Politics through Action: Student Service and Activism in the '90s.

ERIC Educational Resources Information Center

Hirsch, Deborah

1993-01-01

Trends in college student activism and volunteer community service are examined. It is concluded that this generation of students is redefining social consciousness by focusing on practical and rational responses to immediate social issues. Colleges and universities are urged to help students reflect and build on volunteer experiences. (MSE)

Utopian Scenario Sketching: An Imaginal Pedagogy for Life Giving Civilisation

ERIC Educational Resources Information Center

Willis, Peter

2011-01-01

This paper argues that learning for human flourishing needs a balance between small-scale, convivial experiences, imaginary and creative expression, logical, rational planning and autonomous, purposive practices. It is the second one--imaginary and creative expression--which is particularly of interest in this paper. The focus is on the capacity…

Astronomy in the training of teachers and the role of practical rationality in sky observation

NASA Astrophysics Data System (ADS)

Bretones, P. S.; Compiani, M.

2006-08-01

This work analyses a program in the training of teachers that departs from the courses based on the technical rationality. An Astronomy course was offered to Science and Geography teachers of the four last years of high school education, comprising 46 hours, and organized in 2002 by the Instituto Superior de Ciências Aplicadas in Limeira, Brazil. Following the course a study group was established and held five meetings. The data was obtained through assessments, interviews, and accounts by the teachers and records from the classes and meetings. The actions and conceptual changes and the role of the Practical Rationality were then investigated. It was verified that for sky observation, the model of Practical Rationality within the reflective teacher theoretical framework and tutorial actions leads to knowledge acquisition, conceptual changes and extracurricular activities. Examples are: suggestions, personal actions of the teachers without their students, accounts of extracurricular activities and development of astronomical contents in class, actions in the pedagogical practices and reflections of the teachers with the teacher/ researcher towards the assessment of such changes are shown. It is important to stress that sky observation has specific features that lead to an equally specific school practice, in which the contents and procedures based on observations and their representation point towards a more practical rationality. Even in a training course for teachers based on technical rationality, the introduction of sky observation deepens the practical rationality and the development of principles that guide the acquisition and the teaching of knowledge about sky observation.

Using implementation science as the core of the doctor of nursing practice inquiry project.

PubMed

Riner, Mary E

2015-01-01

New knowledge in health care needs to be implemented for continuous practice improvement. Doctor of nursing practice (DNP) programs are designed to increase clinical practice knowledge and leadership skills of graduates. This article describes an implementation science course developed in a DNP program focused on advancing graduates' capacity for health systems leadership. Curriculum and course development are presented, and the course is mapped to depict how the course objectives and assignments were aligned with DNP Essentials. Course modules with rational are described, and examples of how students implemented assignments are provided. The challenges of integrating this course into the life of the school are discussed as well as steps taken to develop faculty for this capstone learning experience. This article describes a model of using implementation science to provide DNP students an experience in designing and managing an evidence-based practice change project. Copyright © 2015 Elsevier Inc. All rights reserved.

A qualitative grounded theory study of the conceptions of clinical practice in osteopathy - a continuum from technical rationality to professional artistry.

PubMed

Thomson, Oliver P; Petty, Nicola J; Moore, Ann P

2014-02-01

How practitioners conceive clinical practice influences many aspects of their clinical work including how they view knowledge, clinical decision-making, and their actions. Osteopaths have relied upon the philosophical and theoretical foundations upon which the profession was built to guide clinical practice. However, it is currently unknown how osteopaths conceive clinical practice, and how these conceptions develop and influence their clinical work. This paper reports the conceptions of practice of experienced osteopaths in the UK. A constructivist grounded theory approach was taken in this study. The constant comparative method of analysis was used to code and analyse data. Purposive sampling was employed to initially select participants. Subsequent theoretical sampling, informed by data analysis, allowed specific participants to be sampled. Data collection methods involved semi-structured interviews and non-participant observation of practitioners during a patient appointment, which was video-recorded and followed by a video-prompted reflective interview. Participants' conception of practice lay on a continuum, from technical rationality to professional artistry and the development of which was influenced by their educational experience, view of health and disease, epistemology of practice knowledge, theory-practice relationship and their perceived therapeutic role. The findings from this study provide the first theoretical insight of osteopaths' conceptions of clinical practice and the factors which influence such conceptions. Copyright © 2013 Elsevier Ltd. All rights reserved.

Critical Thinking as Integral to Social Work Practice

ERIC Educational Resources Information Center

Gibbons, Jill; Gray, Mel

2004-01-01

The paper examines the role of critical thinking in an experience-based model of social work education. Within this model, the development of a critical approach to our own understanding of, as well as to existing knowledge about, the world is fundamental for students and educators alike. Critical thinking is defined as more than a rational,…

Studying the Practical Rationality of Mathematics Teaching: What Goes into "Installing" a Theorem in Geometry?

ERIC Educational Resources Information Center

Herbst, Patricio; Nachlieli, Talli; Chazan, Daniel

2011-01-01

This article presents a way of studying the rationality that mathematics teachers utilize in managing the teaching of theorems in high-school geometry. More generally, the study illustrates how to elicit the rationality that guides teachers in handling the demands of teaching practice. In particular, it illustrates how problematic classroom…

Rationing critical care medicine: recent studies and current trends.

PubMed

Ward, Nicholas S

2005-12-01

This paper reviews the literature on the rationing of critical care resources. Although much has been written about the concept of rationing, there have been few scientific studies as to its prevalence. A recent meta-analysis reviewed all previously published studies on rationing access to intensive care units but little is known about practices within the intensive care unit. Much literature in the past few years has focused on the growing use of critical care resources and projections for the future. Several authors suggest there may be a crisis in financial or personnel resources if some rationing does not take place. Other papers have argued that the methods of rationing critical care previously proposed, such as limiting the care of dying patients or using cost-effectiveness analysis to determine care, may not be effective or viewed as ethical by some. Finally, several recent papers review how critical care is practiced and allocated in India and Asian countries that already practice open rationing in their health care systems. There is currently no published evidence that overt rationing is taking place in critical care medicine. There is growing evidence that in the future, the need for critical care may outstrip financial resources unless some form of rationing takes place. It is also clear from the literature that choosing how to ration critical care will be a difficult task.

Evaluation of the attitudes of the nurses related to rational drug use in Gaziantep University Sahinbey Research and Practice Hospital in Turkey.

PubMed

Oguz, Elif; Alasehirli, Belgin; Demiryurek, Abdullah Tuncay

2015-02-01

This study aimed to evaluate the attitude of nurses about rational drug use in Gaziantep University Sahinbey Research and Practice Hospital. There are a limited number of studies available on this issue and no studies of this scale were conducted among the nurses in our region. A questionnaire generated by the Rational Drug Use Unit of Turkish Ministry of Health General Directorate of Pharmaceuticals and Pharmacy was carried out to nurses. The study was carried out to 162 nurses. The data obtained from nurses by questionnaire were determined as count, percentage and Chi-square test by SPSS statistical package program. The most common type of medication error was giving the medicine at the wrong time. Medication errors were least common among the 36-50-year age group and with a professional experience of 11 years or longer. Nurses had the highest level of knowledge in the areas of drug administration routes and the intended use. The number of nurses reported having good/very good knowledge was higher with 4 to 10 years of professional experience and with a university degree. The nurses aged between 26 and 35 years and those with professional experience of 4 to 10 years provided drug information to patients more often than others. Forty two percent of the nurses were found to actively report any adverse events. Reporting of adverse events and reporting more than 6 adverse events were most common among university degree holders. Nurses required a more comprehensive education on pharmacology both during their training years and working life since the requests for medicinal products are received by the nurses and preparation and administration of drugs are under the control of nurses. Copyright © 2014 Elsevier Ltd. All rights reserved.

An Intricate Fabric: Understanding the Rationality of Practice

ERIC Educational Resources Information Center

Dunne, Joseph

2005-01-01

This article provides an account of a "neo-Aristotelian" conception of practice. It introduces this account through an analysis of internal and external goods of practices. It then delineates a crucial distinction between practical and technical rationality and grounds this distinction in an analysis of the priority of "material" over "method" in…

Rational Design of an Ultrasensitive Quorum-Sensing Switch.

PubMed

Zeng, Weiqian; Du, Pei; Lou, Qiuli; Wu, Lili; Zhang, Haoqian M; Lou, Chunbo; Wang, Hongli; Ouyang, Qi

2017-08-18

One of the purposes of synthetic biology is to develop rational methods that accelerate the design of genetic circuits, saving time and effort spent on experiments and providing reliably predictable circuit performance. We applied a reverse engineering approach to design an ultrasensitive transcriptional quorum-sensing switch. We want to explore how systems biology can guide synthetic biology in the choice of specific DNA sequences and their regulatory relations to achieve a targeted function. The workflow comprises network enumeration that achieves the target function robustly, experimental restriction of the obtained candidate networks, global parameter optimization via mathematical analysis, selection and engineering of parts based on these calculations, and finally, circuit construction based on the principles of standardization and modularization. The performance of realized quorum-sensing switches was in good qualitative agreement with the computational predictions. This study provides practical principles for the rational design of genetic circuits with targeted functions.

Relationship between Student Pharmacist Decision Making Preferences and Experiential Learning.

PubMed

Williams, Charlene R; McLaughlin, Jacqueline E; Cox, Wendy C; Shepherd, Greene

2016-09-25

Objective. To determine if student pharmacists' preferences towards experiential and rational thinking are associated with performance on advanced pharmacy practice experiences (APPEs) and whether thinking style preference changes following APPEs. Methods. The Rational Experiential Inventory (REI), a validated survey of thinking style, was administered to student pharmacists before starting APPEs and re-administered after completing APPEs. APPE grades were compared to initial REI scores. Results. Rational Experiential Inventory scores remained consistent before and after APPEs. Overall, APPE grades were independent of REI scores. In a regression model, the REI experiential score was a significant negative predictor of hospital APPE grades. Conclusion. These findings suggest that overall APPE performance is independent of decision-making preference, and decision-making style does not change following immersion into APPEs. Instead of targeting teaching strategies towards a specific decision-making style, preceptors may use pedagogical approaches that promote sound clinical decision-making skills through critical thinking and reflection.

Relationship between Student Pharmacist Decision Making Preferences and Experiential Learning

PubMed Central

McLaughlin, Jacqueline E.; Cox, Wendy C.; Shepherd, Greene

2016-01-01

Objective. To determine if student pharmacists’ preferences towards experiential and rational thinking are associated with performance on advanced pharmacy practice experiences (APPEs) and whether thinking style preference changes following APPEs. Methods. The Rational Experiential Inventory (REI), a validated survey of thinking style, was administered to student pharmacists before starting APPEs and re-administered after completing APPEs. APPE grades were compared to initial REI scores. Results. Rational Experiential Inventory scores remained consistent before and after APPEs. Overall, APPE grades were independent of REI scores. In a regression model, the REI experiential score was a significant negative predictor of hospital APPE grades. Conclusion. These findings suggest that overall APPE performance is independent of decision-making preference, and decision-making style does not change following immersion into APPEs. Instead of targeting teaching strategies towards a specific decision-making style, preceptors may use pedagogical approaches that promote sound clinical decision-making skills through critical thinking and reflection. PMID:27756927

Max Weber's Types of Rationality: Cornerstones for the Analysis of Rationalization Processes in History.

ERIC Educational Resources Information Center

Kalberg, Stephen

1980-01-01

Explores rationality in Max Weber's works and identifies four types of rationality which play major roles in his writing--practical, theoretical, substantive, and formal. Implications for society and education are discussed. (DB)

General practice--a post-modern specialty?

PubMed Central

Mathers, N; Rowland, S

1997-01-01

The 'modern' view of the world is based on the premise that we can discover the essential truth of the world using scientific method. The assumption is made that knowledge so acquired has been 'uncontaminated' by the mind of the investigator. Post-modern theory, however, is concerned with the process of knowing and how our minds are part of the process, i.e. our perceptions of reality and the relationships between different concepts are important influences on our ways of knowing. The values of post-modern theory are those of uncertainty, many different voices and experiences of reality and multifaceted descriptions of truth. These values are closer to our experience of general practice than the 'modern' values of scientific rationalism and should be reflected in a new curriculum for general practice. PMID:9167325

New social tasks for cognitive psychology; or, new cognitive tasks for social psychology.

PubMed

Wettersten, John

2014-01-01

To elucidate how differing theories of rationality lead to differing practices, their social rules must be analyzed. This is true not merely in science but also in society at large. This analysis of social thinking requires both the identification of innate cognitive social psychological processes and explanations of their relations with differing rules of rational practice. These new tasks can enable social psychologists to contribute to the study of how social situations facilitate or inhibit rational practice and enable cognitive psychologists to improve social psychological theory. In contrast to dominant current research strategies, social and cognitive psychologists can integrate social studies of rational practices and their consequences with studies of underlying cognitive psychological processes. In this article I do not attempt to carry out these tasks but rather point to both their lack of recognition and their importance.

Thinking about thinking: implications for patient safety.

PubMed

Montgomery, Kathryn

2009-01-01

Clinical medicine, a learned, rational, science-using practice, is labelled a science even though physicians have the good sense not to practise it that way. Rather than thinking like scientists - or how we think scientists think - physicians are engaged in analogical, interpretive reasoning that resembles Aristotle's phronesis, or practical reasoning, more closely than episteme, or scientific reasoning. In medicine, phronesis is clinical judgment; and while it depends on both a fund of information and extensive experience, somehow it is not quite teachable. This practical, clinical rationality relies on case narrative for teaching and learning about illness and disease, for recording and communicating about patient care and, inevitably, for thinking about and remembering the details, as well as the overarching rules of practice. At the same time, "anecdotal" remains the most pejorative word in medicine, and the tension between the justifiable caution this disdain expresses and the pervasive narrative structure of medical knowledge is characteristic of clinical knowing generally: a tug-of-war between apparent irreconcilables that can be settled only by an appeal to the circumstances of the clinical situation. Practical rationality in the clinical encounter is characterized by a productive circulation between the particular details of the patient's presentation and general information about disease stored as a taxonomy of cases. Evidence-based medicine can improve this negotiation between general knowledge and the patient's particulars, but it cannot replace it. In a scientific era, clinical judgment remains the quintessential intellectual strength of the clinician. Why, then, do we not teach the epistemology of medicine? Understanding the mis-description of physicians' thinking - and the accompanying claim that medicine is, in itself, a science - could mitigate the misplaced perfectionism that makes mistakes in medicine personal and unthinkable.

Where the champsaur commission's critics Have got it wrong

DOE Office of Scientific and Technical Information (OSTI.GOV)

Santana, Joao; Resende, M.J.

2010-07-15

In order to be constructive, the debate on markets versus electrical system regulation must be based on experience in real operating markets and regulated environments. If dogmatism prevails, it can fall into the contradiction of economical rationality. Unlike the U.S., where evolution has been driven by practice, the European Union wants to impose uniformity - electricity regulation regardless of individual countries' special circumstances. (author)

The Continuing Quest for Rationality in Curriculum Practice.

ERIC Educational Resources Information Center

Gay, Geneva

1979-01-01

Suggests that understanding different conceptual models of curriculum making will increase the effectiveness and rationality of the development process. Presents four commonly used models of curriculum development: empiricism, rationalism, pragmatism, and humanism. (Author/JM)

The Influences of Middle School Mathematics Teachers' Practical Rationality on Instructional Decision Making Regarding the Common Core State Standards for Mathematical Practices

ERIC Educational Resources Information Center

Sobolewski-McMahon, Lauren M.

2017-01-01

The purpose of this study was to examine the influences of various facets of middle school mathematics teachers' practical rationality on their instructional decision making as they plan to enact the Common Core State Standards for Mathematical Practice, CCSS-MP1 (perseverance in problem solving) and CCSS-MP3 (communicating and critiquing). The…

Publics in the making: mediating different methods of engagement and the publics these construct : commentary on: "Technologies of democracy: experiments and demonstrations".

PubMed

Mohr, Alison

2011-12-01

The potential for public engagement to democratise science has come under increasing scrutiny amid concerns that conflicting motivations have led to confusion about what engagement means to those who mediate science and publics. This raises important yet relatively unexplored questions regarding how publics are constituted by different forms of engagement used by intermediary scholars and other actors. It is possible to identify at least two possible 'rationalities of mediation' that mobilise different versions of the public and the roles they are assumed to play, as 'citizens' or 'users', in discussions around technology. However, combinations of rationalities are found in practice and these have significant implications for the 'new' scientific democracy.

Dual processing and organizational justice: the role of rational versus experiential processing in third-party reactions to workplace mistreatment.

PubMed

Skarlicki, Daniel P; Rupp, Deborah E

2010-09-01

The moral perspective of justice proposes that when confronted by another person's mistreatment, third parties can experience a deontic response, that is, an evolutionary-based emotional reaction that motivates them to engage in retribution toward the transgressor. In this article, we tested whether the third party's deontic reaction is less strong when a rational (vs. experiential) processing frame is primed. Further, we tested whether third parties high (vs. low) in moral identity are more resistant to the effects of processing frames. Results from a sample of 185 French managers revealed that following an injustice, managers primed to use rational processing reported lower retribution tendencies compared with managers primed to use experiential processing. Third parties high in moral identity, however, were less affected by the framing; they reported a high retribution response regardless of processing frame. Theoretical and practical implications of these findings are discussed. Copyright 2010 APA, all rights reserved

Expert and non-expert knowledge in medical practice.

PubMed

Nordin, I

2000-01-01

One problematic aspect of the rationality of medical practice concerns the relation between expert knowledge and non-expert knowledge. In medical practice it is important to match medical knowledge with the self-knowledge of the individual patient. This paper tries to study the problem of such matching by describing a model for technological paradigms and comparing it with an ideal of technological rationality. The professionalised experts tend to base their decisions and actions mostly on medical knowledge while the rationality of medicine also involves just as important elements of the personal evaluation and knowledge of the patients. Since both types of knowledge are necessary for rational decisions, the gap between the expert and the non-expert has to be bridged in some way. A solution to the problem is suggested in terms of pluralism, with the patient as ultimate decision-maker.

Effect of information, education and communication intervention on awareness about rational pharmacy practice in pharmacy students

PubMed Central

Gharpure, Kunda; Thawani, Vijay; Sontakke, Smita; Chaudhari, Kiran; Bankar, Mangesh; Diwe, Rajendra

2011-01-01

Background: There is a growing indifference among the pharmacy practitioners towards their duty as information providers to the patients. The patients do not always get enough desired information about proper use of medicines from the prescribers also. This contributes to improper use of medicines by the patients. Objectives: To bring about awareness about rational pharmacy practice in pharmacy students for better service to the patients. Material and Methods: The final year students of Bachelor of Pharmacy (B. Pharm) from four colleges of Nagpur were enrolled for the study after informed consent. Their base knowledge was assessed through a written test which comprised of 27 objective questions related to rational pharmacy practice. This was followed by a series of seven articles on rational medicine use, published in leading local English news daily. The participants were reminded to read them on the day of publication of each article. As a backup, the articles were displayed on the notice board of respective colleges. Second intervention was a half day interactive session where series of six lectures were delivered to the participants on the right and wrong approaches in pharmacy practice. Posters about the do's and dont's of rational pharmacy practice were also displayed at the venue. The session was followed by a repeat test using the same pre-test to assess the change. Pre and post intervention data was compared using Fisher's Exact test. Results: It was observed that the intervention did bring about a positive change in the attitude and knowledge of the final year Pharmacy students about rational pharmacy practice. Discussion: The role of a pharmacist in health care provision is usually overlooked in India. Hence there is strong need for reinforcement in final year B. Pharm when most of the students go in for community service. Such interventions will be helpful in bringing about a positive change towards rational practice of pharmacy. Conclusion: This study showed that a properly timed and meticulously implemented intervention brings about a positive change in the attitude and knowledge of pharmacy students. PMID:21844989

Effect of information, education and communication intervention on awareness about rational pharmacy practice in pharmacy students.

PubMed

Gharpure, Kunda; Thawani, Vijay; Sontakke, Smita; Chaudhari, Kiran; Bankar, Mangesh; Diwe, Rajendra

2011-07-01

There is a growing indifference among the pharmacy practitioners towards their duty as information providers to the patients. The patients do not always get enough desired information about proper use of medicines from the prescribers also. This contributes to improper use of medicines by the patients. To bring about awareness about rational pharmacy practice in pharmacy students for better service to the patients. The final year students of Bachelor of Pharmacy (B. Pharm) from four colleges of Nagpur were enrolled for the study after informed consent. Their base knowledge was assessed through a written test which comprised of 27 objective questions related to rational pharmacy practice. This was followed by a series of seven articles on rational medicine use, published in leading local English news daily. The participants were reminded to read them on the day of publication of each article. As a backup, the articles were displayed on the notice board of respective colleges. Second intervention was a half day interactive session where series of six lectures were delivered to the participants on the right and wrong approaches in pharmacy practice. Posters about the do's and dont's of rational pharmacy practice were also displayed at the venue. The session was followed by a repeat test using the same pre-test to assess the change. Pre and post intervention data was compared using Fisher's Exact test. It was observed that the intervention did bring about a positive change in the attitude and knowledge of the final year Pharmacy students about rational pharmacy practice. The role of a pharmacist in health care provision is usually overlooked in India. Hence there is strong need for reinforcement in final year B. Pharm when most of the students go in for community service. Such interventions will be helpful in bringing about a positive change towards rational practice of pharmacy. This study showed that a properly timed and meticulously implemented intervention brings about a positive change in the attitude and knowledge of pharmacy students.

We still fail to account for Mendel's observations.

PubMed

Porteous, John W

2004-08-16

The present article corrects common textbook accounts of Mendel's experiments by re-establishing what he wrote and how he accounted for his observations. It notes the long-established tests for the validity of any explanations that purport to explain observations obtained by experiment. Application of these tests to Mendel's paper shows that the arguments he used to explain his observations were internally consistent but were, on one crucial issue, implausible. The same tests are applied to the currently accepted explanation for Mendel's observations. The currently favoured explanation for Mendel's observations is untenable. It misrepresents Mendel, fails to distinguish between the parameters and the variables of any system of interacting components, its arguments are inconsistent, it repeats the implausibility in Mendel's paper, fails to give a rational explanation for his observed 3:1 trait ratio and cannot explain why this ratio is not always observed in experimental practice. A rational explanation for Mendel's observations is initiated. Readers are challenged to complete the process before a further article appears.

Ascribing emotion to reasonable use in accelerated cancer services.

PubMed

Obling, Anne Roelsgaard

2013-01-01

A recurrent theme in medical sociology has been the juxtaposition of emotion with scientific rationality in the delivery of health care services. However, apart from addressing this juxtaposition very little is said about the complex intertwinement of "emotional" and "rational" practices which makes up professionals' own day-to-day work experiences - and how these experiences are influenced by present ways of organising health care. This paper aims to explore the ways that hospital doctors relate emotions to their understanding of professional medical work and how they respond to recent organisational changes within the field. Drawing upon a small series of semi-structured interviews (n = 14) with doctors from a public teaching hospital in Denmark, the paper adopts a constructivist framework to analyse personal biographies of health professionals' working lives. The doctors represented rich accounts of professional medical work, which includes an understanding of what a doctor should feel and how he/she should make him/herself emotionally available to others. However, the impetus for making this appearance was not left unaffected by recent new public management reforms and attempts to accelerate the delivery of services. The organisation of cancer services into a work system, which consists of a set of tasks broken down into narrow jobs, underestimates the emotional components of patient-doctor encounters. This makes the creation and maintenance of a genuine patient-doctor relationship difficult and the result is feelings of a failed encounter on behalf of the doctor. The paper suggests that recent rearrangements of cancer services complicate doctors' ability to incorporate emotion into a stream of medical care in a "rational" way. This is shown to challenge their professional ethos and the forms emotional engagement takes in medical practice.

Cognitive success: instrumental justifications of normative systems of reasoning.

PubMed

Schurz, Gerhard

2014-01-01

In the first part of the paper (sec. 1-4), I argue that Elqayam and Evan's (2011) distinction between normative and instrumental conceptions of cognitive rationality corresponds to deontological vs. teleological accounts in meta-ethics. I suggest that Elqayam and Evans' distinction be replaced by the distinction between a-priori intuition-based vs. a-posteriori success-based accounts of cognitive rationality. The value of cognitive success lies in its instrumental rationality for almost-all practical purposes. In the second part (sec. 5-7), I point out that the Elqayam and Evans's distinction between normative and instrumental rationality is coupled with a second distinction: between logically general vs. locally adaptive accounts of rationality. I argue that these are two independent distinctions that should be treated as independent dimensions. I also demonstrate that logically general systems of reasoning can be instrumentally justified. However, such systems can only be cognitively successful if they are paired with successful inductive reasoning, which is the area where the program of adaptive (ecological) rationality emerged, because there are no generally optimal inductive reasoning methods. I argue that the practical necessity of reasoning under changing environments constitutes a dilemma for ecological rationality, which I attempt to solve within a dual account of rationality.

[Development of a basic ration out of commercial foods for nutrition in ground-based simulation experiments].

PubMed

Agureev, A N; Kalandarov, S; Bogatova, R I; Krivitsina, Z A; Vasil'eva, V F

2005-01-01

Food rations composed of canned products were given the physiological and hygienic evaluation in the context of their fitness for human volunteers in experiments with head-down bedrest in isolation and confinement. As a result, the food rations were proven to contain the desired quantities of nutrients. Evaluation of food fitness for human subjects was made based on the data of clinical-physiological and biochemical investigations. The rations met the energy and anabolic metabolism demands of human subjects during extreme chamber experiments and were favorable to maintaining good level of vital processes.

How clinical rationing works in practice: A case study of morbid obesity surgery.

PubMed

Owen-Smith, Amanda; Donovan, Jenny; Coast, Joanna

2015-12-01

Difficulties in setting healthcare priorities are encountered throughout the world. There is no agreement on the most appropriate principles or methods for healthcare rationing although there is some consensus that it should be undertaken as systematically and accountably as possible. Although some steps towards achieving accountability have been made at the macro and meso level, at the consultation level rationing remains implicit and poorly understood. Using morbid obesity surgery as a case study, we observed a series of UK National Health Service consultations where rationing was ongoing and conducted in-depth interviews with doctors and patients (2011-2014). A longitudinal approach was taken to research and in total 22 consultations were observed and 78 interviews were undertaken. Sampling was undertaken purposively and theoretically and analyses were undertaken thematically. Clinicians needed to prioritise 55 patients from 450 eligible referrals, but disagreed over the extent to which clinical and financial factors were the driving force behind decision-making. The most prominent rationing technique observed in consultations was rationing by selection, but examples of rationing by delay, by deterrence, and by deflection were also commonplace. Although all clinicians sought to avoid rationing by denial, only six of the 22 patients recruited to the research were known to have been treated at the end of the three-year period. Most clinicians sought to manage rationing implicitly, and only one explained the link between decision-making criteria and financial constraints on care availability. Although existing frameworks for categorising NHS rationing techniques were useful in identifying implicit strategies, in practice these techniques over-lapped substantially and we have proposed a simpler framework for analysing NHS rationing decisions at the consultation level, which includes just three categories - rationing by exclusion, rationing by deterrence, and rationing by delay. Copyright © 2015. Published by Elsevier Ltd.

When is rational to order a diagnostic test, or prescribe treatment: the threshold model as an explanation of practice variation.

PubMed

Djulbegovic, Benjamin; van den Ende, Jef; Hamm, Robert M; Mayrhofer, Thomas; Hozo, Iztok; Pauker, Stephen G

2015-05-01

The threshold model represents an important advance in the field of medical decision-making. It is a linchpin between evidence (which exists on the continuum of credibility) and decision-making (which is a categorical exercise - we decide to act or not act). The threshold concept is closely related to the question of rational decision-making. When should the physician act, that is order a diagnostic test, or prescribe treatment? The threshold model embodies the decision theoretic rationality that says the most rational decision is to prescribe treatment when the expected treatment benefit outweighs its expected harms. However, the well-documented large variation in the way physicians order diagnostic tests or decide to administer treatments is consistent with a notion that physicians' individual action thresholds vary. We present a narrative review summarizing the existing literature on physicians' use of a threshold strategy for decision-making. We found that the observed variation in decision action thresholds is partially due to the way people integrate benefits and harms. That is, explanation of variation in clinical practice can be reduced to a consideration of thresholds. Limited evidence suggests that non-expected utility threshold (non-EUT) models, such as regret-based and dual-processing models, may explain current medical practice better. However, inclusion of costs and recognition of risk attitudes towards uncertain treatment effects and comorbidities may improve the explanatory and predictive value of the EUT-based threshold models. The decision when to act is closely related to the question of rational choice. We conclude that the medical community has not yet fully defined criteria for rational clinical decision-making. The traditional notion of rationality rooted in EUT may need to be supplemented by reflective rationality, which strives to integrate all aspects of medical practice - medical, humanistic and socio-economic - within a coherent reasoning system. © 2015 Stichting European Society for Clinical Investigation Journal Foundation.

Establishing rational networking using the DL04 quantum secure direct communication protocol

NASA Astrophysics Data System (ADS)

Qin, Huawang; Tang, Wallace K. S.; Tso, Raylin

2018-06-01

The first rational quantum secure direct communication scheme is proposed, in which we use the game theory with incomplete information to model the rational behavior of the participant, and give the strategy space and utility function. The rational participant can get his maximal utility when he performs the protocol faithfully, and then the Nash equilibrium of the protocol can be achieved. Compared to the traditional schemes, our scheme will be more practical in the presence of rational participant.

Many faces of rationality: Implications of the great rationality debate for clinical decision-making.

PubMed

Djulbegovic, Benjamin; Elqayam, Shira

2017-10-01

Given that more than 30% of healthcare costs are wasted on inappropriate care, suboptimal care is increasingly connected to the quality of medical decisions. It has been argued that personal decisions are the leading cause of death, and 80% of healthcare expenditures result from physicians' decisions. Therefore, improving healthcare necessitates improving medical decisions, ie, making decisions (more) rational. Drawing on writings from The Great Rationality Debate from the fields of philosophy, economics, and psychology, we identify core ingredients of rationality commonly encountered across various theoretical models. Rationality is typically classified under umbrella of normative (addressing the question how people "should" or "ought to" make their decisions) and descriptive theories of decision-making (which portray how people actually make their decisions). Normative theories of rational thought of relevance to medicine include epistemic theories that direct practice of evidence-based medicine and expected utility theory, which provides the basis for widely used clinical decision analyses. Descriptive theories of rationality of direct relevance to medical decision-making include bounded rationality, argumentative theory of reasoning, adaptive rationality, dual processing model of rationality, regret-based rationality, pragmatic/substantive rationality, and meta-rationality. For the first time, we provide a review of wide range of theories and models of rationality. We showed that what is "rational" behaviour under one rationality theory may be irrational under the other theory. We also showed that context is of paramount importance to rationality and that no one model of rationality can possibly fit all contexts. We suggest that in context-poor situations, such as policy decision-making, normative theories based on expected utility informed by best research evidence may provide the optimal approach to medical decision-making, whereas in the context-rich circumstances other types of rationality, informed by human cognitive architecture and driven by intuition and emotions such as the aim to minimize regret, may provide better solution to the problem at hand. The choice of theory under which we operate is important as it determines both policy and our individual decision-making. © 2017 The Authors Journal of Evaluation in Clinical Practice Published by John Wiley & Sons Ltd.

Is Engaging in Evidence-Informed Practice in Education Rational? What Accounts for Discrepancies in Teachers' Attitudes towards Evidence Use and Actual Instances of Evidence Use in Schools?

ERIC Educational Resources Information Center

Brown, Chris; Zhang, Dell

2016-01-01

Whilst beneficial, the consistent and regular use of evidence to improve teaching and learning in schools is proving difficult to achieve in practice. This paper attempts to shed new light on this issue by examining the applicability of a model of rational behaviour as it relates to the notion of evidence-informed practice (EIP). Specifically,…

(Un)organizing equal collaboration between users and professionals: on management of patient education in Norway.

PubMed

Stokken, Roar

2013-03-01

This is an article about how patient education is managed in Norway, but it also addresses a matter of broader relevance that of how an organization imbued with a request for rational choices is able to take on board a contradictory ideology. In Norway, patient education under the auspice of hospitals is to be conducted as an equal collaboration between users and professionals, posing challenges to the ethos of rationally justified choices within the hospital sector. This calls for an exploration of how the organization copes with the contradictory demands. A theoretical approach on the basis of theories from Scandinavian institutional theory and science and technology studies, informed by documents, interviews and experiences from national, regional and local levels in Norway. The field of patient education is divided into three decoupled domains: one at management level, one at the practical level, and in the middle a domain that acts as an interface between management and practice. This interface mediates the relationship between ideas and practice, without making overt the fact that ideas might not be possible to put into practice and that practice might not reflect ideas. The decoupling of practice and management allows patient education as equal collaboration between users and professionals to thrive as an idea, not subjugated by practical challenges. Thus, it can exist as a guiding star that both management and practitioners can attune to, but this situation might now be threatened by the demand for quality assurance in the field. © 2011 Blackwell Publishing Ltd.

(Un)organizing equal collaboration between users and professionals: on management of patient education in Norway

PubMed Central

Stokken, Roar

2011-01-01

Abstract Background  This is an article about how patient education is managed in Norway, but it also addresses a matter of broader relevance that of how an organization imbued with a request for rational choices is able to take on board a contradictory ideology. In Norway, patient education under the auspice of hospitals is to be conducted as an equal collaboration between users and professionals, posing challenges to the ethos of rationally justified choices within the hospital sector. This calls for an exploration of how the organization copes with the contradictory demands. Methods  A theoretical approach on the basis of theories from Scandinavian institutional theory and science and technology studies, informed by documents, interviews and experiences from national, regional and local levels in Norway. Discussion  The field of patient education is divided into three decoupled domains: one at management level, one at the practical level, and in the middle a domain that acts as an interface between management and practice. This interface mediates the relationship between ideas and practice, without making overt the fact that ideas might not be possible to put into practice and that practice might not reflect ideas. Conclusions  The decoupling of practice and management allows patient education as equal collaboration between users and professionals to thrive as an idea, not subjugated by practical challenges. Thus, it can exist as a guiding star that both management and practitioners can attune to, but this situation might now be threatened by the demand for quality assurance in the field. PMID:21624027

"Leaky" Rationality: How Research on Behavioral Decision Making Challenges Normative Standards of Rationality.

PubMed

Keys, Daniel J; Schwartz, Barry

2007-06-01

For more than 30 years, decision-making research has documented that people often violate various principles of rationality, some of which are so fundamental that theorists of rationality rarely bother to state them. We take these characteristics of decision making as a given but argue that it is problematic to conclude that they typically represent departures from rationality. The very psychological processes that lead to "irrational" decisions (e.g., framing, mental accounting) continue to exert their influence when one experiences the results of the decisions. That is, psychological processes that affect decisions may be said also to "leak" into one's experience. The implication is that formal principles of rationality do not provide a good enough normative standard against which to assess decision making. Instead, what is needed is a substantive theory of rationality-one that takes subjective experience seriously, considers both direct and indirect consequences of particular decisions, considers how particular decisions fit into life as a whole, and considers the effects of decisions on others. Formal principles may play a role as approximations of the substantive theory that can be used by theorists and decision makers in cases in which the formal principles can capture most of the relevant considerations and leakage into experience is negligible. © 2007 Association for Psychological Science.

The Rational Approach to Budget Cuts: One University's Experience. ASHE 1987 Annual Meeting Paper.

ERIC Educational Resources Information Center

Hardy, Cynthia

The experiences of the University of Montreal in using a rational-analytic framework to allocate resources at a time of budget costs are discussed. The following characteristics for rational decision-making are identified and applied to the University of Montreal: whether goals were known, whether alternative methods of resource allocation were…

Cognitive success: instrumental justifications of normative systems of reasoning

PubMed Central

Schurz, Gerhard

2014-01-01

In the first part of the paper (sec. 1–4), I argue that Elqayam and Evan's (2011) distinction between normative and instrumental conceptions of cognitive rationality corresponds to deontological vs. teleological accounts in meta-ethics. I suggest that Elqayam and Evans' distinction be replaced by the distinction between a-priori intuition-based vs. a-posteriori success-based accounts of cognitive rationality. The value of cognitive success lies in its instrumental rationality for almost-all practical purposes. In the second part (sec. 5–7), I point out that the Elqayam and Evans's distinction between normative and instrumental rationality is coupled with a second distinction: between logically general vs. locally adaptive accounts of rationality. I argue that these are two independent distinctions that should be treated as independent dimensions. I also demonstrate that logically general systems of reasoning can be instrumentally justified. However, such systems can only be cognitively successful if they are paired with successful inductive reasoning, which is the area where the program of adaptive (ecological) rationality emerged, because there are no generally optimal inductive reasoning methods. I argue that the practical necessity of reasoning under changing environments constitutes a dilemma for ecological rationality, which I attempt to solve within a dual account of rationality. PMID:25071624

Abstract Rationality in Education: From Vygotsky to Brandom

ERIC Educational Resources Information Center

Derry, Jan

2008-01-01

Abstract rationality has increasingly been a target of attack in contemporary educational research and practice and in its place practical reason and situated thinking have become a focus of interest. The argument here is that something is lost in this. In illustrating how we might think about the issue, this paper makes a response to the charge…

Does knowing that a suicide was "rational" influence grief?

PubMed

Brazda, Geoffrey F; Range, Lillian M; Remley, Theodore P; White, Carolyn C

2018-03-15

Counseling professionals and graduate students (N = 117) recruited online read a randomly assigned one-paragraph vignette about either a non-rational or rational suicide involving an imaginary loved one. Then, they completed the Grief Experiences Questionnaire (GEQ) about how they would feel. The non-rational suicide group expected significantly more search for explanation than the rational suicide group, but were not significantly different on the other six GEQ subscales. All participants expected few distressing reactions to either vignette, suggesting a one-paragraph vignette may not be sufficient to induce the kind of grief many experience when a loved one dies by suicide.

The Rational Patient and Beyond: Implications for Treatment Adherence in People with Psychiatric Disabilities

PubMed Central

Corrigan, Patrick W.; Rüsch, Nicolas; Ben-Zeev, Dror; Sher, Tamara

2014-01-01

Purpose/Objective Many people with psychiatric disabilities do not benefit from evidence-based practices because they often do not seek out or fully adhere to them. One way psychologists have made sense of this rehabilitation and health decision process and subsequent behaviors (of which adherence might be viewed as one) is by proposing a “rational patient;” namely, that decisions are made deliberatively by weighing perceived costs and benefits of intervention options. Social psychological research, however, suggests limitations to a rational patient theory that impact models of health decision making. Design The research literature was reviewed for studies of rational patient models and alternative theories with empirical support. Special focus was on models specifically related to decisions about rehabilitation strategies for psychiatric disability. Results Notions of the rational patient evolved out of several psychological models including the health belief model, protection motivation theory, and theory of planned behavior. A variety of practice strategies evolved to promote rational decision making. However, research also suggests limitations to rational deliberations of health. (1) Rather than carefully and consciously considered, many health decisions are implicit, potentially occurring outside awareness. (2) Decisions are not always planful; often it is the immediate exigencies of a context rather than an earlier balance of costs and benefits that has the greatest effects. (3) Cool cognitions often do not dictate the process; emotional factors have an important role in health decisions. Each of these limitations suggests additional practice strategies that facilitate a person’s health decisions. Conclusions/Implications Old models of rational decision making need to be supplanted by multi-process models that explain supra-deliberative factors in health decisions and behaviors. PMID:24446671

The rational patient and beyond: implications for treatment adherence in people with psychiatric disabilities.

PubMed

Corrigan, Patrick W; Rüsch, Nicolas; Ben-Zeev, Dror; Sher, Tamara

2014-02-01

Many people with psychiatric disabilities do not benefit from evidence-based practices because they often do not seek out or fully adhere to them. One way psychologists have made sense of this rehabilitation and health decision process and subsequent behaviors (of which adherence might be viewed as one) is by proposing a "rational patient"; namely, that decisions are made deliberatively by weighing perceived costs and benefits of intervention options. Social psychological research, however, suggests limitations to a rational patient theory that impact models of health decision making. The research literature was reviewed for studies of rational patient models and alternative theories with empirical support. Special focus was on models specifically related to decisions about rehabilitation strategies for psychiatric disability. Notions of the rational patient evolved out of several psychological models including the health belief model, protection motivation theory, and theory of planned behavior. A variety of practice strategies evolved to promote rational decision making. However, research also suggests limitations to rational deliberations of health. (1) Rather than carefully and consciously considered, many health decisions are implicit, potentially occurring outside awareness. (2) Decisions are not always planful; often it is the immediate exigencies of a context rather than an earlier balance of costs and benefits that has the greatest effects. (3) Cool cognitions often do not dictate the process; emotional factors have an important role in health decisions. Each of these limitations suggests additional practice strategies that facilitate a person's health decisions. Old models of rational decision making need to be supplanted by multiprocess models that explain supradeliberative factors in health decisions and behaviors. PsycINFO Database Record (c) 2014 APA, all rights reserved.

[Evidence-based medicine: the art of applying scientific knowledge in clinical practice].

PubMed

Lopes, A A

2000-01-01

This article was written with the objective of describing the concept of Evidence Based Medicine (EBM) and the competences required for its practice. EBM should be viewed as an integration of clinical experience with the ability to analyze and rationally apply the scientific information while taking care of patients. The application of methods and strategies to enhance the scientific background of the physician while taking into account the humanitarian values of the medical profession should contribute to improve the quality of the medical care that is offered in Brazil. The Medical Schools and Associations may play important roles in the promotion of EBM.

Rationality, practice variation and person-centred health policy: a threshold hypothesis.

PubMed

Djulbegovic, Benjamin; Hamm, Robert M; Mayrhofer, Thomas; Hozo, Iztok; Van den Ende, Jef

2015-12-01

Variation in practice of medicine is one of the major health policy issues of today. Ultimately, it is related to physicians' decision making. Similar patients with similar likelihood of having disease are often managed by different doctors differently: some doctors may elect to observe the patient, others decide to act based on diagnostic testing and yet others may elect to treat without testing. We explain these differences in practice by differences in disease probability thresholds at which physicians decide to act: contextual social and clinical factors and emotions such as regret affect the threshold by influencing the way doctors integrate objective data related to treatment and testing. However, depending on a theoretical construct each of the physician's behaviour can be considered rational. In fact, we showed that the current regulatory policies lead to predictably low thresholds for most decisions in contemporary practice. As a result, we may expect continuing motivation for overuse of treatment and diagnostic tests. We argue that rationality should take into account both formal principles of rationality and human intuitions about good decisions along the lines of Rawls' 'reflective equilibrium/considered judgment'. In turn, this can help define a threshold model that is empirically testable. © 2015 The Authors. Journal of Evaluation in Clinical Practice published by John Wiley & Sons, Ltd.

Evidence‐based disparities: examining the gap between health expectations and experiences

PubMed Central

Vashdi, Dana R.; Zalmanovitch, Yair

2012-01-01

Abstract Context  In a time of economic austerity, one of the most daunting questions is who decides on healthcare rationing? In the current study, we sought to examine if the public can in fact provide meaningful information regarding healthcare policy issues. Based on theories of public policy, this paper tries to find out if patients behave akin to ‘responsible citizens’ and can provide differentiated expectations between three healthcare dimensions. Methods  One thousand two‐hundred eleven individuals participated in a telephone interview. Participants were asked two series of questions, one regarding their views on the primary care, prevention and promotion practices they experience with their healthcare provider and one regarding the importance of these practices to them. We calculated a difference score representing the gap in each healthcare dimension. Findings  In all three healthcare dimensions, the mean gap is in the positive side of the axis indicating that the public does not receive what it expects to receive, or in policy terms there is ‘a responsiveness deficit’. The mean gap in relation to primary care is significantly lower than the mean gap in both preventive care and health promotion. Conclusions  The public can provide meaningful information even in areas of endless demand and can provide an addition point of view to be considered by policy makers in complicated healthcare rationing decisions. PMID:22738086

Rethinking Difficulties of Teaching Inquiry-Based Practical Work: Stories from elementary pre-service teachers

NASA Astrophysics Data System (ADS)

Kim, Mijung; Tan, Aik-Ling

2011-03-01

To alleviate teachers' reluctance toward practical work, there has been much discussion on teachers' pedagogical content knowledge, teaching materials, and failsafe strategies for practical work. Despite these efforts, practical work is still regarded as a challenging task for many elementary science teachers. To understand the complexity of teachers' conflicts in practical work, this study examines teachers' ideas about teaching and learning that influence teachers' decision-making and action on teaching practical work. More important than knowing technical-rational aspects of practical work is to understand the internal contradictions that teachers have to resolve within themselves regarding their capabilities and beliefs about science teaching and practical work. Using stories and experiences of 38 third-year university students in a science method course in Korea, we seek to understand the conflicts and negotiations that they experience as they make decisions regarding practical work throughout their course. Reflective writings and group discussions on their lived experiences and concerns were used to probe participants' ideas on teaching using practical work. From written and verbal data, themes were saturated in terms of the aspects which could (dis)encourage their practice. Results suggest that there are multifactorial challenges in pre-service teachers' understandings and concerns in practical work. Besides time, materials, and curriculum, pedagogical assumptions and values also compositely challenge the minds of teachers. As the pre-service elementary teachers negotiated within themselves the importance of science in classroom and social levels, the question is raised about their identities as pre-service elementary teachers to appreciate the balance between science teaching and practical work.

CoPs Facing Rationalization: The Politics of Community Reproduction

ERIC Educational Resources Information Center

Kilskar, Stine Skaufel; Ingvaldsen, Jonas A.; Valle, Nina

2018-01-01

Purpose: This paper aims to explore the relationship between the contemporary forms of manufacturing rationalization and the reproduction of communities of practice (CoPs) centred on tasks and craft. Building on critical literature highlighting the tensions between CoPs and rationalization, this paper aims to develop a nuanced account of how CoPs…

Rational drug use--evaluation of a training programme for interns.

PubMed

Natu, M V; Zachariah, P; Zachariah, A; Chand, S; Singh, T; Choudhry, K

1995-09-01

A workshop covering various aspects of rational drug use was conducted for interns of Christian Medical College, Ludhiana. Evaluation of the workshop revealed that it was able to bring about an attitudinal change regarding rational drug use. The methodology and evaluation procedures have been described. It is suggested that similar attempts should be made at all medical colleges so that every graduate enters medical practice with a positive attitude towards rational drug use.

Reversing the gaze: constructing European race discourse as modern witchcraft practice.

PubMed

Perkinson, James W

2004-01-01

In keeping with the challenge of (African American) historian of religions Charles Long to develop a mode of postcolonial encounter that is a process of mutual hermeneusis, I am proposing in this article to think "race" in terms of "indigenous ritual." At the very least it is an effort to relativize the western scientific paradigm and the universalizing humanities discourses that have nestled close to that paradigm. It is not an attempt to repudiate such an episteme but, rather-to borrow a jazz term-to "swing" it, to put it in antiphonal and improvisational circulation. More specifically, this article will trace a thought experiment, probing the historical emergence of white supremacist practice as a kind of modernist embodiment of "witchcraft discourse," which functions-in the institutional grammar it has left on deposit in contemporary social practice and the "intention to consume" (the substance of others) that it "rationalizes"-very much like the "primitive superstitions" it seeks to name and repudiate in positing its own rationalizing superiority. In such an enterprise, witchcraft, I am arguing, can be "good to think with" as a mode of communicative action, signifying with a kind of "boomerang effect" in the intercultural space of rupture between the West and the rest.

Rationality, practice variation and person‐centred health policy: a threshold hypothesis

PubMed Central

Hamm, Robert M.; Mayrhofer, Thomas; Hozo, Iztok; Van den Ende, Jef

2015-01-01

Abstract Variation in practice of medicine is one of the major health policy issues of today. Ultimately, it is related to physicians' decision making. Similar patients with similar likelihood of having disease are often managed by different doctors differently: some doctors may elect to observe the patient, others decide to act based on diagnostic testing and yet others may elect to treat without testing. We explain these differences in practice by differences in disease probability thresholds at which physicians decide to act: contextual social and clinical factors and emotions such as regret affect the threshold by influencing the way doctors integrate objective data related to treatment and testing. However, depending on a theoretical construct each of the physician's behaviour can be considered rational. In fact, we showed that the current regulatory policies lead to predictably low thresholds for most decisions in contemporary practice. As a result, we may expect continuing motivation for overuse of treatment and diagnostic tests. We argue that rationality should take into account both formal principles of rationality and human intuitions about good decisions along the lines of Rawls' ‘reflective equilibrium/considered judgment’. In turn, this can help define a threshold model that is empirically testable. PMID:26639018

Delusions as performance failures.

PubMed

Gerrans, P

2001-08-01

Delusions are explanations of anomalous experiences. A theory of delusion requires an explanation of both the anomalous experience and the apparently irrational explanation generated by the delusional subject. Hence, we require a model of rational belief formation against which the belief formation of delusional subjects can be evaluated. I first describe such a model, distinguishing procedural from pragmatic rationality. Procedural rationality is the use of rules or procedures, deductive or inductive, that produce an inferentially coherent set of propositions. Pragmatic rationality is the use of procedural rationality in context. I then apply the distinction to the explanation of the Capgras and the Cotard delusions. I then argue that delusions are failures of pragmatic rationality. I examine the nature of these failures employing the distinction between performance and competence familiar from Chomskian linguistics. This approach to the irrationality of delusions reconciles accounts in which the explanation of the anomalous experience exhausts the explanation of delusion, accounts that appeal to further deficits within the reasoning processes of delusional subjects, and accounts that argue that delusions are not beliefs at all. (Respectively, one-stage, two-stage, and expressive accounts.) In paradigm cases that concern cognitive neuropsychiatry the irrationality of delusional subjects should be thought of as a performance deficit in pragmatic rationality.

Intercultural palliative care: do we need cultural competence?

PubMed

Gunaratnam, Yasmin

2007-10-01

Recognition of the importance of 'cultural competence' is now central to health care policy and to nurse education and training across the international spectrum. Detailed engagement with models of cultural competence is comparatively recent in palliative care nursing. This article presents the findings from a development project on elders and carers from 'minority ethnic' groups, funded by the Department of Health, to increase awareness of palliative care and to improve understanding of the needs of these groups of service users. The article describes the experiences of nurses involved in the delivery of palliative care who were interviewed in focus groups as a part of the project. It draws attention to the complicated relationships between cultural knowledge and practice and to the non-rational and visceral dimensions of intercultural care. These aspects of nursing are marginalised in current approaches to cultural competence, which emphasise the rational acquisition and application of cultural knowledge and skills by practitioners. It is suggested that recognition of these marginalised experiences can contribute to the development of new approaches to intercultural nursing that are also more attuned to the ethos and values of palliative care.

Equal status in Ultimatum Games promotes rational sharing.

PubMed

Han, Xiao; Cao, Shinan; Bao, Jian-Zhang; Wang, Wen-Xu; Zhang, Boyu; Gao, Zi-You; Sánchez, Angel

2018-01-19

Experiments on the Ultimatum Game (UG) repeatedly show that people's behaviour is far from rational. In UG experiments, a subject proposes how to divide a pot and the other can accept or reject the proposal, in which case both lose everything. While rational people would offer and accept the minimum possible amount, in experiments low offers are often rejected and offers are typically larger than the minimum, and even fair. Several theoretical works have proposed that these results may arise evolutionarily when subjects act in both roles and there is a fixed interaction structure in the population specifying who plays with whom. We report the first experiments on structured UG with subjects playing simultaneously both roles. We observe that acceptance levels of responders approach rationality and proposers accommodate their offers to their environment. More precisely, subjects keep low acceptance levels all the time, but as proposers they follow a best-response-like approach to choose their offers. We thus find that status equality promotes rational sharing while the influence of structure leads to fairer offers compared to well-mixed populations. Our results are far from what is observed in single-role UG experiments and largely different from available predictions based on evolutionary game theory.

The Concept of Practice, Enlightenment Rationality and Education: A Speculative Reading of Michel de Certeau's "The Writing of History"

ERIC Educational Resources Information Center

Giles, Graham

2014-01-01

This article proposes a reading of Michel de Certeau's "The Writing of History" which derives an understanding of the concept of practice as authoritative to the establishment and development of Enlightenment rationality. It is seen as a new form of legitimation established in the redeployment of religious "formalities" in…

Three S's for Teaching Consumer Economics.

ERIC Educational Resources Information Center

Karjala, Jeanette A.

1989-01-01

Business educators have an opportunity to help students develop skills and acquire knowledge necessary to become rational consumers. Involving students is more effective than using lectures--it encourages the practice of rational decision making. (JOW)

Consultant paediatric outreach clinics--a practical step in integration.

PubMed

Spencer, N J

1993-04-01

Ten years' experience of paediatric outreach clinics is reviewed and evaluated. The advantages and disadvantages of paediatric outreach and its possible place in the new era of contracting and more developed community paediatric services are discussed. It is concluded that paediatric outreach increases parental and professional choice and access to paediatric consultant services, increases service flexibility, reduces unnecessary hospital visits, and enables more rational and relevant clinical decision making. Outreach is particularly relevant in areas of deprivation where paediatric needs are greatest.

Consultant paediatric outreach clinics--a practical step in integration.

PubMed Central

Spencer, N J

1993-01-01

Ten years' experience of paediatric outreach clinics is reviewed and evaluated. The advantages and disadvantages of paediatric outreach and its possible place in the new era of contracting and more developed community paediatric services are discussed. It is concluded that paediatric outreach increases parental and professional choice and access to paediatric consultant services, increases service flexibility, reduces unnecessary hospital visits, and enables more rational and relevant clinical decision making. Outreach is particularly relevant in areas of deprivation where paediatric needs are greatest. PMID:8503675

Teaching Rational Number Addition Using Video Games: The Effects of Instructional Variation. CRESST Report 808

ERIC Educational Resources Information Center

Vendlinski, Terry P.; Chung, Greg K. W. K.; Binning, Kevin R.; Buschang, Rebecca E.

2011-01-01

Understanding the meaning of rational numbers and how to perform mathematical operations with those numbers seems to be a perennial problem in the United States for both adults and children. Based on previous work, we hypothesized that giving students more time to practice using rational numbers in an environment that enticed them to apply their…

Defensive medicine: No wonder policymakers are confused.

PubMed

Kapp, Marshall B

2016-01-01

Discussions regarding defensive medical practice often result in proposals for public policy actions. Such proposals generally are premised on assumptions about defensive medicine, namely, that it (a) is driven by physicians' legal anxieties, (b) constitutes bad medical practice, (c) drives up health care costs, (d) varies depending on a jurisdiction's particular tort law climate, (e) depends on medical specialty and a physician's own prior experience as a malpractice defendant, and (f) is a rational response to actual legal risks confronting physicians. This article examines a sample of recent literature focusing on defensive medicine and finds that the messages conveyed vary widely, helping to explain the confusion experienced by many policymakers trying to improve the quality and affordability of health care.

[The concept of "understanding" (Verstehen) in Karl Jaspers].

PubMed

Villareal, Helena; Aragona, Massimiliano

2014-01-01

This article explores the relationship between empathy and psychopathology. It deals with the concept of "understanding" in Jaspers' General Psychopathology, 100 years after the publication of its first edition. The Jaspersian proposal has the person and his/her experience as its primary object of study, just as in Ortegas' vital reason. Jaspers' understanding is not rational but empathetic, based on the co-presence of emotional content and detailed descriptions. Jaspers' methodology is essentially pluralistic, considering both explanation and understanding, necessary for psychopathology. Despite certain limits, the concept of understanding is the backbone of the psychopathological reasoning, and has proven useful over a century of clinical practice. However, it needs a review covering the recent epistemological and clinical findings. "To be understandable" is a relational property that emerges from a semiotic process. Therefore, an effective psychology should encompass an inter-subjective process, and get away from strict rationalism.

Un-Rational Behaviour? What Causes Discrepancies between Teachers' Attitudes towards Evidence Use and Actual Instances of Evidence Use in Schools?

ERIC Educational Resources Information Center

Brown, Chris; Zhang, Dell

2016-01-01

Purpose: Whilst beneficial, the use of evidence to improve teaching and learning in schools is proving difficult to achieve in practice. The purpose of this paper is to shed new light on this issue by examining the applicability of a model of rational behaviour as relates to the notion of evidence-informed practice (EIP). Specifically, exploring…

How to reconcile the multiculturalist and universalist approaches to science education

NASA Astrophysics Data System (ADS)

Hansson, Sven Ove

2017-06-01

The "multiculturalist" and "universalist" approaches to science education both fail to recognize the strong continuities between modern science and its forerunners in traditional societies. Various fact-finding practices in indigenous cultures exhibit the hallmarks of scientific investigations, such as collectively achieved rationality, a careful distinction between facts and values, a search for shared, well-founded judgments in empirical matters, and strivings for continuous improvement of these judgments. Prominent examples are hunters' discussions when tracking a prey, systematic agricultural experiments performed by indigenous farmers, and remarkably advanced experiments performed by craftspeople long before the advent of modern science. When the continuities between science and these prescientific practices are taken into account, it becomes obvious that the traditional forms of both multiculturalism and universalism should be replaced by a new approach that dissolves the alleged conflict between adherence to modern science and respect for traditional cultures.

