Patient safety has only recently been subjected to wide-spread systematic study. Healthcare differs from other high risk industries in being more diverse and multi-contextual, and less certain and regulated. Also many patient safety problems are low-frequency events associated with many, varied contributing factors. The subject of this paper is the epistemology of patient safety (the science of the method of finding out about patient safety). Patient safety research is considered here on the background of a risk management framework which requires (...) researchers to: • Understand the context - as a subset of healthcare quality, services and systems research, with technical and human behavioural (cultural) components and a range of external and internal organisational influences, a wide range of research disciplines is necessary • Identify the risks - identify the things that go wrong and the frequency and nature of different types of incidents from sources such as medical record review, observational studies, audit, incident and medico-legal reports • Analyse the risks - deconstruct the things that go wrong, identifying contributing factors and trying to detect trends and patterns in contributing factors, detection, mitigation factors, ameliorating factors and actions taken to reduce risk • Evaluate the risks - decide on priorities, identifying preventive and corrective strategies and judging the risk- and cost-benefit of potential corrective strategies such as standardisation or simplification of a process or device • Manage the risk - evaluate and scope preventive and/or corrective strategies and then implement these, or place the problem on a risk register pending solution, or accept that what is needed is unaffordable • Communicate and consult - use interactive sessions, audit, on-going feedback, reminders and patient mediated prompts • Monitor and review the state of the problem - get baseline trends and patterns so that changes can be tracked and properly attributed to an intervention A hierarchy of levels of evidence has been proposed for clinical research and we argue that insufficient weighting has been given to lower ranked levels of research and to qualitative research, although critical interpretive synthesis is now gaining acceptance in mainstream thinking (e.g. by the Cochrane Collaboration). Fundamental challenges remain including how to grasp the elusive concept of patient safety, how to quantify, characterise and cost the problems, how to judge the extent to which harm can be attributed to errors, violations or system failures, how to identify contributing factors and the extent to which they can be implicated, how to judge whether incidents or their precursors are preventable, how to generate strong evidence to make healthcare safer and how to translate research into practice. Future directions include addressing the mundane as well as rare, dramatic events, and developing further research in non-hospital settings and in developing countries. In summary, a mixture of qualitative and quantitative methods, using information from all available data sources and combining retrospective, real time and prospective study designs, is necessary to address some of the more difficult patient safety problems. (shrink)

By making use of the method of moments we study some aspects of the statistical behavior of the nonrelativistic harmonic oscillator according to stochastic electrodynamics. We show that the random rotations induced on the particle by the zero-point field account for the magnitude of the spin of the electron, the result differing from the correct one(3/4)h 2 by a factor of2. Assuming that the measurement of a spin projection may be effectively taken into account by considering the action of only (...) the subensemble of the field with the corresponding circular polarization, the calculated value of the spin projection comes out to be the correct one within a factor of order unity. The radiative corrections give rise to both the Lamb shift and the anomalous magnetic moment of the electron, the latter being evaluated to within a factor of2. The magnetic and gyromagnetic properties of the electron come out to be in agreement with quantum mechanics. Interference effects are shown to occur when evaluating the average value of the square of the angular momentum. (shrink)

The aim of this exploratory study was to examine client demographics and expectations, reasons for use, sensations during treatment, and perceived outcomes of Pranic Healing, an energy healing system lacking in scientific documentation but whose use in the general population is becoming more widespread internationally. This study consisted of a cross-sectional survey of adults (18+ years of age) receiving care from 12 Pranic Healing practices in four different states in the U.S. (N = 179) completing online questionnaires. Closed-ended response sets (...) were analyzed descriptively, while qualitative data were analyzed using content analysis. Reasons to use the therapy included physical, mental/emotional, and metaphysical issues, dissatisfaction with conventional care, and overall well-being. Expectations of care included enhanced abilities, cure or relief, or unsure. Respondents were more likely to cite a specific problem from which they needed alleviation than to cite overall health or wellness as their goal. Sensations experienced were reported to be of a relaxing nature and not, as was hypothesized, of an energizing nature. Results show that those who use Pranic Healing fit the sociodemographic profile of CAM (complementary and alternative medicine) users in the United States, that their reasons for use are not homogeneous, and that preliminary descriptive data from a selective subsample of respondents indicated that some respondents are experiencing positive outcomes attributed to this modality. (shrink)

