This study of internal auditors and auditees, who engage in both financial and operational internal audits in Israel, extends theory and research on internal audits in organizational units. It develops and tests a model that examines the role of top management and internal auditors in facilitating learning from internal audits and driving perceived performance improvement. We argue that support from the top management for the internal audit as well as the auditor’s capacity facilitate learning from audits and help audited units (...) to improve ethicality, efficiency, and effectiveness in organizations. The results of time-lagged survey data provide general support for the hypothesized indirect relationships between auditor capacity, auditor–auditee relational exchanges, learning from audits, and three different perceived performance measures: ethical behavior, efficiency, and effectiveness. We discuss the implications for research on internal audits, proactive learning, ethics, and performance improvement of organizational units in the public sector. (shrink)

Effectiveness, efficiency and equity in health care are discussed in this article against the background of concerns that cost containment may lead to reductions in quality of care. It is suggested that effectiveness is best seen from the patient's point of view and that it relates to more than simply improved health status. Efficiency and equity are better viewed from a societal stance.The paper discusses the role of the medical profession in effectiveness, efficiency and (...) equity and argues that the role of medical doctors needs to be constrained. (shrink)

If the exclusive promotion of values inimical to our basic humanity extends to the health care policy arena, we face a defensive, restricted, impersonal and ultimately impoverished health care system. Americans know it already as ‘managed-care’. This is why it is crucial for health policy analysts to make explicit the role of values in policy-making, especially that involving the input of ‘value-neutral’ economics. The nature of any clinical effectiveness policy will be determined by the understanding of cost-effectiveness employed (...) in its design and implementation. Given that cost-effectiveness is nowadays usually defined according to health economists’ criteria, the battle over the meaning of clinical effectiveness is a significant development in health economics’ move to assume control of the NHS. (shrink)

Business Efficiency and Ethics presents both the theory of business efficiency and ethics, and a wealth of case studies based on practical experience. This unique perspective offers a framework for identifying this behaviour and reestablishing appropriate business behavior standards.

In the debate about human bio-sampling the interests of patients and other sample donors are believed to stand against the interests of scientists and of their freedom of research. Scientists want efficient access to and use of human biological samples. Patients and other donors of blood or tissue materials want protection of their integrity. This dichotomy is reflected in the Swedish law on biobanks, which came into effect 1 January 2003. In this article I argue that if the basic interest (...) of scientists using human biological samples is in increasing knowledge and developing better treatments, and if the concept ‘integrity’ is properly understood, then sample donors should also be interested in promotion of efficiency as well as in the protection of their integrity. The basic premise of this argument is that donors of samples have interests related to the donation and use of samples as well as to the use of the results of the research, that is, new medical products and treatments. They have a role both as donors or participants in research and as end users of the research. I conclude that if access to information acquired through biobank research is strictly limited to researchers, the information is protected by secrecy safeguards through coding and the procedures governing the research are open to public and democratic control, then most research using human biobanks may be carried out on the basis of making general information available when collecting biological samples, without further contact with participants. (shrink)

Introduction. Improving control and supervisory activities on the basis of introducing risk-oriented approaches is an urgent area of public administration reforms both in Russia and abroad. Traditionally, assessing the effectiveness of this area is carried out on the basis of the state control intensity indicators (the number of inspections), and assessing risks in controlled areas is carried out on the basis of statistical indicators, partially dependent on state control bodies. To obtain a balanced assessment of the state control (...) class='Hi'>effectiveness and efficiency, it is important to take into account other data sources reflecting the citizens’ and the business community position. The purpose of the study is to conduct a comprehensive assessment of the effectiveness and efficiency of sanitary and epidemiological surveillance on the basis of both statistical data and the results of sociological studies reflecting the position of citizens and business. Methods. The authors suggest their own methods for comprehensive assessment of the effectiveness and efficiency of state control. The scientific novelty of the study consists in a comprehensive assessment of the effectiveness and efficiency of sanitary and epidemiological surveillance, taking into account various data sources and making it possible to assess the progress of implementing the reform of state control in this area. Results. The results of the study indicate, in general, an increase in the effectiveness and budgetary efficiency of sanitary and epidemiological surveillance over the last years of the reform implementation. At the same time, at the level of intermediate and immediate results, there are multidirectional trends, and the growth in the total costs of business and the state is ahead of the growth in the results achieved. Conclusions. The use of the authors’ comprehensive methodology for assessing the effectiveness and efficiency of state control makes it possible to obtain reliable data characterizing the actual state of things in the area under consideration. Further improving the efficiency and effectiveness of sanitary and epidemiological surveillance requires expanding the scope of applying risk-oriented approaches and improving the quality of considering the appeals of the citizens who faced with risks of wrongdoing. (shrink)