Competence, practical rationality and what a patient values.

PubMed

Craigie, Jillian

2011-07-01

According to the principle of patient autonomy, patients have the right to be self-determining in decisions about their own medical care, which includes the right to refuse treatment. However, a treatment refusal may legitimately be overridden in cases where the decision is judged to be incompetent. It has recently been proposed that in assessments of competence, attention should be paid to the evaluative judgments that guide patients' treatment decisions. In this paper I examine this claim in light of theories of practical rationality, focusing on the difficult case of an anorexic person who is judged to be competent and refuses treatment, thereby putting themselves at risk of serious harm. I argue that the standard criteria for competence assess whether a treatment decision satisfies the goals of practical decision-making, and that this same criterion can be applied to a patient's decision-guiding commitments. As a consequence I propose that a particular understanding of practical rationality offers a theoretical framework for justifying involuntary treatment in the anorexia case. © 2009 Blackwell Publishing Ltd.

Ritual and rational action in hospitals.

PubMed

Chapman, G E

1983-01-01

Menzies argues that nursing hierarchies and ritual practices protect nurses from the anxieties provoked by encountering human suffering. This proposition is examined with particular reference to ritual practices in nursing. It is argued that Menzies studied nurses in isolation from the societal and subcultural norms and values which direct hospital activity. Her psychodynamic model is contrasted with a sociological model of human conduct and action. The characteristics of ritual and rational action, and the difference between non-rational and irrational rituals, is explored. The findings of three 5-month periods of participant observation are presented as illustrative case material to support the authors view, that ritual procedures are not only defence mechanisms against anxiety, but social acts which generate and convey meaning. Ritual practices described in this analysis include rituals surrounding birth, death, status and power. It is concluded that if nurses wish to change or alter ritual nursing practices in hospital it is necessary to understand their social as well as their psychological meaning.

Rationalising prescribing: Evidence, marketing and practice-relevant knowledge.

PubMed

Wadmann, Sarah; Bang, Lia E

2015-06-01

Initiatives in the name of 'rational pharmacotherapy' have been launched to alter what is seen as 'inappropriate' prescribing practices of physicians. Based on observations and interviews with 20 general practitioners (GPs) in 2009-2011, we explored how attempts to rationalise prescribing interact with chronic care management in Denmark. We demonstrate how attempts to rationalise prescribing by informing GPs about drug effects, adverse effects and price do not satisfy GPs' knowledge needs. We argue that, for GPs, 'rational' prescribing cannot be understood in separation from the processes that enable patients to use medication. Therefore, GPs do much more to obtain knowledge about medications than seek advice on 'rational pharmacotherapy'. For instance, GPs also seek opportunities to acquaint themselves with the material objects of medication and medical devices. We conceptualise the knowledge needs of GPs as a need for practice-relevant knowledge and argue that industry sales representatives are granted opportunity to access general practice because they understand this need of GPs. Copyright © 2015 Elsevier Ltd. All rights reserved.

Carbon footprint and land requirement for dairy herd rations: impacts of feed production practices and regional climate variations.

PubMed

Henriksson, M; Cederberg, C; Swensson, C

2014-08-01

Feed production is a significant source of greenhouse gas (GHG) emissions from dairy production and demands large arable and pasture acreage. This study analysed how regional conditions influence GHG emissions of dairy feed rations in a life cycle perspective, that is the carbon footprint (CF) and the land area required. Factors assessed included regional climate variations, grass/clover silage nutrient quality, feedstuff availability, crop yield and feed losses. Using the Nordic feed evaluation model NorFor, rations were optimised for different phases of lactation, dry and growing periods for older cows, first calvers and heifers by regional feed advisors and combined to annual herd rations. Feed production data at farm level were based on national statistics and studies. CF estimates followed standards for life cycle assessment and used emissions factors provided by IPCC. The functional unit was 'feed consumption to produce 1 kg energy corrected milk (ECM) from a cow with annual milk yield of 9 900 kg ECM including replacement animals and feed losses'. Feed ration CF varied from 417 to 531 g CO2 e/kg ECM. Grass/clover silage contributed more than 50% of total GHG emissions. Use of higher quality silage increased ration CF by up to 5% as a result of an additional cut and increased rates of synthetic N-fertiliser. Domestically produced horse bean (Vicia faba), by-products from the sugar industry and maize silage were included in the rations with the lowest CF, but horse bean significantly increased ration land requirement. Rations required between 1.4 to 2 m2 cropland and 0.1 to 0.2 m2/kg semi-natural grassland per kg ECM and year. Higher yield levels reduced ration total CF. Inclusion of GHG emissions from land use change associated with Brazilian soya feed significantly increased ration CF. Ration CF and land use depended on ration composition, which was highly influenced by the regional availability and production of feedstuffs. The impact of individual feedstuffs on ration CF varies due to, for example, cultivation practices and climate conditions and feedstuffs should therefore be assessed in a ration and regional perspective before being used to decrease milk CF. Land use efficiency should be considered together with ration CF, as these can generate goal conflicts.

[Participative action research; self-care education for the mature adult, a dialogic and empowered process].

PubMed

Sanchez Gomez, Sheila; Medina Moya, José Luis; Mendoza Pérez de Mendiguren, Beatriz; Ugarte Arena, Ana Isabel; Martínez de Albéniz Arriaran, Mercedes

2015-11-01

Explore and transform dialogic-reflexive learning processes oriented to self-care, capacitation, empowerment and health promotion for "mature-adult" collective. Participative action research on a qualitative and sociocritic approach. Data generation methods are SITE: Field work focuses on the development of the educational program "Care is in your hands" that takes place in two villages (Primary Care. Comarca Araba). Through a theoretical sampling involved people who are in a "mature-adult" life stage and three nurses with extensive experience in development health education programs. Participant observation where health education sessions are recorded in video and group reflection on action. To triangulate the data, have been made in-depth interviews with 4 participants. Carried out a content and discourse analysis. Participant and nurses' Previous Frameworks, and these last ones' discourses as well, reveal a current technical rationality (unidirectional, informative,.) yet in practice that perpetuates the role of passive recipient of care. Educational keys constructed from a viewpoint of Dialogic Learning emerge as elements that facilitate overcoming these previous frames limitations. Finally, Reflective Learning launched, has provided advance in professional knowledge and improve health education. Dialogical learning emerges as key to the training and empowerment, where we have seen how practical-reflexive, and not technical, rationality is meanly useful confronting ambiguous and complex situations of self-care practice and education. Copyright © 2014 Elsevier España, S.L.U. All rights reserved.

Would you rather take orders from Kirk or Spock? The relation between rational thinking and intelligence.

PubMed

Sternberg, R J

1993-10-01

This article considers the relation between rationality and intelligence. The article is divided into three main parts: In the first, I consider the concept of rationality and conclude that rational thinking is a part of intelligence, but not a major part. In the second, I consider Stanovich's concept of dysrationalia, and propose that an alternative concept, practical intelligence (or the lack thereof), may better accomplish the goals that Stanovich wishes to achieve with his concept. Finally, I draw some conclusions.

When general practitioners meet new evidence: an exploratory ethnographic study

PubMed Central

Olsen, Ole

2017-01-01

Objective To explore how general practitioners (GPs) think and act when presented with new evidence in relation to planned home birth and a proposal to change information practices. Design Exploratory ethnographic study of GPs. The GPs were encountered one or more times during a two-year period, 2011–2013, while the author tried to set up formal focus group interviews. Dialogues about the evidence, personal experiences, values and other issues unavoidably occurred. Field notes were written concomitantly. Setting Danish GPs, primarily in Copenhagen. Subjects Fifty Danish GPs. Results The GPs reacted very differently, both spontaneously and later. Spontaneous reactions were often emotional involving private and professional experiences whereas later reactions were more influenced by rational deliberations. Approximately half the GPs (n = 18) who were asked whether they would personally hand out the local information leaflet about home birth were prepared to do so. The time lag between presentation of the evidence and the GPs’ decision to hand out the leaflets was up to one and a half year. Conclusions A significant number of GPs were prepared to change their information practices. However, for many GPs, the new evidence challenged previous perceptions, and ample time and resources for dialogue, deliberations and adaptation to local circumstances were required to accommodate change. Implications Changing information practices on a larger scale will require a systematic approach involving key stakeholders. Key Points Current awareness•Patients and pregnant women should receive evidence-based information about possible choices of care – also in relation to place of birth. Most important results•Doctors often find the new evidence supporting planned home birth counterintuitive and spontaneously react emotionally rather than rationally to the evidence.•The new evidence challenging previous views elicits fast, emotional reactions, later deliberate reflections, perhaps cognitive dissonance and, finally, for some, change in clinical practice. Significance for the readers•The findings may be applicable to other fields where an evidence-based choice between an interventionist and a conservative approach is relevant. PMID:29183265

When general practitioners meet new evidence: an exploratory ethnographic study.

PubMed

Olsen, Ole

2017-12-01

To explore how general practitioners (GPs) think and act when presented with new evidence in relation to planned home birth and a proposal to change information practices. Exploratory ethnographic study of GPs. The GPs were encountered one or more times during a two-year period, 2011-2013, while the author tried to set up formal focus group interviews. Dialogues about the evidence, personal experiences, values and other issues unavoidably occurred. Field notes were written concomitantly. Danish GPs, primarily in Copenhagen. Fifty Danish GPs. The GPs reacted very differently, both spontaneously and later. Spontaneous reactions were often emotional involving private and professional experiences whereas later reactions were more influenced by rational deliberations. Approximately half the GPs (n = 18) who were asked whether they would personally hand out the local information leaflet about home birth were prepared to do so. The time lag between presentation of the evidence and the GPs' decision to hand out the leaflets was up to one and a half year. A significant number of GPs were prepared to change their information practices. However, for many GPs, the new evidence challenged previous perceptions, and ample time and resources for dialogue, deliberations and adaptation to local circumstances were required to accommodate change. Changing information practices on a larger scale will require a systematic approach involving key stakeholders. Key Points Current awareness•Patients and pregnant women should receive evidence-based information about possible choices of care - also in relation to place of birth. Most important results•Doctors often find the new evidence supporting planned home birth counterintuitive and spontaneously react emotionally rather than rationally to the evidence.•The new evidence challenging previous views elicits fast, emotional reactions, later deliberate reflections, perhaps cognitive dissonance and, finally, for some, change in clinical practice. Significance for the readers•The findings may be applicable to other fields where an evidence-based choice between an interventionist and a conservative approach is relevant.

Testing two mechanisms by which rational and irrational beliefs may affect the functionality of inferences.

PubMed

Bond, F W; Dryden, W; Briscoe, R

1999-12-01

This article describes a role playing experiment that examined the sufficiency hypothesis of Rational Emotive Behaviour Therapy (REBT). This proposition states that it is sufficient for rational and irrational beliefs to refer to preferences and musts, respectively, if those beliefs are to affect the functionality of inferences (FI). Consistent with the REBT literature (e.g. Dryden, 1994; Dryden & Ellis, 1988; Palmer, Dryden, Ellis & Yapp, 1995) results from this experiment showed that rational and irrational beliefs, as defined by REBT, do affect FI. Specifically, results showed that people who hold a rational belief form inferences that are significantly more functional than those that are formed by people who hold an irrational belief. Contrary to REBT theory, the sufficiency hypothesis was not supported. Thus, results indicated that it is not sufficient for rational and irrational beliefs to refer to preferences and musts, respectively, if those beliefs are to affect the FI. It appears, then, that preferences and musts are not sufficient mechanisms by which rational and irrational beliefs, respectively, affect the FI. Psychotherapeutic implications of these findings are considered.

Specialty training and the personal use of benzodiazepines by physicians affect their proneness to prescribe tranquilizers.

PubMed

Linden, M; Gothe, H

1998-03-01

The decision on how to treat a patient does not depend on clinical matters or illness characteristics alone, but also on patient, physician and setting variables such as personality, training, or reimbursement. No research has yet been carried out to answer the question whether personal experience with medications also influences prescribing behavior. In this study, 124 physicians stratified according to specialty (neuropsychiatrists vs. general practitioners), type of institution (private practice vs. hospital), years of professional experience (young vs. old), and region (rural vs. urban) participated in a structured interview to evaluate their proneness to prescribe benzodiazepines for sleep disorders as well as their personal experience in taking benzodiazepines for their own sleep problems. Both specialty and personal experience were significantly related to proneness to prescribe. Other variables tested (region, institution, age, gender) did not help to explain the variance in benzodiazepine prescribing practice. Thus physician variables and, importantly, their own personal experience in taking the medication significantly influence treatment choice. Rational medical decision making and treatment guidelines must therefore take into account medical knowledge as well as knowledge of personal treatment preferences and professional biases.

The Warrant for Constructivist Practice within Educational Technology.

ERIC Educational Resources Information Center

Bopry, Jeanette

1999-01-01

Discusses educational technology as a form of technical rationality and considers the conflict between practitioners' epistemological position as constructivists and technical rationality. Topics include cybernetics; autonomous systems theory; enactive constructivism; representation versus effective action; mind and memory; enaction in artificial…

Effects of rational emotive occupational health therapy intervention on the perceptions of organizational climate and occupational risk management practices among electronics technology employees in Nigeria

PubMed Central

Ogbuanya, Theresa Chinyere; Eseadi, Chiedu; Orji, Chibueze Tobias; Ede, Moses Onyemaechi; Ohanu, Ifeanyi Benedict; Bakare, Jimoh

2017-01-01

Abstract Background: Improving employees’ perception of organizational climate, and coaching them to remain steadfast when managing occupational risks associated with their job, might have an important effect on their psychosocial wellbeing and occupational health. This study examined the effects of a rational emotive occupational health therapy intervention program on the perceptions of organizational climate and occupational risk management practices. Methods: The participants were 77 electronics technology employees in the south-east of Nigeria. The study used a pretest–posttest control group design. Results: The rational emotive occupational health therapy intervention program significantly improved perceptions of the organizational climate for the people in the treatment group compared to those in the waitlist control group at post-intervention and follow-up assessments. Occupational risk management practices of the employees in the treatment group were also significantly better than those in the waitlist control group at the same 2 assessments. Conclusions: Corporate application of a rational emotive behavior therapy as an occupational health therapy intervention program is essential for improving the perceptions of organizational climate and promoting the adoption of feasible occupational risk management strategies in the workplace. PMID:28471971

Effects of rational emotive occupational health therapy intervention on the perceptions of organizational climate and occupational risk management practices among electronics technology employees in Nigeria.

PubMed

Ogbuanya, Theresa Chinyere; Eseadi, Chiedu; Orji, Chibueze Tobias; Ede, Moses Onyemaechi; Ohanu, Ifeanyi Benedict; Bakare, Jimoh

2017-05-01

Improving employees' perception of organizational climate, and coaching them to remain steadfast when managing occupational risks associated with their job, might have an important effect on their psychosocial wellbeing and occupational health. This study examined the effects of a rational emotive occupational health therapy intervention program on the perceptions of organizational climate and occupational risk management practices. The participants were 77 electronics technology employees in the south-east of Nigeria. The study used a pretest-posttest control group design. The rational emotive occupational health therapy intervention program significantly improved perceptions of the organizational climate for the people in the treatment group compared to those in the waitlist control group at post-intervention and follow-up assessments. Occupational risk management practices of the employees in the treatment group were also significantly better than those in the waitlist control group at the same 2 assessments. Corporate application of a rational emotive behavior therapy as an occupational health therapy intervention program is essential for improving the perceptions of organizational climate and promoting the adoption of feasible occupational risk management strategies in the workplace.

A gut feeling? Intuition and critical care nursing.

PubMed

Hams, S P

2000-10-01

As nurses, we are knowledgeable about nursing and able, immediately and intuitively, to identify the needs and demands of a given situation. Experienced nurses practise intuitively by virtue of having developed, through critical thought, a deeply grounded knowledge base that can be applied in daily practice. Each gains knowledge about nursing practice in such a way that every clinical experience becomes a lesson which informs the next experience. There is continued debate over the domain of nursing knowledge, where it originates and to whom it belongs. Much of nursing knowledge has emerged from the practice of other professions. There now appears to be an increasing focus within today's modern healthcare environment on the importance of measurable outcomes and the need to predict the consequences of all interventions. The strength of our intuition often urges us to do something more for the patient. When we as nurses report our intuitions, subjective feelings are often at odds with the objective signs and symptoms. Nurses have made great strides in recognizing, analysing and teaching concepts related to logical, rational decision-making. It is imperative, however, also to recognize and teach the concepts related to the intuitive and precognitive components of making decisions in clinical practice.

Reflections on Rational-Emotive Therapy.

ERIC Educational Resources Information Center

Ellis, Albert

1993-01-01

Reflects rational-emotive therapy (RET) in 1955 and discusses some of its recent constructivist and humanist theories and practice. Distinguishes between general RET, called synonymous with general cognitive-behavioral therapy, from preferential RET, called unique kind of cognitive therapy that partially overlaps with general cognitive-behavioral…

Rational Choice and the Framing of Decisions.

DTIC Science & Technology

1986-05-29

decision under risk is the deriva- .- tion of the expected utility rule from simple principles of rational choice that make no . reference to long-run...corrective power of incentives depends on the nature of the particular error and cannot be taken for granted. The assumption of rationality of decision making ...easily eliminated by experience must be demonstrated. Finally, it is sometimes argued that failures of rationality in individual decision making are

Are Grade Expectations Rational? A Classroom Experiment

ERIC Educational Resources Information Center

Hossain, Belayet; Tsigaris, Panagiotis

2015-01-01

This study examines students' expectations about their final grade. An attempt is made to determine whether students form expectations rationally. Expectations in economics, rational or otherwise, carry valuable information and have important implications in terms of both teaching effectiveness and the role of grades as an incentive structure for…

Priority setting in clinical nursing practice: literature review.

PubMed

Hendry, Charles; Walker, Anne

2004-08-01

Time is a valuable resource. When nurses experience demands on their services which exceed their available time, then 'rationing' must occur. In clinical practice such rationing requires practitioners to set priorities for care. The aim of this paper is establish what is currently known about priority setting in nursing, including how nurses set priorities and what factors influence this. CINAHL, Medline, ASSIA, and PsychLit databases for the years 1982-2002 were searched, using the terms (clinical decision-making or problem-solving or planning) and (setting priorities or prioriti*). The publications found were used in a selective, descriptive review. Priority setting is an important skill in nursing, and a skill deficit can have serious consequences for patients. Recent studies have suggested that it is a difficult skill for newly qualified nurses to acquire and may not be given sufficient attention in nurse education. Priority setting can be defined as the ordering of nursing problems using notions of urgency and/or importance, in order to establish a preferential order for nursing actions. A number of factors that may impact on priority setting have been identified in the literature. These include: the expertise of the nurse; the patient's condition; the availability of resources; ward organization; philosophies and models of care; the nurse-patient relationship; and the cognitive strategy used by the nurse to set priorities. However, very little empirical work has been conducted in this area. Further study of priority setting in a range of clinical practice settings is necessary. This could inform both practice and education, promote better use of limited resources and maximize patient outcomes.

[Theoretical and practical considerations in rational polytherapy for epilepsy].

PubMed

Rajna, Péter

2011-11-30

Author analyses the consideration of rational polytherapy for epilepsy. Among the theoretical aspects he points the different effect of seizure inhibitory drugs on the epilepsy models but didn't find data enough for the basis of any successful combination. Combinations of compounds having different way of action are more promising. Rational polytherapy can serve also the epileptic patients' tailored therapy in the daily routine. There have already been some proved synergisms concerning drug interactions. Based on detailed analysis of side effects a possibility occurs for neutralization of side effects when anticonvulsants with side effects of opposite nature are combined. Considering both the side effect profiles and the different (somatic and psychic) habits of the patients we can create a special list of favourable combinations. Co-morbid states and their treatments play a significant role in the application of rational polytherapy. Combination of anticonvulsants of lower potential but without drug-interactions can be the choice in these cases. The non-epileptic indications of the anticonvulsants can also be utilized in polymorbid patients. Based on the theoretical and practical considerations the author defines the ten-step-cognitive-preparation-process in planning the optimal (poly)therapy. On speculative basis he suggests eight beneficial versions of seizure inhibitory rational polytherapy.

Resisting Consumerist Rationalities in Higher Vocational Education

ERIC Educational Resources Information Center

Puaca, Goran; Theandersson, Christer; Carlén, Margareta

2017-01-01

Swedish higher education policy is currently moving toward consumption ideals that focus on promoting the efficiency and economic viability of student choices. This paper scrutinizes students' practical considerations when making decisions regarding their education and future occupations and the choice rationalities and motives that these reflect.…

Adding a Systemic Touch to Rational-Emotive Therapy for Families.

ERIC Educational Resources Information Center

Russell, Todd T.; Morrill, Correen M.

1989-01-01

Proposes a theoretical and practical hybrid model for family counseling based on integrating the rational-emotive and family systems approach. Notes that these combined approaches offer the counselor a systematic theoretical structure for conceptualizing family dysfunction, from which additional strategies for changing inappropriate belief systems…

Rational decision making in medicine: Implications for overuse and underuse.

PubMed

Djulbegovic, Benjamin; Elqayam, Shira; Dale, William

2018-06-01

In spite of substantial spending and resource utilization, today's health care remains characterized by poor outcomes, largely due to overuse (overtesting/overtreatment) or underuse (undertesting/undertreatment) of health services. To a significant extent, this is a consequence of low-quality decision making that appears to violate various rationality criteria. Such suboptimal decision making is considered a leading cause of death and is responsible for more than 80% of health expenses. In this paper, we address the issue of overuse or underuse of health care interventions from the perspective of rational choice theory. We show that what is considered rational under one decision theory may not be considered rational under a different theory. We posit that the questions and concerns regarding both underuse and overuse have to be addressed within a specific theoretical framework. The applicable rationality criterion, and thus the "appropriateness" of health care delivery choices, depends on theory selection that is appropriate to specific clinical situations. We provide a number of illustrations showing how the choice of theoretical framework influences both our policy and individual decision making. We also highlight the practical implications of our analysis for the current efforts to measure the quality of care and link such measurements to the financing of health care services. © 2017 The Authors. Journal of Evaluation in Clinical Practice Published by John Wiley & Sons Ltd.

Turkish Senior Nursing Students' Communication Experience With English-Speaking Patients.

PubMed

Guvenc, Gulten; Unver, Vesile; Basak, Tulay; Yuksel, Cigdem; Ayhan, Hatice; Kok, Gulsah; Konukbay, Dilek; Kose, Gulsah; Aslan, Ozlem; Tastan, Sevinc; Iyigun, Emine

2016-02-01

Simulation has been widely accepted as a valuable learning method in nursing education programs so that nursing students can learn and develop communication skills. The aim of this study was to evaluate nursing students' communication experience with an English-speaking standardized patient in the context of the Rational Administration of Medicines course. Involving both quantitative and qualitative research designs, this descriptive study was conducted with 104 nursing students in Ankara, Turkey, from September 2012 to July 2013. The majority (98.1%) of the participants stated the necessity of improving their English to communicate with English-speaking patients. Three overarching categories, including seven themes, emerged from the description of nursing students' experience: recognition of emotions, experiences during the simulation, and gains. Standardized patient practice emphasized the significance of cultural differences, of knowing and using a foreign language, of communication, and of patient safety. Copyright 2016, SLACK Incorporated.

On the Other Hand Am I Rational? Hemispheric Activation and the Framing Effect

ERIC Educational Resources Information Center

McElroy, Todd; Seta, John J.

2004-01-01

In recent decades the investigation of framing effects has become the foremost studied phenomenon of rational/irrational decision making. Two experiments were conducted to determine whether the functional specializations of the left and the right hemispheres would produce different responses to a traditional framing task. In Experiment 1, a…

Rational non-interventional paternalism: why doctors ought to make judgments of what is best for their patients.

PubMed

Savulescu, J

1995-12-01

This paper argues that doctors ought to make all things considered value judgments about what is best for their patients. It illustrates some of the shortcomings of the model of doctor as 'fact-provider'. The 'fact-provider' model fails to take account of the fact that practising medicine necessarily involves making value judgments; that medical practice is a moral practice and requires that doctors reflect on what ought to be done, and that patients can make choices which fail to express their autonomy and which are based on mistaken judgments of value. If doctors are properly to respect patient autonomy and to function as moral agents, they must make evaluations of what their patients ought to do, all things considered. This paper argues for 'rational, non-interventional paternalism'. This is a practice in which doctors form conceptions of what is best for their patients and argue rationally with them. It differs from old-style paternalism in that it is not committed to doing what is best.

Should informed consent be based on rational beliefs?

PubMed Central

Savulescu, J; Momeyer, R W

1997-01-01

Our aim is to expand the regulative ideal governing consent. We argue that consent should not only be informed but also based on rational beliefs. We argue that holding true beliefs promotes autonomy. Information is important insofar as it helps a person to hold the relevant true beliefs. But in order to hold the relevant true beliefs, competent people must also think rationally. Insofar as information is important, rational deliberation is important. Just as physicians should aim to provide relevant information regarding the medical procedures prior to patients consenting to have those procedures, they should also assist patients to think more rationally. We distinguish between rational choice/action and rational belief. While autonomous choice need not necessarily be rational, it should be based on rational belief. The implication for the doctrine of informed consent and the practice of medicine is that, if physicians are to respect patient autonomy and help patients to choose and act more rationally, not only must they provide information, but they should care more about the theoretical rationality of their patients. They should not abandon their patients to irrationality. They should help their patients to deliberate more effectively and to care more about thinking rationally. We illustrate these arguments in the context of Jehovah's Witnesses refusing life-saving blood transfusions. Insofar as Jehovah's Witnesses should be informed of the consequences of their actions, they should also deliberate rationally about these consequences. PMID:9358347

Should informed consent be based on rational beliefs?

PubMed

Savulescu, J; Momeyer, R W

1997-10-01

Our aim is to expand the regulative ideal governing consent. We argue that consent should not only be informed but also based on rational beliefs. We argue that holding true beliefs promotes autonomy. Information is important insofar as it helps a person to hold the relevant true beliefs. But in order to hold the relevant true beliefs, competent people must also think rationally. Insofar as information is important, rational deliberation is important. Just as physicians should aim to provide relevant information regarding the medical procedures prior to patients consenting to have those procedures, they should also assist patients to think more rationally. We distinguish between rational choice/action and rational belief. While autonomous choice need not necessarily be rational, it should be based on rational belief. The implication for the doctrine of informed consent and the practice of medicine is that, if physicians are to respect patient autonomy and help patients to choose and act more rationally, not only must they provide information, but they should care more about the theoretical rationality of their patients. They should not abandon their patients to irrationality. They should help their patients to deliberate more effectively and to care more about thinking rationally. We illustrate these arguments in the context of Jehovah's Witnesses refusing life-saving blood transfusions. Insofar as Jehovah's Witnesses should be informed of the consequences of their actions, they should also deliberate rationally about these consequences.

Beyond Control and Rationality: Dewey, Aesthetics, Motivation, and Educative Experiences

ERIC Educational Resources Information Center

Wong, David

2007-01-01

Contemporary perspectives in psychology and education characterize ideal students as rational and in control of their thinking and actions. The good student is often described as intentional, cognitive, metacognitive, critical, and reflective. I begin with a brief history of control and rationality to establish how "The Tradition" is deeply rooted…

Development of quality measures for monitoring and improving care in gastroenterology.

PubMed

Germansky, Katharine A; Leffler, Daniel A

2011-06-01

Over the past decade, most quality assurance (QA) efforts in gastroenterology have been aimed at endoscopy. Endoscopic quality improvement was the rational area to begin QA work in gastroenterology due to the relatively acute nature of complications and the high volume of procedures performed. While endoscopy is currently the focus of most quality assurance (QA) measures in gastroenterology, more recent efforts have begun to address clinical gastroenterology practices both in the outpatient and inpatient settings. Clinical outpatient and inpatient gastroenterology is laden with areas where standardization could benefit patient care. While data and experience in clinical gastroenterology QA is relatively limited, it is clear that inconsistent use of guidelines and practice variations in gastroenterology can lead to lower quality care. In this review, we review a variety of areas in clinical gastroenterology where existing guidelines and published data suggest both the need and practicality of active QA measures. Copyright © 2011 Elsevier Ltd. All rights reserved.

Decision making and senior management: the implementation of change projects covering clinical management in SUS hospitals.

PubMed

Pacheco, José Márcio da Cunha; Gomes, Romeu

2016-08-01

This paper analyses the decision making process for senior management in public hospitals that are a part of the National Health Service in Brazil (hereafter SUS) in relation to projects aimed at changing clinical management. The methodological design of this study is qualitative in nature taking a hermeneutics-dialectics perspective in terms of results. Hospital directors noted that clinical management projects changed the state of hospitals through: improving their organizations, mobilizing their staff in order to increase a sense of order and systemizing actions and available resources. Technical rationality was the principal basis used in the decision making process for managers. Due to the reality of many hospitals having fragmented organizations, this fact impeded the use of aspects related to rationality, such as economic and financial factors in the decision making process. The incremental model and general politics also play a role in this area. We concluded that the decision making process embraces a large array of factors including rational aspects such as the use of management techniques and the ability to analyze, interpret and summarize. It also incorporates subjective elements such as how to select values and dealing with people's working experiences. We recognized that management problems are wide in scope, ambiguous, complex and do not come with a lot of structure in practice.

Compensatory growth in hybrid tilapia ( Oreochromis mossambicus ×O. niloticus) reared in seawater, following restricted feeding

NASA Astrophysics Data System (ADS)

Wang, Yan; Cui, Yibo; Yang, Yunxia; Cai, Fasheng

2004-12-01

Hybrid tilapia weighing 7.71 g were reared in seawater at 24.0 29.0°C for 8 weeks. The controls were fed to satiation twice a day throughout the experiment, whereas treatment groups were fed at 0.5%, 1.5% or 3.0% body weight per day for 4 weeks, and then to satiation for the remainder of the experiment. During the first 4-week period, there was a curvilinear relationship between growth rate and ration size. Fish fed 0.5% and 1.5% rations displayed compensatory growth response of 2 weeks duration during realimentation. The weight-adjusted growth rate of fish fed at 3% ration was not significantly different from that of the controls by the end of the experiment, when none of the treatment groups had caught up in body weight with the controls. Hyperphagia was observed for the first 2 weeks of realimenatation in fish previously fed at 3% ration, but persisted for the whole realimentation period in groups previously fed at 0.5% and 1.5% rations. None of the feed restricted groups showed improved digestibility, feed efficiency, or protein and energy retention efficiency.

The Feminist Supervision Scale: A Rational/Theoretical Approach

ERIC Educational Resources Information Center

Szymanski, Dawn M.

2003-01-01

This article reports the development and psychometric properties of the Feminist Supervision Scale (FSS), a new scale designed to assess feminist supervision practices in clinical supervision. This 32-item measure was developed using a rational/theoretical approach of test construction and includes four subscales: (a) collaborative relationships,…

College Textbook Publishing: Patterns of Corporate Diversification and the Rationalization of the Publishing Process.

ERIC Educational Resources Information Center

Suarez, Jacinto E.

1994-01-01

Examines the impact of publishing industry diversification on the college textbook publishing process. Topics discussed include characteristics and trends of the college publishing industry; corporate ownership and managerial practices; the rationalization of editorial and marketing processes; evaluative criteria; author selection; and suggestions…

Rational Emotive Education and the Developmental Stages of Jean Piaget.

ERIC Educational Resources Information Center

Lang, Janet M.

Rational-Emotive Therapy (RET) is predicated on a theory of causality. According to Ellis (1962), beliefs regarding an event, and not the event itself, cause emotional reactions. Mentally healthy persons practice this reational theory of causality. Neurotic persons accept an irrational theory of causality based on coincidental or correlational…

The Possibilities of Education in the Culture of Violence.

ERIC Educational Resources Information Center

Suoranta, Juha

1996-01-01

Reviews Freud, Foucault, Eco, and critical theorists to examine features of postmodern society: a culture of violence, pervasive hidden forms of social control, voyeurism toward life, the sovereignty of instrumental rationality, and threats of fascism. Suggests the need for critical practice in education that values rational self-clarity,…

Adaptation of the rumen microbial population to native potato starch degradation determined with the gas production technique and the nylon bag technique.

PubMed

Cone, J W; van Gelder, A H

2006-12-01

Experiments were conducted to investigate the influence of the adaptation of rumen micro-organisms on the degradation of native potato starch (PS) in the rumen. Cows were fed with rations used for gas production (GP) analysis (dry cows, 1.6% starch) and for the nylon bag (NB) technique (lactating cows, 23% starch, mainly maize starch) and a ration containing 19% native PS (lactating cows). Fermentation characteristics of 13 samples were investigated with the GP technique using rumen fluid from cows fed each of the three rations. The same samples were investigated with the NB technique in the cows obtaining the NB ration and the PS ration. The results showed that the rate of GP was influenced by the source of the rumen fluid. The fermentation rate of PS was considerably enhanced by using rumen fluid adapted to the fermentation of native PS instead of using the other rumen fluids. Incubating in cows fed the PS ration, the rate of PS degradation determined with the NB technique, was higher compared with cows fed other rations. Using the PS ration the observed lag period for PS was shorter. The results show a clear influence of ration on the degradation characteristics of starch, determined with both the GP technique and the NB technique. However, these changes in behaviour did not explain observed differences in amounts of rumen escape PS measured in vivo in animal experiments and in situ, using the NB technique.

Respect for rational autonomy.

PubMed

Walker, Rebecca L

2009-12-01

The standard notion of autonomy in medical ethics does not require that autonomous choices not be irrational. The paper gives three examples of seemingly irrational patient choices and discusses how a rational autonomy analysis differs from the standard view. It then considers whether a switch to the rational autonomy view would lead to overriding more patient decisions but concludes that this should not be the case. Rather, a determination of whether individual patient decisions are autonomous is much less relevant than usually considered in determining whether health care providers must abide by these decisions. Furthermore, respect for rational autonomy entails strong positive requirements of respect for the autonomy of the person as a rational decision maker. The rationality view of autonomy is conceptually stronger than the standard view, allows for a more nuanced understanding of the practical moral calculus involved in respecting patient autonomy, and promotes positive respect for patient autonomy.

[A method for the implementation and promotion of access to comprehensive and complementary primary healthcare practices].

PubMed

Santos, Melissa Costa; Tesser, Charles Dalcanale

2012-11-01

The rendering of integrated and complementary practices in the Brazilian Unified Health System is fostered to increase the comprehensiveness of care and access to same, though it is a challenge to incorporate them into the services. Our objective is to provide a simple method of implementation of such practices in Primary Healthcare, derived from analysis of experiences in municipalities, using partial results of a master's thesis that employed research-action methodology. The method involves four stages: 1 - defininition of a nucleus responsible for implementation and consolidation thereof; 2 - situational analysis, with definition of the existing competent professionals; 3 - regulation, organization of access and legitimation; and 4 - implementation cycle: local plans, mentoring and ongoing education in health. The phases are described, justified and briefly discussed. The method encourages the development of rational and sustainable actions, sponsors participatory management, the creation of comprehensivenessand the broadening of care provided in Primary Healthcare by offering progressive and sustainable comprehensive and complementary practices.

Understanding rational non-adherence to medications. A discrete choice experiment in a community sample in Australia

PubMed Central

2012-01-01

Background In spite of the potential impact upon population health and expenditure, interventions promoting medication adherence have been found to be of moderate effectiveness and cost effectiveness. Understanding the relative influence of factors affecting patient medication adherence decisions and the characteristics of individuals associated with variation in adherence will lead to a better understanding of how future interventions should be designed and targeted. This study aims to explore medication-taking decisions that may underpin intentional medication non-adherence behaviour amongst a community sample and the relative importance of medication specific factors and patient background characteristics contributing to those decisions. Methods A discrete choice experiment conducted through a web-enabled online survey was used to estimate the relative importance of eight medication factors (immediate and long-term medication harms and benefits, cost, regimen, symptom severity, alcohol restrictions) on the preference to continue taking a medication. To reflect more closely what usually occurs in practice, non-disease specific medication and health terms were used to mimic decisions across multiple medications and conditions.161 general community participants, matching the national Australian census data (age, gender) were recruited through an online panel provider (participation rate: 10%) in 2010. Results Six of the eight factors (i.e. immediate and long-term medication harms and benefits, cost, and regimen) had a significant influence on medication choice. Patient background characteristics did not improve the model. Respondents with private health insurance appeared less sensitive to cost then those without private health insurance. In general, health outcomes, framed as a side-effect, were found to have a greater influence over adherence than outcomes framed as therapeutic benefits. Conclusions Medication-taking decisions are the subject of rational choices, influenced by the attributes of treatments and potentially amenable to intervention through education, strategic pricing and the altering of dosing characteristics. Understanding individual treatment preferences is thus an important step to improving adherence support provision in practice. Re-framing future interventions and policies to support rational and informed individual patient choices, is the way forward to realising the full potential health and economic benefits from the efficacious use of medications. PMID:22715853

Understanding rational non-adherence to medications. A discrete choice experiment in a community sample in Australia.

PubMed

Laba, Tracey-Lea; Brien, Jo-Anne; Jan, Stephen

2012-06-20

In spite of the potential impact upon population health and expenditure, interventions promoting medication adherence have been found to be of moderate effectiveness and cost effectiveness. Understanding the relative influence of factors affecting patient medication adherence decisions and the characteristics of individuals associated with variation in adherence will lead to a better understanding of how future interventions should be designed and targeted. This study aims to explore medication-taking decisions that may underpin intentional medication non-adherence behaviour amongst a community sample and the relative importance of medication specific factors and patient background characteristics contributing to those decisions. A discrete choice experiment conducted through a web-enabled online survey was used to estimate the relative importance of eight medication factors (immediate and long-term medication harms and benefits, cost, regimen, symptom severity, alcohol restrictions) on the preference to continue taking a medication. To reflect more closely what usually occurs in practice, non-disease specific medication and health terms were used to mimic decisions across multiple medications and conditions.161 general community participants, matching the national Australian census data (age, gender) were recruited through an online panel provider (participation rate: 10%) in 2010. Six of the eight factors (i.e. immediate and long-term medication harms and benefits, cost, and regimen) had a significant influence on medication choice. Patient background characteristics did not improve the model. Respondents with private health insurance appeared less sensitive to cost then those without private health insurance. In general, health outcomes, framed as a side-effect, were found to have a greater influence over adherence than outcomes framed as therapeutic benefits. Medication-taking decisions are the subject of rational choices, influenced by the attributes of treatments and potentially amenable to intervention through education, strategic pricing and the altering of dosing characteristics. Understanding individual treatment preferences is thus an important step to improving adherence support provision in practice. Re-framing future interventions and policies to support rational and informed individual patient choices, is the way forward to realising the full potential health and economic benefits from the efficacious use of medications.

Guidelines to group practice. Fédération Dentaire Internationale. Technical Report No. 22.

PubMed

1985-09-01

This report reviews the types of group practice, the essential financial arrangements and the management procedures involved. The advantages and disadvantages of group practice to the dentist and the patient are reviewed.

Current concepts in platelet transfusion

PubMed Central

Mohanty, Dipika

2009-01-01

This is the era of component therapy. Therefore there is a need for rational use of platelet concentrate. Lot of knowledge has been added recently in the field of platelet specially about the platelet rich plasma and its application in clinical practice. The current review focuses on improvement in preparation of platelet rich plasma, the procedure to make the same more safe and its rational use. Furthermore newer aspects of platelet concentrate use in surgical practice and for regenerative medicine has also been discussed. It also covers some progress and hurdles in preparation of platelet substitutes. PMID:20041092

Dilemmas in rationing health care services: the case for implicit rationing.

PubMed

Mechanic, D

1995-06-24

With tension between the demand for health services and the cost of providing them, rationing is increasingly evident in all medical systems. Until recently, rationing was primarily through the ability to pay or achieved implicitly by doctors working within fixed budgets. Such forms of rationing are commonly alleged to be inequitable and inefficient and explicit rationing is advocated as more appropriate. Utilisation management in the United States and quasi-markets separating purchasing from provision in the United Kingdom are seen as ways of using resources more efficiently and are increasingly explicit. There is also advocacy to ration explicitly at the point of service. Mechanic reviews the implications of these developments and explains why explicit approaches are likely to focus conflict and dissatisfaction and be politically unstable. Explicit rationing is unlikely to be as equitable as its proponents argue and is likely to make dissatisfaction and perceived deprivation more salient. Despite its limitations, implicit rationing at the point of service is more sensitive to the complexity of medical decisions and the needs and personal and cultural preferences of patients. All systems use a mix of rationing devices, but the clinical allocation of services should substantially depend on the discretion of professionals informed by practice guidelines, outcomes research, and other informational aids.

[Priority setting and bedside rationing: a discussion of empirical findings].

PubMed

Strech, Daniel

2011-01-01

In addition to empirical forecasts on the extent of the current and future limitations on health care resources, empirical data on the status quo of bedside rationing play a significant role in developing suitable alternatives in dealing with limited financial resources. This article presents and discusses selected results of the international and German survey research on bedside rationing. Survey studies among physicians could prove world-wide that rationing decisions are made already today by individual physicians in the in- and out-patient services. In German hospitals, rationing is also a wide-spread though non-transparent and not (yet) very common phenomenon for an individual physician. Varying criteria for bedside rationing contribute to the fact that the current approach to bedside rationing leads to dissatisfaction on the part of physicians and to a potential disadvantage of certain patient groups. Explicit, i.e. transparent and systematic, ways of rationing could remedy these deficiencies and are therefore clearly preferable in this context. However, further specification of the methods of explicit rationing and a critical evaluation of their application in practice are needed. Moreover, it is mainly the quality of the underlying evidence that determines whether or not the actual decisions become more reasonable and fair by means of more explicit rationing approaches. Copyright © 2011 S. Karger AG, Basel.

Dilemmas in rationing health care services: the case for implicit rationing.

PubMed Central

Mechanic, D.

1995-01-01

With tension between the demand for health services and the cost of providing them, rationing is increasingly evident in all medical systems. Until recently, rationing was primarily through the ability to pay or achieved implicitly by doctors working within fixed budgets. Such forms of rationing are commonly alleged to be inequitable and inefficient and explicit rationing is advocated as more appropriate. Utilisation management in the United States and quasi-markets separating purchasing from provision in the United Kingdom are seen as ways of using resources more efficiently and are increasingly explicit. There is also advocacy to ration explicitly at the point of service. Mechanic reviews the implications of these developments and explains why explicit approaches are likely to focus conflict and dissatisfaction and be politically unstable. Explicit rationing is unlikely to be as equitable as its proponents argue and is likely to make dissatisfaction and perceived deprivation more salient. Despite its limitations, implicit rationing at the point of service is more sensitive to the complexity of medical decisions and the needs and personal and cultural preferences of patients. All systems use a mix of rationing devices, but the clinical allocation of services should substantially depend on the discretion of professionals informed by practice guidelines, outcomes research, and other informational aids. Images p1657-a p1659-a PMID:7795458

Educational Research as a Form of Democratic Rationality

ERIC Educational Resources Information Center

Elliott, John

2006-01-01

Educational Research is commonly regarded as a rational pursuit aimed at the production of objective knowledge. Researchers are expected to avoid value bias by detaching themselves from the normative conceptions of education that shape practice in schools and classrooms, and by casting themselves in the role of the impartial spectator. It is…

Gut Instinct: The Body and Learning

ERIC Educational Resources Information Center

Barnacle, Robyn

2009-01-01

In the current socio-political climate pedagogies consistent with rationalism are in the ascendancy. One way to challenge the purchase of rationalism within educational discourse and practice is through the body, or by re-thinking the nature of mind-body relations. While the orientation of this paper is ultimately phenomenological, it takes as its…

The Evidence Base for Gypsy and Traveller Site Planning: A Story of Complexity and Tension

ERIC Educational Resources Information Center

Niner, Pat; Brown, Philip

2011-01-01

The linear technical-rational model has been heavily criticised as theoretically, politically and practically inadequate. The example of accommodation needs assessment as evidence for highly contentious decisions on Gypsy and Traveller caravan site provision suggests, however, that the technical-rational model has great value in coping with…

Ethical Dilemmas of Swedish School Leaders: Contrasts and Common Themes

ERIC Educational Resources Information Center

Norberg, Katarina; Johansson, Olof

2007-01-01

Being a skillful school leader presumes the competence to judge the ethical consequences of actions. This implies a need for all school agents to discover and analyze what values are at stake and, in turn, reconcile didactic rationality with ethical rationality. This article aims to explore ethical dilemmas in daily school practice, experienced…

Cue-Reactive Rationality, Visual Imagery and Volitional Control Predict Cue-Reactive Urge to Gamble in Poker-Machine Gamblers.

PubMed

Clark, Gavin I; Rock, Adam J; McKeith, Charles F A; Coventry, William L

2017-09-01

Poker-machine gamblers have been demonstrated to report increases in the urge to gamble following exposure to salient gambling cues. However, the processes which contribute to this urge to gamble remain to be understood. The present study aimed to investigate whether changes in the conscious experience of visual imagery, rationality and volitional control (over one's thoughts, images and attention) predicted changes in the urge to gamble following exposure to a gambling cue. Thirty-one regular poker-machine gamblers who reported at least low levels of problem gambling on the Problem Gambling Severity Index (PGSI), were recruited to complete an online cue-reactivity experiment. Participants completed the PGSI, the visual imagery, rationality and volitional control subscales of the Phenomenology of Consciousness Inventory (PCI), and a visual analogue scale (VAS) assessing urge to gamble. Participants completed the PCI subscales and VAS at baseline, following a neutral video cue and following a gambling video cue. Urge to gamble was found to significantly increase from neutral cue to gambling cue (while controlling for baseline urge) and this increase was predicted by PGSI score. After accounting for the effects of problem-gambling severity, cue-reactive visual imagery, rationality and volitional control significantly improved the prediction of cue-reactive urge to gamble. The small sample size and limited participant characteristic data restricts the generalizability of the findings. Nevertheless, this is the first study to demonstrate that changes in the subjective experience of visual imagery, volitional control and rationality predict changes in the urge to gamble from neutral to gambling cue. The results suggest that visual imagery, rationality and volitional control may play an important role in the experience of the urge to gamble in poker-machine gamblers.

Statistics is not enough: revisiting Ronald A. Fisher's critique (1936) of Mendel's experimental results (1866).

PubMed

Pilpel, Avital

2007-09-01

This paper is concerned with the role of rational belief change theory in the philosophical understanding of experimental error. Today, philosophers seek insight about error in the investigation of specific experiments, rather than in general theories. Nevertheless, rational belief change theory adds to our understanding of just such cases: R. A. Fisher's criticism of Mendel's experiments being a case in point. After an historical introduction, the main part of this paper investigates Fisher's paper from the point of view of rational belief change theory: what changes of belief about Mendel's experiment does Fisher go through and with what justification. It leads to surprising insights about what Fisher had done right and wrong, and, more generally, about the limits of statistical methods in detecting error.

Rational non-interventional paternalism: why doctors ought to make judgments of what is best for their patients.

PubMed Central

Savulescu, J

1995-01-01

This paper argues that doctors ought to make all things considered value judgments about what is best for their patients. It illustrates some of the shortcomings of the model of doctor as 'fact-provider'. The 'fact-provider' model fails to take account of the fact that practising medicine necessarily involves making value judgments; that medical practice is a moral practice and requires that doctors reflect on what ought to be done, and that patients can make choices which fail to express their autonomy and which are based on mistaken judgments of value. If doctors are properly to respect patient autonomy and to function as moral agents, they must make evaluations of what their patients ought to do, all things considered. This paper argues for 'rational, non-interventional paternalism'. This is a practice in which doctors form conceptions of what is best for their patients and argue rationally with them. It differs from old-style paternalism in that it is not committed to doing what is best. PMID:8778455

The Rational Approach to Budget Cuts: One University's Experience.

ERIC Educational Resources Information Center

Hardy, Cynthia

1988-01-01

The University of Montreal's choice of the rational model of decision-making in managing budget cutbacks is explored and compared with other approaches, including the bureaucratic, garbage can, political, and collegial models. (MSE)

[Construction and practice on rational medication model of Chinese patent medicine for orthopedics based on ″symdrome-dosage-toxicity differentiation″ theory].

PubMed

Wang, Yu-Guang; Jin, Rui; Qiang, Si-Si; Lin, Zhi-Jian; Li, Hong-Yan; Lu, Shu; Kong, Xiang-Wen

2016-01-01

Chinese patent medicines for orthopedics are among the hotspot and difficulty in the rational medication of traditional Chinese medicine (TCM), because they mostly contain toxic medicinal herbs and oriented to special patients. According to the hospital pharmacy practices and the therapeutic theories of TCM, this paper focused on a novel model of rational drug use of Chinese patent medicine for orthopedics based on the principles of ″syndrome-dosage-toxicity differentiation″. We also proposed relevant specifications for guiding their clinical use. Firstly, we proposed a list of the primary clinical application characteristics for rational drug use of orthopedic TCMs, including the syndromes of patient, the dosage of medicine and the toxic ingredients in medicine. Secondly, a database was established for recording the package inserts of all of the 81 orthopedic patent medicines in our hospital, and 2 000 retrospective recipes were analyzed for looking for the high-frequency medicines and common irrational factors. Then clinical case reports involving the adverse reactions and side effects of related drugs were searched from CNKI, VIP and WanFang databases. Then the key information for rational application of each medicine was extracted from these resources and some survey questionnaires. Finally, we established a guide named instructions for clinical use of orthopedic Chinese patient medicines (ICUOCPM) after the discusstion with experts. According to the effect after the practice in hospital for 2 months, the proposed principles of ″syndrome-dosage-toxicity differentiation″ in this paper were believed to be the core elements and the most important clinical monitoring points in TCM for orthopedic patents. It would provide innovative ideas, theoretical guarantee and data support for the development of TCM clinical pharmacy. Copyright© by the Chinese Pharmaceutical Association.

"Drawing the Leaves Anyway": Teachers Embracing Children's Different Ways of Knowing in Preschool Science Practice

ERIC Educational Resources Information Center

Areljung, Sofie; Ottander, Christina; Due, Karin

2017-01-01

This study explores if and how teachers combine practices of science and of preschool (children 1-5 years old) into preschool science practice. Views of knowing may differ between science practices, traditionally associated with masculinity and rationality, and preschool practices, traditionally associated with femininity and caring. Recognising…

From Relevance Rationality to Multi-Stratified Authenticity in Music Teacher Education: Ethical and Aesthetical Frameworks Revisited

ERIC Educational Resources Information Center

Fossum, Hanne

2017-01-01

Despite today's proclaimed open-mindedness, a certain uniformity of thought, followed by a flattening of practices, can be observed in the processes of quality improvement in higher education. This narrowing of thought, which I call "relevance rationality," is an offshoot of instrumental reason and represents a debased,…

Fostering Non-Cognitive Development of Underrepresented Students through Rational Emotive Behavior Therapy: Recommendations for School Counselor Practice

ERIC Educational Resources Information Center

Warren, Jeffrey M.; Hale, Robyn W.

2016-01-01

The non-cognitive factors (NCFs) endorsed by Sedlacek (2004) appear to align with the core values of rational emotive behavior therapy (REBT). This article explores theoretical and empirical evidence that suggests REBT fosters the development of NCFs. School counselors can promote non-cognitive development by embedding REBT throughout direct and…

Transcending as a driver of development.

PubMed

Travis, Frederick

2016-06-01

This paper draws from three different bodies of research to discuss the hypothesis that age-appropriate experiences enhance brain and cognitive development throughout the life span. These age-appropriate experiences could be considered as the drivers of development at each age, including drivers to foster development beyond adult abstract thinking, as described in Piaget's formal operational stage. We explore how a nurturing caregiver is the driver in the first 2 years of life, how language learning is the driver from 3 to 10 years, and how problem solving is the driver in the teenage years. To develop beyond adult rational thinking, we suggest that the driver is transcending thought, which can result when practicing meditations in the automatic self-transcending category, such as Transcendental Meditation. © 2016 New York Academy of Sciences.

Rationalism, Empiricism, and Evidence-Based Medicine: A Call for a New Galenic Synthesis.

PubMed

Webb, William M

2018-04-25

Thirty years after the rise of the evidence-based medicine (EBM) movement, formal training in philosophy remains poorly represented among medical students and their educators. In this paper, I argue that EBM’s reception in this context has resulted in a privileging of empiricism over rationalism in clinical reasoning with unintended consequences for medical practice. After a limited review of the history of medical epistemology, I argue that a solution to this problem can be found in the method of the 2nd-century Roman physician Galen, who brought empiricism and rationalism together in a synthesis anticipating the scientific method. Next, I review several of the problems that have been identified as resulting from a staunch commitment to empiricism in medical practice. Finally, I conclude that greater epistemological awareness in the medical community would precipitate a Galenic shift toward a more epistemically balanced, scientific approach to clinical research.

Antibiotic prescribing behavior among general practitioners - a questionnaire-based study in Germany.

PubMed

Salm, Florian; Schneider, Sandra; Schmücker, Katja; Petruschke, Inga; Kramer, Tobias S; Hanke, Regina; Schröder, Christin; Heintze, Christoph; Schwantes, Ulrich; Gastmeier, Petra; Gensichen, Jochen

2018-05-04

This study investigates the barriers and facilitators of the use of antibiotics in acute respiratory tract infections by general practitioners (GPs) in Germany. A multidisciplinary team designed and pre-tested a written questionnaire addressing the topics awareness of antimicrobial resistance (7 items), use of antibiotics (9 items), guidelines/sources of information (9 items) and sociodemographic factors (7 items), using a five-point-Likert-scale ("never" to "very often"). The questionnaire was mailed by postally to 987 GPs with registered practices in eastern Germany in May 2015. 34% (340/987) of the GPs responded to this survey. Most of the participants assumed a multifactorial origin for the rise of multidrug resistant organisms. In addition, 70.2% (239/340) believed that their own prescribing behavior influenced the drug-resistance situation in their area. GPs with longer work experience (> 25 years) assumed less individual influence on drug resistance than their colleagues with less than 7 years experience as practicing physicians (Odds Ratio [OR] 0.32, 95% Confidence Interval [CI] 0.17-0.62; P < 0.001). 99.1% (337/340) of participants were familiar with the "delayed prescription" strategy to reduce antibiotic prescriptions. However, only 29.4% (74/340) answered that they apply it "often" or "very often". GPs working in rural areas were less likely than those working in urban areas to apply delayed prescription. The knowledge on factors causing antimicrobial resistance in bacteria is good among GPs in eastern Germany. However measures to improve rational prescription are not widely implemented yet. Further efforts have to be made in order to improve rational prescription of antibiotic among GPs. Nevertheless, there is a strong awareness of antimicrobial resistance among the participating GPs.

Prevalence and Determinants of Physician Bedside Rationing

PubMed Central

Hurst, Samia A; Slowther, Anne-Marie; Forde, Reidun; Pegoraro, Renzo; Reiter-Theil, Stella; Perrier, Arnaud; Garrett-Mayer, Elizabeth; Danis, Marion

2006-01-01

BACKGROUND Bedside rationing by physicians is controversial. The debate, however, is clouded by lack of information regarding the extent and character of bedside rationing. DESIGN, SETTING, AND PARTICIPANTS We developed a survey instrument to examine the frequency, criteria, and strategies used for bedside rationing. Content validity was assessed through expert assessment and scales were tested for internal consistency. The questionnaire was translated and administered to General Internists in Norway, Switzerland, Italy, and the United Kingdom. Logistic regression was used to identify the variables associated with reported rationing. RESULTS Survey respondents (N =656, response rate 43%) ranged in age from 28 to 82, and averaged 25 years in practice. Most respondents (82.3%) showed some degree of agreement with rationing, and 56.3% reported that they did ration interventions. The most frequently mentioned criteria for rationing were a small expected benefit (82.3%), low chances of success (79.8%), an intervention intended to prolong life when quality of life is low (70.6%), and a patient over 85 years of age (70%). The frequency of rationing by clinicians was positively correlated with perceived scarcity of resources (odds ratio [OR]=1.11, 95% confidence interval [CI] 1.06 to 1.16), perceived pressure to ration (OR=2.14, 95% CI 1.52 to 3.01), and agreement with rationing (OR=1.13, 95% CI 1.05 to 1.23). CONCLUSION Bedside rationing is prevalent in all surveyed European countries and varies with physician attitudes and resource availability. The prevalence of physician bedside rationing, which presents physicians with difficult moral dilemmas, highlights the importance of discussions regarding how to ration care in the most ethically justifiable manner. PMID:16836629

Effect of Chicken Bone Meal as Phosphorus Supplement on Blood Metabolites in Fattening Lambs

NASA Astrophysics Data System (ADS)

Pujiastuti, A.; Muktiani, A.

