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)

The Krüppel‐like factors (KLFs) comprise a family of evolutionarily conserved zinc finger transcription factors that regulate numerous biological processes including proliferation, differentiation, development and apoptosis. KLF4 and KLF5 are two closely related members of this family and are both highly expressed in epithelial tissues. In the intestinal epithelium, KLF4 is expressed in terminally differentiated epithelial cells at the villus borders of the mucosa and inhibits cell growth, while KLF5 is expressed in proliferating epithelial cells at the base of the intestinal (...) crypts and promotes cell growth. KLF4 and KLF5 respond to a myriad of external stress stimuli and are likely involved in restoring cellular homeostasis following exposure to stressors. Confirming their importance in maintaining tissue integrity, KLF4 and KLF5 are both dysregulated in various types of cancer. Here we review the recent advances in defining the physiological and pathobiological roles of KLF4 and KLF5, focusing on their functions in the intestinal epithelium. BioEssays 29:549–557, 2007. © 2007 Wiley Periodicals, Inc. (shrink)

This study described the relationships between academic class and student moral sensitivity and reasoning and between curriculum design components for ethics education and student moral sensitivity and reasoning. The data were collected from freshman (n = 506) and senior students (n = 440) in eight baccalaureate nursing programs in South Korea by survey; the survey consisted of the Korean Moral Sensitivity Questionnaire and the Korean Defining Issues Test. The results showed that moral sensitivity scores in patient-oriented care and conflict were (...) higher in senior students than in freshman students. Furthermore, more hours of ethics content were associated with higher principled thinking scores of senior students. Nursing education in South Korea may have an impact on developing student moral sensitivity. Planned ethics content in nursing curricula is necessary to improve moral sensitivity and moral reasoning of students. (shrink)

The Iraqi constitution of 2005 grants freedom of religious thought, belief and practice for all religions. This study was also based on the premise that the constitutional rights are not adhered to in Iraq, even by government officials, which could be due to the absence of suitable legislations subsequent to the framing of the constitutional provisions. An analytical and descriptive research design was adopted for this study. Data was collected from primary and secondary sources through documentation research and evaluation of (...) historical sources. The primary data comprised Articles of the Iraqi constitution, and a few national and international legal instruments related to religious freedom. Secondary data included empirical research studies, books, articles and other published sources. This study therefore took the form of an empirical legal research as it involved the issues of constitutional reforms in the field of religious freedom. A comparative approach was adopted in analyzing the documents about religion and politics related to both the Arab region and the West. The focus was on the measures that should be adopted to advance the dialogues of religious freedom and maintain religious neutrality in all government policies. The study found out that there were apparent contradictions between the constitutional provisions and the State Laws. Similarly, the Iraqi civil and penal codes remain silent regarding legal remedies for the violation of constitutional provisions. (shrink)

Research indicates that the perception of available resources is a key factor for the implementation of inclusive education. Regarding the teachers, a relatively high level of perceived personnel and physical resources is associated with more positive attitudes toward inclusive education and experiencing a higher level of self-efficacy. Thus, this study aims to examine the psychometric properties of the teacher version of the Perceptions of Resources Questionnaire. Data were collected from a sample of 1,078 in-service teachers in Austria. Different statistical analyses (...) were used, including Rasch analysis and confirmatory factor analysis. The results indicated good psychometric properties of the PRQ-T regarding internal consistency measured by person separation index and construct validity by both confirmatory factor analysis and the Rasch analysis. Moreover, the findings supported that the PRQ-T is a two-factor scale to measure teachers’ perceptions of personnel and physical resources in inclusive education. Further studies with different samples are necessary to confirm the findings. (shrink)

Purpose: According to literature, students' attitudes towards peers with disabilities are crucial for the social inclusion of students with disabilities.Therefore, knowledge about students' behavioral intention to interact with peers with intellectual disability can help improve the social inclusion of students with ID. This study aimed to examine the psychometric properties of the Arabic version of the Behavioral Intention to Interact with Peers with Intellectual Disability Scale.Data were collected from 887 elementary school students (591 female and 296 male) from third to (...) sixth grades in Saudi Arabia.Psychometric properties of the BIS were examined with a confirmatory factor analysis, measurement invariance analysis (across gender), and reliability scales (internal consistency).The results supported the two-dimensional structure of the BIS. The internal consistency of the BIS and each of its subscales was good.Furthermore, no measurement variance was found for male and female students.The Arabic version of the scale showed good psychometric properties and therefore can be recommended to measure students' behavioral intention to interact with peers with intellectual disability. (shrink)

