In the Netherlands, current policy opinion emphasizes demand-driven health care. Central to this model is the view, advocated by some Dutch health policy makers, that patients should be encouraged to be aware of and make use of health quality and health outcomes information in making personal health care provider choices. The success of the new health care system in the Netherlands is premised on this being the case. After a literature review and description of the new Dutch health care system, (...) the adequacy of this demand-driven health policy is tested. The data from a July 2005, self-administered questionnaire survey of 409 patients (response rate of 94%) as to how they choose a hospital are presented. Results indicate that most patients did not choose by actively employing available quality and outcome information. They were, rather, referred by their general practitioner. Hospital choice is highly related to the importance a patient attaches to his or her physician’s opinion about a hospital. Some patients indicated that their hospital choice was affected by the reputation of the hospital, by the distance they lived from the hospital, etc. but physician’s advice was, by far, the most important factor. Policy consequences are important; the assumptions underlying the demand-driven model of patient health provider choice are inadequate to explain the pattern of observed responses. An alternative, more adequate model is required, one that takes into account the patient’s confidence in physician referral and advice. (shrink)

The study is designed to provide an informal summary of what is known about consumer switching of health insurance plans and to contribute to knowledge about what motivates consumers who choose to switch health plans. Do consumers switch plans largely on the basis of critical reflection and assessment of information about the quality, and price? The literature suggests that switching is complicated, not always possible, and often overwhelming to consumers. Price does not always determine choice. Quality is very hard for (...) consumers to understand. Results from a random sample survey ( n = 2791) of the Alkmaar region of the Netherlands are reported here. They suggest that rather than embracing the opportunity to be active critical consumers, individuals are more likely to avoid this role by handing this activity off to a group purchasing organization. There is little evidence that consumers switch plans on the basis of critical reflection and assessment of information about quality and price. The new data reported here confirm the importance of a group purchasing organizations. In a free-market-health insurance system confidence in purchasing groups may be more important for health insurance choice than health informatics. This is not what policy makers expected and might result a less efficient health insurance market system. (shrink)

The existence of various physical phenomena stems from the concept called asymptotic emergence, that is, they seem to be exclusively reserved for certain limiting theories. Important examples are spontaneous symmetry breaking (SSB) and phase transitions: these would only occur in the classical or thermodynamic limit of underlying finite quantum systems, since for finite quantum systems, due to the uniqueness of the relevant states, such phenomena are excluded by Theory. In Nature, however, finite quantum systems describing real materials clearly exhibit such (...) effects. In this paper we discuss these apparently “paradoxical” phenomena and outline various ideas and mechanisms that encompass both theory and reality, from physical and mathematical points of view. (shrink)

IntroductionCerebral visual impairment is an important cause of visual impairment in western countries. Perinatal hypoxic-ischemic damage is the most frequent cause of CVI but CVI can also be the result of a genetic disorder. The majority of children with CVI have cerebral palsy and/or developmental delay. Early diagnosis is crucial; however, there is a need for consensus on evidence based diagnostic tools and referral criteria. The aim of this study is to develop guidelines for diagnosis and referral in CVI according (...) to the grade method.Patients and MethodsWe developed the guidelines according to the GRADE method 5 searches on CVI were performed in the databases Medline, Embase, and Psychinfo, each with a distinct topic.ResultsBased on evidence articles were selected on five topics: 1. Medical history and CVI-questionnaires 23. 2. Ophthalmological and orthoptic assessment 37. 3. Neuropsychological assessment 5. 4. Neuroradiological evaluation and magnetic resonance imaging 9. 5. Genetic assessment 5.ConclusionIn medical history taking, prematurity low birth weight and APGAR Scores are important. Different questionnaires are advised for children under the age of 3 years, older children and for specific risk groups. In ophthalmological examination, eye movements, specially saccades, accommodation, crowding, contrast sensitivity and visual fields should be evaluated. OCT can show objective signs of trans-synaptic degeneration and abnormalities in fixation and saccades can be measured with eye tracking. Screening of visual perceptive functioning is recommended and can be directive for further assessment. MRI findings in CVI in Cerebral Palsy can be structured in five groups: Brain maldevelopment, white and gray matter lesions, postnatal lesions and a normal MRI. In children with CVI and periventricular leukomalacia, brain lesion severity correlates with visual function impairment. A differentiation can be made between cortical and subcortical damage and related visual function impairment. Additional assessments can be necessary to complete the diagnosis of CVI and/or to reveal the etiology. (shrink)