2018-02-01

The aim of this study was to evaluate the effect of chicken bone meal (CBM) as phosphorus supplementon blood metabolites in fattening lambs. The experiment used 16 of 12 months old local male lambs with initial body weight 27.01 ± 1.51 kg. The experiment used a complete randomized design with 4 treatments and 4 replications. The treatments were T0 (basal ration = native grass + soybean curd waste), T1 (basal ration + 0.49% P Dicalcium phosphate), T2 (basal ration + 0.70% P CBM), T3 (basal ration + 1.39 % P CBM). The results indicated that CBM as phosphorus supplement was significantly different (P<0,05) on P intake, phosphorus and glucose serum and did not different significantly on dry matter intake and alkaline phosphatase activity. In conclusion, CBM is one of requirement organic phosphorus supplement which can be applied on ruminants.

Effect of acarbose on milk yield and composition in early-lactation dairy cattle fed a ration to induce subacute ruminal acidosis.

PubMed

McLaughlin, C L; Thompson, A; Greenwood, K; Sherington, J; Bruce, C

2009-09-01

Subacute ruminal acidosis reduces lactation performance in dairy cattle and most often occurs in animals fed a high concentrate:forage ration with large amounts of readily fermentable starch, which results in increased production of volatile fatty acids and lactic acid and a reduction in ruminal pH. Acarbose is commercially available (Glucobay, Bayer, Wuppertal, Germany) and indicated for the control of blood glucose in diabetic patients. In cattle, acarbose acts as an alpha-amylase and glucosidase inhibitor that slows the rate of degradation of starch to glucose, thereby reducing the rate of volatile fatty acid production and maintaining rumen pH at higher levels. The ability of acarbose to reverse the reduced feed intake and milk fat percentage and yield associated with a high concentrate:forage ration with a high risk of inducing subacute ruminal acidosis was evaluated in 2 experiments with lactating dairy cattle. In 2 preliminary experiments, the effects of a 70:30 concentrate:forage ration on ruminal pH and lactation were evaluated. Ruminal pH was monitored in 5 Holstein steers with ruminal cannulas every 10 min for 5 d. Ruminal pH was <5.5 for at least 4 h in 79% of the animal days. In dairy cows, the 70:30 concentrate:forage ration decreased feed intake 5%, milk fat percentage 7%, and milk fat yield 8% compared with a 50:50 concentrate:forage ration but did not affect milk yield. Early lactating dairy cattle were offered the 70:30 concentrate:forage ration with 0 or 0.75 g/d of acarbose added in a crossover design in 2 experiments. In the first experiment, acarbose increased dry matter feed intake (23.1 vs. 21.6 kg/d) and 3.5% fat-corrected milk yield (33.7 vs. 31.7 kg/d) because of an increase in percentage milk fat (3.33 vs. 3.04%) compared with control cows. In the second experiment, cows were fasted for 3 h before the morning feeding to induce consumption of a large meal to mimic conditions that might be associated with unplanned delayed feeding. In this experiment, acarbose also increased feed intake (22.5 vs. 21.8 kg/d) and 3.5% fat-corrected milk yield (36.9 vs. 33.9 kg/d) due to increased percentage milk fat (3.14 vs. 2.66%) compared with controls. Thus, acarbose reversed the decreased feed intake and low milk fat percentage and yield associated with feeding a high concentrate:forage ration shown to induce subacute ruminal acidosis in Holstein steers.

"That was grown folks' business": narrative reflection and response in older adults' family health history communication.

PubMed

Yamasaki, Jill; Hovick, Shelly R

2015-01-01

Given the importance of family health history and the pivotal role of older adults in communicating it, this study examines how African American older adults (a) characterize their understandings of health-related conditions in their family histories and (b) rationalize their motivations and constraints for sharing this information with current family members. Using narrative theory as a framework, we illustrate how the participants reflect on prior health-related experiences within the family to respond to moral and practical calls for communicating family health information to current relatives. Specifically, our analysis highlights how storied family secrets--as constructed by 28 participants in group and individual interviews--reveal and inform shifting cultural and generational practices that shape the lived health behaviors and communication of older adults at greater risk for health disparities.

Observations on the NHS internal market: will the dodo get the last laugh?

PubMed Central

Royce, R. G.

1995-01-01

Distinguishing between the theory and practice of the internal market has been obscured by the considerable controversy generated by the reforms themselves. In such an environment both the advocates and the opponents of a market based solution have tended to promote their respective claims by reference to underlying political philosophies and economic theories rather than practical experience. Royce gives his observations of the actual operation of the internal market with particular reference to the commissioning function in Wales. He highlights inadequacies and inequities in the current system and proposes some remedial actions. Central to these are the importance of ensuring equitable funding for all purchasers, acknowledging the necessity of rationing, and promoting efficient and effective health care, sometimes at the expense of patient choice and guaranteed local service provision. Images p432-a PMID:7640593

From randomised trials to rational practice.

PubMed

van Gijn, J

2005-01-01

From the age of Enlightenment onwards, philosophical thinking has become increasingly influenced by empiricism: observations lead to theories, but experiments are needed to put the reasoning to the test. However, it was not until the middle of the 20th century that well-designed experiments were at last introduced in medical treatment, in the form of randomised controlled clinical trials. This design is now standard in medicine, but in everyday practice a multitude of management decisions must still be taken without good evidence. There are several reasons for this: there may not be a trial at all or only a single trial; trial results may be equivocal; patients may be different from those enrolled in trials; new procedures require practice, or a trial may not be feasible. 'Logical reasoning', with all its fallacies, is still required - not only to fill the gaps in empirical knowledge but also to interpret existing evidence and to plan new trials. In fact, the generation of new knowledge is a continuous, cyclical process in which newly gained insights in pathophysiology give rise to new therapeutic experiments, the results of which generate fresh hypotheses, and so on. Compassion, curiosity and doubt are the essential forces that keep the cycle moving. Conversely, the progress is slowed down by present-day legalism, which distorts investigator accountability and patient autonomy. Copyright (c) 2005 S. Karger AG, Basel.

How delusion is formed?

PubMed

Park, Jong Suk; Kang, Ung Gu

2016-02-01

Traditionally, delusions have been considered to be the products of misinterpretation and irrationality. However, some theorists have argued that delusions are normal or rational cognitive responses to abnormal experiences. That is, when a recently experienced peculiar event is more plausibly explained by an extraordinary hypothesis, confidence in the veracity of this extraordinary explanation is reinforced. As the number of such experiences, driven by the primary disease process in the perceptual domain, increases, this confidence builds and solidifies, forming a delusion. We tried to understand the formation of delusions using a simulation based on Bayesian inference. We found that (1) even if a delusional explanation is only marginally more plausible than a non-delusional one, the repetition of the same experience results in a firm belief in the delusion. (2) The same process explains the systematization of delusions. (3) If the perceived plausibility of the explanation is not consistent but varies over time, the development of a delusion is delayed. Additionally, this model may explain why delusions are not corrected by persuasion or rational explanation. This Bayesian inference perspective can be considered a way to understand delusions in terms of rational human heuristics. However, such experiences of "rationality" can lead to irrational conclusions, depending on the characteristics of the subject. Copyright © 2015 Elsevier Ltd. All rights reserved.

Local Choices: Rationality and the Contextuality of Decision-Making

PubMed Central

Vlaev, Ivo

2018-01-01

Rational explanation is ubiquitous in psychology and social sciences, ranging from rational analysis, expectancy-value theories, ideal observer models, mental logic to probabilistic frameworks, rational choice theory, and informal “folk psychological” explanation. However, rational explanation appears to be challenged by apparently systematic irrationality observed in psychological experiments, especially in the field of judgement and decision-making (JDM). Here, it is proposed that the experimental results require not that rational explanation should be rejected, but that rational explanation is local, i.e., within a context. Thus, rational models need to be supplemented with a theory of contextual shifts. We review evidence in JDM that patterns of choices are often consistent within contexts, but unstable between contexts. We also demonstrate that for a limited, though reasonably broad, class of decision-making domains, recent theoretical models can be viewed as providing theories of contextual shifts. It is argued that one particular significant source of global inconsistency arises from a cognitive inability to represent absolute magnitudes, whether for perceptual variables, utilities, payoffs, or probabilities. This overall argument provides a fresh perspective on the scope and limits of human rationality. PMID:29301289

Local Choices: Rationality and the Contextuality of Decision-Making.

PubMed

Vlaev, Ivo

2018-01-02

Rational explanation is ubiquitous in psychology and social sciences, ranging from rational analysis, expectancy-value theories, ideal observer models, mental logic to probabilistic frameworks, rational choice theory, and informal "folk psychological" explanation. However, rational explanation appears to be challenged by apparently systematic irrationality observed in psychological experiments, especially in the field of judgement and decision-making (JDM). Here, it is proposed that the experimental results require not that rational explanation should be rejected, but that rational explanation is local , i.e., within a context. Thus, rational models need to be supplemented with a theory of contextual shifts. We review evidence in JDM that patterns of choices are often consistent within contexts, but unstable between contexts. We also demonstrate that for a limited, though reasonably broad, class of decision-making domains, recent theoretical models can be viewed as providing theories of contextual shifts. It is argued that one particular significant source of global inconsistency arises from a cognitive inability to represent absolute magnitudes, whether for perceptual variables, utilities, payoffs, or probabilities. This overall argument provides a fresh perspective on the scope and limits of human rationality.

Reconstructing Iraq

DTIC Science & Technology

2004-09-02

ICG Middle East Report N°30, 2 September 2004 Page 16 and institutions to counter monopolistic practices harmful to both investors and consumers ...204 A senior Ministry of Trade official described large-scale corruption in the food and consumer goods rationing system at all 198 ICG...procurement of items for the ration system also provides fertile ground for current corruption. Black markets thrive on goods whose prices are kept

Rational subjects, marriage counselling and the conundrums of eugenics.

PubMed

Gerodetti, Natalia

2008-06-01

Against the background of degeneration and the perceived threat to the nation's health and stock, family politics came to constitute an important site for eugenic discourses and interventions. Eugenic regulation of reproductive sexuality and marriage was not only pursued through 'negative' eugenics but also through educational policies targeted at young adults and youth. Switzerland serves as a useful case to explore a general idea, namely the limitations for eugenicists of exploiting the concept of a rational subject in order to achieve their ends. Practices of 'positive eugenics' crucially hinged on the utilitarian principle of rationality underpinning positive eugenics which this paper seeks to elaborate. Eugenicists devised tools to deal efficiently with social problems on a collective as well as an individual basis by deploying technologies of government which conceived individuals to be members of a population who were each held responsible for the generation of healthy future generations. As a form of 'sustaining, multiplying and ordering life' eugenics thus relied on the premise that its ideas would be adopted through an appeal to rationality and, where this was insufficient, through a series of coercive measures. Relying on conviction and education about the merits of eugenics, however, posed particular problems to positive eugenic thinking and practice.

When is diagnostic testing inappropriate or irrational? Acceptable regret approach.

PubMed

Hozo, Iztok; Djulbegovic, Benjamin

2008-01-01

The authors provide a new model within the framework of theories of bounded rationality for the observed physicians' behavior that their ordering of diagnostic tests may not be rational. Contrary to the prevailing thinking, the authors find that physicians do not act irrationally or inappropriately when they order diagnostic tests in usual clinical practice. When acceptable regret (i.e., regret that a decision maker finds tolerable upon making a wrong decision) is taken into account, the authors show that physicians tend to order diagnostic tests at a higher level of pretest probability of disease than predicted by expected utility theory. They also show why physicians tend to overtest when regret about erroneous decisions is extremely small. Finally, they explain variations in the practice of medicine. They demonstrate that in the same clinical situation, different decision makers might have different acceptable regret thresholds for withholding treatment, for ordering a diagnostic test, or for administering treatment. This in turn means that for some decision makers, the most rational strategy is to do nothing, whereas for others, it may be to order a diagnostic test, and still for others, choosing treatment may be the most rational course of action.

Computing organic stereoselectivity - from concepts to quantitative calculations and predictions.

PubMed

Peng, Qian; Duarte, Fernanda; Paton, Robert S

2016-11-07

Advances in theory and processing power have established computation as a valuable interpretative and predictive tool in the discovery of new asymmetric catalysts. This tutorial review outlines the theory and practice of modeling stereoselective reactions. Recent examples illustrate how an understanding of the fundamental principles and the application of state-of-the-art computational methods may be used to gain mechanistic insight into organic and organometallic reactions. We highlight the emerging potential of this computational tool-box in providing meaningful predictions for the rational design of asymmetric catalysts. We present an accessible account of the field to encourage future synergy between computation and experiment.

New γ -radiation screening procedures of infrared focal plane arrays (IR FPA)

NASA Astrophysics Data System (ADS)

Chen, Hong-lei; Hao, Lichao; Huang, Ai-Bo; Lin, Jiamu; Zhang, Jun-ling; Feng, Qi; Ding, Rui-jun

2013-01-01

Infrared focal plane HgCdTe device is used in the environment of complicated astrospace radiation. To achieve the instrument's actual service life, the anti-radiation ability is needed to study in our research. The irradiation-induced invalidation mechanism of semiconductor materials is introduced in this paper, and the screening experiments' total radiation dose of American Military Standard is also investigated in our study. Through the simulation of astrospace radiation effect by γ -irradiation, the experimental procedures are proved to be rational by the analysis of the experimental data. With the domestic conditions, radiation screening procedures which meets the practical need is suggested.

Philosophy and the practice of Bayesian statistics

PubMed Central

Gelman, Andrew; Shalizi, Cosma Rohilla

2015-01-01

A substantial school in the philosophy of science identifies Bayesian inference with inductive inference and even rationality as such, and seems to be strengthened by the rise and practical success of Bayesian statistics. We argue that the most successful forms of Bayesian statistics do not actually support that particular philosophy but rather accord much better with sophisticated forms of hypothetico-deductivism. We examine the actual role played by prior distributions in Bayesian models, and the crucial aspects of model checking and model revision, which fall outside the scope of Bayesian confirmation theory. We draw on the literature on the consistency of Bayesian updating and also on our experience of applied work in social science. Clarity about these matters should benefit not just philosophy of science, but also statistical practice. At best, the inductivist view has encouraged researchers to fit and compare models without checking them; at worst, theorists have actively discouraged practitioners from performing model checking because it does not fit into their framework. PMID:22364575

Philosophy and the practice of Bayesian statistics.

PubMed

Gelman, Andrew; Shalizi, Cosma Rohilla

2013-02-01

A substantial school in the philosophy of science identifies Bayesian inference with inductive inference and even rationality as such, and seems to be strengthened by the rise and practical success of Bayesian statistics. We argue that the most successful forms of Bayesian statistics do not actually support that particular philosophy but rather accord much better with sophisticated forms of hypothetico-deductivism. We examine the actual role played by prior distributions in Bayesian models, and the crucial aspects of model checking and model revision, which fall outside the scope of Bayesian confirmation theory. We draw on the literature on the consistency of Bayesian updating and also on our experience of applied work in social science. Clarity about these matters should benefit not just philosophy of science, but also statistical practice. At best, the inductivist view has encouraged researchers to fit and compare models without checking them; at worst, theorists have actively discouraged practitioners from performing model checking because it does not fit into their framework. © 2012 The British Psychological Society.

Many faces of rationality: Implications of the great rationality debate for clinical decision‐making

PubMed Central

Elqayam, Shira

2017-01-01

Abstract Given that more than 30% of healthcare costs are wasted on inappropriate care, suboptimal care is increasingly connected to the quality of medical decisions. It has been argued that personal decisions are the leading cause of death, and 80% of healthcare expenditures result from physicians' decisions. Therefore, improving healthcare necessitates improving medical decisions, ie, making decisions (more) rational. Drawing on writings from The Great Rationality Debate from the fields of philosophy, economics, and psychology, we identify core ingredients of rationality commonly encountered across various theoretical models. Rationality is typically classified under umbrella of normative (addressing the question how people “should” or “ought to” make their decisions) and descriptive theories of decision‐making (which portray how people actually make their decisions). Normative theories of rational thought of relevance to medicine include epistemic theories that direct practice of evidence‐based medicine and expected utility theory, which provides the basis for widely used clinical decision analyses. Descriptive theories of rationality of direct relevance to medical decision‐making include bounded rationality, argumentative theory of reasoning, adaptive rationality, dual processing model of rationality, regret‐based rationality, pragmatic/substantive rationality, and meta‐rationality. For the first time, we provide a review of wide range of theories and models of rationality. We showed that what is “rational” behaviour under one rationality theory may be irrational under the other theory. We also showed that context is of paramount importance to rationality and that no one model of rationality can possibly fit all contexts. We suggest that in context‐poor situations, such as policy decision‐making, normative theories based on expected utility informed by best research evidence may provide the optimal approach to medical decision‐making, whereas in the context‐rich circumstances other types of rationality, informed by human cognitive architecture and driven by intuition and emotions such as the aim to minimize regret, may provide better solution to the problem at hand. The choice of theory under which we operate is important as it determines both policy and our individual decision‐making. PMID:28730671

Rationalization and sensemaking in care management: an experience of change in a hospital of the SUS (Unified Health System).

PubMed

Azevedo, Creuza da Silva; Sá, Marilene de Castilho; Cunha, Marcela; Matta, Gustavo Correa; Miranda, Lilian; Grabois, Victor

2017-06-01

This study aimed to analyze organizational processes of change in the hospital care management by using qualitative evaluation developed in the case study. The study was developed at the Hospital Fornecedores de Cana de Piracicaba, in São Paulo State, Brazil, in September and October of 2012. There were 25 interviews with members of the senior board of directors of the hospital, managers and health professionals linked to healthcare of adults, in addition to the analysis of managerial documents and observations of some activities. In this article it is analyzed part of the results, dividing the organizational change in three axes: the planning process developed in the healthcare sectors; The protocol/creation of assisted routines in order to obtain better efficiency and safety for the patient; and the work of hospitalist physicians. The study highlights the complexity of the processes of change in the care management sphere in hospitals and the dynamism between a given management concept and its rational tools and the subjects and groups that seek, in the micropolitic and intersubjective processes, meanings to their practices.

Controlling Solid–Liquid Conversion Reactions for a Highly Reversible Aqueous Zinc–Iodine Battery

DOE Office of Scientific and Technical Information (OSTI.GOV)

Pan, Huilin; Li, Bin; Mei, Donghai

Aqueous rechargeable batteries are desirable for many energy storage applications due to their low cost and high safety. However, low capacity and short cycle life are the significant obstacles to their practical applications. Here, we demonstrate a highly reversible aqueous zinc-iodine battery using encapsulated iodine in microporous active carbon fibers (ACFs) as cathode materials through the rational control of solid-liquid conversion reactions. The experiments and density function theory (DFT) calculations were employed to investigate the effects of solvents and properties of carbon hosts, e.g. pore size, surface chemistries, on the adsorption of iodine species. The rational manipulation of the competitionmore » between the adsorption in carbon and solvation in electrolytes for iodine species is responsible for the high reversibility and cycling stability. The zinc-iodine batteries deliver a high capacity of 180 mAh g-1 at 1C and a stable cycle life over 3000 cycles with ~90% capacity retention as well as negligible self-discharge. We believe the principles for stabilizing the zinc-iodine system could provide new insight into conversion systems such as Li-S systems.« less

Modes of rationality in nursing documentation: biology, biography and the 'voice of nursing'.

PubMed

Hyde, Abbey; Treacy, Margaret P; Scott, P Anne; Butler, Michelle; Drennan, Jonathan; Irving, Kate; Byrne, Anne; MacNeela, Padraig; Hanrahan, Marian

2005-06-01

This article is based on a discourse analysis of the complete nursing records of 45 patients, and concerns the modes of rationality that mediated text-based accounts relating to patient care that nurses recorded. The analysis draws on the work of the critical theorist, Jurgen Habermas, who conceptualised rationality in the context of modernity according to two types: purposive rationality based on an instrumental logic, and value rationality based on ethical considerations and moral reasoning. Our analysis revealed that purposive rationality dominated the content of nursing documentation, as evidenced by a particularly bio-centric and modernist construction of the workings of the body within the texts. There was little reference in the documentation to central themes of contemporary nursing discourses, such as notions of partnership, autonomy, and self-determination, which are associated with value rationality. Drawing on Habermas, we argue that this nursing documentation depicted the colonisation of the sociocultural lifeworld by the bio-technocratic system. Where nurses recorded disagreements that patients had with medical regimes, the central struggle inherent in the project of modernity became transparent--the tension between the rational and instrumental control of people through scientific regulation and the autonomy of the subject. The article concludes by problematising communicative action within the context of nursing practice.

Application of SOJA and InforMatrix in practice: interactive web and workshop tools.

PubMed

Brenninkmeijer, Rob; Janknegt, Robert

2007-10-01

System of Objectified Judgement Analysis (SOJA) and InforMatrix are decision-matrix techniques designed to support a rational selection of drugs. Both SOJA and InforMatrix can be considered as strategic tools in the practical implementation of rational pharmacotherapy. In order to apply the matrix techniques to drug selection, strategic navigation through essential information (with the aim of reaching consensus in pharmacotherapy) is required. The consensus has to be reached in an interactive, communicative, collegial manner, within a professional environment. This environment is realised in the form of interactive applications in workshops and on the internet. Such interactive applications are illustrated and discussed in this article.

On the Moral Acceptability of Physician-Assisted Dying for Non-Autonomous Psychiatric Patients.

PubMed

Varelius, Jukka

2016-05-01

Several authors have recently suggested that the suffering caused by mental illness could provide moral grounds for physician-assisted dying. Yet they typically require that psychiatric-assisted dying could come to question in the cases of autonomous, or rational, psychiatric patients only. Given that also non-autonomous psychiatric patients can sometimes suffer unbearably, this limitation appears questionable. In this article, I maintain that restricting psychiatric-assisted dying to autonomous, or rational, psychiatric patients would not be compatible with endorsing certain end-of-life practices commonly accepted in current medical ethics and law, practices often referred to as 'passive euthanasia'. © 2015 John Wiley & Sons Ltd.

Rational suicide in the terminally ill.

PubMed

Fontana, Joyce S

2002-01-01

To examine the current debate over the right to die specific to the rational suicide of terminally ill patients. Literature was reviewed for information concerning historical end-of-life practices and the past acceptance of suicide. Another review showed philosophical opinions and perspectives that spanned from ancient Greece and the Roman Empire to modern philosophical discourse. A case study of a terminally ill woman who chose suicide is presented to apply the history and philosophy to nursing care today. As more nursing care is delivered in patients' homes, nurses will face this situation with increasing frequency. A call is made for organizations to provide guidelines for nursing practice.

Pastoral power in HIV prevention: Converging rationalities of care in Christian and medical practices in Papua New Guinea.

PubMed

Shih, P; Worth, H; Travaglia, J; Kelly-Hanku, A

2017-11-01

In his conceptualisation of pastoral power, Michel Foucault argues that modern healthcare practices derive a specific power technique from pastors of the early Christian church. As experts in a position of authority, pastors practise the care of others through implicitly guiding them towards thoughts and actions that effect self-care, and towards a predefined realm of acceptable conduct, thus having a regulatory effect. This qualitative study of healthcare workers from two Christian faith-based organisations in Papua New Guinea examines the pastoral rationalities of HIV prevention practices which draw together globally circulated modern medical knowledge and Christian teachings in sexual morality for implicit social regulation. Community-based HIV awareness education, voluntary counselling and testing services, mobile outreach, and economic empowerment programs are standardised by promoting behavioural choice and individual responsibility for health. Through pastoral rationalities of care, healthcare practices become part of the social production of negative differences, and condemn those who become ill due to perceived immorality. This emphasis assumes that all individuals are equal in their ability to make behavioural choices, and downplays social inequality and structural drivers of HIV risk that are outside individual control. Given healthcare workers' recognition of the structural drivers of HIV, yet the lack of language and practical strategies to address these issues, political commitment is needed to enhance structural competency among HIV prevention programs and healthcare workers. Copyright © 2017 Elsevier Ltd. All rights reserved.

Autonomy, rationality and the wish to die.

PubMed

Clarke, D M

1999-12-01

Although suicide has traditionally carried a negative sanction in Western societies, this is now being challenged, and while there remains substantial public concern surrounding youth and elder suicide, there is a paradoxical push to relax the prohibition under certain circumstances. Central to the arguments behind this are the principles of respect for autonomy and the importance of rationality. It is argued here that the concepts of rationality and autonomy, while valuable, are not strong enough to substantiate a categorical "right to suicide" and that the concepts of "understandability" and "respect" are more useful and able to provide the foundation for responding to a person expressing a wish to die. Roman suicide, sometimes held as an example of "rational suicide", illustrates the effects of culture, tradition and values on the attitudes to, and the practice of, suicide.

Rational, computer-enabled peptide drug design: principles, methods, applications and future directions.

PubMed

Diller, David J; Swanson, Jon; Bayden, Alexander S; Jarosinski, Mark; Audie, Joseph

2015-01-01

Peptides provide promising templates for developing drugs to occupy a middle space between small molecules and antibodies and for targeting 'undruggable' intracellular protein-protein interactions. Importantly, rational or in cerebro design, especially when coupled with validated in silico tools, can be used to efficiently explore chemical space and identify islands of 'drug-like' peptides to satisfy diverse drug discovery program objectives. Here, we consider the underlying principles of and recent advances in rational, computer-enabled peptide drug design. In particular, we consider the impact of basic physicochemical properties, potency and ADME/Tox opportunities and challenges, and recently developed computational tools for enabling rational peptide drug design. Key principles and practices are spotlighted by recent case studies. We close with a hypothetical future case study.

Why the Kantian ideal survives medical learning curves, and why it matters.

PubMed

Brecher, B

2006-09-01

The "Kantian ideal" is often misunderstood as invoking individual autonomy rather than rational self legislation. Le Morvan and Stock's otherwise insightful discussion of "Medical learning curves and the Kantian ideal"--for example--draws the mistaken inference that that ideal is inconsistent with the realities of medical practice. But it is not. Rationally to be a patient entails accepting its necessary conditions.

Scientific and Religious Beliefs about the Origin of Life and Life after Death: Validation of a Scale

ERIC Educational Resources Information Center

Bautista, Jesús Silva; Escobar, Venazir Herrera; Miranda, Rodolfo Corona

2017-01-01

The variety of explanations to questions about the origin of life, life after death or about the role itself of being in the world are built on the rational reflection that integrates the ideology of human beings as well as less rational practices and more emotional ones than in the whole nourish what has been called "beliefs".…

Theoretical Basis for Dynamic Label Propagation in Stationary Metabolic Networks under Step and Periodic Inputs

PubMed Central

Sokol, Serguei; Portais, Jean-Charles

2015-01-01

The dynamics of label propagation in a stationary metabolic network during an isotope labeling experiment can provide highly valuable information on the network topology, metabolic fluxes, and on the size of metabolite pools. However, major issues, both in the experimental set-up and in the accompanying numerical methods currently limit the application of this approach. Here, we propose a method to apply novel types of label inputs, sinusoidal or more generally periodic label inputs, to address both the practical and numerical challenges of dynamic labeling experiments. By considering a simple metabolic system, i.e. a linear, non-reversible pathway of arbitrary length, we develop mathematical descriptions of label propagation for both classical and novel label inputs. Theoretical developments and computer simulations show that the application of rectangular periodic pulses has both numerical and practical advantages over other approaches. We applied the strategy to estimate fluxes in a simulated experiment performed on a complex metabolic network (the central carbon metabolism of Escherichia coli), to further demonstrate its value in conditions which are close to those in real experiments. This study provides a theoretical basis for the rational interpretation of label propagation curves in real experiments, and will help identify the strengths, pitfalls and limitations of such experiments. The cases described here can also be used as test cases for more general numerical methods aimed at identifying network topology, analyzing metabolic fluxes or measuring concentrations of metabolites. PMID:26641860

Evidence accumulation in decision making: unifying the "take the best" and the "rational" models.

PubMed

Lee, Michael D; Cummins, Tarrant D R

2004-04-01

An evidence accumulation model of forced-choice decision making is proposed to unify the fast and frugal take the best (TTB) model and the alternative rational (RAT) model with which it is usually contrasted. The basic idea is to treat the TTB model as a sequential-sampling process that terminates as soon as any evidence in favor of a decision is found and the rational approach as a sequential-sampling process that terminates only when all available information has been assessed. The unified TTB and RAT models were tested in an experiment in which participants learned to make correct judgments for a set of real-world stimuli on the basis of feedback, and were then asked to make additional judgments without feedback for cases in which the TTB and the rational models made different predictions. The results show that, in both experiments, there was strong intraparticipant consistency in the use of either the TTB or the rational model but large interparticipant differences in which model was used. The unified model is shown to be able to capture the differences in decision making across participants in an interpretable way and is preferred by the minimum description length model selection criterion.

Options as information: rational reversals of evaluation and preference.

PubMed

Sher, Shlomi; McKenzie, Craig R M

2014-06-01

This article develops a rational analysis of an important class of apparent preference reversals-joint-separate reversals traditionally explained by the evaluability hypothesis. The "options-as-information" model considers a hypothetical rational actor with limited knowledge about the market distribution of a stimulus attribute. The actor's evaluations are formed via a 2-stage process-an inferential stage in which beliefs are updated on the basis of the sample of options received, followed by an assessment stage in which options are evaluated in light of these updated beliefs. This process generates joint-separate reversals in standard experimental designs. The normative model explains why the evaluability hypothesis works when it does, identifies boundary conditions for the hypothesis, and clarifies some common misconceptions about these effects. In particular, it implies that joint-separate reversals are not irrational; in fact, they are not preference reversals. However, in expanded designs where more than 2 options are jointly evaluated, the model predicts that genuine (and rational) preference reversals will sometimes emerge. Results of 3 experiments suggest an excellent fit between the rational actor model and the judgments of human actors in joint-separate experiments. PsycINFO Database Record (c) 2014 APA, all rights reserved.

Emotions, Social Work Practice and Supervision: An Uneasy Alliance?

PubMed Central

Ingram, Richard

2012-01-01

This paper examines the place of emotions within social work practice. The perceived tensions between emotions and rational decision making are explored and it is argued that their relationship is compatible and necessary. A model for the co-creation of emotionally intelligent supervision is developed to support this vision of practice. PMID:24764612

Emotions, Social Work Practice and Supervision: An Uneasy Alliance?

PubMed

Ingram, Richard

2013-03-01

This paper examines the place of emotions within social work practice. The perceived tensions between emotions and rational decision making are explored and it is argued that their relationship is compatible and necessary. A model for the co-creation of emotionally intelligent supervision is developed to support this vision of practice.

Rational-Emotive Therapy and Youth: Some New Techniques for Counselors.

ERIC Educational Resources Information Center

Roush, David W.

1984-01-01

Derived from experience with cognitively and emotionally impaired juvenile offenders, several techniques are presented to increase the effectiveness of Rational Emotive Therapy with youth. The techniques provide young people with useful tools for building an effective personal problem solving approach to life. (JAC)

Response of sunshine bass to ration at elevated culture temperature

USDA-ARS?s Scientific Manuscript database

Temperature and ammonia increase dramatically during summer production of sunshine bass. Global temperatures are projected to increase. A factorial experiment investigated the effects of three digestible protein (DP; 33, 40, 47%), two lipid (L; 10, 18 %) and two ration levels (satiation, restricted)...

Rationalizing Neglect: An Institutional Response to Transfer Students

ERIC Educational Resources Information Center

Tobolowsky, Barbara F.; Cox, Bradley E.

2012-01-01

This qualitative study focuses on institutional efforts affecting the transfer student experience at a single research institution. Findings based on interviews with institutional representatives, both faculty and staff, using the rational, natural, and open system perspectives of organizational theory, provide insights into the institutional…

[Rationalities of knowledge production: on transformations of objects, technologies and information in biomedicine and the life sciences].

PubMed

Paul, Norbert W

2009-09-01

Since decades, scientific change has been interpreted in the light of paradigm shifts and scientific revolutions. The Kuhnian interpretation of scientific change however is now more and more confronted with non-disciplinary thinking in both, science and studies on science. This paper explores how research in biomedicine and the life sciences can be characterized by different rationalities, sometimes converging, sometimes contradictory, all present at the same time with varying ways of influence, impact, and visibility. In general, the rationality of objects is generated by fitting new objects and findings into a new experimental context. The rationality of hypotheses is a move towards the construction of novel explanatory tools and models. This is often inseparable meshing with the third, the technological rationality, in which a technology-driven, self-supporting and sometimes self-referential refinement of methods and technologies comes along with an extension into other fields. During the second and the third phase, the new and emerging fields tend to expand their explanatory reach not only across disciplinary boundaries but also into the social sphere, creating what has been characterized as "exceptionalism" (e.g. genetic exceptionalism or neuro-exceptionalism). Finally, recent biomedicine and life-sciences reach a level in which experimental work becomes more and more data-driven because the technologically constructed experimental systems generate a plethora of findings (data) which at some point start to blur the original hypotheses. For the rationality of information the materiality of research practices becomes secondary and research objects are more and more getting out of sight. Finally, the credibility of science as a practice becomes more and more dependent on consensus about the applicability and relevance of its results. The rationality of interest (and accountability) has become more and more characteristic for a research process which is no longer primarily determined by the desire for knowledge but by the desire for relevance. This paper explores in which ways object-driven and hypotheses-driven experimental life-sciences transformed into domains of experimental research evolving in a technologically constructed, data-driven environment in which they are subjected to constant morphing due to the forces of different rationalities.

A virtual reality system for arm and hand rehabilitation

NASA Astrophysics Data System (ADS)

Luo, Zhiqiang; Lim, Chee Kian; Chen, I.-Ming; Yeo, Song Huat

2011-03-01

This paper presents a virtual reality (VR) system for upper limb rehabilitation. The system incorporates two motion track components, the Arm Suit and the Smart Glove which are composed of a range of the optical linear encoders (OLE) and the inertial measurement units (IMU), and two interactive practice applications designed for driving users to perform the required functional and non-functional motor recovery tasks. We describe the technique details about the two motion track components and the rational to design two practice applications. The experiment results show that, compared with the marker-based tracking system, the Arm Suit can accurately track the elbow and wrist positions. The repeatability of the Smart Glove on measuring the five fingers' movement can be satisfied. Given the low cost, high accuracy and easy installation, the system thus promises to be a valuable complement to conventional therapeutic programs offered in rehabilitation clinics and at home.

Rationalization of indigenous male circumcision as a sacred religious custom: health beliefs of Xhosa men in South Africa.

PubMed

Mavundla, Thandisizwe Redford; Netswera, Fulufelo Godfrey; Bottoman, Brian; Toth, Ferenc

2009-10-01

This article presents research findings based on the meaning of indigenous circumcision to Xhosa men in South Africa. In South Africa, male circumcision is a rite of passage from adolescence to adulthood. The country has experienced serious problems associated with the practice of this rite ranging from dehydration to death in the traditional "bush" circumcision schools. A qualitative, endogenous research "How do you experience having a son who is undergoing the circumcision rite?" The study revealed cultural circumcision as a "sacred religious practice" with five themes, namely (a) readiness of Xhosa families to engage in the circumcision ritual, (b) the act of circumcision and preparation for manhood, (c) the importance of symbolic purity during the circumcision ritual, (d) celebrating acquired manhood, and (5) aspects of manhood and the rejection of clinical care. Secondary to this are health promotion recommendations made for individuals involved in this ritual.

Decision making in midwifery: rationality and intuition.

PubMed

Steinhauer, Suyai

2015-04-01

Decision making in midwifery is a complex process that shapes and underpins clinical practice and determines, to a large extent, the quality of care. Effective decision making and professional accountability are central to clinical governance, and being able.to justify all decisions is a professional and legal requirement. At the same time, there is an emphasis in midwifery on shared decision making, and keeping women at the centre of their care, and research reveals that feelings of choice, control and autonomy are central to a positive birth experience. However the extent to which decisions are really shared and care truly woman-centred is debatable and affected by environment and culture. Using a case study of a decision made in clinical practice around amniotomy, this article explores the role of the intuitive thinking system in midwifery decision making, and highlights the importance of involving women in the decision making process.

The long overdue medical specialty: bioethiatrics.

PubMed

Kevorkian, J

1986-11-01

Traditional bioethical codes have been unable to cope with the results of modern technology and the drastic changes in life patterns. The medical profession can reestablish bioethical order and reassert leadership through a new and urgently needed medical specialty, which the author tentatively calls bioethiatrics or bioethiatry. Bioethiatrics embodies a unique combination of ethical action and moral judgment.Training for the specialty would start with a residency program, consisting of thorough training in philosophy and religion coupled with continued experience in clinical medicine and indoctrination in contemporary research. Requirements would include the practice of general medicine for at least two years after internship, the passing of oral and written examinations after four years of residency, board certification, and subsequent periodic evaluations.Bioethiatricians would assume all the usual privileges, obligations, and risks associated with the practice of any medical specialty, thereby averting unnecessary ethical crises and ensuring a more rational response to present and future moral challenges.

The Long Overdue Medical Specialty: Bioethiatrics

PubMed Central

Kevorkian, Jack

1986-01-01

Traditional bioethical codes have been unable to cope with the results of modern technology and the drastic changes in life patterns. The medical profession can reestablish bioethical order and reassert leadership through a new and urgently needed medical specialty, which the author tentatively calls bioethiatrics or bioethiatry. Bioethiatrics embodies a unique combination of ethical action and moral judgment. Training for the specialty would start with a residency program, consisting of thorough training in philosophy and religion coupled with continued experience in clinical medicine and indoctrination in contemporary research. Requirements would include the practice of general medicine for at least two years after internship, the passing of oral and written examinations after four years of residency, board certification, and subsequent periodic evaluations. Bioethiatricians would assume all the usual privileges, obligations, and risks associated with the practice of any medical specialty, thereby averting unnecessary ethical crises and ensuring a more rational response to present and future moral challenges. PMID:3795285

Qualitative study of pregnancy and childbirth experiences in Somalian women resident in Sweden.

PubMed

Essén, B; Johnsdotter, S; Hovelius, B; Gudmundsson, S; Sjöberg, N O; Friedman, J; Ostergren, P O

2000-12-01

To explore the attitudes, strategies and habits of Somalian immigrant women related to pregnancy and childbirth, in order to gain an understanding as to how cultural factors might affect perinatal outcome. Interpreter assisted qualitative in depth interviews around topics such as attitudes and strategies regarding childbirth. Fifteen women from the Somalian community in a city in Sweden, between the ages of 20 and 55 years with delivery experience in Somalia and Sweden. The interviews describe how the women themselves perceived their experiences of childbirth in the migrant situation. Many voluntarily decreased food intake in order to have a smaller fetus, an easier delivery and to avoid caesarean section. The participants considered a safe delivery to be the same as a normal vaginal delivery They reduced food intake in order to diminish the growth of the fetus, thereby avoiding caesarean section and mortality. The practice of food intake reduction, while rational for the participants when in Somalia, was found less rational in Sweden and may lead to suboptimal obstetric surveillance. Somalian women have childbirth strategies that differ from those of Swedish women. These strategies should be seen as 'survival behaviours' related to their background in an environment with high maternal mortality. The hypothesis generated is that there is a relationship between the strategies during pregnancy and adverse perinatal outcome among Somalian immigrants. Considering the strong association of the habits to safe birth, it seems doubtful whether the women will change their habits as long as health care providers are unaware of their motives. We suggest a more culturally sensitive perinatal surveillance.

Premises and evidence in the rhetoric of assisted suicide and euthanasia.

PubMed

Mishara, Brian L; Weisstub, David N

2013-01-01

In debates about euthanasia and assisted suicide, it is rare to find an article that begins with an expression of neutral interest and then proceeds to examine the various arguments and data before drawing conclusions based upon the results of a scholarly investigation. Although authors frequently give the impression of being impartial in their introduction, they invariably reach their prior conclusions. Positions tend to be clearly dichotomized: either one believes that the practice of euthanasia or assisted suicide is totally acceptable or completely unacceptable in a just and moral society. Where there is some admission of a gray zone of incertitude, authors attempt to persuade us that their beliefs (preferences) are the only sensible way to resolve outstanding dilemmas. The practice of vehemently promoting a "pro" or "con" position may be useful when societies must decide to either legalize certain practices or not. Although only a handful of countries have thus far accepted the legal practice of euthanasia or assisted suicide (Belgium, Luxembourg, The Netherlands, the U.S. states of Montana, Oregon, Vermont and Washington, and Switzerland), scholarly articles in recent trends mainly promote legalization, to the point of recommending expansion of the current practices. Is this a case of the philosophers being ahead of their time in promoting and rationalizing the wave of the future? Alternatively, does the small number of countries that have legalized these practices indicate a substantial gap between the beliefs and desires of common citizens and the universe of the 'abstracted realm'? For the time being, what we do know is that more countries and states are debating legalization of euthanasia or assisted suicide, the nature of laws and legal practices vary greatly and both ethical and empirical assessments of current practices are the subject of much controversy. This article presents an examination of the premises and evidence in the rhetoric of assisted suicide and euthanasia. Inasmuch as any analysis cannot be totally impartial, we do not contend that our analysis is without influence from our experiences and philosophical affinities. Notwithstanding this caveat, we venture to propose that our scrutiny of the arguments and empirical data may offer some guidance to individuals who are attempting to reach practical conclusions based upon the available evidence, whether empirical or rationalized. © 2013.

Rational suicide among patients who are terminally ill.

PubMed

Valente, S M; Trainor, D

1998-08-01

Patients' end-of-life decisions challenge nurses. Often, aggressive, life prolonging strategies create ethical dilemmas for nurses when patients decide to stop treatment. In Oregon, assisted suicide is legal and will have a profound effect on nursing practice. When a patient considers suicide, nurses need to examine the patient's mental health, symptom management, and rational decision-making ability. Evaluation of suicide risk is a priority. Nurses need to recognize that medical land psychological symptoms often trigger thoughts of suicide, but prompt treatment of pain and symptoms also reduces suicide risk. Ethical issues and guidelines for management of patients considering suicide and evaluation of rationality are presented.

Why the Kantian ideal survives medical learning curves, and why it matters

PubMed Central

Brecher, B

2006-01-01

The “Kantian ideal” is often misunderstood as invoking individual autonomy rather than rational self legislation. Le Morvan and Stock's otherwise insightful discussion of “Medical learning curves and the Kantian ideal”—for example—draws the mistaken inference that that ideal is inconsistent with the realities of medical practice. But it is not. Rationally to be a patient entails accepting its necessary conditions. PMID:16943330

Becoming sustainable: human determinants of change.

PubMed

Frank, Gerhard

2014-05-15

The author is a natural scientist and philosopher who has been involved in the global experience industry for more than 25 years. During this period of time he has developed a coherent, interdisciplinary body of knowledge that appears to be of essential interest as related to the transition towards a sustainable society: the Experience Science (Frank, 2011, 2012). Important scientific inputs come from underlying disciplines like cybernetics, system theory, psychology, and cognitive science. One of the key findings of the Experience Science is the innate structure of human experiencing. Any human experience includes 5 different experiential domains that influence and regulate each other: the emotional domain (feeling); the mental imagery domain (mental narrating); the sensorimotor domain (acting & perceiving); the linguistic domain (rational reasoning); the communicational domain (conversing). In the light of the Experience Science the dilemma of the current transition process towards a sustainable society becomes clearly visible. Any relevant attempt reduces the existing problems to more or less exclusively the linguistic, rational domain. Although ever evolving rational knowledge indeed is an indispensable prerequisite for a sustainable future this is not enough. Societal change towards a sustainable life-style can only happen if the whole experiential system gets a chance to reorganize itself. This leads to the following logical consequence. Any rational knowledge is embedded in a both emotional and narrative knowledge system that underlies and frames human reasoning. As long as human learning restricts itself to an exclusively rational attempt the underlying emotional and narrative program remains untouched. The learner hence continues orienting her attention into the direction determined by the underlying emotional and narrative paradigm. The paper delineates the experiential determinants of change and analyzes their specific, constitutive interrelations. From this a holistic choreography of change learning is outlined that pays tribute to the intrinsic transition principles represented by the human learner. © 2013.

Autonomy, rationality and the wish to die.

PubMed Central

Clarke, D M

1999-01-01

Although suicide has traditionally carried a negative sanction in Western societies, this is now being challenged, and while there remains substantial public concern surrounding youth and elder suicide, there is a paradoxical push to relax the prohibition under certain circumstances. Central to the arguments behind this are the principles of respect for autonomy and the importance of rationality. It is argued here that the concepts of rationality and autonomy, while valuable, are not strong enough to substantiate a categorical "right to suicide" and that the concepts of "understandability" and "respect" are more useful and able to provide the foundation for responding to a person expressing a wish to die. Roman suicide, sometimes held as an example of "rational suicide", illustrates the effects of culture, tradition and values on the attitudes to, and the practice of, suicide. PMID:10635498

The doctor's dilemma.

PubMed

Irvine, D H; Donaldson, L J

1995-10-01

The close relationship between expenditure on health care and the countless individual judgements made by doctors for their patients means that any discussion about rationing must involve the process of clinical decision-making. Increasingly, doctors are being drawn into rationing by two powerful forces. Firstly, through the corporate responsibilities of those working within a managed health care system in which organisational objectives and budgetary constraints are agreed and specified in a much more explicit way than ever before. Secondly, by the professionally-led movement towards more clinically effective practice. These, in combination, are leading towards a fundamental review of the nature and ethical basis of clinical practice in which the duty of doctors to individual patients must be balanced against the wider considerations.

Perturbing Practices: A Case Study of the Effects of Virtual Manipulatives as Novel Didactic Objects on Rational Function Instruction

ERIC Educational Resources Information Center

Pampel, Krysten

2017-01-01

The advancement of technology has substantively changed the practices of numerous professions, including teaching. When an instructor first adopts a new technology, established classroom practices are perturbed. These perturbations can have positive and negative, large or small, and long- or short-term effects on instructors' abilities to teach…

Rationality in Public Sector Salary Scales: The Case of Rural Teachers in Pakistan.

ERIC Educational Resources Information Center

Khan, Shahrukh Rafi

2002-01-01

Examines the relationship between a public-sector teacher salary structure based on qualifications and experience and teacher effectiveness in rural Pakistan. Findings raise questions regarding the rationality of the salary structure's assumed positive association between teacher monetary incentives, teacher cognitive skills, and student academic…

Rational Behavioral Training and Changes in Self-Actualization.

ERIC Educational Resources Information Center

Johnson, Norbert; And Others

1982-01-01

Examined the effects on self-actualization of CETA supervisors who participated in a Rational Behavioral Training (RBT) group. The Personal Orientation Inventory (POI) was administered to experimental and control groups before and after the group. Results indicated the RBT experience enabled participants to move toward self-actualization. (RC)

The "Minority Psychology" of Adolescence: A Concept for Adult Equanimity and Rationality.

ERIC Educational Resources Information Center

Green, L. B.; Hubbard, Joan P.

1982-01-01

Contends that adolescents experience a "minority psychology" that motivates much of their behavior and that the extent to which this minority psychology will or will not lead to pathological thought and behavior can be influenced by the equanimity and rationality maintained by meaningful adults. (Author)

Adult Education and the Rational-Irrational Dimension of Prejudice

ERIC Educational Resources Information Center

Rhyne, Dwight C.

1973-01-01

Teachers and counselors in an eight-week institute on problems of school desegregation were used in this study to estimate the degree of change in ethnic attitudes on the rational-irrational and anti-pro minority dimensions of prejudice as related to participation in an intensive adult education experience. (DS)

The eXperience Induction Machine: A New Paradigm for Mixed-Reality Interaction Design and Psychological Experimentation

NASA Astrophysics Data System (ADS)

Bernardet, Ulysses; Bermúdez I Badia, Sergi; Duff, Armin; Inderbitzin, Martin; Le Groux, Sylvain; Manzolli, Jônatas; Mathews, Zenon; Mura, Anna; Väljamäe, Aleksander; Verschure, Paul F. M. J.

The eXperience Induction Machine (XIM) is one of the most advanced mixed-reality spaces available today. XIM is an immersive space that consists of physical sensors and effectors and which is conceptualized as a general-purpose infrastructure for research in the field of psychology and human-artifact interaction. In this chapter, we set out the epistemological rational behind XIM by putting the installation in the context of psychological research. The design and implementation of XIM are based on principles and technologies of neuromorphic control. We give a detailed description of the hardware infrastructure and software architecture, including the logic of the overall behavioral control. To illustrate the approach toward psychological experimentation, we discuss a number of practical applications of XIM. These include the so-called, persistent virtual community, the application in the research of the relationship between human experience and multi-modal stimulation, and an investigation of a mixed-reality social interaction paradigm.

Deleting 'irrational' responses from discrete choice experiments: a case of investigating or imposing preferences?

PubMed

Lancsar, Emily; Louviere, Jordan

2006-08-01

Investigation of the 'rationality' of responses to discrete choice experiments (DCEs) has been a theme of research in health economics. Responses have been deleted from DCEs where they have been deemed by researchers to (a) be 'irrational', defined by such studies as failing tests for non-satiation, or (b) represent lexicographic preferences. This paper outlines a number of reasons why deleting responses from DCEs may be inappropriate after first reviewing the theory underpinning rationality, highlighting that the importance placed on rationality depends on the approach to consumer theory to which one ascribes. The aim of this paper is not to suggest that all preferences elicited via DCEs are rational. Instead, it is to suggest a number of reasons why it may not be the case that all preferences labelled as 'irrational' are indeed so. Hence, deleting responses may result in the removal of valid preferences; induce sample selection bias; and reduce the statistical efficiency and power of the estimated choice models. Further, evidence suggests random utility theory may be able to cope with such preferences. Finally, we discuss a number of implications for the design, implementation and interpretation of DCEs and recommend caution regarding the deletion of preferences from stated preference experiments. Copyright 2006 John Wiley & Sons, Ltd.

Effects of long-term feeding dairy cows on a diet supplemented with clinoptilolite on certain serum trace elements.

PubMed

Katsoulos, P D; Roubies, N; Panousis, N; Karatzias, H

2005-01-01

The objective of the experiment was to investigate the effect of clinoptilolite (a natural zeolite) supplementation in the ration of dairy cows on serum copper (Cu), zinc (Zn), and iron (Fe) concentrations. Fifty-two clinically healthy Holstein cows were randomly assigned to one of three groups according to their age and parity. The first group (group A) comprised 17 cows fed a ration supplemented with 1.25% clinoptilolite, the second group (group B) comprised also 17 cows was given a ration with 2.5% clinoptilolite, and the third group (group C, the control), comprised 18 cows fed the basal ration that did not contain any clinoptilolite. The experiment started when the cows entered the fourth week before the expected parturition and lasted until the end of lactation. All cows were fed the above concentrates during the entire experimental period. Blood samples were collected from each animal at the starting day of the experiment, at the day of calving, and at monthly intervals thereafter. All samples were tested for serum Cu, Zn, and Fe concentrations. The results showed that the 1.25 and 2.5% supplementation of clinoptilolite did not have any adverse effects on serum concentrations of Cu, Zn, and Fe.

Clinical reasoning in the real world is mediated by bounded rationality: implications for diagnostic clinical practice guidelines.

PubMed

Bonilauri Ferreira, Ana Paula Ribeiro; Ferreira, Rodrigo Fernando; Rajgor, Dimple; Shah, Jatin; Menezes, Andrea; Pietrobon, Ricardo

2010-04-20

Little is known about the reasoning mechanisms used by physicians in decision-making and how this compares to diagnostic clinical practice guidelines. We explored the clinical reasoning process in a real life environment. This is a qualitative study evaluating transcriptions of sixteen physicians' reasoning during appointments with patients, clinical discussions between specialists, and personal interviews with physicians affiliated to a hospital in Brazil. FOUR MAIN THEMES WERE IDENTIFIED: simple and robust heuristics, extensive use of social environment rationality, attempts to prove diagnostic and therapeutic hypothesis while refuting potential contradictions using positive test strategy, and reaching the saturation point. Physicians constantly attempted to prove their initial hypothesis while trying to refute any contradictions. While social environment rationality was the main factor in the determination of all steps of the clinical reasoning process, factors such as referral letters and number of contradictions associated with the initial hypothesis had influence on physicians' confidence and determination of the threshold to reach a final decision. Physicians rely on simple heuristics associated with environmental factors. This model allows for robustness, simplicity, and cognitive energy saving. Since this model does not fit into current diagnostic clinical practice guidelines, we make some propositions to help its integration.

Clinical Reasoning in the Real World Is Mediated by Bounded Rationality: Implications for Diagnostic Clinical Practice Guidelines

PubMed Central

Bonilauri Ferreira, Ana Paula Ribeiro; Ferreira, Rodrigo Fernando; Rajgor, Dimple; Shah, Jatin; Menezes, Andrea; Pietrobon, Ricardo

2010-01-01

Background Little is known about the reasoning mechanisms used by physicians in decision-making and how this compares to diagnostic clinical practice guidelines. We explored the clinical reasoning process in a real life environment. Method This is a qualitative study evaluating transcriptions of sixteen physicians' reasoning during appointments with patients, clinical discussions between specialists, and personal interviews with physicians affiliated to a hospital in Brazil. Results Four main themes were identified: simple and robust heuristics, extensive use of social environment rationality, attempts to prove diagnostic and therapeutic hypothesis while refuting potential contradictions using positive test strategy, and reaching the saturation point. Physicians constantly attempted to prove their initial hypothesis while trying to refute any contradictions. While social environment rationality was the main factor in the determination of all steps of the clinical reasoning process, factors such as referral letters and number of contradictions associated with the initial hypothesis had influence on physicians' confidence and determination of the threshold to reach a final decision. Discussion Physicians rely on simple heuristics associated with environmental factors. This model allows for robustness, simplicity, and cognitive energy saving. Since this model does not fit into current diagnostic clinical practice guidelines, we make some propositions to help its integration. PMID:20421920

From the numinous to the sacred.

PubMed

MacKenna, Christopher

2009-04-01

Jung took the idea of the 'numinous' from Rudolf Otto's book Das Heilige (E.T. The Idea of the Holy) and made it central to his understanding of religion. However, as Lucy Huskinson has recently pointed out, this involves a misreading of Otto's work in which we have to look beyond the numinous (which is the non-rational factor in religion) towards the 'holy' which, like a symbol, holds the rational and non-rational aspects of religious experience together in a personally transformative way. This understanding of the spiritual and psychological journey is supported by case material in which a numinous experience, arising in the context of intensive analytical psychotherapy, proved to be but the first step in a process which led, through a period of mourning, towards the development of the patient's capacity to symbolize. In the light of this, the author suggests that the sacred is to be found in the capacity for a certain quality of symbolic relatedness--to self and other--which may or may not be attended by numinous experience.

Rational Thinking and Belief in Psychic Abilities: It Depends on Level of Involvement.

PubMed

Stone, Anna

2016-02-01

Previous research has shown that lay believers in psychic abilities are more prone to intuitive thinking, less inclined to rational thinking, and have an external locus of control, compared to non-believers. Psychic practitioners, however, may have different characteristics. Psychic practitioners ( n = 31; M age = 42.7 yr., SD = 13.1), lay believers ( n = 33; M age = 33.0 yr., SD = 10.3), and non-believers ( n = 31; M age = 34.4 yr., SD = 15.4) completed questionnaires measuring thinking styles, locus of control, and psychic belief. Comparisons of lay believers with non-believers confirmed previous observations: believers had a higher propensity for intuitive thinking, lower propensity for rational thinking, and more external locus of control. In contrast, practitioners were equivalent to non-believers in rational thinking and had the highest internal locus of control. This highlights the importance of considering level of involvement with psychic practice in understanding the thinking styles of believers. Results suggested that practitioners may have rationalized their beliefs and constructed a coherent model of psychic phenomena that satisfies a propensity for rational thinking within a community of belief.

The dilemma of osteopathic physicians and the rationalization of medical practice.

PubMed

Eckberg, D L

1987-01-01

Years ago, Peter New observed that osteopathic medical students faced a dilemma concerning their identity. On the one hand, they wished to be considered complete medical practitioners. On the other hand, they wished to be seen as different from MDs. There is evidence that osteopathic physicians continue to face that dilemma. I hypothesize that in part this stems from a conflict between classical 'lifestyle commitments' of the osteopathic community (e.g. toward general practice, osteopathic manipulative therapy, holism) and the rationalized model of medicine practiced by MDs (characterized by specialization and scientific elitism). Results of a survey of a local population of osteopathic physicians generally confirm this. Specific findings are that (1) classical elements of osteopathic commitment are not tied to commitment to the profession in general, (2) there appears to be a waning of commitment to general practice, (3) an increasing number of osteopathic physicians used the DO degree as a 'back door' into medicine and are less likely to identify with classical osteopathic norms, and (4) DOs from socially conservative backgrounds are more likely than others to maintain commitment to the classical elements of osteopathic practice.

Professional practices and perception towards rational use of medicines according to WHO methodology in United Arab Emirates

PubMed Central

Abdul Rasool, Bazigha K.; Fahmy, Sahar A.; Abu-Gharbieh, Eman F.; Ali, Heyam S.

