Definite Descriptions and the Gettier Example

This paper challenges the first Gettier counterexample to the tripartite account of knowledge. Noting that 'the man who will get the job' is a description and invoking Donnellan's distinction between their 'referential' and 'attributive' uses, I argue that Smith does not actually believe that the man who will get the job has ten coins in his pocket. Smith's ignorance about who will get the job shows that the belief cannot be understood referentially, his ignorance of the coins in his pocket shows that it cannot be understood attributively. An explanation for why Smith appeared to have justified true belief is given by distinguishing between 'belief' and 'belief in truth'. Smith believes the sentence 'the man who will get the job has ten coins in his pocket' to be true (he mistakenly believes that Jones will get the job, of whom he knows that he has ten coins in his pocket) (hence his 'belief'), the sentence is true (hence 'truth'), and he has sufficient reason to assent to it (hence his 'justification'). But he does not believe the proposition expressed. Hence he does not know it eithe

Market Dominance and Barriers To Competition in Financial Trading Venues

The Market in Financial Instruments Directive (MiFID) aims to increase competition and to foster client protection in the European financial market. Among other provisions, it abolishes the concentration rule and challenges the market ower of existing trading venues. The directive introduces venue competition in order to achieve better execution and ultimately lower trading costs. In this paper I address the question of whether fostering competition between alternative trading venues alone may or not be able to impact actual competition in the market. I consider two reasons for why it may not: direct network effects together with increasing returns to scale, and post-trading constraints. In particular, I (a) evaluate the actual degree of competition between trading venues, (b) measure the impact of network effects on competition, and lastly (c) assess the barriers to competition induced to post-trading constraints. The results imply that financial intermediaries tend to value liquidity more (than total fees) when deciding where to route a given order for execution - implying that being the incumbent venue translates into a competitive advantage. Furthermore, eliminating the mentioned barriers to competition seems to be associated with a significant decrease (of similar magnitude) in the asymetry of the industry

The depression report: a new deal for depression and anxiety disorders.

Crippling depression and chronic anxiety are the biggest causes of misery in Britain today. They are the great submerged problem, which shame keeps out of sight. But if you mention them, you soon discover how many families are affected. According to the respected Psychiatric Morbidity Survey, one in six of us would be diagnosed as having depression or chronic anxiety disorder, which means that one family in three is affected. That is the bad news. The good news is that we now have evidence-based psychological therapies that can lift at least a half of those affected out of their depression or their chronic fear. These new therapies are not endless nor backwardlooking treatments. They are short, forward-looking treatments that enable people to challenge their negative thinking and build on the positive side of their personalities and situations. The most developed of these therapies is cognitive behaviour therapy (CBT). The official guidelines from the National Institute for Clinical Excellence (NICE) say these treatments should be available to all people with depression or anxiety disorders or schizophrenia, unless the problem is very mild or recent. But the NICE guidelines cannot be implemented because we do not have enough therapists. In most areas waiting lists for therapy are over nine months, or there is no waiting list at all because there are no therapists. So, if you go to the GP, all that can be provided is medication (plus at some surgeries a little counselling). But many people will not take medication, either because they dislike the side effects or because they want to control their own mood. The result is tragic. Only one in four of those who suffer from depression or chronic anxiety is receiving any kind of treatment. The rest continue to suffer, even though at least half of them could be cured at a cost of no more than £750. This is a waste of people’s lives. It is also costing a lot of money. For depression and anxiety make it difficult or impossible to work, and drive people onto Incapacity Benefits. We now have a million people on Incapacity Benefits because of mental illness – more than the total number of unemployed people receiving unemployment benefits. At one time unemployment was our biggest social problem, but we have done a lot to reduce it. So mental illness is now the biggest problem, and we know what to do about it. It is time to use that knowledge. 2 But can we afford the £750 it costs to treat someone? The money which the government spends will pay for itself. For someone on Incapacity Benefit costs us £750 a month in extra benefits and lost taxes. If the person works just a month more as a result of the treatment, the treatment pays for itself. So we have a massive problem – the biggest problem they have for one in three of our families. But we also have a solution that can improve the lives of millions of families, and cost the taxpayer nothing. We should implement the NICE guidelines; and most people with mental illness should be offered the choice of psychological therapy. Everyone who wants something done should write to their MP calling for action.

