Research studies demonstrate wide variation in how physicians diagnose and treat patients with similar medical conditions and suggest that at least some of the variation reflects inefficiencies and unnecessary medical costs. Health care researchers are actively examining ways to reduce variations in practice through standardization of medicine to reduce the cost of treatment and ensure the quality of outcomes. The most widely accepted form of this standardization is Evidence Based Best Practices. Furthermore, financial health care providers such as hospitals and (...) managed care organizations are investigating methods to tie resource usage to medical protocols in their efforts to monitor and control health care costs. Such proposals are contentious because they report on physicians' medical practice behaviors and such reports could potentially be used to influence their clinical behaviors. The intent of this exploratory study was to examine physicians' perceptions about linking a standard costing system to EBBP guidelines. The authors interviewed nine practicing physicians asking each physician to respond to the question, 'As a physician working in a hospital environment, what are your reactions to and concerns with combining standard costing techniques with EBBP?' The interviews were in-depth and free form in nature. The physicians' responses were recorded and analyzed using Grounded Theory Methodology. Using this methodology the field data was categorized into two major themes. The most important theme centered on ethics and the second theme was concerned with the implementation and use of a standard cost system in regard to EBBP. If physicians' worries about ethical dilemmas and implementation issues are not resolved, then it is likely that doctors would be unwilling to participate in any efforts to develop or use a standard cost-reporting system in medicine. While this study was exploratory in nature, it should provide future guidance to accountants, health care researchers and health care providers about physicians' issues with the use of standard costing methods in medicine. (shrink)

Research studies demonstrate wide variation in how physicians diagnose and treat patients with similar medical conditions and suggest that at least some of the variation reflects inefficiencies and unnecessary medical costs. Health care researchers are actively examining ways to reduce variations in practice through standardization of medicine to reduce the cost of treatment and ensure the quality of outcomes. The most widely accepted form of this standardization is Evidence Based Best Practices. Furthermore, financial health care providers such as hospitals and (...) managed care organizations are investigating methods to tie resource usage to medical protocols in their efforts to monitor and control health care costs. Such proposals are contentious because they report on physicians’ medical practice behaviors and such reports could potentially be used to influence their clinical behaviors. The intent of this exploratory study was to examine physicians’ perceptions about linking a standard costing system to EBBP guidelines. The authors interviewed nine practicing physicians asking each physician to respond to the question, ‘As a physician working in a hospital environment, what are your reactions to and concerns with combining standard costing techniques with EBBP?’ The interviews were in-depth and free form in nature. The physicians’ responses were recorded and analyzed using Grounded Theory Methodology. Using this methodology the field data was categorized into two major themes. The most important theme centered on ethics and the second theme was concerned with the implementation and use of a standard cost system in regard to EBBP. If physicians’ worries about ethical dilemmas and implementation issues are not resolved, then it is likely that doctors would be unwilling to participate in any efforts to develop or use a standard cost-reporting system in medicine. While this study was exploratory in nature, it should provide future guidance to accountants, health care researchers and health care providers about physicians’ issues with the use of standard costing methods in medicine. (shrink)

We are the funny organisms that make and follow rules. To understand us, one must understand what is it to institute and follow a rule, to perform correctly or in error. This question is more important than it might at first seem for linguistic meaning is constituted by rules that govern uses of expressions. For example, the fact that 'squid' is correctly applied to squid and incorrectly applied to cuttlefish is part of what makes 'squid' mean what it does. Philosophers (...) sometimes argue further that all representations are rule-governed so that a theory of representation must explain the possibility of misrepresentation. ;The rule-following problem makes an explanation of correctness surprisingly difficult. Philosophers have also not been clear on just what is the problem with rules. I provide a statement of the features of rules and the problems they drive. I then show that some well-known accounts of rule following---Kripke's, Wright's, Blackburn's---are inadequate. My formulation also shows that some favored theories of content---causal, evolutionary, interpretivist---are inadequate. ;Positively, I argue that an essentially social and irreducibly normative organization---a practice---solves the rule-following problem. Therefore, only participants in social practices can follow rules and thence traffic in linguistic meaning. Still, an account of the correctness of a linguistic performance is not yet an explanation of its representational content. I argue that linguistic content is constituted by correctness facts but also by the representational purport of expressions. I explain an expression's purport to represent naturalistically in terms of syndromes of psychological and behavioral symptoms. A theory of linguistic representation, then, must join the non-natural social facts that constitute correctness with the natural individualistic facts that constitute representational purport. ;Such a hybrid theory reveals that thought and language are not as intimately connected as philosophers assume. Whereas linguistic content constitutively partakes of the social organization that sets humans apart from other creatures, thought content involves only refinements of the psycho-behavioral syndromes that we share with most vertebrates. It follows that linguistic content and thought content cannot be explained one in terms of the other. (shrink)

