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)

Scientists and 'anti-scientists' alike need a more realistic image of science. The traditional mode of research, academic science, is not just a 'method': it is a distinctive culture, whose members win esteem and employment by making public their findings. Fierce competition for credibility is strictly regulated by established practices such as peer review. Highly specialized international communities of independent experts form spontaneously and generate the type of knowledge we call 'scientific' - systematic, theoretical, empirically-tested, quantitative, and so on. Ziman shows (...) that these familiar 'philosophical' features of scientific knowledge are inseparable from the ordinary cognitive capabilities and peculiar social relationships of its producers. This wide-angled close-up of the natural and human sciences recognizes their unique value, whilst revealing the limits of their rationality, reliability, and universal applicability. It also shows how, for better or worse, the new 'post-academic' research culture of teamwork, accountability, etc. is changing these supposedly eternal philosophical characteristics. (shrink)

In this 1974 book a practising scientist and gifted expositor sets forth an exciting point of view on the nature of science and how it works.

This is the collection of essays presented to Bochenski on his 60th birthday, and it contains, as a mirror of Bochenski's own work, a broad spectrum of studies ranging from formal logic and history of logic, to the philosophy of logic and language, and to the methodology of explanation in Greek philosophy. Of the seventeen articles, these are some of the more important to the reviewer: "Betrachtungen zum Sequenzen Kalkül" by Paul Bernays, which is an extensive study of Gentzen-type formulations (...) of logic; "Remarks on Formal Deduction," H. B. Curry, a further discussion of sequenzen-logics; "Marginalia on Gentzen's Sequenzen Kalkül" by Hughes Leblanc; "Method and Logic in Presocratic Explanation," Jerry Stannard; "On the Logic of Preference and Choice," H. S. Houthakker, a suggestive presentation of decision and utility theory in logical form; "Leibniz's Law in Belief Contexts," Chisholm; "On Ontology and the Province of Logic," R. M. Martin; and "N. A. Vasilev and the Development of Many-valued Logics," G. L. Kline, an important addition to the history of logic. Other contributors are: Storrs McCall, Albert Menne, E. W. Beth, Benson Mates, Ivo Thomas, J. F. Staal, F. R. Barbò, A.-T. Tymieniecka, and N. M. Luyten. There is a bibliography of Bochenski's writings through 1962.—P. J. M. (shrink)

Malthus did not leave us with a systematic treatment of colonization, but from remarks scattered throughout his publications and correspondence it is possible to assemble a fairly coherent account of his views on the advantages and disadvantages of colonies, and on the reasons why some have failed and others succeeded. Included in these scattered remarks are some comparisons between his own views on colonies and those of Adam Smith. The question of the relationship between Malthus and Adam Smith is a (...) rather complex and subtle one, and cannot be given the full consideration it deserves in one short paper. But, as a general summary, it can be said that Malthus had a high regard for Smith and considered himself a follower and disciple of Smith, by contrast with Ricardo, James Mill, and McCulloch etc., whom he considered as exponents of a ‘New System of Political Economy”. His own Principles of Political Economy was conceived as a collection of ‘tracts or essays”, not as a new systematic treatise replacing the Wealth of Nations, Joseph Gamier in his article ‘Malthus” in the Dictionnaire de l'Economie Politique, 1852, saw that the title of the Principles was in fact a misnomer: ‘Malgré son titre, le livre sur les Principes n'est point un traité complet, mais seulement une collection de dissertations.” In what was probably intended as a criticism of Ricardo's Principles of Political Economy and Taxation, 1817, Malthus stated that the ‘present period … seems to be unpropitious to the publication of a new systematic treatise on political economy”, and, referring to Smith's work, stated that ‘the treatise which we already possess is still of the very highest value”. Nevertheless, despite professing his affiliation, Malthus did not hesitate to criticize Smith when he disagreed with him. He recognized that the Wealth of Nations contained ‘controverted points” and that it would require some ‘additions … which the more advanced stage of the science has rendered necessary”. (shrink)

BLWith new text and full apparatus criticus The Eudemian Ethics was one of two ethical treatises which Aristotle wrote on the subject of ethica or `matters to do with character'. Although the two works cover much the same ground, the Nicomachean Ethics is better known; the poor manuscript tradition of the Eudemian Ethics has made correct translation and interpretation of the text extremely difficult. The subject of the work is the choice of a certain means of conduct, made by a (...) `man of practical wisdom', between two extremes of behaviour: asceticism and yielding to uncontrolled impulses. Aristotle also stresses the notion of moral intention and the importance of virtue of character. This new Oxford Classical Text of the Eudemian Ethics is the result of many years of work. After Sir David Ross's death, his original text was substantially reworked and revised by his friend and colleague R. R. Walzer, who was aided in the revision by his former pupil Mrs Jean Mingay, who continued his work after his death in 1974. Mrs Mingay was fortunate in being able to make use of previously unpublished contributions from D. J. Allan after his death in the late seventies, and more recently has been helped in her work by the suggestions of Professor D. A. Russell, David Robinson, and Christopher Rowe. (shrink)

