perceptible legal judgments, (ii) a sub-system of valid legal conditions, and (iii) a sub-system of observable social practices. (shrink)

Originally published in 1977, this volume analyzes aspects of elementary schooling in the nineteenth century and the ways in which it prepared working-class children for life in industrial Britain. The book examines: The procedures and practices of different types of schools. The ideologies guiding elementary education The social implications of curriculum content and pupils’ and parents’ attitudes to the education provided by the church and state.

This book has been written in the hopes of equipping teachers-in-training—that is, teacher candidates—with the skills needed for action research: a process that leads to focused, effective, and responsive strategies that help students succeed.

In this collection of essays, Feinberg gathers together a number of articles which he has written over the past few years, most of which have appeared in print elsewhere. The few changes made for the present edition do not alter the fundamental content of any of the articles. In the introduction, Feinberg suggests that just as there are general areas of philosophical interest called "theory of value," "theory of knowledge," etc., so there should similarly be a general rubric for the (...) area dealing with questions which are applicable both to the philosophy of law and moral philosophy. For this purpose, Feinberg chooses "theory of responsibility." Both the title of the book and the name for this area of philosophical concern reflect the difficulties inherent in this general area. "Doing" can be applied to an individual who performs actions. Does "deserving" have an equivalent extension? "Responsibility" is a concept which covers both the moral notion of "culpability" and the legal notion of "liability." But is the same criterion for application of the concept of responsibility operative in both the legal and moral domains? Is the concept of "at fault" used univocally in moral and legal contexts? These are just a few of the many questions which arise when discussing a "theory of responsibility." Feinberg has answers for some. He points readers in a direction from which other answers might be found. If nothing else this book is a good launching pad into an area of philosophical concern which is just beginning to be explored.--W. P. G. (shrink)

Pada musim semi, entah kenapa, tidak banyak ikan. Karena tangkapannya sangat tidak stabil, Pekakak mulai berpikir. Lalu membuat beberapa rencana. Dengan otoritas komandonya, dia memanggil Bangau: – Ini adalah musim penangkapan ikan yang sangat sulit. Jika kita ingin kenyang, kita harus membuat usaha patungan. Bangau mengangguk, menambahkan: - Saya setuju; mari kita beternak ikan kakap putih dan ikan mas krusia. Jenis ini berumur panjang dan sangat produktif. Pekakak dan Bangau sepakat untuk berbagi tugas beternak, dan tidak ada diskriminasi yang diizinkan. (...) Namun imbalannya berbeda: Pekakak bertanggung jawab untuk ikan kakap putih dan, dengan demikian, dapat memiliki lebih banyak ikan kakap putih, sedangkan Bangau mendapat ikan mas krusia. Siapapun yang memelihara ikan mana yang lebih banyak akan menikmati 80% dari panen akhir ikan tersebut. Keduanya akan mengevaluasi dan membagi produk ternak pada akhir musim beternak. Ini berarti mengantongi sendiri ikan hasil usaha patungan untuk diri sendiri itu dilarang. (shrink)

A scholarly edition of a work by Adam Smith. The edition presents an authoritative text, together with an introduction, commentary notes, and scholarly apparatus.

Macquarrie is thorough in his coverage of the subject matter, precise in the exposition of his thought, and creative in his attempt to explicate the principles upon which a Christian theology for the twentieth century can be based. In Twentieth Century Religious Thought, Macquarrie concluded that religion and philosophy need each other. There he claimed that from the philosophical side attention should be paid to Martin Heidegger, and from the religious side one should look at Bultmann and Tillich. Macquarrie has (...) done just this in Principles of Christian Theology. This book is divided into three main parts: philosophical theology, symbolic theology, and applied theology. Although there is much of significance in the last two sections, it is in the first one that the author makes his distinctive contribution to theology. His approach is phenomenological. This leads him to an existential interpretation of theology. What he arrived at by means of this approach he called "Existential-Ontological Theism." Although there are some theologians who may have a few doubts as to whether or not Macquarrie has reached his conclusions by stretching some fundamental interpretations too far, it still remains a certainty that this book opens up a new and creative approach to some of the traditional concepts of theology which have been under so much fire in the last few decades.—W. P. G. (shrink)

In all of the writings of Martin Buber there is one major theme which serves as a peg upon which he hangs most of his further thoughts. Nahum Glatzer uses this underlying theme, interpreting it as a "way of response," and brings together selections from many of Buber's works. Thus not only does the reader see the centrality of the "way of response" for this great Jewish thinker, but he captures a feeling for the man himself as well. The "way (...) of response" is not a concept expounded but a life lived, and the selections Glatzer employs in his book brings this out very well.—W. P. G. (shrink)