2009-01-01

Inappropriate prescribing reduces the quality of medical care and leads to a waste of resources. No study has been reported concerning rational drug use in United Arab Emirates, UAE, recently. Objectives assessing patterns of use and defining problems regarding the rational drug use.Setting baseline situational analysis study for practices in the health care system relevant to drug use. Method A descriptive pilot study, consisting of pharmacists, physicians and patients (100 of each of category) from four private hospitals, (12) medical clinics, (80) community pharmacies in addition to 150 prescriptions. A questionnaire of three sections was designed to include WHO indicators regarding patients, facility and prescribing patterns that are relevant to rational drug use was carried out in four emirates of the UAE in the period December 2008-Febreuary 2009. Results Consultation and dispensing times were 10 (SD=2.75) min and 68 (SD=9.7) seconds, respectively. Average no. of drugs per prescription was (2.9 + 0.97), % of prescriptions using generic name (7.35%), % of antibiotic containing prescriptions (31.1%), % of injection containing prescriptions (2.9%), adherence to Standard Treatment Protocols (46%), adherence to the essential drug list (64%), patient’s knowledge of correct dosage (55%), adequately labeled drugs (45%), patient’s information (65%). Conclusions Several areas of deficiency in rational drug use had been defined in the private sector through UAE that can be remedied through adopting several strategies such as adherence to national standard treatment guidelines and essential drug list based on treatments of choice, interaction between health care system and providing drugs information to consumers. PMID:25152796

Professional practices and perception towards rational use of medicines according to WHO methodology in United Arab Emirates.

PubMed

Rasool, Bazigha K Abdul; Fahmy, Sahar A; Abu-Gharbieh, Eman F; Ali, Heyam S

2010-01-01

Inappropriate prescribing reduces the quality of medical care and leads to a waste of resources. No study has been reported concerning rational drug use in United Arab Emirates, UAE, recently. assessing patterns of use and defining problems regarding the rational drug use.Setting baseline situational analysis study for practices in the health care system relevant to drug use. A descriptive pilot study, consisting of pharmacists, physicians and patients (100 of each of category) from four private hospitals, (12) medical clinics, (80) community pharmacies in addition to 150 prescriptions. A questionnaire of three sections was designed to include WHO indicators regarding patients, facility and prescribing patterns that are relevant to rational drug use was carried out in four emirates of the UAE in the period December 2008-Febreuary 2009. Consultation and dispensing times were 10 (SD=2.75) min and 68 (SD=9.7) seconds, respectively. Average no. of drugs per prescription was (2.9 + 0.97), % of prescriptions using generic name (7.35%), % of antibiotic containing prescriptions (31.1%), % of injection containing prescriptions (2.9%), adherence to Standard Treatment Protocols (46%), adherence to the essential drug list (64%), patient's knowledge of correct dosage (55%), adequately labeled drugs (45%), patient's information (65%). Several areas of deficiency in rational drug use had been defined in the private sector through UAE that can be remedied through adopting several strategies such as adherence to national standard treatment guidelines and essential drug list based on treatments of choice, interaction between health care system and providing drugs information to consumers.

Pandemic Ventilator Rationing and Appeals Processes

PubMed Central

Patrone, Daniel; Resnik, David

2014-01-01

In a severe influenza pandemic, hospitals will likely experience serious and widespread shortages of patient pulmonary ventilators and of staff qualified to operate them. Deciding who will receive access to mechanical ventilation will often determine who lives and who dies. This prospect raises an important question whether pandemic preparedness plans should include some process by which individuals affected by ventilator rationing would have the opportunity to appeal adverse decisions. However, the issue of appeals processes to ventilator rationing decisions has been largely neglected in state pandemic planning efforts. If we are to devise just and effective plans for coping with a severe influenza pandemic, more attention to the issue of appeals processes for pandemic ventilator rationing decisions is needed. Arguments for and against appeals processes are considered, and some suggestions are offered to help efforts at devising more rational pandemic preparedness plans. PMID:20354793

Pandemic ventilator rationing and appeals processes.

PubMed

Patrone, Daniel; Resnik, David

2011-06-01

In a severe influenza pandemic, hospitals will likely experience serious and widespread shortages of patient pulmonary ventilators and of staff qualified to operate them. Deciding who will receive access to mechanical ventilation will often determine who lives and who dies. This prospect raises an important question whether pandemic preparedness plans should include some process by which individuals affected by ventilator rationing would have the opportunity to appeal adverse decisions. However, the issue of appeals processes to ventilator rationing decisions has been largely neglected in state pandemic planning efforts. If we are to devise just and effective plans for coping with a severe influenza pandemic, more attention to the issue of appeals processes for pandemic ventilator rationing decisions is needed. Arguments for and against appeals processes are considered, and some suggestions are offered to help efforts at devising more rational pandemic preparedness plans.

The materials processing research base of the Materials Processing Center. Report for FY 1982

NASA Technical Reports Server (NTRS)

Flemings, M. C.

1983-01-01

The work described, while involving research in the broad field of materials processing, has two common features: the problems are closed related to space precessing of materials and have both practical and fundamental significance. An interesting and important feature of many of the projects is that the interdisciplinary nature of the problem mandates complementary analytical modeling/experimental approaches. An other important aspect of many of the projects is the increasing use of mathematical modeling techniques as one of the research tools. The predictive capability of these models, when tested against measurements, plays a very important role in both the planning of experimental programs and in the rational interpretation of the results. Many of the projects described have a space experiment as their ultimate objective. Mathematical models are proving to be extremely valuable in projecting the findings of ground - based experiments to microgravity conditions.

The Role of Ethics Committees and Ethics Consultation in Allocation Decisions

PubMed Central

Strech, Daniel; Hurst, Samia; Danis, Marion

2013-01-01

Background Decisions about the allocation and rationing of medical interventions likely occur in all health care systems worldwide. So far very little attention has been given to the question of what role ethics consultation and ethics committees could or should play in questions of allocation at the hospital level. Objectives and Methods This article argues for the need for ethics consultation in rationing decisions using empirical data about the status quo and the inherent nature of bedside rationing. Subsequently, it introduces a 4-stage process for establishing and conducting ethics consultation in rationing questions with systematic reference to core elements of procedural justice. Results Qualitative and quantitative findings show a significant demand for ethics consultation expressed directly by doctors, as well as additional indirect evidence of such a need as indicated by ethically challenging circumstances of inconsistent and structurally disadvantaging rationing decisions. To address this need, we suggest 4 stages for establishing and conducting ethics consultation in rationing questions we recommend: (1) training, (2) identifying actual scarcity-related problems at clinics, (3) supporting decision-making, and (4) evaluation. Conclusion This process of ethics consultation regarding rationing decisions would facilitate the achievement of several practical goals: (i) encouragement of an awareness and understanding of ethical problems in bedside rationing, (ii) encouragement of achieving efficiency along with rationing, (iii) reinforcement of consistency in inter- and intraindvidual decision-making, (iv) encouragement of explicit reflection and justification of the prioritization criteria taken into consideration, (v) improvement in internal (in-house) and external transparency, and (vi) prevention of the misuse of the corresponding consulting structures. PMID:20706163

Paradigms Lost: Academic Practice and Exteriorising Technologies

ERIC Educational Resources Information Center

Land, Ray

2006-01-01

Using Milton's "Paradise Lost" as metaphor, this article examines shifting positions of authority, and the role of technology, in higher education practice. As higher education becomes caught up in the performative agendas of globalised market rationalism, technology is mobilised in a specific way which sits uncomfortably with…

Environmental risk, precaution, and scientific rationality in the context of WTO/NAFTA trade rules.

PubMed

Crawford-Brown, Douglas; Pauwelyn, Joost; Smith, Kelly

2004-04-01

This article considers the role of scientific rationality in understanding statements of risk produced by a scientific community. An argument is advanced that, while scientific rationality does impose constraints on valid scientific justifications for restrictions on products and practices, it also provides flexibility in the judgments needed to both develop and apply characterizations of risk. The implications of this flexibility for the understanding of risk estimates in WTO and NAFTA deliberations are explored, with the goal of finding an intermediate ground between the view that science unambiguously justifies or rejects a policy, and the view that science is yet another cultural tool that can be manipulated in support of any decision. The result is a proposal for a dialogical view of scientific rationality in which risk estimates are depicted as confidence distributions that follow from a structured dialogue of scientific panels focused on judgments of evidence, evidential reasoning, and epistemic analysis.

Linking patient satisfaction with nursing care: the case of care rationing - a correlational study.

PubMed

Papastavrou, Evridiki; Andreou, Panayiota; Tsangari, Haritini; Merkouris, Anastasios

2014-01-01

Implicit rationing of nursing care is the withholding of or failure to carry out all necessary nursing measures due to lack of resources. There is evidence supporting a link between rationing of nursing care, nurses' perceptions of their professional environment, negative patient outcomes, and placing patient safety at risk. The aims of the study were: a) To explore whether patient satisfaction is linked to nurse-reported rationing of nursing care and to nurses' perceptions of their practice environment while adjusting for patient and nurse characteristics. b) To identify the threshold score of rationing by comparing the level of patient satisfaction factors across rationing levels. A descriptive, correlational design was employed. Participants in this study included 352 patients and 318 nurses from ten medical and surgical units of five general hospitals. Three measurement instruments were used: the BERNCA scale for rationing of care, the RPPE scale to explore nurses' perceptions of their work environment and the Patient Satisfaction scale to assess the level of patient satisfaction with nursing care. The statistical analysis included the use of Kendall's correlation coefficient to explore a possible relationship between the variables and multiple regression analysis to assess the effects of implicit rationing of nursing care together with organizational characteristics on patient satisfaction. The mean score of implicit rationing of nursing care was 0.83 (SD = 0.52, range = 0-3), the overall mean of RPPE was 2.76 (SD = 0.32, range = 1.28 - 3.69) and the two scales were significantly correlated (τ = -0.234, p < 0.001). The regression analysis showed that care rationing and work environment were related to patient satisfaction, even after controlling for nurse and patient characteristics. The results from the adjusted regression models showed that even at the lowest level of rationing (i.e. 0.5) patients indicated low satisfaction. The results support the relationships between organizational and environmental variables, care rationing and patient satisfaction. The identification of thresholds at which rationing starts to influence patient outcomes in a negative way may allow nurse managers to introduce interventions so as to keep rationing at a level at which patient safety is not jeopardized.

Engaging Whole-Number Knowledge for Rational-Number Leaning Using a Computer-Based Tool.

ERIC Educational Resources Information Center

Hunting, Robert P.; And Others

1996-01-01

This constructivist teaching experiment investigated the role of whole-number knowledge in fraction learning. Two nine-year-old students worked for one year with a computer program (Copycat) and demonstrated that the development of whole-number knowledge and rational-number knowledge is interdependent. Contains 59 references. (KMC)

The role of cognitive, emotional and personality factors in the experience of fatigue in a university and community sample.

PubMed

Kangas, Maria; Montgomery, Guy H

2011-05-01

The aim of this study was to investigate the contribution of cognitive, emotional and personality factors to the experience of fatigue severity in healthy adult individuals. Specifically, the study examined whether fatigue catastrophising and emotional distress mediated the relationships between neuroticism, general irrational and rational thoughts to fatigue severity. One hundred and eighty nine university students and community volunteers completed self-report questionnaires assessing fatigue catastrophising and symptom severity, neuroticism, general rational and irrational thoughts and emotional distress. A series of correlational and path analyses were conducted to test the study hypotheses. Neuroticism and more general negative, irrational cognitions were associated with elevated fatigue catastrophising and fatigue severity, whereas more adaptive, rational cognitions were related to lower fatigue catastrophising and fatigue severity. Both elevated fatigue catastrophising and emotional distress uniquely and simultaneously mediated the relationships between irrational and rational cognitions and neuroticism to fatigue severity. These findings demonstrate that cognitions play a role in fatigue severity. The results have implications in the assessment and treatment of fatigue disturbances in the general community.

The effect of iconicity of visual displays on statistical reasoning: evidence in favor of the null hypothesis.

PubMed

Sirota, Miroslav; Kostovičová, Lenka; Juanchich, Marie

2014-08-01

Knowing which properties of visual displays facilitate statistical reasoning bears practical and theoretical implications. Therefore, we studied the effect of one property of visual diplays - iconicity (i.e., the resemblance of a visual sign to its referent) - on Bayesian reasoning. Two main accounts of statistical reasoning predict different effect of iconicity on Bayesian reasoning. The ecological-rationality account predicts a positive iconicity effect, because more highly iconic signs resemble more individuated objects, which tap better into an evolutionary-designed frequency-coding mechanism that, in turn, facilitates Bayesian reasoning. The nested-sets account predicts a null iconicity effect, because iconicity does not affect the salience of a nested-sets structure-the factor facilitating Bayesian reasoning processed by a general reasoning mechanism. In two well-powered experiments (N = 577), we found no support for a positive iconicity effect across different iconicity levels that were manipulated in different visual displays (meta-analytical overall effect: log OR = -0.13, 95% CI [-0.53, 0.28]). A Bayes factor analysis provided strong evidence in favor of the null hypothesis-the null iconicity effect. Thus, these findings corroborate the nested-sets rather than the ecological-rationality account of statistical reasoning.

"You can't choose these emotions… they simply jump up": Ambiguities in Resilience-Building Interventions in Israel.

PubMed

Yankellevich, Ariel; Goodman, Yehuda C

2017-03-01

Following the growing critique of the use of Post-Traumatic Stress Disorder in post-disaster interventions, a new type of intervention aimed at building resilience in the face of traumatic events has been making its first steps in the social field. Drawing on fieldwork of a resilience-building program for pre-clinical populations in Israel, we analyze the paradoxes and ambiguities entailed in three inter-related aspects of this therapeutic project: The proposed clinical ideology aimed at immunizing against traumas; the discursive and non-discursive practices used by the mental-health professionals; and, participants' difficulties to inhabit the new resilient subject. These contradictions revolve around the injunction to rationally handle emotions in response to disruptive traumatic events. Hence, the attempt to separate between a sovereign rational subject and a post-traumatic subject is troubled in the face of experiences of trauma and social suffering. Furthermore, we demonstrate how these difficulties reconstitute unresolved tensions between mimetic and anti-mimetic tendencies that have been pervading the understanding of trauma in the therapeutic professions. Finally, we discuss how the construction of the resilient subject challenges the expanding bio-medical and neoliberal self-management paradigm in mental health.

Self-medication practices and rational drug use habits among university students: a cross-sectional study from Kahramanmaraş, Turkey.

PubMed

Okyay, Ramazan Azim; Erdoğan, Ayşegül

2017-01-01

Self-medication refers to the use of medicines to treat self-diagnosed diseases without consulting any healthcare professionals. Irrational drug use and self-medication have serious negative consequences both on health and economy. Therefore, the aim of this study is to assess the habits related to rational use of drugs (RUD) and to estimate the prevalence of self-medication practices among university students. This cross-sectional study was conducted on university students in Kahramanmaraş. From May 2017 to June 2017 a total of 960 students filled a "Rational Use of Drugs Questionnaire". The prevalence of practicing self-medication in students was 63.4%. The most common medicines that the students had consumed without prescription were analgesics by 39.5%, antibiotics by 36.9% and cold remedies by 24.0%. The rate of students who declared that they were familiar with RUD and "rational use of antibiotics" (RUA) was 45.9%. Reading/checking the instructions in the prospectus (OR = 1.529, 95% CI [1.176-1.990]), understanding the context of the prospectus (OR = 1.893, 95% CI [1.387-2.584]), compliance with the duration of antibiotic treatment (OR = 1.597, 95% CI [1.231-2.071]) and consulting a physician in case of a side effect (OR = 1.350, 95% CI [1.037-1.757]) were significantly higher among students who were familiar with RUD as compared to who were not. Since the awareness of RUD among university students was found to be inadequate, it has critical importance to hold educational activities with the cooperation of physicians, health organizations, universities, non-governmental organizations and media to avoid negative consequences of irrational drug use and self-medication.

[Home blood transfusion].

PubMed

Gay, V; Prévôt, G; Amico, I; Bonnet, B; Mansard, M-O

2010-12-01

The development of alternatives to hospitalization including home medical care (HAD), an aging population and a more secure transfusion raises the question of the feasibility of home blood transfusion. The legislation allows the home blood transfusion under specified conditions, but when they are met, the texts on nursing care and the transfusion gesture may hamper this progress. We report our experience of 3 years: a protocol was established to do home blood transfusions by trained transfusion nurses from the HAD. Six patients were eligible for transfusion at home but only three of them could be treated at home. Moreover, since late 2009, the Nursing Department no longer allows this practice for legal reasons. At the same time, a questionnaire was sent to 224 HAD to find out about their practice on the subject. In the light of practices in different countries, earnings for the quality of life of the patient, lack of space in hospitals and the aging population, it seems essential to change the law to permit a rational transfusion, thoughtful, safe for the patient at home and for caregivers who are involved. Copyright © 2010 Elsevier Masson SAS. All rights reserved.

A survey of Ethiopian physicians' experiences of bedside rationing: extensive resource scarcity, tough decisions and adverse consequences.

PubMed

Defaye, Frehiwot Berhane; Desalegn, Dawit; Danis, Marion; Hurst, Samia; Berhane, Yemane; Norheim, Ole Frithjof; Miljeteig, Ingrid

2015-10-14

Resource scarcity in health care is a universal challenge. In high-income settings, bedside rationing is commonly discussed and debated as a means to addressing scarcity. However, little is known about physicians' experiences in resource-limited contexts in low- income countries. Here we describe physicians' experiences regarding scarcity of resources, bedside rationing, use of various strategies to save resources, and perceptions of the consequences of rationing in Ethiopia. A national survey was conducted amongst physicians from 49 public hospitals using stratified, multi-stage sampling in six regions. All physicians in the selected hospitals were invited to respond to a self-administered questionnaire. Data were weighted and analyzed using descriptive statistics. In total, 587 physicians responded (91% response rate). The majority had experienced system-wide shortages of various types of medical services. The services most frequently reported to be in short supply, either daily or weekly, were access to surgery, specialist and intensive care units, drug prescriptions and admission to hospital (52, 49, 46, 47 and 46% respectively). The most common rationing strategies used daily or weekly were limiting laboratory tests, hospital drugs, radiological investigations and providing second best treatment (47, 47, 47 and 39% respectively). Availability of institutional or national guidelines for whom to see and treat first was lacking. Almost all respondents had witnessed different adverse consequences of resource scarcity; 54% reported seeing patients who, in their estimation, had died due to resource scarcity. Almost 9 out of 10 physicians were so troubled by limited resources that they often regretted their choice of profession. This study provides the first glimpses of the untold story of resource shortage and bedside rationing in Ethiopia. Physicians encounter numerous dilemmas due to resource scarcity, and they report they lack adequate guidance for how to handle them. The consequences for patients and the professionals are substantial.

Inside 'bed management': ethnographic insights from the vantage point of UK hospital nurses.

PubMed

Allen, Davina

2015-03-01

In the face of unprecedented financial and demographic challenges, optimising acute bed utilisation by the proactive management of patient flows is a pressing policy concern in high-income countries. Despite the growing literature on this topic, bed management has received scant sociological attention. Drawing on practice-based approaches, this article deploys ethnographic data to examine bed management from the perspective of UK hospital nurses. While the nursing contribution to bed management is recognised formally in their widespread employment in patient access and discharge liaison roles, nurses at all levels in the study site were enrolled in this organisational priority. Rather than the rational, centrally controlled processes promulgated by policymakers, bed management emerges as a predominantly distributed activity, described here as match-making. An example of micro-level rationing, for the most part, match-making was not informed by explicit criteria nor did it hinge on clearly identifiable decisions to grant or deny access. Rather it was embedded in the everyday practices and situated rationalities through which nurses accomplished the accommodations necessary to balance demand with resources. © 2014 Foundation for the Sociology of Health & Illness.

Immunonutrition in septic patients: a philosophical view of the current situation.

PubMed

Bertolini, Guido; Luciani, Davide; Biolo, Gianni

2007-02-01

Two different ways of thinking pervaded the history of science: rationalism and empiricism. In theory, these two paradigms are not necessarily in conflict. In practice, there has always been tension between them. The coming of evidence-based medicine put empiricism in a privileged position, but empiricism without a rationalistic guide could even be usefulness. The aim of this work is to present the tension between the rational reasons to administer immunonutrients to patients with sepsis and the controversial empirical evidence stemming from clinical trials. We reviewed the literature on immunonutrition in sepsis from the rationalist and the empiricist perspectives. The large body of evidence for positive effects of immunonutrients in experimental models and the contradictory results from clinical trials make the discussion on immunonutrition in sepsis a typical example where the conflict between rationalism and empiricism hampered the advancement of knowledge and the implementation of new effective therapies into clinical practice. Future research projects involving immunonutrients should be based on robust knowledge of basic mechanisms of action to be properly addressed in clinical trials.

A rational approach to the selection of useful drugs for clinical practice.

PubMed

Spector, Reynold; Vesell, Elliot S

2002-05-01

Confusion exists concerning optimal selection of drugs for clinical practice. Many reasons contribute to this confusion which derives from various sources including industry, the FDA and often less than ideal education of physicians in clinical pharmacology during medical school and thereafter. This presentation does not focus on allocating blame for the current unsatisfactory situation, but rather offers a solution to improve drug therapy. Our educational solution consists of a paradigm for rational drug therapy, specifically a checklist of eight criteria for physicians to review before prescribing drugs. Such a review would facilitate better estimation by physicians of risk/benefit ratios involving new, often expensive and, in some cases, questionably effective and safe drugs. Copyright 2002 S. Karger AG, Basel

The role of self-interest in elite bargaining.

PubMed

LeVeck, Brad L; Hughes, D Alex; Fowler, James H; Hafner-Burton, Emilie; Victor, David G

2014-12-30

One of the best-known and most replicated laboratory results in behavioral economics is that bargainers frequently reject low offers, even when it harms their material self-interest. This finding could have important implications for international negotiations on many problems facing humanity today, because models of international bargaining assume exactly the opposite: that policy makers are rational and self-interested. However, it is unknown whether elites who engage in diplomatic bargaining will similarly reject low offers because past research has been based almost exclusively on convenience samples of undergraduates, members of the general public, or small-scale societies rather than highly experienced elites who design and bargain over policy. Using a unique sample of 102 policy and business elites who have an average of 21 y of practical experience conducting international diplomacy or policy strategy, we show that, compared with undergraduates and the general public, elites are actually more likely to reject low offers when playing a standard "ultimatum game" that assesses how players bargain over a fixed resource. Elites with more experience tend to make even higher demands, suggesting that this tendency only increases as policy makers advance to leadership positions. This result contradicts assumptions of rational self-interested behavior that are standard in models of international bargaining, and it suggests that the adoption of global agreements on international trade, climate change, and other important problems will not depend solely on the interests of individual countries, but also on whether these accords are seen as equitable to all member states.

The role of self-interest in elite bargaining

PubMed Central

LeVeck, Brad L.; Hughes, D. Alex; Fowler, James H.; Hafner-Burton, Emilie; Victor, David G.

2014-01-01

One of the best-known and most replicated laboratory results in behavioral economics is that bargainers frequently reject low offers, even when it harms their material self-interest. This finding could have important implications for international negotiations on many problems facing humanity today, because models of international bargaining assume exactly the opposite: that policy makers are rational and self-interested. However, it is unknown whether elites who engage in diplomatic bargaining will similarly reject low offers because past research has been based almost exclusively on convenience samples of undergraduates, members of the general public, or small-scale societies rather than highly experienced elites who design and bargain over policy. Using a unique sample of 102 policy and business elites who have an average of 21 y of practical experience conducting international diplomacy or policy strategy, we show that, compared with undergraduates and the general public, elites are actually more likely to reject low offers when playing a standard “ultimatum game” that assesses how players bargain over a fixed resource. Elites with more experience tend to make even higher demands, suggesting that this tendency only increases as policy makers advance to leadership positions. This result contradicts assumptions of rational self-interested behavior that are standard in models of international bargaining, and it suggests that the adoption of global agreements on international trade, climate change, and other important problems will not depend solely on the interests of individual countries, but also on whether these accords are seen as equitable to all member states. PMID:25512497

Administrative Practices as Institutional Identity: Bureaucratic Impediments to HE "Internationalisation" Policy in Japan

ERIC Educational Resources Information Center

Poole, Gregory S.

2016-01-01

This paper explores how bureaucracy impedes the implementation of higher education (HE) policy at Japanese universities. Administrative systems employ Weberian legal-rational bureaucratic practices that are central to the institutional identity of a university. Rather than the means to internationalisation and reform in general, these systems…

Researching the Effects of Frame-Focused Instruction on Second Language Acquisition

ERIC Educational Resources Information Center

Sokolova, Elena; Burmistrova, Anna

2012-01-01

In the context of globalization, the research of innovative teaching methods and techniques becomes relevant. The traditional teaching approach where the training of practice material is preceded by rule-presentation (explanation + mechanical form-oriented practice) does not meet the requirements of constantly developing rational language…

[What did bachelard mean by "applied rationalism" ?].

PubMed

Tiles, Mary

2013-01-01

Bachelard was concerned with the processes whereby scientific knowledge is acquired, including the activity of knowing subjects. He did not equate reasoning with logic but rather argued that reasoning resulted from the use of mathematics in organizing both thought and experimental practices, which is why he conceived science as applied mathematics. This had material and technical implications, for Bachelard was concerned with the element of reason inherent in technical materialism as well as the concrete reality inherent in applied rationalism.

Monitoring total mixed rations and feed delivery systems.

PubMed

Oelberg, Thomas J; Stone, William

2014-11-01

This article is intended to give practitioners a method to evaluate total mixed ration (TMR) consistency and to give them practical solutions to improve TMR consistency that will improve cattle performance and health. Practitioners will learn how to manage the variation in moisture and nutrients that exists in haylage and corn silage piles and in bales of hay, and methods to reduce variation in the TMR mixing and delivery process. Copyright © 2014 Elsevier Inc. All rights reserved.

Cancer care, money, and the value of life: whose justice? Which rationality?

PubMed

Sulmasy, Daniel P

2007-01-10

Cost-containment in oncology is a moral issue. While economists use the word "rationing" to describe all limitations on resource utilization that result from human choice, the ordinary language distinction between allocation and rationing is morally meaningful and can help oncologists to determine their proper moral role in cost-containment. It is argued that oncologists should not be required to ration at the bedside, nor should they be given financial incentives to practice frugally, nor should they be subjected to a variety of bureaucratic mechanisms to control costs indirectly. In addition, it is argued that the fact that treatments have a price does not logically imply that patients have a price. Cost-effectiveness analysis is often suggested as a means of deciding how best to allocate resources, but some of its many ethical limitations are discussed. The alternative is an open, public, participatory process about how to ration care, abandoning the formulaic pretenses of cost-effectiveness analysis, but with a commitment to reason, good will, and common sense. Oncologists would then be free to advocate for their patients within the constraints imposed by this public process.

'It ain't what you do it's the way that you do it': lessons for health care from decommissioning of older people's services.

PubMed

Robinson, Suzanne; Glasby, Jon; Allen, Kerry

2013-11-01

Public sector organisations are facing one of the most difficult financial periods in history and local decision-makers are tasked with making tough rationing decisions. Withdrawing or limiting services is an emotive and complex task and something the National Health Service has always found difficult. Over time, local authorities have gained significant experience in the closure of care homes - an equally complex and controversial issue. Drawing on local knowledge and best practice examples, this article highlights lessons and themes identified by those decommissioning care home services. We believe that such lessons are relevant to those making disinvestment decisions across public sector services, including health-care. The study employed semi-structured interviews with 12 Directors of Adult Social Services who had been highlighted nationally as having extensive experience of home closures. Interviews were conducted over a 2-week period in March 2011. Results from the study found that having local policy guidance that is perceived as fair and reasonable was advocated by those involved in home closures. Many local policies had evolved over time and had often been developed following experiences of home closures (both good and bad). Decisions to close care home services require a combination of strong leadership, clear strategic goals, a fair decision-making process, strong evidence of the need for change and good communication, alongside wider stakeholder engagement and support. The current financial challenge means that public sector organisations need to make tough choices on investment and disinvestment decisions. Any such decisions need to be influenced by what we know constitutes best practice. Sharing lessons and experiences within and between sectors could well inform and develop decision-making practices. © 2013 John Wiley & Sons Ltd.

Risk, rationality, and regret: responding to the uncertainty of childhood food anaphylaxis.

PubMed

Hu, W; Kerridge, I; Kemp, A

2005-06-01

Risk and uncertainty are unavoidable in clinical medicine. In the case of childhood food allergy, the dysphoric experience of uncertainty is heightened by the perception of unpredictable danger to young children. Medicine has tended to respond to uncertainty with forms of rational decision making. Rationality cannot, however, resolve uncertainty and provides an insufficient account of risk. This paper compares the medical and parental accounts of two peanut allergic toddlers to highlight the value of emotions in decision making. One emotion in particular, regret, assists in explaining the actions taken to prevent allergic reactions, given the diffuse nature of responsibility for children. In this light, the assumption that doctors make rational judgments while patients have emotion led preferences is a false dichotomy. Reconciling medical and lay accounts requires acknowledgement of the interrelationship between the rational and the emotional, and may lead to more appropriate clinical decision making under conditions of uncertainty.

Topology-dependent rationality and quantal response equilibria in structured populations

NASA Astrophysics Data System (ADS)

Roman, Sabin; Brede, Markus

2017-05-01

Given that the assumption of perfect rationality is rarely met in the real world, we explore a graded notion of rationality in socioecological systems of networked actors. We parametrize an actors' rationality via their place in a social network and quantify system rationality via the average Jensen-Shannon divergence between the games Nash and logit quantal response equilibria. Previous work has argued that scale-free topologies maximize a system's overall rationality in this setup. Here we show that while, for certain games, it is true that increasing degree heterogeneity of complex networks enhances rationality, rationality-optimal configurations are not scale-free. For the Prisoner's Dilemma and Stag Hunt games, we provide analytic arguments complemented by numerical optimization experiments to demonstrate that core-periphery networks composed of a few dominant hub nodes surrounded by a periphery of very low degree nodes give strikingly smaller overall deviations from rationality than scale-free networks. Similarly, for the Battle of the Sexes and the Matching Pennies games, we find that the optimal network structure is also a core-periphery graph but with a smaller difference in the average degrees of the core and the periphery. These results provide insight on the interplay between the topological structure of socioecological systems and their collective cognitive behavior, with potential applications to understanding wealth inequality and the structural features of the network of global corporate control.

Topology-dependent rationality and quantal response equilibria in structured populations.

PubMed

Roman, Sabin; Brede, Markus

2017-05-01

Given that the assumption of perfect rationality is rarely met in the real world, we explore a graded notion of rationality in socioecological systems of networked actors. We parametrize an actors' rationality via their place in a social network and quantify system rationality via the average Jensen-Shannon divergence between the games Nash and logit quantal response equilibria. Previous work has argued that scale-free topologies maximize a system's overall rationality in this setup. Here we show that while, for certain games, it is true that increasing degree heterogeneity of complex networks enhances rationality, rationality-optimal configurations are not scale-free. For the Prisoner's Dilemma and Stag Hunt games, we provide analytic arguments complemented by numerical optimization experiments to demonstrate that core-periphery networks composed of a few dominant hub nodes surrounded by a periphery of very low degree nodes give strikingly smaller overall deviations from rationality than scale-free networks. Similarly, for the Battle of the Sexes and the Matching Pennies games, we find that the optimal network structure is also a core-periphery graph but with a smaller difference in the average degrees of the core and the periphery. These results provide insight on the interplay between the topological structure of socioecological systems and their collective cognitive behavior, with potential applications to understanding wealth inequality and the structural features of the network of global corporate control.

Cognitive restructuring and exposure with a compulsive washer: a test of reciprocal inhibition.

PubMed

Giles, T R

1982-09-01

Reciprocal inhibition was tested with a compulsive washer using the affect elicited by rational self-statements as the response competitor to anxiety. Three conditions, CS alone, CS plus irrational self-statements, and CS plus rational self-statements, were randomly and continuously repeated over six trials. The CS was presented both imaginally and in vivo. It was hypothesized: (1) that subjective anxiety in all conditions would substantially diminish by the experiment's end; (2) that the rational self-statement condition would reduce (inhibit) subjective anxiety to a significantly greater degree than the other two conditions; and (3) that significant anxiety reduction would occur only during the rational restructuring trials. All three hypotheses were supported by the results.

Organizational culture predicts job satisfaction and perceived clinical effectiveness in pediatric primary care practices.

PubMed

Brazil, Kevin; Wakefield, Dorothy B; Cloutier, Michelle M; Tennen, Howard; Hall, Charles B

2010-01-01

In recent years, there has been a growing understanding that organizational culture is related to an organization's performance. However, few studies have examined organizational culture in medical group practices. The purpose of this study was to examine the relationship of organizational culture on provider job satisfaction and perceived clinical effectiveness in primary care pediatric practices. This cross-sectional study included 36 primary care pediatric practices located in Connecticut. There were 374 participants in this study, which included 127 clinicians and 247 nonclinicians. Office managers completed a questionnaire that recorded staff and practice characteristics; all participants completed the Organizational Culture Scale, a questionnaire that assessed the practice on four cultural domains (i.e., group, developmental, rational, and hierarchical), and the Primary Care Organizational Questionnaire that evaluated perceived effectiveness and job satisfaction. Hierarchical linear models using a restricted maximum likelihood estimation method were used to evaluate whether the practice culture types predicted job satisfaction and perceived effectiveness. Group culture was positively associated with both satisfaction and perceived effectiveness. In contrast, hierarchical and rational culture were negatively associated with both job satisfaction and perceived effectiveness. These relationships were true for clinicians, nonclinicians, and the practice as a whole. Our study demonstrates that practice culture is associated with job satisfaction and perceived clinical effectiveness and that a group culture was associated with high job satisfaction and perceived effectiveness.

Spray-on-skin cells in burns: a common practice with no agreed protocol.

PubMed

Allouni, Ammar; Papini, Remo; Lewis, Darren

2013-11-01

Cultured epithelial autograft (CEA) has been used for skin coverage after burn wound excision since 1981. It is used in burn units and centres throughout the U.K.; however, there appears to be no agreed standards of practice. We aimed to investigate the experience and current practice with its usage in the management of acute burn injury. An online survey was sent to twenty-five burns consultants in the U.K., who are members of the British Burn Association. We received 14 responses. Rarely have the responders agreed to the same practice in most of the questions. Different choices were given by responders with regards the indications for cell culture, techniques used, primary and secondary dressings used, first wound review timing, and measures used to evaluate outcomes. In the current economic environment, the NHS needs to rationalize services on the basis of cost effectiveness. CEA is an expensive procedure that requires an adequately sterile laboratory, special equipments and highly experienced dedicated staff. When dealing with expensive management options, it is important to have an agreed protocol that can form the standard that can be referred to when auditing practices and results to improve burn management and patients' care. Crown Copyright © 2013. Published by Elsevier Ltd. All rights reserved.

Changes in feed intake, growth, feed efficiency, and body composition of beef cattle fed forage then concentrate diets

USDA-ARS?s Scientific Manuscript database

The objective of this experiment was to determine changes in production traits and body composition of beef steers and heifers when fed a forage-based ration followed by a concentrate-based ration. Cattle were progeny of composite breed cows bred to Charolais, Simmental, and Red Angus bulls. Appro...

The Myth of Rational Objectivity and Leadership: The Realities of a Hospital Merger from a CEO's Perspective

ERIC Educational Resources Information Center

Tobin, John H.

2009-01-01

Executive power and status depends on others' belief in the executive's capacity for control via rational decision-making, "by the numbers" and above the fray of day to day minutia. By exploring his own experience in the complex social dynamics of a long, complicated merger process--characterised by misunderstanding, incomplete…

Rationing hepatitis C treatment in the context of austerity policies in France and Cameroon: A transnational perspective on the pharmaceuticalization of healthcare systems.

PubMed

Chabrol, Fanny; David, Pierre-Marie; Krikorian, Gaëlle

2017-08-01

New powerful drugs against hepatitis C can cure the disease, but they are not widely distributed because their exorbitant prices are destabilizing healthcare systems in both African and European countries. This article takes access to hepatitis C treatments since 2013 in France and in Cameroon as a lens to analyze the rationing of pharmaceutical treatments in relation to recent transformations of health systems. Access to these treatments is analyzed thanks to ethnographic observation and interviews lead in Paris and Yaoundé, with patients, associations, health professionals and public health experts. In Cameroon, rationing takes place through various layers of socio-economic restrictions, and no patient organization advocates for hepatitis treatment. In France, access to hepatitis C treatments has become politicized, and collective mobilizations have denounced rationing as a threat to the promise of universal social security. In this study, we examine Africa's long experience with rationing in the context of structural adjustment, and we bring together experiences in France and Cameroon. This article analyses the phenomenon of the pharmaceuticalization of healthcare systems, that is to say the growing use of pharmaceuticals in healthcare systems, by documenting the social and political construction of scarcity. Indeed, whereas pharmaceuticalization is a concept that has often been used in situations of drugs abundance, a parallel analysis of rationing highlights a political economy of pharmaceuticals that shapes public health debates and policies according to an economy of scarcity, especially in times of austerity. Copyright © 2017. Published by Elsevier Ltd.

Neural mechanisms of understanding rational actions: middle temporal gyrus activation by contextual violation.

PubMed

Jastorff, Jan; Clavagnier, Simon; Gergely, György; Orban, Guy A

2011-02-01

Performing goal-directed actions toward an object in accordance with contextual constraints, such as the presence or absence of an obstacle, has been widely used as a paradigm for assessing the capacity of infants or nonhuman primates to evaluate the rationality of others' actions. Here, we have used this paradigm in a functional magnetic resonance imaging experiment to visualize the cortical regions involved in the assessment of action rationality while controlling for visual differences in the displays and directly correlating magnetic resonance activity with rationality ratings. Bilateral middle temporal gyrus (MTG) regions, anterior to extrastriate body area and the human middle temporal complex, were involved in the visual evaluation of action rationality. These MTG regions are embedded in the superior temporal sulcus regions processing the kinematics of observed actions. Our results suggest that rationality is assessed initially by purely visual computations, combining the kinematics of the action with the physical constraints of the environmental context. The MTG region seems to be sensitive to the contingent relationship between a goal-directed biological action and its relevant environmental constraints, showing increased activity when the expected pattern of rational goal attainment is violated.

Intergroup Conflict and Rational Decision Making

PubMed Central

Martínez-Tur, Vicente; Peñarroja, Vicente; Serrano, Miguel A.; Hidalgo, Vanesa; Moliner, Carolina; Salvador, Alicia; Alacreu-Crespo, Adrián; Gracia, Esther; Molina, Agustín

2014-01-01

The literature has been relatively silent about post-conflict processes. However, understanding the way humans deal with post-conflict situations is a challenge in our societies. With this in mind, we focus the present study on the rationality of cooperative decision making after an intergroup conflict, i.e., the extent to which groups take advantage of post-conflict situations to obtain benefits from collaborating with the other group involved in the conflict. Based on dual-process theories of thinking and affect heuristic, we propose that intergroup conflict hinders the rationality of cooperative decision making. We also hypothesize that this rationality improves when groups are involved in an in-group deliberative discussion. Results of a laboratory experiment support the idea that intergroup conflict –associated with indicators of the activation of negative feelings (negative affect state and heart rate)– has a negative effect on the aforementioned rationality over time and on both group and individual decision making. Although intergroup conflict leads to sub-optimal decision making, rationality improves when groups and individuals subjected to intergroup conflict make decisions after an in-group deliberative discussion. Additionally, the increased rationality of the group decision making after the deliberative discussion is transferred to subsequent individual decision making. PMID:25461384

Intergroup conflict and rational decision making.

PubMed

Martínez-Tur, Vicente; Peñarroja, Vicente; Serrano, Miguel A; Hidalgo, Vanesa; Moliner, Carolina; Salvador, Alicia; Alacreu-Crespo, Adrián; Gracia, Esther; Molina, Agustín

2014-01-01

The literature has been relatively silent about post-conflict processes. However, understanding the way humans deal with post-conflict situations is a challenge in our societies. With this in mind, we focus the present study on the rationality of cooperative decision making after an intergroup conflict, i.e., the extent to which groups take advantage of post-conflict situations to obtain benefits from collaborating with the other group involved in the conflict. Based on dual-process theories of thinking and affect heuristic, we propose that intergroup conflict hinders the rationality of cooperative decision making. We also hypothesize that this rationality improves when groups are involved in an in-group deliberative discussion. Results of a laboratory experiment support the idea that intergroup conflict -associated with indicators of the activation of negative feelings (negative affect state and heart rate)- has a negative effect on the aforementioned rationality over time and on both group and individual decision making. Although intergroup conflict leads to sub-optimal decision making, rationality improves when groups and individuals subjected to intergroup conflict make decisions after an in-group deliberative discussion. Additionally, the increased rationality of the group decision making after the deliberative discussion is transferred to subsequent individual decision making.

Factors related to rational antibiotic prescriptions in community health centers in Depok City, Indonesia.

PubMed

Andrajati, Retnosari; Tilaqza, Andri; Supardi, Sudibyo

Irrational antibiotic prescription is common in developing countries, including in Indonesia. The aims of this study were to evaluate antibiotic prescription patterns and the factors related to the rationale for antibiotic prescriptions in community health centers in Depok City, Indonesia. The study employed a cross-sectional design in eleven primary health centers in Depok City, Indonesia. The sample consisted of 28 physicians and 788 oral antibiotic prescriptions, 392 of which were evaluated for rationality according to local guidelines issued by the Ministry of Health Republic of Indonesia from October to December 2012. Data were analyzed with chi-square tests and logistic regression analysis. The most widely prescribed antibiotics were amoxicillin (73.5%) and co-trimoxazole (17.4%). The most frequent diseases were acute pharyngitis (40.2%) and non-specific respiratory infection (25.4%). Approximately 220 of the 392 prescriptions did not meet the criteria for rational antibiotic prescriptions with regard to antibiotic selection (22.7%), duration of administration (72.3%), frequency of administration (3.2%), or duration and frequency of administration (1.8%). Physicians who had attended training for rational drug use were 2.01 times more rational than physicians who had never attended training. Physicians with a short working period (i.e., <7 years) were 3.95 times more rational in prescribing antibiotics than physicians who had been working for longer periods (i.e., >7 years). Most antibiotics were prescribed irrationally. Training for rational drug use and length of practice were factors related to the rationality of antibiotic prescriptions. Suitable interventions are urgently required to encourage the rational prescription of antibiotics in the PHCs. Copyright © 2016 King Saud Bin Abdulaziz University for Health Sciences. Published by Elsevier Ltd. All rights reserved.

Effect of feeding sorghum straw based complete rations with different roughage to concentrate ratio on dry matter intake, nutrient utilization, and nitrogen balance in Nellore ram lambs.

PubMed

Malisetty, Venkateswarlu; Yerradoddi, Ramana Reddy; Devanaboina, Nagalakshmi; Mallam, Mahender; Mitta, Pavani

2014-06-01

An experiment was conducted by feeding sorghum straw (Sorghum bicolor) based complete rations at roughage concentrate ratio 70:30 (CR-I), 60:40 (CR-II), 50:50 (CR-III), and 40:60 (CR-IV) for 180 days to find out suitable ratio of sorghum straw in the complete ration (mash form) on nutrient utilization and nitrogen balance in Nellore ram lambs. The DMI (g/day) increased significantly (P < 0.05) as level of concentrate increased in complete rations. No significant difference was found in digestibilities of proximate nutrients. However, CP digestibility was higher either significantly or nonsignificantly by 2.12, 5.50, and 9.36 %, respectively, in lambs fed with CR-II (P > 0.05), CR-III (P > 0.05), and CR-IV (P < 0.05) rations in comparison to lambs fed with CR-I ration. Furthermore, CP digestibility was higher by 7.09 and 3.66 % in lambs fed with CR-IV ration than those fed with CR-II (P < 0.05) and CR-III (P > 0.05) ration. The average CWC digestibility coefficients were comparable among four rations. The N intake (g/day) was significantly (P < 0.01) different and progressively increased by 31.46, 48.69, and 82.86 % in ram lambs fed with CR-II, CR-III, and CR-IV rations, respectively, in comparison to CR-I ration. The N balance (g/day) was higher either significantly or nonsignificantly by 34.46 (P > 0.05), 133.46 (P < 0.01), and 198.87 % (P < 0.01) with CR-II, CR-III, and CR-IV rations, respectively, in comparison to CR-I ration. Based on results, it is inferred that the level of sorghum straw in complete ration had no effect on digestibility of nutrients barring crude protein in Nellore ram lambs.

State-dependent decisions cause apparent violations of rationality in animal choice.

PubMed

Schuck-Paim, Cynthia; Pompilio, Lorena; Kacelnik, Alex

2004-12-01

Normative models of choice in economics and biology usually expect preferences to be consistent across contexts, or "rational" in economic language. Following a large body of literature reporting economically irrational behaviour in humans, breaches of rationality by animals have also been recently described. If proven systematic, these findings would challenge long-standing biological approaches to behavioural theorising, and suggest that cognitive processes similar to those claimed to cause irrationality in humans can also hinder optimality approaches to modelling animal preferences. Critical differences between human and animal experiments have not, however, been sufficiently acknowledged. While humans can be instructed conceptually about the choice problem, animals need to be trained by repeated exposure to all contingencies. This exposure often leads to differences in state between treatments, hence changing choices while preserving rationality. We report experiments with European starlings demonstrating that apparent breaches of rationality can result from state-dependence. We show that adding an inferior alternative to a choice set (a "decoy") affects choices, an effect previously interpreted as indicating irrationality. However, these effects appear and disappear depending on whether state differences between choice contexts are present or not. These results open the possibility that some expressions of maladaptive behaviour are due to oversights in the migration of ideas between economics and biology, and suggest that key differences between human and nonhuman research must be recognised if ideas are to safely travel between these fields.

Finite Deformations and Internal Forces in Elastic-Plastic Crystals: Interpretations From Nonlinear Elasticity and Anharmonic Lattice Statics

DTIC Science & Technology

2009-09-01

Sec. 2, while the latter ase—which implicitly includes the effects of image forces of efects in neighboring volume elements—may be more practical rom...versetzungen und eigenspannungen,” Arch . Ration. Mech. Anal., 4, pp. 273–334. 25 Lee, E. H., 1969, “Elastic-Plastic Deformation at Finite Strains,” ASME J...Rev., 73, pp. 373–382. 27 Kroner, E., and Seeger, A., 1959, “Nicht-Lineare Elastizitatstheorie der Verset- zungen und Eigenspannungen,” Arch . Ration

Children's understanding of the costs and rewards underlying rational action.

PubMed

Jara-Ettinger, Julian; Gweon, Hyowon; Tenenbaum, Joshua B; Schulz, Laura E

2015-07-01

Humans explain and predict other agents' behavior using mental state concepts, such as beliefs and desires. Computational and developmental evidence suggest that such inferences are enabled by a principle of rational action: the expectation that agents act efficiently, within situational constraints, to achieve their goals. Here we propose that the expectation of rational action is instantiated by a naïve utility calculus sensitive to both agent-constant and agent-specific aspects of costs and rewards associated with actions. In four experiments, we show that, given an agent's choices, children (range: 5-6 year olds; N=96) can infer unobservable aspects of costs (differences in agents' competence) from information about subjective differences in rewards (differences in agents' preferences) and vice versa. Moreover, children can design informative experiments on both objects and agents to infer unobservable constraints on agents' actions. Copyright © 2015 Elsevier B.V. All rights reserved.

[Research about re-evaluation of screening of traditonal Chinese medicine symptoms item of post-marketing medicine Xuezhikang].

PubMed

He, Wei; Xie, Yanming; Wang, Yongyan

2011-10-01

The purpose of post-marketing Chinese medicine re-evaluation is to identify Chinese medicine clinical indications, while designing scientific and rational of Chinese medicine symptoms items are important to the result of symptoms re-evaluation. This study give screening of traditional Chinese medicine(TCM) symptoms item of post-marketing medicine Xuezhikang re-evaluation as example that reference to principle dyslipidemia clinical research, academic dissertations, Xuezhikang directions, clinical expert practice experience etc. while standardization those symptom names and screening 41 dyslipidemia common symptoms. Furthermore, this paper discuss about the accoerdance and announcements when screening symptoms item, so as to providing a research thread to manufacture PRO chart for post-marketing medicine re-evaluation.

Local knowledge, state power, and the science of industrial labor relations: William Leiserson, David Saposs, and American labor economics in the interwar years.

PubMed

Wang, Jessica

2010-01-01

Recent scholarship has frequently emphasized modern states' use of social science to impose universalized conceptions of rationality and order upon diverse, highly localized settings. The New Deal era experiences of William M. Leiserson and David J. Saposs, however, provide an analytical alternative. As students of the pioneering labor economist John R. Commons, Leiserson and Saposs sought to create mechanisms for state oversight of industrial labor relations that recognized local practices and arrangements. Although their approach failed to take hold within the National Labor Relations Board, localized institutional and political contingencies, and not a hegemonic modernism, account best for their frustrated aspirations in the late 1930s. © 2010 Wiley Periodicals, Inc.

The pseudo-Boolean optimization approach to form the N-version software structure

NASA Astrophysics Data System (ADS)

Kovalev, I. V.; Kovalev, D. I.; Zelenkov, P. V.; Voroshilova, A. A.

2015-10-01

The problem of developing an optimal structure of N-version software system presents a kind of very complex optimization problem. This causes the use of deterministic optimization methods inappropriate for solving the stated problem. In this view, exploiting heuristic strategies looks more rational. In the field of pseudo-Boolean optimization theory, the so called method of varied probabilities (MVP) has been developed to solve problems with a large dimensionality. Some additional modifications of MVP have been made to solve the problem of N-version systems design. Those algorithms take into account the discovered specific features of the objective function. The practical experiments have shown the advantage of using these algorithm modifications because of reducing a search space.

Improving Professional Development System through Quality Assurance Practices in the Universities of Pakistan

ERIC Educational Resources Information Center

Shabbir, Muhammad; Khalid, M. Ibrahim; Bakhsh, Khuda; Mohsin, Muhammad Naeem; Rasool, Shafqat; Mohsin, M. Saleem

2016-01-01

The rationalization of this research was to investigate about improving professional development system through Quality Assurance Practices (QAP) in the Universities of Pakistan pertaining to the opinions of students, teachers and Directors of Quality Enhancement Cells (QECs) and to differentiate the ideas of students, teachers and Directors of…

The Practice of Educational Evaluation: A View from the Inside.

ERIC Educational Resources Information Center

Jolly, S. Jean; Gramenz, Gary W.

The literature on the practice of educational evaluation is reviewed, and internal and external evaluations in a school setting are compared. The paper states that the typical external evaluation is conducted as if school districts were rational organizations, a view which permeated 19th century evaluation activities. The internal evaluator, on…

Fraud Prevention and Employee Rationalization in New York State Public Schools

ERIC Educational Resources Information Center

Slezak, Kathleen

2013-01-01

Prompted by frequent media reports of school fraud and a lack of relevant K-12 literature, this research study was designed to investigate current fraud prevention practices in public school districts in New York State. Using a "fraud triangle" model, an analysis of existing legislation and professional practice guidelines reveals that…

Mobile Learning in Nursing Practice Education: Applying Koole's FRAME Model

ERIC Educational Resources Information Center

Kenny, Richard F.; Van Neste-Kenny, Jocelyne M. C.; Park, Caroline L.; Burton, Pamela A.; Meiers, Jan

2009-01-01

We report here on an exploratory formative evaluation of a project to integrate mobile learning into a Western Canadian college nursing program. Third-year students used Hewlett Packard iPAQ mobile devices for five weeks in a practice education course in April-May, 2007. Koole's (2009) "Framework for the Rational Analysis of Mobile…

"Measuring up"? Assessment and Students with Disabilities in the Modern University

ERIC Educational Resources Information Center

Bessant, Judith

2012-01-01

In this article, I ask how university students with disabilities negotiate with staff arrangements for alternative assessment practices. I draw on three case studies using a personal pronoun perspective to challenge the conventional view that educational policy and teaching practice are forms of rational action. I demonstrate how the lives of…

A Hybrid Trust-Based Recommender System for Online Communities of Practice

ERIC Educational Resources Information Center

Zheng, Xiao-Lin; Chen, Chao-Chao; Hung, Jui-Long; He, Wu; Hong, Fu-Xing; Lin, Zhen

2015-01-01

The needs for life-long learning and the rapid development of information technologies promote the development of various types of online Community of Practices (CoPs). In online CoPs, bounded rationality and metacognition are two major issues, especially when learners face information overload and there is no knowledge authority within the…

Strategy selection as rational metareasoning.

PubMed

Lieder, Falk; Griffiths, Thomas L

2017-11-01

Many contemporary accounts of human reasoning assume that the mind is equipped with multiple heuristics that could be deployed to perform a given task. This raises the question of how the mind determines when to use which heuristic. To answer this question, we developed a rational model of strategy selection, based on the theory of rational metareasoning developed in the artificial intelligence literature. According to our model people learn to efficiently choose the strategy with the best cost-benefit tradeoff by learning a predictive model of each strategy's performance. We found that our model can provide a unifying explanation for classic findings from domains ranging from decision-making to arithmetic by capturing the variability of people's strategy choices, their dependence on task and context, and their development over time. Systematic model comparisons supported our theory, and 4 new experiments confirmed its distinctive predictions. Our findings suggest that people gradually learn to make increasingly more rational use of fallible heuristics. This perspective reconciles the 2 poles of the debate about human rationality by integrating heuristics and biases with learning and rationality. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Rationality, Experience and Theory.

ERIC Educational Resources Information Center

Shaw, K. E.

1983-01-01

A discussion of the usefulness of reasoning, as compared to experience, in three levels of decision making in school management informs this critique of the state of educational management theory and research. (MJL)

Linking patient satisfaction with nursing care: the case of care rationing - a correlational study

PubMed Central

2014-01-01

Background Implicit rationing of nursing care is the withholding of or failure to carry out all necessary nursing measures due to lack of resources. There is evidence supporting a link between rationing of nursing care, nurses’ perceptions of their professional environment, negative patient outcomes, and placing patient safety at risk. The aims of the study were: a) To explore whether patient satisfaction is linked to nurse-reported rationing of nursing care and to nurses’ perceptions of their practice environment while adjusting for patient and nurse characteristics. b) To identify the threshold score of rationing by comparing the level of patient satisfaction factors across rationing levels. Methods A descriptive, correlational design was employed. Participants in this study included 352 patients and 318 nurses from ten medical and surgical units of five general hospitals. Three measurement instruments were used: the BERNCA scale for rationing of care, the RPPE scale to explore nurses’ perceptions of their work environment and the Patient Satisfaction scale to assess the level of patient satisfaction with nursing care. The statistical analysis included the use of Kendall’s correlation coefficient to explore a possible relationship between the variables and multiple regression analysis to assess the effects of implicit rationing of nursing care together with organizational characteristics on patient satisfaction. Results The mean score of implicit rationing of nursing care was 0.83 (SD = 0.52, range = 0–3), the overall mean of RPPE was 2.76 (SD = 0.32, range = 1.28 – 3.69) and the two scales were significantly correlated (τ = −0.234, p < 0.001). The regression analysis showed that care rationing and work environment were related to patient satisfaction, even after controlling for nurse and patient characteristics. The results from the adjusted regression models showed that even at the lowest level of rationing (i.e. 0.5) patients indicated low satisfaction. Conclusions The results support the relationships between organizational and environmental variables, care rationing and patient satisfaction. The identification of thresholds at which rationing starts to influence patient outcomes in a negative way may allow nurse managers to introduce interventions so as to keep rationing at a level at which patient safety is not jeopardized. PMID:25285040

The rationing agenda in the NHS. Rationing Agenda Group.

PubMed Central

New, B.

1996-01-01

The Rationing Agenda Group has been founded to deepen the British debate on rationing health care. It believes that rationing in health care is inevitable and that the public must be involved in the debate about issues relating to rationing. The group comprises people from all parts of health care, none of whom represent either their group or their institutions. RAG has begun by producing this document, which attempts to set an agenda of all the issues that need to be considered when debating the rationing of health care. We hope for responses to the document. The next stage will be to incorporate the responses into the agenda. Then RAG will divide the agenda into manageable chunks and commission expert, detailed commentaries. From this material a final paper will be published and used to prompt public debate. This stage should be reached early in 1997. While these papers are being prepared RAG is developing ways to involve the public in the debate and evaluate the whole process. We present as neutrally as possible all the issues related to rationing and priority setting in the NHS. We focus on the NHS for two reasons. Firstly, for those of us resident in the United Kingdom the NHS is the health care system with which we are most familiar and most concerned. Secondly, focusing on one system alone allows more coherent analysis than would be possible if issues in other systems were included as well. Our concern is with the delivery of health care, not its finance, though we discuss the possible effects of changing the financing system of the NHS. Finally, though our position is neutral, we hold two substantive views--namely, that rationing is unavoidable and that there should be more explicit debate about the principles and issues concerned. We consider the issues under four headings: preliminaries, ethics, democracy, and empirical questions. Preliminaries deal with the semantics of rationing, whether rationing is necessary, and with the range of services to which rationing relates. Under ethics and democracy are the substantive issues of principle and theory. The final section deals with empirical questions and those relating to the practicality of various strategies. PMID:8664673

The Oil Drop Experiment: A Rational Reconstruction of the Millikan-Ehrenhaft Controversy and Its Implications for Chemistry Textbooks.