AimThis study aimed to examine the dimensionality of the BCFQOL-AR using Rasch analysis.MethodThe sample consisted of 320 families having a member with intellectual or developmental disabilities. Rasch analysis was used to validate the dimensionality of the scale. The participants were from Riyadh, Saudi Arabia.ResultsThe BCFQOL-AR 25-item scale was multidimensional. Rasch analyses support the unidimensionality of the five subscales. There were no indicators of differential item function for any of the items, regardless of sex or age.ConclusionThe BCFQOL-AR is a multidimensional scale (...) that measures families with members who are satisfied with their quality of life. Therefore, obtaining a total score at the subscale level is supported and showed that each of the five subscales of the BCFQOL can be used alone. This study partially supports the practices used with other versions of the scale, by providing the statistical base, where means were used at the subscale level in different countries. (shrink)

The aim of the study was to illustrate the impact of teachers’ implementation of differentiation and individualization on students’ perception of their inclusion regarding their social inclusion, emotional wellbeing and academic self-concept. The study sample comprised 824 third-to-eighth-grade students [255 males and 569 females ]. Around 10% of the sample had special educational needs. Students’ perceived inclusion levels and academic self-concept were examined with the Arabic version of the Perceptions of Inclusion Questionnaire. Students’ ratings of inclusive practices in their classroom (...) were examined using the Arabic version of the Inclusive Teaching Practices Scale. SEN students expressed lower perceived social inclusion, emotional inclusion, and academic self-concept in comparison with non-SEN students. Moreover, high levels of inclusive teaching practices strongly predicted students’ perceived emotional inclusion, social inclusion, and academic self-concept. The results of the study supported the importance of school-level inclusive teaching practices and their relation to students’ school experiences. It also highlighted the need for schools and teachers to work towards improved school-level inclusion experiences for SEN students. (shrink)

In recent literature, panpsychism has been defended by appeal to two main arguments: first, an argument from philosophy of mind, according to which panpsychism is the only view which successfully integrates consciousness into the physical world (Strawson 2006; Chalmers 2013); second, an argument from categorical properties, according to which panpsychism offers the only positive account of the categorical or intrinsic nature of physical reality (Seager 2006; Adams 2007; Alter and Nagasawa 2012). Historically, however, panpsychism has also been defended by appeal (...) to a third argument based on considerations about the nature and observability of causation. This argument has not been much discussed in recent times. Here is a concise version from William James: "… the concrete perceptual flux, taken just as it comes, offers in our own activity-situations perfectly comprehensible instances of causal agency … If we took these experiences as the type of what actual causation is, we should have to ascribe to cases of causation outside of our life, to physical cases also, an inwardly experiential nature. In other words, we should have to espouse a so-called “pan-psychic” philosophy" (James 1911: 218). James here suggests that we have direct experience of causation in our own agency. He thereby directly contradicts David Hume, who famously denied that we have any experience of causation. James goes on to claim that if this experience is representative of causation in general, it follows that all causation is mental, and that panpsychism is true. This kind of argument for panpsychism can be called the argument from (experience of) causation. This chapter offers, first, a history of this argument and arguments closely related to it, and second, an analysis of the argument – is it valid, are its premises in any way defensible, and how does it relate to the other, more popular arguments for panpsychism from philosophy of mind and categorical properties? (shrink)

Traditional Chinese commentators rightly see that understanding Zhuangzi's way with words is the presupposition for understanding Zhuangzi at all. They are not sure, however, if Zhuangzi's words are super-effective or pure nonsense. I consider Zhuangzi's experience with language, and then turn to Heidegger's word of being to see if it may throw light on Zhuangzi's way of saying. I argue that a conversation between Heidegger and Zhuangzi on language is possible, but only by expanding Heidegger's notion of Gestell and through (...) a destruction of the dominant Confucian discourse that obscures Zhuangzi's way of saying. (shrink)

The 2017 Riyadh Summit is one of the events that various media outlets densely covered. Drawing upon Van Dijk [ 53 ] Ideological Square, this study aims at identifying the in-group and out-group in ten pro-government Arab newspapers and investigating the discursive sub-strategies that were utilized in the representation of “us” and “them.” The findings reveal that most of the Arab newspapers tended to utilize a bundle of negative other-representation discursive sub-strategies to establish a dichotomy between “us” and “them” and (...) thus, construct “us” either directly or indirectly. It was found that negative lexicalization, distancing, and vagueness were the most frequently employed discursive sub-strategies in negative other-representation, while national self-glorification was the most frequently used discursive sub-strategies in positive self-representation. The study concludes by recommending other researchers to explore the same topic but in broadcast media, taking into account the prosodic aspects as well as the discourse itself. (shrink)