In the debate about human bio-sampling the interests of patients and other sample donors are believed to stand against the interests of scientists and of their freedom of research. Scientists want efficient access to and use of human biological samples. Patients and other donors of blood or tissue materials want protection of their integrity. This dichotomy is reflected in the Swedish law on biobanks, which came into effect 1 January 2003. In this article I argue that if the basic interest (...) of scientists using human biological samples is in increasing knowledge and developing better treatments, and if the concept ‘integrity’ is properly understood, then sample donors should also be interested in promotion of efficiency as well as in the protection of their integrity. The basic premise of this argument is that donors of samples have interests related to the donation and use of samples as well as to the use of the results of the research, that is, new medical products and treatments. They have a role both as donors or participants in research and as end users of the research. I conclude that if (i) access to information acquired through biobank research is strictly limited to researchers, (ii) the information is protected by secrecy safeguards through coding and (iii) the procedures governing the research are open to public and democratic control, then most research using human biobanks may be carried out on the basis of making general information available when collecting biological samples, without further contact with participants. (shrink)

As humans, we constantly change our movement strategies to adapt to changes in physical functions and the external environment. We have to walk very slowly in situations with a high risk of falling, such as walking on slippery ice, carrying an overflowing cup of water, or muscle weakness owing to aging or motor deficit. However, previous studies have shown that a normal gait pattern at low speeds results in reduced efficiency and stability in comparison with those at a normal (...) speed. Another possible strategy is to change the gait pattern from normal to step-to gait, in which the other foot is aligned with the first swing foot. However, the efficiency and stability of the step-to gait pattern at low speeds have not been investigated yet. Therefore, in this study, we compared the efficiency and stability of the normal and step-to gait patterns at intermediate, low, and very low speeds. Eleven healthy participants were asked to walk with a normal gait and step-to gait on a treadmill at five different speeds, ranging from very low to normal walking speed. The efficiency parameters and stability parameters were analyzed from the motion capture data and then compared for the two gait patterns. The results suggested that step-to gait had a more efficient gait pattern at very low speeds of 10–30 m/min, with a larger percent recovery, and was more stable at 10–60 m/min in comparison with a normal gait. However, the efficiency of the normal gait was better than that of the step-to gait pattern at 60 m/min. Therefore, step-to gait is effective in improving gait efficiency and stability when faced with situations that force us to walk slowly or hinder quick walking because of muscle weakness owing to aging or motor deficit along with a high risk of falling. (shrink)

Abstract:Standard lessons from economics tell us that an externality creates inefficiency, and that this inefficiency can be removed by internalizing the externality. This papers considers how successfully these lessons can be extended to intergenerational externalities such as emissions of greenhouse gas. For intergenerational externalities, the standard lessons involve comparisons between states whose populations of people differ, either in their identities or their numbers. Common notions of efficiency break down in these comparisons. This paper supplies a new notion of (...) class='Hi'>efficiency that allows the lessons to survive, but at the cost of reducing their practical significance. (shrink)

Voluntary active euthanasia and physician assisted suicide should not be legalised because too much that is important about living and dying will be lostIn the first of this two part series, I unpack the historical philosophical distinction between killing and allowing a patient to die in order to clear up the confusion that exists. Historically speaking the two kinds of actions are morally distinct because of older notions of causality and human agency. We no longer understand that distinction primarily because (...) we have shifted our notions of causality from a traditional formulation to a modern formulation of causality and thus of moral assessment that focuses on the effects of an action. In this essay, I prepare the ground for a companion essay by showing that the traditional formulation allows us to maintain notions of meaning and purpose to human living and dying that are precluded in the efficiency paradigm of modernity. Taken together with the companion essay, I am claiming that voluntary active euthanasia and physician assisted suicide should not be legalised because too much that is important about dying and living will be lost.TWO LIESIt would be naïve to think that euthanasia, in either the VAE sense, or in the more passive sense of PAS, does not happen. It would even be naïve to think that it does not occur in a non-voluntary form. It would be equally naïve, however, to think it could be controlled through governmental regulation. The real question with regard to PAS/VAE, put so eloquently by Martha Minow, is which lie do you countenance: the lie that euthanasia does not already happen, or the lie that it can be controlled without having repercussions well beyond the limits of procedural mastery?1 With this two part paper series, I will argue that the …. (shrink)

