Concerns a problem posed, but not solved, by Frege in part III of his Grundgesetze. As a preliminary to defining ‘real number’, Frege attempts to analyse the notion of a quantitative domain. He was unaware of the previous attempt of Otto Holder to do this; it is remarked how much weaker Frege's assumptions were in deriving theorems than Holder's. Frege deals with groups on which there is a right‐invariant semilinear ordering, although he does not use this terminology. He is uncertain (...) whether it can be deduced that the ordering is also left‐invariant, and proves as much as possible without invoking the assumption that it is. The independence proof, due to Dr Peter Neumann, establishes that it could not be deduced. (shrink)

This is a critical response to Dr. Tamara Dobler's paper “What Is Wrong with Hacker's Wittgenstein? On Grammar, Context and Sense-Determination.” It demonstrates that Dr. Dobler has no idea of what Wittgenstein meant by “grammar” or “rule of grammar.” She does not know what Wittgenstein meant by “grammatical proposition,” nor does she know what a compositional account of meaning or a category mistake is. She labours under the illusion that to say, as Wittgenstein did, that a rule of grammar excludes (...) a form of words from use is incompatible with the claim that whether an utterance makes sense may be a context-dependent issue. Unlike Dr. Dobler, Wittgenstein did not. (shrink)

Bhattacharyya, K. The Advaita concept of subjectivity.--Deutsch, E. Reflections on some aspects of the theory of rasa.--Nakamura, H. The dawn of modern thought in the East.--Organ, T. Causality, Indian and Greek.--Chatterjee, M. On types of classification.--Lacombe, O. Transcendental imagination.--Bahm, A. J. Standards for comparative philosophy.--Herring, H. Appearance, its significance and meaning in the history of philosophy.--Chang Chung-yuan. Pre-rational harmony in Heidegger's essential thinking and Chʼan thought.--Staal, J. F. Making sense of the Buddhist tetralemma.--Enomiya-Lassalle, H. M. The mysticism of Carl Albrecht (...) and Zen.--Parrinder, G. The nature of mysticism.--Cairns, G. E. Axiological contributions of East and West to the spiritual development of mankind.--Mayeda, S. Śaṇkara's view of ethics.--Mercier, A. On peace.--Barlingay, S. S. A discussion of some aspects of Gaudapāda's philosophy. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:NEWMAN'S PSYCHOLOGICAL DISCOVERY: THE ILLATIVE SENSE (Continued) VI THE FACULTIES OF COGNITION AND APPETITION Since the Grammar of Assent gives us a phenorhenological analysis of the art of thinking and often refers to the influence of other faculties in our reasoning processes, it will be very instructive to examine what the author holds about our faculties of cognition and appetition. This will make us better acquainted with the nature (...) of the illative sense. I. THE SENSES 1. The External Senses and their Objects. We had already arrived at the conclusion that Newman rejects the mere subjectivity of our knowledge. When he writes about this matter he explicitly deals with sensation or sensuous cognition. Although he takes exception to the word "immediate perception," 1 we may nevertheless call him an adherent of direct or immediate realism according to Scholastic terminology, because he emphatically excludes the intervention of a reasoning process from sense perception and uses the term "mediate perception" only to express the instrumentality of experience. In this meaning our perception of external objects is mediate or indirect indeed.2 The fact is that as early as 1839 he wrote in his University Sermons: "Of the material we have direct knowledge through the senses"3 and in 1843: "The senses are direct, immediate, and ordinary informants, and act spontaneously without any will or effort on our part."4 On the importance of sense perception for our mental activities he writes in a series of hitherto unpublished notes, entitled Elements of Thought:6 "I grant or I assume that the soul would not think without some external stimulus; that if it were cut off from all communication from the external world, it would pass this life in a sort of torpor... But then, as soon as it is roused, it reflects upon itself, and thereby gains a number of ideas..." 1. See supra V, 14.2. Supra V, 14.3. P. 205. 4.P. 303 ; cf. Gramm., p. 260. 5.See the unpublished Philosophical Papers, note Fcbr. 24, 1859. 40 DR. ZENO, OJM. CAP.41 Apart from the passages already referred to, Newman nowhere enlarges on the doctrine about the senses. He does not speak about the distinctions between sensible objects; he does not explain the difference between sensation and perception, and uses those terms promiscuously.6 There are no statements on the subject which contradict current Scholastic notions, although sometimes his vague terminology may be an occasion for misunderstandings. For instance, some passages in connection with "images" and "impressions," when read apart from the context, would appear to imply that he identifies them with the Scholastic species a sensibili accepta. However, we shall show further on that. Newman means something quite different. He deals with these species and the so-called sensibilia per acci· dens by the way when describing our knowledge of God7 and teaching that we have evidence of the presence of individuals or substances in the phenomena which occur to our senses. We picture those things to ourselves in those phenomena. They are like pictures, he says, but at the same time "they give us no exact measure or character of the unknown things beyond them." "Therefore when we speak of our having a picture of the things which are perceived through the senses, we mean a certain representation, true as far as it goes, but not adequate." 2. The Internal Senses and their Objects. Newman nowhere gives a distinction between external and internal senses, but nevertheless he speaks about those faculties of the mind which by the Scholastics are called the internal senses. These philosophers distinguish a common sense or rather a central sense (sensus communis), which unites the impressions of the external senses into one whole, makes us conscious of the conditions of our body and notifies to us the sensations of our external as well as internal senses; — the imagination or the faculty which preserves and reproduces things perceived; — the sensuous memory, i. e., the power to retain and to reproduce sense images; — and the vis aestimativa or the instinctive faculty, which discovers without any intellectual means, what is good and what is bad for our welfare. 6.It would seem that he generally... (shrink)