Philosophy & Social Criticism, Volume 48, Issue 5, Page 782-788, June 2022.

Philosophy & Social Criticism, Ahead of Print.

Philosophy & Social Criticism, Ahead of Print.

Philosophy & Social Criticism, Ahead of Print.

To a world assaulted by private interests, this book argues that peace must be a public thing. Distinguished philosophers of peace have always worked publicly for public results. Opposing nuclear proliferation, organizing communities of the disinherited, challenging violence within status quo establishments, such are the legacies of truly engaged philosophers of peace. This volume remembers those legacies, reviews the promise of critical thinking for crises today, and expands the free range of thinking needed to create more mindful and peaceful relations. (...) With essays by committed peace philosophers, this volume shows how public engagement has been a significant feature of peace philosophers such as Camus, Sartre, Dewey, and Dorothy Day. Today we also confront historical opportunities to transform practices for immigration, police interrogation, and mental health, as we seek to sustain democracies of increasing multicultural diversity. In such cases our authors consider points of view developed by renowned thinkers such as Weil, Mouffe, Conway, and Martín-Baró. This volume also presents critical analysis of concepts for thinking about violence, reconsiders Plato’s philosophy of justice, and examines the role of ethical theory for liberation struggles such as Occupy! (shrink)

There are decision problems in which rational deliberation fails to result in choosing a pure act. This phenomenon is known as decision instability and has been discussed in the literature on causal decision theory. In this paper we investigate another type of instability, called structural instability in dynamical systems theory. Structural instability indicates that certain qualitative features of the process of rational deliberation are under-determined in a decision situation. We illustrate some of the issues arising from structural instability with a (...) recent argument against causal decision theory proposed by Caspar Hare and Brian Hedden. We show that their argument is undermined by considerations arising from decision instability and structural instability. (shrink)

The objective of this paper is to examine the ‘Code of Ethics Quality’ (CEQ) in the largest companies of Australia, Canada and the United States. For this purpose, a proposed CEQ construct has been applied. It appears from the empirical findings that while Australia, Canada and the United States are extremely similar in their economic and social development, there may well be distinct cultural mores and issues that are forming their business ethics practices. A research implication derived from the performed (...) research is that the construct provides a selection of observable and measurable elements in the context of CEQ. The construct of CEQ consists of nine measures divided into two dimensions (i.e. staff support and regulation). They should not be seen as a complete list. On the contrary, it is encouraged that others propose and elaborate revisions and extensions. A practical implication of this paper is a structure of what and how to examine the CEQ in a managerial setting. It may assist companies in their efforts to establish, maintain and improve their ethical culture, norms and beliefs within the organization and supporting them in their ethical business practices with different stakeholders in the marketplace and society. The dimensions and measures of the construct may be used as a frame of reference for further research. They may be useful and applicable across contexts and over time using similar samples when it comes to large companies, as small‐ or medium‐sized ones may not have considered all areas nor have the elements in place. This is a research limitation, but it provides an opportunity for further research. (shrink)

Although there is a growing recognition that older adults and those with extensive comorbid conditions undergo cancer screening too frequently, there is little information about patients’ perceptions regarding cessation of cancer screening. Information on older adults’ views of screening cessation would be helpful both for clinicians and for those designing interventions to reduce overscreening.