Iedereen zoekt geborgenheid in een eigenhuis, een plek onder de zon. Het vinden van een thuisplek is nochtans niet zo idyllisch als René Froger bezingt. Vooral in een multiculturele samenleving is de drang naar een thuisplek hevig. Op die plek exclusieve rechten uitoefenen wars van elke vorm van diversiteit, is een nieuw adagio. Wat voor de ene gemeenschap geborgenheid betekent, vormt voor een andere een regelrechte bedreiging. Hiertegen formuleren de auteurs een alternatieve landethiek in het spoor van Aldo Leopold. Deze (...) landethiek bouwen zij uit tot een fundamentele filosofie die radicaal breekt met de klassieke opvattingen van de Verlichting. De Leibniziaanse ruimte-tijd wordt de fundamentele basis voor de thuisplek. Cultuur, taal en landschap creeren de geborgenheid. Alle participanten van de thuisplek worden door diversiteit en het vreemde uitgenodigd tot openheid. Een ecologische ágape'verschijnt als een hernieuwde horizon. De onherbergzaamheid van de postmoderne samenleving heeft afgedaan. Steden transformeren tot multiculturele thuisplekken. Kunstwerken creeren landschappen tot plekken van identificatie. Thuisplekken worden plekken van geborgenheid waarmee men verbonden is, zoals een schildpad met haar schild... (shrink)

Since the early Medieval Time people contested theological legitimation and rational discursive discours on authority as well as retreated to refuges to escape from any secular or ecclesiastical authority. Modern attempts formulated rational legitimation of authority in several ways: pragmatic authority by Monteigne, Bodin and Hobbes, or the contract authority of Locke and Rousseou. However, Enlightened Anarchism, first formulated in 1793 by the English philosopher William Godwin fulminated against all rational restrictions of human freedom and self-determination. However, we do not (...) analyze anarchism by the ‘what’ and the ‘why’, but by looking for the best actual approach of Anarchist’s ‘Promised Land’. Furthermore, we follow the footsteps of Thoreau’s Walden Pond experiment considered as a place of salvation and prototype of 19th century romantic’s extreme individualism towards Leopold’s ethics of the land. Indeed, Thoreau’s and later Muir’s concepts of refuges are tightly connected to territorial and temporal bio-regional constraints and imply an internally organized public area based on mutualism and Hannah Arendt’s agape. From these ideas of refuges, Aldo Leopold formulated his Land-ethics that claimed integrity and autonomy of the ‘Land’. His foundation is a prototype of the eco-centric free space version of eco-anarchism as formulated by Bookchin. In order to formulate a philosophical foundation of eco-anarchism we reject Newtonian homogeneous space-temporal conception, preceding the whole Modern discours about authority and state. On the contrary, we adopt the pluralistic Leibnizian space-time from which thinking-humans do not dissociate themselves, but participate as part of the rational infrastructure of eco-refuges. In eco-refuges, citizen belong to the civil society that stays in equilibrium with the landscape and all forms of biological life. Space is the boundary condition of human activity and determines how borders, environmental organization and institutes are sustained. Space has its proper essence of sustainability, unity and integrity. The individual feelings of security are embedded in a timelike tradition and evolution of the free space, while individual particular conceptions of space and time integrate into the social processes of identification with the refuge. Therefore, the creation of eco-refuges transforms the actual world of national authorities into a world of anarchistic democratic eco-regional homelands. (shrink)

This volume offers the first English language collection of academic essays on the post-Holocaust thought of Jean Améry, a Jewish-Austrian-Belgian essayist, journalist and literary author. Comprehensive in scope and multi-disciplinary in orientation, contributors explore central aspects of Améry's philosophical and ethical position, including dignity, responsibility, resentment, and forgiveness.

Our planet contains 194 independent states and much more nations. They share membership of the United Nations and in consequence they subscribed the Universal Declaration of Rights. These are rooted in the modern universal conception of states and human rights formulated by philosophers of the Enlighten Age like Locke, Kant., Montesquieu, Voltaire and Rousseau. Concepts like democracy are mirrored to the organization of the political life as it was developed in North America and Europe at the end of the 18th (...) and the 19th century. Universality was deeply rooted in the Western intellectual, moral and religious tradition of that part of the world. Even globalization of the economic and social life is governed by the same Western standards and worldwide consumed basic goods like prime matter,. food and energy is expressed in terms of Western currency like dollar, pound sterling or euro. Despite this economic globalization there were two contradictory political evolution to discern: At the one hand more than 70 new states where created and on the other hand 28 European states started to integrate to a political European Union. The latter trend was based on a deep economic integration and since the creation of the euro also a financial integration. Basic idea was the creation of a free economic market as bases for a political unified Europe. Euro criticism is not only identified with conservatism, nationalism, narrow mind and even racism, euro criticism is deprived from any intellectual significance. However other trends put some shadow on the European project. First the Soviet experience around Marxism, Leninism and Stalinism unified more different nations than the European Union but ended in a complete political and economic chaos. Secondly the financial euro crisis involves only the tacit undermining of the national political independence of the member states, but does not make room for a deep analysis what the fundamentals are of this crisis such as lack of confidence of the citizen in the created unified political and financial market and its main instruments like banks that we consider as the fundamental boundary conditions of the worldwide globalization of goods, power and all aspects of human life. Furthermore we claim that this market in al its aspects is the worst answer to the inconvenient yet unavoidable truth that Western way of life of consumption includes a ecological footprint that exceeds since many years the sustainability of our planet. -/- . (shrink)

