Background Defensive medicine is physicians’ deviation from standard medical care which is primarily intended either to reduce or avoid medico legal litigation. Although the Federal Ethics Committee review in Ethiopia has shown that applications for medical/surgical error investigation claims are increasing at an alarming rate, there is no study to date done to estimate the degree of defensive practice done by the physicians with an intention of avoiding this increasing legal claim. This study assessed the practice of defensive medicine among (...) highly litigious disciplines (surgery) and described factors associated with its practice. Methods Cross sectional quantitative study using online survey questionnaires was conducted to assess the degree of defensive practice and six factors (age, years of experience, specialty, monthly income, place of practice and previous medico legal history) associated with its practice were assessed among surgeons working in Ethiopia. Results A total of 430 surgeons directly received an online survey questionnaire and 236 of them successfully completed the questionnaire making the response rate 51.2%. Nearly half of the study participants (51.7%) were aware of the concept of defensive medicine and 174 (74%) reported performing one form of defensive practice. Twenty-nine (12.3%) of the participants have legal dispute history, though only 1.3% of them ended up in penalty. Avoiding high risk procedures was the commonest defensive act performed by 60% of the participants, followed by ordering tests unnecessarily (52.1%). Multinomial logistic regression model showed that there was no association between age of the participant, place of practice, year of experience and defensive practice. This model also showed that cardiothoracic and vascular surgeons perform less defensively than surgeons with other specialty with P value of 0.02. Conclusion The practice of defensive medicine is widespread among surveyed Ethiopian surgeons and further studies are required to objectively estimate the effect of defensive practice on the health care system of the country. Policy makers need to develop strategy towards decreasing this high rate of defensive practice. (shrink)

We discuss the problem of finding forcing posets which introduce closed unbounded subsets to a given stationary set.

We motivate and introduce a new method of abduction, Matrix Abduction, and apply it to modelling the use of non-deductive inferences in the Talmud such as Analogy and the rule of Argumentum A Fortiori. Given a matrix $${\mathbb {A}}$$ with entries in {0, 1}, we allow for one or more blank squares in the matrix, say a i,j =?. The method allows us to decide whether to declare a i,j = 0 or a i,j = 1 or a i,j =? (...) undecided. This algorithmic method is then applied to modelling several legal and practical reasoning situations including the Talmudic rule of Kal-Vachomer. We add an Appendix showing that this new rule of Matrix Abduction, arising from the Talmud, can also be applied to the analysis of paradoxes in voting and judgement aggregation. In fact we have here a general method for executing non-deductive inferences. (shrink)

An innovative literary analysis of Freud's "Wolf Man.".

Mutual feedback between human-made environments and facets of thought throughout history has yielded two myths: the Garden and the Citadel. Both myths correspond to Jung’s feminine and masculine collective subconscious, as well as to Nietzsche’s premise of Apollonian and Dionysian impulses in art. Nietzsche’s premise suggests, furthermore, that the feminine myth of the Garden is time-bound whereas the masculine myth of the Citadel, or the Ideal City, constitutes a spatial deportment. Throughout history the two myths have continually molded the built (...) environment and thought, but the myth of the Ideal City – from Plato to Descartes to modernity – came to dominate city-form and ensuing aspects of contemplation. This relationship seems to have shifted during the twentieth century. Intellectual dispositions have begun to be largely nurtured by an incongruous city-form emerging from the gap between the incessant promise for an automated, well-functioning city, on the one hand, and looming alienation, coupled with the factual, malfunctioning city, on the other hand. Urban decay, a persisting and time-bound urban event that is a byproduct of this configuration, suggests the ascent of the Garden myth in post-modern city-form. (shrink)

Philosophers have in the past had difficulty in determining how to define ethical terms. here they are defined as open-context terms with a loosely limited range of substitution instances, in conformity with actual language usage. ethical terms are in themselves meaningless. it is a misuse to say, "x is wrong in itself." ethical terms then reduce to empirical terms concerning wants, likes, knowledge of cause and effect and consequences, knowledge of how ethical terms themselves work. ethical commands reduce to if-then (...) statements. blame may possibly never make sense. (shrink)

Including the first English edition of the Treatise of the Three Impostors since 1904, this book examines the treatise in its literary, political, and philosophical context.

