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)

This paper traces an expanded ethical perspective for youth and community work (YCW) practice in response to the climate and biodiversity crises. Discussing ecological ethics, we problematise the liberal humanist emphasis on utilitarianism and reject it as inappropriate for YCW in these times. Instead, we argue for an ecocentric practice ethic which intrinsically values the non-human world. To advance an ecocentric ethical perspective for YCW we draw on decolonial and posthuman theory. Inspired by a Freirean dialogical approach, we apply these (...) theoretical domains as lenses to problematise YCW practice, seeking a generative dialogue between perspectives. Through this, we identify three emergent tasks for ecocentric YCW: (a) thinking and acting beyond the individual; (b) cultivating reciprocal care and connection and (c) practicing critical pedagogies of place. This third element builds on YCW's social pedagogic tradition and provides a practical means to incorporate ecocentric ideas into practice. We conclude that, given the unprecedented implications of climate crises and biodiversity collapse, a YCW ethics that does not consider these implications for young people is insufficient for the context of practice today. Enacting an ecocentric YCW ethics requires ongoing collective praxis and dialogue between young people, practitioners, educators, managers and students. (shrink)

New pedagogical visions and technological developments have brought argumentation to the fore of educational practice. Whereas students previously 'learned to 'argue', they now 'argue to learn': collaborative argumentation-based learning has become a popular and valuable pedagogical technique, across a variety of tasks and disciplines. Researchers have explored the conditions under which arguing to learn is successful, have described some of its learning potentials and have developed Internet-based tools to support such learning. However, the further advancement of this field presently faces (...) several problems, which the present book addresses. Three dimensions of analysis - historical, theoretical and empirical - are integrated throughout the book. Given the nature of its object of study - dialogue, interaction, argumentation, learning and teaching - the book is resolutely multidisciplinary, drawing on research on learning in educational and psychological sciences, as well as on philosophical and linguistic theories of dialogue and argumentation. (shrink)

We report evidence further supporting homology between proteins in the F1FO‐ATP synthetase and the bacterial flagellar motor (BFM). BFM proteins FliH, FliI, and FliJ have been hypothesized to be homologous to FO‐b + F1‐δ, F1‐α/β, and F1‐γ, with similar structure and interactions. We conduct a further test by constructing a gene order dataset, examining the order offliH,fliI, andfliJgenes across the phylogenetic breadth of flagellar and nonflagellar type 3 secretion systems, and comparing this to published surveys of gene order in the (...) F1FO‐ATP synthetase, its N‐ATPase relatives, and the bacterial/archaeal V‐ and A‐type ATPases. Strikingly, thefliHIJgene order was deeply conserved, with the few exceptions appearing derived, and exactly matching the widely conserved F‐ATPase gene orderatpFHAG, coding for subunits b‐δ‐α‐γ. The V/A‐type ATPases have a similar conserved gene order. Our results confirm homology between these systems, and suggest a rare case of synteny conserved over billions of years, predating the Last Universal Common Ancestor (LUCA). (shrink)

The decision-theoretic account of probability in the Everett or many-worlds interpretation, advanced by David Deutsch and David Wallace, is shown to be circular. Talk of probability in Everett presumes the existence of a preferred basis to identify measurement outcomes for the probabilities to range over. But the existence of a preferred basis can only be established by the process of decoherence, which is itself probabilistic.

We report the identification of a recurrent, 520-kb 16p12.1 microdeletion associated with childhood developmental delay. The microdeletion was detected in 20 of 11,873 cases compared with 2 of 8,540 controls and replicated in a second series of 22 of 9,254 cases compared with 6 of 6,299 controls. Most deletions were inherited, with carrier parents likely to manifest neuropsychiatric phenotypes compared to non-carrier parents. Probands were more likely to carry an additional large copy-number variant when compared to matched controls. The clinical (...) features of individuals with two mutations were distinct from and/or more severe than those of individuals carrying only the co-occurring mutation. Our data support a two-hit model in which the 16p12.1 microdeletion both predisposes to neuropsychiatric phenotypes as a single event and exacerbates neurodevelopmental phenotypes in association with other large deletions or duplications. Analysis of other microdeletions with variable expressivity indicates that this two-hit model might be more generally applicable to neuropsychiatric disease. © 2010 Nature America, Inc. All rights reserved. (shrink)