BackgroundSocially assistive devices (care robots, companions, smart screen assistants) have been advocated as a promising tool in elderly care in Western healthcare systems. Ethical debates indicate various challenges. One of the most prevalent arguments in the debate is the double-benefit argument claiming that socially assistive devices may not only provide benefits for autonomy and well-being of their users but might also be more efficient than other caring practices and might help to mitigate scarce resources in healthcare. Against this background, we (...) used a subset of comparative empirical studies from a comprehensive systematic review on effects and perceptions of human-machine interaction with socially assistive devices to gather and appraise all available evidence supporting this argument from the empirical side.MethodsElectronic databases and additional sources were queried using a comprehensive search strategy which generated 9851 records. Studies were screened independently by two authors. Methodological quality of studies was assessed. For 39 reports using a comparative study design, a narrative synthesis was performed.ResultsThe data shows positive evidential support to claim that some socially assistive devices (Paro) might be able to contribute to the well-being and autonomy of their users. However, results also indicate that these positive findings may be heavily dependent on the context of use and the population. In addition, we found evidence that socially assistive devices can have negative effects on certain populations. Evidence regarding the claim of efficiency is scarce. Existing results indicate that socially assistive devices can be more effective than standard of care but are far less effective than plush toys or placebo devices.DiscussionWe suggest using the double-benefit argument with great caution as it is not supported by the currently available evidence. The occurrence of potentially negative effects of socially assistive devices requires more research and indicates a more complex ethical calculus than suggested by the double-benefit argument. (shrink)

The paper deals with the mutual interest of both economic and social theory in exploring a broader concept of the rational and in finding validity claims for rational discourse. Efficiency and effectiveness are discussed as possible validity criteria in evaluating norms in practical discussion. In addition to the problem of defining validity criteria for argumentation on norms and social choices, a major difficulty arises from the lack of a legitimate reflective centre in society which could integrate behaviour with (...) norms and metapreferences. As ways of motivating cooperative, collective action, both norm commitment and self‐interest should be appealed to. (shrink)

Many countries tightly ration access to publicly funded fertility treatments such as in vitro fertilisation. One basis for excluding people from access to IVF is their body mass index. In this paper, I consider a number of potential justifications for such a policy, based on claims about effectiveness and cost-efficiency, and reject these as unsupported by available evidence. I consider an alternative justification: that those whose subfertility results from avoidable behaviours for which they are responsible are less deserving (...) of treatment. I ultimately stop short of endorsing or rejecting such a justification, though highlight some reasons for thinking it is unlikely to be practicable. (shrink)

If the exclusive promotion of values inimical to our basic humanity extends to the health care policy arena, we face a defensive, restricted, impersonal and ultimately impoverished health care system. Americans know it already as ‘managed-care’. This is why it is crucial for health policy analysts to make explicit the role of values in policy-making, especially that involving the input of ‘value-neutral’ economics. The nature of any clinical effectiveness policy will be determined by the understanding of cost-effectiveness employed (...) in its design and implementation. Given that cost-effectiveness is nowadays usually defined according to health economists’ criteria, the battle over the meaning of clinical effectiveness is a significant development in health economics’ move to assume control of the NHS. (shrink)