© 2017. The American Astronomical Society. All rights reserved.We present new observations of the low-mass companion to HD 984 taken with the Gemini Planet Imager as a part of the GPI Exoplanet Survey campaign. Images of HD 984 B were obtained in the J and H bands. Combined with archival epochs from 2012 and 2014, we fit the first orbit to the companion to find an 18 au orbit with a 68% confidence interval between 14 and 28 au, an eccentricity (...) of 0.18 with a 68% confidence interval between 0.05 and 0.47, and an inclination of 119°with a 68% confidence interval between 114°and 125°. To address the considerable spectral covariance in both spectra, we present a method of splitting the spectra into low and high frequencies to analyze the spectral structure at different spatial frequencies with the proper spectral noise correlation. Using the split spectra, we compare them to known spectral types using field brown dwarf and low-mass star spectra and find a best-fit match of a field gravity M6.5 ±1.5 spectral type with a corresponding temperature of K. Photometry of the companion yields a luminosity of log=2.88 ± 0.07 dex with DUSTY models. Mass estimates, again from DUSTY models, find an age-dependent mass of 34 ±1 to 95 ±4 M Jup. These results are consistent with previous measurements of the object. (shrink)

OBJECTIVES: To study the accuracy of reviewing ward notes (chart review) as a measure of the quality of care rendered to patients with "Do Not Resuscitate" (DNR) orders. DESIGN: We reviewed the charts of 19 consecutive, competent inpatients with DNR orders for evidence that the staff addressed a broad range of patient care needs called Concurrent Care Concerns (CCCs), such as withholding treatments other than resuscitation itself, and attention to patient comfort needs. We then interviewed the patient, consultant physician, (...) house officer, and primary nurse and compared the ward notes with the understandings of these staff members. SETTING: The medical service of an urban university medical centre. RESULTS: The average number of documented CCCs addressed per DNR order was 1.1. The ward notes generally agreed with the perceptions of patients, house officers, and nurses (% agreement with notes = 79%, 77%, and 82%; kappa = 0.43, 0.40, 0.50). Consultant physicians' understandings were poorly reflected in the ward notes (% agreement = 59%; kappa = 0.18). They overestimated attention to CCCs compared with the notes (P < 0.0001) and with other observers (P < 0.0001). CONCLUSION: Chart review for attention to CCCs accurately reflects the understandings of patients, house officers, and nurses, but consultant physicians report more attention to CCCs than is recorded in the ward notes or understood by other observers. Better communication regarding end-of-life care plans should be encouraged. (shrink)