Deduction has frequently been condemned as a useless intellectual instrument because of its tautological character. To thoroughgoing opponents of rationalism, the pretensions of deduction are on the same level with those of induction. Both presume to yield more knowledge from the fact that we have some knowledge; and this is an impossible paradox, which not even so powerful an opponent of the “Philosophy of Experience” as Bradley could resolve to his own satisfaction. I wish in this brief note to indicate (...) how this semblance of paradox may very easily be removed without having to deny, as has often been thought necessary, the tautologicality of deduction. (shrink)

El propósito de este escrito radica en precisar los sentidos de los existenciarios Existenz y Jemeinigkeit, presentes en la Analítica del Dasein, que Martin Heidegger desarrolla en Sein und Zeit. Estos, aun cuando no sean el inicio del citado despliegue teórico, son troncales para entender la reflexión sobre el ser del ente humano que allí se expone. Además, mostraremos cómo aparecen conceptualizadas ambas nociones en la lección del semestre de verano de 1925 tituladas Prolegomena zur Geschichte des Zeitbegriffs. Asimismo, destacaremos (...) como Heidegger interpreta a la Existenz de Sein und Zeit en Brief über den Humanismus. Cabe aclarar que la labor exegética de la obra magna de 1927 se efectuará basándonos también en estos dos últimos escritos, es decir, en Prolegomena zur Geschichte des Zeitbegriffs y en Brief über den Humanismus. (shrink)

Paralogismen betreffs der Leibnizschen Prädikatlehre werden aufgezeigt und widerlegt. Enthaltensein heißt die Inverse von Ableitung; den zwei Arten von Ableitung, die Leibniz kennt, entsprechen zwei Arten von Enthaltensein. Die beiden Arten von Enthaltensein bieten Leibniz die Möglichkeit zu der logischen und irreduziblen Unterscheidung zwischen notwendigen und bedingten Wahrheiten. Die Unterscheidung zwischen einem Individuum und einer Eigenschaft wird mit mengentheoretischen Methoden und auch mit Hilfe von epistemologischen Begriffen untersucht. Die besondere kategorische Form des Aussagesatzes impliziert, daß es für alle Aussagesätze nur (...) eine einzige Tiefen-Grammatik gibt, welche wesentlich verschiedene Ausdruckweisen von kategorischen Aussagen umfaßt. (shrink)

The discovery, made in Oxford, that crude penicillin could cure systemic and life‐threatening bacterial infections was followed by attempts to purify penicillin, to determine its structure and then to produce it by total chemical synthesis. The β‐lactam structure of the molecule, first proposed in October 1943, was a source of controversy until 1945. However, no useful chemical synthesis was achieved and fermentation became the commercial source of the antibiotic.In 1953, one of the products of a Cephalosporium sp. from Sardinia was (...) shown to be a new and hydrophilic penicillin (penicillin N). This was contaminated with a substance having the same side‐chain but a characteristic absorption spectrum. The latter, cephalosporin C, showed antibacterial activity but was not inactivated by a penicillinase. The determination of its β‐lactam structure and isolation of its nucleus enabled pharmaceutical companies to produce many semisynthetic cephalosporins.A new tripeptide was later found to be an intermediate in the biosynthesis of both penicillin N and cephalosporin C, and this was followed by the complete elucidation of the biosynthetic pathways leading to these compounds and to benzylpenicillin. (shrink)

