The Evolution Of Science: A Systems Approach

This thesis is concerned with two interrelated sets of problems: (1) How can we have knowledge in a universe of processes? (2) How can knowledge be improved, and how is scientific progress possible?;To address the epistemological question in conjunction with the ontological is not a common approach in contemporary philosophy of science. I therefore begin the dissertation by arguing that these two areas of philosophy are intimately interrelated, and that the one-sided concentration on epistemological issues has led to an unsatisfactory account of the nature of knowledge. In particular it has led to a conflation of epistemology with methodology. I argue that methodologies carry with themselves certain presuppositions concerning the nature of the world and of human beings.;I suggest that we should attempt to construct a philosophical system within which epistemology and ontology mutually support one another. Insights derived from modern science provide us with a basis for the construction of such a system.;I begin this task by arguing that scientific knowledge can be viewed as an extension of perception. Relying on insights derived from Gregory and Piaget I emphasize the constructive characteristics of our perceptual system and argue that they find their counterpart in the constructive nature of modern science.;Having outlined a constructivist view of knowledge I turn to the discussion of the ontological issues.;I propose as an alternative the adoption of a metaphysics of processes. I outline such an ontology, basing my model upon ideas derived from Prigogine\u27s research on dissipative structures and Pattee\u27s investigation of hierarchical organization. I explain how dissipative structures create stability in an instable world and link this insight to the constructive features of our perceptual and conceptual systems.;The resulting model shows how knowledge is possible in the strange world of processes which we probably inhabit. It further shows how knowledge can be improved and what progress through evolution means. This issue is pursued in greater detail in the last part of the Dissertation There I expound Waddington\u27s cybernetic model of evolutionary change and show how it finds its counterpart in cognitive evolution

Development and psychometric evaluation of an observational coding system measuring person-centred care in spouses of people with dementia

YesBackground: The notion of person-centered care has been important in investigating relationships between people with dementia and paid carers, and measures are available to assess this. It has been suggested that person-centered care may be a useful construct to apply to understand family-care relationships. However, no measures of person-centered care in this context exist. The study aimed to develop an observational measure of person-centered care for this purpose. Method: First, a coding system incorporating a range of behaviors that could be considered person-centered or non-person-centered was constructed. Examples included a code relating to whether the person with dementia was involved in planning a task, and a code relating to how the spouse responded to confusion/distress. Second, 11 couples, where one partner had a dementia, were recruited and videotaped cooperating on an everyday task. The system was applied to the care-giving spouse's behaviors, labeling examples of behavior as person-centered or non-person-centered. The final step involved assessing the inter-rater reliability of the system. Results: The system captured nine categories of behavior, which were each divided into person-centered and non-person-centered types. The system had good reliability (Cohen's κ coefficients were: 0.65 for category and whether behaviors needed to be placed in a category; 0.81 for category excluding the decision about whether behaviors needed to be placed in a category; and 0.79 in relation to whether behaviors were person-centered or non-person-centered.) Conclusions: Although the small sample size limits the implications of the results, the system is a promising quantitative measure of spousal person-centered care

17 Tipps wie man Kinder erzieht - Welche Erziehungsstrategien setzen Eltern ein?

Untersucht wird, welche der im Triple P-Gruppentraining vermittelten Erziehungsstrategien von den Eltern im Alltag umgesetzt werden. Die Daten stammen aus dem Projekt "Zukunft Familie", in dem die längerfristige Wirksamkeit des Elterntrainings in einer kontrollierten Studie an 280 Familien untersucht wurde. Insgesamt nahmen 144 Eltern am Gruppentraining teil und füllten vor, direkt nach der Intervention und bei der Ein-Jahres-Katamnese Kursbeurteilungs- bzw. Fragebogen zu den Erziehungsstrategien aus. Die Ergebnisse zeigten, dass die positiven Erziehungsstrategien zur Förderung der kindlichen Entwicklung bereits vor dem Training weiter verbreitet waren als die Tipps zum Umgang mit kindlichem Problemverhalten. Über 90 Prozent der Eltern praktizierten die positiven Erziehungsstrategien auch bei der Ein-Jahres-Nachuntersuchung. Darüber hinaus gab es eine signifikante Abnahme bei der Verwendung der "Auszeit"-Strategie. (ZPID

Systemische Mykosen bei Patienten nach Knochenmarktransplantation und unter Intensivtherapie