Aims: To assess patient receipt of written information. To ensure patients understand the written information about a resuscitation policy and to determine whether they disapproved of or had concerns about the policy. Methods: All admissions to four wards of the hospital were approached for an interview. A set questionnaire was asked by one of 2 interviewers. Results: 72% of 572 admissions were interviewed. Refusal accounted for only 2 of the people not interviewed. 11% were unable to advocate for themselves by (...) reason of mental incompetence, inability to communicate or impairment secondary to their illness. Of the 401 interviewed only 49% recalled receiving the patient information booklet. Few patients (17%) recalled reading the information in the patient information booklet. They were all then given the paragraph about the hospital’s resuscitation policy. 352 were asked their understanding and only 61% demonstrated that they understood the paragraph. 91% of all 401 patients approved of the hospital having the option of DNR orders. 31% of people however had concerns related to DNR orders. These are discussed. Conclusions: Many acutely unwell patients are unable to advocate for themselves. Written information is a poor method of communicating with patients. There was limited receipt of the information and many misunderstood the paragraph about the hospitals resuscitation policy. There was a wide range of patient thoughts and concerns expressed. (shrink)

Aim: This study explores priority dilemmas in dialysis treatment and care offered elderly patients within the Norwegian public healthcare system.Background: Inadequate healthcare due to advanced age is frequently reported in Norway. The Norwegian guidelines for healthcare priorities state that age alone is not a relevant criterion. However, chronological age, if it affects the risk or effect of medical treatment, can be a legitimate criterion.Method: A qualitative approach is used. Data were collected through semistructured interviews and analysed through hermeneutical content analysis. (...) The informants were five physicians and four nurses from dialysis wards.Findings: Pressing priority dilemmas centre around decision-making concerning withholding and withdrawal of dialysis treatment. Advanced age is rarely an absolute or sole priority criterion. It seems, however, that advanced age appears to be a more subtle criterion in relation with, for example, comorbidity, functional status and cognitive impairment. Nurses primarily prioritise specialised dialysis care and not comprehensive nursing care. The complex needs of elderly patients are therefore often not always met.Conclusions: Clinical priorities should be made more transparent in order to secure legitimate and fair resource allocation in dialysis treatment and care. Difficult decisions concerning withholding or withdrawal of dialysis ought to be openly discussed within the healthcare team as well as with patients and significant others. The biomedical focus and limitations on comprehensive care during dialysis should be debated. (shrink)