The main designs of modern theories of syntax assume a process of syntagmatic organization. However, research on first language acquisition leaves no doubt that the structured combination of single lexical items cannot begin until a critical mass of lexical items has been acquired such that the lexicon is structured hierarchically on the basis of hierarchical feature bundling. Independent of a decision between the main views about the design of a proto language (the grammarless “Holophrastic view”,Arbib & Bickerton 2010: 1,Bickerton 2014) (...) or the ‘Compositional View’ as taken byRizzi (2010),Carstairs-McCarthy (2010), and others. What seems to be the minimal offset for language is the existence of grammatical categories like verb and noun, on the one hand, and, on the other hand, functional categories as needed for the expression of all kinds of agreement between the distinct categories to form recursively structured complexes. I follow the different stages of complexification asking whether there is paradigmatic next to syntagmatic organization and what its added value is for the evolution of grammar. The conclusion will be that paradigmatics is an indismissible part of the organization of early language in that it structures the lexicon so as to make primary and secondary syntactic merge possible and, consequently, is also a prerequisite for movement. The guiding idea of this position is Roman Jakobson’s insistence on the twofold organization of language and grammar. The two organizational designs, syntagmatics and paradigmatics, are manifest within each module: in the phonetic, the morphological, the syntactic, the semantic, and the pragmatic form (consider Jakobson’s1971a,breiterated argument). (shrink)

Urban void sometimes amplifies alienation within urban space, and thus leads the way to the human craving for authenticity. Juxtaposing urban void with the conventional notion of urban objects, furthermore, conforms to Nietzsche's distinction between Dionysian and Apollonian deportment. The Apollonian is at the founding of the Platonic myth of the Ideal City and its modern descendant, the myth of the Rational City. Modern urban planning has been object-directed and, consistent with the historical trend since the Renaissance, has become a (...) constituent of a Neo-Platonic mythology that insists on forging a city as an urban technological artifact. Most existing urban parks and squares, as well as suburban gardens, within this approach, only augment the subordinate standing of urban voids. Yet the significance of urban void, as the unplanned place that represents the pre-rational, the genuine and the unadulterated, ought to lead to its re-introduction into city-form as a conduit for self-reflection and authenticity. Recognizing urban void for its significance may reintroduce an important Dionysian feature into city-form, leading to deliberate carving of authentic urban spaces. (shrink)

Book reviewed in this article: Mama Might Be Better Off Dead: The Failure of Health Care in Urban America. By Laurie Kaye Abraham. Not All of Us Are Saints: A Doctor's Journey with the Poor. By David Hilfiker.

Abraham Verghese proposes to renew medicine by training physicians to read the right texts—literary fiction and patients' bodies—with skilled attention. Analyzing Verghese's proposal with reference to Foucault's idea of the "clinical gaze," I find that Verghese conceives of patients as texts that only physicians can read, meaning that physicians become the storytellers of the bodies, lives, and deaths of the people they meet as patients. I conclude that Verghese's project is unsustainable and alternatively propose thinking analogically of physicians as (...) ship captains who maintain therapeutic distance to reopen interpretative spaces for communities outside of medicine. (shrink)

Abraham Pais's Subtle Is the Lord was a publishing phenomenon: a mathematically sophisticated exposition of the science and the life of Albert Einstein that reached a huge audience and won an American Book Award. Reviewers hailed the book as "a monument to sound scholarship and graceful style", "an extraordinary biography of an extraordinary man", and "a fine book". In this groundbreaking new volume, Pais undertakes a history of the physics of matter and of physical forces since the discovery of (...) x-rays. The book attempts to relate not only what has happened over the last hundred years but why it happened the way it did, what it was like for those scientists involved, and how what at the time may have seemed a series of bizarre or unrelated events, now with hindsight emerges as a logical sequence of events. Pais, a noted physicist, was personally involved in many of the developments he describes, and thus Inward Bound, like his earlier book, is filled with unique insights into the world of big and small physics. Between 1895 and 1983, the period he covers, the smallest distances explored have shrunk a hundred millionfold, Pais notes. Along this incompletely traveled "road inward," scientists have established markers that later generations will rank among the principal monuments of the twentieth century. In alternating technical and nontechnical sections, this magisterial survey richly conveys what has been discovered about the constituents of matter, the laws to which they are subject, and the forces that act on them. But the advances have certainly not come smoothly. The book shows that these have been times of progress and stagnation, of order and chaos, of clarity and confusion, of belief and incredulity, of the conventional and the bizarre; also of revolutionaries and conservatives, of science by individuals and by consortia, of little gadgets and big machines, and of modest funds and big money. About the Author: Abraham Pais is Detlev W. Bronk Professor of Physics at the Rockefeller University. The author of the prizewinning biography of Einstein now undertakes a history of modern physics. (shrink)