Evidence based or person centered? An ontological debate

Evidence based medicine (EBM) is under critical debate, and person centered healthcare (PCH) has been proposed as an improvement. But is PCH offered as a supplement or as a replacement of EBM? Prima facie PCH only concerns the practice of medicine, while the contended features of EBM also include methods and medical model. I here argue that there are good philosophical reasons to see PCH as a radical alternative to the existing medical paradigm of EBM, since the two seem committed to conflicting ontologies. This paper aims to make explicit some of the most fundamental assumptions that motivate EBM and PCH, respectively, in order to show that the choice between them ultimately comes down to ontological preference. While EBM has a solid foundation in positivism, or what I here call Humeanism, PCH is more consistent with causal dispositionalism. I conclude that if there is a paradigmatic revolution on the way in medicine, it is first of all one of ontology

IPPs: The Real Issues

Since May 1998, an important issue facing Pakistan policy-makers has been whether independent power producers (IPPs) produce expensive electricity. It is contended that IPPs’ expensive power has rendered the state utility, Water and Power Development Authority (WAPDA), bankrupt. It is also alleged that IPPs indulged in corruption and colluded with WAPDA officials to get their signatures on contracts which allowed procurement of expensive power by WAPDA and which it can ill afford now. This paper shifts through the rhetoric surrounding IPPs and focuses on the central issue of whether IPPs produce expensive power. If it can be established that IPPs produce cheaper power than WAPDA, then the second part of the argument that WAPDA became financially weak because of IPPs’ expensive power is destroyed. The alleged corruption issues are not discussed as they are beyond the scope of the paper. Section 1 provides a background to the establishment of the private power sector in Pakistan. Section 2 discusses various project risks faced by shareholders and lenders. Section 3 outlines the components of the electricity tariff. Section 4 traces the reasons for increase in electricity tariffs since 1994 when the Power Purchase Agreements (PPA) were signed. Section 5 shows the comparative costs of production of IPPs and WAPDA.

Health initiatives to target obesity in surface transport industries: review and implications for action

Lifestyle-related chronic diseases pose a considerable burden to the individual and the wider society, with correspondingly negative effects on industry. Obesity is a particular problem for the Australasian road and rail industries where it is associated with specific cardiac and fatigue-related safety risks, and levels are higher than those found in the general population. Despite this recognition, and the introduction of National Standards, very little consensus exists regarding approaches to preventative health for surface transport workers. A review of evidence regarding effective health promotion initiatives is urgently needed to inform best practice in this cohort. This review draws together research informing the scope and effectiveness of health promotion programs, initiatives and interventions targeting overweight and obesity in safety critical surface transport domains including the truck, bus and rail industries. A number of health interventions demonstrated measurable successes, including incentivising, peer mentoring, verbal counselling, development of personalised health profiles, and offer of healthier on-site food choices – some of which also resulted in sizeable return on investment over the long term. &nbsp

Adaptive System Identification using Markov Chain Monte Carlo

One of the major problems in adaptive filtering is the problem of system identification. It has been studied extensively due to its immense practical importance in a variety of fields. The underlying goal is to identify the impulse response of an unknown system. This is accomplished by placing a known system in parallel and feeding both systems with the same input. Due to initial disparity in their impulse responses, an error is generated between their outputs. This error is set to tune the impulse response of known system in a way that every change in impulse response reduces the magnitude of prospective error. This process is repeated until the error becomes negligible and the responses of both systems match. To specifically minimize the error, numerous adaptive algorithms are available. They are noteworthy either for their low computational complexity or high convergence speed. Recently, a method, known as Markov Chain Monte Carlo (MCMC), has gained much attention due to its remarkably low computational complexity. But despite this colossal advantage, properties of MCMC method have not been investigated for adaptive system identification problem. This article bridges this gap by providing a complete treatment of MCMC method in the aforementioned context

Polymorphism and danger susceptibility of system call DASTONs

We have proposed a metaphor “DAnger Susceptible daTa codON� (DASTON) in data subject to processing by Danger Theory (DT) based Artificial Immune System (DAIS). The DASTONs are data chunks or data point sets that actively take part to produce “danger�; here we abstract “danger� as required outcome. To have closer look to the metaphor, this paper furthers biological abstractions for DASTON. Susceptibility of DASTON is important parameter for generating dangerous outcome. In biology, susceptibility of a host to pathogenic activities (potentially dangerous activities) is related to polymorphism. Interestingly, results of experiments conducted for system call DASTONs are in close accordance to biological theory of polymorphism and susceptibility. This shows that computational data (system calls in this case) exhibit biological properties when processed with DT point of view

New Local Government System: A Step Towards Community Empowerment?

Failure of the central/provincial governments to adequately capture local preferences and provide basic services strengthened the case for a new local government system for delivery of public services along with the authority to impose fees, taxes, user charges, etc. to finance these services. The new System aims at transferring political, administrative and fiscal powers1 from higher tiers of the government to lower tiers (Figure 1) in order to bring governments closer to common citizens for greater accountability and better understanding of the needs and preferences of people. National Reconstruction Bureau (NRB) was entrusted the task of designing a local government system which presented its first blue print in the form of “Devolution Plan 2000”. As a result of this exercise a new Local Government System has been installed in Pakistan on 14th August 2001 after the promulgation of Local Government Ordinance 2001 by all the four Provinces. The new System comprises a District Government or a City District Government and Zila Council in a district, Tehsil Municipal Administration and Tehsil Council in a tehsil (a Town Municipal Administration and Town Council in a town in a city district) and Union Administration and Union Council in a union. Village/Neighbourhood councils provide an interface with the lowest tier of the Local Government (Union Administration) with the community.

The Twin Deficits Phenomenon: Evidence from Pakistan

Like most developing countries a steady budget deficit in Pakistan is the primary cause of all major ills of the economy. It has varied between 5.4 to 8.7 percent during last two decades. On the other hand the current account deficit varied between 2.7 to 7.2 percent during the same period. The variations in fiscal policy can lead to predictable developments in an open economy’s performance on current account, remains a controversial issue. An important aspect of this issue concerns what is termed as twin deficit analysis, according to which fiscal deficits and current account balances are very closely related so that reductions in the former are both necessary and sufficient to obtain improved performance in the later. Theoretical work on the relationship that exist between variations in fiscal policy and the current account balance has been based upon two types of models. These models are constructed from postulated behavioural relationships that purport to describe how the economy works in aggregate without explaining the behaviour of agents who make up the economy.