Background Recent publications reveal shortcomings in evidence review and summarization methods for patient decision aids. In the large-scale "Share to Care (S2C)" Shared Decision Making (SDM) project at the University Hospital Kiel, Germany, one of 4 SDM interventions was to develop up to 80 decision aids for patients. Best available evidence on the treatments' impact on patient-relevant outcomes was systematically appraised to feed this information into the decision aids. Aims of this paper were to (1) describe how PtDAs are developed (...) and how S2C evidence reviews for each PtDA are conducted, (2) appraise the quality of the best available evidence identified and (3) identify challenges associated with identified evidence. Methods The quality of the identified evidence was assessed based on GRADE quality criteria and categorized into high-, moderate-, low-, very low-quality evidence. Evidence appraisal was conducted across all outcomes assessed in an evidence review and for specific groups of outcomes, namely mortality, morbidity, quality of life, and treatment harms. Challenges in evidence interpretation and summarization resulting from the characteristics of decision aids and the type and quality of evidence are identified and discussed. Conclusions Evidence reviews in this project were carefully conducted and summarized. However, the evidence identified for our decision aids was indeed a "scattered landscape" and often poor quality. Facing a high prevalence of low-quality, non-directly comparative evidence for treatment alternatives doesn't mean it is not necessary to choose an evidence-based approach to inform patients. While there is an urgent need for high quality comparative trials, best available evidence nevertheless has to be appraised and transparently communicated to patients. (shrink)

BackgroundCritical Incident Reporting Systems (CIRS) provide a well-proven method to identify clinical risks in hospitals. All professions can report critical incidents anonymously, low-threshold, and without sanctions. Reported cases are processed to preventive measures that improve patient and staff safety. Clinical ethics consultations offer support for ethical conflicts but are dependent on the interaction with staff and management to be effective. The aim of this study was to investigate the rationale of integrating an ethical focus into CIRS.MethodsA six-step approach combined the (...) analysis of CIRS databases, potential cases, literature on clinical and organizational ethics, cases from ethics consultations, and experts’ experience to construct a framework for CIRS cases with ethical relevance and map the categories with principles of biomedical ethics.ResultsFour main categories of critical incidents with ethical relevance were derived: (1) patient-related communication; (2) consent, autonomy, and patient interest; (3) conflicting economic and medical interests; (4) staff communication and corporate culture. Each category was refined with different subcategories and mapped with case examples and exemplary related ethical principles to demonstrate ethical relevance.ConclusionThe developed framework for CIRS cases with its ethical dimensions demonstrates the relevance of integrating ethics into the concept of risk-, quality-, and organizational management. It may also support clinical ethics consultations’ presence and effectiveness. The proposed enhancement could contribute to hospitals’ ethical infrastructure and may increase ethical behavior, patient safety, and employee satisfaction. (shrink)

(2012). Gingerbread Nuts and Pebbles: Frege and the Neo-Kantians – Two Recently Discovered Documents. British Journal for the History of Philosophy. ???aop.label???. doi: 10.1080/09608788.2012.692665.

Social enterprises, as typical hybrid organisations, are embedded in a plural institutional environment in which some stakeholders regard achieving social goals as fundamental, while others see economic profit as the priority. A great challenge for social enterprises is dealing with the conflicts resulting from the diverse expectations of stakeholders. Based on the existing works on organisational legitimacy and the social business model, we propose a legitimacy-based social enterprise model composed of three main phases, namely, legitimacy proposition, legitimacy strategy planning, and (...) legitimacy strategy implementation. Our model is meant to serve as an effective legitimacy-building tool for social enterprises of various kinds. (shrink)

It has been proved that total generalized variation can better preserve edges while suppressing staircase effect. In this paper, we propose an effective hybrid regularization model based on second-order TGV and wavelet frame. The proposed model inherits the advantages of TGV regularization and wavelet frame regularization, can eliminate staircase effect while protecting the sharp edge, and simultaneously has good capability of sparsely estimating the piecewise smooth functions. The alternative direction method of multiplier is employed to solve the new model. Numerical (...) results show that our proposed model can preserve more details and get higher image visual quality than some current state-of-the-art methods. (shrink)