Apparent tensions, even contradictions, within the letters of Paul have led some to abandon the attempt to find coherence in his theology, and others to locate it in his psychological make-up lather than his thought, neither solution represents an adequate response to the apostle's theological reflections.

The basic question today is: Can biblical theology do the job of revitalizing the Bible? And in the discussion around the Bible, is the alternative correct: biblical history or biblical kerygmatic theology? Are we, caught in this alternative, not responsible for the rejection of biblical studies today— for avoiding the heart of Bible, namely, the consideration of the validity of biblical religion for us today?

The 2005 UNESCO Convention on the Protection and Promotion of the Diversity of Cultural Expressions provides an international policy lens for analysing broad debates on issues of cultural globalization and development. The interdisciplinary contributions in this volume offer a fresh understanding of these key issues whilst examining cultural globalization, which is conceived in terms of artistic expressions and entertainment industries and interpreted anthropologically as the rituals, symbols, and practices of everyday life. The broad gamut of theories, methods, and evidence collected (...) by the editors outlines UNESCO's accomplishments, shortcomings, and future policy prospects. This edited collection has a clear message: The Convention is a useful and important instrument in the debate on cultural diversity, but not broad enough or sufficient to confront major challenges concerning human rights, sustainability, and cultural diversity as a whole. (shrink)

Bernard Lonergan argued that a Thomist theory of intellect must begin with advertence to the act of understanding. He distinguished his cognitional theory from a conceptualism that neglects the experience of insight and reflection on it. Early in his career, he explained how the conceptualist approach misinterprets Aquinas and creates problems for the metaphysics of rational psychology. This article explains Lonergan’s position and illustrates the conceptualist alternative by analysing Joseph Owens’s view of cognition. By explaining the metaphysical differences between Lonergan’s (...) and Owens’s opposing views of human knowing in relation to their distinctive readings of Aquinas, this article contributes to a more accurate reading of Aquinas on the act of understanding. (shrink)

This short essay analyzes an unusual typographical feature in the Epistle to the Reader that precedes Locke’s Essay. Specifically, it asks why there is a line prior to Christiaan Huygens’ name in the famous Underlaborer Passage. The paper provides a thorough look at the line’s longevity through early editions of the Essay and considers a number of possible explanations for the line’s presence. It is argued that the line may well have held some meaning for early readers; contemporary scholars (...) should be motivated to investigate the issue further. (shrink)

Algebraic equations in the tradition of Descartes and Frans Van Schooten accompany Christiaan Huygens’s early work on collision, which later would be reorganized and presented as De motu corporum ex percussione. Huygens produced the equations at the same time as his announcement of his rejection of Descartes’s rules of collision. Never intended for publication, the equations appear to have been used as preliminary scaffolding on which to build his critiques of Descartes’s physics. Additionally, Huygens used algebraic equations of this (...) form to accurately predict the speeds of bodies after collision in experiments carried out at the Royal Society. Despite their deceptive simplicity, Huygens’s algebraic equations pose significant conceptual problems both mathematically and for their physical interpretation especially for negative speeds; they may very well have been the source of a new principle, the conservation of quantity of motion with direction. (shrink)