Distinct among contemporary philosophical studies focused on education, this book engages the history of phenomenological thought as it moves from philosophy proper (the European phenomenological-hermeneutic tradition) through curriculum studies. It thus presents the "best of both worlds" for the reader; there is a "play" or movement from philosophy proper to educational philosophy and then back again in order to locate and explicate what is intimated, suggested, and in some cases, left "unsaid" by educational philosophers. This amounts to a work on (...) education-philosophy that elucidates, through various permutations within the unique foci of each essay, the general phenomenological theme of the fundamental ontology of the human being as primordial learner. Reflecting his experience as scholar, teacher, and perennial learner, the author suggests how research in phenomenology might prove beneficial to the enhancement of both the theoretical and practical aspects of education; readers are invited to envision education as far more than merely a means by which to organize an effective learning experience in which knowledge is assimilated and skill sets are efficiently imparted, but rather as a holistic and integrated process in which knowing, acting, and valuing are original ways of Being-in-the-world. (shrink)

In this article I provide a conceptual analysis of an underexplored issue in the debate about effective altruism: its theory of effectiveness. First, I distinguish effectiveness from efficiency and claim that effective altruism understands effectiveness through the lens of efficiency. Then, I discuss the limitations of this approach in particular with respect to the charge that it is incapable of supporting structural change. Finally, I propose an expansion of the notion of effectiveness of effective (...) altruism by referring to the debate in political philosophy about realism and the practical challenge of normative theories. I argue that effective altruism, both as a social movement and as a conceptual paradigm, would benefit from clarifying its ideal, taking into account the role of institutions, and expanding its idea of feasibility. (shrink)

We study randomness beyond${\rm{\Pi }}_1^1$-randomness and its Martin-Löf type variant, which was introduced in [16] and further studied in [3]. Here we focus on a class strictly between${\rm{\Pi }}_1^1$and${\rm{\Sigma }}_2^1$that is given by the infinite time Turing machines introduced by Hamkins and Kidder. The main results show that the randomness notions associated with this class have several desirable properties, which resemble those of classical random notions such as Martin-Löf randomness and randomness notions defined via effective descriptive set theory such as${\rm{\Pi (...) }}_1^1$-randomness. For instance, mutual randoms do not share information and a version of van Lambalgen’s theorem holds.Towards these results, we prove the following analogue to a theorem of Sacks. If a real is infinite time Turing computable relative to all reals in some given set of reals with positive Lebesgue measure, then it is already infinite time Turing computable. As a technical tool towards this result, we prove facts of independent interest about random forcing over increasing unions of admissible sets, which allow efficient proofs of some classical results about hyperarithmetic sets. (shrink)

Non-technical summary: -/- When developing and deploying negative emissions technologies (NETs), little attention has been paid to where. On the one hand, one might develop NETs where they are likely to contribute most to global mitigation targets, contributing to a global climate solution. On the other hand, one might develop NETs where they can help support development on a regional basis, justified by regional demands. I defend these arguments and suggest that they reflect the values of efficiency and responding (...) to need, respectively. To the extent that these values conflict, they introduce what I call the Need-Efficiency Trade-off Effect (‘NET Effect’). -/- Technical summary: -/- Unlike other geoengineering methods, the effectiveness of negative emissions technologies (NETs) tends to be sensitive to regional siting. This paper argues that this point raises morally and legally important implications by identifying a trade-off between ‘efficiency’ and ‘need’. First, it introduces two arguments justifying NETs: one focused on contributions to global mitigation and the other focused on contributions to regional development. Second, reflecting the two arguments, the paper discusses the moral values of efficiency and need, respectively. For instance, if the strategy is to try to use NETs to maximize expected mitigation contributions to reflect efficiency, then deployment should occur in regions with the best prospects for success (e.g. Western countries). However, if the strategy is to try to use NETs to improve the chances of simultaneous development and mitigation to respond to need, then deployment should occur in regions with limited development and expected growth of demand for NETs (e.g. Asian countries). When these values conflict, I call that a Need-Efficiency Trade-off Effect (‘NET Effect’). The paper concludes by considering the NET Effect in the context of bioenergy with carbon capture and storage as well as direct air carbon capture and storage. [Open access]. (shrink)

The ontology of Stoic causes and effects was clearly anti-platonic, since the Stoics did not want to admit that any incorporeal entity could have an effect. However, by asserting that any cause was the cause of an incorporeal effect, they returned to Plato’s syntax of causes in the Sophist, whose doctrine of the asymmetry of nouns and verbs identified names with the agents and verbs with the actions. The ontological asymmetry of causes and effects blocked the multiplication of causes by (...) reducing it to an efficient cause. However, while ontology and syntax merged into the doctrine of the effect as an incorporeal predicate, this was further complicated by a relational description of a cause as the effect of a body on a body and by the distinction of causes. Since there are different kinds of causes, not every kind of cause has the same syntactical role in the nexus of causal relations. This refinement of the original syntactical model presumably allowed the Stoics to give a more coherent view of human action than is usually assumed. (shrink)

