Quality improvement (QI) is fundamental to maintaining high standards of health care. Significant debate exists concerning the necessity for an ethical approval system for those QI projects that push the boundaries, appearing more similar to research than QI. The authors discuss this issue identifying the core ethical issues in family medicine (FM), drawing upon the fundamental principles of medical ethics, including principles of autonomy, utility, justice and non-maleficence. Recent debate concerning the application of QI ethics boards is discussed with relevance (...) to primary care and issues such as general practitioner (GP) intentions, the impact of QI on patients and the use of confidential patient data and the impact of dissemination. The authors conclude that a system of QI ethical approval leaves many issues unresolved and potentially creates several barriers to implementing QI. To ensure ethical QI work is generated within FM it is essential for GPs to learn about and engage in more ethical reflection so that they can better judge and resolve these issues. (shrink)
Recent attempts at preventing the social exclusion of vulnerable children in England have been driven by notions of resilience which centre primarily on changing children so that they may be better able to cope with adversity. Drawing on the concepts of Cultural Historical Activity Theory (CHAT), we suggest that the idea of resilience should be expanded to include developing a capacity to act on and reshape the social conditions of one’s development. We use evidence from two studies of practices in (...) recent re-configurations of children’s services in England to examine whether practitioners are seeing resilience in these terms. We present examples of work which embody these views but suggest that they are not easily incorporated into practices where expertise is centred on care and clear communication. The care and communication model of practice reflects the emphases given to evolutionary notions of child development while a CHAT view of resilience reflects Vygotsky’s concerns with a dialectic between individuals and the social situations of their development. (shrink)
In popular articles that play down the genetical differences among human populations, it is often stated that about 85% of the total genetical variation is due to individual differences within populations and only 15% to differences between populations or ethnic groups. It has therefore been proposed that the division of Homo sapiens into these groups is not justified by the genetic data. This conclusion, due to R.C. Lewontin in 1972, is unwarranted because the argument ignores the fact that most of (...) the information that distinguishes populations is hidden in the correlation structure of the data and not simply in the variation of the individual factors. The underlying logic, which was discussed in the early years of the last century, is here discussed using a simple genetical example. (shrink)
The interpretive literature in the history of political thought is now vast, complex and esoteric, posing as much a barrier to the understanding of the undergraduate student as it offers assistance. This unique and innovative text provides the student with a guide through this maze of argument. Each chapter sets out the major positions and debates that surround the texts of key thinkers, analyzes major problems of interpreting them, examines the sources of disagreement, and evaluates the different interpretations in terms (...) of their strengths, weaknesses and contributions to scholarship. (shrink)
In an era of political, economic and epistemological uncertainty, this book provides an accessible, critical and thorough analysis of the difficulties that beset teacher education. The authors draw on philosophical, psychological and sociological perspectives and illustrate their points with a detailed mix of international examples.
UK government policies for social inclusion through engaging with the learning society aim at repositioning people as capable participants in their social worlds. These policies at first sight appear to be aimed at a sophisticated restructuring of social contexts as well as at an enhancing of individual learning. However there is a degree of conceptual confusion within these policies. In this paper we explore some of the tensions evident in a study of a family learning centre in an English city. (...) In the exploration we examine the extent to which the tools offered by sociocultural and activity theory (SAT) can assist in resolving that conceptual confusion and how SAT itself might need to develop in order to analyse complex and sustained forms of intervention. (shrink)
Dr Edwards' stimulating and provocative book advances the thesis that the appropriate axiomatic basis for inductive inference is not that of probability, with its addition axiom, but rather likelihood - the concept introduced by Fisher as a measure of relative support amongst different hypotheses. Starting from the simplest considerations and assuming no more than a modest acquaintance with probability theory, the author sets out to reconstruct nothing less than a consistent theory of statistical inference in science.