The objective of this study is to test the embeddedness of codes of ethics (ECE) in organizations on aggregated data from three countries, namely Australia, Canada and the United States. The properties of four constructs of ECE are described and tested, including surveillance/training, internal communication, external communication and guidance. The data analysis shows that the model has satisfactory fit, validity and reliability. Furthermore, the results are fairly consistent when tested on each of the three samples (i.e. cross-national validation). This cross-national (...) study makes a contribution beyond previous descriptive or exploratory studies by using confirmatory factor analysis and structural equation modeling. Nevertheless, a number of limitations are raised, all of which provide opportunities for further research in refining, extending and testing the proposed ECE model in other cultural and corporate settings. (shrink)

The objective of this study is to test the embeddedness of codes of ethics (ECE) in organizations on aggregated data from three countries, namely Australia, Canada and the United States. The properties of four constructs of ECE are described and tested, including surveillance/training, internal communication, external communication and guidance. The data analysis shows that the model has satisfactory fit, validity and reliability. Furthermore, the results are fairly consistent when tested on each of the three samples (i.e. cross‐national validation). This cross‐national (...) study makes a contribution beyond previous descriptive or exploratory studies by using confirmatory factor analysis and structural equation modeling. Nevertheless, a number of limitations are raised, all of which provide opportunities for further research in refining, extending and testing the proposed ECE model in other cultural and corporate settings. (shrink)

There are decision problems in which rational deliberation fails to result in choosing a pure act. This phenomenon is known as decision instability and has been discussed in the literature on causal decision theory. In this paper we investigate another type of instability, called structural instability in dynamical systems theory. Structural instability indicates that certain qualitative features of the process of rational deliberation are under-determined in a decision situation. We illustrate some of the issues arising from structural instability with a (...) recent argument against causal decision theory proposed by Caspar Hare and Brian Hedden. We show that their argument is undermined by considerations arising from decision instability and structural instability. (shrink)

Do continuing education (CE) mandates increase participation in ethics programs and enhance their perceived outcomes? In a study of 5,198 North American psychologists, significant differences were found between mandated and nonmandated psychologists in relation to their participation in ethics programs but not in the perceived outcomes associated with those trainings. Although 64.3% of those psychologists operating under ethics mandates reported completing at least one ethics training within the previous year, only 40.7% of those without such mandates reported doing likewise. Overall, (...) both groups tended to view their ethics training quite favorably in relation to its perceived outcomes, though they differed in relation to their endorsement of CE mandates. Results are discussed in relation to the ongoing development of evidence-based CE and its role in developing critical professional competencies. (shrink)

ABSTRACT With few exceptions, the effectiveness of continuing education mandates has been measured by self-report assessments of the professional psychologists who fulfill them. The present investigation provided a longitudinal look at the number of approved CE providers and the incidence of licensing board complaints across a succession of two-year cycles prior to, and following, the 2012 implementation of CE mandates in the State of Illinois. Findings showed a substantial increase in the number of CE providers across that time, though no (...) significant change in the incidence of licensing board complaints, suggesting that the increased availability of CE did not translate into lower complaint rates. Possible reasons for these findings are noted, and recommendations for future work are detailed in support of an evidence-based approach to CE that better articulates and aligns its objectives with its outcomes in an era of renewed accountability in the health professions. (shrink)

Guilt and shame are self-conscious emotions with implications for mental health, social and occupational functioning, and the effectiveness of sports practice. To date, the assessment and role of athlete-specific guilt and shame has been under-researched. Reporting data from 174 junior elite cricketers, the present study utilized exploratory factor analysis in validating the Athletic Perceptions of Performance Scale, assessing three distinct and statistically reliable factors: athletic shame-proneness, guilt-proneness, and no-concern. Conditional process analysis indicated that APPS shame-proneness mediated the relationship between general (...) and athlete-specific distress. While APPS domains of guilt-proneness and no-concern were not significant mediators, they exhibited correlations in the expected direction with indices of psychological distress and well-being. The APPS may assist coaches and support staff identify players who may benefit from targeted interventions to reduce the likelihood of experiencing shame-prone states. (shrink)

