Zagzebski on Rationality

This paper examines Linda Zagzebski’s account of rationality, as set out in her rich, wide-ranging, and important book, Epistemic Authority: A Theory of Trust, Authority, and Autonomy in Belief. We briefly describe the account that she offers and then consider its plausibility. In particular, in the first section we argue that a number of Zagzebski’s claims with regard to rationality require more support than she offers for them. Moreover, in the second section, we contend that far from offering Zagzebski a quick way of dealing with radical scepticism, her account of rationality actually seems to be particularly vulnerable to this problem

Influence Of Fall Grazing By Sheep On Plant Productivity, Shrub Age Class Structure And Herbaceous Species Diversity In Sagebrush Steppe

Managing Wyoming Big Sagebrush (Artemisia tridentata ssp. wyomingensis) systems biologically with grazing can potentially reduce costs and increase both biodiversity and understory production as well as rejuvenate Wyoming Big Sagebrush (ARTRWY). Sheep were provided a protein-energy supplement to facilitate use of the secondary metabolites found in ARTRWY forage. Phytomass ( ) was estimated for the following plant categories: total phytomass, current annual growth (CAG) of ARTRWY, the woody portion of ARTRWY, CAG of other shrubs, the woody portion of other shrubs, grasses, forbs, litter, and standing dead material. I also measured plant species richness and abundance, as well as estimates of the age class structure of sagebrush. One year following grazing, total phytomass decreased by 43%, due primarily to the reduction of ARTRWY. The CAG of ARTRWY decreased by 66%, while grasses increased by 43%, forbs increased 60%, and the number of species encountered in the grazed plots increased 42%

Quantum dot clusters as single-molecules: deciphering collective fluorescence and energy transfer signatures

2016 Fall.Includes bibliographical references.Applications of quantum dot nanocrystals span from the individual single-molecule use to large, densely-packed bulk solids. Already, the fluorescence behavior of individual particles is complex and nuanced, particularly involving the blinking phenomenon. When particles are combined into higher-order structures where interaction may occur, a complete description becomes intractable. However, clusters---between two and ten particles---can be effective model systems to explore the local behaviors that occur in larger networks. A benefit of small clusters is the viability of using single-molecule spectroscopic techniques, which are often more informative than bulk measurements. In this work we combine fluorescence microscopy with structure-probing electron microscopy to elucidate the fluorescence dynamics clusters of semiconductor nanocrystals. The spectral characteristics of clusters are explored in the context of an energy transfer model showing low-intensity emission is blue-shifted, corresponding to the weaker emission from donor particles with a larger band gap. Because energy transfer depends intimately on the specific topographical structure of the cluster, the inter-particle spacing, and relative alignment, characterization of specific cluster behavior is better informed by correlated measurements. Next, we present the mapping results from super-resolution microscopy where the spatial distributions of fluorescence in the sub-10 nanometer realm is clearly correlated with scanning electron microscopy imaging of the same clusters. Stochastic blinking events enable such observations. The enhanced blinking associated with energy transfer has practical implications for donor and acceptor roles in clusters. Finally, the dynamic evolution of the emission dipole orientation for single nanocrystals and nanocrystal clusters is measured. The orientation signature suggests coupling strengths and constitutes a first-step towards determining corrections to Förster resonant energy transfer theory involving nanocrystals

Using shared goal setting to improve access and equity: a mixed methods study of the Good Goals intervention

Background: Access and equity in children’s therapy services may be improved by directing clinicians’ use of resources toward specific goals that are important to patients. A practice-change intervention (titled ‘Good Goals’) was designed to achieve this. This study investigated uptake, adoption, and possible effects of that intervention in children’s occupational therapy services. Methods: Mixed methods case studies (n = 3 services, including 46 therapists and 558 children) were conducted. The intervention was delivered over 25 weeks through face-to-face training, team workbooks, and ‘tools for change’. Data were collected before, during, and after the intervention on a range of factors using interviews, a focus group, case note analysis, routine data, document analysis, and researchers’ observations. Results: Factors related to uptake and adoptions were: mode of intervention delivery, competing demands on therapists’ time, and leadership by service manager. Service managers and therapists reported that the intervention: helped therapists establish a shared rationale for clinical decisions; increased clarity in service provision; and improved interactions with families and schools. During the study period, therapists’ behaviours changed: identifying goals, odds ratio 2.4 (95% CI 1.5 to 3.8); agreeing goals, 3.5 (2.4 to 5.1); evaluating progress, 2.0 (1.1 to 3.5). Children’s LoT decreased by two months [95% CI −8 to +4 months] across the services. Cost per therapist trained ranged from £1,003 to £1,277, depending upon service size and therapists’ salary bands. Conclusions: Good Goals is a promising quality improvement intervention that can be delivered and adopted in practice and may have benefits. Further research is required to evaluate its: (i) impact on patient outcomes, effectiveness, cost-effectiveness, and (ii) transferability to other clinical contexts

A systematic review and meta-analysis of the effectiveness of pharmacist-led medication reconciliation in the community after hospital discharge

BACKGROUND Pharmacists’ completion of medication reconciliation in the community after hospital discharge is intended to reduce harm due to prescribed or omitted medication and increase healthcare efficiency, but the effectiveness of this approach is not clear. We systematically review the literature to evaluate intervention effectiveness in terms of discrepancy identification and resolution, clinical relevance of resolved discrepancies and healthcare utilisation, including readmission rates, emergency department attendance and primary care workload. DESIGN Systematic literature review and meta-analysis of extracted data. METHODS Medline, CINHAL, EMBASE, AMED, ERIC, SCOPUS, NHS evidence and the Cochrane databases were searched using a combination of Medical Subject Heading (MeSH) terms and free text search terms. Controlled studies evaluating pharmacist-led medication reconciliation in the community after hospital discharge were included. Study quality was appraised using CASP. Evidence was assessed through meta-analysis of readmission rates. Discrepancy identification rates, emergency department attendance and primary care workload were assessed narratively. RESULTS Fourteen studies were included comprising five RCTs, six cohort studies and three pre-post intervention studies. Twelve studies had a moderate or high risk of bias. Increased identification and resolution of discrepancies was demonstrated in the four studies where this was evaluated. Reduction in clinically relevant discrepancies was reported in two studies. Meta-analysis did not demonstrate a significant reduction in readmission rate. There was no consistent evidence of reduction in emergency department attendance or primary care workload. CONCLUSIONS Pharmacists can identify and resolve discrepancies when completing medication reconciliation after hospital discharge but patient outcome or care workload improvements were not consistently seen. Future research should examine the clinical relevance of discrepancies and potential benefits on reducing healthcare team workload