Invasive Pilzinfektionen stellen ein großes Problem bei Transplantatempfängern dar. Candida und Aspergillus spp. sind die häufigsten pathogenen Pilze bei Patienten nach KMT und Organtransplantationen. Diese Infektionen sind durch eine hohe Morbidität und Mortalität gekennzeichnet, insbesondere bei Patienten mit persistierender Granulozytopenie und damit jene nach allogener KMT. Die Mortalitätsrate kann durch eine Frühdiagnostik und durch Gabe einer geeigneten Therapie wesentlich reduziert werden. Die Symptome und Zeichen einer systemischen Pilzinfektion sind bei Transplantatempfängern untypisch. Die serologische Diagnostik von invasiven Candidosen oder Aspergillosen stellt eine zusätzliche Möglichkeit zur klinischen Untersuchung und anderen diagnostischen Maßnahmen dar. Diese Untersuchung umfasste 252 Patienten (17 Patienten nach KMT) und 235 Patienten von Intensivtherapiestationen (z. B. nach Organtransplantationen) in den Jahren 1991-1994 von der Humboldt-Universität zu Berlin (Charite). Die Patientenseren wurden routinemäßig auf das Vorkommen einer Candida- und Aspergillus Antigenämie geprüft. Zum Nachweis von zirkulierendem Galactomannan wurde ein Latex Agglutinationstest- Pastorex Candida und Aspergillus, Sanofi Diagnostics Pasteur, genutzt. Invasive Aspergillus-Pilzinfektionen wurden bei acht von 235 Patienten unter Intensivtherapie gefunden. Alle acht Patienten mit invasiver Aspergillose hatten einen positiven Aspergillus-Antigen-Test. Der direkte Nachweis von Antigenbestandteilen von Candida oder Aspergillus spp. erwies sich als vielversprechender frühdiagnostischer Test bei kritisch kranken und immunsupprimierten Patienten.Invasive fungal infections are a major problem in transplant recipients. Candida and Aspergillus spp. are the most common fungal pathogens causing infection in patients undergoing BMT or solid organ transplantation. These infections are characterised by high morbidity and mortality, especially in patients with persistent granulocytopenia and in these receiving allogeneic bone marrow transplant. The mortality rate can be substantially reduced if an early diagnosis is made and the proper therapy given. The symptoms and signs of deep fungal infection in the transplant recipients are unreliable and often absent regardless of the type of organism or the site of infection. Laboratory tests are essential to establish the diagnosis of invasive fungal infection. The serological diagnosis of invasive candidosis or aspergillosis is at best an adjunct to clinical evaluation and other diagnostic procedures. The study comprises 252 patients undergoing allogeneic bone marrow transplantation (17 patients) and 235 patients from intensive care units (for instance after solid organ transplantation) in the years 1991-1994 at the Humboldt-University of Berlin (Charité). The serum of the patients were routinely screened for the occurrence of Candida and Aspergillus antigenemia (circulating galactomannan was detected using a latex agglutination test-Pastorex Candida and Aspergillus, Sanofi Diagnostics Pasteur). Invasive Aspergillus fungal infection was found in eight of the 235 intensive care patients. All these eight patients with invasive aspergillosis had an positive Aspergillus antigen test. The direct detection of antigenic components of Aspergillus and Candida spp. in serum appears promising as an early diagnostic test in critical ill and immunocompromised patients

Das Verhältnis von Kunst und Politik in Österreich am Beispiel der Wiener Gruppe

Die vorliegende Arbeit beschäftigt sich mit dem Verhältnis zwischen Kunst und Politik, welches exemplarisch Anhand des Wirkens und Schaffens der Wiener Gruppe erarbeitet wurde. Die Akteure der Wiener Gruppe schlossen sich im Jahr 1955 zusammen. Die Mitglieder der Gruppe waren Friedrich Achleitner, H.C. Artmann, Konrad Bayer, Gerhard Rühm und Oswald Wiener. Gemeinsam veranstalten sie Lesungen, „literarische cabarets“ und weitere Aktionen die in der Öffentlichkeit auf ein breites Echo stießen. Zum größten Teil wurde ihnen mit harscher Kritik begegnet - besonders von den Literaten der frühen Nachkriegszeit. Im Nachhinein allerdings werden sie als radikalste deutschsprachige Nachkriegsavantgarde bezeichnet. Immer wieder finden Ausstellungen statt, die sich mit der Wiener Gruppe beschäftigen. Zwar hatten die Akteure der Wiener Gruppe keinen unmittelbar politischen Anspruch in ihren Arbeiten und doch sind die Arbeiten im höchsten Grade als politisch zu sehen. Moderne Kunst und damit auch die Kunst der Wiener Gruppe regt den Menschen zum Denken an, gerade weil sie oft nicht leicht verständlich ist. Damit trägt die Kunst zu einer Intellektualisierung der gesamten Gesellschaft bei. Der Konsumenten dieser Kunst wird angeregt Gestalter der Gesellschaft zu werden. Und weil nun diese Kunst Denkarbeit voraussetzt und damit den Intellekt fördert und zwar aller Menschen die diese Kunst konsumieren, ist die moderne Kunst als tendenziell demokratisch zu sehen. Anhand dieser Überlegungen ist das Verhältnis von Kunst und Politik festzustellen