Met dit boek schreef de auteur een thematische benadering van het wijsgerig denken. Hij onderzoekt cyclische en niet-cyclische opvattingen over tijd zoals ze zich manifesteren in de verschillende onderzoeksdomeinen van de filosofie, met name de natuurwetenschappen, de theologie, de ethiek en de metafysica. De waarheidsproblematiek die filosofen al 2000 jaar bezig houdt, komt uitgebreid aan bod in een bespreking van het werk van Heidegger, Wittgenstein, Derrida. Een kritische levensbeschouwing alléén, zonder een daaraan gekoppelde levenshouding leidt uiteindelijk echter tot een deconstructie (...) van de filosofie zelf. Buber, Girard en Levinas bieden volgens de auteur een antropologisch-ethisch alternatief voor het gebrek aan zingeving dat de twintigste eeuw kenmerkt. Maar bovenal wil de auteur de lezer een instrument aanbieden voor zijn zoektocht naar een zinvolle levenshouding. (shrink)

Het hyperrealistische denken waaraan natuurkundigen zich vaak schuldig maken als zij deterministische wetten extrapoleren naar de menswetenschappen, houdt volgens de auteur geen rekening met het metafysische dat niet enkel onze maatschappij maar ook het natuurwetenschappelijke denken zélf beheerst. In dit boek onderzoekt hij hoe dit natuurwetenschappelijke denken, en dan vooral de technologie die het begeleidt, als paradigma fungeert voor ons denken over de maatschappij en onze persoonlijke levenshouding. De zoektocht van de auteur naar een ethische houding die wél rekening houdt (...) met de technologie als maatschappelijke randvoorwaarde maar er geen allesoverheersende werkelijkheidswaarde aan toekent, resulteerde in een kritische inleiding tot het denken over de maatschappij. (shrink)

Grenzen van dialoog -/- De universalismegedachte van de Verlichting heeft een -postmodernistische maatschappij van slachtoffers geschapen. Het geloofsverlies in de grote verhalen en de universalisering van het individu zorgen ervoor, dat zijn schreeuw naar verontwaardiging geen toehoorders meer vindt. Zijn roep in de woestijn gaat verloren in het chaotisch geschreeuw van de anderen. Tegenover dit koude, steriele postmodernisme stellen wij het eco-communautarisme. Vanuit de vaststelling dat het individu denkt, spreekt en handelt in de context van zijn taal en cultuur, dus (...) vanuit zijn gemeenschap, voegen wij aan Kants transcendentale ideeën 'Ik', 'Wereld' en 'God', een vierde idee toe: het 'Wij' of het principe van inclusiviteit. De Kantiaanse burgermoraal is Copernicaans geïnspireerd en steunt op de Newtoniaanse ruimte-tijdstructuur. Door middel van Hackings sociaal constructivisme, het Leibniziaanse meer-werelden-beeld en het biologische paradigma als nieuw denkkader, structureren wij de -gemeenschap volgens een cyclisch en een lineair tijdsverloop. Het cyclische waarborgt de traditie van een gemeenschap, het lineaire doet de gemeenschap evolueren naar een moreel betere toekomst. Het eco-communautarisme biedt het kader voor een kwalitatieve evolutie van individuen en gemeenschappen. Het normerend aspect hiervan is de pluriforme en multi-culturele dialoog. Een dialoog met grenzen. (shrink)

Theophrasti Characteres recensuit Hermannus Diels. Oxford Classical Texts. 1909. 3s. 6d. net. Pp. xxviii + .Θεοφρστου Xαρακτxs22EFρες. The Characters of Theophrastus. An English Translation from a Revised Text. With Introduction and Notes by R. C. Jebb, M.A. A new edition. Edited by J. E. Sandys, Litt.D. Macmillan. 1909. 7s. 6d. net. c. 23×14½. Pp. xvi+229.

In this century the major insight in the field of moral philosophy has been that moral arguments need not proceed by way of the deduction of moral conclusions from non-moral premises. This realisation sprang from a recognition that the purpose of moral argument was not just to get one party to a moral disagreement to assent to a proposition that at the outset of the discussion he denied. If a moral argument was to be able to be considered successful it (...) was insufficient for someone to recognise that an action he had previously considered right was wrong; it was essential that this recognition have an influence on his subsequent conduct. The change in belief was important only in so far as it led to a change in action. And although this insight led people to over diminish the importance of belief and propose various types of non-cognitive theories of ethics, it is none the less true that the acceptance of a proposition of the form ‘action X is wrong’ must have an impact of some kind on the behaviour of those who accept it. (shrink)