Recent years have seen a surge in accounts motivated by information theory that consider language production to be partially driven by a preference for communicative efficiency. Evidence from discourse production (i.e., production beyond the sentence level) has been argued to suggest that speakers distribute information across discourse so as to hold the conditional per-word entropy associated with each word constant, which would facilitate efficient information transfer (Genzel & Charniak, 2002). This hypothesis implies that the conditional (contextualized) probabilities of linguistic (...) units affect speakers’ preferences during production. Here, we extend this work in two ways. First, we explore how preceding cues are integrated into contextualized probabilities, a question which so far has received little to no attention. Specifically, we investigate how a cue's maximal informativity about upcoming words (the cue's effectiveness) decays as a function of the cue's recency. Based on properties of linguistic discourses as well as properties of human memory, we analytically derive a model of cue effectiveness decay and evaluate it against cross-linguistic data from 12 languages. Second, we relate the information theoretic accounts of discourse production to well-established mechanistic (activation-based) accounts: We relate contextualized probability distributions over words to their relative activation in a lexical network given preceding discourse. (shrink)

Machine stability and energy efficiency have become major issues in the manufacturing industry, primarily during the COVID-19 pandemic where fluctuations in supply and demand were common. As a result, Predictive Maintenance (PdM) has become more desirable, since predicting failures ahead of time allows to avoid downtime and improves stability and energy efficiency in machines. One type of machine failure stands out due to its impact, machine overstrain, which can occur when machines are used beyond their tolerable limit. From (...) the current literature, there are little to no relevant works that focus on machine overstrain failure detection or prediction. Accordingly, the purpose of this paper is to implement and compare four Machine Learning (ML) algorithms for PdM applied to machine overstrain failures: Artificial Neural Network (ANN), Gradient Boosting, Random Forest and Support Vector Machine (SVM). Moreover, it proposes a training methodology for imbalanced data and the automatic optimization of hyperparameters, which aims to improve performance in the ML models. To evaluate the performance of the ML models, a synthetic dataset that simulates industrial machine data is used. The obtained results show the robustness of the proposed methodology, with the ANN and SVM models achieving a perfect recall score, with 98.95% and 98.85% in accuracy, respectively. (shrink)

The aging of attentional and emotional functions has been extensively studied but relatively independently. Therefore, the relationships between aging and the interactions of attentional and emotional processes remain elusive. This study aimed to determine how age affected the interactions between attentional and emotional processes during adulthood. One-hundred forty adults aged 18–79 performed the emotional variant of the Attention Network Test, which probed alerting, orienting, and executive control in the presence and absence of threatening faces. During this task, contexts with varying (...) levels of task preparatory processes were created to modulate the effect of threatening faces on attention, and functional near-infrared spectroscopy (fNIRS) was used to examine the neural underpinnings of the behavioural effects. The behavioural results showed that aging was associated with a significant decline in alerting efficiency, and there was a statistical trend for age-related deficits in executive control. Despite these age differences, age did not significantly moderate the interactions among attentional networks or between attention and emotion. Additionally, the fNIRS results showed that decreased frontal cortex functioning might underlie the age-related decline in executive control. Therefore, while aging has varying effects on different attentional networks, the interactions of attentional and emotional processes remain relatively unaffected by age. (shrink)