Several intrinsic/extrinsic distinctions amongst properties, current in the literature, are discussed and contrasted. The proponents of such distinctions tend to present them as competing, but it is suggested here that at least three of the relevant distinctions (including here that between non-relational and relational properties) arise out of separate perfectly legitimate intuitive considerations: though of course different proposed explications of the informal distinctions involved in any one case may well conflict. Special attention is paid to the question of whether a (...) single notion of property is capable of supporting the various distinctions. (shrink)

We consider the modal logic of non-contingency in a general setting, without making special assumptions about the accessibility relation. The basic logic in this setting is axiomatized, and some of its extensions are discussed, with special attention to the expressive weakness of the language whose sole modal primitive is non-contingency , by comparison with the usual language based on necessity.

This paper considers the question: what becomes of the notion of a logic as a way of codifying valid arguments when the customary assumption is dropped that the premisses and conclusions of these arguments are statements from some single language? An elegant treatment of the notion of a logic, when this assumption is in force, is that provided by Dana Scott's theory of consequence relations; this treatment is appropriately generalized in the present paper to the case where we do not (...) make this assumption of linguistic homogeneity. Several applications of the resulting concept of a heterogeneous logic are suggested, but the main emphasis is on the formal development. One topic touched on is a certain contrast between the boolean and the intensional sentence-connectives in this more general setting. (shrink)

For the claim that the satisfaction of certain conditions is sufficient for the application of some concept to serve as part of the (`reductive') analysis of that concept, we require the conditions to be specified without employing that very concept. An account of the application conditions of a concept not meeting this requirement, we call analytically circular. For such a claim to be usable in determining the extension of the concept, however, such circularity may not matter, since if the concept (...) figures in a certain kind of intensional context in the specification of the conditions, the satisfaction of those conditions may not itself depend on the extension of the concept. We put this by saying that although analytically circular, the account may yet not be inferentially circular. (shrink)

An account of desire as a species of belief may owe its appeal to the details of its proposal as to precisely what sort of beliefs desires are to be identified with, and its downfall may be due to those details it does provide. For example, it may be proposed that the desire that α is in fact the belief that it ought to be that α, or is morally good or desirable that it should be the case that α. (...) Here the appeal might be that of forging a link between the holding of a moral belief and the acknowledgment that one has a reason for acting a certain way; and the shortcoming of the suggestion is its evident implausibility: even if the ‘necessity’ direction could be established, having a desire hardly seems sufficient for the holding of any such belief. Again: it might be proposed, perhaps simply to bring some order into the realm of propositional attitudes by reducing some to others, that the belief with which we should identify a’s desire that α is a’s belief that he will or would be happy if α. This proposed identification can be seen to be incorrect by consideration of examples such as the following, due to J. Gosling. An aging and ailing parent might forego numerous pleasures in order that his children should reap the benefits of his saving and have a good start in life – perhaps by receiving an expensive education – after his impending death. Oearly he may want that they should so benefit even if he does not believe in an after-death existence in which he might come to know of, and so take pleasure in, his children’s subsequent well-being. So his wanting that they should prosper cannot consist in his believing that he will be happy if/when they do, since he has no expectation of even being in existence in that eventuality. As Gosling puts it, there is a clear difference between thinking that something’s coming about will bring one pleasure, on the one hand, and viewing the prospect of its coming about with pleasure, on the other. (shrink)