ERIC Educational Resources Information Center

Niaz, Mansoor

2000-01-01

Develops a history and philosophy of science framework based on a rational reconstruction of experimental observations that led to the Millikan-Ehrenhaft controversy, and evaluates 31 chemistry books for coverage of the controversy. Finds that most books lacked a history and philosophy of science perspective and did not adequately address several…

Infants Understanding of Everyday Social Interactions: A Dual Process Account

ERIC Educational Resources Information Center

Gredeback, Gustaf; Melinder, Annika

2010-01-01

Six- and 12-month-old infant's eye movements were recorded as they observed feeding actions being performed in a rational or non-rational manner. Twelve-month-olds fixated the goal of these actions before the food arrived (anticipation); the latency of these gaze shifts being dependent (r=0.69) on infants life experience being feed. In addition,…

Rational and Empirical Play in the Simple Hot Potato Game

ERIC Educational Resources Information Center

Butts, Carter T.; Rode, David C.

2007-01-01

We define a "hot potato" to be a good that may be traded a finite number of times, but which becomes a bad if and when it can no longer be exchanged. We describe a game involving such goods, and show that non-acceptance is a unique subgame perfect Nash equilibrium for rational egoists. Contrastingly, experiments with human subjects show…

Developing and Using an Applet to Enrich Students' Concept Image of Rational Polynomials

ERIC Educational Resources Information Center

Mason, John

2015-01-01

This article draws on extensive experience working with secondary and tertiary teachers and educators using an applet to display rational polynomials (up to degree 7 in numerator and denominator), as support for the challenge to deduce as much as possible about the graph from the graphs of the numerator and the denominator. Pedagogical and design…

Is Respecting Children's Rationality in Their Best Interest in an Authoritarian Context?

ERIC Educational Resources Information Center

Ghazinejad, Parvaneh; Ruitenberg, Claudia

2014-01-01

Based on the experiences of one of the authors teaching philosophy for children (P4C) in Iran, the paper asks whether respecting children's rationality, in the form of cultivating their ability and disposition to think critically, is in their best interest in an authoritarian context such as Iran. It argues that, in authoritarian contexts, respect…

Rationals and Decimals as Required in the School Curriculum Part 3. Rationals and Decimals as Linear Functions

ERIC Educational Resources Information Center

Brousseau, Guy; Brousseau, Nadine; Warfield, Virginia

2008-01-01

In the late seventies, Guy Brousseau set himself the goal of verifying experimentally a theory he had been building up for a number of years. The theory, consistent with what was later named (non-radical) constructivism, was that children, in suitable carefully arranged circumstances, can build their own knowledge of mathematics. The experiment,…

Rationals and Decimals as Required in the School Curriculum Part 2: From Rationals to Decimals

ERIC Educational Resources Information Center

Brousseau, Guy; Brousseau, Nadine; Warfield, Virginia

2007-01-01

In the late seventies, Guy Brousseau set himself the goal of verifying experimentally a theory he had been building up for a number of years. The theory, consistent with what was later named (non-radical) constructivism, was that children, in suitable carefully arranged circumstances, can build their own knowledge of mathematics. The experiment,…

Gender and work-family conflict: testing the rational model and the gender role expectations model in the Spanish cultural context.

PubMed

Calvo-Salguero, Antonia; Martínez-de-Lecea, José-María Salinas; del Carmen Aguilar-Luzón, María

2012-01-01

Gutek, Searle, and Klepa (1991) proposed two models to explain the gender differences in work-family conflict: the rational model and the gender role expectations model. Both models have mostly been tested on American and Canadian samples, and have obtained partial support. Given the cultural differences between North American countries and Spain, we should question whether the two models are equally applicable to Spanish society or whether one of them captures Spanish men and women's experience of work-family conflict better than the other. So, the aim of this study is to test which of the models better explains the gender differences in work-family conflict in the Spanish cultural context (or if, indeed, the two models apply equally well). Given the typical cultural dimensions of Spanish society, we expected to find greater support for the gender role expectations model than for the rational model. However, the results obtained in this study indicated that, while the rational model can explain the gender differences that were found, the gender role expectations model cannot capture Spanish people's work-family conflict experiences. The results are interpreted in terms of cultural dimensions characteristic of the Spanish context.

That's not funny! - But it should be: effects of humorous emotion regulation on emotional experience and memory.

PubMed

Kugler, Lisa; Kuhbandner, Christof

2015-01-01

Previous research has shown that humorous reappraisal can reduce elicited negative emotions, suggesting that humor may be a functional strategy to cope with emotionally negative situations. However, the effect of humorous reappraisal on later memory about the emotion-eliciting situation is currently unknown, although this is crucial for more adaptive responding in future situations. To address this issue, we examined the effects of humorous reappraisal on both emotional experience and memory, compared to non-humorous rational reappraisal and a non-reappraisal control condition. Replicating previous findings, humorous reappraisal reduced evoked negative valence and arousal levels very effectively, and the down-regulation of experienced negative emotions was even more pronounced after humorous compared to rational reappraisal. Regarding later memory for emotion-eliciting stimuli, both humorous and rational reappraisal reduced free recall, but recognition memory was unaffected, with memory strength being stronger after humorous than after rational reappraisal. These results indicate that humor seems to be indeed an optimal strategy to cope with negative situations because humor can help us to feel better when confronted with negative stimuli, but still allows us to retrieve stimulus information later when afforded to do so by the presence of appropriate contextual features.

Log D versus HPLC derived hydrophobicity: The development of predictive tools to aid in the rational design of bioactive peptoids

DOE PAGES

Bolt, H. L.; Williams, C. E. J.; Brooks, R. V.; ...

2017-01-13

Hydrophobicity has proven to be an extremely useful parameter in small molecule drug discovery programmes given that it can be used as a predictive tool to enable rational design. For larger molecules, including peptoids, where folding is possible, the situation is more complicated and the average hydrophobicity (as determined by RP-HPLC retention time) may not always provide an effective predictive tool for rational design. Herein, we report the first ever application of partitioning experiments to determine the log D values for a series of peptoids. By comparing log D and average hydrophobicities we highlight the potential advantage of employing themore » former as a predictive tool in the rational design of biologically active peptoids.« less

Log D versus HPLC derived hydrophobicity: The development of predictive tools to aid in the rational design of bioactive peptoids

DOE Office of Scientific and Technical Information (OSTI.GOV)

Bolt, H. L.; Williams, C. E. J.; Brooks, R. V.

Hydrophobicity has proven to be an extremely useful parameter in small molecule drug discovery programmes given that it can be used as a predictive tool to enable rational design. For larger molecules, including peptoids, where folding is possible, the situation is more complicated and the average hydrophobicity (as determined by RP-HPLC retention time) may not always provide an effective predictive tool for rational design. Herein, we report the first ever application of partitioning experiments to determine the log D values for a series of peptoids. By comparing log D and average hydrophobicities we highlight the potential advantage of employing themore » former as a predictive tool in the rational design of biologically active peptoids.« less

Three-Dimensional Numerical Simulation to Mud Turbine for LWD

NASA Astrophysics Data System (ADS)

Yao, Xiaojiang; Dong, Jingxin; Shang, Jie; Zhang, Guanqi

Hydraulic performance analysis was discussed for a type of turbine on generator used for LWD. The simulation models were built by CFD analysis software FINE/Turbo, and full three-dimensional numerical simulation was carried out for impeller group. The hydraulic parameter such as power, speed and pressure drop, were calculated in two kinds of medium water and mud. Experiment was built in water environment. The error of numerical simulation was less than 6%, verified by experiment. Based on this rationalization proposals would be given to choice appropriate impellers, and the rationalization of methods would be explored.

Cognitive synergy in groups and group-to-individual transfer of decision-making competencies

PubMed Central

Curşeu, Petru L.; Meslec, Nicoleta; Pluut, Helen; Lucas, Gerardus J. M.

2015-01-01

In a field study (148 participants organized in 38 groups) we tested the effect of group synergy and one's position in relation to the collaborative zone of proximal development (CZPD) on the change of individual decision-making competencies. We used two parallel sets of decision tasks reported in previous research to test rationality and we evaluated individual decision-making competencies in the pre-group and post-group conditions as well as group rationality (as an emergent group level phenomenon). We used multilevel modeling to analyze the data and the results showed that members of synergetic groups had a higher cognitive gain as compared to members of non-synergetic groups, while highly rational members (members above the CZPD) had lower cognitive gains compared to less rational group members (members situated below the CZPD). These insights extend the literature on group-to-individual transfer of learning and have important practical implications as they show that group dynamics influence the development of individual decision-making competencies. PMID:26441750

From bricolage to BioBricks™: Synthetic biology and rational design.

PubMed

Lewens, Tim

2013-12-01

Synthetic biology is often described as a project that applies rational design methods to the organic world. Although humans have influenced organic lineages in many ways, it is nonetheless reasonable to place synthetic biology towards one end of a continuum between purely 'blind' processes of organic modification at one extreme, and wholly rational, design-led processes at the other. An example from evolutionary electronics illustrates some of the constraints imposed by the rational design methodology itself. These constraints reinforce the limitations of the synthetic biology ideal, limitations that are often freely acknowledged by synthetic biology's own practitioners. The synthetic biology methodology reflects a series of constraints imposed on finite human designers who wish, as far as is practicable, to communicate with each other and to intervene in nature in reasonably targeted and well-understood ways. This is better understood as indicative of an underlying awareness of human limitations, rather than as expressive of an objectionable impulse to mastery over nature. Copyright © 2013 Elsevier Ltd. All rights reserved.

Cognitive synergy in groups and group-to-individual transfer of decision-making competencies.

PubMed

Curşeu, Petru L; Meslec, Nicoleta; Pluut, Helen; Lucas, Gerardus J M

2015-01-01

In a field study (148 participants organized in 38 groups) we tested the effect of group synergy and one's position in relation to the collaborative zone of proximal development (CZPD) on the change of individual decision-making competencies. We used two parallel sets of decision tasks reported in previous research to test rationality and we evaluated individual decision-making competencies in the pre-group and post-group conditions as well as group rationality (as an emergent group level phenomenon). We used multilevel modeling to analyze the data and the results showed that members of synergetic groups had a higher cognitive gain as compared to members of non-synergetic groups, while highly rational members (members above the CZPD) had lower cognitive gains compared to less rational group members (members situated below the CZPD). These insights extend the literature on group-to-individual transfer of learning and have important practical implications as they show that group dynamics influence the development of individual decision-making competencies.

Rationing nurses: Realities, practicalities, and nursing leadership theories.

PubMed

Fast, Olive; Rankin, Janet

2018-04-01

In this paper, we examine the practicalities of nurse managers' work. We expose how managers' commitments to transformational leadership are undermined by the rationing practices and informatics of hospital reform underpinned by the ideas of new public management. Using institutional ethnography, we gathered data in a Canadian hospital. We began by interviewing and observing frontline leaders, nurse managers, and expanded our inquiry to include interviews with other nurses, staffing clerks, and administrators whose work intersected with that of nurse managers. We learned how nurse managers' responsibility for staffing is accomplished within tightening budgets and a burgeoning suite of technologies that direct decisions about whether or not there are enough nurses. Our inquiry explicates how technologies organize nurse managers to put aside their professional knowledge. We describe professionally committed nurse leaders attempting to activate transformational leadership and show how their intentions are subsumed within information systems. Seen in light of our analysis, transformational leadership is an idealized concept within which managers' responsibilities are shaped to conform to institutional purposes. © 2017 John Wiley & Sons Ltd.

Rational selection of experimental readout and intervention sites for reducing uncertainties in computational model predictions.

PubMed

Flassig, Robert J; Migal, Iryna; der Zalm, Esther van; Rihko-Struckmann, Liisa; Sundmacher, Kai

2015-01-16

Understanding the dynamics of biological processes can substantially be supported by computational models in the form of nonlinear ordinary differential equations (ODE). Typically, this model class contains many unknown parameters, which are estimated from inadequate and noisy data. Depending on the ODE structure, predictions based on unmeasured states and associated parameters are highly uncertain, even undetermined. For given data, profile likelihood analysis has been proven to be one of the most practically relevant approaches for analyzing the identifiability of an ODE structure, and thus model predictions. In case of highly uncertain or non-identifiable parameters, rational experimental design based on various approaches has shown to significantly reduce parameter uncertainties with minimal amount of effort. In this work we illustrate how to use profile likelihood samples for quantifying the individual contribution of parameter uncertainty to prediction uncertainty. For the uncertainty quantification we introduce the profile likelihood sensitivity (PLS) index. Additionally, for the case of several uncertain parameters, we introduce the PLS entropy to quantify individual contributions to the overall prediction uncertainty. We show how to use these two criteria as an experimental design objective for selecting new, informative readouts in combination with intervention site identification. The characteristics of the proposed multi-criterion objective are illustrated with an in silico example. We further illustrate how an existing practically non-identifiable model for the chlorophyll fluorescence induction in a photosynthetic organism, D. salina, can be rendered identifiable by additional experiments with new readouts. Having data and profile likelihood samples at hand, the here proposed uncertainty quantification based on prediction samples from the profile likelihood provides a simple way for determining individual contributions of parameter uncertainties to uncertainties in model predictions. The uncertainty quantification of specific model predictions allows identifying regions, where model predictions have to be considered with care. Such uncertain regions can be used for a rational experimental design to render initially highly uncertain model predictions into certainty. Finally, our uncertainty quantification directly accounts for parameter interdependencies and parameter sensitivities of the specific prediction.

Prediction of utilizable true protein of mixed rations for sheep using an in vitro incubation technique.

PubMed

Li, Yuan-Xiao; Zhao, Guang-Yong

2007-04-01

The objective of the present experiment was to study the relationship between in vitro utilizable true protein (uTP) and in vivo-uTP of sheep rations by regression analysis. A further aim was to analyse if in vivo-uTP of mixed rations could be predicted by regression analysis between in vitro-uTP and in vivo-uTP, using N-retention of sheep as important evaluation criteria of protein value. Three adult male sheep (body weight [BW] 46 + 1.3 kg) fitted with rumen cannulas and simple T-type duodenal cannulas were fed with twelve typical rations with graded levels of crude protein and true protein in four experiments according a 3 x 3 Latin square design. Each experimental period included an adaptation (7 days), a N balance trial (4 days) and a collection of duodenal digesta (3 days). During collection of duodenal digesta, polyethylene glycol and chromium oxide were used as dual markers for the measurement of duodenal digesta flow and calculation of the in vivo-uTP of duodenal digesta. The in vitro-uTP of the rations was determined using the in vitro incubation technique of Zhao and Lebzien (2000). It was found that both in vitro-uTP intake and in vivo-uTP intake were significantly correlated with N-retention (p < 0.001) and that there was a significant linear relationship between the content of in vitro-uTP and in vivo-uTP in rations (p < 0.001). Therefore, it was concluded that the used in vitro incubation technique is suitable for the determination of in vitro-uTP of mixed rations for sheep, and that the amount of in vivo-uTP can be predicted by regression between in vitro-uTP and in vivo-uTP.

A study of structure of phenomenology of consciousness in meditative and non-meditative states.

PubMed

Venkatesh, S; Raju, T R; Shivani, Y; Tompkins, G; Meti, B L

1997-04-01

Twelve senior Kundalini (Chakra) meditators were assessed during meditation session and non-meditation or control session using Phenomenology of Consciousness Inventory. The data has been analyzed using structural analysis to measure the altered state of consciousness and the identity state by comparing meditative state with non-meditative state. The structural analysis of pattern of consciousness during the meditative state revealed altered experience in perception (percentile rank PR = 90), meaning (PR = 82) and time sense (PR = 87), while positive affect dimension showed increased joy (PR = 73) and love (PR = 67). The imagery vividness (PR = 72), self-awareness (PR = 77), rationality (PR = 73) and arousal (PR = 69) were found to be structurally different from the ordinary state. With regards to identity state meditative experience was found to produce statistically significant changes in terms of intensity in meaning (P < 0.05), time sense (P < 0.05), joy (P < 0.05), love (P < 0.05) and state of awareness (P < 0.01). Our results indicate that long term practice of meditation appears to produce structural as well as intensity changes in phenomenological experiences of consciousness.

Rational and mechanistic perspectives on reinforcement learning.

PubMed

Chater, Nick

2009-12-01

This special issue describes important recent developments in applying reinforcement learning models to capture neural and cognitive function. But reinforcement learning, as a theoretical framework, can apply at two very different levels of description: mechanistic and rational. Reinforcement learning is often viewed in mechanistic terms--as describing the operation of aspects of an agent's cognitive and neural machinery. Yet it can also be viewed as a rational level of description, specifically, as describing a class of methods for learning from experience, using minimal background knowledge. This paper considers how rational and mechanistic perspectives differ, and what types of evidence distinguish between them. Reinforcement learning research in the cognitive and brain sciences is often implicitly committed to the mechanistic interpretation. Here the opposite view is put forward: that accounts of reinforcement learning should apply at the rational level, unless there is strong evidence for a mechanistic interpretation. Implications of this viewpoint for reinforcement-based theories in the cognitive and brain sciences are discussed.

If only I had taken my usual route…: age-related differences in counter-factual thinking.

PubMed

Horhota, Michelle; Mienaltowski, Andrew; Blanchard-Fields, Fredda

2012-01-01

Previous research suggests that young adults can shift between rational and experiential modes of thinking when forming social judgments. The present study examines whether older adults demonstrate this flexibility in thinking. Young and older adults completed an If-only task adapted from Epstein, Lipson, and Huh's (1992 , Journal of Personality and Social Psychology, 62, 328) examination of individuals' ability to adopt rational or experiential modes of thought while making a judgment about characters who experience a negative event that could have been avoided. Consistent with our expectations for their judgments of the characters, young adults shifted between experiential and rational modes of thought when instructed to do so. Conversely, regardless of the mode of thought being used or the order with which they adopted the different modes of thought (i.e., shifting from experiential to rational in Study 1 and from rational to experiential in Study 2), older adults consistently offered judgments and justifications that reflected a preference for experiential-based thought.

Principles underlying rational design of live attenuated influenza vaccines

PubMed Central

Jang, Yo Han

2012-01-01

Despite recent innovative advances in molecular virology and the developments of vaccines, influenza virus remains a serious burden for human health. Vaccination has been considered a primary countermeasure for prevention of influenza infection. Live attenuated influenza vaccines (LAIVs) are particularly attracting attention as an effective strategy due to several advantages over inactivated vaccines. Cold-adaptation, as a classical means for attenuating viral virulence, has been successfully used for generating safe and effective donor strains of LAIVs against seasonal epidemics and occasional pandemics. Recently, the advent of reverse genetics technique expedited a variety of rational strategies to broaden the pool of LAIVs. Considering the breadth of antigenic diversity of influenza virus, the pool of LAIVs is likely to equip us with better options for controlling influenza pandemics. With a brief reflection on classical attenuating strategies used at the initial stage of development of LAIVs, especially on the principles underlying the development of cold-adapted LAIVs, we further discuss and outline other attenuation strategies especially with respect to the rationales for attenuation, and their practicality for mass production. Finally, we propose important considerations for a rational vaccine design, which will provide us with practical guidelines for improving the safety and effectiveness of LAIVs. PMID:23596576

Melioration as rational choice: sequential decision making in uncertain environments.

PubMed

Sims, Chris R; Neth, Hansjörg; Jacobs, Robert A; Gray, Wayne D

2013-01-01

Melioration-defined as choosing a lesser, local gain over a greater longer term gain-is a behavioral tendency that people and pigeons share. As such, the empirical occurrence of meliorating behavior has frequently been interpreted as evidence that the mechanisms of human choice violate the norms of economic rationality. In some environments, the relationship between actions and outcomes is known. In this case, the rationality of choice behavior can be evaluated in terms of how successfully it maximizes utility given knowledge of the environmental contingencies. In most complex environments, however, the relationship between actions and future outcomes is uncertain and must be learned from experience. When the difficulty of this learning challenge is taken into account, it is not evident that melioration represents suboptimal choice behavior. In the present article, we examine human performance in a sequential decision-making experiment that is known to induce meliorating behavior. In keeping with previous results using this paradigm, we find that the majority of participants in the experiment fail to adopt the optimal decision strategy and instead demonstrate a significant bias toward melioration. To explore the origins of this behavior, we develop a rational analysis (Anderson, 1990) of the learning problem facing individuals in uncertain decision environments. Our analysis demonstrates that an unbiased learner would adopt melioration as the optimal response strategy for maximizing long-term gain. We suggest that many documented cases of melioration can be reinterpreted not as irrational choice but rather as globally optimal choice under uncertainty.

Rational choice and the political bases of changing Israeli counterinsurgency strategy.

PubMed

Brym, Robert J; Andersen, Robert

2011-09-01

Israeli counterinsurgency doctrine holds that the persistent use of credible threat and disproportionate military force results in repeated victories that eventually teach the enemy the futility of aggression. The doctrine thus endorses classical rational choice theory's claim that narrow cost-benefit calculations shape fixed action rationales. This paper assesses whether Israel's strategic practice reflects its counterinsurgency doctrine by exploring the historical record and the association between Israeli and Palestinian deaths due to low-intensity warfare. In contrast to the expectations of classical rational choice theory, the evidence suggests that institutional, cultural and historical forces routinely override simple cost-benefit calculations. Changing domestic and international circumstances periodically cause revisions in counterinsurgency strategy. Credible threat and disproportionate military force lack the predicted long-term effect. © London School of Economics and Political Science 2011.

Focusing on changing clinical practice to enhance rational prescribing--collaboration and networking enable comprehensive approaches.

PubMed

Helin-Salmivaara, Arja; Huupponen, Risto; Klaukka, Timo; Hoppu, Kalle

2003-10-01

Most western societies are enhancing rational pharmacotherapy to get best value for the constantly increasing expenditure on drugs. Government bodies and the medical profession took joint responsibility for the education programme for rational prescribing, launched in Finland at the end of the 1990s. The goals were to enhance critical thinking, and when appropriate, change prescribing behaviour. Various approaches that included evidence-based continuing medical education (CME), implementing clinical guidelines, delivering information, and providing prescribing feedback were used simultaneously. The commitment of the stakeholders and participants has been strong and the approaches have succeeded even though there is no clear outcome measure. The Government has recently decided to continue and widen the process, which started as a pilot programme, on a tight budget.

The creative psychopharmacotherapy and personalized medicine: The art & practice of the learning organization.

PubMed

Jakovljević, Miro

2010-06-01

There is a huge gap between possibilities for achieving high treatment effectiveness and poor results in clinical practice. It is possible to achieve a more positive impact and better treatment outcome by individualizing and personalizing treatments in a more creative and rational manner. This review describes the short history and principles of creative psychopharmacotherapy.

Some Reflections about Writing "A History of Thought and Practice in Educational Administration."

ERIC Educational Resources Information Center

Campbell, Roald F.

A coauthor of a book on the history of thought and practice in educational administration reflects on issues raised during the writing of the book as follows: (1) Categories of administrative thought are difficult to establish. Two categories were derived from Richard Scott's rational systems approach--scientific management and bureaucracy. The…

Education and the Democratic Person: Towards a Political Conception of Democratic Education

ERIC Educational Resources Information Center

Biesta, Gert

2007-01-01

Background/Context: Ever since the Enlightenment, there has been a strong tendency in educational theory and practice to think of education as the "production" of a subject with particular qualities, most notably the quality of rationality. This way of thinking has deeply influenced the theory and practice of democratic education and has led to an…

The Mode of Professional Teaching Practice of FCS Teacher-Leaders and Non-Teacher-Leaders.

ERIC Educational Resources Information Center

Fox, Candace K.; Laster, Janet F.

A study was conducted to determine which of the following modes of professional practice is the dominant mode used by Ohio family and consumer science (FCS) teachers when implementing a refined critical science based curriculum: technical-rational; reflective-ethical; and process-oriented. The target population consisted of 1,013 secondary…

The relationship of staffing and work environment with implicit rationing of nursing care in Swiss nursing homes--A cross-sectional study.

PubMed

Zúñiga, Franziska; Ausserhofer, Dietmar; Hamers, Jan P H; Engberg, Sandra; Simon, Michael; Schwendimann, René

2015-09-01

Implicit rationing of nursing care refers to the withdrawal of or failure to carry out necessary nursing care activities due to lack of resources, in the literature also described as missed care, omitted care, or nursing care left undone. Under time constraints, nurses give priority to activities related to vital medical needs and the safety of the patient, leaving out documentation, rehabilitation, or emotional support of patients. In nursing homes, little is known about the occurrence of implicit rationing of nursing care and possible contributing factors. The purpose of this study was (1) to describe levels and patterns of self-reported implicit rationing of nursing care in Swiss nursing homes and (2) to explore the relationship between staffing level, turnover, and work environment factors and implicit rationing of nursing care. Cross-sectional, multi-center sub-study of the Swiss Nursing Home Human Resources Project (SHURP). Nursing homes from all three language regions of Switzerland. A random selection of 156 facilities with 402 units and 4307 direct care workers from all educational levels (including 25% registered nurses). We utilized data from established scales to measure implicit rationing of nursing care (Basel Extent of Rationing of Nursing Care), perceptions of leadership ability and staffing resources (Practice Environment Scale of the Nursing Work Index), teamwork and safety climate (Safety Attitudes Questionnaire), and work stressors (Health Professions Stress Inventory). Staffing level and turnover at the unit level were measured with self-developed questions. Multilevel linear regression models were used to explore the proposed relationships. Implicit rationing of nursing care does not occur frequently in Swiss nursing homes. Care workers ration support in activities of daily living, such as eating, drinking, elimination and mobilization less often than documentation of care and the social care of nursing homes residents. Statistically significant factors related to implicit rationing of care were the perception of lower staffing resources, teamwork and safety climate, and higher work stressors. Unit staffing and turnover levels were not related to rationing activities. Improving teamwork and reducing work stressors could possibly lead to less implicit rationing of nursing care. Further research on the relationship of implicit rationing of nursing care and resident and care worker outcomes in nursing homes is requested. Copyright © 2015 Elsevier Ltd. All rights reserved.

Maximization, learning, and economic behavior

PubMed Central

Erev, Ido; Roth, Alvin E.

2014-01-01

The rationality assumption that underlies mainstream economic theory has proved to be a useful approximation, despite the fact that systematic violations to its predictions can be found. That is, the assumption of rational behavior is useful in understanding the ways in which many successful economic institutions function, although it is also true that actual human behavior falls systematically short of perfect rationality. We consider a possible explanation of this apparent inconsistency, suggesting that mechanisms that rest on the rationality assumption are likely to be successful when they create an environment in which the behavior they try to facilitate leads to the best payoff for all agents on average, and most of the time. Review of basic learning research suggests that, under these conditions, people quickly learn to maximize expected return. This review also shows that there are many situations in which experience does not increase maximization. In many cases, experience leads people to underweight rare events. In addition, the current paper suggests that it is convenient to distinguish between two behavioral approaches to improve economic analyses. The first, and more conventional approach among behavioral economists and psychologists interested in judgment and decision making, highlights violations of the rational model and proposes descriptive models that capture these violations. The second approach studies human learning to clarify the conditions under which people quickly learn to maximize expected return. The current review highlights one set of conditions of this type and shows how the understanding of these conditions can facilitate market design. PMID:25024182

Maximization, learning, and economic behavior.

PubMed

Erev, Ido; Roth, Alvin E

2014-07-22

The rationality assumption that underlies mainstream economic theory has proved to be a useful approximation, despite the fact that systematic violations to its predictions can be found. That is, the assumption of rational behavior is useful in understanding the ways in which many successful economic institutions function, although it is also true that actual human behavior falls systematically short of perfect rationality. We consider a possible explanation of this apparent inconsistency, suggesting that mechanisms that rest on the rationality assumption are likely to be successful when they create an environment in which the behavior they try to facilitate leads to the best payoff for all agents on average, and most of the time. Review of basic learning research suggests that, under these conditions, people quickly learn to maximize expected return. This review also shows that there are many situations in which experience does not increase maximization. In many cases, experience leads people to underweight rare events. In addition, the current paper suggests that it is convenient to distinguish between two behavioral approaches to improve economic analyses. The first, and more conventional approach among behavioral economists and psychologists interested in judgment and decision making, highlights violations of the rational model and proposes descriptive models that capture these violations. The second approach studies human learning to clarify the conditions under which people quickly learn to maximize expected return. The current review highlights one set of conditions of this type and shows how the understanding of these conditions can facilitate market design.

Rational Action Selection in 1 1/2- to 3-Year-Olds Following an Extended Training Experience

ERIC Educational Resources Information Center

Klossek, Ulrike M. H.; Dickinson, Anthony

2012-01-01

Previous studies failed to find evidence for rational action selection in children under 2 years of age. The current study investigated whether younger children required more training to encode the relevant causal relationships. Children between 1 1/2 and 3 years of age were trained over two sessions to perform actions on a touch-sensitive screen…

Social work in health care: do practitioners' writings suggest an applied social science?

PubMed

Rehr, H; Rosenberg, G; Showers, N; Blumenfield, S

1998-01-01

There are two sources of literature in social work-one from academics and the other from practitioners. Each group is driven by different motivations to write. Academics seek a 'scientific rationality' for the field, while practitioners assume practical and intuitive reasoning, experience aligned with theory, and the 'art of practice' to guide them. It has been said that practitioners do not write and that 'faculty' are the trustees of the knowledge base of the profession, and are responsible for its promulgation via publication. Practitioners, however, do write about their practice and their programs, and analyze both, but publish much of their work in non-social work media. Their work tends not to be referenced by academic writers. One department's social workers' publications are described. We learn, from their practice writings, what concerns clinicians. Theirs is case-based learning, theoretically supported, in which the organization of services calls for their participation in multi-professional decision-making. There is the growing realization among social workers that practice wisdom and scientific technologies need to be reassessed together to find ways to enhance social work services. Clinicians' knowledge can lead to continuing refinement of practice and enhanced institutional services. If practitioners' writings can be assessed, they may lead to a written practice knowledge base, subject to timely change. Academic and practitioner separateness hampers progress in the field. They need each other, and a shared professional literature. There is beginning indication they are getting together.

[Clinical Work Experience of Korean Immigrant Nurses in U.S. Hospitals].

PubMed

Seo, Kumsook; Kim, Miyoung

2016-04-01

The purpose of this qualitative study was to explore the meaning of the experience of Korean immigrant nurses working in US hospitals. Purposive sampling yielded 15 Korean immigrant nurses who had more than one year of clinical experience in US hospitals. Data were collected from March to August 2012 through in-depth interviews and thematic analysis was conducted using van Manen's hermeneutic phenomenological approach. The findings were classified into eight themes: 'struggling from staff at workplace being territorial to outsiders', 'feeling oppressed due to language barrier', 'accepting rational and horizontal relationships at work', 'staying alert in the environment where lawsuits are rife', 'feeling a sense of stability from the social system that values human dignity', 'maintaining self-confidence from prominent nursing practices and senior Korean nurses' professional reputation', 'performing essential comprehensive nursing care', 'promoting self-development to be equipped with professionalism.' The findings indicate that the Korean immigrant nurses were able to excel in their workplace when their clinical experience at US hospitals was combined with the lived space in US politics and environment, lived time of patience, lived body to be alert, and lived others with multi cultural characteristics.

Changing Conspiracy Beliefs through Rationality and Ridiculing.

PubMed

Orosz, Gábor; Krekó, Péter; Paskuj, Benedek; Tóth-Király, István; Bőthe, Beáta; Roland-Lévy, Christine

2016-01-01

Conspiracy theory (CT) beliefs can be harmful. How is it possible to reduce them effectively? Three reduction strategies were tested in an online experiment using general and well-known CT beliefs on a comprehensive randomly assigned Hungarian sample ( N = 813): exposing rational counter CT arguments, ridiculing those who hold CT beliefs, and empathizing with the targets of CT beliefs. Several relevant individual differences were measured. Rational and ridiculing arguments were effective in reducing CT, whereas empathizing with the targets of CTs had no effect. Individual differences played no role in CT reduction, but the perceived intelligence and competence of the individual who conveyed the CT belief-reduction information contributed to the success of the CT belief reduction. Rational arguments targeting the link between the object of belief and its characteristics appear to be an effective tool in fighting conspiracy theory beliefs.

Influences on the Consumption of Australian Ration Packs: Review of a Contextual Model and Application to Australian Defence Force Data

DTIC Science & Technology

2011-03-01

to consuming the same product types contained in the ration pack (e.g. instant noodles ). We can speculate that this may be a practice that supports... instant rice. Unpopular items were cheese with bacon, noodles and mulligatawny. Items needing improvement were meat bars cheese and instant milk. 35...complimentary food items (e.g. BBQ Beef might be consumed with rice or noodles ) UNCLASSIFIED 5 UNCLASSIFIED DSTO-TR-2526 the CR5M were found to be of no

Focus: Bounded Rationality and the History of Science. Introduction.

PubMed

Cowles, Henry M; Deringer, William; Dick, Stephanie; Webster, Colin

2015-09-01

Historians of science see knowledge and its claimants as constrained by myriad factors. These limitations range from the assumptions and commitments of scientific practitioners to the material and ideational contexts of their practice. The precise nature of such limits and the relations among them remains an open question in the history of science. The essays in this Focus section address this question by examining one influential portrayal of constraints--Herbert Simon's theory of "bounded rationality"--as well as the responses to which it has given rise over the last half century.

The national science agenda as a ritual of modern nation-statehood: The consequences of national "Science for National Development" projects

NASA Astrophysics Data System (ADS)

Drori, Gili S.

This study is a comparative investigation of the ways by which the globalization of modern science affects the characteristics of different nation-states. Whereas much research and policy discussion focuses on science as an instrumental, or technical, system with immediate consequences for national conditions, such as economic development, science should also be regarded as a general cultural framework, which is highly institutionalized at the global level. As such, the institutionalization of science at both the global and national levels affects a wide variety of national properties. Following this line of reasoning, this dissertation study employs cross-national and longitudinal data and multiple-indicator methods to show national-level consequences of scientific expansion on the processes of rationalization and modernization of social and political life. It appears that the cross-national expansion of science practice results in, or is associated with, a variety of measures of (a) the standardization of civil and governmental procedures and (b) the expansion of the political rights and political engagement. I conclude from these empirical findings that scientization encourages (a) greater general societal rationalization and (b) expanded notions of social actorhood and agency. This evidence demonstrates how the globalization of science alters local conditions, both civil and political, by supporting the institutionalization of bureaucratic practices and participatory politics. Thus, the expansion of science--clearly affected by global processes--carries a general secularized faith in a rationalized world and in human agency. In this sense, the practice of science is a national ritual, whose social role is as a legitimacy-providing institution, rather then a technically functional institution. On a broader level, the study emphasizes the relations between globalization processes and the sovereignty of the nation-state. I conclude that science carries modernist and global notions of rational governance, identity politics, self-determination, and democratization. Science globalization processes, therefore, encourage the worldwide institutionalization of the liberal mode of governmentality.

The (un)managed self: paradoxical forms of agency in self-management of bipolar disorder.

PubMed

Weiner, Talia

2011-12-01

Self-management of mental illness is a therapeutic paradigm that draws on a distinctly biomedical conceptualization of the isolability of personhood from pathology. This discourse posits a stable and rational patient/consumer who can observe, anticipate, and preside over his disease through a set of learned practices. But in the case of bipolar disorder, where the rationality of the patient is called into question, the managing self is elusive, and the disease that is managed coincides with the self. While humanist critiques of the biomedical model as applied to mental illness have argued that its logic fatalistically denies patients intentionality and effectiveness (Luhrmann, Of Two Minds: The Growing Disorder in American Psychiatry, 2000), biomedical proponents claim that psychiatry's way of envisioning the body as under the control of the intentional mind actually returns agency to the patient/consumer. Rose (The Psychiatric Gaze, 1999) remarks that biomedical models have the potential to "[open] that which was considered natural to a form of choice" (p. 37), and that techniques of medical self-control help constitute the free embodied liberal subject who is obliged to calculate and choose. Through an examination of clinical literature as well as the practices and narratives of members of a bipolar support group, this paper explores ethnographically the possibilities for subjectivity and agency that are conditioned or foreclosed by the self-management paradigm, which seems to simultaneously confer and deny rational selfhood to bipolar patients. To express their expertise as rational self-managers, patients/consumers must, paradoxically, articulate constant suspicion toward their present thoughts and emotions, and distrust of an imagined future self. I argue that through their self-management practices, bipolar support group members model provisional and distributed forms of agency based on an elusive, discontinuous, and only partially knowable or controllable self-revealing, perhaps, the limits of the contemporary reification and medicalization of both selfhood and disease.

The myth of informed consent: in daily practice and in clinical trials.

PubMed

Silverman, W A

1989-03-01

Until about thirty years ago, the extent of disclosure about and consent-seeking for medical interventions was influenced by a beneficence model of professional behaviour. Informed consent shifted attention to a duty to respect the autonomy of patients. The new requirement arrived on the American scene in two separate contexts: for daily practice in 1957, and for clinical study in 1966. A confusing double standard has been established. 'Daily consent' is reviewed, if at all, only in retrospect. Doctors are merely exhorted to obtain informed consent; they often minimise uncertainties about 'best' treatment and they feel duty-bound to provide patients with an unequivocal recommendation for action. 'Study consent' in a clinical trial is reviewed prospectively, and doctors are compelled by regulation to point out that there is insufficient evidence to make a rational choice between two compared treatments. It has been impossible to devise informed consent practices that satisfy, in full, the competing moral imperatives of respect for autonomy, concern for beneficence with emphasis on the value of health, and a vigil for justice. A way must be found to experiment with various discretionary approaches that would strike a realistic balance among competing interests.

Science, practice and mythology: a definition and examination of the implications of scientism in medicine.

PubMed

Loughlin, Michael; Lewith, George; Falkenberg, Torkel

2013-06-01

Scientism is a philosophy which purports to define what the world 'really is'. It adopts what the philosopher Thomas Nagel called 'an epistemological criterion of reality', defining what is real as that which can be discovered by certain quite specific methods of investigation. As a consequence all features of experience not revealed by those methods are deemed 'subjective' in a way that suggests they are either not real, or lie beyond the scope of meaningful rational inquiry. This devalues capacities that (we argue) are in fact essential components of good reasoning and virtuous practice. Ultimately, the implications of scientism for statements of value undermine value-judgements essential for science itself to have a sound basis. Scientism has implications, therefore, for ontology, epistemology and also for which claims we can assert as objective truths about the world. Adopting scientism as a world view will have consequences for reasoning and decision-making in clinical and other contexts. We analyse the implications of this approach and conclude that we need to reject scientism if we are to avoid stifling virtuous practice and to develop richer conceptions of human reasoning.

[The portfolio in health sciences teacher education: a tool for learning and assessment].

PubMed

Roni, Carolina; Eder, María L; Schwartzman, Gisela

2013-01-01

The Portfolio is an assessment tool of learning that recently appears in academic forums, and since 2008 is part of the University Teacher Education Program (Teaching Training) at University Institute of Hospital Italiano. Was included to allow teachers reflect on their own practices and accompany them in their educational work everyday. This paper shares the evaluative experience focused on the educational value of the writing process of the Portfolio, as long as is a reflection and a learning tool, by the relationship that promotes between theory and practice. Writing promotes psychological processes that enable students gain new meanings of the knowledge and take over them. At the same time, it can attend the construction of practical rationality that governs the ways of intervening in the classroom, because they write and reflect from their own teaching work. They have been introduced changes in the proposed during the course of its implementation to preserve its purposes: to accompany the draft review, jointly define index, etc. Students point that it is high impact training and conclude that writing is re-think about what they have learned, and therefore keep learning.

Moving Perspectives on Patient Competence: A Naturalistic Case Study in Psychiatry.

PubMed

Ruissen, A M; Abma, T A; Van Balkom, A J L M; Meynen, G; Widdershoven, G A M

2016-03-01

Patient competence, defined as the ability to reason, appreciate, understand, and express a choice is rarely discussed in patients with obsessive compulsive disorder (OCD), and coercive measures are seldom used. Nevertheless, a psychiatrist of psychologist may doubt whether OCD patients who refuse treatment understand their disease and the consequences of not being treated, which could result in tension between respecting the patient's autonomy and beneficence. The purpose of this article is to develop a notion of competence that is grounded in clinical practice and corresponds with the experiences of patients with obsessions and/or compulsions. We present a naturalistic case study giving both the patient's and the therapist's perspective based on in-depth interviews and a narrative analysis. The case study shows that competence is not merely an assessment by a therapist, but also a co-constructed reality shaped by the experiences and stories of patient and therapist. The patient, a medical student, initially told her story in a restitution narrative, focusing on cognitive rationality. Reconstructing the history of her disease, her story changed into a quest narrative where there was room for emotions, values and moral learning. This fitted well with the therapist's approach, who used motivational interventions with a view to appealing to the patient's responsibility to deal with her condition. We conclude that in practice both the patient and therapist used a quest narrative, approaching competence as the potential for practical reasoning to incorporate values and emotions.

MAPPING CHILDREN'S POLITICS: SPATIAL STORIES, DIALOGIC RELATIONS AND POLITICAL FORMATION.

PubMed

Elwood, Sarah; Mitchell, Katharyne

2012-03-01

This article confronts a persistent challenge in research on children's geographies and politics: the difficulty of recognizing forms of political agency and practice that by definition fall outside of existing political theory. Children are effectively "always already" positioned outside most of the structures and ideals of modernist democratic theory, such as the public sphere and abstracted notions of communicative action or "rational" speech. Recent emphases on embodied tactics of everyday life have offered important ways to recognize children's political agency and practice. However, we argue here that a focus on spatial practices and critical knowledge alone cannot capture the full range of children's politics, and show how representational and dialogic practices remain a critical element of their politics in everyday life. Drawing on de Certeau's notion of spatial stories, and Bakhtin's concept of dialogic relations, we argue that children's representations and dialogues comprise a significant space of their political agency and formation, in which they can make and negotiate social meanings, subjectivities, and relationships. We develop these arguments with evidence from an after-school activity programme we conducted with 10-13 year olds in Seattle, Washington, in which participants explored, mapped, wrote and spoke about the spaces and experiences of their everyday lives. Within these practices, children negotiate autonomy and self-determination, and forward ideas, representations, and expressions of agreement or disagreement that are critical to their formation as political actors.

The Emotional Experience of School Change: Resistance, Loss, and Grief.

ERIC Educational Resources Information Center

Marshak, David

1996-01-01

Ignoring the emotional experience of school change may unintentionally sabotage rational planning. Reinventing schools means attending to educators' emotional experience, particularly their expectations, sense of loss, and resulting grief. School norms must be transformed so that teachers and administrators can have meaningful conversations about…

More Fair Play in an Ultimatum Game after Resettlement in Zimbabwe: A Field Experiment and a Structural Model

PubMed Central

Kohler, Stefan

2013-01-01

Zimbabwean villagers of distinct background have resettled in government-organized land reforms for more than three decades. Against this backdrop, I assess the level of social cohesion in some of the newly established communities by estimating the average preferences for fairness in a structural model of bounded rationality. The estimations are based on behavioral data from an ultimatum game field experiment played by 234 randomly selected households in 6 traditional and 14 resettled villages almost two decades after resettlement. Equal or higher degrees of fairness are estimated in all resettlement schemes. In one, or arguably two, out of three distinct resettlement schemes studied, the resettled villagers exhibit significantly higher degrees of fairness ( ) and rationality ( ) than those who live in traditional villages. Overall, villagers appear similarly rational, but the attitude toward fairness is significantly stronger in resettled communities ( ). These findings are consistent with the idea of an increased need for cooperation required in recommencement. PMID:23724095

More fair play in an ultimatum game after resettlement in Zimbabwe: a field experiment and a structural model.

PubMed

Kohler, Stefan

2013-01-01

Zimbabwean villagers of distinct background have resettled in government-organized land reforms for more than three decades. Against this backdrop, I assess the level of social cohesion in some of the newly established communities by estimating the average preferences for fairness in a structural model of bounded rationality. The estimations are based on behavioral data from an ultimatum game field experiment played by 234 randomly selected households in 6 traditional and 14 resettled villages almost two decades after resettlement. Equal or higher degrees of fairness are estimated in all resettlement schemes. In one, or arguably two, out of three distinct resettlement schemes studied, the resettled villagers exhibit significantly higher degrees of fairness (p ≤ 0.11) and rationality (p ≤ 0.04) than those who live in traditional villages. Overall, villagers appear similarly rational, but the attitude toward fairness is significantly stronger in resettled communities (p ≤ 0.01). These findings are consistent with the idea of an increased need for cooperation required in recommencement.

Improving fermented quality of cider vinegar via rational nutrient feeding strategy.

PubMed

Qi, Zhengliang; Dong, Die; Yang, Hailin; Xia, Xiaole

2017-06-01

This work aimed to find a rational nutrient feeding strategy for cider vinegar fermentation based on adequate information on the nutritional requirement of acetic acid bacteria. Through single nutrient lack experiment assay, necessary nutrient recipe for Acetobacter pasteurianus CICIM B7003 in acetous fermentation was confirmed. Compounds from the essential nutrient recipe were tested further to find out the key substrates significantly influencing cider vinegar fermentation. The findings showed that aspartate, glutamate, proline and tryptophan should be considered in detail for optimizing nutritional composition of cider. Finally, a nutrient feeding strategy that simultaneously adds proline, glutamate, aspartate and tryptophan to form final concentrations of 0.02g/L, 0.03g/L, 0.01g/L and 0.005g/L in cider was achieved by orthogonal experiment design. Comparing to the original fermentation, the yield of acetic acid from alcohol reached 93.3% and the concentration of most volatile flavor compounds increased with the rational nutrient feeding strategy. Copyright © 2016 Elsevier Ltd. All rights reserved.

Modern approach to metabolic rehabilitation of cancer patients: biguanides (phenformin and metformin) and beyond.

PubMed

Berstein, Lev M

2010-08-01

Comparing the experience accumulated for more than 40 years in the Laboratory of Endocrinology of Petrov Institute of Oncology (St Petersburg, Russia) with similar approaches practiced elsewhere, evidence supports the reasonability of metabolic rehabilitation of patients suffering from breast cancer or other hormone-dependent malignancies. The primary objective of such approaches is to improve treatment results by ameliorating hormonal-metabolic disturbances, including excess body fat, glucose intolerance, insulin resistance and manifestations of endocrine-genotoxic switchings, and modify tissue and cellular targets or mechanisms related or nondirectly related to the aforementioned disturbances. The relevant measures may be categorized as pharmacological (antidiabetic biguanides exemplified with metformin being most popular but not exclusive) and nonpharmacological (rational nutrition, moderate physical activity and so forth) and used separately or in different combinations.

Application of truss analysis for the quantification of changes in fish condition

USGS Publications Warehouse

Fitzgerald, Dean G.; Nanson, Jeffrey W.; Todd, Thomas N.; Davis, Bruce M.

2002-01-01

Conservation of skeletal structure and unique body ratios in fishes facilitated the development of truss analysis as a taxonomic tool to separate physically-similar species. The methodology is predicated on the measurement of across-body distances from a sequential series of connected polygons. Changes in body shape or condition among members of the same species can be quantified with the same technique, and we conducted a feeding experiment using yellow perch (Perca flavescens) to examine the utility of this approach. Ration size was used as a surrogate for fish condition, with fish receiving either a high (3.0% body wt/d) or a low ration (0.5%). Sequentially over our 11-week experiment, replicate ration groups of fish were removed and photographed while control fish were repeatedly weighed and measured. Standard indices of condition (total lipids, weight-length ratios, Fulton's condition) were compared to truss measurements determined from digitized pictures of fish. Condition indices showed similarity between rations while truss measures from the caudal region were important for quantifying changing body shape. These findings identify truss analysis as having use beyond traditional applications. It can potentially be used as a cheap, accurate, and precise descriptor of fish condition in the lab as shown here, and we hypothesize that it would be applicable in field studies.

That’s not funny! – But it should be: effects of humorous emotion regulation on emotional experience and memory

PubMed Central

Kugler, Lisa; Kuhbandner, Christof

2015-01-01

Previous research has shown that humorous reappraisal can reduce elicited negative emotions, suggesting that humor may be a functional strategy to cope with emotionally negative situations. However, the effect of humorous reappraisal on later memory about the emotion-eliciting situation is currently unknown, although this is crucial for more adaptive responding in future situations. To address this issue, we examined the effects of humorous reappraisal on both emotional experience and memory, compared to non-humorous rational reappraisal and a non-reappraisal control condition. Replicating previous findings, humorous reappraisal reduced evoked negative valence and arousal levels very effectively, and the down-regulation of experienced negative emotions was even more pronounced after humorous compared to rational reappraisal. Regarding later memory for emotion-eliciting stimuli, both humorous and rational reappraisal reduced free recall, but recognition memory was unaffected, with memory strength being stronger after humorous than after rational reappraisal. These results indicate that humor seems to be indeed an optimal strategy to cope with negative situations because humor can help us to feel better when confronted with negative stimuli, but still allows us to retrieve stimulus information later when afforded to do so by the presence of appropriate contextual features. PMID:26379608

Counterfactual and Factual Reflection: The Influence of Past Misdeeds on Future Immoral Behavior.

PubMed

Gaspar, Joseph P; Seabright, Mark A; Reynolds, Scott J; Yam, Kai Chi

2015-01-01

Though the decision to behave immorally is situated within the context of prior immoral behavior, research has provided contradictory insights into this process. In a series of experiments, we demonstrate that the effects of prior immoral behavior depend on how individuals think about, or reflect on, their immoral behavior. In Experiment 1, participants who reflected counterfactually on their prior moral lapses morally disengaged (i.e., rationalized) less than participants who reflected factually. In Experiment 2, participants who reflected counterfactually on their prior moral lapses experienced more guilt than those who reflected factually. Finally, in Experiments 3 and 4, participants who reflected counterfactually lied less on unrelated tasks with real monetary stakes than those who reflected factually. Our studies provide important insights into moral rationalization and moral compensation processes and demonstrate the profound influence of reflection in everyday moral life.

Decision making: rational or hedonic?

PubMed Central

Cabanac, Michel; Bonniot-Cabanac, Marie-Claude

2007-01-01

Three experiments studied the hedonicity of decision making. Participants rated their pleasure/displeasure while reading item-sentences describing political and social problems followed by different decisions (Questionnaire 1). Questionnaire 2 was multiple-choice, grouping the items from Questionnaire 1. In Experiment 1, participants answered Questionnaire 2 rapidly or slowly. Both groups selected what they had rated as pleasant, but the 'leisurely' group maximized pleasure less. In Experiment 2, participants selected the most rational responses. The selected behaviors were pleasant but less than spontaneous behaviors. In Experiment 3, Questionnaire 2 was presented once with items grouped by theme, and once with items shuffled. Participants maximized the pleasure of their decisions, but the items selected on Questionnaires 2 were different when presented in different order. All groups maximized pleasure equally in their decisions. These results support that decisions are made predominantly in the hedonic dimension of consciousness. PMID:17848195

Moral Education: A Handbook for Teachers. Insights and Practical Strategies for Helping Adolescents to Become More Caring, Thoughtful, and Responsible Persons.

ERIC Educational Resources Information Center

Hall, Robert T.

This handbook contains background readings, teaching strategies, and units of study for teaching moral education at the elementary, secondary, and adult levels. It offers practical strategies and insights for helping adolescents become more caring, thoughtful, and responsible persons. The intent is to help young people make more rational decisions…

Rethinking Critically Reflective Research Practice: Beyond Popper's Critical Rationalism

ERIC Educational Resources Information Center

Ulrich, Werner

2006-01-01

We all know that ships are safest in the harbor; but alas, that is not what ships are built for. They are destined to leave the harbor and to confront the challenges that are waiting beyond the harbor mole. A similar challenge confronts the practice of research. Research at work cannot play it safe and stay in whatever theoretical and…

Deconstruction and Reconstruction of Legal Education in China: Legitimacy and Diffusion of an Academic Discipline from 1949 to 2012

ERIC Educational Resources Information Center

Liu, Zixi; Ting, Kwok-Fai

2017-01-01

Using documentary data, we investigate the evolution of legal education in China from 1949 to 2012. During this period, legal education evolved from an illegitimate practice to a legitimate practice over three distinct periods of nullification, reconstruction, and rationalization. Textual data suggest that the legitimization of legal education has…

"Taking It Personally:" Examining Patterns of Emotional Practice in Leading Primary Schools in the Republic of Ireland

ERIC Educational Resources Information Center

Brennan, Jarlath; Mac Ruairc, Gerry

2011-01-01

The exploration of the emotional practice of school leadership is a recent focus of enquiry with respect to scholarship on school leadership and management. This development provides a much needed addition to the recent proliferation of technical-rational, managerial discourses on leadership. Three dimensions of this complex field of enquiry are…

Artificial intelligence and the future.

PubMed

Clocksin, William F

2003-08-15

We consider some of the ideas influencing current artificial-intelligence research and outline an alternative conceptual framework that gives priority to social relationships as a key component and constructor of intelligent behaviour. The framework starts from Weizenbaum's observation that intelligence manifests itself only relative to specific social and cultural contexts. This is in contrast to a prevailing view, which sees intelligence as an abstract capability of the individual mind based on a mechanism for rational thought. The new approach is not based on the conventional idea that the mind is a rational processor of symbolic information, nor does it require the idea that thought is a kind of abstract problem solving with a semantics that is independent of its embodiment. Instead, priority is given to affective and social responses that serve to engage the whole agent in the life of the communities in which it participates. Intelligence is seen not as the deployment of capabilities for problem solving, but as constructed by the continual, ever-changing and unfinished engagement with the social group within the environment. The construction of the identity of the intelligent agent involves the appropriation or 'taking up' of positions within the conversations and narratives in which it participates. Thus, the new approach argues that the intelligent agent is shaped by the meaning ascribed to experience, by its situation in the social matrix, and by practices of self and of relationship into which intelligent life is recruited. This has implications for the technology of the future, as, for example, classic artificial intelligence models such as goal-directed problem solving are seen as special cases of narrative practices instead of as ontological foundations.

Predisposing factors to the practice of self-medication in Brazil: Results from the National Survey on Access, Use and Promotion of Rational Use of Medicines (PNAUM).

PubMed

Pons, Emilia da Silva; Knauth, Daniela Riva; Vigo, Álvaro; Mengue, Sotero Serrate

2017-01-01

To understand the predisposing factors that lead to the practice of self-medication and the factors associated with the use of medicines via self-medication in the adult population of Brazil. The analyzed data are part of the National Survey on Access, Use and Promotion of Rational Use of Medicines (PNAUM), a survey whose population consisted of individual residents permanently domiciled in urban areas in Brazil. In this work, the data references the 31 573 respondents aged 20 or higher (76.2% of the final PNAUM sample). Poisson regression models with robust variance were used for estimating the independent effect of each variable with medicine use via self-medication. Of the interviewees, 73.6% stated they had used some medication without medical recommendation if they had previously used the same product; 73.8% stated they had used non-prescribed medicine when the medicine was already present at home; and 35.5% stated they had used some non-prescribed medication when they knew someone who had already taken the same medication. The prevalence of self-medication was 18.3%. The variables associated with the highest probability of using medicine via self-medication were: geographic region within Brazil, gender, age group, per capita income, self-assessment of health, self-reported use of previously used non-prescribed medication, and self-reported use of non-prescribed medication when that medication was already present at home. The use of medicines via self-medication in Brazil is relatively frequent and influenced by previous experience and familiarity with the medications, and is more common among women and individuals with low self-assessment of health.

A rational explanation of wave-particle duality of light

NASA Astrophysics Data System (ADS)

Rashkovskiy, S. A.

2013-10-01

The wave-particle duality is a fundamental property of the nature. At the same time, it is one of the greatest mysteries of modern physics. This gave rise to a whole direction in quantum physics - the interpretation of quantum mechanics. The Wiener experiments demonstrating the wave-particle duality of light are discussed. It is shown that almost all interpretations of quantum mechanics allow explaining the double-slit experiments, but are powerless to explain the Wiener experiments. The reason of the paradox, associated with the wave-particle duality is analyzed. The quantum theory consists of two independent parts: (i) the dynamic equations describing the behavior of a quantum object (for example, the Schrodinger or Maxwell equations), and (ii) the Born's rule, the relation between the wave function and the probability of finding the particle at a given point. It is shown that precisely the Born's rule results in paradox in explaining the wave-particle duality. In order to eliminate this paradox, we propose a new rational interpretation of the wave-particle duality and associated new rule, connecting the corpuscular and wave properties of quantum objects. It is shown that this new rational interpretation of the wave-particle duality allows using the classic images of particle and wave in explaining the quantum mechanical and optical phenomena, does not result in paradox in explaining the doubleslit experiments and Wiener experiments, and does not contradict to the modern quantum mechanical concepts. It is shown that the Born's rule follows immediately from proposed new rules as an approximation.

