Rationale In Belgium, several policies regulating reimbursement of acid suppressant drugs and evidence-based recommendations for clinical practice were issued in a short period of time, creating a unique opportunity to observe their effect on prescribing. Aims and objectives To describe the evolution of prescriptions for acid suppressants and explore the interaction of policies and practice recommendations with prescribing patterns. Method Monthly claims-based data for proton pump inhibitors (PPIs) and H-2-antihistamines by general practitioners, internists and "astroenterologists were obtained from the Belgian (...) national health insurance database (1997-2005). The evolution of reimbursed defined daily doses and expenses after introduction of reimbursement regulations and dissemination of practice recommendations was explored. Results Recommendations had no impact on prescribing. All changes can be related to concomitant policies. Lifting reimbursement restrictions for cheaper products did not control growth or save costs in the Iona term. Only restricting reimbursement of all PPIs managed to curb the growth. We observed an unintended increase of non-omeprazole PPIs by gastroenterologists. Conclusions Reimbursement policies influence prescribing, but their effect can be unintended. A dialogue between policymakers and guideline developers, and evidence-based policies that are linked to clinical guidelines, could be an effective way to pursue both cost-containment and quality of care. (shrink)
Background A team-based approach has been advocated for advance care planning in nursing homes. While nurses are often put forward to take the lead, it is not clear to what extent other professions could be involved as well. Objectives To examine to what extent engagement in advance care planning practices, knowledge and self-efficacy differ between nurses, care assistants and allied care staff in nursing homes. Design Survey study. Participants/setting The study involved a purposive sample of 14 nursing homes in Flanders, (...) Belgium. Nurses, care assistants and allied care staff completed a survey. Ethical considerations The study was approved by the University Hospital of Brussels, as part of a cluster randomized controlled trial. Results One hundred ninety-six nurses, 319 care assistants and 169 allied staff participated. After adjusting for confounders, nurses were significantly more likely than care assistants to have carried out advance care planning conversations and documented advance care planning ; differences not found between allied staff and care assistants. Advance care planning knowledge total scores differed significantly, with nurses ; 95% confidence interval 0.08–0.17; p < 0.001) and allied staff scoring higher than care assistants. We found no significant differences regarding self-efficacy. Discussion While nursing home nurses conducted more advance care planning conversations and documentation than allied care staff and care assistants, these two professional groups may be a valuable support to nurses in conducting advance care planning, if provided with additional training. Conclusions Allied care staff and care assistants, if trained appropriately, can be involved more strongly in advance care planning to enhance relational and individual autonomy of nursing home residents, alongside nurses. Future research to improve and implement advance care planning should consider this finding at the intervention development stage. (shrink)
International Rules brings together exemplary works from the most prominent approaches to international rules of International Law and International Relations disciplines. Included are chapters on Natural Law, Legal Positivism, Classical Realism, the New Haven School, Institutionalism, Structural Realism, the New Stream, and Feminist Voices. Each of the eight chapters begins with a brief overview, offers a representative work or works, and concludes with a selected bibliography. From Hugo Grotius to David Kennedy, from George Kennan to Robert Keohane, the featured (...) authors provide valuable insights into their common subject: international rules. Despite divergent methods and objectives, they address fundamentally the same questions: What is the nature of such rules? What is their purpose? How do they originate? What role, if any, do they play in politics? Framing the selections assembled are two original chapter-length essays. The first chapter of this volume assesses the prospects for interdisciplinary collaboration; the final one suggests a direction for future research. (shrink)
Oxford Studies in Ancient Philosophy is an annual publication which includes original articles, which may be of substantial length, on a wide range of topics in ancient philosophy, and review articles of major books. Contributors to this volume; Paul A. Vander Waerdt, Christopher Rowe, Rachel Rue, Paula Gottlieb, Robert Bolton, and John M. Cooper.
