Ten Years of The Philosophical Foundations Mini-Track at AMCIS - Some Patterns

The Origins The first decade of the Philosophical Foundations mini-track at AMCIS has come to an end. Ten years of a lively discourse on a variety of topics hinging on philosophy, systems theory and ethics have left the core supporters of the track emotionally attached to the community of participants and the international effort that first grew out of the frustration of four individuals (Bunker et al., 2004, 2005) who felt strongly about promoting a more philosophical, systems-theoretical and ethical agenda for the information systems research field. At the time, it was difficult to find conference forums or publishing outlets for articles that built upon philosophy, systems theory or ethics. The general feeling amongst the founding members of the track was that the IS field considered ideas of many world-class philosophers too detached from IS research practice to be interesting or important. Similarly, systems theory had fallen out of fashion despite the fact that the very ideas of a computer and an information system originated from the concepts of that theory. Globa

Tidal energy machines: A comparative life cycle assessment

Marine energy in the UK is currently undergoing a period of exponential growth in terms of development and implementation. The current installed tidal energy capacity of around 4MW is expected to rise to provide up to 20% of the UK’s electricity demand by 2050 [5]. With this in mind, there is a huge range of energy devices, all seemingly promoted by their developers as the best method of extracting power from the ocean. Embodied energy is an important aspect of any power producing device or process, and is used to describe the amount of energy required to begin and maintain the process of energy generation. Until a device or process has generated this amount of energy it cannot be said to be a net contributor of energy. This work used Life Cycle Assessment to study four tidal energy devices, representing a cross section of the existing designs, and compares their embodied energy and carbon dioxide emissions. In order to ensure a fair comparison, a hypothetical installation site is used, with conditions typical of those found at potential array installation sites in the UK. The designs studied include a multi-blade turbine, two three blade horizontal axis turbine machines, and an Archimedes’ screw device. These machines were chosen to represent a cross section of device, foundation, installation and operation designs. They have all been developed to prototype stage, meaning that actual manufacturing data is available. Embodied energy is considered over the entire lifetime of each device, beginning with extraction of raw materials. Energy use from fabrication, transport, installation, lifetime maintenance, end-of-life decommissioning and recycling are all calculated, and compared to the energy generation from each device at the test site. Finally, the embodied energy; CO2 intensity; and energy payback periods are compared to those of conventional power generating systems as well as other renewable energy sources. A range of data sources are used. Embodied energy of steel has been provided by the World Steel Association. Of the four devices studied, all were found to achieve CO2 and energy payback within the first 12 years of their lifetime, and exhibited CO2 intensity of between 18 and 35 gCO2/kWh. This compares favourably to many current energy sources, and is likely to fall as technology improves, array size increases and industry experience progresses

Ongoing Initiatives to Improve the Quality and Efficiency of Medicine Use within the Public Healthcare System in South Africa; A Preliminary Study

Introduction: South Africa has an appreciable burden of both communicable and non-communicable diseases as well as high maternal, neonatal, and child morbidity. In recent years there have been significant strides with improving the public health system, and addressing current inequalities, with the right to health a constitutional provision in South Africa. Initiatives include the introduction of National Health Insurance, programmes to enhance access to medicines for patients with chronic diseases, as well as activities to improve care in hospitals, including improving pharmacovigilance. Consequently, the objective of this paper is to review ongoing initiatives within the public healthcare sector in South Africa and their influence to provide future direction.Method: Principally a structured review of current and planned activities.Results: There have been a number of major activities and initiatives surrounding the availability and access to medicines in the public system in recent years in South Africa. This includes a National Surveillance Centre and an innovative early warning system for the supply of medicines as well as the development of a National Health Care Pricing Authority and initiatives to improve contracting. There have also been developments to improve the supply chain including instigating Medicine Procurement Units in the provinces and enhancing forecasting capabilities. Access to medicines is improving though the instigation of stable chronic disease management initiatives to increase the number of external pick-up points for medicines. There are also ongoing programmes to enhance adherence to medicines as well as enhance adherence to the Standard Treatment Guidelines and the Essential Medicines List with their increasing availability. In addition, there is a movement to enhance the role of health technology assessment in future decision making. Hospital initiatives include increased focus on reducing antimicrobial resistance through instigating stewardship programmes as well as improving adverse drug reaction reporting and associated activities.Conclusion: Overall, there are an appreciable number of ongoing activities within the public healthcare system in South Africa attempting to ensure and sustain universal healthcare. It is too early to assess their impact, which will be the subject of future research

Well-being and philosophy of science

This article is a mutual introduction of the science of well-being to philosophy of science and an explanation of how the two disciplines can benefit each other. In the process I argue that the science of well-being is not helpfully viewed as a social or a natural, but rather as a mixed, science. Hence its methodology will have to attend to its specific features. I discuss two of its methodological problems: justifying the role of values, and validating measures. I suggest that tackling them calls for developing mid-level rather than high theories of well-being.This is the author's accepted manuscript and will be under embargo until 24 months after the date of publication. The final version is available from Wiley at onlinelibrary.wiley.com/doi/10.1111/phc3.12203/abstrac