In theTractatus, Wittgenstein advocates two major notational innovations in logic. First, identity is to be expressed by identity of the sign only, not by a sign for identity. Secondly, only one logical operator, called “N” by Wittgenstein, should be employed in the construction of compound formulas. We show that, despite claims to the contrary in the literature, both of these proposals can be realized, severally and jointly, in expressively complete systems of first-order logic. Building on early work of Hintikka’s, we (...) identify three ways in which the first notational convention can be implemented, show that two of these are compatible with the text of theTractatus, and argue on systematic and historical grounds, adducing posthumous work of Ramsey’s, for one of these as Wittgenstein’s envisaged method. With respect to the second Tractarian proposal, we discuss how Wittgenstein distinguished between general and non-general propositions and argue that, claims to the contrary notwithstanding, an expressively adequate N-operator notation is implicit in theTractatuswhen taken in its intellectual environment. We finally introduce a variety of sound and complete tableau calculi for first-order logics formulated in a Wittgensteinian notation. The first of these is based on the contemporary notion of logical truth as truth in all structures. The others take into account the Tractarian notion of logical truth as truth in all structures over one fixed universe of objects. Here the appropriate tableau rules depend on whether this universe is infinite or finite in size, and in the latter case on its exact finite cardinality.As it is obviously easy to express how propositions can be constructed by means of this operation and how propositions are not to be constructed by means of it, this must be capable of exact expression.5.503. (shrink)

Condoravdi shows that the ignorance component is not a presupposition: • Ignorance is not signalled as taken for granted • No presupposition denial • No presupposition filtering So, what else could I have reached for in 2000? Not much, because I tend to buy my tools on the open market rather than develop them myself.

Media guidelines on safe suicide-related reporting are within the suicide prevention armamentarium. However, implementation issues beleaguer real-world practice. This study evaluated the perspectives of the Malaysian media community, persons with lived experience of suicidal behavior, and mental health professionals on suicide-related reporting in terms of the impact, strategies, challenges, and the implementation of guidelines on safe reporting. Three focus group discussions of purposively sampled Malaysian media practitioners, PLE, and MHP were audio-recorded, transcribed, coded and thematically analyzed. Inclusion criteria were: English (...) fluency, no clinical depression or suicidal ideation, no recent previous suicide attempts or suicide bereavement. Three major themes emerged: Unsafe Reporting; Impact; and Safe Reporting. Most described current reporting as unsafe by being potentially triggering to media users and may contribute to contagion effect. Positive impacts identified included raised awareness toward suicide and its prevention. Unsafe reporting was attributed to inadequate awareness, knowledge, and guidance, lack of empathy and accountability, job-related factors, popularity-seeking, lack of monitoring and governance, and information source with unsafe content. Majority agreed on how suicide stories should be framed to produce a safe report. The media community diverged on how detailed a suicide story should be. Safe reporting challenges included difficulties in balancing beneficial versus harmful details, social media ubiquity and its citizen reporters. Participants suggested these safe reporting strategies: stakeholder engagement, educational approaches, improving governance and surveillance, and guidelines revision. Most acknowledged the relevance of guidelines but were unaware of the existence of local guidelines. Implementation challenges included the dilemma in balancing media industry needs vis-à-vis safe reporting requirements, stakeholder engagement difficulties and social media regulation. There is poor awareness regarding safe suicide-related reporting across all groups. PLE and MHP were negatively impacted by current unsafe messaging which aggravated trauma and grief reactions. Postvention support gaps for mental health professionals were highlighted. Safe reporting promotion strategies should include stakeholder engagement to increase awareness on minimizing Werther and maximizing Papageno effects. Strategic re-examination and dissemination of local media guidelines to address new media issues, and effective surveillance mechanisms, are crucial in sustainable improvement of safe reporting practices. (shrink)