Information can be public among a group. Whether or not information is public matters, for example, for accounts of interdependent rational choice, of communication, and of joint intention. A standard analysis of public information identifies it with (some variant of) common belief. The latter notion is stipulatively defined as an infinite conjunction: for p to be commonly believed is for it to believed by all members of a group, for all members to believe that all members believe it, and so (...) forth. This analysis is often presupposed without much argument in philosophy. Theoretical entrenchment or intuitions about cases might give some traction on the question, but give little insight about why the identification holds, if it does. The strategy of this paper is to characterize a practical-normative role for information being public, and show that the only things that play that role are (variants of) common belief as stipulatively characterized. In more detail: a functional role for “taking a proposition for granted” in non-isolated decision making is characterized. I then present some minimal conditions under which such an attitude is correctly held. The key assumption links this attitude to beliefs about what is public. From minimal a priori principles, we can argue that a proposition being public among a group entails common commitment to believe among that group. Later sections explore partial converses to this result, the factivity of publicity and publicity from the perspective of outsiders to the group, and objections to the aprioricity of the result deriving from a posteriori existential presuppositions. (shrink)

Living out of silence, out of a fully functioning, lovingly attentive mind, and not just out of thought, out of a partially functioning mind, is requisite for depth or profundity in living or relating. A fully attentive, truly silent or meditative mind sees that there is real dualism of time and the timeless and that time and the timeless each has its own unique value. The timeless, or real silence, that which alone can make for depth in one's living and (...) relating, can be there only when, in one's awareness, time and all that is related to time, have come to an end. An examination of a wide variety of statements made by writers, both past and present, shows that these understandings are seldom there in contemporary writings, just as they were not there in writings that have come down to us from the past. 'Living beyond the One and the Many' invites readers to consider the possibility that what is presented in it can bring deep meaning to one's way of living in the world"--Publisher's description, back cover. (shrink)

Should we regard Jennifer Lackey’s ‘Creationist Teacher’ as understanding evolution, even though she does not, given her religious convictions, believe its central claims? We think this question raises a range of important and unexplored questions about the relationship between understanding, factivity and belief. Our aim will be to diagnose this case in a principled way, and in doing so, to make some progress toward appreciating what objectual understanding—i.e., understanding a subject matter or body of information—demands of us. Here is the (...) plan. After some ground clearing in §1, §2 outlines and motivates a plausible working model—moderate factivity—for characterising the sense in which objectual understanding should be regarded as factive. §3 shows how the datum that we can understand false theories can, despite initial suggestions to the contrary, be assimilated straightforwardly within the moderate factivity model. §4 highlights how the inverse kind of case to that explored in §3—viz., a variant of Lackey’s creationist teacher case—poses special problems for moderate factivity. With reference to recent work on moral understanding by Hills, §5 proposes a solution to the problem, and §6 attempts to diagnose why it is that we might originally have been led to draw the wrong conclusion. (shrink)

The achievements of the textile industry in Roman Britain are often underestimated as a result of the meagreness of our available evidence. The Edict on maximum prices issued by Diocletian in A.D. 301 shows that British capes commanded high prices on the markets of the Empire, and that in the late third century A.D. British rugs were the best in the world. In view of the competition from the traditional centres of rug manufacture in the East, this is an astonishing (...) achievement. (shrink)

The received translation and interpretation of many of the technical terms current in the textile industry of the Roman Empire are inaccurate, because lexicographers have either fought shy of being precise, or have thought that they recognized in the ancient world technical processes which originated at a much later date. The evidence is often equivocal or insufficient, but may still yield details that have been overlooked. The textile expression scutulatus, to take an example, deserves more attention than Blümner has devoted (...) to it. When it refers to the appearance of a garment, Lewis and Short, s.v. scutulatus, translate ‘diamond or lozenge-shaped, checkered’. It seems worth while to attempt a more precise translation, and, if possible, to estimate the significance in context of the goods so designated. (shrink)

Husserlian phenomenology, as the study of conscious experience, has often been accused of solipsism. Husserl’s method, it is argued, does not have the resources to provide an account of consciousness of other minds. This chapter will address this issue by providing a brief overview of the multiple angles from which Husserl approached the theme of intersubjectivity, with specific focus on the details of his account of the concrete interpersonal encounter – “empathy.” Husserl understood empathy as a direct, quasi-perceptual form of (...) intentionality through which the sense of the Other is constituted. Furthermore, his account of empathy is holistically integrated with his overall theory of intersubjectivity, including his discussions of the objectivity of nature, and the social, historical, and communal aspects of subjectivity. Husserl’s theory of empathy continues to cast a long shadow, influencing both the analytic and continental approaches to the problem of other minds, as well as contemporary account of social cognition in the cognitive sciences. (shrink)