A.N. Prior once showed that on certain apparently reasonable assumptions, a thesis sometimes associated with the name of Hume to the effect that no set of factual statements can ever entail an evaluative statement, is quite untenable. We assume only that there is at least one statement of each kind, and that the negation of a factual statement is factual — a principle we may call ‘N'. Now consider the disjunction F V E of some factual with some evaluative statement. (...) Since the disjunction is entailed by F, a factual statement, it must, if principle H is correct, be classified as factual. But by N, ∽ F is also factual, and this together with F V E entails E, thus violating H since E was exhypothesi an evaluative statement. (shrink)

For the claim that the satisfaction of certain conditions is sufficient for the application of some concept to serve as part of the (‘reductive’) analysis of that concept, we require the conditions to be specified without employing that very concept. An account of the application conditions of a concept not meeting this requirement, we call analytically circular. For such a claim to be usable in determining the extension of the concept, however, such circularity may not matter, since if the concept (...) figures in a certain kind of intensional context in the specification of the conditions, the satisfaction of those conditions may not itself depend on the extension of the concept. We put this by saying that although analytically circular, the account may yet not be inferentially circular. (shrink)

SummaryIf you know you can recognise positive instances of a property, can you use this knowledge so as to be able to recognise also its negative instances? This is the question to be adressed.

An analogy between functional dependencies and implicational formulas of sentential logic has been discussed in the literature. We feel that a somewhat different connexion between dependency theory and sentential logic is suggested by the similarity between Armstrong's axioms for functional dependencies and Tarski's defining conditions for consequence relations, and we pursue aspects of this other analogy here for their theoretical interest. The analogy suggests, for example, a different semantic interpretation of consequence relations: instead of thinking ofB as a consequence of (...) a set of formulas {A1,...,A n} whenB is true on every assignment of truth-values on which eachA i is true, we can think of this relation as obtaining when every pair of truth-value assignments which give the same truth-values toA 1, the same truth-values toA 2,..., and the same truth-values toA n, also make the same assignment in respect ofB. We describe the former as the consequence relation inference-determined by the class of truth-value assignments (valuations) under consideration, and the latter as the consequence relation supervenience-determined by that class of assignments. Some comparisons will be made between these two notions. (shrink)

An account of desire as a species of belief may owe its appeal to the details of its proposal as to precisely what sort of beliefs desires are to be identified with, and its downfall may be due to those details it does provide. For example, it may be proposed that the desire that α is in fact the belief that it ought to be that α, or is morally good or desirable that it should be the case that α. (...) Here the appeal might be that of forging a link between the holding of a moral belief and the acknowledgment that one has a reason for acting a certain way; and the shortcoming of the suggestion is its evident implausibility: even if the ‘necessity’ direction could be established, having a desire hardly seems sufficient for the holding of any such belief. Again: it might be proposed, perhaps simply to bring some order into the realm of propositional attitudes by reducing some to others, that the belief with which we should identify a’s desire that α is a’s belief that he will or would be happy if α. This proposed identification can be seen to be incorrect by consideration of examples such as the following, due to J. Gosling. An aging and ailing parent might forego numerous pleasures in order that his children should reap the benefits of his saving and have a good start in life – perhaps by receiving an expensive education – after his impending death. Oearly he may want that they should so benefit even if he does not believe in an after-death existence in which he might come to know of, and so take pleasure in, his children’s subsequent well-being. So his wanting that they should prosper cannot consist in his believing that he will be happy if/when they do, since he has no expectation of even being in existence in that eventuality. As Gosling puts it, there is a clear difference between thinking that something’s coming about will bring one pleasure, on the one hand, and viewing the prospect of its coming about with pleasure, on the other. (shrink)

Tarski 1968 makes a move in the course of providing an account of ?definitionally equivalent? classes of algebras with a businesslike lack of fanfare and commentary, the significance of which may accordingly be lost on the casual reader. In ?1 we present this move as a response to a certain difficulty in the received account of what it is to define a function symbol (or ?operation symbol?). This difficulty, which presents itself as a minor technicality needing to be got around (...) especially for the case of symbols for zero-place functions (for ?distinguished elements?), has repercussions?not widely recognised?for the account of functional completeness in sentential logic. A similarly stark comment in Church 1956 reveals an appreciation of this difficulty, though not every subsequent author on the topic has taken the point. We fill out this side of the picture in ?2. The discussion of functional completeness in ?2 is supplemented by some remarks on what is involved in defining a connective, which have been included in an Appendix. The emphasis throughout is on conceptual clarification rather than on proving theorems, and the main body of the paper may be regarded as an elaboration on the remarks just mentioned by Tarski and Church. The Appendix (?3) is intended to be similarly clarificatory, though this time with some corrective intent, of remarks made in and about Makinson 1973. (shrink)