This chapter explores the relationship between Goldman's thesis and the classical jury theorem. It identifies the minimal modification needed in order to recover Goldman's thesis in a Condorcetian framework. Goldman's thesis can be recast as a generalization of the classical Condorcet jury theorem. The central move needed to recover Goldman's thesis from a generalized jury theorem is to replace Condorcet's assumption that there is a single truth to be tracked with the assumption of multiple such truths: one for each voter. (...) In Goldman's picture, there is still an indirect, derivative sense in which there exists an 'overall' truth about the correct outcome for the electorate in aggregate. This 'overall' truth is determined, of course, by the profile of voter‐specific truths and therefore depends on the identity of the electorate. The chapter also provides some numerical examples to illustrate the implications of the generalized jury theorem. (shrink)

In pathological conditions associated with persistent increases in hemodynamic workload (old myocardial infarction, high blood pressure, valvular heart disease), a number of signalling pathways are activated in the heart, all of which promote hypertrophic growth of the heart, characterised at the cellular level by increases in individual cardiac myocyte size. Some of these pathways are required for a successful adaptation to cardiac injury. Other pathways are maladaptive, however, as they lead to progressive contractile dysfunction and heart failure. The free radical (...) gas nitric oxide and natriuretic peptides, both of which are produced in the heart, have emerged as endogenous inhibitors of maladaptive hypertrophy signalling. Overall, it appears that cardiac hypertrophy is controlled by an interplay of pro‐ and antihypertrophic signalling networks. This delicate balance can tip towards adaptation or heart failure. In the future, patients living with cardiac disease may benefit from therapeutic strategies targeting maladaptive hypertrophy signalling pathways. BioEssays 26:608–615, 2004. © 2004 Wiley Periodicals, Inc. (shrink)

This paper describes an innovative just-in-time health humanities programme to educate and provide support to COVID-19 frontline doctors-in-training. The programme incorporates small-group screening of the Netflix documentary, The Next Pandemic from the Explained series, followed by a one-hour facilitated discussion to explore themes surrounding the current pandemic and its impact on frontline doctors in a tertiary paediatric hospital in Singapore. Themes derived from the film included preparedness, blame, and the impact on healthcare workers and public, which were further discussed to (...) include concerns regarding current local readiness levels given global connectivity, the need for international cooperation, and the effects of blame such as racism and prejudice. The association with culture; the current impact on healthcare workers, physician-patient relationships, and the public including the role of social media, the government and associated public reactions were also explored. These rich discussions demonstrate the pivotal role health humanities has in times of uncertainty such as an emerging infectious disease outbreak by providing timely pandemic education and supporting reflective learning. (shrink)

This study investigates switching costs in landmark-based wayfinding using olfactory and visual landmark information. It has already been demonstrated that there seem to be no switching costs, in terms of correct route decisions, when switching between acoustically and visually presented landmarks. Olfaction, on the other hand, is not extensively focused on in landmark-based wayfinding thus far, especially with respect to modality switching. The goal of this work is to empirically test and compare visual and olfactory landmark information with regard to (...) their suitability for wayfinding including a modality switch. To investigate this, an experiment within a virtual environment was conducted in which participants were walked along a virtual route of 12 intersections. At each intersection, landmark information together with directional information was presented, which was to be memorized and recalled in the following phase, either in the same or in the other modality. The results of the study show that, in contrast to the no-switching costs between auditory and visual landmarks in previous studies, switching costs occur when switching modality from visual to olfactory and vice versa. This is indicated by both longer decision times and fewer correct decisions. This means that a modality switch involving olfactory landmark information is possible but could lead to poorer performance. Therefore, olfaction may still be valuable for landmark-based-wayfinding. We argue that the poorer performance in the switching-condition is possibly due to higher cognitive load and the separate initial processing of odors and images in different cognitive systems. (shrink)