How should we evaluate research on counselling and the treatment of depression? A case study on how NICE’s draft 2018 guideline considered what counts as best evidence

Background: Health guidelines are developed to improve patient care by ensuring the most recent and “best available evidence” is used to guide treatment recommendations (NICE Guidance, 2017). NICE’s revised guideline development methodology acknowledges that evidence needed to answer one question (treatment efficacy) may be different from evidence needed to answer another (cost effectiveness, treatment acceptability to patients; NICE, 2014/2017). This review uses counselling in the treatment of depression as a case study, and interrogates the constructs of ‘best’ evidence and ‘best’ guideline methodologies. Method: The review comprises six sections: (1) the implications of diverse definitions of counselling in research; (2) research findings from meta-analyses and randomised controlled trials (RCTs); (3) limitations to trials-based evidence; (4) findings from large routine outcome datasets; (5) the inclusion of qualitative research that emphasises service-user voices; and (6) conclusions and recommendations. Results: Research from meta-analyses and RCTs reviewed in the draft 2018 NICE guideline is limited but positive in relation to the effectiveness of counselling in the treatment for depression. The weight of evidence suggests little, if any, advantage to CBT over counselling once bias and researcher allegiance are taken into account. A growing body of evidence from large NHS datasets also evidences that counselling is both effective and cost-effective when delivered in NHS settings. Conclusion: Recommendations in NICE’s own updated procedures suggest that sole reliance on RCTs and meta-analyses as best methodologies is no longer adequate. There is a need to include large standardised collected datasets from routine practice as well as the voice of patients via high-quality qualitative research

Competencies for food graduate careers: developing a language tool

Unlike many other graduate career pathways in the UK, the food industry does not have a cohesive competency framework to support employers, students and degree providers. Food sciences-based technical graduates are a significant proportion of the industry’s graduate intake; this study aims to provide such a framework. Initial work involving a sample of representative stakeholders has created a list of typical attributes and associated definitions that may be desirable in food sciences graduates. Material was gathered by semi-structured qualitative interviews and analysed by thematic analysis followed by a modified Delphi technique. The resulting framework is tailored to needs and terminology prevalent in food industry employment. The process employed could be utilised for building other vocational graduate competency frameworks. Further plans include using the framework to ascertain the important elements for typical graduate entry roles, better informing students about desirable qualities and supporting future competency-based curriculum review

Whose responsibility is adolescent's mental health in the UK? The perspectives of key stakeholders

The mental health of adolescents is a salient contemporary issue attracting the attention of policy makers in the UK and other countries. It is important that the roles and responsibilities of agencies are clearly established, particularly those positioned at the forefront of implementing change. Arguably, this will be more efective if those agencies are actively engaged in the development of relevant policy. An exploratory study was conducted with 10 focus groups including 54 adolescents, 8 mental health practitioners and 16 educational professionals. Thematic analysis revealed four themes: (1) mental health promotion and prevention is not perceived to be a primary role of a teacher; (2) teachers have limited skills to manage complex mental health difculties; (3) adolescents rely on teachers for mental health support and education about mental health; and (4) the responsibility of parents for their children’s mental health. The research endorses the perspective that teachers can support and begin to tackle mental well-being in adolescents. However, it also recognises that mental health difculties can be complex, requiring adequate funding and support beyond school. Without this support in place, teachers are vulnerable and can feel unsupported, lacking in skills and resources which in turn may present a threat to their own mental well-being