The speeches delivered by Former U.S. President Donald Trump during his last presidential campaign (2015–2016) included hateful remarks against Muslims and immigrants. This study explored strategies of hate speech used in Trump’s political discourse against out-groups. The data consisted of a corpus of Trump’s speeches and interviews. Our analysis was based on Whillock’s [ 48 ] criteria of hate speech and Erjavec and Kovačič’s [ 13 ] strategies of hate speech. The results revealed that Trump employed re-articulation of meaning and (...) renaming by attributing any problem to immigrants and Muslims to express hatred against them, using direct hatred words. His overt use of hate speech strategies stemmed from his legitimate power and social authority as a successful businessman in his field. (shrink)

Background. The COVID-19 pandemic necessitated drastic changes to undergraduate medical training at the University of Botswana (UB). To save the academic year when campus was locked down, the Department of Medical Education conducted a needs assessment to determine the readiness for emergency remote teaching (ERT) of the Faculty of Medicine, UB. Objectives. To report on the findings of needs assessment surveys to assess learner and teaching staff preparedness for fair and just ERT, as defined by philosopher John Rawls. Methods. Needs (...) assessment surveys were conducted using Office 365 Forms distributed via WhatsApp, targeting medical students and teaching staff during the 5 undergraduate years. Data were analysed quantitatively and qualitatively. Results. Ninety-two percent (266/289) of students and 73.5% (62/84) of teaching staff responded. Surveys revealed a high penetration of smartphones among students, but poor internet accessibility and affordability in homes. Some teaching staff also reported internet and device insufficiencies. Only WhatsApp was accessible to students and teaching staff. Conclusions. For equitable access to ERT in the future, the surveys revealed infrastructural improvement needs, including wider, stronger, affordable WiFi coverage within Botswana and enhanced digital infrastructures in educational institutions, with increased support for students. (shrink)

The ideal introduction for students of semantics, Lexical Meaning fills the gap left by more general semantics textbooks, providing the teacher and the student with insights into word meaning beyond the traditional overviews of lexical relations. The book explores the relationship between word meanings and syntax and semantics more generally. It provides a balanced overview of the main theoretical approaches, along with a lucid explanation of their relative strengths and weaknesses. After covering the main topics in lexical meaning, such as (...) polysemy and sense relations, the textbook surveys the types of meanings represented by different word classes. It explains abstract concepts in clear language, using a wide range of examples, and includes linguistic puzzles in each chapter to encourage the student to practise using the concepts. 'Adopt-a-Word' exercises give students the chance to research a particular word, building a portfolio of specialist work on a single word. (shrink)

Kurt Godel, the greatest logician of our time, startled the world of mathematics in 1931 with his Theorem of Undecidability, which showed that some statements in mathematics are inherently "undecidable." His work on the completeness of logic, the incompleteness of number theory, and the consistency of the axiom of choice and the continuum theory brought him further worldwide fame. In this introductory volume, Raymond Smullyan, himself a well-known logician, guides the reader through the fascinating world of Godel's incompleteness theorems. The (...) level of presentation is suitable for anyone with a basic acquaintance with mathematical logic. As a clear, concise introduction to a difficult but essential subject, the book will appeal to mathematicians, philosophers, and computer scientists. (shrink)

I propose to consider the question, "Can machines think?" This should begin with definitions of the meaning of the terms "machine" and "think." The definitions might be framed so as to reflect so far as possible the normal use of the words, but this attitude is dangerous, If the meaning of the words "machine" and "think" are to be found by examining how they are commonly used it is difficult to escape the conclusion that the meaning and the answer to (...) the question, "Can machines think?" is to be sought in a statistical survey such as a Gallup poll. But this is absurd. Instead of attempting such a definition I shall replace the question by another, which is closely related to it and is expressed in relatively unambiguous words. The new form of the problem can be described in terms of a game which we call the 'imitation game." It is played with three people, a man (A), a woman (B), and an interrogator (C) who may be of either sex. The interrogator stays in a room apart front the other two. The object of the game for the interrogator is to determine which of the other two is the man and which is the woman. He knows them by labels X and Y, and at the end of the game he says either "X is A and Y is B" or "X is B and Y is A." The interrogator is allowed to put questions to A and B. We now ask the question, "What will happen when a machine takes the part of A in this game?" Will the interrogator decide wrongly as often when the game is played like this as he does when the game is played between a man and a woman? These questions replace our original, "Can machines think?". (shrink)

The relationship of part to whole is one of the most fundamental there is; this is the first and only full-length study of this concept. This book shows that mereology, the formal theory of part and whole, is essential to ontology. Peter Simons surveys and criticizes previous theories, especially the standard extensional view, and proposes a more adequate account which encompasses both temporal and modal considerations in detail. 'Parts could easily be the standard book on mereology for the next twenty (...) or thirty years.' Timothy Williamson, Grazer Philosophische Studien. (shrink)