Undoubtedly, the internet has become the most convenient and efficient communication and service delivery channel adopted by most government agencies, referred to as eGovernment. This study explores how eGovernment efficiency influences users’ subjective wellbeing, using trust as a covert stimulus with the capacity to alter individuals’ overt behavior. Covert and overt stimuli act as significant factors influencing the relationship between citizens and the online environment, moderated by socio-demographic characteristics. Using situation–organism–behavior–consequence theory, we propose a research model consisting of online (...) environment eGovernment efficiency influencing trust development, which in turn influences utilization, generating an impact on an individuals’ SWB. We followed the structural equation modeling approach to analyze the data survey N = 300, using Amos statistical techniques. Results reveal that the correlation between eGovernment efficiency and trust is positive and strong, trust and utilization is positive and moderate, and the correlation between utilization and SWB is positive and very strong. Stepwise regression analysis reveals that the control variables affect the relationship between eGovernment efficiency and trust. In the regression model: the highest education level explained 36% of the variance ; adding age increased the variance explained to 39%, and adding internet use frequency increased the variance explained to 41%. This study develops theoretical concepts of eGovernment use and how it affects citizens by indicating the psychological and behavioral situations as antecedents and mediators influencing SWB. It also provides practical suggestions for improving systems to correlate users’ feelings and behavior patterns to motivate trusting behavior, positively impacting users’ SWB to benefit citizens effectively. (shrink)

Digital mental health technologies have been promoted with the promise of delivering wide-scale access to more efficient and effective mental health diagnosis and care. During the pandemic, the rap...

Group contingency (GC) is an effective and cost-efficient strategy that can be successfully applied to technology-based interventions. This study examined the relative effectiveness and cost efficiency of three types of technology-based group contingencies on walking among adults. Seventy two students were divided into teams of three. Each team was randomly assigned to one of three GC conditions (independent, interdependent, or dependent) and underwent 66 days of technology-based group contingency intervention. Sixty five participants completed the intervention and 61 completed (...) the follow-up assessment 2 months later. Step counts and self-reported walking activity increased after the intervention under all three conditions. The proportion of participants that met the target step counts was significantly higher under the dependent group contingency condition. However, 2 months later, intervention effects were not maintained under any condition. For cost efficiency, the increase in step count per point was significantly higher under the interdependent group contingency condition. Group cohesion and social validity (point satisfaction and point utility) were significantly higher under the dependent group contingency condition. Finally, the clinical implications and limitations of this study are discussed. (shrink)

Boolean games are a logical setting for representing strategic games in a succinct way, taking advantage of the expressive power and conciseness of propositional logic. A Boolean game consists of a set of players, each of which controls a set of propositional variables and has a specific goal expressed by a propositional formula. We show here that Boolean games are a very simple setting, yet sophisticated enough, for analysing the formation of coalitions. Due to the fact that players have dichotomous (...) preferences, the following notion emerges naturally: a coalition in a Boolean game is efficient if it has the power to guarantee that all goals of the members of the coalition are satisfied. We study the properties of efficient coalitions. (shrink)

In this note, I provide an axiomatic characterization of the relative utilitarian bargaining solution to Nash bargaining problems. The solution is obtained when Nash’s independence of irrelevant alternatives axiom is replaced by the weak linearity axiom, while retaining the other three axioms. RU maximizes the sum of proportional gains, or, equivalently, minimizes the sum of proportional losses. RU is scale invariant and compared to the Nash and Kalai and Smorodinsky solutions, it is ex ante efficient when the bargaining problem is (...) considered as a lottery of future bargaining problems. (shrink)

In China, cultivation of the craftsmanship spirit is strongly advocated, but little attention is devoted to whether and how “working for the family” promotes heritage of this spirit. A configuration model of family motivation and organizational learning is proposed and expounded. Fuzzy set qualitative comparative analysis was used to further explore the conditional configuration. The results show that the fitting family motivation to organizational learning is important for promoting heritage of the craftsmanship spirit. There are two paths that promote efficient (...) heritage of this spirit: the institution-led path and the motivation-driven interpretation-led path. For the institution-led path, when apprentices have strong institution learning ability, the anterior-cause condition involves low family motivation, but this factor plays a weak role in promoting efficient heritage of the craftsmanship spirit. In a configuration consisting of intuition, interpretation, integration and institution, family motivation becomes irrelevant, which explains the phenomenon that organizational learning behavior reinforcement leads to a lack of family motivation. For the motivation-driven interpretation-led path, even without regular and institutionalized learning behaviors in the organization, the core conditions of high family motivation and high explanation learning, together with low intuition learning and low integration learning, will promote efficient heritage of the craftsmanship spirit. (shrink)