Universelle Prävention kindlicher Verhaltensstörungen durch Elterntrainings: Wirksamkeit nach 10 Jahren aus Sicht von Müttern, Vätern und Jugendliche

Background: Mental problems in children are widespread and cannot be reduced through treatment only. Prevention is therefore urgently needed although it is unclear how effective such strategies may be, particularly in the long term. Aim: Can a parent-centered universal prevention program that is effective in the short term also yield effects after 10 years? Method: According to their preschool location, N = 477 families were randomly assigned to the parent training prevention program (Triple P Positive Parenting Program, TP; Sanders, 2012) or the control group (CG). In all, 77% accepted the TP offer (T+), while 23% declined it (T‐). The 10-year effectiveness of the program was established with self-report measures of mothers, fathers, and adolescents from N = 361 families. Results: The intention-to treat analysis (comparison TP vs. CG) yielded negligible findings. By contrast, the differential analysis from the T+ mothers’ perspective found long-term improvements in Child Behavior Checklist (CBCL) internalizing and externalizing behavior and relationship satisfaction in comparison with CG and T- mothers. At 10 years, compared with pre-assessment, T+ mothers reported the smallest increase in the CBCL sum score of internalizing and externalizing behaviors, 5%, while CG (20%) and T- (33%) mothers reported far higher rates. Contrary to the hypotheses, parenting behavior did not change over time. T+ fathers reported improvements in parenting behavior, while adolescents reported negligible outcomes. Conclusion: The results support the long-term effectiveness of the TP program as a universal prevention intervention, at least from the T+ mothers’ perspective. More research should be conducted with the T- families because they showed worse outcomes than the control group

Long-term outcome of a randomized controlled universal prevention trial through a positive parenting program: is it worth the effort?

Hahlweg K, Heinrichs N, Kuschel A, Bertram H, Naumann S. Long-term outcome of a randomized controlled universal prevention trial through a positive parenting program: is it worth the effort? Child and Adolescent Psychiatry and Mental Health. 2010;4(1): 14.Background Approximately 20% of children experience internalizing or externalizing DSM-IV-TR disorders. This prevalence rate cannot be reduced through treatment only. Effective preventive interventions are therefore urgently needed. The aim of the current investigation is to evaluate the two-year efficacy of the group Triple P parenting program administered universally for the prevention of child behavior problems. Methods Based on their respective preschool, N = 280 families were randomly assigned either to the parent training or to the control group. The efficacy was analyzed using multi-source assessments, including questionnaires by mother and father, behavioral observation of mother-child interaction, and teacher evaluations. Results At the 2-year follow-up, both parents in the Triple P intervention reported significant reductions in dysfunctional parenting behavior, and mothers also an increase in positive parenting behavior. In addition, mothers reported significant reductions in internalizing and externalizing child behavior. Single-parent mothers in the Triple P intervention did not report significant changes in parenting or child problem behavior which is primarily due to inexplicable high positive effects in single parent mothers of the control group. Neither mother-child interactions nor teacher ratings yielded significant results. Conclusions The results support the long-term efficacy of the Triple P - group program as a universal prevention intervention for changing parenting behavior in two-parent households, but not necessarily in single-parent mothers

In Absentia: an Exploratory Study of How Patients are Considered in Multidisciplinary Cancer Team Meetings

Background: Multidisciplinary team meetings and shared decision-making are potential means of delivering patient-centred care. Not much is known about how those two paradigms fit together in cancer care. This study aimed to investigate how decisions are made in multidisciplinary team meetings and whether patient perspectives are incorporated in these decisions. Materials and Methods: A qualitative study was conducted using non-participant observation at multidisciplinary team meetings (also called tumor boards) at the University Cancer Center Hamburg-Eppendorf, Germany. Two researchers recorded structured field notes from a total of N = 15 multidisciplinary team meetings. Data were analyzed using content analysis and descriptive statistics. Results: Physicians mainly exchanged medical information and based their decision-making on this information. Individual patient characteristics or their treatment preferences were rarely considered or discussed. In the few cases where patient preferences were raised as a topic, this information did not seem to be taken into account in decision-making processes about treatment recommendations. Conclusion: The processes in multidisciplinary team meetings we observed did not exhibit shared decision-making. Patient perspectives were absent. If multidisciplinary team meetings wish to become more patient-centred they will have to modify their processes and find a way to include patient preferences into the decision-making process