The American Medical Association enacted its Code of Ethics in 1847, the first such national codification. In this volume, a distinguished group of experts from the fields of medicine, bioethics, and history of medicine reflect on the development of medical ethics in the United States, using historical analyses as a springboard for discussions of the problems of the present, including what the editors call "a sense of moral crisis precipitated by the shift from a system of fee-for-service medicine to a (...) system of fee-for-system medicine, better known as 'managed care.'" The authors begin with a look at how the medical profession began to consider ethical issues in the 1800s and subsequent developments in the 1900s. They then address the sociological, historical, ethical, and legal aspects of the practice of medicine. Later chapters discuss current and future challenges to medical ethics and professional values. Appendixes display various versions of the AMA's Code of Ethics as it has evolved over time. Contributors: George J. Annas, J.D., M.P.H., Arthur Isak Applbaum, Ph.D., Robert B. Baker, Ph.D., Chester R. Burns, M.D., Ph.D., Arthur L. Caplan, Ph.D., Alexander Morgan Capron, J.D., Christine K. Cassel, M.D., Linda L. Emanuel, M.D., Ph.D., Eliot L. Freidson, Ph.D., Albert R. Jonsen, Ph.D., Stephen R. Latham, J.D., Ph.D., Susan E. Lederer, Ph.D., Florencia Luna, Ph.D., Edmund D. Pellegrino, M.D., Charles E. Rosenberg, Ph.D., Mark Siegler, M.D., Rosemary A. Stevens, Ph.D., Robert M. Tenery, Jr., M.D., Robert M. Veatch, Ph.D., John Harley Warner, Ph.D., Paul Root Wolpe, Ph.D. (shrink)

The gist of Edward Said’s attack on Israel is that Zionism is racism. The very appearance of his essay in a special issue devoted to racism is an interesting fact in itself. But the fact that the editors up until now received no responses to Said carries special significance. It signals, or can be read as signaling, that the literary-critical establishment has reached a consensus and that liberal supporters of Israel in our discipline have retreated from the field.I may be (...) wrong about this, of course, for other explanations are possible, but Houston A. Baker, Jr.’s observations a year later on that special issue would seem to reinforce my view. Baker describes Said’s method as aiming “to prove that ‘A’ is as good as ‘B’ and to induce shame in defenders of ‘B’ who have made other axiological choices.” Baker protests against this method, however, since it gives too much play to “B,” so that “it is difficult to hear a Palestinian voice separate from the world of Jewish discourse.” Then he adds in parentheses: “”2 In Baker’s language, only Jews are likely to disagree, and these “Jews,” conceived as a unitary group, are a client state and are compared by means of allusion to the corrupt, libidinous king who executed the true prophet , the herald of Jesus. These comments are remarkable in any context, but especially so in a forum on racism. Robert J. Griffin is a lecturer in English at Tel Aviv University. He is currently working on two books, one on Samuel Johnson and one on literary historiography. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:Dictionary of Scripture and Ethics ed. by Joel B. GreenTimothy J. SandovalDictionary of Scripture and Ethics Edited by Joel B. Green grand rapids, mi: baker academic, 2011. 912 pp. $60.00.An important addition to the scholarly literature that relates the Bible and ethics, the Dictionary of Scripture and Ethics (DSE) stands as a marker of how far that scholarly enterprise has come in the last forty years. As (...) the volume’s editor notes, if a generation ago James Gustafson lamented the paucity of efforts to link scripture and ethics, this is no longer the case in either ethics or biblical studies (1).DSE (to which I contributed one entry) is comprehensive, containing entries on a range of ethical topics and every biblical book. The volume includes an introduction delineating the organizational principles of the dictionary and three fine essays sketching the ethical shape of scripture, the history of relating scripture to ethics, and methodological issues in this endeavor. Published by a Christian press with entries betraying a mix of conservative (Catholic, evangelical) and liberal perspectives, DSE is oriented toward Christian scripture and Christian ethics. This is no criticism but an observation about DSE’s scope in relation to its title (21).In its approximately nine hundred pages, DSE contains some entries on ethical topics that barely allude to the biblical tradition while other entries on biblical material read not much differently from a standard Bible dictionary entry. Yet most articles on topics in ethics helpfully point to key biblical texts associated with the topic. Many others also deftly relate the history of thinking on an ethical issue and its biblical foundations. Most entries on the Bible likewise successfully sketch how biblical texts explore moral matters, and these articles regularly point out ethical “problems” that many biblical texts evoke for contemporary readers (e.g., concerning nationalism, violence, sexuality, and the like).Those of us in biblical studies who seek to articulate what Hans Frei called the “abiding significance” of the Bible sometimes falter in this effort, offering [End Page 222] stale, strained, or canned ideas about what passage X or Y “might mean for us today.” We falter, perhaps, because we have been deeply formed by the historical-critical study of the Bible. We thus often lack a vocabulary and logic, a different sort of discourse that does not merely translate into ethical and theological terms the exegetical findings we arrive at as classically trained biblical scholars but also engages in a quite different sort of exegetical work. In particular, the entries in DSE that treat broader topics in ethics will expose biblical scholars to different modes of relating critically to the texts than we are accustomed to. DSE will thus prove particularly useful for those of us who wish to explore and cultivate an exegetical practice as well as an identity as exegetes that is distinct from what emerges when we apply the historical and other critical tools that our training has bequeathed us (33).Ethicists can be assured that the entries on the Bible reliably sketch basic, current discussions in biblical studies although inevitably specialists will quibble over details and occasionally over broader issues—something the editor notes happens even between entries within DSE (2). As one of those quibbling specialists, I hoped to find an entry on “hermeneutics” or “biblical hermeneutics” in a volume so concerned with biblical interpretation, though a number of articles do, more or less, address such issues. I must leave it to ethicists to discern the quality and consistency of DSE entries on ethics.In short, DSE may offer only a first step for students and scholars seeking to relate scripture and ethics, but it is an important step.Timothy J. SandovalBrite Divinity SchoolCopyright © 2016 Society of Christian Ethics... (shrink)