A systematic review of strategies to recruit and retain primary care doctors

Background There is a workforce crisis in primary care. Previous research has looked at the reasons underlying recruitment and retention problems, but little research has looked at what works to improve recruitment and retention. The aim of this systematic review is to evaluate interventions and strategies used to recruit and retain primary care doctors internationally. Methods A systematic review was undertaken. MEDLINE, EMBASE, CENTRAL and grey literature were searched from inception to January 2015.Articles assessing interventions aimed at recruiting or retaining doctors in high income countries, applicable to primary care doctors were included. No restrictions on language or year of publication. The first author screened all titles and abstracts and a second author screened 20%. Data extraction was carried out by one author and checked by a second. Meta-analysis was not possible due to heterogeneity. Results 51 studies assessing 42 interventions were retrieved. Interventions were categorised into thirteen groups: financial incentives (n=11), recruiting rural students (n=6), international recruitment (n=4), rural or primary care focused undergraduate placements (n=3), rural or underserved postgraduate training (n=3), well-being or peer support initiatives (n=3), marketing (n=2), mixed interventions (n=5), support for professional development or research (n=5), retainer schemes (n=4), re-entry schemes (n=1), specialised recruiters or case managers (n=2) and delayed partnerships (n=2). Studies were of low methodological quality with no RCTs and only 15 studies with a comparison group. Weak evidence supported the use of postgraduate placements in underserved areas, undergraduate rural placements and recruiting students to medical school from rural areas. There was mixed evidence about financial incentives. A marketing campaign was associated with lower recruitment. Conclusions This is the first systematic review of interventions to improve recruitment and retention of primary care doctors. Although the evidence base for recruiting and care doctors is weak and more high quality research is needed, this review found evidence to support undergraduate and postgraduate placements in underserved areas, and selective recruitment of medical students. Other initiatives covered may have potential to improve recruitment and retention of primary care practitioners, but their effectiveness has not been established

Effect of second timed appointments for non-attenders of breast cancer screening in England : a randomised controlled trial

BACKGROUND: In England, participation in breast cancer screening has been decreasing in the past 10 years, approaching the national minimum standard of 70%. Interventions aimed at improving participation need to be investigated and put into practice to stop this downward trend. We assessed the effect on participation of sending invitations for breast screening with a timed appointment to women who did not attend their first offered appointment within the NHS Breast Screening Programme (NHSBSP). METHODS: In this open, randomised controlled trial, women in six centres in the NHSBSP in England who were invited for routine breast cancer screening were randomly assigned (1:1) to receive an invitation to a second appointment with fixed date and time (intervention) or an invitation letter with a telephone number to call to book their new screening appointment (control) in the event of non-attendance at the first offered appointment. Randomisation was by SX number, a sequential unique identifier of each woman within the NHSBSP, and at the beginning of the study a coin toss decided whether women with odd or even SX numbers would be allocated to the intervention group. Women aged 50-70 years who did not attend their first offered appointment were eligible for the analysis. The primary endpoint was participation (ie, attendance at breast cancer screening) within 90 days of the date of the first offered appointment; we used Poisson regression to compare the proportion of women who participated in screening in the study groups. All analyses were by intention to treat. This trial is registered with Barts Health, number 009304QM. FINDINGS: We obtained 33 146 records of women invited for breast cancer screening at the six centres between June 2, 2014, and Sept 30, 2015, who did not attend their first offered appointment. 26 054 women were eligible for this analysis (12 807 in the intervention group and 13 247 in the control group). Participation within 90 days of the first offered appointment was significantly higher in the intervention group (2861 [22%] of 12 807) than in the control group (1632 [12%] of 13 247); relative risk of participation 1·81 (95% CI 1·70-1·93; p<0·0001). INTERPRETATION: These findings show that a policy of second appointments with fixed date and time for non-attenders of breast screening is effective in improving participation. This strategy can be easily implemented by the screening sites and, if combined with simple interventions, could further increase participation and ensure an upward shift in the participation trend nationally. Whether the policy should vary by time since last attended screen will have to be considered. FUNDING: National Health Service Cancer Screening Programmes and Department of Health Policy Research Programme

Multifactorial Analysis of Differences Between Sporadic Breast Cancers and Cancers Involving BRCA1 and BRCA2 Mutations

Background: We have previously demonstrated that breast cancers associated with inherited BRCA1 and BRCA2 gene mutations differ from each other in their histopathologic appearances and that each of these types differs from breast cancers in patients unselected for family history (i.e., sporadic cancers). We have now conducted a more detailed examination of cytologic and architectural features of these tumors. Methods: Specimens of tumor tissue (5-µm-thick sections) were examined independently by two pathologists, who were unaware of the case or control subject status, for the presence of cell mitosis, lymphocytic infiltration, continuous pushing margins, and solid sheets of cancer cells; cell nuclei, cell nucleoli, cell necrosis, and cell borders were also evaluated. The resulting data were combined with previously available information on tumor type and tumor grade and further evaluated by multifactorial analysis. All statistical tests are two-sided. Results: Cancers associated with BRCA1 mutations exhibited higher mitotic counts (P = .001), a greater proportion of the tumor with a continuous pushing margin (P<.0001), and more lymphocytic infiltration (P = .002) than sporadic (i.e., control) cancers. Cancers associated with BRCA2 mutations exhibited a higher score for tubule formation (fewer tubules) (P = .0002), a higher proportion of the tumor perimeter with a continuous pushing margin (P<.0001), and a lower mitotic count (P = .003) than control cancers. Conclusions: Our study has identified key features of the histologic phenotypes of breast cancers in carriers of mutant BRCA1 and BRCA2 genes. This information may improve the classification of breast cancers in individuals with a family history of the disease and may ultimately aid in the clinical management of patients. [J Natl Cancer Inst 1998;90:1138-45

FCIC Official Transcript of the Hearing on Too Big to Fail : Expectations and Impact of Extraordinary Government Intervention and The Role of Systemic Risk in the Financial Crisis

This hearing is the first session in a series on Too Big to Fail : Expectations and Impact of Extraordinary Government Intervention and The Role of Systemic Risk in the Financial Crisis