A.N. Prior once showed that on certain apparently reasonable assumptions, a thesis sometimes associated with the name of Hume to the effect that no set of factual statements can ever entail an evaluative statement, is quite untenable. We assume only that there is at least one statement of each kind, and that the negation of a factual statement is factual — a principle we may call ‘N'. Now consider the disjunction F V E of some factual with some evaluative statement. (...) Since the disjunction is entailed by F, a factual statement, it must, if principle H is correct, be classified as factual. But by N, ∽ F is also factual, and this together with F V E entails E, thus violating H since E was exhypothesi an evaluative statement. (shrink)

The adverse reaction to Hempel's 'ravens paradox' embodied in giving it that description is compared with the usual reaction of experimental subjects to the Wason selection task.

A purported axiomatization, by P. Gärdenfors, of intuitionistic propositional logic is shown to be incomplete, and that the mistaken claim to completeness is seen to result from carelessness in the choice of primitive logical vocabulary. This leads to a consideration of various ways of conceiving the distinction between primitive and defined vocabularies, along with the bearing of these differences on such matters as are discussed in connection with Gärdenfors.

The sources of the real conflict between science and various kinds of undertakings in occultism pretending to be science date back to the end of the 16th and beginning of the 17th centuries, when modern scientific method was barely taking shape. The natural philosophy of the 16th century, which put forth natural magic in place of divine magic, was the ideological antipode of the new science in process of formation. The pantheistic reinterpretation of monotheistic Christian creationism is a characteristic feature (...) of constructs in natural philosophy with their striving toward maximal substantialization of the nonmaterial. Thus, for example, the rationalist mystic of natural philosophy, Girolamo Cardano, returns in his work to the medieval notion of the world soul, but understands by it an entirely material substance which he identifies with light and heat. (shrink)

We illustrate, with three examples, the interaction between boolean and modal connectives by looking at the role of truth-functional reasoning in the provision of completeness proofs for normal modal logics. The first example (§ 1) is of a logic (more accurately: range of logics) which is incomplete in the sense of being determined by no class of Kripke frames, where the incompleteness is entirely due to the lack of boolean negation amongst the underlying non-modal connectives. The second example (§ 2) (...) focusses on the breakdown, in the absence of boolean disjunction, of the usual canonical model argument for the logic of dense Kripke frames, though a proof of incompleteness with respect to the Kripke semantics is not offered. An alternative semantic account is developed, in terms of which a completeness proof can be given, and this is used (§ 3) in the discussion of the third example, a bimodal logic which is, as with the first example, provably incomplete in terms of the Kripke semantics, the incompleteness being due to the lack of disjunction (as a primitive or defined boolean connective). (shrink)

This paper is about a support information management system for a wind power producer having an energy storage system and participating in a day-ahead electricity market. Energy storage can play not only a leading role in mitigation of the effect of uncertainty faced by a WP producer, but also allow for conversion of wind energy into electric energy to be stored and then released at favourable hours. This storage provides capability for arbitrage, allowing an increase on profit of a WP (...) producer, but must be supported by a convenient problem formulation. The formulation proposed for the support information management system is based on an approach of stochasticity written as a mixed integer linear programming problem. WP and market prices are considered as stochastic processes represented by a set of scenarios. The charging/discharging of the ESS are considered dependent on scenarios of market prices and on scenarios of WP. The effectiveness of the proposed formulation is tested by comparison of case studies using data from the Iberian Electricity Market. The comparison is in favour of the proposed consideration of stochasticity. (shrink)