Practical and conceptual, the Responsible Research and Innovation set of books contributes to the clarification of this new requirement for all sciences and technological innovation. It covers the multiple and international responsibilities, by using various philosophical resources, mostly discussing the following topics: ethics, contingency, normative economy, freedom, corporate social responsibility (CSR), participative technological evaluation, sustainable development, geoengineering, the precautionary principle, standards, interdisciplinarity, and climate management. The ethics of efficiency must be considered with regard to the logic of action or (...) to economic, political, legal or scientific systems. This book presents a question on the central theme of responsible research and innovation (RRI), which has an ethical influence on effective logics. The issue is to question the opportunity and modularities of an ethical effective influence on the logics of efficiency of research and innovation. From the distinction of efficiency and effectiveness, lies the problem of efficacy, the ethical accord between the two. Thus appears the possibility of taking effective responsibility with respect to systematic injustices potentially linked to this efficiency. This book proposes categories to understand the ethical implications of research and innovation processes, under the aspect of their efficacy. (shrink)

Alasdair MacIntyre described the late modern West as driven by two moral values: efficiency and effectiveness. Regardless of whether you accept MacIntyre's overarching story, it seems clear that efficiency and effectiveness have achieved a zenith in institutional health care structures, such that these two aspects of care become the final arbiters of what counts as “good” care. At the very least, they are dominant in many clinical contexts and act as the interpretative lens for the judgments (...) of successful health care managers. The drive of efficiency can also be seen in “lean” management methods (originally imported from the automotive manufacturing industry) increasingly deployed in the intensive care unit. This drive gives us pause. The high stress of the ICU is exacerbated by the enormous complexity of technological interventions designed to maintain physiological functioning as the body heals, as well as the ever‐present concerns related to cost, effectiveness, and efficiency. The ICU, therefore, provides an illustrative view of the challenges facing clinicians, as well as resource managers, in terms of delivering care. In short, the goal of technocratic efficiency often ends up at odds with humane purposes. To better understand these contemporary health care dynamics, we conducted a limited series of focus group discussions and interviews with residents experienced in the challenges of delivering care in the ICU environment. In what follows, we highlight some narrative observations drawn from these focus groups. We found a recurrent and disconcerting refrain among our informants that has not been adequately described or addressed in the literature: technocratic management techniques have crept into and bifurcated clinical care strategies in the ICU. Specifically, we highlight the influence of concerns around efficiency and effectiveness and the ways in which these foci have contributed to a bifurcation in care in the ICU along two trajectories: either compassionate care or curative care. (shrink)

The aim of the study was to compare the acute effects of traditional resistance training and superset training on training duration, training volume and different perceptive measures. Twenty-nine resistance-trained participants performed a whole-body workout traditionally and as supersets of exercises targeting different muscle groups, in a randomized-crossover design. Each session was separated by 4–7 days, and consisted of eight exercises and three sets to failure. Training duration and number of repetitions lifted were recorded during the sessions. Rate of perceived exertion (...) for effort, rate of perceived exertion for discomfort, session displeasure/pleasure, and exercise enjoyment were measured 15 min after each session. Forty-eight hours after the final session participants reported which session they preferred. The superset session led to significantly higher values for RPE and RPD and tended to be higher for sPDF, i.e., more pleasurable, compared to the traditional session. There was no difference in EES. The traditional session led to significantly increased training volume and lasted 23 min longer than the superset session. Eighteen of the participants preferred the superset session, while 11 preferred the traditional session. In conclusion, performing a whole-body workout as a superset session was more time-efficient, but reduced the training volume and was perceived with greater exertion for effort and discomfort than a traditional workout. (shrink)

The objective of our study is to capture the roles of product quality and network effects in the success and efficiency of network markets under strategic settings that defined in terms of market share as a strategic factor and profit as a financial indicator. The research paper shows that the efficiency of network markets depends heavily on the phase adjustment of competition models and the balance of network effects and product quality among enterprises. the network market is always (...) efficient in price competition, but not true in quantity competition when the network effect difference is sufficiently large or/and the quality difference is relatively small, then network effects may play a perverse role in market efficiency. The main findings reveal that network effects do not always enhance the role of quality in market efficiency and market growth. The research outcomes point to high quality enterprises’ attitude toward compatibility with enterprises with large network effects. This research paper also offers insights on government intervention to correct the distorted impacts of sufficiently large network effects on the efficiency of network markets. (shrink)