[Robert Stalnaker] Saul Kripke made a convincing case that there are necessary truths that are knowable only a posteriori as well as contingent truths that are knowable a priori. A number of philosophers have used a two-dimensional model semantic apparatus to represent and clarify the phenomena that Kripke pointed to. According to this analysis, statements have truth-conditions in two different ways depending on whether one considers a possible world 'as actual' or 'as counterfactual' in determining the truth-value of the (...) statement relative to that possible world. There are no necessary a posteriori or contingent a priori propositions: rather, contingent a priori and necessary a posteriori statements are statements that are necessary when evaluated one way, and contingent when evaluated the other way. This paper distinguishes two ways that the two-dimensional framework can be interpreted, and argues that one of them gives the better account of what it means to 'consider a world as actual', but that it provides no support for any notion of purely conceptual a priori truth. /// [Thomas Baldwin] Two-dimensional possible world semantic theory suggests that Kripke's examples of the necessary a posteriori and contingent a priori should be handled by interpreting names as implicitly indexical. Like Stalnaker, I reject this account of names and accept that Kripke's examples have to be accommodated within a metasemantic theory. But whereas Stalnaker maintains that a metasemantic approach undermines the conception of a priori truth, I argue that it offers the opportunity to develop a conception of the a priori aspect of stipulations, conceived as linguistic performances. The resulting position accommodates Kripke's examples in a way which is both intrinsically plausible and fits with Kripke's actual discussion of them. (shrink)
"The availability of a paperback version of Boyle's philosophical writings selected by M. A. Stewart will be a real service to teachers, students, and scholars with seventeenth-century interests. The editor has shown excellent judgment in bringing together many of the most important works and printing them, for the most part, in unabridged form. The texts have been edited responsibly with emphasis on readability.... Of special interest in connection with Locke and with the reception of Descarte's Corpuscularianism, to students of the (...) Scientific Revolution and of the history of mechanical philosophy, and to those interested in the relations among science, philosophy, and religion. In fact, given the imperfections in and unavailability of the eighteenth-century editions of Boyle’s works, this collection will benefit a wide variety of seventeenth-century scholars." --Gary Hatfield, University of Pennsylvania. (shrink)
Drawing on Aristotle’s notion of “ultimate responsibility,” Robert Kane argues that to be exercising a free will an agent must have taken some character forming decisions for which there were no sufficient conditions or decisive reasons.<sup>1</sup> That is, an agent whose will is free not only had the ability to develop other dispositions, but could have exercised that ability without being irrational. To say it again, a person has a free will just in case her character is the product (...) of decisions that she could have rationally avoided making. That one’s character is the product of such decisions entails ultimate responsibility for its manifestations, engendering a free will. (shrink)
Robert Owen was one of the most extraordinary Englishmen who ever lived and a great man. In a way his history is the history of the establishment of modern industrial Britain, reflected in the mind and activities of a very intelligent, capable and responsible industrialist, alive to the best social thought of his time. The organisation of industrial labour, factory legislation, education, trade unionism, co-operation, rationalism: he was passionately and ably engaged in all of them. His community at New (...) Lanark was the nearest thing to an industrial heaven in the Britain of dark satanic mills; he tried to found a rational co-operative community in the USA. In everything he contemplated, he saw education as a key. This selection of his writings on education illustrates his rationalist concept of the formation of character and its implications for education and society; also his growing utopian concern with social reorganisation; and third, his impact on social movements. Silver's introduction shows Owen's relationship to particular educational traditions and activities and his long-term influence on attitudes to education. (shrink)
Kelly Aguirre, Phil Henderson, Cressida J. Heyes, Alana Lentin, and Corey Snelgrove engage with different aspects of Robert Nichols’ Theft is Property! Dispossession and Critical Theory. Henderson focuses on possible spaces for maneuver, agency, contradiction, or failure in subject formation available to individuals and communities interpellated through diremptive processes. Heyes homes in on the ritual of antiwill called “consent” that systematically conceals the operation of power. Aguirre foregrounds tensions in projects of critical theory scholarship that aim for dialogue and (...) solidarity with Indigenous decolonial struggles. Lentin draws attention to the role of race in undergirding the logic of Anglo-settler colonial domination that operates through dispossession, while Snelgrove emphasizes the link between alienation, capital, and colonialism. In his reply to his interlocutors, Nichols clarifies aspects of his “recursive logics” of dispossession, a dispossession or theft through which the right to property is generated. (shrink)
This volume is a continuation of Robert Greystones on the Freedom of the Will: Selections from His Commentary on the Sentences. From this, five of the most relevant questions were selected for editing and translation in this timely volume. This edition should prompt not just a footnote to, but a re-writing of the history of philosophy.
Robert Brandom's latest book, the product of his John Locke lectures in Oxford in 2006, is a return to the philosophy of language and is easily read as a continuation and development of the views defended in Making it Explicit. The text of the lectures is presented much as they were delivered, but it contains an ‘Afterword’ of more than 30 pages which responds to questions raised when he gave the lectures, and also when they were subsequently delivered in (...) Prague the following year. The published text also contains relatively technical appendices to two of the lectures.The individual lectures engage with some important and difficult issues, often ones that were explored in detail in the earlier book. However, these discussions are located within a broader meta-philosophical context, and it says something about the abstract and difficult character of these views that they provide the main subject matter of the Afterword. This framework affects how we should understand the relations between this book and Making It Explicit too. Although most of the detailed discussions happily belong within the general project of the earlier book, they are offered as illustrations of a framework that is independent of this project. Indeed, Brandom suggests that defenders of the semantic views of David Lewis, for example, could embrace his main message as well as those who favour Brandom's own form of pragmatism.Neo-pragmatist philosophers such as Brandom's teacher, Richard Rorty, often present themselves as rejecting the analytic tradition in philosophy. When Brandom describes the ‘pragmatist challenge’ to the ‘classical project of analysis’, he appeals to the criticisms found in the work of Wittgenstein and Sellars that are often appealed to by the critics of the analytic tradition. The message of the new book is that the views he has built on this …. (shrink)
Drawing on Aristotle’s notion of “ultimate responsibility,” Robert Kane argues that to be exercising a free will an agent must have taken some character forming decisions for which there were no sufficient conditions or decisive reasons. That is, an agent whose will is free not only had the ability to develop values and beliefs besides those that presently make up her motives, but could have exercised that ability without being irrational. An agent wills freely, on this view, by beingultimately (...) responsible for how she is currently disposed to act. Kane needs, then, to show how an agent could be responsible for decisions that her deliberations did not guarantee. He must also explain how a decision for which there is no decisive reason could yet be rational, assuming that the responsibility engendering decisions forming the basis of a free will would be rational. I shall argue here that Kane has achieved neither of these goals. (shrink)