The author interprets Lopez's work as a case of mythologizing a historical figure for the Filipino masses. It is therefore a proletarian myth in contrast to bourgeois myths which Roland Barthes talks about. Myth indeed is a language - a metalanguage - and Lopez made use of it to express the theme of emulation and the responsibility of the proletarian man through traits that endure in the Filipino psyche: his loob (inner self), budhi (conscience), hiya (shame), and sense of responsibility. (...) The author agrees with Barthes that history and myth do not mix. Where a piece of work does not portray historical facts faithfully it should not be taken as a historical document but - in the context of Lopez's awit - as a piece of literary work that must be enjoyed. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:(P)rescription Narratives: Feminist Medical Fiction and the Failure of American Censorship. by Stephanie Peebles TaveraEtta M. MaddenStephanie Peebles Tavera. (P)rescription Narratives: Feminist Medical Fiction and the Failure of American Censorship. Edinburgh: Edinburgh University Press, 2022. Hardback, xii + 220 pp. ISBN 978-1-4744-9319-2.Utopian Studies readers first saw Stephanie Peebles Tavera’s work in print in her 2018 essay on reproductive health in Charlotte Perkins Gilman’s Herland. More recently, in (P)rescription (...) Narratives, she gives readers a view of the much broader historical scope of her scholarship in literary and cultural studies. Tavera’s analysis of what she labels “feminist medical fiction” considers not only novels and short stories but also literary reviews, dramas, and documentary films, many of which will be unfamiliar to readers of utopian and dystopian literature. Yet the book contextualizes the ways in which these works capture the “utopian possibilities” of women writers who pushed for breaking the boundaries of the dystopian strictures of embodied life. The literary works “rescript” what had been prescribed by others as “normalized behavior,” from the latter-nineteenth century through the Progressive Era (5, 37). As Tavera illustrates through her detailed analysis, these women’s narratives provide “interventions that... interrupt the dissemination of false [End Page 612] narratives of the female body” and “alter the course of cultural development toward greater inclusivity” (5).To establish the temporal boundaries for the project, Tavera emphasizes the Comstock Law, established in 1873, and the death of its author Anthony Comstock in 1915. While Comstock’s work often has been understood as restricting pornography, she explains the Comstock Law as more than merely that. Comstock sought to control what he and others saw as sexual deviation, which included birth control in any form. Tavera also bookends the project with lawsuits associated with Victoria Woodhull and Margaret Sanger, both women who advocated for abortion and birth control as means of allowing women to avoid the strictures over their bodies. Additionally, she explains, Comstock’s racism caused him to completely overlook Black women, ironically allowing a space in which Black women’s feminist medical fiction especially rescripts “normalized behavior” (37)—a topic she pursues in two parts of the book.The book follows a roughly chronological path as it examines four topics related to women’s health, brilliantly organized into “(p)rescriptions,” indicated by Rx, rather than chapters with numbers. Rx1, “Crip Medicine,” illustrates how authors such as Charlotte Perkins Gilman pointed to the socially constructed status of “hysteria” in a patriarchal culture that saw women as deviant by nature. Instead, these authors advocated for a more holistic examination of women’s health, impacted by the environments in which they lived. Drawing from Lyman Tower Sargent’s widely accepted view of utopianism as dreaming of a place “considerably better than the society in which the author lived,” she underscores “the utopian impulse underlies much of the work of feminist medical fiction” (39). In particular, writers of feminist medical fiction were “driven by failure.”Perhaps most familiar to illustrate this point is Gilman’s work, such as “The Yellow Wallpaper,” which illustrated how the culture failed certain characters. The narrator of that story suffers postpartum depression and is made worse by Dr. S. Weir Mitchell’s rest cure. Consequently, Gilman proceeded to write other works, such as Moving the Mountain (1911) and then Herland (1915), which push readers to envision “alternative societies” without such destructive patriarchal medical practices (39). But Tavera also explains how Louisa May Alcott’s Eight Cousins, or the Aunt-Hill (1875) critiques contemporary culture by providing a “domestic utopia” in the female domain of Aunt-Hill, wherein the male Dr. Alec Campbell demonstrates “a better way... of caring for the female body” (55). And another key example is Rebecca Harding [End Page 613] Davis’s Kitty’s Choice: A Story of Berrytown (1875). Berrytown is described as “the Utopia in actual laths, orchards, and bushel-measures of the advance guard of the reform party in the United States” (qtd. in Tavera 55). Through its two physicians, Dr. Muller and Dr. McCall, who represent homeopathic and allopathic practitioners, readers see that the society... (shrink)

Thoughts of Raden Mas Panji Sosrokartono on Javanese spiritual philosophy.

Thoughts of Raden Mas Panji Sosrokartono on Javanese spiritual philosophy.

Geleitwort von Prof. P. Nicki -- Dr. Hermann Freund im Gespräch mit Prof. Dr. Dr. Hinderk M. Emrich -- Die Angst und der existentielle Sprung -- Die neue Zeit -- Der gedachte Gott -- Wie kommt das Ich zum Du? - Hysterie als Lebensform -- Was heisst, sich entscheiden? - Zur Theologie der Freiheit -- Re-formation der Reformation -- Das metaphysische und zugleich dämonische Wesen des Schlosses in Franz Kafkas Schloss-Roman -- Nachwort von Wolfgang Teichert: Epiphanie oder wo sprechende Philosophie (...) und Theologie aufhören müssen -- Literatur -- Verzeichnis der Mitwirkenden -- Abbildungsverzeichnis. (shrink)