Naturalism is perhaps the most pervasive “-ism” in contemporary philosophy. Different variations of naturalism can be found in virtually all corners of theoretical and practical philosophy. Critics have rightfully noted that it is (a) often not clear what “naturalism” means exactly and, subsequently, (b) whether those who consider themselves naturalists in the same philosophical debate actually hold compatible, let alone the same, beliefs. -/- Among the different forms of naturalism that hold currency today, scientific naturalism seems to be the most (...) widespread and therefore articulated. It can be summarized as the ontological thesis that what exists are solely the entities posited by the natural sciences and the methodological thesis that philosophical inquiry should take the results of the natural sciences as authoritative. The paradigm of scientific naturalism has received a growing amount of critical attention from within and outside of analytic philosophy in the last few decades. The main thrust of a host of these critiques is to “soften” the claim of scientific naturalism by rejecting its reductionist or even eliminativist implications, yet retaining a commitment to naturalism under a new description. This has led to a proliferation of new forms of naturalism that seek to broaden the criteria which determine what belongs to the natural world, usually self-titled as a “liberal” or “relaxed” naturalism. Within the analytic tradition, naturalism has been thus critiqued since the 1990s by thinkers like Hornsby, Strawson, Nagel, Stroud, Putnam, McDowell or more recently Baker, De Caro, Macarthur, Beale & Kidd, Cahill & Raleigh. Such critiques are commonly motivated by Neo-Aristotelian and/or Wittgensteinian intuitions. From outside the analytic tradition, phenomenologists in the Husserlian tradition as well as thinkers in the Idealist tradition have been steadfastly critical of scientific naturalism as well, albeit for different reasons. However, these new proposals all have to contend with scientific naturalism and its more restrictive criteria for what counts as natural (although these are debated in their own right). (shrink)

An in-situ transmission electron microscopy straining technique has been used to investigate the dynamics of dislocation-defect interactions in ion-irradiated copper and the subsequent formation of defect-free channels. Defect removal frequently required interaction with multiple dislocations, although screw dislocations were more efficient at annihilating defects than edge dislocations were. The defect pinning strength was determined from the dislocation curvature prior to breakaway and exhibited values ranging from 15 to 175 MPa. Pre-existing dislocations percolated through the defect field but did not show (...) long-range motion, indicating that they are not responsible for creating the defect-free channels and have a limited contribution to the total plasticity. Defect-free channels were associated with the movement of many dislocations, which originated from grain boundaries or regions of high stress concentration such as at a crack tip. These experimental results are compared with atomistic simulations of the interaction of partial dislocations with defects in copper and a dispersed-barrier-hardening crystal plasticity model to correlate the observations to bulk mechanical properties. (shrink)

Woodger's substitution of the "allegedly more precise term 'an environmentally insensitive set of lives'" for the term 'an inborn character' is discussed by haldane. He proposes that "woodger's definitions do not appear to have reached precision." (staff).