One of our great behavioral scientists, the bestselling author of Behave, plumbs the depths of the science and philosophy of decision-making to mount a devastating case against free will, an argument with profound consequences Robert Sapolsky's Behave, his now classic account of why humans do good and why they do bad, pointed toward an unsettling conclusion: We may not grasp the precise marriage of nature and nurture that creates the physics and chemistry at the base of human behavior, but that (...) doesn't mean it doesn't exist. Now, in Determined, Sapolsky takes his argument all the way, mounting a brilliant (and in his inimitable way, delightful) full-frontal assault on the pleasant fantasy that there is some separate self telling our biology what to do. Determined offers a marvelous synthesis of what we know about how consciousness works-the tight weave between reason and emotion and between stimulus and response in the moment and over a life. One by one, Sapolsky tackles all the major arguments for free will and takes them out, cutting a path through the thickets of chaos and complexity science and quantum physics, as well as touching ground on some of the wilder shores of philosophy. He shows us that the history of medicine is in no small part the history of learning that fewer and fewer things are somebody's "fault"; for example, for centuries we thought seizures were a sign of demonic possession. Yet, as he acknowledges, it's very hard, and at times impossible, to uncouple from our zeal to judge others and to judge ourselves. Sapolsky applies the new understanding of life beyond free will to some of our most essential questions around punishment, morality, and living well together. By the end, Sapolsky argues that while living our daily lives recognizing that we have no free will is going to be monumentally difficult, doing so is not going to result in anarchy, pointlessness, and existential malaise. Instead, it will make for a much more humane world. (shrink)

This collection addresses a post-WWII shift in the hierarchy of scientific explanations, where the highest goal moves from reductionism towards some ...

At the beginning of his Metaphysics, Aristotle attributed several strange-sounding theses to Plato. Generations of Plato scholars have assumed that these could not be found in the dialogues. In heated arguments, they have debated the significance of these claims, some arguing that they constituted an 'unwritten teaching' and others maintaining that Aristotle was mistaken in attributing them to Plato. In a prior book-length study on Plato's late ontology, Kenneth M. Sayre demonstrated that, despite differences in terminology, these claims correspond to (...) themes developed by Plato in the Parmenides and the Philebus. In this book, he shows how this correspondence can be extended to key, but previously obscure, passages in the Statesman. He also examines the interpretative consequences for other sections of that dialogue, particularly those concerned with the practice of dialectical inquiry. (shrink)

Contrary to Vaesen's argument that humans are unique with respect to nine cognitive capacities essential for tool use, we suggest that although such cognitive processes contribute to variation in tool use, it does not follow that these capacities arenecessaryfor tool use, nor that tool use shaped cognition per se, given the available data in cognitive neuroscience and behavioral biology.

Emily Carroll and Parker Crutchfield propose a new inconsistency argument against abortion restrictivism. In response, I raised several objections to their argument. Recently Carroll and Crutchfield have replied and seem to be under the impression that I’m a restrictivist. This is puzzling, since my criticism of their view included a very thinly veiled, but purposely more charitable, anti-restrictivist inconsistency argument. In this response, I explain how Carroll and Crutchfield mischaracterize my position and that of the restrictivist.

Consciousness and Mind presents David Rosenthal's influential work on the nature of consciousness. Central to that work is Rosenthal's higher-order-thought theory of consciousness, according to which a sensation, thought, or other mental state is conscious if one has a higher-order thought that one is in that state. The first four essays develop various aspects of that theory. The next three essays present Rosenthal's homomorphism theory of mental qualities and qualitative consciousness, and show how that theory fits with and helps sustain (...) the HOT theory. A crucial feature of homomorphism theory is that it individuates and taxonomizes mental qualities independently of the way we're conscious of them, and indeed independently of our being conscious of them at all. So the theory accommodates the qualitative character not only of conscious sensations and perceptions, but also of those which fall outside our stream of consciousness. Rosenthal argues that, because this account of mental qualities makes no appeal to consciousness, it enables us to dispel such traditional quandaries as the alleged conceivability of undetectable quality inversion, and to disarm various apparent obstacles to explaining qualitative consciousness and understanding its nature. Six further essays build on the HOT theory to explain various important features of consciousness, among them the complex connections that hold in humans between consciousness and speech, the self-interpretative aspect of consciousness, and the compelling sense we have that consciousness is unified. Two of the essays, one an extended treatment of homomorphism theory, appear here for the first time. There is also a substantive introduction, which draws out the connections between the essays and highlights their implications. (shrink)