The ability to differentiate between what is just and what is unjust may be considered as the precondition to demand one's own rights. Starting from this point, this research was carried out to describe the level of awareness of patients concerning their rights. The main hypothesis was: the higher the socioeconomic and cultural level of patients, the higher is their awareness of their rights. This research was conducted in one of the state hospitals in Turkey in 1998. It is a (...) descriptive study carried out on 128 inpatients in medical and surgical wards. The data were collected by a questionnaire, which included questions on the rights of patients and gave sample cases. The sample cases were designed by referring to the World Health Organization Declaration on the Promotion of Patients' Rights in Europe. Only 23% of the participants were able to recognize patient rights, while 32% could not; the majority (45%) were undecided in recognizing patient rights. The awareness scores were statistically significantly different for educational level categories (F = 5.84; p<0.001). A continuously declining trend was observed for patient rights awareness scores from the highest educational level to the lowest. This partly proves the hypothesis of the research. However, the awareness scores were not significantly different for the other background variables (p>0.05). Most strikingly, 38% of the patients had no idea about their diagnosis and 63% of those who had undergone surgery did not know why they had had the operation. (shrink)

Book Reviewed in this article: Traditional Sayings in the Old Testament. By Carole R. Fontaine. Pp. viii, 279, Sheffield, The Almond Press, 1982, £17.95, £8.95. The First Day of the New Creation: The Resurrection and the Christian Faith. By Vesilin Keisch. Pp.206, Crestwood, New York, St Vladimirs Seminary Press, 1982, £6.25. The First Day of the New Creation: The Resurrection and the Christian Faith. By Vesilin Keisch. Pp.206, Crestwood, New York, St Vladimir's Seminary Press, 1982, £6.25. The Resurrection of Jesus: (...) A Jewish Perspective. By Pinchas Lapide. Pp.160, London, SPCK, 1983, 4.95. Easter Enigma. By John Wenham. Pp.162, Exeter, Paternoster Press, 1984, £2.95. The Anastasis: the Resurrection of Jesus as an Historical Event. By J. Duncan M. Derrett. Pp.xiv, 166, Shipston‐on‐Stour, P. Drinkwater, 1982, £5.00. The Open Heaven: A Study of Apocalyptic in Judaism and Early Christianity. By Christopher Rowland. Pp. xii, 562, London, SPCK, 1982, £22.50. Christianity Rediscovered: An Epistle from the Masai. By Vincent J. Donovan. Pp. viii, 200, London, SCM Press, 1982, £5.50. Basics of a Roman Catholic Theology. By William A. Van Roo, S.J. Pp.387, Rome, Gregorian University Press, 1982, $21.00. Charisms and Charismatic Renewal: a Biblical and Theological Study. By Francis A. Sullivan. Pp.184, Dublin, Gill & Macmillan, 1982, £5.95. Holiness and Politics. By Peter Hinchliff. Pp.214, London, Darton, Longman and Todd, 1982, £8.95. Rational Theology and the Creativity of God. By Keith Ward. Pp.240, Oxford, Blackwell, 1982, £14.00. The Point of Christology. By S.M. Ogden. Pp.xii, 193, London, SCM Press, 1982, £5.95. Fullness of Humanity: Christ's Humanness and Ours. By T.E. Pollard. Pp.126, Sheffield, The Almond Press, 1982, £9.95, £5.95. Milton's Good God: A Study in Literary Theodicy. By Dennis Richard Danielson. Pp.xi, 292, Cambridge University Press, 1982, £20.00. Biblical Tradition in Blake's Early Prophecies: The Great Code of Art. By Leslie Tannenbaum. Pp.xiii, 373, Princeton University Press, 1982, £17.60. The Inner Journey of the Poet and Other Papers. By Kathleen Raine, edited by Brian Keeble. Pp.xii, 208, London, George Allen and Unwin, 1982, £9.95.iVol. 34: Horayot and Niddah. Translated by Jacob Neusner. Pp.xiii, 243, Chicago, The University of Chicago Press, 1982, £17.50. Holy Land Pilgrimage in the Later Roman Empire A.D. 312–460. By Ed. Hunt. Pp. £+ 269, Oxford University Press, 1982, £16.50. Constantine versus Christ: The Triumph of Ideology. By Alistair Kee. Pp.186, London, SCM Press, 1982, £5.95. Society and the Holy in Late Antiquity. By Peter Brown. Pp.347, London, Faber and Faber, 1982, £10.50. Elishe: History of Vardan and the Armenian War. Translation and commentary by Robert W. Thomson. Pp.x, 353, 1 map, Cambridge, Harvard University Press, 1982, £21.00. Ireland