An Essay on Human Action seeks to provide a comprehensive, detailed, enlightening, and (in its detail) original account of human action. This account presupposes a theory of events as abstract, proposition-like entities, a theory which is given in the first chapter of the book. The core-issues of action-theory are then treated: what acting in general is (a version of the traditional volitional theory is proposed and defended); how actions are to be individuated; how long actions last; what acting intentionally is; (...) what doing one thing by doing another is; what basic action is; and what omitting to do something is. Attention is also given to the concepts of causation, intention, volition, deciding, choosing, and trying. Finally, a libertarian account of free action is tentatively proposed and defended. (shrink)

We develop and apply a multi-dimensional conception of explanatory depth towards a comparative analysis of inflationary and bouncing paradigms in primordial cosmology. Our analysis builds on earlier work due to Azhar and Loeb (2021) that establishes initial condition fine-tuning as a dimension of explanatory depth relevant to debates in contemporary cosmology. We propose dynamical fine-tuning and autonomy as two further dimensions of depth in the context of problems with instability and trans-Planckian modes that afflict bouncing and inflationary approaches respectively. In (...) the context of the latter issue, we argue that the recently formulated trans-Planckian censorship conjecture leads to a trade-off for inflationary models between dynamical fine-tuning and autonomy. We conclude with the suggestion that explanatory preference with regard to the different dimensions of depth is best understood in terms of differing attitudes towards heuristics for future model building. (shrink)

Global Media Ethics is the first comprehensive cross-cultural exploration of the conceptual and practical issues facing media ethics in a global world. A team of leading journalism experts investigate the impact of major global trends on responsible journalism. The first full-length, truly global textbook on media ethics; Explores how current global changes in media promote and inhibit responsible journalism; Includes relevant and timely ethical discussions based on major trends in journalism and global media; Questions existing frameworks in media ethics in (...) light of the impact of global media; Contributors are leading experts in global journalism and communication. (shrink)