Financial Times Industrial Ordinary Share Index, 1969

Abstract copyright UK Data Service and data collection copyright owner.The purpose of this dataset is to create a price index of the equities of leading industrial and commercial companies covering a wide range of industry and distribution in Britain.Main Topics:Closing share prices are recorded for the following: Associated Portland Cement, Beecham, Boots Pure Drug, Bowater Paper, British Leyland Motor, British Oxygen, Courtalds, Distillers, Dunlop, Electric and Musical Industries, General Electric and English Electric, Glaxo, Guest Keen and Nettlefolds, Hawker Siddeley, Alfred Herbert, Marks and Spencer, Imperial Chemical Industries, Imperial Tobacco, London Brick, Peninsular and Oriental, Plessey, Spillers, Rolls Royce, Tate and Lyle, Tube Investments, Turner and Newall, United Drapery Stores, Vickers, Watney Mann, F W Woolworth.<br

An evidence-based approach to the use of telehealth in long-term health conditions: development of an intervention and evaluation through pragmatic randomised controlled trials in patients with depression or raised cardiovascular risk

Background: Health services internationally are exploring the potential of telehealth to support the management of the growing number of people with long-term conditions (LTCs). Aim: To develop, implement and evaluate new care programmes for patients with LTCs, focusing on two common LTCs as exemplars: depression or high cardiovascular disease (CVD) risk. Methods Development: We synthesised quantitative and qualitative evidence on the effectiveness of telehealth for LTCs, conducted a qualitative study based on interviews with patients and staff and undertook a postal survey to explore which patients are interested in different forms of telehealth. Based on these studies we developed a conceptual model [TElehealth in CHronic disease (TECH) model] as a framework for the development and evaluation of the Healthlines Service for patients with LTCs. Implementation: The Healthlines Service consisted of regular telephone calls to participants from health information advisors, supporting them to make behaviour change and to use tailored online resources. Advisors sought to optimise participants’ medication and to improve adherence. Evaluation: The Healthlines Service was evaluated with linked pragmatic randomised controlled trials comparing the Healthlines Service plus usual care with usual care alone, with nested process and economic evaluations. Participants were adults with depression or raised CVD risk recruited from 43 general practices in three areas of England. The primary outcome was response to treatment and the secondary outcomes included anxiety (depression trial), individual risk factors (CVD risk trial), self-management skills, medication adherence, perceptions of support, access to health care and satisfaction with treatment. Trial results Depression trial: In total, 609 participants were randomised and the retention rate was 86%. Response to treatment [Patient Health Questionnaire 9-items (PHQ-9) reduction of ≥ 5 points and score of < 10 after 4 months] was higher in the intervention group (27%, 68/255) than in the control group (19%, 50/270) [odds ratio 1.7, 95% confidence interval (CI) 1.1 to 2.5; p = 0.02]. Anxiety also improved. Intervention participants reported better access to health support, greater satisfaction with treatment and small improvements in self-management, but not improved medication adherence. CVD risk trial: In total, 641 participants were randomised and the retention rate was 91%. Response to treatment (maintenance of/reduction in QRISK®2 score after 12 months) was higher in the intervention group (50%, 148/295) than in the control group (43%, 124/291), which does not exclude a null effect (odds ratio 1.3, 95% CI 1.0 to 1.9; p = 0.08). The intervention was associated with small improvements in blood pressure and weight, but not smoking or cholesterol. Intervention participants were more likely to adhere to medication, reported better access to health support and greater satisfaction with treatment, but few improvements in self-management. The Healthlines Service was likely to be cost-effective for CVD risk, particularly if the benefits are sustained, but not for depression. The intervention was implemented largely as planned, although initial delays and later disruption to delivery because of the closure of NHS Direct may have adversely affected participant engagement. Conclusion: The Healthlines Service, designed using an evidence-based conceptual model, provided modest health benefits and participants valued the better access to care and extra support provided. This service was cost-effective for CVD risk but not depression. These findings of small benefits at extra cost are consistent with previous pragmatic research on the implementation of comprehensive telehealth programmes for LTCs