These texts, the property of the Egypt Exploration Society, were purchased, together with other literary and documentary material, from a Greek lady at Medînet-el-Faiyûm by Dr. J. de M. Johnson in 1914. I am grateful to the Secretary of the Society for permission to publish them.

These two texts come from a store of papyrus fragments which are at present being examined and worked over at Oxford. They are the property of the Egypt Exploration Society and will be republished in vol. xxxi of the Oxyrhynchus Papyri as Nos. 2544 and 2534; permission for their separate publication here has been granted by the Society in view of the relevance of the former of them to the article by Mr. W. S. Barrett which appears on pp. 58–71 (...) below. We are much indebted to Mr. Barrett and Professor Hugh Lloyd-Jones for many valuable suggestions and criticisms. The nature of both texts was recognized by R. A. Coles, of Magdalen College, Oxford, one of the collaborators in this article. (shrink)

This chapter describes the potential far‐reaching consequences of contemplative higher education for the fields of science and medicine.

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 spectacular development of medical knowledge over the last two centuries has brought intrusive advances in the capabilities of medical technology. These advances have been remarkable over the last century, but especially over the last few decades, culminating in such high technology interventions as heart transplants and renal dialysis. These increases in medical powers have attracted societal interest in acquiring more such knowledge. They have also spawned concerns regarding the use of human subjects in research and regarding the byproducts of (...) basic research as in the recent recombinant DNA debate. As a consequence of the development of new biomedical knowledge, physicians and biomedical scientists have been placed in positions of new power and responsibility. The emergence of this group of powerful and knowledgeable experts has occasioned debates regarding the accountability of physicians and biomedical scientists. But beyond that, the very investment of resources in the acquisition of new knowledge has been questioned. Societies must decide whether finite resources would not be better invested at this juncture, or in general, in the alleviation of the problems of hunger or in raising general health standards through interventions which are less dependent on the intensive use of high technology. To put issues in this fashion touches on philosophical notions concerning the claims of distributive justice and the ownership of biomedical knowledge. (shrink)

A change in sense of self is an outcome commonly associated with Buddhist meditation. However, the sense of self is construed in multiple ways, and which changes in self-related processing are expected, intended, or possible through meditation is not well understood. In a qualitative study of meditation-related challenges, six discrete changes in sense of self were reported by Buddhist meditators: change in narrative self, loss of sense of ownership, loss of sense of agency, change in sense of embodiment, change in (...) self-other or self-world boundaries, and loss of sense of basic self. Changes in sense of self could be transient or enduring, positive or distressing, enhancing or impairing. These changes were also given varied appraisals, ranging from insights associated with Buddhist doctrines to psychopathologies such as depersonalization. In this study of practitioners reporting meditation-related challenges, more global changes in sense of self were associated with higher levels of impairment. These results have implications for both Buddhist meditation as well as mindfulness-based interventions. (shrink)

An information-theoretic approach is shown to derive both the classical weak-field equations and the quantum phenomenon of metric fluctuation within the Planck length. A key result is that the weak-field metric $\bar h_{\mu \nu } $ is proportional to a probability amplitude φuv, on quantum fluctuations in four-position. Also derived is the correct form for the Planck quantum length, and the prediction that the cosmological constant is zero. The overall approach utilizes the concept of the Fisher information I acquired in (...) a measurement of the weak-field metric. An associated physical information K is defined as K=I−J, where J is the information that is intrinsic to the physics (stress-energy tensor Tμv) of the measurement scenario. A posited conservation of information change δI=ΔJ implies a variational principle δK=0. The solution is the weak-field equations in the metric $\bar h_{\mu \nu } $ and associated equations in the probability amplitudes φuv. The gauge condition φ v uv =0 (Lorentz condition) and conservation of energy and momentum Tv μv=0 are used. A well-known “bootstrapping” argument allows the weak-field assumption to be lifted, resulting in the usual Einstein field equations. A special solution of these is well known to be the geodesic equations of motion of a particle. Thus, the information approach derives the classical field equations and equations of motion, as well as the quantum nature of the probability amplitudes φuv. (shrink)