Metaphor is a pervasive and significant feature of language. We use metaphor to talk about the world in familiar and innovative ways, and in contexts ranging from everyday conversation to literature and scientific theorizing. However, metaphor poses serious challenges for standard philosophical theories of meaning, because it straddles so many important boundaries: between language and thought, between semantics and pragmatics, between rational communication and mere causal association. ;In this dissertation, I develop a pragmatic theory of metaphorical utterances which reconciles two (...) apparently incompatible intuitions. The first is that metaphors are vehicles for undertaking speech acts with a propositional content distinct from their conventional sentence meaning. The second is that metaphors are tools for inducing the essentially non-propositional effect of 'seeing things in a new light' or under a new aspect. These intuitions seem to be incompatible because it is assumed that only one can capture the essential function of metaphor. I propose instead that non-propositional 'seeing-as' or aspectual thought serves as the means by which speakers intend to accomplish their end of communicating content. This does not imply that speakers are not interested in and even committed to the effects of aspectual thought as well, only that it is not their sole, ultimate intention. ;In order to substantiate this proposal about how metaphor works, I develop an account of the psychological structures on which aspectual thought operates and the changes it engenders; I then show how the content of the speaker's intended speech act is determined by the aspect the sentence generates. By bringing propositional content and non-propositional aspectual thought together in this way, my account can treat the full range of metaphors, from 'ordinary' to 'poetic', within a unified theory. Armed with this account, we have the explanatory resources necessary to acknowledge both that ordinary conversational metaphors are efficient and sometimes essential vehicles for communicating determinate propositional contents, and also that rich, poetic metaphors are invitations to an open-ended contemplation of the subject under discussion. These apparently very different effects turn out to be manifestations of the same basic process of comprehension. (shrink)

Efficiency is an important value for all publicly funded healthcare systems. Limited resources need to be used prudently and wisely in order to ensure best possible outcomes and waste avoidance. Since 2010, the drive for efficiency, in the UK, has acquired a new impetus, as the country embarked on an ‘age of austerity’ purportedly to balance its books and reduce national deficit. Although the NHS did not suffer any direct budget cuts, the austerity policies imposed on the welfare (...) system, including social and mental healthcare, have had a direct and detrimental impact on the healthcare service. This paper draws from a qualitative study conducted in three A&E Departments in England to explore the effects of austerity policies on the everyday experiences of doctors and nurses working in Emergency Departments. It discusses the operationalisation of efficiency in A&E, in a climate of austerity, and its effects on the experiences and practices of healthcare professionals. It uses the empirical data as a springboard to highlight the role of structures and regulations, in this case targets and protocols, in how core healthcare ethical values, such as empathy, are exercised in practice. It provides an analysis of the normative role structures and regulations can play on the perception and practice of professional duties and obligations in healthcare. (shrink)

Two experiments were conducted with variants of Wason's (1966) selection task. The common focus was the effect of differences in the sizes of the sets represented by P and not-Q in assertions of the form _If P then Q_ (conditional) or _All P are Q_ (categorical). Results support the conclusion that such set size differences affect the strategies people adopt when asked to determine, efficiently, the truth or falsity of such assertions, but they do not entirely negate the tendency to (...) select the term represented by P (the antecedent of the conditional or the subject of the categorical) in preference to the term represented by not-Q (the complement of the consequent of the conditional or the complement of the predicate of the categorical). Several possible explanations of this perseverance are considered. Results also support the conclusion that people find it easier to assess categorical assertions than logically equivalent conditional assertions. (shrink)

Greenhouse gas emissions are adversely affecting the earth’s climate, a global common and a public good. The contribution of individual countries has a limited effect on the biosphere, implying that only globally coordinated efforts may result in significant climate improvements. The Rio Earth Summit (1992) and Kyoto Protocol (1997) are manifestations of international efforts to achieve sustainable development through efficient use of energy and incorporating more renewable sources in global economy. In this article, the author examines the energy-related emissions of (...) greenhouse gases and the utilization of renewable energy sources in Canada with respect to Agenda 21 commitments. An overview of the results of Canada’s policies on climate change since Rio in terms of energy consumption, various sources of energy, and emission rates of greenhouse gases is also presented. It is concluded that the current plans of the Canadian government to deal with greenhouse gas emissions have not been effective. (shrink)