Teaching and Learning Science for Transformative, Aesthetic Experience

ERIC Educational Resources Information Center

Girod, Mark; Twyman, Todd; Wojcikiewicz, Steve

2010-01-01

Drawing from the Deweyan theory of experience (1934, 1938), the goal of teaching and learning for transformative, aesthetic experience is contrasted against teaching and learning from a cognitive, rational framework. A quasi-experimental design was used to investigate teaching and learning of fifth grade science from each perspective across an…

Epigenesis and the rationality of nature in William Harvey and Margaret Cavendish.

PubMed

Goldberg, Benjamin

2017-06-01

The generation of animals was a difficult phenomenon to explain in the seventeenth century, having long been a problem in natural philosophy, theology, and medicine. In this paper, I explore how generation, understood as epigenesis, was directly related to an idea of rational nature. I examine epigenesis-the idea that the embryo was constructed part-by-part, over time-in the work of two seemingly dissimilar English philosophers: William Harvey, an eclectic Aristotelian, and Margaret Cavendish, a radical materialist. I chart the ways that they understood and explained epigenesis, given their differences in philosophy and ontology. I argue for the importance of ideas of harmony and order in structuring their accounts of generation as a rational process. I link their experiences during the English Civil war to how they see nature as a possible source for the rationality and concord sorely missing in human affairs.

Technologies in older people's care.

PubMed

Andersson Marchesoni, Maria; Axelsson, Karin; Fältholm, Ylva; Lindberg, Inger

2017-03-01

The tension between care-based and technology-based rationalities motivates studies concerning how technology can be used in the care sector to support the relational foundation of care. This study interprets values related to care and technologies connected to the practice of good care. This research study was part of a development project aimed at developing innovative work practices through information and communication technology. Participants and research context: All staff (n = 18) working at two wards in a care facility for older people were asked to participate in interviews, and 12 accepted. We analysed the data using latent content analysis in combination with normative analysis. Ethical considerations: The caregivers were informed that participation was voluntary and that they could drop out at any time without providing any explanation. Four values were identified: 'presence', 'appreciation', 'competence' and 'trust'. Caregivers wanted to focus on care receivers as unique persons, a view that they thought was compromised by time-consuming and beeping electronic devices. Appraising from next-of-kin and been seen as someone who can contribute together with knowledge to handle different situations were other desires. The caregivers also desired positive feedback from next-of-kin, as they wanted to be seen as professionals who have the knowledge and skills to handle difficult situations. In addition, the caregivers wanted their employer to trust them, and they wanted to work in a calm environment. Caregivers' desire for disturbance-free interactions, being valued for their skills and working in a trustful working environment were interpreted as their base for providing good care. The caregivers' arguments are based on caring rationality, and sometimes they felt the technological rationality interfered with their main mission, providing quality care. Introducing new technology in caring should support the caring relationship. Although society's overall technology-based approach may have gained popularity as a problem solver, technology-based rationality may compromise a care-based rationality. A shift in attitudes towards care as a concept on all societal levels is needed.

Are Staffing, Work Environment, Work Stressors, and Rationing of Care Related to Care Workers' Perception of Quality of Care? A Cross-Sectional Study.

PubMed

Zúñiga, Franziska; Ausserhofer, Dietmar; Hamers, Jan P H; Engberg, Sandra; Simon, Michael; Schwendimann, René

2015-10-01

To describe care worker-reported quality of care and to examine its relationship with staffing variables, work environment, work stressors, and implicit rationing of nursing care. Cross-sectional study. National, randomly selected sample of Swiss nursing homes, stratified according to language region and size. A total of 4311 care workers of all educational backgrounds (registered nurses, licensed practical nurses, nurse aides) from 402 units in 155 nursing homes completed a survey between May 2012 and April 2013. Care worker-reported quality of care was measured with a single item; predictors were assessed with established instruments (eg, Practice Environment Scale-Nurse Working Index) adapted for nursing home use. A multilevel logistic regression model was applied to assess predictors for quality of care. Overall, 7% of care workers rated the quality of care provided as rather low or very low. Important factors related to better quality of care were higher teamwork and safety climate (odds ratio [OR] 6.19, 95% confidence interval [CI] 4.36-8.79); better staffing and resources adequacy (OR 2.94, 95% CI 2.08-4.15); less stress due to workload (OR 0.71, 95% CI 0.55-0.93); less implicit rationing of caring, rehabilitation, and monitoring (OR 0.34, 95% CI 0.24-0.49); and less rationing of social care (OR 0.80, 95% CI 0.69-0.92). Neither leadership nor staffing levels, staff mix, or turnover was significantly related to quality of care. Work environment factors and organizational processes are vital to provide high quality of care. The improvement of work environment, support in handling work stressors, and reduction of rationing of nursing care might be intervention points to promote high quality of care in nursing homes. Copyright © 2015 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

Feeding of Total Mixed Ration on the Productivity of Friesian Holstein Cross-Grade Cattle

NASA Astrophysics Data System (ADS)

Sunarso; Christiyanto, M.; Nuswantara, L. K.

2018-02-01

An experiment was conducted to evaluate feeding of total mixed ration (TMR) on the productivity of Friesian Holstein (FH) male cross-grade cattle at Semarang Municipality. TMR was a ration formulated with agricultural and agro-industrial by-product (no grass and/or green forage were used) to fulfilled the nutrient requirement of beef cattle. Total mixed ration were formulated on iso-energy of 66% of total digestible nutrients (TDN) and different level of crude protein (CP) content of 11%, 12%, 13%, and 14%. Twenty (20) heads of FH male cross-grade cattle with initial body weight of 292.40+33.06 kg were used in this experiment, and were arranged into 5 treatments T0, T1, T2, T3, and T4), and 4 replications. Data collected were analysed statistically using analyses of variance (Anova) based on the completely randomized design (CRD), then followed by Duncan’s Multiple Range Test (DMRT) for different among treatments. Results of the experiment showed significantly different effect (P<0.05) on dry matter intake (DMI), CP intake, TDN intake, and average daily gain (ADG). There were no different effect (P>0.05) on feed conversion ratio (FCR), and feed efficiency. Others parameter showed that there were no significantly different (P>0.05) effect on the dry matter and organic matter digestibility in vitro, rumen ammonia concentration, and volatile fatty acid’s rumen concentration. It was concluded that feeding TMR was potentially prospected for fattening of beef cattle, particularly as feeding strategy when there was no grass and/or green forage anymore.

The effects of mortality salience and conceptual focus in CISM providers: implications for mental health response to mass fatality disasters.

PubMed

Morrow, Hope E; Haussmann, Robert

2012-01-01

On the basis of terror management theory (TMT) and cognitive-experiential self-theory (CEST), research has demonstrated that when individuals are experientially (rather than rationally)focused, mortality salience (MS) can engender world view defense in the form of increased in-group bias, increased favoritism toward others who uphold cultural values, and greater derogation of those who threaten them. The goal of the present study was to replicate previously observed effects of mortality salience on world view defense in a sample of disaster responders, specifically Criticallncident Stress Management (CISM) providers, and to examine the potential moderating effect of conceptual mode (rational versus experiential) on these effects. Sixty-two participants at the International Critical Incident Stress Foundation's 2011 World Congress were selected for participation in the study. Subsequent manipulation checks revealed that neither,manipulation (mortality salience: MS versus non-MS or conceptual mode: rational versus experiential) was effective. This failure is discussed in terms of the potentially mortality salient nature of conference proceedings that preceded data collection, the depletion of self-control resources required to maintain a rational focus on conference presentations, participants 'need to maintain their focus during future conference presentations, and profession-related practice effects that may have made it easier for some participants to maintain a rational focus.

Treatment limitation decisions under uncertainty: the value of subsequent euthanasia.

PubMed

Savulescu, Julian

1994-01-01

This paper examines how decisions to limit treatment to critically ill patients under uncertainty can be made rationally. Expected utility theory offers one way of making rational decisions under uncertainty. One problem with using this approach is that we may not know the value of each option. One rational course open is to treat until further information becomes available. However, treatment can limit the range of options open. With treatment, a patient may recover such that he no longer requires life-supporting treatment. However, his life may be not worth living. If active euthanasia of 'non-terminal' conditions is prohibited, the option of dying will no longer be available. Taking a rational 'wait and see' course may result in being trapped within an unbearable life. On the other hand, sometimes present practice 'lets nature take its course'. Critically ill patients are allowed to die because it is believed that their lives will be not worth living. It is likely that some patients are allowed to die when there is some objective chance of worthwhile future life. This paper argues that a policy of treating critically ill patients until the nature of future options can be better evaluated, in company with an offer of subsequent euthanasia where appropriate, allows a more rational and humane approach to treatment limitation decisions under uncertainty.

Occupational musculoskeletal and mental health: Significance of rationalization and opportunities to create sustainable production systems - A systematic review.

PubMed

Westgaard, R H; Winkel, J

2011-01-01

This literature review aims to identify occupational musculoskeletal and mental health effects of production system rationalization as well as organizational-level measures that may improve health outcome ("modifiers" in this review). A short review of the effect of ergonomic interventions is included as background and rationalization is discussed as a theoretical concept. Indicator variables for occupational musculoskeletal and mental health and related risk factors are presented. Variables with a generalized format were allowed in the literature searches (e.g., job satisfaction and absenteeism were accepted as risk factor and health indicator, respectively), suitable for the research fields of work sociology, organization science, human resource management (HRM) and economics research. One hundred and sixty-two studies of rationalization effects on health and risk factors and 72 organization-level modifier results were accepted into the final database. Entries were sorted by rationalization strategy and work life sector, and trends in outcome (positive, mixed, no effect, or negative effect on health and risk factors) were determined. Rationalizations have a dominant negative effect on health and risk factors (57% negative, 19% positive); the most negative effects were found for downsizing and restructuring rationalizations in general (71 studies negative, 13 positive) and for the health care sector in particular (36 studies negative, 2 positive). The rationalization strategy High Performance Work System (HPWS) was associated with the highest fraction positive outcome studies (6 of 10 studies). Other rationalization strategies (lean practices, parallel vs. serial production and mechanization level) reported intermediate results, in part dependent on work life sector, but also on the year when studies were carried out. Worker participation, resonant management style, information, support, group autonomy and procedural justice were modifiers with favourable influence on outcome. It is concluded that production system rationalization represents a pervasive work life intervention without a primary occupational health focus. It has considerable and mostly negative influence on worker health, but this can be reduced by attention to modifiers. The results create a basis for new priorities in ergonomic intervention research. Copyright © 2010 Elsevier Ltd and The Ergonomics Society. All rights reserved.

Dynamic pricing of network goods with boundedly rational consumers.

PubMed

Radner, Roy; Radunskaya, Ami; Sundararajan, Arun

2014-01-07

We present a model of dynamic monopoly pricing for a good that displays network effects. In contrast with the standard notion of a rational-expectations equilibrium, we model consumers as boundedly rational and unable either to pay immediate attention to each price change or to make accurate forecasts of the adoption of the network good. Our analysis shows that the seller's optimal price trajectory has the following structure: The price is low when the user base is below a target level, is high when the user base is above the target, and is set to keep the user base stationary once the target level has been attained. We show that this pricing policy is robust to a number of extensions, which include the product's user base evolving over time and consumers basing their choices on a mixture of a myopic and a "stubborn" expectation of adoption. Our results differ significantly from those that would be predicted by a model based on rational-expectations equilibrium and are more consistent with the pricing of network goods observed in practice.

Antimicrobial drug use and related management practices among Ontario swine producers.

PubMed

Dunlop, R H; McEwen, S A; Meek, A H; Friendship, R A; Clarke, R C; Black, W D

1998-02-01

A mail survey of swine producers in Ontario was undertaken during 1991 to describe the types, frequency, and motives for antimicrobial use. Two hundred operations that marketed fewer than 350 hogs per year, and 800 that marketed more than 350 per year were sent questionnaires, 63% of which were completed and returned. Most operations (86%) added antimicrobials to starter (weanling pig) rations, while fewer (29%) added these drugs to finisher pig rations. The most commonly used antimicrobials were tylosin, carbadox, and furazolidone in weanling pigs, and tylosin, lincomycin, and tetracycline in finishers. Water medication of grower-finisher pigs was practised on 25% of farms; 80% of farms had injected at least some grower-finisher pigs with antimicrobials in the 12 mo preceding the survey. Approximately 20% of operations that added antimicrobials to finisher rations did so for growth promotion purposes only, while others used them for disease treatment, prevention, control, or a combination of reasons. Among those not using antimicrobials in finisher rations, 83% did not believe they were necessary and 37% were concerned about the potential for residues in marketed hogs.

Antimicrobial drug use and related management practices among Ontario swine producers.

PubMed Central

Dunlop, R H; McEwen, S A; Meek, A H; Friendship, R A; Clarke, R C; Black, W D

1998-01-01

A mail survey of swine producers in Ontario was undertaken during 1991 to describe the types, frequency, and motives for antimicrobial use. Two hundred operations that marketed fewer than 350 hogs per year, and 800 that marketed more than 350 per year were sent questionnaires, 63% of which were completed and returned. Most operations (86%) added antimicrobials to starter (weanling pig) rations, while fewer (29%) added these drugs to finisher pig rations. The most commonly used antimicrobials were tylosin, carbadox, and furazolidone in weanling pigs, and tylosin, lincomycin, and tetracycline in finishers. Water medication of grower-finisher pigs was practised on 25% of farms; 80% of farms had injected at least some grower-finisher pigs with antimicrobials in the 12 mo preceding the survey. Approximately 20% of operations that added antimicrobials to finisher rations did so for growth promotion purposes only, while others used them for disease treatment, prevention, control, or a combination of reasons. Among those not using antimicrobials in finisher rations, 83% did not believe they were necessary and 37% were concerned about the potential for residues in marketed hogs. PMID:10051955

Dynamic pricing of network goods with boundedly rational consumers

PubMed Central

Radner, Roy; Radunskaya, Ami; Sundararajan, Arun

2014-01-01

We present a model of dynamic monopoly pricing for a good that displays network effects. In contrast with the standard notion of a rational-expectations equilibrium, we model consumers as boundedly rational and unable either to pay immediate attention to each price change or to make accurate forecasts of the adoption of the network good. Our analysis shows that the seller’s optimal price trajectory has the following structure: The price is low when the user base is below a target level, is high when the user base is above the target, and is set to keep the user base stationary once the target level has been attained. We show that this pricing policy is robust to a number of extensions, which include the product’s user base evolving over time and consumers basing their choices on a mixture of a myopic and a “stubborn” expectation of adoption. Our results differ significantly from those that would be predicted by a model based on rational-expectations equilibrium and are more consistent with the pricing of network goods observed in practice. PMID:24367101

Guidelines for the Bioremediation of Marine Shorelines and Freshwater Wetlands

EPA Pesticide Factsheets

For oil spill responders:presents rational approach, evaluates current practices and state-of-the-art research results pertaining to bioremediation of hydrocarbon contamination relative to types and amounts of amendments used, application frequency, extent

Audit of Endotracheal Tube Suction in a Pediatric Intensive Care Unit.

PubMed

Davies, Kylie; Bulsara, Max K; Ramelet, Anne-Sylvie; Monterosso, Leanne

2017-02-01

We report outcomes of a clinical audit examining criteria used in clinical practice to rationalize endotracheal tube (ETT) suction, and the extent these matched criteria in the Endotracheal Suction Assessment Tool(ESAT)©. A retrospective audit of patient notes ( N = 292) and analyses of criteria documented by pediatric intensive care nurses to rationalize ETT suction were undertaken. The median number of documented respiratory and ventilation status criteria per ETT suction event that matched the ESAT© criteria was 2 [Interquartile Range (IQR) 1-6]. All criteria listed within the ESAT© were documented within the reviewed notes. A direct link was established between criteria used for current clinical practice of ETT suction and the ESAT©. The ESAT©, therefore, reflects documented clinical decision making and could be used as both a clinical and educational guide for inexperienced pediatric critical care nurses. Modification to the ESAT © requires "preparation for extubation" to be added.

A geometric modeler based on a dual-geometry representation polyhedra and rational b-splines

NASA Technical Reports Server (NTRS)

Klosterman, A. L.

1984-01-01

For speed and data base reasons, solid geometric modeling of large complex practical systems is usually approximated by a polyhedra representation. Precise parametric surface and implicit algebraic modelers are available but it is not yet practical to model the same level of system complexity with these precise modelers. In response to this contrast the GEOMOD geometric modeling system was built so that a polyhedra abstraction of the geometry would be available for interactive modeling without losing the precise definition of the geometry. Part of the reason that polyhedra modelers are effective is that all bounded surfaces can be represented in a single canonical format (i.e., sets of planar polygons). This permits a very simple and compact data structure. Nonuniform rational B-splines are currently the best representation to describe a very large class of geometry precisely with one canonical format. The specific capabilities of the modeler are described.

[What else is Evidence-based Medicine?].

PubMed

Hauswaldt, Johannes

2010-01-01

The practice of evidence-based medicine means integrating individual clinical expertise with the best available external clinical evidence. Strange enough, scientific discussion focuses on external evidence from systematic research, but neglects its counterpart, i.e., individual clinical expertise. Apart from a lack of appropriate intellectual tools for approaching the latter, this might be due to the mutual concealment of thought and action, of sensor and motor activity (Viktor von Weizsaecker's principle of the revolving door). Behind this, and incommensurably different from each other, lie the world of physics and the world of biology with an ego animal, that is, the dilemma of the self-conscious subject in a world of objects. When practicing medicine, this dilemma of self-reference is being resolved but only through a holistic approach combining rational and external evidence with biographical, spiritual, emotional and pre-rational elements represented in the physician's individual clinical expertise. Copyright © 2010. Published by Elsevier GmbH.

Challenges in Expanding Access to Dialysis in South Africa-Expensive Modalities, Cost Constraints and Human Rights.

PubMed

Etheredge, Harriet; Fabian, June

2017-07-31

South Africa is a country with two distinct health sectors, which are both characterised by inequalities. Within this context, patients with end stage renal disease face unique and sometimes impenetrable barriers to accessing dialysis. There are a number of reasons for this situation. These include: the South African government's endorsement of discordant, unequal policies, which disadvantage the most vulnerable; a lack of robust national guidelines; and divisive rationing practices, which are ad hoc and place the burden of responsibility for rationing dialysis on the clinician. In this paper, we trace the socio-economic mechanisms of how we have come to be in this situation, and overlay this with a detailed examination of South African legislation. Finally, we make comprehensive practical recommendations for rectifying the situation, which include engagement with key stakeholders, public-private partnerships, and more equitable funding mechanisms.

Antibiotics Smart Use: a workable model for promoting the rational use of medicines in Thailand

PubMed Central

Chongtrakul, Pisonthi; Anuwong, Kunyada; Pumtong, Somying; Kongsomboon, Kedsenee; Butdeemee, Parichart; Khonglormyati, Jurairat; Chomyong, Santi; Tongyoung, Parnuchote; Losiriwat, Suraphol; Seesuk, Piyanooch; Suwanwaree, Pongthep; Tangcharoensathien, Viroj

2012-01-01

Abstract The Antibiotics Smart Use (ASU) programme was introduced in Thailand as a model to promote the rational use of medicines, starting with antibiotics. The programme’s first phase consisted of assessing interventions intended to change prescribing practices; the second phase examined the feasibility of programme scale-up. Currently the programme is in its third phase, which centres on sustainability. This paper describes the concept behind ASU, the programme’s functional modalities, the development of its conceptual framework and the implementation of its first and second phases. To change antibiotic prescription practices, multifaceted interventions at the individual and organizational levels were implemented; to maintain behaviour change and scale up the programme, interventions at the network and policy levels were used. The National Health Security Office has adopted ASU as a pay-for-performance criterion, a major achievement that has led to the programme’s expansion nationwide. Despite limited resources, programme scale-up and sustainability have been facilitated by the promotion of local ownership and mutual recognition, which have generated pride and commitment. ASU is clearly a workable entry point for efforts to rationalize the use of medicines in Thailand. Its long-term sustainability will require continued local commitment and political support, effective auditing and integration of ASU into routine systems with appropriate financial incentives. PMID:23284196

Antibiotics Smart Use: a workable model for promoting the rational use of medicines in Thailand.

PubMed

Sumpradit, Nithima; Chongtrakul, Pisonthi; Anuwong, Kunyada; Pumtong, Somying; Kongsomboon, Kedsenee; Butdeemee, Parichart; Khonglormyati, Jurairat; Chomyong, Santi; Tongyoung, Parnuchote; Losiriwat, Suraphol; Seesuk, Piyanooch; Suwanwaree, Pongthep; Tangcharoensathien, Viroj

2012-12-01

The Antibiotics Smart Use (ASU) programme was introduced in Thailand as a model to promote the rational use of medicines, starting with antibiotics. The programme's first phase consisted of assessing interventions intended to change prescribing practices; the second phase examined the feasibility of programme scale-up. Currently the programme is in its third phase, which centres on sustainability. This paper describes the concept behind ASU, the programme's functional modalities, the development of its conceptual framework and the implementation of its first and second phases. To change antibiotic prescription practices, multifaceted interventions at the individual and organizational levels were implemented; to maintain behaviour change and scale up the programme, interventions at the network and policy levels were used. The National Health Security Office has adopted ASU as a pay-for-performance criterion, a major achievement that has led to the programme's expansion nationwide. Despite limited resources, programme scale-up and sustainability have been facilitated by the promotion of local ownership and mutual recognition, which have generated pride and commitment. ASU is clearly a workable entry point for efforts to rationalize the use of medicines in Thailand. Its long-term sustainability will require continued local commitment and political support, effective auditing and integration of ASU into routine systems with appropriate financial incentives.

A Kantian argument against comparatively advantageous genetic modification.

PubMed

Jensen, David

2011-08-01

The genetic modification of children is becoming a more likely possibility given our rapid progress in medical technologies. I argue, from a broadly Kantian point of view, that at least one kind of such modification-modification by a parent for the sake of a child's comparative advantage-is not rationally justified. To argue this, I first characterize a necessary condition on reasons and rational justification: what is a reason for an agent to do an action in one set of circumstances must be a reason for any in those circumstances to do the action. I then show that comparatively advantageous genetic modification violates this principle since a child's "getting ahead" through genetic modification cannot be rationally justified unless other children also could receive the modification, thus rendering the advantage useless. Finally, I consider the major objection to this it seems to disallow all cases of a parent's helping a child get ahead, something that parents normally engage in with their children. I argue that typical practices of developing a comparative advantage in a child, as well as practices of societal competition in general, do not conflict because they involve circumstances that mitigate the universal character of reasons. Many ordinary cases of competitive advantage that we think of as unjust, in fact, can be explained by my argument.

Reasoning about instrumental and communicative agency in human infancy.

PubMed

Gergely, György; Jacob, Pierre

2012-01-01

Theoretical rationality and practical rationality are, respectively, properties of an individual's belief system and decision system. While reasoning about instrumental actions complies with practical rationality, understanding communicative actions complies with the principle of relevance. Section 2 reviews the evidence showing that young infants can reason about an agent's instrumental action by representing her subjective motivations and the episodic contents of her epistemic states (including false beliefs). Section 3 reviews the evidence showing special sensitivity in young human infants to some ostensive behavioral signals encoding an agent's communicative intention. We also address the puzzle of imitative learning of novel means actions by 1-year olds and argue that it can be resolved only by assuming that the infant construes the model's demonstration as a communicative, not an instrumental, action. Section 4 reviews the evidence for natural pedagogy, a species-unique social communicative learning mechanism that exploits human infants' receptivity to ostensive-communicative signals and enables infants to acquire kind-wide generalizations from the nonverbal demonstrations of communicative agents. We argue that the essentialist bias that has been shown to be involved in children's concepts of natural kinds also applies to infants' concepts of artifacts. We further examine how natural pedagogy may also boost inductive learning in human infancy.

Ethical issues for otolaryngology and surgery in the elderly.

PubMed

Seidman, M D; Shapiro, D P; Shirwany, N A

1999-06-01

Clinical ethics is an intrinsic aspect of medical practice. Concerns for ethical conduct arise in the management of medical benefits, patient preferences, quality of life, and the relationship between patient care and its attendant familial, social, economic, and legal circumstances. Ethical concerns in surgical practice are central to the essence of the Hippocratic doctrine, "First do no harm." In caring for our patients, particularly in light of the modern practice of medicine, we often use the risk-benefit calculus. The range of ethical concerns for the otolaryngologist who deals with the elderly and infirm covers many diverse situations. Superimposed over this spectrum is the idea of patient autonomy, which is considered to be a cardinal issue in any ethical discussion. Furthermore, increasing medical care costs have created a debate regarding the rationing of healthcare. Ethicists continue the discussion as to whether age should be a decisive factor in the rationing of this care. Definitions of "heroic" and "extraordinary" assume greater significance, and controversies of language become pivotal when the comprehension and cognitive orientation of the patient are compromised by disease and senescence.

[Drug advertising to the general public: conceptual parameters of a risk producer practice].

PubMed

Nascimento, Alvaro César

2010-11-01

This article analyzes some concepts relating to marketing, advertising, medications, regulation and manipulation. It discusses ethical and health surveillance parameters of drugs advertising for the general public. The focus of this work is the analysis of contradictions from a conceptual point of view between the practice of pharmaceutical advertising as a tool for the increase of sales and the conquest of markets versus the policy of rational use of medicines. Academic studies and monitoring of drugs advertising conducted by the National Health Surveillance Agency show that the contents of the advertising pieces oriented towards the general public overestimate the - sometimes dubious - qualities of their medication, focusing almost exclusively on the benefits and put them in a central position in the therapeutic process. They also fail to mention the risks inherent in their use. Rather than focusing on regulatory proposals aimed at creating constraints to this practice, this article discusses the impossibility, considering the interests of public health, of the coexistence of marketing with the policies for the correct, rational and safe use of drugs.

Nutritional modulation of IGF-1 in relation to growth and body condition in Sceloporus lizards.

PubMed

Duncan, Christine A; Jetzt, Amanda E; Cohick, Wendie S; John-Alder, Henry B

2015-05-15

Nutrition and energy balance are important regulators of growth and the growth hormone/insulin-like growth factor (GH/IGF) axis. However, our understanding of these functions does not extend uniformly to all classes of vertebrates and is mainly limited to controlled laboratory conditions. Lizards can be useful models to improve our understanding of the nutritional regulation of the GH/IGF-1 axis because many species are relatively easy to observe and manipulate both in the laboratory and in the field. In the present study, the effects of variation in food intake on growth, body condition, and hepatic IGF-1 mRNA levels were measured in (1) juveniles of Sceloporus jarrovii maintained on a full or 1/3 ration and (2) hatchlings of Sceloporus undulatus subjected to full or zero ration with or without re-feeding. These parameters plus plasma IGF-1 were measured in a third experiment using adults of S. undulatus subjected to full or zero ration with or without re-feeding. In all experiments, plasma corticosterone was measured as an anticipated indicator of nutritional stress. In S. jarrovii, growth and body condition were reduced but lizards remained in positive energy balance on 1/3 ration, and hepatic IGF-1 mRNA and plasma corticosterone were not affected in comparison to full ration. In S. undulatus, growth, body condition, hepatic IGF-1 mRNA, and plasma IGF-1 were all reduced by zero ration and restored by refeeding. Plasma corticosterone was increased in response to zero ration and restored by full ration in hatchlings but not adults of S. undulatus. These data indicate that lizards conform to the broader vertebrate model in which severe food deprivation and negative energy balance is required to attenuate systemic IGF-1 expression. However, when animals remain in positive energy balance, reduced food intake does not appear to affect systemic IGF-1. Consistent with other studies on lizards, the corticosterone response to reduced food intake is an unreliable indicator of nutritional stress. Further studies on ecologically relevant variation in food intake are required to establish the importance of nutrition as an environmental regulator of the GH/IGF axis. Within the range of positive energy balance, the potential involvement of molecular signals in growth regulation requires further investigation. Copyright © 2015 Elsevier Inc. All rights reserved.

Approaches to rationing antiretroviral treatment: ethical and equity implications.

PubMed Central

Bennett, Sara; Chanfreau, Catherine

2005-01-01

Despite a growing global commitment to the provision of antiretroviral therapy (ART), its availability is still likely to be less than the need. This imbalance raises ethical dilemmas about who should be granted access to publicly-subsidized ART programmes. This paper reviews the eligibility and targeting criteria used in four case-study countries at different points in the scale-up of ART, with the aim of drawing lessons regarding ethical approaches to rationing. Mexico, Senegal, Thailand and Uganda have each made an explicit policy commitment to provide antiretrovirals to all those in need, but are achieving this goal in steps--beginning with explicit rationing of access to care. Drawing upon the case-studies and experiences elsewhere, categories of explicit rationing criteria have been identified. These include biomedical factors, adherence to treatment, prevention-driven factors, social and economic benefits, financial factors and factors driven by ethical arguments. The initial criteria for determining eligibility are typically clinical criteria and assessment of adherence prospects, followed by a number of other factors. Rationing mechanisms reflect several underlying ethical theories and the ethical underpinnings of explicit rationing criteria should reflect societal values. In order to ensure this alignment, widespread consultation with a variety of stakeholders, and not only policy-makers or physicians, is critical. Without such explicit debate, more rationing will occur implicitly and this may be more inequitable. The effects of rationing mechanisms upon equity are critically dependent upon the implementation processes. As antiretroviral programmes are implemented it is crucial to monitor who gains access to these programmes. PMID:16175829

Toward Re-Thinking Science Education in Terms of Affective Practices: Reflections from the Field

ERIC Educational Resources Information Center

Kayumova, Shakhnoza; Tippins, Deborah

2016-01-01

Rational and operationalized views of science and what it means for teachers and students to know and enact legitimate science practices have dominated science education research for many decades (Fusco and Barton in "J Res Sci Teach" 38(3):337-354, 2001. doi: 10.1002/1098-2736(200103)38:3<337::AID-TEA1009>3.0.CO;2-0). Michalinos…

Accounting for Discrepancies in Teachers' Attitudes towards Evidence Use and Actual Instances of Evidence Use in Schools

ERIC Educational Resources Information Center

Brown, Chris; Zhang, Dell

2017-01-01

While beneficial, the consistent and regular use of evidence to improve teaching and learning is proving difficult to achieve in practice. This paper attempts to shed new light on this issue by examining the question: "If using evidence to inform teaching practice is rational behaviour, why aren't all teachers engaged in it?" It first…

Reaching Agreement in Uncertain Circumstances: The Practice of Evidence-Based Policy in the Case of the Swedish National Guidelines for Heart Diseases

ERIC Educational Resources Information Center

Eckard, Nathalie; Nedlund, Ann-Charlotte; Janzon, Magnus; Levin, Lars-Åke

2017-01-01

This paper explores the practice of evidence-based policy in a Swedish healthcare context. The study focused on how policymakers in the specific working group, the Priority-Setting Group (PSG), handled the various forms of evidence and values and their competing rationalities, when producing the Swedish National Guidelines for heart diseases that…

Surrogate biochemical markers: precise measurement for strategic drug and biologics development.

PubMed

Lee, J W; Hulse, J D; Colburn, W A

1995-05-01

More efficient drug and biologics development is necessary for future success of pharmaceutical and biotechnology companies. One way to achieve this objective is to use rationally selected surrogate markers to improve the early decision-making process. Using typical clinical chemistry methods to measure biochemical markers may not ensure adequate precision and reproducibility. In contrast, using analytical methods that meet good laboratory practices along with rational selection and validation of biochemical markers can give those who use them a competitive advantage over those who do not by providing meaningful data for earlier decision making.

[Prescribing monitoring in clinical practice: from enlightened empiricism to rational strategies].

PubMed

Buclin, Thierry; Herzig, Lilli

2013-05-15

Monitoring of a medical condition is the periodic measurement of one or several physiological or biological variables to detect a signal regarding its clinical progression or its response to treatment. We distinguish different medical situations between diagnostic, clinical and therapeutic process to apply monitoring. Many clinical, variables can be used for monitoring, once their intrinsic properties (normal range, critical difference, kinetics, reactivity) and external validity (pathophysiological importance, predictive power for clinical outcomes) are established. A formal conceptualization of monitoring is being developed and should support the rational development of monitoring strategies and their validation through appropriate clinical trials.

Why bioethicists have nothing useful to say about health care rationing.

PubMed Central

Seedhouse, D

1995-01-01

Bioethicists are increasingly commenting on health care resource allocation, and sometimes suggest ways to solve various rationing dilemmas ethically. I argue that both because of the assumptions bioethicists make about social reality, and because of the methods of argument they use, they cannot possibly make a useful contribution to the debate. Bioethicists who want to make a practical difference should either approach health care resource allocation as if the matter hinged upon tribal competition (which is essentially what it does), or they should do political philosophy in the traditional sense, and examine the health system from the outside. PMID:8558543

International Cooperation in Environmental Management and Rational Use of Natural Resources

NASA Astrophysics Data System (ADS)

Fedulova, E. A.; Korchagina, I. V.; Vik, S. V.; Kalinina, O. I.; Martyanov, V. L.

2017-01-01

The progress in technologies is developing towards the unlimited growth of production and consumption, wasteful use of natural resources and biosphere. These problems require adequate response such as international cooperation and integration of the efforts of authorities, scientists, representatives of educational system. Such cooperation is important to ensure the transition to the sustainable, ecologically-oriented practices of natural resources rational use. This is impossible without establishing a new environmental management system based upon formation of ecological competence of all scientific and technological progress participants among which the higher school scholars must play a leading role.

Extensions of Fundamental Flow Physics to Practical MAV Aerodynamics

DTIC Science & Technology

2016-05-01

performances aérodynamiques. En cas de génération instable de la portance, certaines structures formées par la séparation de l’écoulement, telles...que le vortex du bord d’attaque, peuvent augmenter la portance bien au-delà des espérances à l’état stable. Le présent document étudie les rotations...une accélération dans le sens de l’écoulement à incidence constante (également lissée). Nous examinons de quelle façon la vitesse du mouvement

Craniofacial Reconstruction Using Rational Cubic Ball Curves

PubMed Central

Majeed, Abdul; Mt Piah, Abd Rahni; Gobithaasan, R. U.; Yahya, Zainor Ridzuan

2015-01-01

This paper proposes the reconstruction of craniofacial fracture using rational cubic Ball curve. The idea of choosing Ball curve is based on its robustness of computing efficiency over Bezier curve. The main steps are conversion of Digital Imaging and Communications in Medicine (Dicom) images to binary images, boundary extraction and corner point detection, Ball curve fitting with genetic algorithm and final solution conversion to Dicom format. The last section illustrates a real case of craniofacial reconstruction using the proposed method which clearly indicates the applicability of this method. A Graphical User Interface (GUI) has also been developed for practical application. PMID:25880632

The Qur’ān and the development of rational thinking

PubMed Central

Abdel-Maguid, Thoraya E.; Abdel-Halim, Rabie E.

2015-01-01

In this study, the means utilized by the Qur’ān in actualizing the possibilities of all intellect to face the problem of blind imitation of ancestors were elaborated. Rationality as meant by the Qur’ān and embodied in its unique style is presented. Furthermore, the Qur’ānic documentation of the role of practical demonstration on the individual's mind as well as the societies’ collective mind is pointed out. In addition, the study shows how the Qur’ān guides people to the proper use of reason within a scientific framework of mind. PMID:25837451

Patient education about cough: effect on the consulting behaviour of general practice patients.

PubMed

Rutten, G; Van Eijk, J; Beek, M; Van der Velden, H

1991-07-01

The aim of this general practice study was to examine how the consulting behaviour of patients with a cough was affected when the tasks and responsibilities of patients, practice nurses and general practitioners were reorganized. In four 'average' single-handed general practices the effects on the consulting behaviour of patients of a rational practice policy on cough and the provision of systematic patient education on cough were compared with patient behaviour in four matched control practices. Changes of behaviour were measured in 548 patients who consulted for cough at least twice, in two successive autumn-winter periods. Significantly more patients in the experimental practice changed their behaviour to follow the practice guidelines than did patients in the control practices (56% versus 30%, P less than 0.001). The proportion of patients who continued to consult in the approved manner was greater among patients receiving intervention (66% versus 29%, P less than 0.001). This was equally true for patients who had suffered less than four episodes of cough or more than four episodes. The more often the patients received the education, the more effective it was. All patients who consulted the general practitioner for cough during the first autumn-winter period filled in a cough diary during the second period. From this it appeared that the intervention did not result in patients delaying consultation when they had a cough lasting longer than three weeks or one with 'serious' symptoms. It would appear that a rational practice policy and the provision of patient education can stimulate patients to modify their consulting behaviour. This could result in a reduction in the costs of health care.

Transformative Learning: Reader's Guide

ERIC Educational Resources Information Center

Chang, Bo

2017-01-01

Mezirow's (1978) transformative learning was influenced by Kuhn's (1962) paradigm and Freire's (1970) emancipatory learning. In this paper, the author provides readers a clear guide about the main components of transformative learning: Experience, critical reflection, and rational discourse. The author emphasizes that experience in transformative…

Chronic Sublethal Effects of San Francisco Bay Sediments on Nereis (Neanthes) arenaceodentata; Effect of Food Ration on Sediment Toxicity

DTIC Science & Technology

1993-09-01

developing oocytes. In effect , gametogenesis and subsequent reproductive success are largely dependent on the energy and metabolic substrates assimi- lated...Miscellaneous Paper D-93-4 September 1993 US Army Corps AD-A269 901 of Engineers Waterways Experiment i Ii Station Long- Term Effects of Dredging...Operations Program Chronic Sublethal Effects of San Francisco Bay Sediments on Nereis (Neanthes) arenaceodentata; Effect of Food Ration on Sediment

Standardized toxicity testing may underestimate ecotoxicity: Environmentally relevant food rations increase the toxicity of silver nanoparticles to Daphnia.

PubMed

Stevenson, Louise M; Krattenmaker, Katherine E; Johnson, Erica; Bowers, Alexandra J; Adeleye, Adeyemi S; McCauley, Edward; Nisbet, Roger M

2017-11-01

Daphnia in the natural environment experience fluctuations in algal food supply, with periods when algal populations bloom and seasons when Daphnia have very little algal food. Standardized chronic toxicity tests, used for ecological risk assessment, dictate that Daphnia must be fed up to 400 times more food than they would experience in the natural environment (outside of algal blooms) for a toxicity test to be valid. This disconnect can lead to underestimating the toxicity of a contaminant. We followed the growth, reproduction, and survival of Daphnia exposed to 75 and 200 µg/L silver nanoparticles (AgNPs) at 4 food rations for up to 99 d and found that AgNP exposure at low, environmentally relevant food rations increased the toxicity of AgNPs. Exposure to AgNP at low food rations decreased the survival and/or reproduction of individuals, with potential consequences for Daphnia populations (based on calculated specific population growth rates). We also found tentative evidence that a sublethal concentration of AgNPs (75 µg/L) caused Daphnia to alter energy allocation away from reproduction and toward survival and growth. The present findings emphasize the need to consider resource availability, and not just exposure, in the environment when estimating the effect of a toxicant. Environ Toxicol Chem 2017;36:3008-3018. © 2017 SETAC. © 2017 SETAC.

Factors that impact on emergency nurses' ethical decision-making ability.

PubMed

Alba, Barbara

2016-11-10

Reliance on moral principles and professional codes has given nurses direction for ethical decision-making. However, rational models do not capture the emotion and reality of human choice. Intuitive response must be considered. Supporting intuition as an important ethical decision-making tool for nurses, the aim of this study was to determine relationships between intuition, years of worked nursing experience, and perceived ethical decision-making ability. A secondary aim explored the relationships between rational thought to years of worked nursing experience and perceived ethical decision-making ability. A non-experimental, correlational research design was used. The Rational Experiential Inventory measured intuition and rational thought. The Clinical Decision Making in Nursing Scale measured perceived ethical decision-making ability. Pearson's r was the statistical method used to analyze three primary and two secondary research questions. A sample of 182 emergency nurses was recruited electronically through the Emergency Nurses Association. Participants were self-selected. Approval to conduct this study was obtained by the Adelphi University Institutional Review Board. A relationship between intuition and perceived ethical decision-making ability (r = .252, p = .001) was a significant finding in this study. This study is one of the first of this nature to make a connection between intuition and nurses' ethical decision-making ability. This investigation contributes to a broader understanding of the different thought processes used by emergency nurses to make ethical decisions. © The Author(s) 2016.

LeishVet guidelines for the practical management of canine leishmaniosis

PubMed Central

2011-01-01

The LeishVet group has formed recommendations designed primarily to help the veterinary clinician in the management of canine leishmaniosis. The complexity of this zoonotic infection and the wide range of its clinical manifestations, from inapparent infection to severe disease, make the management of canine leishmaniosis challenging. The recommendations were constructed by combining a comprehensive review of evidence-based studies, extensive clinical experience and critical consensus opinion discussions. The guidelines presented here in a short version with graphical topic displays suggest standardized and rational approaches to the diagnosis, treatment, follow-up, control and prevention of canine leishmaniosis. A staging system that divides the disease into four stages is aimed at assisting the clinician in determining the appropriate therapy, forecasting prognosis, and implementing follow-up steps required for the management of the leishmaniosis patient. PMID:21599936

[Alternative medicine: faith or science?].

PubMed

Pletscher, A

1990-04-21

For the success of both alternative and scientific (conventional) medicine, factors such as the psychological influence of the doctor, loving care, human affection, the patient's belief in the treatment, the suggestive power of attractive (even unproven) theories, dogmas and chance events (e.g. spontaneous remissions) etc. play a major role. Some practices of alternative medicine have a particularly strong appeal to the non-rational side of the human being. Conventional medicine includes a component which is based on scientific and statistical methods. The possibility that in alternative medicine principles and effects exist which are not (yet) known to scientific medicine, but which match up to scientific criteria, cannot be excluded. However, up to now this has not been convincingly proven. The difficulties which arise in the elucidation of this problem are discussed in the light of examples from the literature and some experiments of our own.

Subwavelength core/shell cylindrical nanostructures for novel plasmonic and metamaterial devices

NASA Astrophysics Data System (ADS)

Kim, Kyoung-Ho; No, You-Shin

2017-12-01

In this review, we introduce novel plasmonic and metamaterial devices based on one-dimensional subwavelength nanostructures with cylindrical symmetry. Individual single devices with semiconductor/metal core/shell or dielectric/metal core/multi-shell structures experience strong light-matter interaction and yield unique optical properties with a variety of functions, e.g., invisibility cloaking, super-scattering/super-absorption, enhanced luminescence and nonlinear optical activities, and deep subwavelength-scale optical waveguiding. We describe the rational design of core/shell cylindrical nanostructures and the proper choice of appropriate constituent materials, which allow the efficient manipulation of electromagnetic waves and help to overcome the limitations of conventional homogeneous nanostructures. The recent developments of bottom-up synthesis combined with the top-down fabrication technologies for the practical applications and the experimental realizations of 1D subwavelength core/shell nanostructure devices are briefly discussed.

Computer-aided rational design of the phosphotransferase system for enhanced glucose uptake in Escherichia coli

PubMed Central

Nishio, Yousuke; Usuda, Yoshihiro; Matsui, Kazuhiko; Kurata, Hiroyuki

2008-01-01

The phosphotransferase system (PTS) is the sugar transportation machinery that is widely distributed in prokaryotes and is critical for enhanced production of useful metabolites. To increase the glucose uptake rate, we propose a rational strategy for designing the molecular architecture of the Escherichia coli glucose PTS by using a computer-aided design (CAD) system and verified the simulated results with biological experiments. CAD supports construction of a biochemical map, mathematical modeling, simulation, and system analysis. Assuming that the PTS aims at controlling the glucose uptake rate, the PTS was decomposed into hierarchical modules, functional and flux modules, and the effect of changes in gene expression on the glucose uptake rate was simulated to make a rational strategy of how the gene regulatory network is engineered. Such design and analysis predicted that the mlc knockout mutant with ptsI gene overexpression would greatly increase the specific glucose uptake rate. By using biological experiments, we validated the prediction and the presented strategy, thereby enhancing the specific glucose uptake rate. PMID:18197177

Technology, Biopolitics, Rationalities and Choices: Recent Studies of Reproduction.

PubMed

Whittaker, Andrea

2015-01-01

New synergies across anthropology, science and technology studies (STS), legal studies and sociology, bring fresh theoretical perspectives to the study of reproduction. Recent works on reproduction trace some of the changing rationalities: from the tactics of feminist self-help health movements in 1970s and 1980s in the US, to the commercialized experience of pregnancy and the various configurations, policies and legalities addressing globalized genetic and assisted reproductive technologies. Reproductive decision-making is deeply entangled with neoliberalism, welfare reforms, racial and geographic disparities, economic stratification and cultural rationalities to produce inequalities. Studies of reproduction remain central to basic anthropological questions: what it means to be human, what constitutes life, how we live our lives, and how societies value particular lives.

Analysis of host response to bacterial infection using error model based gene expression microarray experiments

PubMed Central

Stekel, Dov J.; Sarti, Donatella; Trevino, Victor; Zhang, Lihong; Salmon, Mike; Buckley, Chris D.; Stevens, Mark; Pallen, Mark J.; Penn, Charles; Falciani, Francesco

2005-01-01

A key step in the analysis of microarray data is the selection of genes that are differentially expressed. Ideally, such experiments should be properly replicated in order to infer both technical and biological variability, and the data should be subjected to rigorous hypothesis tests to identify the differentially expressed genes. However, in microarray experiments involving the analysis of very large numbers of biological samples, replication is not always practical. Therefore, there is a need for a method to select differentially expressed genes in a rational way from insufficiently replicated data. In this paper, we describe a simple method that uses bootstrapping to generate an error model from a replicated pilot study that can be used to identify differentially expressed genes in subsequent large-scale studies on the same platform, but in which there may be no replicated arrays. The method builds a stratified error model that includes array-to-array variability, feature-to-feature variability and the dependence of error on signal intensity. We apply this model to the characterization of the host response in a model of bacterial infection of human intestinal epithelial cells. We demonstrate the effectiveness of error model based microarray experiments and propose this as a general strategy for a microarray-based screening of large collections of biological samples. PMID:15800204

Risk as analysis and risk as feelings: some thoughts about affect, reason, risk, and rationality.

PubMed

Slovic, Paul; Finucane, Melissa L; Peters, Ellen; MacGregor, Donald G

2004-04-01

Modern theories in cognitive psychology and neuroscience indicate that there are two fundamental ways in which human beings comprehend risk. The "analytic system" uses algorithms and normative rules, such as probability calculus, formal logic, and risk assessment. It is relatively slow, effortful, and requires conscious control. The "experiential system" is intuitive, fast, mostly automatic, and not very accessible to conscious awareness. The experiential system enabled human beings to survive during their long period of evolution and remains today the most natural and most common way to respond to risk. It relies on images and associations, linked by experience to emotion and affect (a feeling that something is good or bad). This system represents risk as a feeling that tells us whether it is safe to walk down this dark street or drink this strange-smelling water. Proponents of formal risk analysis tend to view affective responses to risk as irrational. Current wisdom disputes this view. The rational and the experiential systems operate in parallel and each seems to depend on the other for guidance. Studies have demonstrated that analytic reasoning cannot be effective unless it is guided by emotion and affect. Rational decision making requires proper integration of both modes of thought. Both systems have their advantages, biases, and limitations. Now that we are beginning to understand the complex interplay between emotion and reason that is essential to rational behavior, the challenge before us is to think creatively about what this means for managing risk. On the one hand, how do we apply reason to temper the strong emotions engendered by some risk events? On the other hand, how do we infuse needed "doses of feeling" into circumstances where lack of experience may otherwise leave us too "coldly rational"? This article addresses these important questions.

Not Merely Experiential: Unconscious Thought Can Be Rational

PubMed Central

Garrison, Katie E.; Handley, Ian M.

2017-01-01

Individuals often form more reasonable judgments from complex information after a period of distraction vs. deliberation. This phenomenon has been attributed to sophisticated unconscious thought during the distraction period that integrates and organizes the information (Unconscious Thought Theory; Dijksterhuis and Nordgren, 2006). Yet, other research suggests that experiential processes are strengthened during the distraction (relative to deliberation) period, accounting for the judgment and decision benefit. We tested between these possibilities, hypothesizing that unconscious thought is distinct from experiential processes, and independently contributes to judgments and decisions during a distraction period. Using an established paradigm, Experiment 1 (N = 319) randomly induced participants into an experiential or rational mindset, after which participants received complex information describing three roommates to then consider consciously (i.e., deliberation) or unconsciously (i.e., distraction). Results revealed superior roommate judgments (but not choices) following distraction vs. deliberation, consistent with Unconscious Thought Theory. Mindset did not have an influence on roommate judgments. However, planned tests revealed a significant advantage of distraction only within the rational-mindset condition, which is contrary to the idea that experiential processing alone facilitates complex decision-making during periods of distraction. In a second experiment (N = 136), we tested whether effects of unconscious thought manifest for a complex analytical reasoning task for which experiential processing would offer no advantage. As predicted, participants in an unconscious thought condition outperformed participants in a control condition, suggesting that unconscious thought can be analytical. In sum, the current results support the existence of unconscious thinking processes that are distinct from experiential processes, and can be rational. Thus, the experiential vs. rational nature of a process might not cleanly delineate conscious and unconscious thought. PMID:28729844

Not Merely Experiential: Unconscious Thought Can Be Rational.

PubMed

Garrison, Katie E; Handley, Ian M

2017-01-01

Individuals often form more reasonable judgments from complex information after a period of distraction vs. deliberation. This phenomenon has been attributed to sophisticated unconscious thought during the distraction period that integrates and organizes the information (Unconscious Thought Theory; Dijksterhuis and Nordgren, 2006). Yet, other research suggests that experiential processes are strengthened during the distraction (relative to deliberation) period, accounting for the judgment and decision benefit. We tested between these possibilities, hypothesizing that unconscious thought is distinct from experiential processes, and independently contributes to judgments and decisions during a distraction period. Using an established paradigm, Experiment 1 ( N = 319) randomly induced participants into an experiential or rational mindset, after which participants received complex information describing three roommates to then consider consciously (i.e., deliberation) or unconsciously (i.e., distraction). Results revealed superior roommate judgments (but not choices) following distraction vs. deliberation, consistent with Unconscious Thought Theory. Mindset did not have an influence on roommate judgments. However, planned tests revealed a significant advantage of distraction only within the rational-mindset condition, which is contrary to the idea that experiential processing alone facilitates complex decision-making during periods of distraction. In a second experiment ( N = 136), we tested whether effects of unconscious thought manifest for a complex analytical reasoning task for which experiential processing would offer no advantage. As predicted, participants in an unconscious thought condition outperformed participants in a control condition, suggesting that unconscious thought can be analytical. In sum, the current results support the existence of unconscious thinking processes that are distinct from experiential processes, and can be rational. Thus, the experiential vs. rational nature of a process might not cleanly delineate conscious and unconscious thought.

Influence of ration composition on nutritive and digestive variables in captive giraffes (Giraffa camelopardalis) indicating the appropriateness of feeding practice.

PubMed

Gussek, I; Große-Brinkhaus, C; Südekum, K-H; Hummel, J

2018-04-01

The nutrition of captive giraffe (Giraffa camelopardalis), a browsing ruminant, is challenging because browse availability is limited in zoos and rations need to be composed of compensatory feeds. In this study, ration composition for giraffes in 12 German zoos was documented and linked to animal variables that indicate suitability of nutrition. Rations differed in proportion of ration items and chemical composition resulting in various grades of accordance with feeding recommendations. An estimated daily metabolisable energy (ME) intake (MEI; mean ± SD) of 0.61 MJ ME/kg 0.75 body weight (BW; ±0.1) was sufficient to cover estimated energy requirements. Daily dry matter (DM) intake (DMI) was 61 g DM/kg 0.75 BW (±10) and correlated negatively to dietary ME content (p = .009; r = -.596). Apparently, feed intake was regulated by energetic satiety and not by physical properties of forage. A negative correlation between produce proportion and DMI (p = .002; r = -.676) led to the assumption of a low ruminal pH in giraffes fed high proportions of produce. Increasing dietary forage proportions led to an increasing duration of feed intake (p = .045; r = .477) and decreasing occurrence of oral stereotypies (p = .047; r = -.474). The weighted average faecal particle size was larger than reported for free-ranging giraffes, but no relation to ration characteristics among the facilities existed. The abrasiveness of rations was not excessive, as contents of silicate in faeces were similar to values from the wild. Body condition was generally acceptable, but there was no evident relation to ration characteristics. The capacity to self-regulate DM and ME intakes with lucerne hay may work at higher forage proportions than often assumed for captive giraffes. Rations with less energetic density can result in a greater DMI, including maximisation of forage intake and reduction of oral stereotypies. © 2017 Blackwell Verlag GmbH.

Antiretroviral therapy (ART) rationing and access mechanisms and their impact on youth ART utilization in Malawi.

PubMed

Dixon, Jimmy-Gama; Gibson, Sarah; McPake, Barbara; Maleta, Ken

2011-06-01

The World Health Organization (WHO) staging is a commonly used rationing mechanism for highly active antiretroviral therapy (HAART) among various HIV infected populations including youths in most developing countries. Rationing is defined as any policy or practice that restricts consumption of or access to certain goods due to its limited supply. However, as HIV prevalence is rapidly increasing among youth, understanding the capacity of the staging approach to achieve HAART uptake in youth is of considerable importance. This study aimed to explore how HAART rationing and access mechanisms impact on youth's utilization of HAART in Malawi. The study used mixed methods with quantitative analysis of existing Ministry of Health Clinical HIV Unit data used to determine existing levels of youth HAART use. Qualitative methods employed in-depth interviews that interviewed nine ART providers, nine HIV positive youth on HAART and nine HIV positive youth not on HAART; and field observations to nine ART clinics were used to understand HAART rationing and access mechanisms and how such mechanisms impact youth uptake of HAART. The findings revealed that ART providers use both explicit rationing mechanisms like WHO clinical staging and implicit rationing mechanisms like use of waiting lists, queues and referral in ART provision. However, the WHO staging approach had some challenges in its implementation. It was also observed that factors like non-comprehensive approach to HAART provision, costs incurred to access HAART, negative beliefs and misconceptions about HAART and HIV were among the key factors that limit youth access to HAART. The study recommends that while WHO staging is successful as a rationing mechanism in Malawi, measures should be put in place to improve access to CD4 assessment for clients who may need it. ART providers also need to be made aware of the implicit rationing mechanisms that may affect HAART access. There is also need to improve monitoring of those HIV positive youth not on HAART in order for the system to be able to commence them on treatment on time. Additionally, ART programmes need to address individual, programme and structural/social factors that may affect t youth's access to HAART.

Lying to ourselves: rationality, critical reflexivity, and the moral order as 'structured agency'.

PubMed

Goodman, Benny

2016-07-01

A report suggests that United States' army officers may engage in dishonest reporting regarding their compliance procedures. Similarly, nurses with espoused high ethical standards sometimes fail to live up to them and may do so while deceiving themselves about such practices. Reasons for lapses are complex. However, multitudinous managerial demands arising within 'technical and instrumental rationality' may impact on honest decision-making. This paper suggests that compliance processes, which operates within the social structural context of the technical and instrumental rationality manifest as 'managerialism', contributes to professional 'dishonesty' about lapses in care, sometimes through 'thoughtlessness'. The need to manage risk, measure, account, and control in order to deliver efficiency, effectiveness, and economy (technical rationality) thus has both unintended and dysfunctional consequences. Meeting compliance requirements may be mediated by factors such as the 'affect heuristic' and 'reflexive deliberations' as part of the 'structured agency' of nurses. It is the complexity of 'structured agency' which may explain why some nurses fail to respond to such things as sentinel events, a failure to recognize 'personal troubles' as 'public issues', a failure which to outsiders who expect rational and professional responses may seem inconceivable. There is a need to understand these processes so that nurses can critique the context in which they work and to move beyond either/or explanations of structure or agency for care failures, and professional dishonesty. © 2016 John Wiley & Sons Ltd.

Effect of ration size on fillet fatty acid composition, phospholipid allostasis and mRNA expression patterns of lipid regulatory genes in gilthead sea bream (Sparus aurata).