The sense of agency is a basic feature of our subjective experience. Experimental studies usually focus on either its attributional aspects or on its motoric aspects. Here, we combine both aspects and focus on the subjective experience of the time between action and effect. Previous studies [Haggard, P., Aschersleben, G., Gehrke, J., & Prinz, W.. Action, binding and awareness. In W. Prinz, & B. Hommel, Common mechanisms in perception and action: Attention and performance. Oxford: Oxford University Press] have shown a (...) temporal attraction in the perceived times of actions and effects, but did directly not study the relation between them. In three experiments, time estimates of an interval between an action and its subsequent sensory effect were obtained. The actions were either voluntary key press actions performed by the participant or kinematically identical movements applied passively to the finger. The effects were either auditory or visual events or a passive movement induced to another finger. The results first indicated a shortening of the interval between one’s own voluntary action and a subsequent effect, relative to passive movement conditions. Second, intervals initiated by observed movements, either of another person or of an inanimate object, were always perceived like those involving passive movements of one’s own body, and never like those involving active movements. Third, this binding effect was comparable for auditory, somatic and visual effects of action. Our results provide the first direct evidence that agency involves a generalisable relation between actions and their consequences, and is triggered by efferent motor commands. (shrink)

This festschrift includes a dozen essays on issues that have been at the focus of Kai Nielsen's research, mainly issues in ethics and political philosophy. Among these are four essays on socialism and Marxism. There are also essays on philosophy of religion, epistemology, and meta-philosophy.

I thought the paper by Kai-yee Wong and Chris Fraser was fascinating and insightful. Two things I especially appreciated are the clarity with which they summarize my views. I think they are quite fair and accurate. Second, I appreciate their suggestion that the way to deal with the practical problem of weakness of will has much to do with the role of the Background in shaping our actions. I think they are especially on the right track when they say that (...) the improvement of Background skills may actually narrow the range of real options for action, (p. 21) nonetheless, they do not decrease freedom. As they say, “It is a process of strengthening the self, and the agent is likely to experience the concomitant restriction of ‘live’ options not as a limitation but as strength of character.” (p. 21). That seems to me very much on the right track. What they are suggesting, and it is a powerful addition to my own writings, is that we should not just think of the Background as facilitating languages, games and social practices generally, but for morality as well (p. 23). (shrink)

Drawing on insights of thinkers in the natural rights tradition, Draper analyzes numerous hypothetical cases including those involving a runaway trolley, then seeks to determine if killing civilians in war is ever justified. In his consideration of this issue he avoids appealing to the principle of double effect. Having considered hypothetical cases at length, he leaves it to others to decide if any option to go to war is justifiable. In this regard he himself is sceptical.

African ethics is primarily concerned with community and harmonious communal relationships. The claim is frequently made on behalf of African moral beliefs and customs that African society does not objectify and exploit nature and natural existents, unlike Western moral attitudes and practices. This book investigates whether this claim is correct by examining religious and philosophical thought, as well as traditional cultural practices in Africa. Through exploration of what kind of status is reserved for other-than-human animals in African ethics, Horsthemke argues (...) that moral perceptions and attitudes on the African continent remain resolutely anthropocentric, or human-centred. Although values like ubuntu (humanness) and ukama (relationality) have been expanded to include nonhuman nature, animals have no rights, and human duties to them are almost exclusively 'indirect'. Animals and African Ethics concludes by asking whether those who, following their own liberation, continue to exploit and oppress other creatures, are not thereby contributing to their own dehumanization. (shrink)