in Early Mediaeval Europe: Studies in Memory of Kathleen Hughes. Edited by Dorothy Whitelock, Rosamond McKitterick and David Dumville. Pp.x, 406, Cambridge University Press, 1982, £39.00. Letters from Ireland 1228–1229 by Stephen of Lexington. Translated with an introduction by B.W. O'Dwyer. Pp.vii, 292, Kalamazoo, Cistercian Publications, 1982, $24.95. The Occupation of Celtic Sites in Ireland by the Canons Regular of St Augustine and the Cistercians. By Geraldine Carville. Pp.ix, 158, Kalamazoo, Cistercian Publications, 1982, $13.95. Chartres: The Masons who built a Legend. By John James. Pp.200, London, Routledge and Kegan Paul, 1982, £17.50. Temples, Churches and Mosques: A Guide to the Appreciation of Religious Architecture. By J.G. Davies. Pp.x, 262, Oxford, Basil Blackwell, 1982, £12.50. The Murdered Magicians: The Templars and their Myth. By Peter Partner. Pp.xxi, 209. Oxford University Press, 1982, £12.95. The Italian Crusades: The Papal‐Angevin Alliance and the Crusades Against Christian Lay Powers, 1254–1343. By Norman Housley. Pp.xi, 293, Oxford, Clarendon Press: Oxford University Press, 1982, £17.50. The Westminster Chronicle, 1381–1394. Edited and Translated by L.C. Hector and Barbara F. Harvey. Pp.lxxvii, 563. Oxford, the Clarendon Press, 1982, £42.00. Frömmigkeitstheologie am Anfang des 16. Jahrhunderts. By Berndt Hamm. Pp.xv, 378, Tübingen, J.C.B. Mohr, 1982, 168 DM. Erasmi Opera omnia, IX, 2: Desiderii Erasmi Roterodami Apologia respondens ad ea quae Iambus Lopis Stunica taxavrat in prima duntaxat Novi Testamenti aeditione. Edited by Henk Jan de Jonge. Pp.292, Amsterdam, North‐Holland Publishing Company, 1983, 280 guilders. The Christian Polity of John Calvin. By Harro Höpfl. Pp.x, 303, Cambridge University Press, 1982, £27.50. Concerning the Eternal Predestination of God. By John Calvin, translated with an Introduction by J.K.S. Reid. Pp.191, Cambridge, James Clarke & Co., 1982, £5.95. Spanish Protestants and Reformers in the Sixteenth Century: A Bibliography. By A. Gordon Kinder. Pp.108, London, Grant & Cutler, 1983, £6.80. Moderate Puritans and the Elizabethan Church. By Peter Lake. Pp.viii, 357, Cambridge University Press, 1982, £27.50. Resistance and Compromise: The Political Thought of Elizabethan Catholics. By Peter Holmes. Pp.viii, 279, Cambridge University Press, 1982, £22.50. Dutch Puritanism: A History of English and Scottish Churches of the Netherlands in the Sixteenth and Seventeenth Centuries. By Keith L. Sprunger. Pp.xiii, 485, Leiden, E.J. Brill, 1982, 172 guilders. John Toland and the Deist Controversy. By Robert E. Sullivan. Pp.viii, 355, Cambridge, Harvard University Press, 1982, £19.95. Radical Sects of Revolutionary New England. By Stephen A. Marini. Pp. 213, Cambridge, Harvard University Press, 1982, £11.55. Religion and Society in North America: An Annotated Bibliography. Edited by Robert deV: Brunkow. Pp.xi, 515, Santa Barbara, ABC‐Clio; Oxford, EBC‐Clio, 1983, £57.75. Charles Lowder and the Ritualist Movement. By Lida Ellsworth. Pp.vi, 234, London, Darton, Longman & Todd, 1982, £17.95. How the Pope became Infallible: Pius IX and the Politics of Persuasion. By August Bernhard Hasler. Pp.xi, 383, New York, Doubleday, 1981, $14.95; London, Sheldon Pres, 1982, £15.00. Hauptsache der Papst ist katholisch. Edited by Bruno Nies. Pp.104, Salzburg, Otto Müller, 1982, öS 140. Religious Change in Contemporary Poland: Secularization and Politics. By Maciej Pomian‐Srednicki. Pp.227, London, Routledge & Kegan Paul, 1982, £12.50. World Christian Encyclopedia: A Comparative Survey of Churches and Religions in the Modern World. Edited by David B. Barrett. Pp.1010, Nairobi, Oxford University Press, 1982, £55.00. Probability and Evidence. By Paul Horwich. Pp.vii, 146, Cambridge University Press, 1982, £15.00. Philosophical Foundations of Probability Theory. By Roy Weatherford. Pp.xi, 282, London, Routledge and Kegan Paul, 1982, £15.00. The Origins of Greek Thought. By Jean‐Pierre Vernant. Pp.144, London, Methuen, 1982, £9.95. Portraying Analogy. By J.F. Ross. Pp.xi, 244, Cambridge University Press, 1981, £20.00. The Marriage of East and West. By Bede Griffiths. Pp.224, London, Collins, 1982, £5.95. The Religious Experience: A Socio‐Psychological Perspective. By C.D. Batson & W.L. Ventis Pp.ix, 356, New York, Oxford University Press, 1982, £18.50,£9.95. (shrink)