PubMed

Benedito-Palos, Laura; Calduch-Giner, Josep A; Ballester-Lozano, Gabriel F; Pérez-Sánchez, Jaume

2013-04-14

The effect of ration size on muscle fatty acid (FA) composition and mRNA expression levels of key regulatory enzymes of lipid and lipoprotein metabolism have been addressed in juveniles of gilthead sea bream fed a practical diet over the course of an 11-week trial. The experimental setup included three feeding levels: (i) full ration until visual satiety, (ii) 70 % of satiation and (iii) 70 % of satiation with the last 2 weeks at the maintenance ration. Feed restriction reduced lipid content of whole body by 30 % and that of fillet by 50 %. In this scenario, the FA composition of fillet TAG was not altered by ration size, whereas that of phospholipids was largely modified with a higher retention of arachidonic acid and DHA. The mRNA transcript levels of lysophosphatidylcholine acyltransferases, phosphatidylethanolamine N-methyltransferase and FA desaturase 2 were not regulated by ration size in the present experimental model. In contrast, mRNA levels of stearoyl-CoA desaturases were markedly down-regulated by feed restriction. An opposite trend was found for a muscle-specific lipoprotein lipase, which is exclusive of fish lineage. Several upstream regulatory transcriptions were also assessed, although nutritionally mediated changes in mRNA transcripts were almost reduced to PPARα and β, which might act in a counter-regulatory way on lipolysis and lipogenic pathways. This gene expression pattern contributes to the construction of a panel of biomarkers to direct marine fish production towards muscle lean phenotypes with increased retentions of long-chain PUFA.

Functional Nanomaterials for Environmental Applications and Bioassemblies

NASA Astrophysics Data System (ADS)

Nguyen, Michelle Anne

The rational design of nanomaterials has yielded new technologies that have revolutionized numerous diverse fields. The work detailed herein first describes the application of photocatalytic nanomaterials towards the environmental remediation of harmful toxins. Specifically, a low-temperature solution-phase synthetic route for size-controlled Cu2O octahedra particles was developed, and these materials were evaluated as catalysts for the photocatalytic degradation of aromatic organic compounds. Moreover, cubic Cu2O/Pd composite structures were fabricated and demonstrated to be effective photocatalysts for the generation of H2 and the reductive dehalogenation of polychlorinated biphenyls, well-known carcinogens present at many contaminated sites around the world. This photocatalytic approach to environmental remediation exemplifies the adaptation of light-driven technologies and sustainable practices to energy-intensive catalytic systems. In addition, this work also investigates the organic/inorganic interface of peptide-mediated Au nanoparticles as a means to identify rational design principles for materials binding peptide sequences for the advancement of stimuli-responsive bionanoassemblies. Factors inherent to peptide sequences that can promote strong materials-binding affinity and/or effective nanoparticle stabilization capability were identified in order to progress biomimetic technologies. These findings were elucidated using a combinational approach of peptide binding experiments to Au in partnership with molecular dynamics simulations. Overall, this work demonstrates the growing applications of nanomaterials in remediation technologies and aids in the understanding of the origins of peptide material affinity and nanoparticle stabilization.

How to use Hydra as a model system to teach biology in the classroom.

PubMed

Bossert, Patricia; Galliot, Brigitte

2012-01-01

As scientists it is our duty to fight against obscurantism and loss of rational thinking if we want politicians and citizens to freely make the most intelligent choices for the future generations. With that aim, the scientific education and training of young students is an obvious and urgent necessity. We claim here that Hydra provides a highly versatile but cheap model organism to study biology at any age. Teachers of biology have the unenviable task of motivating young people, who with many other motivations that are quite valid, nevertheless must be guided along a path congruent with a 'syllabus' or a 'curriculum'. The biology of Hydra spans the history of biology as an experimental science from Trembley's first manipulations designed to determine if the green polyp he found was plant or animal to the dissection of the molecular cascades underpinning, regeneration, wound healing, stemness, aging and cancer. It is described here in terms designed to elicit its wider use in classrooms. Simple lessons are outlined in sufficient detail for beginners to enter the world of 'Hydra biology'. Protocols start with the simplest observations to experiments that have been pretested with students in the USA and in Europe. The lessons are practical and can be used to bring 'life', but also rational thinking into the study of life for the teachers of students from elementary school through early university.

A Reflection on Musical Experience as Existential Experience: An Ontological Turn

ERIC Educational Resources Information Center

Pio, Frederik; Varkoy, Oivind

2012-01-01

In the current world of education, politics and public opinion, musical experience is increasingly threatened. It is designated ever more as an expendable luxury. This kind of general trend has hardly left the thinking in the field of music and music education untouched. Inspiration comes from the technical rationality of our time. This…

Rational learning and information sampling: on the "naivety" assumption in sampling explanations of judgment biases.

PubMed

Le Mens, Gaël; Denrell, Jerker

2011-04-01

Recent research has argued that several well-known judgment biases may be due to biases in the available information sample rather than to biased information processing. Most of these sample-based explanations assume that decision makers are "naive": They are not aware of the biases in the available information sample and do not correct for them. Here, we show that this "naivety" assumption is not necessary. Systematically biased judgments can emerge even when decision makers process available information perfectly and are also aware of how the information sample has been generated. Specifically, we develop a rational analysis of Denrell's (2005) experience sampling model, and we prove that when information search is interested rather than disinterested, even rational information sampling and processing can give rise to systematic patterns of errors in judgments. Our results illustrate that a tendency to favor alternatives for which outcome information is more accessible can be consistent with rational behavior. The model offers a rational explanation for behaviors that had previously been attributed to cognitive and motivational biases, such as the in-group bias or the tendency to prefer popular alternatives. 2011 APA, all rights reserved

Response threshold variance as a basis of collective rationality

PubMed Central

Yamamoto, Tatsuhiro

2017-01-01

Determining the optimal choice among multiple options is necessary in various situations, and the collective rationality of groups has recently become a major topic of interest. Social insects are thought to make such optimal choices by collecting individuals' responses relating to an option's value (=a quality-graded response). However, this behaviour cannot explain the collective rationality of brains because neurons can make only ‘yes/no’ responses on the basis of the response threshold. Here, we elucidate the basic mechanism underlying the collective rationality of such simple units and show that an ant species uses this mechanism. A larger number of units respond ‘yes’ to the best option available to a collective decision-maker using only the yes/no mechanism; thus, the best option is always selected by majority decision. Colonies of the ant Myrmica kotokui preferred the better option in a binary choice experiment. The preference of a colony was demonstrated by the workers, which exhibited variable thresholds between two options' qualities. Our results demonstrate how a collective decision-maker comprising simple yes/no judgement units achieves collective rationality without using quality-graded responses. This mechanism has broad applicability to collective decision-making in brain neurons, swarm robotics and human societies. PMID:28484636

Response threshold variance as a basis of collective rationality.

PubMed

Yamamoto, Tatsuhiro; Hasegawa, Eisuke

2017-04-01

Determining the optimal choice among multiple options is necessary in various situations, and the collective rationality of groups has recently become a major topic of interest. Social insects are thought to make such optimal choices by collecting individuals' responses relating to an option's value (=a quality-graded response). However, this behaviour cannot explain the collective rationality of brains because neurons can make only 'yes/no' responses on the basis of the response threshold. Here, we elucidate the basic mechanism underlying the collective rationality of such simple units and show that an ant species uses this mechanism. A larger number of units respond 'yes' to the best option available to a collective decision-maker using only the yes/no mechanism; thus, the best option is always selected by majority decision. Colonies of the ant Myrmica kotokui preferred the better option in a binary choice experiment. The preference of a colony was demonstrated by the workers, which exhibited variable thresholds between two options' qualities. Our results demonstrate how a collective decision-maker comprising simple yes/no judgement units achieves collective rationality without using quality-graded responses. This mechanism has broad applicability to collective decision-making in brain neurons, swarm robotics and human societies.

Rational action selection in 1½- to 3-year-olds following an extended training experience.

PubMed

Klossek, Ulrike M H; Dickinson, Anthony

2012-02-01

Previous studies failed to find evidence for rational action selection in children under 2 years of age. The current study investigated whether younger children required more training to encode the relevant causal relationships. Children between 1½ and 3 years of age were trained over two sessions to perform actions on a touch-sensitive screen to obtain video clips as outcomes. Subsequently, a visual habituation procedure was employed to devalue one of the training outcomes. As in previous studies, 2- and 3-year-olds chose actions associated with an expected valued outcome significantly more often during a subsequent choice test. Moreover, analysis of children's first responses in the post-devaluation test revealed evidence of rational action selection even in the youngest age group (18-23 months). Consistent with dual-process accounts of action control, the findings support the view that the ability to make rational action choices develops gradually. 2011 Elsevier Inc. All rights reserved.

Local site preference rationalizes disentangling by DNA topoisomerases

NASA Astrophysics Data System (ADS)

Liu, Zhirong; Zechiedrich, Lynn; Chan, Hue Sun

2010-03-01

To rationalize the disentangling action of type II topoisomerases, an improved wormlike DNA model was used to delineate the degree of unknotting and decatenating achievable by selective segment passage at specific juxtaposition geometries and to determine how these activities were affected by DNA circle size and solution ionic strength. We found that segment passage at hooked geometries can reduce knot populations as dramatically as seen in experiments. Selective segment passage also provided theoretical underpinning for an intriguing empirical scaling relation between unknotting and decatenating potentials.

ProgrammingRationalAgents in GOAL

NASA Astrophysics Data System (ADS)

Hindriks, Koen V.

The agent programming language GOAL is a high-level programming language to program rational agents that derive their choice of action from their beliefsand goals. The language provides the basic building blocks to design and implementrationalagents by meansofa setofprogramming constructs. These programming constructs allow and facilitate the manipulation of an agent’sbeliefs and goals and to structure its decision-making. GOAL agents are called rational because they satisfy a numberof basic rationality constraints and because they decide to perform actions to further their goals based uponareasoning scheme derived from practical reasoning. The programming concepts of belief and goal incorporated into GOAL provide the basis for this form of reasoning and are similarto their common sense counterparts used everyday to explain the actions that we perform. In addition, GOAL provides the means for agents to focus their attention on specic goals and to communicate at the knowledge level. This provides an intuitive basis for writing high-level agent programs. At the same time these concepts and programming constructs have a well-dened, formal semantics. The formal semantics provides the basis for deninga verication framework for GOAL for verifying and reasoning about GOAL agents whichis similar to some of the wellknownagent logics introduced in the literature.

Choices without reasons: citizens' juries and policy evaluation

PubMed Central

Price, D.

2000-01-01

Citizens' juries are commended as a new technique for democratising health service reviews. Their usefulness is said to derive from a reliance on citizens' rational deliberation rather than on the immediate preferences of the consumer. The author questions the assertion of critical detachment and asks whether juries do in fact employ reason as a means of resolving fundamental disagreements about service provision. He shows that juries promote not so much a critically detached point of view as a particular evaluative framework suited to the bureaucratic idiom of social welfare maximisation. Reports of jury practice reveal a tendency among juries to suppress by non-rational means the everyday moral language of health care evaluation and substitute for it a system of thought in which it can be deemed permissible to deny treatment to sick people. The author concludes that juries are chiefly concerned with non-rational persuasion and because of this they are morally and democratically irrelevant. Juries are no substitute for voting when it comes to protecting the public from zealous minorities. Key Words: Citizens' juries • deliberative democray • health care rationing • public consultation • social welfare • public choice PMID:10951923

Affordability as a discursive accomplishment in a changing National Health Service.

PubMed

Russell, Jill; Greenhalgh, Trisha

2012-12-01

Health systems worldwide face the challenges of rationing. The English National Health Service (NHS) was founded on three core principles: universality, comprehensiveness, and free at the point of delivery. Yet patients are increasingly hearing that some treatments are unaffordable on the NHS. We considered affordability as a social accomplishment and sought to explore how those charged with allocating NHS resources achieved this in practice. We undertook a linguistic ethnography to examine the work practices of resource allocation committees in three Primary Care Trusts (PCTs) in England between 2005 and 2012, specifically deliberations over 'individual funding requests' (IFRs)--requests by patients and their doctors for the PCT to support a treatment not routinely funded. We collected and analysed a diverse dataset comprising policy documents, legal judgements, audio recordings, ethnographic field notes and emails from PCT committee meetings, interviews and a focus group with committee members. We found that the fundamental values of universality and comprehensiveness strongly influenced the culture of these NHS organisations, and that in this context, accomplishing affordability was not easy. Four discursive practices served to confer legitimacy on affordability as a guiding value of NHS health care: (1) categorising certain treatments as only eligible for NHS funding if patients could prove 'exceptional' circumstances; (2) representing resource allocation decisions as being not (primarily) about money; (3) indexical labelling of affordability as an ethical principle, and (4) recontextualising legal judgements supporting refusal of NHS treatment on affordability grounds as 'rational'. The overall effect of these discursive practices was that denying treatment to patients became reasonable and rational for an organisation even while it continued to espouse traditional NHS values. We conclude that deliberations about the funding of treatments at the margins of NHS care have powerful consequences both for patients and for redrawing the ideological landscape of NHS care. Copyright © 2012 Elsevier Ltd. All rights reserved.

Pattern of prescription drug use in Nigerian army hospitals.

PubMed

Adebayo, E T; Hussain, N A

2010-01-01

Most health expenditure of developing countries is on drugs and medical sundries but inappropriate use of such resources is common. To our knowledge, only few studies have been done in Africa on this issue , with inadequate consideration of the sociological context of the knowledge, attitude and practice of the prescribers especially doctors. This study presents the pooled data of the pattern of prescription drug use from three Nigerian Army hospitals using some WHO criteria, and the knowledge and attitude underlying doctors' prescribing practices in these hospitals. Retrospective cross-sectional survey of one year (March 2006-February 2007). Systematic random sample of general out patient case notes from three hospitals were collected using WHO criteria. The knowledge, attitude and practice survey of doctors at each study site towards the concept of rational drug use (RDU) were assessed using a self-administered questionnaire. Data collected from 660 case notes showed that average number of drugs per encounter was 2.8 while 49.3% of drugs were prescribed in the generic form. An average of 28.1% of patients encountered antibiotics. From the knowledge, attitude and practice survey, it is evident that 90.5% of 74 prescribers were aware of the existence of national essential drugs list but 58.1% of them did not use it as basis of prescriptions. In describing types of medicines preferred, 56.7% of prescribers claimed they prescribed a mixture of generic and branded drugs. Only 12.1% of prescribers could accurately detail the 5 steps of rational prescribing. The pattern of prescription drug use in Nigerian Army hospitals is unsatisfactory. It is characterised by high number of drugs per prescription, high rate of antibiotic usage and unscientific prescription by doctors. There is a need for further education and research on rational drug use among prescribers in Nigerian military health facilities.

Conducting phenomenological research: Rationalizing the methods and rigour of the phenomenology of practice.

PubMed

Errasti-Ibarrondo, Begoña; Jordán, José Antonio; Díez-Del-Corral, Mercedes P; Arantzamendi, María

2018-07-01

To offer a complete outlook in a readable easy way of van Manen's hermeneutic-phenomenological method to nurses interested in undertaking phenomenological research. Phenomenology, as research methodology, involves a certain degree of complexity. It is difficult to identify a single article or author which sets out the didactic guidelines that specifically guide research of this kind. In this context, the theoretical-practical view of Max van Manen's Phenomenology of Practice may be seen as a rigorous guide and directive on which researchers may find support to undertake phenomenological research. Discussion paper. This discussion paper is based on our own experiences and supported by literature and theory. Our central sources of data have been the books and writings of Max van Manen and his website "Phenomenologyonline". The principal methods of the hermeneutic-phenomenological method are addressed and explained providing an enriching overview of phenomenology of practice. A proposal is made for the way the suggestions made by van Manen might be organized for use with the methods involved in Phenomenology of Practice: Social sciences, philosophical and philological methods. Thereby, nurse researchers interested in conducting phenomenological research may find a global outlook and support to understand and conduct this type of inquiry which draws on the art. The approach in this article may help nurse scholars and researchers reach an overall, encompassing perspective of the main methods and activities involved in doing phenomenological research. Nurses interested in doing phenomenology of practice are expected to commit with reflection and writing. © 2018 John Wiley & Sons Ltd.

A Trial of the Suitability and Practicality of a Proposed Meal Based Ration Scale

DTIC Science & Technology

1998-09-01

scales. This partially related to the popularity of the yoghurt and flavoured milk. It was also observed that some soldiers removed milk (and other...Tomato Granules - 20 18 DSTO-TR-0723 Appendix 1 continued GROUP SERIAL BASIC AND RATIONING BASIS ALTERNATIVE (g or mL per person) ITEMS B/Fast Lunch/Din...1.98 2.08 0.75 1.41 0.91 0.66 0.92 Milk ( flavoured ) 0 0.11 0 0 0.04 0 0 Skim milk 0 0.02 0 0 0 0.05 0 Yoghurt 0 0 0 0.04 0.17 0.02 0 TOTAL SERIAL 1 1.98

Developing Moral Responsibleness through Professional Education.

ERIC Educational Resources Information Center

Strom, Sharon M.; Tennyson, W. Wesley

1989-01-01

Argues that more attention must be given in counselor preparation and practice to developing critical reflectiveness about valued ends when making professional judgments. Describes and evaluates an instructional model designed to further students' capacities and motivations for making rational moral judgments in counseling. (Author/TE)

Moral Development, Ego Autonomy and Questions of Practicality in the Critical Theory of Schooling.

ERIC Educational Resources Information Center

Young, R. E.

1988-01-01

This article summarizes Habermas' critical theory of education, examines relevant features of the development of children's capacity to enter into rational argumentation, and examines the significance of this development for a critical theory of schooling. (IAH)

Post-Doctoral Training Program in Bio-Behavioral Breast Cancer Research

DTIC Science & Technology

2005-05-01

therapy with a particular interest in Rational Emotive- Behavior Therapy ( REBT ) and its application to clinical populations, including breast cancer...Implication for my idiosyncratic practice of REBT . Psychological Annals of Oradea State University (Annalele Universitatii din Oradea-Psihologie), 4: 29-55

REHABILITATION OF AGING WATER INFRASTRUCTURE SYSTEMS: KEY CHALLENGES AND ISSUES

EPA Science Inventory

Presented in this paper are the results of a state-of-the-practice survey on the rehabilitation of water distribution and wastewater collection systems. The survey identified several needs, including the need for rational and common design approaches for rehabilitation systems, ...

[Prescribing and drug utilization at community health centers].

PubMed

Diawara, A; Sangho, H; Maiga, D; Kone, A B D; Maiga, M D; Simaga, S Y

2007-01-01

The rationalization of the prescription and the good use of the drugs generally constitute a major problem in the health facilities. The present survey led in November 2002 in Mali assessed the practices of prescription and the use of the drugs by the populations. The indicators of drugs use rational have been measured from 600 drawn prescriptions randomly select at the level of 20 community health center (CSCOM) retained at random in the regions of Ségou, Sikasso, Mopti and the District of Bamako. The means of drugs by order (2.8), the percentages of prescription with antibiotic (61.6%) and injectable drugs (35%) are raised in relation to the normative values of WHO (Wold Health Organization). The rate of conformity to the treatments standardized estimated on exploitation of consultations registers in the centers is estimated to 0.5% for the simple diarrhoea, 13.5% for the acute respiratory infections (ARI) without pneumonia and 60.5% for the pneumonia. On 293 patients in the households our survey permitted to estimate to 84.6% the observance of the treatment by the persons having bought the prescribed drugs totality. The percentage of antibiotics prescription and injectable drugs, and the big insufficiency in the non respect of the treatment standard constitutes some practices potentially to high risk justifying the necessity of an urgent training to the rational prescription.

Ethical principles and the rationing of health care: a qualitative study in general practice

PubMed Central

Berney, Lee; Kelly, Moira; Doyal, Len; Feder, Gene; Griffiths, Chris; Jones, Ian Rees

2005-01-01

Background Researching sensitive topics, such as the rationing of treatments and denial of care, raises a number of ethical and methodological problems. Aim To describe the methods and findings from a number of focus group discussions that examined how GPs apply ethical principles when allocating scarce resources. Design of study A small-scale qualitative study involving purposive sampling, semi-structured interviews and focus groups. Setting Twenty-four GPs from two contrasting areas of London: one relatively affluent and one relatively deprived. Method Initial interviews asked GPs to identify key resource allocation issues. The interviews were transcribed and themes were identified. A number of case studies, each illustrative of an ethical issue related to rationing, were written up in the form of vignettes. In focus group discussions, GPs were given a number of these vignettes to debate. Results With respect to the ethical basis for decision making, the findings from this part of the study emphasised the role of social and psychological factors, the influence of the quality of the relationship between GPs and patients and confusion among GPs about their role in decision making. Conclusion The use of vignettes developed from prior interviews with GPs creates a non-threatening environment to discuss sensitive or controversial issues. The acceptance by GPs of general moral principles does not entail clarity of coherence of the application of these principles in practice. PMID:16105371

The becoming of methadone in Kenya: How an intervention's implementation constitutes recovery potential.

PubMed

Rhodes, Tim

2018-03-01

This analysis treats the recent introduction of methadone treatment in Kenya as a case of 'evidence-making intervention'. Using 30 qualitative interviews with people in receipt of methadone treatment in Nairobi, Kenya, methadone's becoming is treated as an effect of its narrative and material implementations. The interviews are shown to enact a narrative of methadone recovery potential towards normalcy beyond addiction. Such recovery potential is materialised in practice through social interactions wherein methadone's embodied effects are seen to be believed. Here, the recovering body affects others' recovery potential. In a context of competing claims about methadone's effects, including the circulation of doubt about experimenting with methadone treatment, embodied methadone effect helps moderate the multiverse of methadone knowledge. The material dynamics of methadone treatment delivery also affect its recovery potential, with the methadone queue enacting a rationing of recovery hope. Here, the experience of methadone's implementation loops back to a life with drugs. I conclude that there is a coexistence of potentiality and actuality, a 'methadone multiple', produced through its narrative and material implementations. Copyright © 2018 Elsevier Ltd. All rights reserved.

A rational inference approach to group and individual-level sentence comprehension performance in aphasia.

PubMed

Warren, Tessa; Dickey, Michael Walsh; Liburd, Teljer L

2017-07-01

The rational inference, or noisy channel, account of language comprehension predicts that comprehenders are sensitive to the probabilities of different interpretations for a given sentence and adapt as these probabilities change (Gibson, Bergen & Piantadosi, 2013). This account provides an important new perspective on aphasic sentence comprehension: aphasia may increase the likelihood of sentence distortion, leading people with aphasia (PWA) to rely more on the prior probability of an interpretation and less on the form or structure of the sentence (Gibson, Sandberg, Fedorenko, Bergen & Kiran, 2015). We report the results of a sentence-picture matching experiment that tested the predictions of the rational inference account and other current models of aphasic sentence comprehension across a variety of sentence structures. Consistent with the rational inference account, PWA showed similar sensitivity to the probability of particular kinds of form distortions as age-matched controls, yet overall their interpretations relied more on prior probability and less on sentence form. As predicted by rational inference, but not by other models of sentence comprehension in aphasia, PWA's interpretations were more faithful to the form for active and passive sentences than for direct object and prepositional object sentences. However contra rational inference, there was no evidence that individual PWA's severity of syntactic or semantic impairment predicted their sensitivity to form versus the prior probability of a sentence, as cued by semantics. These findings confirm and extend previous findings that suggest the rational inference account holds promise for explaining aphasic and neurotypical comprehension, but they also raise new challenges for the account. Copyright © 2017 Elsevier Ltd. All rights reserved.

When health policy and empirical evidence collide: the case of cigarette package warning labels and economic consumer surplus.

PubMed

Song, Anna V; Brown, Paul; Glantz, Stanton A

2014-02-01

In its graphic warning label regulations on cigarette packages, the Food and Drug Administration severely discounts the benefits of reduced smoking because of the lost "pleasure" smokers experience when they stop smoking; this is quantified as lost "consumer surplus." Consumer surplus is grounded in rational choice theory. However, empirical evidence from psychological cognitive science and behavioral economics demonstrates that the assumptions of rational choice are inconsistent with complex multidimensional decisions, particularly smoking. Rational choice does not account for the roles of emotions, misperceptions, optimistic bias, regret, and cognitive inefficiency that are germane to smoking, particularly because most smokers begin smoking in their youth. Continued application of a consumer surplus discount will undermine sensible policies to reduce tobacco use and other policies to promote public health.

On Loss Aversion in Capuchin Monkeys

ERIC Educational Resources Information Center

Silberberg, Alan; Roma, Peter G.; Huntsberry, Mary E.; Warren-Boulton, Frederick R.; Sakagami, Takayuki; Ruggiero, Angela M.; Suomi, Stephen J.

2008-01-01

Chen, Lakshminarayanan, and Santos (2006) claim to show in three choice experiments that monkeys react rationally to price and wealth shocks, but, when faced with gambles, display hallmark, human-like biases that include loss aversion. We present three experiments with monkeys and humans consistent with a reinterpretation of their data that…

Applications of Chemiluminescence in the Teaching of Experimental Design

ERIC Educational Resources Information Center

Krawczyk, Tomasz; Slupska, Roksana; Baj, Stefan

2015-01-01

This work describes a single-session laboratory experiment devoted to teaching the principles of factorial experimental design. Students undertook the rational optimization of a luminol oxidation reaction, using a two-level experiment that aimed to create a long-lasting bright emission. During the session students used only simple glassware and…

Spouses' conceptions of the pre-hospital phase when their partners suffered an acute myocardial infarction--a qualitative analysis.

PubMed

Johansson, Ingela; Swahn, Eva; Strömberg, Anna

2008-09-01

Delay from onset of acute myocardial infarction symptoms to the delivery of medical care is a major determinant of prognosis. Although studies have explored patient reasons for delay, there are only limited data concerning experiences of the spouse. Was to describe spouses' conceptions of the pre-hospital phase when their partners suffered an acute myocardial infarction. A phenomenographic approach was applied. Fifteen spouses were interviewed <48 h after the partner's hospital admittance. Two categories with underlying sub-categories conceptualised the spouses' experiences. The category being resourceful contained: sharing the experience, having knowledge, understanding the severity, being rational, and consulting others. The category respecting independence contained: accepting the need for control, marital roles and experiences, restraining emotions, and seeking agreement. Our findings suggest that spouses have a strong influence on the course of events. When accepting the partner's need for control through following earlier marital roles and experiences, restraining own emotions and seeking agreement, this seemed to contribute to delay. However, when the spouse was resourceful by sharing the experience, having knowledge, understanding the severity, being rational and consulting others when needed, this seemed to have a positive influence on the pre-hospital time.

Teaching Moral Education: Principles of Instruction.

ERIC Educational Resources Information Center

Doris, Dennis A.

1978-01-01

A nonindoctrinating, sound theoretical and practical base upon which to develop the teaching of moral education relies on several principles: discussion of moral conflict situations; knowledge of the student's stage of moral development; guidance of developmental matches; encouragement of role taking; and focus on rational thinking. (JMF)

Muck Utilization Planning - Urban Transportation Tunneling : A Handbook of Rational Practices for Planners and Designers

DOT National Transportation Integrated Search

1977-05-01

This handbook alerts transportation system planners and designers to planning methods which can lead to more efficient use of earth and rock materials produced during excavation for transportation tunnels and large excavations. The earth and rock mat...

State-Dependent Decisions Cause Apparent Violations of Rationality in Animal Choice

PubMed Central

Schuck-Paim, Cynthia; Pompilio, Lorena

2004-01-01

Normative models of choice in economics and biology usually expect preferences to be consistent across contexts, or “rational” in economic language. Following a large body of literature reporting economically irrational behaviour in humans, breaches of rationality by animals have also been recently described. If proven systematic, these findings would challenge long-standing biological approaches to behavioural theorising, and suggest that cognitive processes similar to those claimed to cause irrationality in humans can also hinder optimality approaches to modelling animal preferences. Critical differences between human and animal experiments have not, however, been sufficiently acknowledged. While humans can be instructed conceptually about the choice problem, animals need to be trained by repeated exposure to all contingencies. This exposure often leads to differences in state between treatments, hence changing choices while preserving rationality. We report experiments with European starlings demonstrating that apparent breaches of rationality can result from state-dependence. We show that adding an inferior alternative to a choice set (a “decoy”) affects choices, an effect previously interpreted as indicating irrationality. However, these effects appear and disappear depending on whether state differences between choice contexts are present or not. These results open the possibility that some expressions of maladaptive behaviour are due to oversights in the migration of ideas between economics and biology, and suggest that key differences between human and nonhuman research must be recognised if ideas are to safely travel between these fields. PMID:15550984

Features and perspectives of automatized construction crane-manipulators

NASA Astrophysics Data System (ADS)

Stepanov, Mikhail A.; Ilukhin, Peter A.

2018-03-01

Modern construction industry still has a high percentage of manual labor, and the greatest prospects of improving the construction process are lying in the field of automatization. In this article automatized construction manipulator-cranes are being studied in order to achieve the most rational design scheme. This is done through formulating a list of general conditions necessary for such cranes and a set of specialized kinematical conditions. A variety of kinematical schemes is evaluated via these conditions, and some are taken for further dynamical analisys. The comparative dynamical analisys of taken schemes was made and the most rational scheme was defined. Therefore a basis for a more complex and practical research of manipulator-cranes design is given and ways to implement them on practical level can now be calculated properly. Also, the perspectives of implementation of automated control systems and informational networks on construction sites in order to boost the quality of construction works, safety of labour and ecological safety are shown.

The political economy of the introduction of Western medicine in India and preexisting health practices.

PubMed

Banerji, Debabar

2009-01-01

In India, by the second century B.C., Ayurvedic medicine had already taken the momentous step of becoming rational therapeutics. Physicians created a methodology based on the supreme importance of direct observation of natural phenomena and the technique of rational processing of empirical data. However, over the long history of the country, Ayurvedic medicine underwent severe erosion of its knowledge and practice because of profound political, cultural, social, and economic changes. Nevertheless, it was used by the poor because access to Western medicine was denied by the ruling classes. Alarm bells started to ring with the declaration of self-reliance and self-determination by the poor at Alma-Ata in 1978. A syndicate of the rich countries, with active support of India's ruling elite, mobilized the enormous influence and resources of organizations such as the International Monetary Fund, World Health Organization, UNICEF, and World Bank to promote their unconcealed agenda of promoting the private health sector and further decimating the public sector.

Breaking the silence: nurses' understandings of change in clinical practice.

PubMed

Copnell, Beverley; Bruni, Nina

2006-08-01

This paper reports a study exploring critical care nurses' understandings of change in their practice. In contemporary nursing literature, change in clinical nursing practice is generally understood to be a rational process, synonymous with progress. It is seen as invariably contested, and hence difficult to achieve. It is represented as occurring infrequently. This literature effectively silences clinicians as this discourse of change does not recognize or incorporate their views or practices. This study was informed by a Foucauldian poststructuralist framework. The participants were 12 critical care nurses who engaged in three individual in-depth, focused interviews. The transcripts were deconstructed to reveal participants' discourses of change and the implications of these discourses for nursing work. The data were generated between 1996 and 1998 as part of a study whose in-depth analysis was completed in 2003. Change was revealed as a highly complex phenomenon, closely intertwined with understandings of clinical nursing work. Participants showed difficulty in identifying or recalling clinical changes. Several dichotomies shaped their understandings of change, including change/stasis, formal/informal and dramatic/subtle. Their experiences of change frequently conflicted with prevailing dominant understandings, but they did not openly challenge them. Rather, they employed dichotomies, such as abstract/concrete and other/self, to enable them to work with these conflicts. As a result, they engaged in practices such as naming other nurses as 'irrational'. The data provide new understandings of change in clinical nursing practice, some of which challenge many widely held views (for example, that such change is a rare occurrence). It is argued that a lack of open challenge by clinical nurses contributes to their silencing, promotes disharmony amongst nurses and, hence, works against a collaborative approach to decisions about clinical practice.

Prescribing patterns of rural family physicians: a study in Kermanshah Province, Iran.

PubMed

Ahmadi, Fariba; Zarei, Ehsan

2017-11-28

The inappropriate use of drugs due to irrational prescriptions is a common problem in Iran, but there is little evidence of prescription patterns in rural family physicians. This study aimed to explore the prescribing pattern and rational drug use indicators for family physicians using Index of Rational Drug Prescribing (IRDP) in Kermanshah Province, Iran. In this retrospective study, 352,399 prescriptions from 184 family physicians in 103 primary health care (PHC) centers were examined. As stated, an analysis was done for rational use indicators suggested by World Health Organization (WHO): e.g., the percentage of prescriptions containing antibiotics, injections, and those prescribed by a generic name and from a national essential medicine list, plus the average number of drugs per prescription; these factors were all taken into account. Rational drug use was studied with the IRDP. The average number of drugs per prescription was 3.14 (± 1.2) and the average cost per prescription was 116,740 IRR (USD 3.6). Around 19% of prescriptions had more than four drugs, while the percentage of prescriptions involving antibiotics and injections was 52.1% and 24.4%, respectively. There was 95.1% drugs prescribed by their generic name and 95.9% were retrieved from the essential drugs list. The value of the IRDP was 3.70 out of 5. The findings of this study showed that some degree of irrational drug prescribing exists among family physicians, especially in terms of injections, antibiotics, and polypharmacy. It is recommended that there be continuing education programs for physicians regarding rational prescribing for different kinds of medical indications. Clinical practice guidelines should also assist with the rational use of medicine.

Comparison of rational pharmacotherapy decision-making competence of general practitioners with intern doctors.

PubMed

Akici, A; Kalaça, S; Gören, M Z; Akkan, A G; Karaalp, A; Demir, D; Uğurlu, U; Oktay, S

2004-04-01

The aim of this study was to compare rational pharmacotherapy decision-making competency of interns (final-year medical students) who had received rational pharmacotherapy education (RPE), with their classmates at another medical school and general practitioners (GPs) who had not been exposed to RPE. A written, objective, structured clinical examination (OSCE), consisting of open and structured questions, was given to all participants. The participants were expected to make a treatment plan and prescribe for simple, uncomplicated beta-hemolytic streptococcal tonsillitis and mild-to-moderate essential hypertension patients, explain their proposed treatment plans and reasons affecting their drug choice. After the OSCE, a questionnaire to assess knowledge of the rational use of drugs was given to the participants. Fifty RPE(+) interns, 54 RPE(-) interns and 53 GPs participated in the study. Mean scores of RPE(+) interns were higher than those of GPs, which were in turn found to be higher than those of RPE(-) interns for all cases. The RPE(+) interns scored the highest regarding all components of rational pharmacotherapy process for all cases of both indications. However, participants in all groups had higher scores for the structured questions compared with the corresponding open ones for both diseases. Prescription analysis also revealed better results for RPE(+) interns regarding the number of drugs/prescription and treatment costs. The present study demonstrated that the final-year medical students (interns) markedly benefited from undergraduate RPE at the medical school in developing rational prescribing skills compared with their classmates from a medical school with traditional pharmacology education. Interestingly, they got higher scores than not only RPE(-) interns, but also than the GPs participating in this study, indicating the urgent need for continuous medical education programs in this field throughout the country for practicing GPs.

Rational drug therapy education in clinical phase carried out by task-based learning

PubMed Central

Bilge, S. Sırrı; Akyüz, Bahar; Ağrı, Arzu Erdal; Özlem, Mıdık

2017-01-01

Objectives: Irrational drug use results in drug interactions, treatment noncompliance, and drug resistance. Rational pharmacotherapy education is being implemented in many faculties of medicine. Our aim is to introduce rational pharmacotherapy education by clinicians and to evaluate task-based rational drug therapy education in the clinical context. Methods: The Kirkpatrick's evaluation model was used for the evaluation of the program. The participants evaluated the program in terms of constituents of the program, utilization, and contribution to learning. Voluntary participants responded to the evaluation forms after the educational program. Data are evaluated using both quantitative and qualitative tools. SPSS (version 21) used for quantitative data for determining mean and standard deviation values. Descriptive qualitative analysis approach is used for the analysis of open-ended questions. Results: It was revealed that the program and its components have been favorable. A total 95.9% of the students consider the education to be beneficial. Simulated patients practice and personal drug choice/problem-based learning sessions were appreciated by the students in particular. 93.9% of the students stated that all students of medicine should undergo this educational program. Among the five presentations contained in the program, “The Principles of Prescribing” received the highest points (9 ± 1.00) from participating students in general evaluation of the educational program. Conclusion: This study was carried out to improve task-based rational drug therapy education. According to feedback from the students concerning content, method, resource, assessment, and program design; some important changes, especially in number of facilitators and indications, are made in rational pharmacotherapy education in clinical task-based learning program. PMID:28458432

Markets and medical care: the United States, 1993-2005.

PubMed

White, Joseph

2007-09-01

Many studies arguing for or against markets to finance medical care investigate "market-oriented" measures such as cost sharing. This article looks at the experience in the American medical marketplace over more than a decade, showing how markets function as institutions in which participants who are self-seeking, but not perfectly rational, exercise power over other participants in the market. Cost experience here was driven more by market power over prices than by management of utilization. Instead of following any logic of efficiency or equity, system transformations were driven by beliefs about investment strategies. At least in the United States' labor and capital markets, competition has shown little ability to rationalize health care systems because its goals do not resemble those of the health care system most people want.

Markets and Medical Care: The United States, 1993–2005

PubMed Central

White, Joseph

2007-01-01

Many studies arguing for or against markets to finance medical care investigate “market-oriented” measures such as cost sharing. This article looks at the experience in the American medical marketplace over more than a decade, showing how markets function as institutions in which participants who are self-seeking, but not perfectly rational, exercise power over other participants in the market. Cost experience here was driven more by market power over prices than by management of utilization. Instead of following any logic of efficiency or equity, system transformations were driven by beliefs about investment strategies. At least in the United States' labor and capital markets, competition has shown little ability to rationalize health care systems because its goals do not resemble those of the health care system most people want. PMID:17718663

Coordinating management of water, salinity and trace elements for cotton under mulched drip irrigation with brackish water

NASA Astrophysics Data System (ADS)

Jin, M.; Chen, W.; Liang, X.

2016-12-01

Rational irrigation with brackish water can increase crop production, but irrational use may cause soil salinization. In order to understand the relationships among water, salt, and nutrient (including trace elements) and find rational schemes to manage water, salinity and nutrient in cotton fields, field and pot experiments were conducted in an arid area of southern Xinjiang, northwest China. Field experiments were performed from 2008 to 2015, and involved mulched drip irrigation during the growing season and flood irrigation afterwards. The average cotton yield of seven years varied between 3,575 and 5,095 kg/ha, and the irrigation water productivity between 0.91 and 1.16 kg/m3. With the progress of brackish water irrigation, Cu, Fe, Mn, and Na showed strong aggregation in topsoil at the narrow row, whereas the contents of Ca and K decreased in the order of inter-mulch gap, the wide inter row, and the narrow row. The contents of Cu, Fe, Mn, Ca and K in root soil reduced with cotton growth, whereas Na increased. Although mulched drip irrigation during the growing season resulted in an increase in salinity in the root zone, flood irrigation after harvesting leached the accumulated salts below background levels. Based on experiments a scheme for coordinating management of soil water, salt, and nutrient is proposed, that is, under the planting pattern of one mulch, two drip lines and four rows, the alternative irrigation plus a flood irrigation after harvesting or before seeding was the ideal scheme. Numerical simulations using solute transport model coupled with the root solute uptake based on the experiments and extended by another 20 years, suggest that the mulched drip irrigation using alternatively fresh and brackish water during the growing season and flood irrigation with fresh water after harvesting, is a sustainable irrigation practice that should not lead to soil salinization. Pot experiments with trace elements and different saline water showed significantly antagonistic effects on cotton growth and yield between NaCl and Mn or Zn or B. Zn concentration in irrigation water under salinity stress affected the uptake of nutrient elements and caused the different contents of nutrient elements in cotton, and influenced cotton growth and yields.

New auto-segment method of cerebral hemorrhage

NASA Astrophysics Data System (ADS)

Wang, Weijiang; Shen, Tingzhi; Dang, Hua

2007-12-01

A novel method for Computerized tomography (CT) cerebral hemorrhage (CH) image automatic segmentation is presented in the paper, which uses expert system that models human knowledge about the CH automatic segmentation problem. The algorithm adopts a series of special steps and extracts some easy ignored CH features which can be found by statistic results of mass real CH images, such as region area, region CT number, region smoothness and some statistic CH region relationship. And a seven steps' extracting mechanism will ensure these CH features can be got correctly and efficiently. By using these CH features, a decision tree which models the human knowledge about the CH automatic segmentation problem has been built and it will ensure the rationality and accuracy of the algorithm. Finally some experiments has been taken to verify the correctness and reasonable of the automatic segmentation, and the good correct ratio and fast speed make it possible to be widely applied into practice.

The oncology pharmacy in cancer care delivery in a resource-constrained setting in western Kenya.

PubMed

Strother, R Matthew; Rao, Kamakshi V; Gregory, Kelly M; Jakait, Beatrice; Busakhala, Naftali; Schellhase, Ellen; Pastakia, Sonak; Krzyzanowska, Monika; Loehrer, Patrick J

2012-12-01

The movement to deliver cancer care in resource-limited settings is gaining momentum, with particular emphasis on the creation of cost-effective, rational algorithms utilizing affordable chemotherapeutics to treat curable disease. The delivery of cancer care in resource-replete settings is a concerted effort by a team of multidisciplinary care providers. The oncology pharmacy, which is now considered integral to cancer care in resourced medical practice, developed over the last several decades in an effort to limit healthcare provider exposure to workplace hazards and to limit risk to patients. In developing cancer care services in resource-constrained settings, creation of oncology pharmacies can help to both mitigate the risks to practitioners and patients, and also limit the costs of cancer care and the environmental impact of chemotherapeutics. This article describes the experience and lessons learned in establishing a chemotherapy pharmacy in western Kenya.

Acceleration of a ground-state reaction by selective femtosecond-infrared-laser-pulse excitation

NASA Astrophysics Data System (ADS)

Stensitzki, Till; Yang, Yang; Kozich, Valeri; Ahmed, Ashour A.; Kössl, Florian; Kühn, Oliver; Heyne, Karsten

2018-02-01

Infrared (IR) excitation of vibrations that participate in the reaction coordinate of an otherwise thermally driven chemical reaction are believed to lead to its acceleration. Attempts at the practical realization of this concept have been hampered so far by competing processes leading to sample heating. Here we demonstrate, using femtosecond IR-pump IR-probe experiments, the acceleration of urethane and polyurethane formation due to vibrational excitation of the reactants for 1:1 mixtures of phenylisocyanate and cyclohexanol, and toluene-2,4-diisocyanate and 2,2,2-trichloroethane-1,1-diol, respectively. We measured reaction rate changes upon selective vibrational excitation with negligible heating of the sample and observed an increase of the reaction rate up to 24%. The observation is rationalized using reactant and transition-state structures obtained from quantum chemical calculations. We subsequently used IR-driven reaction acceleration to write a polyurethane square on sample windows using a femtosecond IR pulse.

Focal role of tolerability and reasonableness in the radiological protection system.

PubMed

Schneider, T; Lochard, J; Vaillant, L

2016-06-01

The concepts of tolerability and reasonableness are at the core of the International Commission on Radiological Protection (ICRP) system of radiological protection. Tolerability allows the definition of boundaries for implementing ICRP principles, while reasonableness contributes to decisions regarding adequate levels of protection, taking into account the prevailing circumstances. In the 1970s and 1980s, attempts to find theoretical foundations in risk comparisons for tolerability and cost-benefit analysis for reasonableness failed. In practice, the search for a rational basis for these concepts will never end. Making a wise decision will always remain a matter of judgement and will depend on the circumstances as well as the current knowledge and past experience. This paper discusses the constituents of tolerability and reasonableness at the heart of the radiological protection system. It also emphasises the increasing role of stakeholder engagement in the quest for tolerability and reasonableness since Publication 103. © The International Society for Prosthetics and Orthotics.

Current status of functional gastrointestinal evaluation in clinical practice

PubMed Central

Ang, Daphne; Fock, Kwong Ming; Law, Ngai Moh; Ang, Tiing Leong

2015-01-01

Neurogastroenterology and motility disorders of the gastrointestinal (GI) tract encompass a broad spectrum of diseases involving the GI tract and central nervous system. They have varied pathophysiology, clinical presentation and management, and make up a substantial proportion of outpatient clinic visits. Typically, patients experience persistent symptoms referable to the GI tract despite normal endoscopic and radiologic findings. An appropriate evaluation is thus important in the patient’s care. Advances in technology and understanding of the disease pathophysiology have provided better insight into the physiological basis of disease and a more rational approach to patient management. While technological advances serve to explain patients’ persistent symptoms, they should be balanced against the costs of diagnostic tests. This review highlights the GI investigative modalities employed to evaluate patients with persistent GI symptoms in the absence of a structural lesion, with particular emphasis on investigative modalities available locally and the clinical impact of such tools. PMID:25715853

Design and development of the mobile game based on the J2ME technology

NASA Astrophysics Data System (ADS)

He, Junhua

2011-12-01

With the continuous improvement of mobile performance, mobile entertainment applications market trend has been increasingly clear, mobile entertainment applications will be after the PC entertainment applications is another important business growth. Through the full analysis of the current mobile entertainment applications market demand and trends, the author has accumulated a lot of theoretical knowledge and practical experience. Rational, using of some new technology for a mobile entertainment games design, and described the development of key technologies required for mobile game an analysis and design of the game, and to achieve a complete game development. Light of the specific mobile game project - "Battle City", detailed the development of a mobile game based on the J2ME platform, the basic steps and the various key elements, focusing on how to use object-oriented thinking on the role of mobile phones in the abstract and Game Animation package, the source code with specific instructions.

Design and development of the mobile game based on the J2ME technology

NASA Astrophysics Data System (ADS)

He, JunHua

2012-01-01

With the continuous improvement of mobile performance, mobile entertainment applications market trend has been increasingly clear, mobile entertainment applications will be after the PC entertainment applications is another important business growth. Through the full analysis of the current mobile entertainment applications market demand and trends, the author has accumulated a lot of theoretical knowledge and practical experience. Rational, using of some new technology for a mobile entertainment games design, and described the development of key technologies required for mobile game an analysis and design of the game, and to achieve a complete game development. Light of the specific mobile game project - "Battle City", detailed the development of a mobile game based on the J2ME platform, the basic steps and the various key elements, focusing on how to use object-oriented thinking on the role of mobile phones in the abstract and Game Animation package, the source code with specific instructions.

Frequency-Weighting Filter Selection, for H2 Control of Microgravity Isolation Systems: A Consideration of the "Implicit Frequency Weighting" Problem

NASA Technical Reports Server (NTRS)

Hampton, Roy David; Whorton, Mark S.

1999-01-01

Many space-science experiments need an active isolation system to provide them with the requisite microgravity environment. The isolation systems planned for use with the International Space Station (ISS) have been appropriately modeled using relative position, relative velocity, and acceleration states. In theory, frequency-weighting design filters can be applied to these state-space models, in order to develop optimal H2 or mixed-norm controllers with desired stability and performance characteristics. In practice, however, since there is a kinematic relationship among the various states, any frequency weighting applied to one state will implicitly weight other states. These implicit frequency-weighting effects must be considered, for intelligent frequency-weighting filter assignment. This paper suggests a rational approach to the assignment of frequency-weighting design filters, in the presence of the kinematic coupling among states that exists in the microgravity vibration isolation problem.

Magnitude comparison with different types of rational numbers.

PubMed

DeWolf, Melissa; Grounds, Margaret A; Bassok, Miriam; Holyoak, Keith J

2014-02-01

An important issue in understanding mathematical cognition involves the similarities and differences between the magnitude representations associated with various types of rational numbers. For single-digit integers, evidence indicates that magnitudes are represented as analog values on a mental number line, such that magnitude comparisons are made more quickly and accurately as the numerical distance between numbers increases (the distance effect). Evidence concerning a distance effect for compositional numbers (e.g., multidigit whole numbers, fractions and decimals) is mixed. We compared the patterns of response times and errors for college students in magnitude comparison tasks across closely matched sets of rational numbers (e.g., 22/37, 0.595, 595). In Experiment 1, a distance effect was found for both fractions and decimals, but response times were dramatically slower for fractions than for decimals. Experiments 2 and 3 compared performance across fractions, decimals, and 3-digit integers. Response patterns for decimals and integers were extremely similar but, as in Experiment 1, magnitude comparisons based on fractions were dramatically slower, even when the decimals varied in precision (i.e., number of place digits) and could not be compared in the same way as multidigit integers (Experiment 3). Our findings indicate that comparisons of all three types of numbers exhibit a distance effect, but that processing often involves strategic focus on components of numbers. Fractions impose an especially high processing burden due to their bipartite (a/b) structure. In contrast to the other number types, the magnitude values associated with fractions appear to be less precise, and more dependent on explicit calculation. PsycINFO Database Record (c) 2014 APA, all rights reserved.

An Integrative Theory of Psychotherapy: Research and Practice

PubMed Central

Epstein, Seymour; Epstein, Martha L.

2016-01-01

A dual-process personality theory and supporting research are presented. The dual processes comprise an experiential system and a rational system. The experiential system is an adaptive, associative learning system that humans share with other higher-order animals. The rational system is a uniquely human, primarily verbal, reasoning system. It is assumed that when humans developed language they did not abandon their previous ways of adapting, they simply added language to their experiential system. The two systems are assumed to operate in parallel and are bi-directionally interactive. The validity of these assumptions is supported by extensive research. Of particular relevance for psychotherapy, the experiential system, which is compatible with evolutionary theory, replaces the Freudian maladaptive unconscious system that is indefensible from an evolutionary perspective, as sub-human animals would then have only a single system that is maladaptive. The aim of psychotherapy is to produce constructive changes in the experiential system. Changes in the rational system are useful only to the extent that they contribute to constructive changes in the experiential system. PMID:27672302

An Integrative Theory of Psychotherapy: Research and Practice.

PubMed

Epstein, Seymour; Epstein, Martha L

2016-06-01

A dual-process personality theory and supporting research are presented. The dual processes comprise an experiential system and a rational system. The experiential system is an adaptive, associative learning system that humans share with other higher-order animals. The rational system is a uniquely human, primarily verbal, reasoning system. It is assumed that when humans developed language they did not abandon their previous ways of adapting, they simply added language to their experiential system. The two systems are assumed to operate in parallel and are bi-directionally interactive. The validity of these assumptions is supported by extensive research. Of particular relevance for psychotherapy, the experiential system, which is compatible with evolutionary theory, replaces the Freudian maladaptive unconscious system that is indefensible from an evolutionary perspective, as sub-human animals would then have only a single system that is maladaptive. The aim of psychotherapy is to produce constructive changes in the experiential system. Changes in the rational system are useful only to the extent that they contribute to constructive changes in the experiential system.

Rational Chebyshev spectral transform for the dynamics of broad-area laser diodes

DOE Office of Scientific and Technical Information (OSTI.GOV)

Javaloyes, J., E-mail: julien.javaloyes@uib.es; Balle, S.

2015-10-01

This manuscript details the use of the rational Chebyshev transform for describing the transverse dynamics of broad-area laser diodes and amplifiers. This spectral method can be used in combination with the delay algebraic equations approach developed in [1], which substantially reduces the computation time. The theory is presented in such a way that it encompasses the case of the Fourier spectral transform presented in [2] as a particular case. It is also extended to the consideration of index guiding with an arbitrary transverse profile. Because their domain of definition is infinite, the convergence properties of the Chebyshev rational functions allowmore » handling the boundary conditions with higher accuracy than with the previously studied Fourier transform method. As practical examples, we solve the beam propagation problem with and without index guiding: we obtain excellent results and an improvement of the integration time between one and two orders of magnitude as compared with a fully distributed two dimensional model.« less

Construction Monitoring of Soft Ground Tunnels : A Rational Handbook of Practices for Rapid Transit System Planners and Managers.

DOT National Transportation Integrated Search

1977-01-01

This report aims to fit the objectives of the Urban Mass Transportation Administration (UMTA) Tunneling Program - to lower subway construction costs and to reduce construction hazards and damage to the environment. This report generated from an UMTA ...

Inventing Democracy: Future Alternatives for Social Action.

ERIC Educational Resources Information Center

Deethardt, John F.

1983-01-01

Considers the rational basis for participatory democracy and six ideas designed to embody that conceptual basis. Contends that the mission of speech communication scholars to the civic culture should be an activation of civic competencies and an invention of new places to practice free speech skills. (PD)

A Case of Ritual Resistance in a Polish School.

ERIC Educational Resources Information Center

Szkudlarek, Tomasz

1994-01-01

A Polish youngster's school, as "read" in her imaginative composition about classroom anarchy, bears many characteristics of a postmodern institution, with its power relations permeating everyday practices, its rationalism undergoing subversive critique, and its mixed message of subjugation and emancipation. An 11-year-old's "ritual…

Therapeutic Crystals

ERIC Educational Resources Information Center

Bond, Charles S.

2014-01-01

Some readers might not fully know what the difference is between crystallography, and the "new age" practice of dangling crystals around the body to capitalise on their healing energy. The latter is often considered to be superstition, while ironically, the former has actually resulted in real rationally-based healing of human diseases…

Heidegger on Transforming the Circumspect Activity of Spatial Thought

ERIC Educational Resources Information Center

Shepperd, Josh

2016-01-01

This paper examines the relationship between Heidegger's critique of educational comportment and his analysis of space in "Being and Time." It posits that providing an educational corrective to the practice of tacit rational, described as "circumspection" in "Being and Time," would provide an opportunity to reorient…

Differentiating Writing Instruction: Meeting the Diverse Needs of Authors in a Classroom

ERIC Educational Resources Information Center

Shea, Mary

2015-01-01

This article outlines a rational for responsive, differentiated writing instruction that targets students' identified needs with respect to various dimensions of the writing process. Discussed is a cycle that requires ongoing assessment, instructional decision-making, responsive, differentiated instruction, guided practice, and assessment.…

Accounting for People: Can Business Measure Human Value?

ERIC Educational Resources Information Center

Workforce Economics, 1997

1997-01-01

Traditional business practice undervalues human capital, and most conventional accounting models reflect this inclination. The argument for more explicit measurements of human resources is simple: Improved measurement of human resources will lead to more rational and productive choices about managing human resources. The business community is…

Anagogy of autonomy.

PubMed

Boyd, A L

2000-07-01

The philosophical and ethical concept of autonomy is herein examined, ex post facto, using an existential lens to examine the process of a personal friend's dying. Anagogy, defined as interpretation of a word, passage, or text that finds beyond the literal, allegorical, and moral senses a fourth and ultimate spiritual or mystical sense, is intended to enlarge the understanding of the use of autonomy in this case. The idea of personhood linked inextricably to reason is, therefore, understood as empowering an individual to choose among various actions, to define and redefine life goals, and to give priority to selected values and moral tenants, which reveal a moral hermeneutic. Conditions and circumstances, existentially exposed, limit choice in unexpected ways, such that the predicted value of autonomy is vulnerable to misuse or misunderstanding. The intent to respect the dignity of every person is central to the philosophy of Respect for Persons ethics, and assumes that autonomy, as freedom of the moral agent, is a moral duty. Implicit reality of freedom is, in a practical sense, essential to being rational agents who can thereby exercise informed choice. The moral law, law of freedom, involves the autonomy of the will and an ultimate end to which all action is directed. Defined as the highest good, morality unites virtue and happiness by ascribing the ultimate end sought as God. The freedom to use rational will finds principles within its own rational nature. The ability to create maxims is autonomy of the will, which equates with the dignity of persons. My recent experience as a companion to a personal friend with a terminal illness inspired me to re-evaluate the concept of autonomy as it is too often interpreted in modern ethical discourse as a individualistic right of choice as opposed to the hermeneutic of dignity of person. This paper describes a shift of position in understanding the paradox of autonomy in this existential context.

Experiential and rational decision making: a survey to determine how emergency physicians make clinical decisions.

PubMed

Calder, Lisa A; Forster, Alan J; Stiell, Ian G; Carr, Laura K; Brehaut, Jamie C; Perry, Jeffrey J; Vaillancourt, Christian; Croskerry, Patrick

2012-10-01

Dual-process psychological theories argue that clinical decision making is achieved through a combination of experiential (fast and intuitive) and rational (slower and systematic) cognitive processes. To determine whether emergency physicians perceived their clinical decisions in general to be more experiential or rational and how this compared with other physicians. A validated psychometric tool, the Rational Experiential Inventory (REI-40), was sent through postal mail to all emergency physicians registered with the College of Physicians and Surgeons of Ontario, according to their website in November 2009. Forty statements were ranked on a Likert scale from 1 (Definitely False) to 5 (Definitely True). An initial survey was sent out, followed by reminder cards and a second survey to non-respondents. Analysis included descriptive statistics, Student t tests, analysis of variance and comparison of mean scores with those of cardiologists from New Zealand. The response rate in this study was 46.9% (434/925). The respondents' median age was 41-50 years; they were mostly men (72.6%) and most had more than 10 years of clinical experience (66.8%). The mean REI-40 rational scores were higher than the experiential scores (3.93/5 (SD 0.35) vs 3.33/5 (SD 0.49), p<0.0001), similar to the mean scores of cardiologists from New Zealand (mean rational 3.93/5, mean experiential 3.05/5). The mean experiential scores were significantly higher for female respondents than for male respondents (3.40/5 (SD 0.49) vs 3.30/5 (SD 0.48), p=0.003). Overall, emergency physicians favoured rational decision making rather than experiential decision making; however, female emergency physicians had higher experiential scores than male emergency physicians. This has important implications for future knowledge translation and decision support efforts among emergency physicians.