Safe stair negotiation is an everyday task that children with developmental coordination disorder are commonly thought to struggle with. Yet, there is currently a paucity of research supporting these claims. We investigated the visuomotor control strategies underpinning stair negotiation in children with and without DCD by measuring kinematics, gaze behavior and state anxiety as they ascended and descended a staircase. A questionnaire was administered to determine parents' confidence in their child's ability to safely navigate stairs and their child's fall history. (...) Kinematics were measured using three-dimensional motion capture, whilst gaze was measured using mobile eye-tracking equipment. The parents of DCD children reported significantly lower confidence in their child's ability to maintain balance on the stairs and significantly more stair-related falls in the previous year compared to the parents of typically developing children. During both stair ascent and stair descent, the children with DCD took longer to ascend/descend the staircase and displayed greater handrail use, reflecting a more cautious stair negotiation strategy. No differences were observed between groups in their margin of stability, but the DCD children exhibited significantly greater variability in their foot-clearances over the step edge, which may increase the risk of a fall. For stair descent only, the DCD children reported significantly higher levels of state anxiety than the TD children and looked significantly further along the staircase during the initial entry phase, suggesting an anxiety-related response that may bias gaze toward the planning of future stepping actions over the accurate execution of an ongoing step. Taken together, our findings provide the first quantifiable evidence that safe stair negotiation is a significant challenge for children with DCD, and that this challenge is reflected by marked differences in their visuomotor control strategies and state anxiety levels. Whilst it is currently unclear whether these differences are contributing to the frequency of stair-related falls in children with DCD, our findings pave the way for future research to answer these important questions. (shrink)

Physical activity and sedentary behaviour have been linked to the mental health of children and adolescents, yet the timing of behaviours may play a role in this relationship and clarifying this could inform interventions. We explored cross-sectional associations of PA and SED in varying time segments throughout the school day with the mental health of school-aged children and adolescents from rural Northeastern Ontario, Canada. A total of 161 students wore accelerometers for 8 days and completed a self-report survey. Mental health (...) was measured using the Strengths and Difficulties Questionnaire. Accelerometer-measured SED, light PA, and moderate and vigorous PA were estimated in the time-segments before school, school time, after school, and evenings. Associations were tested with multilevel linear regressions while adjusting for confounding factors. Students spent 72.6 min in MVPA, 209.0 min in LPA, and 621.0 min in SED per day. Daily SED was associated with less conduct problems. Evening LPA was inversely associated with hyperactivity, while SED was associated with hyperactivity and with peer problems before school, and during school. No associations were observed for MVPA, emotional symptoms, or prosocial behaviour. In conclusion, displacing SED with LPA in some specific periods of the day may benefit the mental health of students; taking this into account could strengthen interventions. (shrink)

BackgroundPeople with upper extremity amputations report receiving insufficient information about treatment options. Furthermore, patients commonly report not knowing what questions to ask providers. A question prompt sheet, or list of questions, can support patient-centered care by empowering patients to ask questions important to them, promoting patient-provider communication, and increasing patient knowledge. This study assessed information needs among people with UE amputations about UE vascularized composite allotransplantation and developed a UE VCA-QPS.MethodsThis multi-site, cross-sectional, mixed-methods study involved in-depth and semi-structured interviews with (...) people with UE amputations to assess information needs and develop a UE VCA-QPS. Qualitative data were analyzed by thematic analysis; quantitative data were analyzed by descriptive statistics. The initial UE VCA-QPS included 130 items across 18 topics.ResultsEighty-nine people with UE amputations participated. Most were male, had a mean age of 46 years, and had a unilateral and below-elbow amputation. Participants desired information about UE VCA eligibility, evaluation process, surgery, risks, rehabilitation, and functional outcomes. After refinement, the final UE VCA-QPS included 35 items, across 9 topics. All items were written at a ≤ 6th grade reading level. Most semi-structured interview participants reported being ‘completely’ or ‘very’ likely to use a UE VCA-QPS.ConclusionPeople with UE amputations have extensive information needs about UE VCA. The UE VCA-QPS aims to address patients’ information needs and foster patient-centered care. Future research should assess whether the UE VCA-QPS facilitates patient-provider discussion and informed decision-making for UE VCA. (shrink)