In einer qualitativen Interviewstudie zur Situation und zu Veränderungen in deutschen Krankenhäusern berichteten GeschäftsführerInnen und ÄrztInnen übereinstimmend von hohem und zunehmendem Druck, mittels der medizinisch-pflegerischen Leistungen Gewinne machen zu müssen. Während die GeschäftsführerInnen dabei jedoch bei patientenbezogenen ärztlichen Entscheidungen keine ethischen Konflikte sahen, berichteten ÄrztInnen von erheblichen Verletzungen des ärztlichen Ethos. Während die GeschäftsführerInnen erklärten, sie würden von den ÄrztInnen „ethisch korrektes Entscheiden“ erwarten, berichteten ÄrztInnen, dass die Rahmenbedingungen ihrer Arbeit die Unabhängigkeit ärztlicher Entscheidungen untergrüben, indem betriebswirtschaftliche Interessen die Medizin (...) korrumpierten. Entscheidungen zur stationären Aufnahme, zur Wahl der Behandlungsprozesse und zur Entlassung der PatientInnen seien in zunehmendem Maße an wirtschaftlichen Interessen des Hauses und damit nicht allein an den medizinischen Bedarfen der PatientInnen orientiert. GeschäftsführerInnen bewerteten die Unabhängigkeit ärztlicher Entscheidungen hoch, während ÄrztInnen diese als deutlich eingeschränkt bezeichneten. Die Ergebnisse verweisen auf ungelöste Konflikte zwischen Medizinethik und „Ökonomie“. Organisationsethik ist zur Vermittlung auf der Ebene der Krankenhäuser und des Gesundheitswesens insgesamt gefordert. Sie muss sich darüber hinaus mit der Wissensproduktion im Feld der Versorgungs- und Qualitätsforschung kritisch auseinandersetzen. (shrink)

We investigate whether ordinary quantification over objects is an extensional phenomenon, or rather creates non-extensional contexts; each claim having been propounded by prominent philosophers. It turns out that the question only makes sense relative to a background theory of syntax and semantics (here called a grammar) that goes well beyond the inductive definition of formulas and the recursive definition of satisfaction. Two schemas for building quantificational grammars are developed, one that invariably constructs extensional grammars (in which quantification, in particular, thus (...) behaves extensionally) and another that only generates non-extensional grammars (and in which quantification is responsible for the failure of extensionality). We then ask whether there are reasons to favor one of these grammar schemas over the other, and examine an argument according to which the proper formalization of deictic utterances requires adoption of non-extensional grammars. (shrink)

Successful innovations are deemed to be necessary requisites for enterprise success. On the other hand, works council participation and employee participation are judged differently as either fostering employee and enterprise benefits or only the former or even none. Both forms of participation have found diverging theoretical and empirical argumentations regarding innovations. Here, we argue and show empirically that both forms of participation deliver positive contributions to innovation success, economically and employee-related, substantiated with qualitative reports from 36 process innovation cases and (...) quantitative data from 44 cases. Qualitative case analyses reveal different profiles of works council participation depending on the innovation type. Independent of the innovation types, more successful innovations are marked by more intensive participation. Quantitative examinations of a causal model with path analysis specify how this is achieved: works council and employee participation further the growth of appropriate knowledge and the former also raises the coordination capability; both are essential preconditions for innovation success. A direct impact of works councils on innovation success complements the indirect effects. The slightly modified path analysis explains 53% of the innovation success variance. (shrink)

What happens in a conversation between a committed Atheist and a committed Christian? While agreeing to disagree on almost every detail, Kai Nielsen, Chair of the Department of Philosophy, University of Calgary, and Hendrik Hart, Senior Member in Philosophy at the graduate Institute for Christian Studies, Toronto, agree that it is not fruitless.

Kripke (Wittgenstein on rules and private language: an elementary exposition. Harvard University Press, Cambridge Mass, 1982 ) rejected a naturalistic dispositional account of meaning (hereafter semantic dispositionalism) in a skeptical argument about rule-following he attributes to Wittgenstein (Philosophical investigation. Basil Blackwell, Oxford, 1958 ). Most philosophers who oppose Kripke’s criticisms of semantic dispositionalism take the stance that the argument proves too much: semantic dispositionalism is similar to much of our respected science in some important aspects, and hence to discard the (...) former would mean to give up the latter, which is obviously wrong. In this paper, I shall discuss and reject a recent defense of Kripke by Kusch (Analysis 65(2):156–163 2005 ; Sceptical guide to meaning and rules: defending Kripke’s Wittgenstein. McGill-Queen’s, London, 2006 ). Kusch attempts to show that semantic dispositionalism differs from the sciences, and consequently, Kripke’s attack can only target semantic dispositionalism, but not the sciences. Specifically, Kusch identifies some important features of the sciences with regard to how it employs idealization and ceteris paribus clauses, and argues that the ways in which semantic dispositionalism uses them are dramatically different. I argue that, upon close examination, the two are more similar than otherwise in each of those features. (shrink)