In the Foundations of the Metaphysics of Morals Kant presented a method for discovering what morality requires us to do in any situation and claimed that it is a method everyone can use. The method consists in testing one's maxim against the requirement stated in the formulations of the categorical imperative. There has been endless discussion of the adequacy of Kant's method in giving moral guidance, but there has been little effort to situate Kant's view of ethical method in its (...) historical context. In this paper I try to do so. I take the label "method of ethics" from the work of Henry Sidgwick. A method of ethics, he says, is any rational procedure by which we determine what it is right for an individual to do or what an individual ought to do. Since the moralists I want to consider do not all think of morality as rational, I shall broaden the notion by saying that a method is any systematic or regular procedure, rational or not, by which we determine what morality requires... (shrink)

Company–community agreements are widely considered to be a practical mechanism for recognising the rights, needs and priorities of peoples impacted by mining, for managing impacts and ensuring that mining-derived benefits are shared. The use and application of company–community agreements is increasing globally. Notwithstanding the utility of these agreements, the gender dimensions of agreement processes in mining have rarely been studied. Prior research on women and mining demonstrates that women are often more adversely impacted by mining than men, and face greater (...) challenges in accessing development opportunities that mining can bring. Nonetheless, there is currently little guidance for companies, government or communities in bringing a gender perspective to the fore in mining and agreement processes. It is undisputed in human development literature that investment in women and sensitivity to gender delivers long-term health, education and local development outcomes. In mining and development, a number of key factors remain unexplored. These include: women’s participation in agreement processes, the gendered distribution of agreement benefits, and the extent to which impacts and benefits influence women’s development and economic inclusion. This paper presents the results of the first phase of an applied research project undertaken by the Centre for Social Responsibility in Mining at The University of Queensland and funded by the Minerals Council of Australia and the Department of Foreign Affairs and Trade. The project sought to connect with experienced practitioners who had been directly involved in mining and agreement processes to document and analyse grounded perspectives on gender dynamics and agreements, and connect those experiences with the broader literature. Findings from this study have implications for the role of mining companies and governments in promoting gender equality and empowerment as part of their commitments to sustainable development. They also have implications for community groups and their representatives in terms of how they might engage in agreement processes to maximise women’s participation and influence. In many social contexts, a key challenge will be navigating the territory of cultural norms and gender equality, particularly in cultures where women’s influence in the public sphere is not strong. The authors argue that without consideration of a gender perspective, including gender’s intersection with other factors such as class, race, poverty level, ethnic group and age, mining agreements will not be inclusive, may exacerbate gender inequalities, and fail to contribute to long-term sustainable development. (shrink)

The path to consensus about physicians’ exercise of conscience was not linear. It looped back on itself as new insights illuminated earlier deliberations and in turn led to further insights. In particular, coming to agreement about physicians’ responsibility in regard to referral charted a route through many course corrections.

Disturbed identity is one of the defining characteristics of Borderline Personality Disorder manifested in a broad spectrum of dysfunctions related to the self, including disturbances in meaning-generating self-narratives. Autobiographical memories are memories of personal events that provide crucial building-blocks in our construction of a life-story, self-concept, and a meaning-generating narrative identity. The cultural life script represents culturally shared expectations as to the order and timing of life events in a prototypical life course within a given culture. It is used to (...) organize one’s autobiographical memories. Here, 17 BPD-patients, 14 OCD-patients, and 23 non-clinical controls generated three important autobiographical memories and their conceptions of the cultural life script. BPD-patients reported substantially more negative memories, fewer of their memories were of prototypical life script events, their memory narratives were less coherent and more disoriented, and the overall typicality of their life scripts was lower as compared with the other two groups. (shrink)

We give a unified account of some results in the development of Polyadic Inductive Logic in the last decade with particular reference to the Principle of Spectrum Exchangeability, its consequences for Instantial Relevance, Language Invariance and Johnson's Sufficientness Principle, and the corresponding de Finetti style representation theorems.