Trope theory is a leading metaphysical theory in analytic ontology. One of its classic statements is found in the work of Donald C. Williams who argued that tropes qua abstract particulars are the very alphabet of being. The concept of an abstract particular has been repeatedly attacked in the literature. Opponents and proponents of trope theory alike have levelled their criticisms at the abstractness of tropes and the associated act of abstraction. In this paper I defend the concept of a (...) trope qua abstract particular by rejecting arguments that purport to show that tropes should not be understood as abstract and by arguing that the abstractness of tropes plays an indispensable role in one of our more promising trope-theoretic analyses of universals and of concrete objects. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:BOOK REVIEWS 177 Amsterdam, appears in the series of the International Archives of the History of Ideas, published under the direction of P. Dibon of Nijmegen and R. Popkin of the University of California at San Diego and a distinguished international editorial committee. Other volumes demonstrate the philosophical respectability of the collection: three on Descartes and Cartesianism, one on Berkeley's immaterialism, three on Pierre Bayle, the rest on philosophical (...) topics from the Renaissance to the 19th century. In this gallery, these letters by a not very good French poet---who was yet an acute and rather individualistic judge of men and books, already one of the arbiters of intellectual and artistic life in France--may seem a little out of place. Yet, to many historians of intellectual affairs, the firm establishment of dates and personal relationships is a matter of much importance, and documents such as these, largely devoted as they are to the communication of news about books and writers, the activities of rulers and ambassadors, printers and curious travelers, can be a substantial aid in determining the structure of an historical moment, the succession and interrelationship of events. One is willing to grant that much of what Chapelain wrote to Heinsius is trivial and concerns books and literary news of slight importance, that a delicate irony makes less of some of his comments than they were worth at the time. The triviality itself is a clue to the temper of Paris during the Fronde and in the late years of the regency of Mazarin. Great ideas were not being discussed in public when Pascal was writing his Pensdes; the irony is a mode of defense against involvement, and fashionable at the time. Bray's elaborate introduction is more concerned with the artistic and subjective aspect of the letters than with their contribution to intellectual history. In about a hundred pages, he discusses his author's method of writing, the genre which this kind of letter represents, the artistry it exhibits, from basic structure to stylistic ornamentation, and finally the human and even ethical implications of this collection. His notes are full and informative; identifications are well documented and cross-referencing in the notes and in the index of names make the volume a usable source of information, even though it cannot be recommended as stimulating debate or lively narrative. The topics discussed by Chapelain range over a considerable area, without becoming controversial. There is one exceptional letter in which he instructs Heinsius in adapting his integrity to the role of a diplomat; he must acquire "un peu de dissimulation" to oppose to "l'ing~nuit~ du Parnasse." There are references to civil strife, to foreign affairs, to the rivalry of Dutch and English navies, to the sympathy of the French for the Swedish Lutheran dynasty as opposed to the Catholic ttapsburgs and the ecclesiastical electors of Mainz, Cologne, and Trier. Queen Christina of Sweden plays a continually less attractive part as the letters proceed to their end; and Christiaan Huygens, the Duc de Montausier, Ismael Boulliau, Guez de Balzac, and Gilles M4nage figure more or less regularly in these pages. Of philosophers there is little mention, and of discussion of ideas for their own sake still less. The letters are, like many another collection deriving from the age before the learned and scientific journals, a source of valuable information about certain persons and certain books; they are hardly a serious contribution to the history of ideas. H~covaT BROWN Brown University Pascal. By J. H. Broome. (New York: Barnes & Noble, Inc., 1966. pp. x + 250. $6.00.) The most remarkable feature of this work is that it locates and forcefully interprets philosophical themes common to all of Pascal's widely=diversified writing. In his works on the vacuum, the computer, geometry, hydrostatics, Grace, freedom and the art of persuasion as well as the Pens~es, Broome locates five regular features of Pascal's thought: 1) the three orders (pp. 103-4, inter alia); 2) the deux infinis (p. 146); 3) a theory of knowl- 178 HISTORY OF PHILOSOPHY edge; 4) a dialecticalmethod; and 5) a theory of communication. The former two themes are commonly discussed by students of... (shrink)

The legal environment -- Regulation of nursing practice -- Nurses in legal actions -- Standards of care -- Defenses to negligence or malpractice -- Prevention of malpractice -- Nurses as witnesses -- Professional liability insurance -- Accepting or refusing an assignment/patient abandonment -- Delegation to unlicensed assistive personnel -- Patients' rights and responsibilities -- Confidential communication -- Competency and guardianship -- Informed consent -- Refusal of treatment -- Pain control -- Patient teaching and health counseling -- Medication administration -- Clients (...) with AIDS and HIV testing -- Abusive situations -- Reproductive services -- Restraints -- Emergency psychiatric admissions -- Organ and tissue donation and transplantation -- Discharge against medical advice -- The medical record and documentation standards -- Electronic health information and communications -- Interdependent nursing functions: verbal orders and telenursing -- Event reporting and compliance -- Quality and safety in nursing practice -- Forensic issues -- Employer and employee rights -- Contracts -- Corporate liability -- Employment contracts and unionization -- Employment status liability -- Staffing issues and floating -- Americans with Disabilities Act -- Employees with AIDS/HIV infection and exposure to bloodborne pathogens -- Impaired nurses -- Sexual harassment in the workplace -- Violence in the workplace -- Intentional torts -- Environmental health and safety -- Ethical decision making -- Professional boundaries and patient relationships -- Moral courage and patient advocacy -- Social media and online professionalism -- Reporting illegal, unethical, or unsafe conduct -- Maternal versus fetal rights -- Futility of care -- Advance directives and end-of-life decisions -- Assisted suicide. (shrink)

The concept of instantiation is realized differently across a variety of metaphysical theories. A certain realization of the concept in a given theory depends on what roles are specified and associated with the concept and its corresponding term as well as what entities are suited to fill those roles. In this paper, the classic realization of the concept of instantiation in a one-category ontology of abstract particulars or tropes is articulated in a novel way and defended against unaddressed objections.