This paper is an exploration of the nature of what is perhaps the most widely recognized justification for inflicting harm on human beings: the appeal to defense (self-defense and other-defense). I develop and defend a rights-based account of the appeal to defense that takes into account whether and to what degree both the aggressor and his potential victim are morally responsible for the relevant threat. However, unlike most extant rights-based accounts, mine is not a forfeiture account. That is, I do (...) not attempt to explain the permissibility of defense in terms of the aggressor’s loss of a right not to be harmed. Instead I appeal directly to the fact that defense in the relevant cases prevents the aggressor from infringing upon the rights of his potential victim. Accordingly, I call my account a “prevention account.”. (shrink)

The purpose of the present paper is to challenge some received assumptions about the logical analysis of modal English, and to show that these assumptions are crucial to certain debates in current philosophy of language. Specifically, I will argue that the standard analysis in terms of quantified modal logic mistakenly fudges important grammatical distinctions, and that the validity of Kripke's modal argument against description theories of proper names crucially depends on ensuing equivocations.

The purpose of this article is to examine empirically the impact of environmental certification on firm financial performance (FP). The main question is whether there is a "green premium" for certified firms, and, if so, for what kind of certification. We analyze the short-run and the long-run stock price performance using an event-study methodology on a sample of Canadian and U.S. firms. The results of short-run event abnormal returns indicate that forest certification does not have any significant impact on firm (...) FP regardless of the certification system carried out by firms. Unlike the short-run results, the long-run post-event abnormal returns suggest that forest certification has, on average, a negative impact on firm FP. However, the impact of forest certification on firm FP depends on who grants the certification, since only industry-led certification (Sustainable Forestry Initiative, Canadian Standards Association and ISO14001) are penalized by financial markets, whereas non-governmental organizations—led Forest Stewardship Council certification is not. (shrink)

Papers presented cover: new approaches to evolutionary epistemology, new applications, critical evaluations, and the nature of the mind. Paper edition (unseen), $25.50. Annotation copyrighted by Book News, Inc., Portland, OR.

Fine bases his influential conception of essence on a particular account of definitions. And he complements it with a specific account of analyticity. I will argue that Fine's conception of relative analyticity confuses the idea of a sentence's being true in virtue of a term's definition with the idea of a sentence's being true in virtue of a term's meaning. His idea that correct definitions specify essential properties of meanings is mistaken. The correctness of definitions can only be assessed by (...) reference to the actual usage of the terms involved. The resulting conception of definitions leads to a deflationary interpretation of claims about essences. (shrink)

_ Group Duties: Their Existence and Their Implications for Individuals _, by CollinsStephanie. Oxford: Oxford University Press, 2019. Pp. vii + 218.

- uneducated in the field authors who defend a consensus they are being TOLD when they enter offices of Ed-Sci, teaching and writing works on learning-theory - but never checked the facts, PART I and PART II.

Hitchcock advances a diachronic Dutch Book argument (DDB) for a 1/3 answer to the Sleeping Beauty problem. Bradley and Leitgeb argue that Hitchcock’s DDB argument fails. We demonstrate the following: (a) Bradley and Leitgeb’s criticism of Hitchcock is unconvincing; (b) nonetheless, there are serious reasons to worry about the success of Hitchcock’s argument; (c) however, it is possible to construct a new DDB for 1/3 about which such worries cannot be raised.