Objectives To conduct an independent evaluation of the first phase of the Health Foundation’s Safer Patients Initiative (SPI), and to identify the net additional effect of SPI and any differences in changes in participating and non-participating NHS hospitals. Design Mixed method evaluation involving five substudies, before and after design. Setting NHS hospitals in the United Kingdom. Participants Four hospitals (one in each country in the UK) participating in the first phase of the SPI (SPI1); 18 control hospitals. Intervention The SPI1 (...) was a compound (multi-component) organisational intervention delivered over 18 months that focused on improving the reliability of specific frontline care processes in designated clinical specialties and promoting organisational and cultural change. Results Senior staff members were knowledgeable and enthusiastic about SPI1. There was a small (0.08 points on a 5 point scale) but significant (P<0.01) effect in favour of the SPI1 hospitals in one of 11 dimensions of the staff questionnaire (organisational climate). Qualitative evidence showed only modest penetration of SPI1 at medical ward level. Although SPI1 was designed to engage staff from the bottom up, it did not usually feel like this to those working on the wards, and questions about legitimacy of some aspects of SPI1 were raised. Of the five components to identify patients at risk of deterioration—monitoring of vital signs (14 items); routine tests (three items); evidence based standards specific to certain diseases (three items); prescribing errors (multiple items from the British National Formulary); and medical history taking (11 items)—there was little net difference between control and SPI1 hospitals, except in relation to quality of monitoring of acute medical patients, which improved on average over time across all hospitals. Recording of respiratory rate increased to a greater degree in SPI1 than in control hospitals; in the second six hours after admission recording increased from 40% (93) to 69% (165) in control hospitals and from 37% (141) to 78% (296) in SPI1 hospitals (odds ratio for “difference in difference” 2.1, 99% confidence interval 1.0 to 4.3; P=0.008). Use of a formal scoring system for patients with pneumonia also increased over time (from 2% (102) to 23% (111) in control hospitals and from 2% (170) to 9% (189) in SPI1 hospitals), which favoured controls and was not significant (0.3, 0.02 to 3.4; P=0.173). There were no improvements in the proportion of prescription errors and no effects that could be attributed to SPI1 in non-targeted generic areas (such as enhanced safety culture). On some measures, the lack of effect could be because compliance was already high at baseline (such as use of steroids in over 85% of cases where indicated), but even when there was more room for improvement (such as in quality of medical history taking), there was no significant additional net effect of SPI1. There were no changes over time or between control and SPI1 hospitals in errors or rates of adverse events in patients in medical wards. Mortality increased from 11% (27) to 16% (39) among controls and decreased from 17% (63) to 13% (49) among SPI1 hospitals, but the risk adjusted difference was not significant (0.5, 0.2 to 1.4; P=0.085). Poor care was a contributing factor in four of the 178 deaths identified by review of case notes. The survey of patients showed no significant differences apart from an increase in perception of cleanliness in favour of SPI1 hospitals. Conclusions The introduction of SPI1 was associated with improvements in one of the types of clinical process studied (monitoring of vital signs) and one measure of staff perceptions of organisational climate. There was no additional effect of SPI1 on other targeted issues nor on other measures of generic organisational strengthening. (shrink)