[How I treat: from specialized pharmacology to drug therapy: a plea for an optimal educational program for rational therapeutics, from decision making to drug prescription].

PubMed

Scheen, A J

2000-09-01

Clinical pharmacology and therapeutics are two complementary disciplines which should lead the medical student, through an optimized training, to a rational prescription of drugs, ultimate and important step of the medical approach. Such a learning should occur progressively throughout the medical education, focusing, first, on the therapeutic reasoning ("why?") and, second, on the practical application leading to the prescription ("how?"). The medical student should learn the difficult task of integrating disease, drug and patient, in order to optimize the benefit/risk ratio, while being informed about new concepts such as "Evidence-Based Medicine" and pharmacoeconomics.

Vaccine adjuvant technology: from mechanistic concepts to practical applications.

PubMed

Degen, Winfried G J; Jansen, Theo; Schijns, Virgil E J C

2003-04-01

Distinct types of immune responses are required for efficient elimination of different pathogens. Programming of the desired type of immune response by safe nonreplicating vaccines requires suitable vaccine adjuvants. Adjuvants largely determine the magnitude and quality of immune responses specific for the coadministered antigen. Unfortunately, rational vaccine design requiring a rational choice of vaccine adjuvant, is hampered by a lack of knowledge about the mechanism(s) of vaccine adjuvant activity. The current review addresses different critical immunological processes possibly explaining adjuvant functions. In addition, we discuss traditional vaccine adjuvant formulations and their possible mode of action. Finally, we reflect on the latest technologies for the identification of novel adjuvants using molecular analysis of immune activation and functional genomics.

Medical ethics: a rational approach to patient management.

PubMed

Livadas, Gerry

2002-01-01

Physicians make their decisions based upon scientific evidence with their first consideration being the Hippocratic axiom 'not to do harm'. In practice, a number of non-medical issues influence this process and generate conflicting judgments. We analyze these issues that form the context of medical ethics which is perceived as a subject wider than morality. It is also a religious, social, political, economic, legal and cultural issue. Therefore, the patient, physician and other professionals play important roles in the decision-making. The final decision is not a decision based on medical textbooks, but is rational in that it is based on reason for the benefit of the individual. Copyright 2002 S. Karger AG, Basel

Fundamental understanding and rational design of high energy structural microbatteries

DOE Office of Scientific and Technical Information (OSTI.GOV)

Wang, Yuxing; Li, Qiuyan; Cartmell, Samuel

Microbatteries play a critical role in determining the lifetime of downsized sensors, wearable devices and medical applications, etc. More often, structural batteries are required from the perspective of aesthetics and space utilization, which is however rarely explored. Herein, we discuss the fundamental issues associated with the rational design of practically usable high energy microbatteries. The tubular shape of the cell further allows the flexible integration of microelectronics. A functioning acoustic micro-transmitter continuously powered by this tubular battery has been successfully demonstrated. Multiple design features adopted to accommodate large mechanical stress during the rolling process are discussed providing new insights inmore » designing the structural microbatteries for emerging technologies.« less

Coinductive Logic Programming with Negation

NASA Astrophysics Data System (ADS)

Min, Richard; Gupta, Gopal

We introduce negation into coinductive logic programming (co-LP) via what we term Coinductive SLDNF (co-SLDNF) resolution. We present declarative and operational semantics of co-SLDNF resolution and present their equivalence under the restriction of rationality. Co-LP with co-SLDNF resolution provides a powerful, practical and efficient operational semantics for Fitting's Kripke-Kleene three-valued logic with restriction of rationality. Further, applications of co-SLDNF resolution are also discussed and illustrated where Co-SLDNF resolution allows one to develop elegant implementations of modal logics. Moreover it provides the capability of non-monotonic inference (e.g., predicate Answer Set Programming) that can be used to develop novel and effective first-order modal non-monotonic inference engines.

Rational Ignorance in Education: A Field Experiment in Student Plagiarism

ERIC Educational Resources Information Center

Dee, Thomas S.; Jacob, Brian A.

2012-01-01

Plagiarism appears to be a common problem among college students, yet there is little evidence on the effectiveness of interventions designed to minimize plagiarism. This study presents the results of a field experiment that evaluated the effects of a web-based educational tutorial in reducing plagiarism. We found that assignment to the treatment…

Teacher Education Students: Their Experience of Mathematics Anxiety, Self-Efficacy, and Teacher Professional Development

ERIC Educational Resources Information Center

Olson, Amy M.

2014-01-01

This dissertation adds to the teacher education literature by exploring the experiences education students have of mathematics anxiety and self-efficacy for teaching and learning mathematics. Further, the utility of a specific in-service teacher professional development project, focused on improving rational number instruction, in pre-service…

Teaching Bank Runs with Classroom Experiments

ERIC Educational Resources Information Center

Balkenborg, Dieter; Kaplan, Todd; Miller, Timothy

2011-01-01

Once relegated to cinema or history lectures, bank runs have become a modern phenomenon that captures the interest of students. In this article, the authors explain a simple classroom experiment based on the Diamond-Dybvig model (1983) to demonstrate how a bank run--a seemingly irrational event--can occur rationally. They then present possible…

Exploring Teacher Identity from a Holistic Perspective: Reconstructing and Reconnecting Personal and Professional Selves

ERIC Educational Resources Information Center

Bukor, Emese

2015-01-01

This article explores the influence of personal and professional experiences on the development of teacher identity. The holistic perspective in this article refers to the language teachers' exploration of their personal and professional experiences with the use of both conscious/rational and intuitive/tacit thought processes. Three language…

A Simple Experiment Demonstrating the Relationship between Response Curves and Absorption Spectra.

ERIC Educational Resources Information Center

Li, Chia-yu

1984-01-01

Describes an experiment for recording two individual spectrophotometer response curves. The two curves are directly related to the power of transmitted beams that pass through a solvent and solution. An absorption spectrum of the solution can be constructed from the calculated rations of the curves as a function of wavelength. (JN)

[Rationing in German health care with particular consideration of oncology: view points of German stakeholders--a qualitative interview study].

PubMed

Lange, J; Gönner, C; Vollmann, J; Rauprich, O

2015-01-01

Germany is at the beginning of a discussion about possible rationing in the health-care system. Cancer treatment, which is often cost-intensive but not always cost-effective, is frequently considered as a field for rationing. Against this background, we conducted semi-structured, guideline-based interviews with different stakeholders of the German health-care system and analysed them with the help of grounded theory techniques. The goal of the study was to collect the experiences and opinions of members of the German Medical Review Board of the Statutory Health Insurance Funds (MDK), leading officials in central administrations of the German health-care sector and health politicians (members of the Parliamentary Committee for Health of the Federal German Parliament, the Bundestag) regarding cost-considerations in treatment decisions in health care with a special focus on oncology. (1) Cost-considerations have a limited role in the daily routine of the interviewed experts; (2) the interviewed personnel of the MDK were open to discuss rationing, while the group of leading officials was ambivalent and the health politicians rejected rationing and its discussion altogether; (3) the awareness of the opportunity costs of medical services varied with the profession of the interviewee: the members of the MDK saw opportunity costs primarily within the field of medicine, the leading officials noted the opportunity costs for other social services, and the health policy makers interpreted opportunity costs under fiscal budgetary aspects; (4) according to the interviewees, decisions on rationing require a legal basis, which should be based on a broad public discussion and an interdisciplinary debate among experts; (5) defining criteria for rationing was regarded as being outside of the professional competence of the interviewees; however, a preference with regard to the criterion of cost-effectiveness became apparent. The results of this study indicate that the strongest opposition to a debate on rationing in Germany does not stem from the medical, but rather from the political sector. The criteria for rationing suggested in the theoretical debate are in need of a context-sensitive examination and specification for the field of oncology. A possible approach to constructively promote the debate on rationing is a stronger focus on social opportunity costs of health care. The exact role of experts in a discourse on rationing, which was emphasised by the interviewees, requires a thorough determination. It is necessary to differentiate between the roles of impartial experts and stakeholders. Decisions on rationing can ultimately only be legitimised politically by parliament. © Georg Thieme Verlag KG Stuttgart · New York.

The problem of suffering as a driving force of rationalization and social change.

PubMed

Wilkinson, Iain

2013-03-01

This article documents and analyses a reconstructed Weberian conception of the problem of suffering. In this setting a focus is brought to how the problem of suffering is constituted in the dynamic interplay between, on the one hand, the compulsion to impose rational sense and order on the world, and on the other, the necessity to find a means to satiate charismatic needs. The discussion highlights Weber's account of the tendency for problems of suffering to increase in volume and scale along with the intensification and spread of modern processes of rationalization. It offers a case for the development of further sociological inquiries into the role played by experiences of the problem of suffering within the dynamics of social and cultural change. © London School of Economics and Political Science 2013.

When Health Policy and Empirical Evidence Collide: The Case of Cigarette Package Warning Labels and Economic Consumer Surplus

PubMed Central

Song, Anna V.; Brown, Paul

2014-01-01

In its graphic warning label regulations on cigarette packages, the Food and Drug Administration severely discounts the benefits of reduced smoking because of the lost “pleasure” smokers experience when they stop smoking; this is quantified as lost “consumer surplus.” Consumer surplus is grounded in rational choice theory. However, empirical evidence from psychological cognitive science and behavioral economics demonstrates that the assumptions of rational choice are inconsistent with complex multidimensional decisions, particularly smoking. Rational choice does not account for the roles of emotions, misperceptions, optimistic bias, regret, and cognitive inefficiency that are germane to smoking, particularly because most smokers begin smoking in their youth. Continued application of a consumer surplus discount will undermine sensible policies to reduce tobacco use and other policies to promote public health. PMID:24328661

Empirical evidence for resource-rational anchoring and adjustment.

PubMed

Lieder, Falk; Griffiths, Thomas L; M Huys, Quentin J; Goodman, Noah D

2018-04-01

People's estimates of numerical quantities are systematically biased towards their initial guess. This anchoring bias is usually interpreted as sign of human irrationality, but it has recently been suggested that the anchoring bias instead results from people's rational use of their finite time and limited cognitive resources. If this were true, then adjustment should decrease with the relative cost of time. To test this hypothesis, we designed a new numerical estimation paradigm that controls people's knowledge and varies the cost of time and error independently while allowing people to invest as much or as little time and effort into refining their estimate as they wish. Two experiments confirmed the prediction that adjustment decreases with time cost but increases with error cost regardless of whether the anchor was self-generated or provided. These results support the hypothesis that people rationally adapt their number of adjustments to achieve a near-optimal speed-accuracy tradeoff. This suggests that the anchoring bias might be a signature of the rational use of finite time and limited cognitive resources rather than a sign of human irrationality.

Thinking about the patient's wishes: practical wisdom of discharge planning nurses in assisting surrogate decision-making.

PubMed

Kageyama, Yoko; Asano, Midori

2017-12-01

The accelerating trend towards shorter hospital stays in Japan has made modes of decision-making essential for effective patient transition from the hospital to recuperation in the regional community, and the ageing of the population has brought a rise in surrogate decision-making by the families of patients lacking decision-making ('self-decision') capacity. To verbalise and elucidate the practical wisdom of discharge planning nurses by focusing on the perceptions and judgements, they apply in practice and describing their methodology in concrete terms. Participants were six discharge planning nurses and one person with previous experience as a discharge planning nurse, all working at discharge planning departments of acute care hospitals. Separate, semi-structured, interactive interviews were conducted with each participant. The study design was qualitative descriptive in form with qualitative content analysis. All participants provided written informed consent to participate in the study, which was approved by the study institution. Three concepts were extracted as the basis for discharge planning nurses' perception and judgement at acute care hospitals: working for mutual envisionment of the available postdischarge options; helping the family act as spokesperson(s) for the patient's wishes; and understanding the family inclusive of the patient as a relationship of strongly interaffecting interests. The practical wisdom of the nurse, working in mutual envisionment with the family, and collaborative decision-making through discussion with those who know the patient, leads to rational discharge assistance. © 2017 Nordic College of Caring Science.

Interns' knowledge of clinical pharmacology and therapeutics after undergraduate and on-going internship training in Nigeria: a pilot study

PubMed Central

Oshikoya, Kazeem A; Senbanjo, Idowu O; Amole, Olufemi O

2009-01-01

Background A sound knowledge of pathophysiology of a disease and clinical pharmacology and therapeutics (CPT) of a drug is required for safe and rational prescribing. The aim of this study was therefore to assess how adequately the undergraduate CPT teaching had prepared interns in Nigeria for safe and rational prescribing and retrospectively, to know how they wanted the undergraduate curriculum to be modified so as to improve appropriate prescribing. The effect of internship training on the prescribing ability of the interns was also sought. Methods A total of 100 interns were randomly selected from the Lagos State University Teaching Hospital (LASUTH), Ikeja; Lagos University Teaching Hospital (LUTH), Idiaraba; General Hospital Lagos (GHL); the EKO Hospital, Ikeja; and Havana Specialist Hospital, Surulere. A structured questionnaire was the instrument of study. The questionnaire sought information about the demographics of the interns, their undergraduate CPT teaching, experience of adverse drug reactions (ADRs) and drug interactions since starting work, confidence in drug usage and, in retrospect; any perceived deficiencies in their undergraduate CPT teaching. Results The response rate was 81%. All the respondents graduated from universities in Nigeria. The ability of the interns to prescribe rationally (66, 81.4%) and safely (47, 58%) was provided by undergraduate CPT teaching. Forty two (51.8%) respondents had problems with prescription writing. The interns would likely prescribe antibiotics (71, 87.6%), nonsteroidal analgesics (66, 81.4%), diuretics (55, 67.9%), sedatives (52, 62.9%), and insulin and oral hypoglycaemics (43, 53%) with confidence and unsupervised. The higher the numbers of clinical rotations done, the more confident were the respondents to prescribe unsupervised (χ2 = 19.98, P < 0.001). Similarly, respondents who had rotated through the four major clinical rotations and at least a special posting (χ2 = 11.57, P < 0.001) or four major clinical rotations only (χ2 = 11.25, P < 0.001) were significantly more confident to prescribe drugs unsupervised. Conclusion Undergraduate CPT teaching in Nigeria appears to be deficient. Principles of rational prescribing, drug dose calculation in children and pharmacovigilance should be the focus of undergraduate CPT teaching and should be taught both theoretically and practically. Medical students and interns should be periodically assessed on prescribing knowledge and skills during their training as a means of minimizing prescribing errors. PMID:19638199

Coercive and legitimate authority impact tax honesty: evidence from behavioral and ERP experiments

PubMed Central

Pfabigan, Daniela M.; Lamm, Claus; Kirchler, Erich; Hofmann, Eva

2017-01-01

Abstract Cooperation in social systems such as tax honesty is of central importance in our modern societies. However, we know little about cognitive and neural processes driving decisions to evade or pay taxes. This study focuses on the impact of perceived tax authority and examines the mental chronometry mirrored in ERP data allowing a deeper understanding about why humans cooperate in tax systems. We experimentally manipulated coercive and legitimate authority and studied its impact on cooperation and underlying cognitive (experiment 1, 2) and neuronal (experiment 2) processes. Experiment 1 showed that in a condition of coercive authority, tax payments are lower, decisions are faster and participants report more rational reasoning and enforced compliance, however, less voluntary cooperation than in a condition of legitimate authority. Experiment 2 confirmed most results, but did not find a difference in payments or self-reported rational reasoning. Moreover, legitimate authority led to heightened cognitive control (expressed by increased MFN amplitudes) and disrupted attention processing (expressed by decreased P300 amplitudes) compared to coercive authority. To conclude, the neuronal data surprisingly revealed that legitimate authority may led to higher decision conflict and thus to higher cognitive demands in tax decisions than coercive authority. PMID:28402477

Systems Theory, Excellence, and Values: Will They Mix?

ERIC Educational Resources Information Center

Bowen, Howard R.

1977-01-01

Academic planning in higher education is strongly influenced by business management theories and practices. The author questions the usefulness of this approach because the nature of higher education differs from the nature of a profit-making business. However, rational planning to achieve efficiency is relevant if efficiency is not confined to…

Beyond "What Works": Understanding Teacher Identity as a Practical and Political Tool

ERIC Educational Resources Information Center

Mockler, Nicole

2011-01-01

Drawing on previous research that focused upon the formation and mediation of teacher professional identity, this paper develops a model for conceptualising teacher professional identity. Increasingly, technical-rational understandings of teachers' work and "role" are privileged in policy and public discourse over more nuanced and holistic…

The Practice of Evaluation Research and the Use of Evaluation Results.

ERIC Educational Resources Information Center

Van den Berg, G.; Hoeben, W. Th. J. G.

1984-01-01

Lack of use of educational evaluation results in the Netherlands was investigated by analyzing 14 curriculum evaluation studies. Results indicated that rational decision making with a technical (empirical) evaluation approach makes utilization of results most likely. Incremental decision making and a conformative approach make utilization least…

Scientific Allocation of Water Resources.

ERIC Educational Resources Information Center

Buras, Nathan

Oriented for higher education students, researchers, practicing engineers and planners, this book surveys the state of the art of water resources engineering. A broad spectrum of issues is embraced in the treatment of water resources: quantity aspects as well as quality aspects within a systems approach. Using a rational mode for water resources…

Critiquing Human Resource Development's Dominant Masculine Rationality and Evaluating Its Impact

ERIC Educational Resources Information Center

Bierema, Laura L.

2009-01-01

The purpose of this article is to critique human resource development's (HRD) dominant philosophy, practices, and research; illustrate how they negatively affect women HRD practitioners and recipients; and recommend alternative conceptualizations of the field. This article is grounded in a critical feminist theoretical framework, draws on critical…

On Being More Accountable: The Push and Pull of Risk in School Leadership

ERIC Educational Resources Information Center

McWilliam, Erica; Perry, Lea-Anne

2006-01-01

This article addresses risk and its minimization as a powerful rationality for driving leadership practices in contemporary schools. It explores risk-consciousness as "a moral climate of politics" (Giddens 2002) and as a management imperative that impacts on any contemporary organization, including schools. The impact of…

Abstract for 1999 Rational Software User Conference

NASA Technical Reports Server (NTRS)

Dunphy, Julia; Rouquette, Nicolas; Feather, Martin; Tung, Yu-Wen

1999-01-01

We develop spacecraft fault-protection software at NASA/JPL. Challenges exemplified by our task: 1) high-quality systems - need for extensive validation & verification; 2) multi-disciplinary context - involves experts from diverse areas; 3) embedded systems - must adapt to external practices, notations, etc.; and 4) development pressures - NASA's mandate of "better, faster, cheaper".

Critical Thinking, Autonomy and Practical Reason

ERIC Educational Resources Information Center

Cuypers, Stefaan E.

2004-01-01

This article points out an internal tension, or even conflict, in the conceptual foundations of Harvey Siegel's conception of critical thinking. Siegel justifies critical thinking, or critically rational autonomy, as an educational ideal first and foremost by an appeal to the Kantian principle of respect for persons. It is made explicit that this…

In Search of Rationality: The Purposes behind the Use of Formal Analysis in Organizations.

ERIC Educational Resources Information Center

Langley, Ann

1989-01-01

Examines how formal analysis is actually practiced in 3 different organizations. Identifies 4 main groups of purposes for formal analysis and relates them to various hierarchical relationships. Formal analysis and social interaction seem inextricably linked in organizational decision-making. Different structural configurations may generate…

Teaching Cognitive-Behavioral Therapy to Undergraduate Psychology Students

ERIC Educational Resources Information Center

Ryan, Tracey Ellen; Blau, Shawn; Grozeva, Dima

2011-01-01

This article describes an experimental undergraduate psychology course that ran for two semesters during the 2009 academic year at a private, urban university in the United States. Students learned the techniques and strategies of cognitive behavioral therapy (CBT) and rational emotive behavior therapy (REBT) with a focus on the practical elements…

Postmodern Ethics for Active-Directive Counseling and Psychotherapy.

ERIC Educational Resources Information Center

Ellis, Albert

1997-01-01

Discusses how Rational Emotive Behavior Therapy (REBT) includes some basic postmodern ideas and can be practiced with important caveats and cautions that keep it open-ended, flexible, and relativist. Describes how REBT shows clients how their conscious and unconscious absolutistic philosophies lead to much of their dysfunctional feelings and…

Exploring science and mathematics teaching experiences in Thailand using reflective journals of an internship program between Vietnamese and Thai students

NASA Astrophysics Data System (ADS)

Pruekpramool, Chaninan; Kanyaprasith, Kamonwan; Phonphok, Nason; Diem, Huynh Thi Thuy

2018-01-01

An internship program between Vietnamese student teachers from Cantho University and Thai graduate students from Srinakharinwirot University has occurred in June 2016. There were six Vietnamese student teachers and four Thai graduate students participated in this program with the help of science teachers from two schools in Sa Kaeo and Chachoengsao Provinces of Thailand. To explore Vietnamese and Thai students' life experiences and their perceptions in science and Mathematics teaching, reflective journals were used to record their progress as team teaching in primary and lower secondary classrooms in the form of the online format via social media in English language. The data were collected from 54 reflective journals from their eight days experiences at the schools. The data were analyzed qualitatively using Van Manen's level of reflectivity which composed of three levels; 1) Technical Rationality (TR), 2) Practical Action (PA) and 3) Critical Reflection (CR). The results explicitly revealed that the three levels of reflectivity have appeared in the reflective journals. Besides, Vietnamese and Thai students have learned more from each other and can exchange their educational experiences and culture. Certainly, this was the first time for them to teach science and mathematics in English to Thai students. Moreover, they have shared their impressions toward schools, teachers and also students in the schools in their reflective journal as well.

[Thoughts about patient education: the experience of diabetes].

PubMed

Grimaldi, André; Simon, Dominique; Sachon, Claude

2009-12-01

Patient education is not simply information or teaching or coaching. It is learning that is both practical and specialized, intended to help patients acquire therapeutic skills and to support them in changing their self-care practices to attain personalized objectives. It is therapeutic. An effective strategy to overcome health problems requires that patients not avoid the problem by denying the disease. Health prevention behavior requires that the patient be simultaneously confident in the prescribed treatments and able to project into the future. It is more difficult for asymptomatic patients to have a mental representation of the disease and thus be able to modify their lifestyle. Self-measurement of blood glucose can create anxiety and make the risk of complications more tangible, but it is beneficial only if it induces action or reassurance. Changing behavior is possible only to the extent that it does not challenge the patient's own well-being. It may be unreasonable but it is also rational to refuse what the patient perceives as a threat to his or her own identity. Thus, physicians caring for patients with a chronic disease must be skilled in three different fields: biomedicine, pedagogy, and psychology.

IsoDesign: a software for optimizing the design of 13C-metabolic flux analysis experiments.

PubMed

Millard, Pierre; Sokol, Serguei; Letisse, Fabien; Portais, Jean-Charles

2014-01-01

The growing demand for (13) C-metabolic flux analysis ((13) C-MFA) in the field of metabolic engineering and systems biology is driving the need to rationalize expensive and time-consuming (13) C-labeling experiments. Experimental design is a key step in improving both the number of fluxes that can be calculated from a set of isotopic data and the precision of flux values. We present IsoDesign, a software that enables these parameters to be maximized by optimizing the isotopic composition of the label input. It can be applied to (13) C-MFA investigations using a broad panel of analytical tools (MS, MS/MS, (1) H NMR, (13) C NMR, etc.) individually or in combination. It includes a visualization module to intuitively select the optimal label input depending on the biological question to be addressed. Applications of IsoDesign are described, with an example of the entire (13) C-MFA workflow from the experimental design to the flux map including important practical considerations. IsoDesign makes the experimental design of (13) C-MFA experiments more accessible to a wider biological community. IsoDesign is distributed under an open source license at http://metasys.insa-toulouse.fr/software/isodes/ © 2013 Wiley Periodicals, Inc.

Descartes the doctor: rationalism and its therapies.

PubMed

Shapin, S

2000-06-01

During the Scientific Revolution one important gauge of the quality of reformed natural philosophical knowledge was its ability to produce a more effective medical practice. Indeed, it was sometimes thought that philosophers who pretended to possess new and more potent philosophical knowledge might display that possession in personal health and longevity. Rene Descartes repeatedly wrote that a better medical practice was a major aim of his philosophical enterprise. He said that he had made important strides towards achieving that aim, on that basis, he offered practical medical advice to others and advertised the expectation that, taking his own advice, he would live a very long time. This paper describes what Cartesian medicine looked like in practice and what that practice owed to the power of modernist Reason.

Pruritus: Management Algorithms and Experimental Therapies

PubMed Central

Steinhoff, Martin; Cevikbas, Ferda; Ikoma, Akihiko; Berger, Timothy G.

2013-01-01

Pruritus (itch) is a major symptom in many dermatologic as well as systemic diseases and has a dramatic impact on the quality of life in these patients. The symptom of itch has to be treated on the basis of its pathophysiology and its underlying disease. In daily practice, a “quick” diagnosis of the underlying disease is often difficult, although a rapid relief of the itch is desired. We often treat patients on the basis of the symptomatology. A rational therapeutic ladder for a symptomatic therapy is useful until the final diagnosis has been confirmed. There are probably many subtypes of pruritus, just as there are many diseases that cause itch. The pathophysiology in many subtypes of pruritus is still poorly understood, hindering a rapid and targeted treatment strategy. An extensive diagnostic workup is often required to determine the final cause(s) of the itch. Thus, in daily life, physicians often start with a more or less rational therapeutic strategy to combat the debilitating itch. We present possible therapeutic ladders that form the basis for effective therapeutic itch strategies in various diseases. On the basis of our current knowledge about the different pathophysiologies of itch, on clinical trials or case reports, and our own clinical experience, we aim to present therapeutic ladders for the rapid as well as long-term management of itch. Finally, we summarize current exciting developments of experimental strategies in itch research and in clinical development for itch therapy. PMID:21767775

Intergroup Cooperation in Common Pool Resource Dilemmas.

PubMed

Sadowski, Jathan; Spierre, Susan G; Selinger, Evan; Seager, Thomas P; Adams, Elizabeth A; Berardy, Andrew

2015-10-01

Fundamental problems of environmental sustainability, including climate change and fisheries management, require collective action on a scale that transcends the political and cultural boundaries of the nation-state. Rational, self-interested neoclassical economic theories of human behavior predict tragedy in the absence of third party enforcement of agreements and practical difficulties that prevent privatization. Evolutionary biology offers a theory of cooperation, but more often than not in a context of discrimination against other groups. That is, in-group boundaries are necessarily defined by those excluded as members of out-groups. However, in some settings human's exhibit behavior that is inconsistent with both rational economic and group driven cooperation of evolutionary biological theory. This paper reports the results of a non-cooperative game-theoretic exercise that models a tragedy of the commons problem in which groups of players may advance their own positions only at the expense of other groups. Students enrolled from multiple universities and assigned to different multi-university identity groups participated in experiments that repeatedly resulted in cooperative outcomes despite intergroup conflicts and expressions of group identity. We offer three possible explanations: (1) students were cooperative because they were in an academic setting; (2) students may have viewed their instructors as the out-group; or (3) the emergence of a small number of influential, ethical leaders is sufficient to ensure cooperation amongst the larger groups. From our data and analysis, we draw out lessons that may help to inform approaches for institutional design and policy negotiations, particularly in climate change management.

How do practising clinicians and students apply newly learned causal information about mental disorders?

PubMed

de Kwaadsteniet, Leontien; Kim, Nancy S; Yopchick, Jennelle E

2013-02-01

New causal theories explaining the aetiology of psychiatric disorders continuously appear in the literature. How might such new information directly impact clinical practice, to the degree that clinicians are aware of it and accept it? We investigated whether expert clinical psychologists and students use new causal information about psychiatric disorders according to rationalist norms in their diagnostic reasoning. Specifically, philosophical and Bayesian analyses suggest that it is rational to draw stronger inferences about the presence of a disorder when a client's presenting symptoms are from disparate locations in a causal theory of the disorder than when they are from proximal locations. In a controlled experiment, we presented experienced clinical psychologists and students with recently published causal theories for different disorders; specifically, these theories proposed how the symptoms of each disorder stem from a root cause. Participants viewed hypothetical clients with presenting proximal or diverse symptoms, and indicated either the likelihood that the client has the disorder, or what additional information they would seek out to help inform a diagnostic decision. Clinicians and students alike showed a strong preference for diverse evidence, over proximal evidence, in making diagnostic judgments and in seeking additional information. They did not show this preference in the control condition, in which they gave their own opinions prior to learning the causal information. These findings suggest that experienced clinical psychologists and students are likely to use newly learned causal knowledge in a normative, rational way in diagnostic reasoning. © 2011 Blackwell Publishing Ltd.

An analysis of parental roles during haematopoietic stem cell transplantation of their offspring: a qualitative and participant observational study.

PubMed

Larsen, Hanne Baekgaard; Heilmann, Carsten; Johansen, Christoffer; Adamsen, Lis

2011-07-01

The aim of this study was to investigate the parents' experiences and reflections on their parental role while taking care of their child. Parents of children undergoing treatment with allogeneic haematopoetic stem cell transplantation for life threatening diseases in protective isolation, experience distress related to the child's care. Parents struggle to cope with the stress related to the child's disease, treatment and survival possibilities. During the period 2007-2009, eight participant studies and 16 in-depth interviews were performed and analysed using a theoretical ideal type construction and an interactionistic approach. Three ideal types of approaches were identified (1) expertise-mindedness, (2) dialogue-mindedness and (3) the approach of the socially challenged parents. Expertise-minded parents base their rationality for care and interactions on medical knowledge. It is important for dialogue-minded parents that emotions are included in the rationality for care. Being able to manage these two approaches requires emotional work in the form of both surface- and deep acting from the parents. Socially challenged parents fail to adapt to either of the two approaches since they often fail to manage the required emotional work. The three described ideal types give a new perspective on the complex interactions that occur between parents, child and staff during treatment with haematopoetic stem cell transplantation. Understanding the rationality behind the different approaches adopted by parents may assist medical staff to understand the parents' rationality for care of their child and to identify socially challenged parents who need help in managing the care of their child. © 2011 Blackwell Publishing Ltd.

Childbirth in ancient Rome: from traditional folklore to obstetrics.

PubMed

Todman, Donald

2007-04-01

In ancient Rome, childbirth was a hazardous event for both mother and child with high rates of infant and maternal mortality. Traditional Roman medicine centred on folklore and religious practices, but with the development of Hippocratic medicine came significant advances in the care of women during pregnancy and confinement. Midwives or obstetrices played an important role and applied rational scientific practices to improve outcomes. This evolution from folklore to obstetrics was a pivotal point in the history of childbirth.

[Rational antibiotic therapy in the dental office: Practical guidelines for decision-making].

PubMed

Zadik, Y

2016-04-01

Although most dental and periodontal diseases are caused by bacteria, the usual therapy is mechanical/surgical rather than antimicrobial medications. However, sometimes antibiotic administration may be necessary in addition to or as an alternative to the surgical/mechanical treatment. Many studies have shown that the misuse of antibiotics by dentists may be mostly attributed to unnecessity or inefficient regimen, and could contribute to bacterial resistance to antibiotics. The article presents practical guidelines to the administration of antibiotics in the dental office.

Who to Blame: Irrational Decision-Makers or Stupid Modelers? (Arne Richter Award for Outstanding Young Scientists Lecture)

NASA Astrophysics Data System (ADS)

Madani, Kaveh

2016-04-01

Water management benefits from a suite of modelling tools and techniques that help simplifying and understanding the complexities involved in managing water resource systems. Early water management models were mainly concerned with optimizing a single objective, related to the design, operations or management of water resource systems (e.g. economic cost, hydroelectricity production, reliability of water deliveries). Significant improvements in methodologies, computational capacity, and data availability over the last decades have resulted in developing more complex water management models that can now incorporate multiple objectives, various uncertainties, and big data. These models provide an improved understanding of complex water resource systems and provide opportunities for making positive impacts. Nevertheless, there remains an alarming mismatch between the optimal solutions developed by these models and the decisions made by managers and stakeholders of water resource systems. Modelers continue to consider decision makers as irrational agents who fail to implement the optimal solutions developed by sophisticated and mathematically rigours water management models. On the other hand, decision makers and stakeholders accuse modelers of being idealist, lacking a perfect understanding of reality, and developing 'smart' solutions that are not practical (stable). In this talk I will have a closer look at the mismatch between the optimality and stability of solutions and argue that conventional water resources management models suffer inherently from a full-cooperation assumption. According to this assumption, water resources management decisions are based on group rationality where in practice decisions are often based on individual rationality, making the group's optimal solution unstable for individually rational decision makers. I discuss how game theory can be used as an appropriate framework for addressing the irrational "rationality assumption" of water resources management models and for better capturing the social aspects of decision making in water management systems with multiple stakeholders.

Raising standards of clinical practice--the fundamental issue of effective nursing practice.

PubMed

Kitson, A L

1987-05-01

The proposition put forward in this paper is that standards of nursing practice can only be assured if the profession is able to find ways of responding to the intuitions and gut reactions of its practitioners. Rather than deny them, nurses have to know how to test and thus legitimize them. Such a validation process demands more clinically based nursing research projects and the proliferation of arrangements such as clinical nursing practice units. It is further argued that by linking the intuitive and rational aspects of nursing in this way the profession is in a better position not only to fulfil its societal obligations but also to build up its own knowledge and skills.

Non-medical influences on medical decision-making.

PubMed

McKinlay, J B; Potter, D A; Feldman, H A

1996-03-01

The influence of non-medical factors on physicians' decision-making has been documented in many observational studies, but rarely in an experimental setting capable of demonstrating cause and effect. We conducted a controlled factorial experiment to assess the influence of non-medical factors on the diagnostic and treatment decisions made by practitioners of internal medicine in two common medical situations. One hundred and ninety-two white male internists individually viewed professionally produced video scenarios in which the actor-patient, presenting with either chest pain or dyspnea, possessed various balanced combinations of sex, race, age, socioeconomic status, and health insurance coverage. Physician subjects were randomly drawn from lists of internists in private practice, hospital-based practice, and HMO's, at two levels of experience. The most frequent diagnoses for both chest pain and dyspnea were psychogenic origin and cardiac problems. Smoking cessation was the most frequent treatment recommendation for both conditions. Younger patients (all other factors being the same) were significantly more likely to receive the psychogenic diagnosis. Older patients were more likely to receive the cardiac diagnosis for chest pain, particularly if they were insured. HMO-based physicians were more likely to recommend a follow-up visit for chest pain. Several interactions of patient and physician factors were significant in addition to the main effects. The variability in decision-making evidenced by physicians in this experiment was not entirely accounted for by strictly rational Bayesian inference (the common prescriptive model for medical decision-making), in-as-much as non-medical factors significantly affected the decisions that they made. There is a need to supplement idealized medical schemata with considerations of social behavior in any comprehensive theory of medical decision-making.

Rationing a "Free" Good: A Classroom Experiment

ERIC Educational Resources Information Center

Alden, Lori

2006-01-01

The author describes a classroom experiment that illustrates the welfare effects of allocating a good on a first-come, first-served basis. In the first round, each student must decide how long to wait in an imaginary line for candy, without knowing how much will be distributed or how long others are willing to wait. In making this decision, a…

The Step to Rationality: The Efficacy of Thought Experiments in Science, Ethics, and Free Will

ERIC Educational Resources Information Center

Shepard, Roger N.

2008-01-01

Examples from Archimedes, Galileo, Newton, Einstein, and others suggest that fundamental laws of physics were--or, at least, could have been--discovered by experiments performed not in the physical world but only in the mind. Although problematic for a strict empiricist, the evolutionary emergence in humans of deeply internalized implicit…

When Global Structure "Explains Away" Local Grammar: A Bayesian Account of Rule-Induction in Tone Sequences

ERIC Educational Resources Information Center

Dawson, Colin; Gerken, LouAnn

2011-01-01

While many constraints on learning must be relatively experience-independent, past experience provides a rich source of guidance for subsequent learning. Discovering structure in some domain can inform a learner's future hypotheses about that domain. If a general property accounts for particular sub-patterns, a rational learner should not…

Towards More Flexibility in Training: A Review of Some Experiences in Rationalizing the Provision of Vocational Qualifications. Employment and Training Papers.

ERIC Educational Resources Information Center

Tchaban, A., Ed.

This document presents five papers, each describing different experiences in the introduction, promotion and implementation of innovative adult training approaches aimed at achieving more flexibility in skill development. An introduction (Anatoli Tchaban) presents background information and a synthesis of the studies covering definitions, concepts…

Mathematical anxiety is linked to reduced cognitive reflection: a potential road from discomfort in the mathematics classroom to susceptibility to biases.

PubMed

Morsanyi, Kinga; Busdraghi, Chiara; Primi, Caterina

2014-09-01

When asked to solve mathematical problems, some people experience anxiety and threat, which can lead to impaired mathematical performance (Curr Dir Psychol Sci 11:181-185, 2002). The present studies investigated the link between mathematical anxiety and performance on the cognitive reflection test (CRT; J Econ Perspect 19:25-42, 2005). The CRT is a measure of a person's ability to resist intuitive response tendencies, and it correlates strongly with important real-life outcomes, such as time preferences, risk-taking, and rational thinking. In Experiments 1 and 2 the relationships between maths anxiety, mathematical knowledge/mathematical achievement, test anxiety and cognitive reflection were analysed using mediation analyses. Experiment 3 included a manipulation of working memory load. The effects of anxiety and working memory load were analysed using ANOVAs. Our experiments with university students (Experiments 1 and 3) and secondary school students (Experiment 2) demonstrated that mathematical anxiety was a significant predictor of cognitive reflection, even after controlling for the effects of general mathematical knowledge (in Experiment 1), school mathematical achievement (in Experiment 2) and test anxiety (in Experiments 1-3). Furthermore, Experiment 3 showed that mathematical anxiety and burdening working memory resources with a secondary task had similar effects on cognitive reflection. Given earlier findings that showed a close link between cognitive reflection, unbiased decisions and rationality, our results suggest that mathematical anxiety might be negatively related to individuals' ability to make advantageous choices and good decisions.

Evidence on the validity and reliability of the German, French and Italian nursing home version of the Basel Extent of Rationing of Nursing Care instrument.

PubMed

Zúñiga, Franziska; Schubert, Maria; Hamers, Jan P H; Simon, Michael; Schwendimann, René; Engberg, Sandra; Ausserhofer, Dietmar

2016-08-01

To develop and test psychometrically the Basel Extent of Rationing of Nursing Care for Nursing Homes instrument, providing initial evidence on the validity and reliability of the German, French and Italian-language versions. In the hospital setting, implicit rationing of nursing care is defined as the withholding of nursing activities due to lack of resources, such as staffing or time. No instrument existed to measure this concept in nursing homes. Cross-sectional study. We developed the instrument in three phases: (1) adaption and translation; (2) content validity testing; and (3) initial validity and reliability testing. For phase 3, we analysed survey data from 4748 care workers collected between May 2012-April 2013 from a randomly selected sample of 162 nursing homes in the German-, French- and Italian-speaking regions of Switzerland to provide evidence from response processes (e.g. missing), internal structure (exploratory factor analysis), inter-item inconsistencies (e.g. Cronbach's alpha) and interscorer differences (e.g. within-group agreement). Exploratory factor analysis revealed a four-factor structure with good fit statistics. Rationing of nursing care was structured in four domains: (1) activities of daily living; (2) caring, rehabilitation and monitoring; (3) documentation; and (4) social care. Items of the social care subscale showed lower content validity and more missing values than items of other subscales. First evidence indicates that the new instrument can be recommended for research and practice to measure implicit rationing of nursing care in nursing homes. Further refinements of single items are needed. © 2016 John Wiley & Sons Ltd.

Rational Manipulation of the Standard Laparoscopic Instruments for Single-Incision Laparoscopic Right Colectomy

PubMed Central

Watanabe, Makoto; Murakami, Masahiko; Kato, Takashi; Onaka, Toru; Aoki, Takeshi

2013-01-01

This report clarifies the rational manipulation of standard laparoscopic instruments for single-incision laparoscopic right colectomy (SILRC) using the SILS Port. We classified the manipulations required into 4 techniques. Vertical manipulation was required for medial-to-lateral retroperitoneal dissection. Frontal manipulation was needed for extension and establishment of a retroperitoneal plane. External crossing manipulation was used for dissection or ligation of the ileocolic or right colic vessels. Internal crossing manipulation was required for mobilization from the cecum to ascending colon. We performed SILRC for a series of 30 consecutive patients. One additional port was needed in 5 of the patients (16.7%) because of severe adhesion between the ileum and abdominal wall. No intraoperative complications were encountered. Four rational manipulations of the standard laparoscopic instruments are required for SILRC using the SILS Port. However, more experience and comparative trials are needed to determine the exact role of SILRC. PMID:23971771

Employing imaginative rationality: using metaphor when discussing death.

PubMed

Llewellyn, Rebecca; Jaye, Chrystal; Egan, Richard; Cunningham, Wayne; Young, Jessica; Radue, Peter

2017-03-01

The prevalence of metaphors in medicine is widely acknowledged. In a qualitative study exploring expectations of longevity, we observed repeated recourse to the imaginative rationality provided by metaphors to express perspectives on longevity and death. Bafflement, acceptance, uncertainty and distress were conveyed through metaphors, providing valuable insight into the internal healthcare frameworks of participants. Skilful use of imaginative rationality in the healthcare setting may illuminate the elusive and often eschewed topic of death in a way that fosters clarity and new understandings, and pave the way towards a better life, and death for patients. By becoming aware of the nuances contained within patients'-as well as their own-metaphors, clinicians may enhance patients' overall healthcare experience and avert unintended miscommunication. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Adaptive non-interventional heuristics for covariation detection in causal induction: model comparison and rational analysis.

PubMed

Hattori, Masasi; Oaksford, Mike

2007-09-10

In this article, 41 models of covariation detection from 2 × 2 contingency tables were evaluated against past data in the literature and against data from new experiments. A new model was also included based on a limiting case of the normative phi-coefficient under an extreme rarity assumption, which has been shown to be an important factor in covariation detection (McKenzie & Mikkelsen, 2007) and data selection (Hattori, 2002; Oaksford & Chater, 1994, 2003). The results were supportive of the new model. To investigate its explanatory adequacy, a rational analysis using two computer simulations was conducted. These simulations revealed the environmental conditions and the memory restrictions under which the new model best approximates the normative model of covariation detection in these tasks. They thus demonstrated the adaptive rationality of the new model. 2007 Cognitive Science Society, Inc.

[Effect of psychotropic drugs on activity of anticonvulsants in maximal electroshock test].

PubMed

Alikina, N A; Tregubov, A L; Kotegov, V P

2010-08-01

The effect ofpsychotropic drugs on the pharmacological properties of anticonvulsants was studied on white mice under maximal electroshock (ME) test conditions. Changes in the anticonvulsant effect of phenobarbital, diphenin, carbamazepine, hexamidine were traced upon their joint administration with psychotropic drugs, including piracetam, aminalon, amitriptyline, imizine, levomepromazine, and lithium oxybutyrate. An important result of research is the fact, that in no one of combinations the basic pharmacological effect of anticonvulsants was decreased. Based on the results of experiments, the most rational combinations of anticonvulsants with psychotropic preparations were revealed as manifested in the ME test. As criterion of rational combination was the increase in the activity of anticonvulsants and reduction of their toxicity in combination or at least invariance of this parameter. Rational combinations include (i) phenobarbital with piracetam, amitriptyline, levomepromazine, and lithium oxybutyrate; (ii) carbamazepine with piracetam; and (iii) hexamidine with amitriptyline, levomepromazine and imizine.

Design of Mobile Augmented Reality in Health Care Education: A Theory-Driven Framework.

PubMed

Zhu, Egui; Lilienthal, Anneliese; Shluzas, Lauren Aquino; Masiello, Italo; Zary, Nabil

2015-09-18

Augmented reality (AR) is increasingly used across a range of subject areas in health care education as health care settings partner to bridge the gap between knowledge and practice. As the first contact with patients, general practitioners (GPs) are important in the battle against a global health threat, the spread of antibiotic resistance. AR has potential as a practical tool for GPs to combine learning and practice in the rational use of antibiotics. This paper was driven by learning theory to develop a mobile augmented reality education (MARE) design framework. The primary goal of the framework is to guide the development of AR educational apps. This study focuses on (1) identifying suitable learning theories for guiding the design of AR education apps, (2) integrating learning outcomes and learning theories to support health care education through AR, and (3) applying the design framework in the context of improving GPs' rational use of antibiotics. The design framework was first constructed with the conceptual framework analysis method. Data were collected from multidisciplinary publications and reference materials and were analyzed with directed content analysis to identify key concepts and their relationships. Then the design framework was applied to a health care educational challenge. The proposed MARE framework consists of three hierarchical layers: the foundation, function, and outcome layers. Three learning theories-situated, experiential, and transformative learning-provide foundational support based on differing views of the relationships among learning, practice, and the environment. The function layer depends upon the learners' personal paradigms and indicates how health care learning could be achieved with MARE. The outcome layer analyzes different learning abilities, from knowledge to the practice level, to clarify learning objectives and expectations and to avoid teaching pitched at the wrong level. Suggestions for learning activities and the requirements of the learning environment form the foundation for AR to fill the gap between learning outcomes and medical learners' personal paradigms. With the design framework, the expected rational use of antibiotics by GPs is described and is easy to execute and evaluate. The comparison of specific expected abilities with the GP personal paradigm helps solidify the GP practical learning objectives and helps design the learning environment and activities. The learning environment and activities were supported by learning theories. This paper describes a framework for guiding the design, development, and application of mobile AR for medical education in the health care setting. The framework is theory driven with an understanding of the characteristics of AR and specific medical disciplines toward helping medical education improve professional development from knowledge to practice. Future research will use the framework as a guide for developing AR apps in practice to validate and improve the design framework.

Design of Mobile Augmented Reality in Health Care Education: A Theory-Driven Framework

PubMed Central

Lilienthal, Anneliese; Shluzas, Lauren Aquino; Masiello, Italo; Zary, Nabil

2015-01-01

Background Augmented reality (AR) is increasingly used across a range of subject areas in health care education as health care settings partner to bridge the gap between knowledge and practice. As the first contact with patients, general practitioners (GPs) are important in the battle against a global health threat, the spread of antibiotic resistance. AR has potential as a practical tool for GPs to combine learning and practice in the rational use of antibiotics. Objective This paper was driven by learning theory to develop a mobile augmented reality education (MARE) design framework. The primary goal of the framework is to guide the development of AR educational apps. This study focuses on (1) identifying suitable learning theories for guiding the design of AR education apps, (2) integrating learning outcomes and learning theories to support health care education through AR, and (3) applying the design framework in the context of improving GPs’ rational use of antibiotics. Methods The design framework was first constructed with the conceptual framework analysis method. Data were collected from multidisciplinary publications and reference materials and were analyzed with directed content analysis to identify key concepts and their relationships. Then the design framework was applied to a health care educational challenge. Results The proposed MARE framework consists of three hierarchical layers: the foundation, function, and outcome layers. Three learning theories—situated, experiential, and transformative learning—provide foundational support based on differing views of the relationships among learning, practice, and the environment. The function layer depends upon the learners’ personal paradigms and indicates how health care learning could be achieved with MARE. The outcome layer analyzes different learning abilities, from knowledge to the practice level, to clarify learning objectives and expectations and to avoid teaching pitched at the wrong level. Suggestions for learning activities and the requirements of the learning environment form the foundation for AR to fill the gap between learning outcomes and medical learners’ personal paradigms. With the design framework, the expected rational use of antibiotics by GPs is described and is easy to execute and evaluate. The comparison of specific expected abilities with the GP personal paradigm helps solidify the GP practical learning objectives and helps design the learning environment and activities. The learning environment and activities were supported by learning theories. Conclusions This paper describes a framework for guiding the design, development, and application of mobile AR for medical education in the health care setting. The framework is theory driven with an understanding of the characteristics of AR and specific medical disciplines toward helping medical education improve professional development from knowledge to practice. Future research will use the framework as a guide for developing AR apps in practice to validate and improve the design framework. PMID:27731839

Nano Dreams and Nano Worlds: The Emergence and Disciplinary Formation of Nanoengineering

NASA Astrophysics Data System (ADS)

York, Emily

This dissertation analyzes the sociotechnical practices through which nanoengineering is produced as a new disciplinary and professional site of "innovation for the benefit of society." I argue that innovation constitutes a rationalizing discourse that serves to justify the establishment of a field, department, and major. Additionally, it serves as an organizing logic that constitutes the nanoengineer as an inherently ethical actor, and nanoengineering as a benefactor of a universalized consumer-subject. I contribute an empirically grounded feminist science studies perspective on how material and discursive practices of innovation rationalize, define, and justify a new scientific discipline; how moral and ethical reasoning is figured within technical practices and pedagogies; and how sociocultural, historical, political, and technical imaginaries figure and are themselves refigured in the constitution of nanoengineering. My analysis is based on an ethnography I conducted from 2010-2014 of one of the world's first nanoengineering departments and its new undergraduate nanoengineering major, located at the University of California, San Diego. This included observing most of the undergraduate courses; conducting 85 interviews with faculty, students, and administrators; observing a nanoengineering laboratory; participating in department meetings and events; collaborating with the department to produce a new department newsletter; and analyzing the media used in the department and curriculum. More specifically, my dissertation chapters examine how popular culture is enrolled in the consolidation of a new discipline; how a particular ethos, with a moral stance and value positions, gets taught in the context of technical education; how liberal and neoliberal logics of rational individualism, autonomy, and the invisible hand get worked into the material and discursive practices of self-assembly in the nanoengineering laboratory; how the institutional goal of producing human capital manifests in the undergraduate major in the form of entrepreneurialism; how translational research as a paradigm of innovation becomes the right tool for the job of aligning nanoengineering's commitments to innovation and utility with the institutional imperative to produce intellectual capital; and how the higher-ed science classroom is an important site for considering the ethics and politics of knowledge production. I present my work in both prose and graphic novel style narrative illustration.

The influence of diet composition upon growth and development of sandhill cranes

USGS Publications Warehouse

Serafin, J.A.

1982-01-01

Experiments were conducted to evaluate the effect of protein, metabolizable energy, and sulfur amino acid content of five diets upon growth and development of captive Florida Sandhill Crane (Grus canadensis pratensis) and Greater Sandhill Crane (G. c. tabida) chicks raised under controlled conditions. A high protein (32%) diet resulted in faster growth than that obtained when a lower protein (24%) ration was supplied. Florida Sandhill Crane chicks fed a diet containing 2,160 kcal/kg grew significantly slower than chicks fed a ration containing 2,830 kcal/kg. Reducing the sulfur amino acid content of a ration containing 24% protein from 0.88% to 0.73% significantly slowed the growth of young cranes. A 17% incidence of leg disorders and a 25% incidence of wing abnormalities occurred between 7 and 28 days of age among Greater Sandhill Cranes fed a high protein diet. Florida Sandhill Cranes grew slower than Greater Sandhill Cranes irrespective of the type of ration they were provided and did not develop leg or wing abnormalities. Abnormalities invariably developed only in the most rapidly growing Greater Sandhill Cranes. Diets that promoted slower growth reduced the incidence of abnormalities. A ration formulated to contain a low (0.73%) sulfur amino acid level appeared to be the most suitable for slowing growth rates of captive-reared Sandhill Cranes and reducing the risk of abnormaiwing or leg development.

Milk Production of Ettawah Grade Goat Fed Diet Containing Different Protein and Energy Contents Supplemented with Organic Mineral and Grapes Seed Oil

NASA Astrophysics Data System (ADS)

Muktiani, A.; Kusumanti, E.; Harjanti, D. W.

2018-02-01

This study aimed to investigate the effect of different protein and energy contents and supplementation ofZinc (Zn), Chromium (Cr) and grapes seed oil on milk production in dairy goat.Randomized block design(RBD) was used in this study. Twelve lactating Ettawah crossbreed goats divided into three groupsbased on milk production. The treatment ration were:T1 = ration containing 16% CPand 66% TDN; T2 = ration containing 14% CP and 63% TDN supplemented with Zn 20 ppm + Cr 2 ppm; and T3 = T2 + 22 ml grapes seed oil/head/day. The ration wasa dry complete feed in the form of pellet. The feed ingredients used were rice bran, cassava, wheat pollard, soybean meal, coconut meal, molasses, coffee husk and corn straw.Experiment was conducted over 30 days. Results revealed that the goat fed the ration supplemented with Zn and Cr(T2) producehigher milk yield (1012.29 g/day) and better in milk fat production (P<0.05)compared to those fedT1 and T3. Feed intake was decreased in treatment supplemented with grapes seed oil in the T3 (P<0.05), but no significant in milk fat production compared with T1. In conclusion,drycomplete feed containingof CP 14%, TDN 63% supplemented with Zn 20 ppm + Cr 2ppm is recommended for lactating dairy goat.

Optimal design of piezoelectric transformers: a rational approach based on an analytical model and a deterministic global optimization.

PubMed

Pigache, Francois; Messine, Frédéric; Nogarede, Bertrand

2007-07-01

This paper deals with a deterministic and rational way to design piezoelectric transformers in radial mode. The proposed approach is based on the study of the inverse problem of design and on its reformulation as a mixed constrained global optimization problem. The methodology relies on the association of the analytical models for describing the corresponding optimization problem and on an exact global optimization software, named IBBA and developed by the second author to solve it. Numerical experiments are presented and compared in order to validate the proposed approach.

[The effect of pectin and cellulose on the metabolism of lipids and complex carbohydrates under experimental conditions].

PubMed

Burmeĭstere, M F; Zhikhare, L Iu; Feldmane, L E; Breĭde, B S

1976-01-01

Experiments conducted with albino rats have evidenced that under the effect of an atherogenic ration the level of lipids and cholesterol in the blood plasma and hepatic tissue and of sillac acids in the blood plasma increased. In the aortic intima the content of acid mucopolysaccharides was rising, this being attended by a concurrent swelling of the main interstitial substance and of the collagen fibers in the subendothelial layer. An addition of apple pectin or of cellulose to the atherogenic ration deferred the development of the mentioned changes.

Effects of rational-emotive therapy on psychophysiological and reported measures of test anxiety arousal.

PubMed

Barabasz, A F; Barabasz, M

1981-07-01

Developed audio taped lectures, taped therapy session models, and homework assignments designed to reduce irrational beliefs associated with test anxiety within Ellis' rational-emotive therapy (RET) approach. The initial sample consisted of 148 university students. Comparisons with an attention placebo counseling program, which was established to be equally credible by a post-experiment inquiry and a no-treatment group found the RET Ss to show significantly lower skin conductance responses to a test anxiety visualization and lower reported anxiety on a questionnaire. However, skin conductance responses to an alternative test anxiety visualization did not show treatment effects.

Neither Humean nor (Fully) Kantian be: Reply to Cuypers

ERIC Educational Resources Information Center

Siegel, Harvey

2005-01-01

In this paper I reply to Stefaan Cuypers' explication and critique of my views on rationality and critical thinking (Cuypers, 2004). While Cuypers' discussion is praiseworthy in several respects, I argue that it (1) mistakenly attributes to me a Humean view of (practical) reason, and (2) unsuccessfully argues that my position lacks the resources…

Evaluating Learning and Teaching: Institutional Needs and Individual Practices

ERIC Educational Resources Information Center

Bamber, Veronica; Anderson, Sally

2012-01-01

Rather than a rational, technical activity, evaluation reflects the socio-political dynamics of the evaluative context. This presents a challenge for universities and the individuals within them, who may assume that plans or policies for evaluation will result in straightforward outcomes. This small-scale study in one institution looks at the…

Education of the Emotions: The Rationality of Feeling.

ERIC Educational Resources Information Center

Best, David

1988-01-01

Addresses the question of whether education of the emotions is a coherent possibility. Argues that much confusion on the topic derives from the common myth of the separate and opposed faculties of feeling and reason, often reflected in misguided curriculum practice. Finds that education of emotions is a crucially important possibility, requiring…

Schools under Pressure: The External Environment and Recent Organizational Reforms.

ERIC Educational Resources Information Center

Salganik, Laura H.

Reductions in resources and increases in external demands place schools under pressure that can be relieved to some extent by organizational changes. When resources are sufficient, these changes may take the form of technical rationality--that is, decisions concerning policy and practices are made on the basis of neutral, measurable data rather…

Factors that Contribute to Undergraduate Student Success

ERIC Educational Resources Information Center

Dearnley, Christine; Matthew, Bob

2007-01-01

In this paper, we report on the outcomes of a study that was designed to explore the significant characteristics of a nursing professional development programme, which was perceived as having a successful outcome in terms of student attrition, academic attainment, practice development, and motivation for study. We provide a rational for the study,…

The Doctoral Thesis and Supervision: The Student Perspective

ERIC Educational Resources Information Center

Kiguwa, Peace; Langa, Malose

2009-01-01

The doctoral thesis constitutes both a negotiation of the supervision relationship as well as mastery and skill in participating in a specific community of practice. Two models of supervision are discussed: the technical rationality model with its emphasis on technical aspects of supervision, and the negotiated order model with an emphasis on…