Objectives To conduct an independent evaluation of the first phase of the Health Foundation’s Safer Patients Initiative (SPI), and to identify the net additional effect of SPI and any differences in changes in participating and non-participating NHS hospitals. Design Mixed method evaluation involving five substudies, before and after design. Setting NHS hospitals in the United Kingdom. Participants Four hospitals (one in each country in the UK) participating in the first phase of the SPI (SPI1); 18 control hospitals. Intervention The SPI1 (...) was a compound (multi-component) organisational intervention delivered over 18 months that focused on improving the reliability of specific frontline care processes in designated clinical specialties and promoting organisational and cultural change. Results Senior staff members were knowledgeable and enthusiastic about SPI1. There was a small (0.08 points on a 5 point scale) but significant (P<0.01) effect in favour of the SPI1 hospitals in one of 11 dimensions of the staff questionnaire (organisational climate). Qualitative evidence showed only modest penetration of SPI1 at medical ward level. Although SPI1 was designed to engage staff from the bottom up, it did not usually feel like this to those working on the wards, and questions about legitimacy of some aspects of SPI1 were raised. Of the five components to identify patients at risk of deterioration—monitoring of vital signs (14 items); routine tests (three items); evidence based standards specific to certain diseases (three items); prescribing errors (multiple items from the British National Formulary); and medical history taking (11 items)—there was little net difference between control and SPI1 hospitals, except in relation to quality of monitoring of acute medical patients, which improved on average over time across all hospitals. Recording of respiratory rate increased to a greater degree in SPI1 than in control hospitals; in the second six hours after admission recording increased from 40% (93) to 69% (165) in control hospitals and from 37% (141) to 78% (296) in SPI1 hospitals (odds ratio for “difference in difference” 2.1, 99% confidence interval 1.0 to 4.3; P=0.008). Use of a formal scoring system for patients with pneumonia also increased over time (from 2% (102) to 23% (111) in control hospitals and from 2% (170) to 9% (189) in SPI1 hospitals), which favoured controls and was not significant (0.3, 0.02 to 3.4; P=0.173). There were no improvements in the proportion of prescription errors and no effects that could be attributed to SPI1 in non-targeted generic areas (such as enhanced safety culture). On some measures, the lack of effect could be because compliance was already high at baseline (such as use of steroids in over 85% of cases where indicated), but even when there was more room for improvement (such as in quality of medical history taking), there was no significant additional net effect of SPI1. There were no changes over time or between control and SPI1 hospitals in errors or rates of adverse events in patients in medical wards. Mortality increased from 11% (27) to 16% (39) among controls and decreased from 17% (63) to 13% (49) among SPI1 hospitals, but the risk adjusted difference was not significant (0.5, 0.2 to 1.4; P=0.085). Poor care was a contributing factor in four of the 178 deaths identified by review of case notes. The survey of patients showed no significant differences apart from an increase in perception of cleanliness in favour of SPI1 hospitals. Conclusions The introduction of SPI1 was associated with improvements in one of the types of clinical process studied (monitoring of vital signs) and one measure of staff perceptions of organisational climate. There was no additional effect of SPI1 on other targeted issues nor on other measures of generic organisational strengthening. (shrink)

This essay introduces the second installment of a symposium in Common Knowledge called “Apology for Quietism.” This introductory piece concerns the sociology of quietism and why, given the supposed quietude of quietists, there is such a thing at all. Dealing first with the “activist” Susan Sontag's attraction to the “quietist” Simone Weil, it then concentrates on the “activist” William Empson's attraction to the Buddha and to Buddhist quietism, with special reference to Empson's lost manuscript Asymmetry in Buddha Faces. The author, (...) who is also editor of the journal, argues against the effort of some contributors to substitute new terms for quietism and emphasizes instead what he calls “the need for repose.”. (shrink)