There is much to learn from and admire in Danielle Wenner's "Nondomination and the Limits of Relational Autonomy." The core claim Wenner advances is that the very concerns that have motivated feminist relational autonomy theorists would be better pursued by foregoing their concern with autonomy and pursuing instead the political aim of promoting a neorepublican conception of freedom as nondomination. While leaving open the possibility that "autonomy speak may remain valuable in some contexts", Wenner nevertheless claims that "for the purposes (...) of understanding and combating relations of oppression and subjection, freedom as nondomination provides a more useful conceptual apparatus than the ideal of... (shrink)

In its comprehensive overview of Alain Locke's pragmatist philosophy this book captures the radical implications of Locke's approach within pragmatism, the critical temper embedded in Locke's works, the central role of power and empowerment of the oppressed and the concept of broad democracy Locke employed.

In: Ruse, M., editor. Philosophy of Biology. Prometheus Books. Amherst, NY. Pp. 385-392.

By Gregory M. Mikkelson School of Environment and Department of Philosophy McGill University, 3534 University Street Montréal, QC H3A 2A7 CANADA [email protected] Keynote contribution to the session "Integrating Ecological and Social Scales" Electronic conference "Landscape Scale Biodiversity Assessment" European Platform for Biodiversity, www.bioplatform.info Posted March 9th, 2005..

In: Hull, D. L. and M. Ruse, editors. Cambridge Companion to the Philosophy of Biology. Cambridge University Press. New York, NY. Pp. 372-387.

Governmental organizations funding science m several nations are creating large research centers that draw on several disciplines and that focus research on an area of immediate use to industrial concerns. I analyze eight proposals for a U.K. center devoted to human communication. I argue that the boundaries that such a center seeks to cross— between areas of knowledge, between disciplines, between academic and nonacademic research—are constructed in the proposals for strategic purposes m the immediate situations. The study supports other recent (...) work on the crucial role of texts as interme diaries in the science policy processes, and on the need to recognize the unexpected contingencies and unintended consequences of textual circulation. (shrink)

Martin Luther King, Jr. was born in the family home on Auburn Ave. in Atlanta, Georgia on January 15, 1929, as the second child of Alberta and Rev. M.L. King. Alberta’s husband had taken up the duties of her father as pastor of the nearby Ebenezer Baptist Church, and her second son was destined to assume leadership of the congregation and community that had nurtured the family life. -/- Along with his older sister, Christine, and his younger brother A.D., the (...) young Martin King enjoyed the kind of security and prestige that would come with life in one of the leading families of Atlanta. He wrote and spoke of a childhood that was experienced with love and fullness. . . . (shrink)

Machine generated contents note: -- Series Editors' PrefaceAcknowledgementsNotes on ContributorsHow Things Are Elsewhere; W. Schwarz Information Change and First-Order Dynamic Logic; B.Kooi Interpreting and Applying Proof Theories for Modal Logic; F.Poggiolesi & G.Restall The Logic(s) of Modal Knowledge; D.Cohnitz On Probabilistically Closed Languages; H.Leitgeb Dogmatism, Probability and Logical Uncertainty; B.Weatherson & D.Jehle Skepticism about Reasoning; S.Roush, K.Allen & I.HerbertLessons in Philosophy of Logic from Medieval Obligations; C.D.Novaes How to Rule Out Things with Words: Strong Paraconsistency and the Algebra of Exclusion; (...) F.Berto Lessons from the Logic of Demonstratives; G.RussellThe Multitude View on Logic; M.Eklund Index. (shrink)

I’m delighted to have the opportunity to respond to Hartry Field’s Saving Truth From Paradox [3]. This is a wonderful book: it’s clear and precise, interesting and engaging, and deep and important all at once. Truth and the paradoxes..