This empirical study of Fortune 1000 firms assesses the degree to which those firms have adopted various practices associated with corporate ethics programs. The study examines the following aspects of formalized corporate ethics activity: ethics-oriented policy statements; formalization of management responsibilities for ethics; free-standing ethics offices; ethics and compliance telephone reporting/advice systems; top management and departmental involvement in ethics activities; usage of ethics training and other ethics awareness activities; investigatory functions; and evaluation of ethics program activities. Results show a high (...) degree of corporate adoption of ethics policies, but wide variability in the extent to which these policies are implemented by various supporting structures and managerial activities. In effect, the vast majority of firms have committed to the low cost, possibly symbolic side of ethics management (e.g., adoption of ethics codes and policies, etc.). But firms differ substantially in their efforts to see that those policies or codes actually are put into practice. (shrink)

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)

For a period of almost twenty years Aldous Huxley made use in his novels and biographies of the theories of physique and character developed by the psychometrist William Sheldon. This is most clearly seen in the novel Time must have a stop, whose characters follow Sheldon's theories in the most intricate and precise fashion. Huxley's use of Sheldon's work in this novel will be examined, and his motives for embarking on this relatively rare use of science in literature discussed.

At the beginning of the 1950s, Reinhold Niebuhr used the Christian concept of ‘irony’ to explain the difficult condition of the United States in the international system. In The Irony of American History the protestant theologian analyzed the ambiguity of American foreign policy during the first years of the Cold War. According to Niebuhr, the United States was involved in an ironic confutation of its sense of virtue, strength, security and wisdom. This confutation was due not only to its lack (...) of (Christian) realism but also to its false claim to dominate history. After the Fall of the Berlin Wall, when America became the most powerful nation of the international system, the irony of its history did not disappear. Even in a totally different situation for structure and distribution of power, compared to the one of sixty years ago, the ambiguous situation the United States is dealing with, can be spelt out trough irony again. This article discusses the lasting validity of the concept of ‘irony’ used to explain American present and, perhaps, future. (shrink)

Die Frequenzkurven, die die lebendige Substanz charakterisieren, können als eine statische Beschreibung oder als das Ergebnis einer Entwicklung betrachtet werden.Im ersten Falle akzeptiert man ohne weiteres die gegebenen Verteilungen und man versucht, ihnen durch mathematische Gleichungen, die keine unmittelbare Wirklich-keitsbedeutung haben, nahezukommen. Das kausale Denken wird hier ausgeschaltet oder man gibt sich wenigstens mit nur sehr groben Analogien zufrieden.Verschiedene Methoden über die Genese der Frequenzkurven werden besprochen; dabei wird gezeigt, dass die Mehrheit der Fälle auf Hypothesen beruht, die biologisch wenig (...) begründet sind. Eine Ausnahme davon macht die Theorie vonJ. C. Kapteyn, weil er den Vorgang des Wachstums in die Genese einbezieht. Seine Methode weiter ausbauend kann man sich vorstellen, dass die Genese einer Frequenzkurve in erblich homogenem Pflanzenmaterial durch Variation der Wachstumsgeschwindigkeit zustandekommt.Auf solche Weise kann man in einem Koordinatensystem mit Länge und Zeit als Koordinaten ein “Deviationsraster” konstruieren.In einem experimentell untersuchten Fall ergab die graphische Methode mit völlig ausreichender Genauigkeit die schon gefundene Frequenz.Les courbes de fréquence qui caractérisent la matière vivante, peuvent être considérées ou comme une description statique ou bien comme le produit d'un développement.Dans le premier cas on accepte les distributions obtenues et on essaie de s'en rapprocher par des équations mathématiques qui n'ont pas une réalité effective. On ne recherche plus la causalité ou alors on se contente le plus souvent d'analogies très grossières.Les auteurs traitent des diverses méthodes de la genèse des courbes de fréquence et démontrent que la plupart des cas reposent sur des hypothèses qui ont peu de fond biologique. La théorie deM. J. C. Kapteyn fait exception parcequ'il introduit le processus de croissance dans la genèse. En poursuivant plus loin dans sa méthode on peut se figurer que la genèse d'une courbe de fréquence de plantes homogènes par hérédité s'expliquerait par des variations de vitesse de croissance.De cette façon on peut construire une “grille de déviation” dans un système en prenant longueur et temps comme coordonnées.Dans un cas essayé expérimentalement ce graphique donnait avec une exactitude assez grande la distribution de fréquence déjà trouvée. (shrink)

On August 29, 1995, the United States District Court for the Northern District of Ohio ruled that certain practices of Blue Cross and Blue Shield of Ohio relating to the calculation of copayments on insurance claims violated provisions of ERISA, and thus BCBSO could be liable for unpaid benefits and breach of fiduciary duty ). According to BCBSO's Explanation of Benefits and Schedule of Benefits, beneficiaries were responsible for a 20 percent copayment for hospital charges, and the remaining 80 percent (...) of the Provider's Reasonable Charges would be paid by BCBSO. BCBSO negotiated with the hospitals to create discount agreements whereby the actual charge to BCBSO was less than 80 percent of the total amount of the hospital's charges. By this arrangement, BCBSO paid less than 80 percent of what patients were billed; concurrently, patients paid more than 20 percent of the amount ultimately paid to hospitals for their services. (shrink)

Обобщен опыт работы по диагностике микробиологических повреждений памятников искусства и культуры. Большой иллюстративный материал и конкретные примеры проведения микологических экспертиз памятников помогут разобраться в представленном материале.

Sur la toile de fond de la theologie negative, tissee par la discussion des apories que soulevent les notions de l'ineffable et de l'un, Damascius, le dernier diadoque de l'Ecole d'Athenes, elaboreson systeme metaphysique, sans se departir de la rigueur de sa methode aporetique, qui est une critique radicale du langage a l'interieur des coordonnees fixees par le Parmenide de Platon et par les Oracles Chaldaiques. Damascius, dans une enquete unique par son ampleur et son originalite questionne tour a tour (...) Porphyre, Jamblique, Syrianus et Proclus sur les principes; il examine les problemes que pose, en derivation de l'un, la formation de la trinite; de l'un-tout (la limite), du tout-un (l'infini) et de l'unifie (le mixte ou l'etre). Lien a priori entre l'un-tout et le tout-un, l'unifie est le principe de constitution de tout ordre et de toute realite. Damascius etudie sa nature de mixte originaire et autoconstituant, d'etre exemplaire et de premier intelligible. Cette notion lui permet de pas au crible, pour la mieux fonder, la problematique neoplatonicienne de la manence, de la procession et de la conversion. Les divers niveaux d'unification de la pluralite intelligible l'amenent a construire une theorie generale des elements, des parties et des formes Au passage, de nombreux textes, capitaux du point de vue de l'ontologie et de la doctrine de la connaissance, font regretter qu'ils aient ete inconnus du Moyen Age et qu'ils le demeurent pour beaucoup de nos contemporains. (shrink)

An extension of the hypothetical experiment of Szilard, which involved the action of a one-molecule gas in an isolated isothermal system, is developed to illustrate how irreversibility may arise out of Brownian motion. As this development requires a consideration of nonmolecular components such as wheels and pistons, the thought-experiment is remodeled in molecular terms and appears to function as a perpetuum mobile.

These essays use particular issues, thinkers and texts to engage the question of God in early Christianity.