This essay introduces the second installment of a symposium in Common Knowledge called “Apology for Quietism.” This introductory piece concerns the sociology of quietism and why, given the supposed quietude of quietists, there is such a thing at all. Dealing first with the “activist” Susan Sontag's attraction to the “quietist” Simone Weil, it then concentrates on the “activist” William Empson's attraction to the Buddha and to Buddhist quietism, with special reference to Empson's lost manuscript Asymmetry in Buddha Faces (and to (...) Sharon Cameron's work on the topic in her book Impersonality). The author, who is also editor of the journal, argues against the effort of some contributors to substitute new terms for quietism and emphasizes instead what he calls (quoting Sontag) “the need for repose.”. (shrink)

BackgroundAdverse Childhood Experiences have been associated with long-term physical and mental health conditions, toxic stress levels, developing unstable interpersonal relationships, and substance use disorders due to unresolved childhood adversities.AimsThis study assessed the perspectives of mental health providers regarding their adult patients’ coping with ACEs during COVID-19 in Houston, Texas. Specifically, we explored how individuals with ACEs are coping with the increased stresses of the pandemic, how MHPs may provide therapeutic support for individuals with ACEs during this pandemic, pandemic-related challenges of (...) accessing and utilizing mental health services for individuals with ACEs, and the awareness and treatment of ACEs among MHPs.MethodsTen in-depth semi-structured virtual interviews were conducted with licensed MHPs from November 2021 to April 2022 in Houston, Texas. Interviews were coded and analyzed for emerging themes through an inductive open coding approach to discover insights regarding coping with ACEs during COVID-19.ResultsFour key themes experienced by individuals with ACEs emerged from the MHP interviews: Maladaptive emotional dissonance and coping outlets during the pandemic, Difficulties with social connectedness and significance of social support, Heightened daily life stressors and coping with the ongoing disruption of the pandemic, and Changing interactions with the mental health system. Themes from this study highlighted that resilience, seeking treatment, and strong social support can help develop healthy coping strategies among individuals with ACEs.ConclusionThis study may help inform best clinical practices to develop interventions and policies regarding ACEs such as a resilience-promotion approach that targets all the socio-ecological levels. In addition, findings highlight the synergy of psychotherapeutic and pharmacological management via tele-health modalities, in helping individuals with ACEs continue receiving the care they deserve and need during a persistent pandemic and an uncertain future. (shrink)

Merker et al.'s critique calls for a deeper analysis of panpsychism. In principle, the concept of integrated information can be applied to photodiodes and subatomic particles, but I suggest the main obstacle is the lack of any evidence to confirm the presence of consciousness. Also MRW's perspectivalist theory illustrates the difficulties in synthesizing a full-fledged theory of consciousness.

The classical Athenian philosopher Socrates was tried in 399 BCE on the basis of two notoriously ambiguous charges: corrupting the youth and impiety (in Greek, asebeia). A majority of the 501 dikasts (Athenian citizen-jurors) voted to convict him. Socrates was ultimately sentenced to death by drinking a hemlock-based liquid. This well-known account of the trial is by Plato, one of Socrates' students and a famous philosopher in his own right. Whether Socrates was punished unjustly is a contested issue which to (...) this day inspires discussions about the nature and meaning of justice. (shrink)

The primary aim of this study was to investigate the relation between self-perceived executive functions and the school achievement of young adolescents, while controlling for parental education and sex. We specifically focused on executive aspects of daily life behavior and the higher-order EFs, as measured with self-report, rather than on the more basic EFs which have been the primary focus of prior investigations. In two independent samples of sixth graders, students evaluated their EFs on a self-report questionnaire, the Amsterdam Executive (...) Functioning Inventory. School achievement in the domains of mathematics and reading comprehension were evaluated with nationally used, norm-based achievement tests. Results revealed that the self-perceived EFs of young adolescents were significantly correlated with their school achievement in both study samples. School achievement was also correlated with the level of parental education, but the factor sex did not have such influence. In study 1, self-perceived EFs explained additional variance in school achievement, while controlling for parental education and sex. In study 2, this was only the case for the most robust measure of school achievement, i.e., the end-of-primary-school final achievement test. Furthermore, besides the relation with achievement tests, we also found a relation between self-perceived EFs and teacher ratings behavioral problems in the classroom. Together, our findings imply that young students can properly reflect on the effectiveness and appropriateness of their EFs in a way that is relevant to their academic achievement and classroom behavior. The findings underscore the importance of considering the development of EFs and parental education in the evaluation of academic achievements in early adolescence. (shrink)

ETUDES DE PHILOLOGIE 38 ETD'HISTOIRE JEANETTE MA BEER Narrative Conventions of Truth in the Middle Ages GENEVE ...