Context: The majority of contemporary enactivist work is influenced by the philosophical biology of Hans Jonas. Jonas credits all living organisms with experience that involves particular “existential” structures: nascent forms of concern for self-preservation and desire for objects and outcomes that promote well-being. We argue that Jonas’s attitude towards living systems involves a problematic anthropomorphism that threatens to place enactivism at odds with cognitive science, and undermine its legitimate aims to become a new paradigm for scientific investigation and understanding of (...) the mind. Problem: Enactivism needs to address the tension between its Jonasian influences and its aspirations to become a new paradigm for cognitive science. By relying on Jonasian phenomenology, contemporary enactivism obscures alternative ways in which phenomenology can be more smoothly integrated with cognitive science. Method: We outline the historical relationship between enactivism and phenomenology, and explain why anthropomorphism is problematic for a research program that aspires to become a new paradigm for cognitive science. We examine the roots of Jonas’s existential interpretation of biological facts, and describe how and why Jonas himself understood his project as founded on an anthropomorphic assumption that is incompatible with a crucial methodological assumption of scientific enquiry: the prohibition of unexplained natural purposes. We describe the way in which phenomenology can be integrated into Maturana’s autopoietic theory, and use this as an example of how an alternative, non-anthropomorphic science of the biological roots of cognition might proceed. Results: Our analysis reveals a crucial tension between Jonas’s influence on enactivism and enactivism’s paradigmatic aspirations. This suggests the possibility of, and need to investigate, other ways of integrating phenomenology with cognitive science that do not succumb to this tension. Implications: In light of this, enactivists should either eliminate the Jonasian inference from properties of our human experience to properties of the experience of all living organisms, or articulate an alternative conception of scientific enquiry that can tolerate the anthropomorphism this inference entails. The Maturanian view we present in the article’s final section constitutes a possible framework within which enactivist tools and concepts can be used to understand cognition and phenomenology, and that does not involve a problematic anthropomorphism. Constructivist content: Any constructivist approach that aims for integration with current scientific practice must either avoid the type of anthropomorphic inference on which Jonas bases his work, or specify a new conception of scientific enquiry that renders anthropomorphism unproblematic. (shrink)

In this article, we hypothesize that individuals with autism spectrum disorder (ASD) are born with a deficit in invariance detection, which is a learning process whereby people and animals come to attend the relatively stable patterns or structural regularities in the changing stimulus array. This paper synthesizes a substantial body of research which suggests that a deficit in the domain-general perceptual learning process of invariant detection in ASD can lead to a cascade of consequences in different developmental domains. We will (...) outline how this deficit in invariant detection can cause uncertainty, unpredictability, and a lack of control for individuals with ASD and how varying degrees of impairments in this learning process can account for the heterogeneity of the ASD phenotype. We also describe how differences in neural plasticity in ASD underlie the impairments in perceptual learning. The present account offers an alternative to prior theories and contributes to the challenge of understanding the developmental trajectories that result in the variety of autistic behaviors. (shrink)