Peirce’s doctrine of God has scarcely been studied at all. This is surprising because his own naturally religious temperament, his desire for philosophical completeness and the influence of Kant, all led him to give an important place to theistic speculation in his philosophy. It is true that few parts of his philosophy reveal more than the fragmentary and unfinished nature of his thinking. This however does not take away from its importance both for the interpretation of his philosophy and for (...) the evaluation of its contribution. In this paper I want to examine his doctrine of God mainly in order to discover and outline what views he held in the matter. Such examination is an essential preliminary to any consideration of the value of his theistic thinking. Moreover, an objective exposition is already the best beginning of evaluation. However it is impossible to undertake this kind of examination without a careful search into various corners of his writings and a meticulous and slightly laboured presentation of one’s findings. But I think that the patience involved in such research has a rich reward. (shrink)

Positive changes or transformations have been the subject of study within spiritual traditions as well as humanistic and transpersonal psychology. The aim of the current study is to understand the process of transformation among Moslems in Indonesia, who follow spiritual practices, to achieve the nafs al-muṭma ínnah [tranquil self]. Ten participants in Yogyakarta province were involved in this study. They were recruited using nafs al-muṭmaʾinnah scale developed by the authors. In-depth interviews of both the participants and their significant others were (...) conducted. To analyse the data, an interpretative phenomenological analysis was employed. Five themes emerged from the data, including deviation from the basis of religious environment, spiritual discipline, transformative experiences, new characters and a continuous process. We conclude that participants experience spiritual-religious transformation and achieve the state of nafs al-muṭma ínnah [tranquil self]. The process of transformation occurs gradually after a sudden experience, and it continuously happens throughout the course of life. Three factors contribute to the transformation, including the role of predisposition, the role of a spiritual guide and the role of spiritual experiences.Contribution: As the study of spiritual-religious transformation is mainly conducted within a Judea-Christian tradition, this study significantly contributes to the literature by providing spiritual-religious transformation from an Islamic-Sufi perspective. (shrink)

Contents include a translator's introduction, selected bibliography, note on the text, glossary of technical terms, biographical index, and The Meditations of Marcus Aurelius -- books 1-12.

The teachings, style and impact of the Qur'an have always been matters of controversy, among both Muslims and non-Muslims. But in a modern context of intercultural sensitivity, what the Qur'an says and means are perhaps more urgent questions than ever before. This major new book by one of the world's finest Islamic scholars responds to that urgency. Building on his earlier groundbreaking work, the author challenges misinterpretations of particular Qur'anic verses from whatever quarter. He addresses the infamous 'sword' verse, frequently (...) cited as a justification for jihad. He also questions the 'tribute' verse, associated with the Muslim state subjugating Jews and Christians; and the idea of Paradise in the Qur'an, often viewed by the West as emphasising merely physical pleasures, or used by Islamic fighters as their just reward for holy war. The author argues that wrenching the verses out of the context of the whole has led to dangerous ideologies being built on isolated phrases which have then assumed afterlives of their own. This nuanced, holistic reading has vital interfaith ramifications. (shrink)

ABSTRCTIn recent times, Information and Communication Technology (ICT) hasbeen developed and widely spread around world. ICT is used in various sectorsand considered a basis in the emergence of some important technologies such asvirtual reality technology. Virtual Reality (VR) is a special technology as anadvanced technology connected to several fields, e.g. training, learning, science,engineering, medicine, military, etc. VR has great potentials which enabled toperform several phenomena and experiments. Hence, several scenarios havebecome available. The purpose of this study is to shed light (...) on virtual realitytechnology and list a glimpse of common publications and studies involved. (shrink)