Collapsing Arguments for Facts and Propositions

Kurt Gödel argues in “Russell’s Mathematical Logic” that on the assumption that, contrary to Russell, definite descriptions are terms, it follows given only several “apparently obvious axioms” that “all true sentences have the same signification (as well as all false ones).” Stephen Neale has written that this argument, and others by Church, Davidson, and Quine to similar conclusions, are of considerable philosophical interest. Graham Oppy, responding to this opinion, says they are of minimal interest. Falling between these is my opinion that implications of these arguments for propositions and facts are of moderate philosophical interest, and that these arguments provide occasions for reflection of possible interest on fine lines of several theories of definite descriptions and class–abstractions

Collapsing Arguments for Facts and Propositions

Kurt Gödel argues in “Russell’s Mathematical Logic” that on the assumption that, contrary to Russell, definite descriptions are terms, it follows given only several “apparently obvious axioms” that “all true sentences have the same signification (as well as all false ones).” Stephen Neale has written that this argument, and others by Church, Davidson, and Quine to similar conclusions, are of considerable philosophical interest. Graham Oppy, responding to this opinion, says they are of minimal interest. Falling between these is my opinion that implications of these arguments for propositions and facts are of moderate philosophical interest, and that these arguments provide occasions for reflection of possible interest on fine lines of several theories of definite descriptions and class–abstractions

Consumer Stockpiling and Sales Promotions

In retailing markets of storable goods, consumer behavior is typically characterized by stockpiling. While existing research has developed rich models for such strategic consumer behavior, little is known about how sellers should ideally respond to it. In this paper, we provide insights into how frequency and depth of promotions affect consumer purchases and seller revenues in the long run. We show an application to the U.S. market for laundry detergent. We use estimates from a structural dynamic demand model to simulate different pricing policies and find that in the detergent market, an increase in promotion depth is more effective than a change in promotion length. Our results suggest that this finding can be translated to markets with a large heterogeneity in storage costs and steady consumption rates

A research agenda to improve incidence and outcomes of assisted vaginal birth

Access to emergency obstetric care, including assisted vaginal birth and caesarean birth, is crucial for improving maternal and childbirth outcomes. However, although the proportion of births by caesarean section has increased during the last few decades, the use of assisted vaginal birth has declined. This is particularly the case in low- and middle-income countries, despite an assisted vaginal birth often being less risky than caesarean birth. We therefore conducted a three-step process to identify a research agenda necessary to increase the use of, or reintroduce, assisted vaginal birth: after conducting an evidence synthesis, which informed a consultation with technical experts who proposed an initial research agenda, we sought and incorporated the views of women's representatives of this agenda. This process has allowed us to identify a comprehensive research agenda, with topics categorized as: (i) the need to understand women's perceptions of assisted vaginal birth, and provide appropriate and reliable information; (ii) the importance of training health-care providers in clinical skills but also in respectful care, effective communication, shared decision-making and informed consent; and (iii) the barriers to and facilitators of implementation and sustainability. From women's feedback, we learned of the urgent need to recognize labour, childbirth and postpartum experiences as inherently physiological and dignified human processes, in which interventions should only be implemented if necessary. The promotion and/or reintroduction of assisted vaginal birth in low-resource settings requires governments, policy-makers and hospital administrators to support skilled health-care providers who can, in turn, respectfully support women in labour and childbirth. [Abstract copyright: (c) 2023 The authors; licensee World Health Organization.

Opportunities lost: Barriers to increasing the use of effective contraception in the Philippines.

BackgroundIn the Philippines, one in four pregnancies are unintended and 610 000 unsafe abortions are performed each year. This study explored the association between missed opportunities to provide family planning counseling, quality of counseling and its impact on utilization of effective contraception in the Philippines.MethodsOne-hundred-one nationally representative health facilities were randomly selected from five levels of the health system. Sexually-active women 18-49 years old, wanting to delay or limit childbearing, attending primary care clinics between April 24 and August 8, 2017 were included. Data on contraceptive use, counseling and availability were collected using interviews and facility assessments. Effective contraceptive methods were defined as those with rates of unintended pregnancy of less than 10 per 100 women in first year of typical use.Findings849 women were recruited of whom 51.1% currently used effective contraceptive methods, 20.6% were former effective method users and 28.3% had never used an effective method. Of 1664 cumulative clinic visits reported by women in the previous year, 72.6% had a missed opportunity to receive family planning counseling at any visit regardless of level of facility, with 83.7% having a missed counseling opportunity on the day of the interview. Most women (55.9%) reported health concerns about modern contraception, with 2.9% receiving counseling addressing their concerns. Only 0.6% of former users and 2.1% never-users said they would consider starting a modern contraceptive in the future. Short and long acting reversible contraceptive methods were available in 93% and 68% of facilities respectively.ConclusionsMissed opportunities to provide family planning counseling are widespread in the Philippines. Delivery of effective contraceptive methods requires that wider legal, policy, social, cultural, and structural barriers are addressed, coupled with systems approaches for improving availability and quality of counseling at all primary health care contacts

Early Essential Newborn Care Is Associated With Reduced Adverse Neonatal Outcomes in a Tertiary Hospital in Da Nang, Viet Nam: A Pre- Post- Intervention Study

Background: To accelerate reductions in neonatal mortality, Viet Nam rolled out early essential newborn care (EENC) using clinical coaching, quality improvement assessments in hospitals, and updated protocols. Da Nang Hospital for Women and Children, a tertiary referral hospital in central Viet Nam, compared outcomes pre- and post-EENC introduction. Methods: Records of live births and NICU admissions were reviewed pre- (November 2013–October 2014) and post- (November 2014–October 2015) EENC implementation. Delivery room practices, NICU admissions and adverse outcomes on NICU admission were compared using descriptive statistics. Findings: A total of 13,201 live births were delivered pre- and 14,180 live births post-EENC introduction. Post-EENC, delivery practice scores, rates of early and prolonged skin-to-skin contact and early breastfeeding rose significantly. There was a significant reduction in risk of NICU admissions (relative risk [RR] 0.68; 95% confidence interval [CI] 0.64–0.71; p < 0.0001), hypothermia on NICU admission (RR 0.72; 95% CI 0.65–0.81, p < 0.0001) and sepsis (RR 0.28; 95% CI 0.23–0.35, p < 0.0001). Exclusive breastfeeding rates in NICU increased from 49% to 88% (p < 0.0001) and of kangaroo mother care (KMC) from 52% to 67% (p < 0.0001). Reduced formula use resulted in decreased monthly costs. Interpretation: EENC introduction, including staff coaching, quality improvement assessments and changes in hospital protocols and environments, were associated with improved clinical practices, reduced NICU admissions, admissions with hypothermia and sepsis and increased rates of exclusive breastfeeding and KMC in the NICU. Funding: Data collection was funded by the World Health Organization Western Pacific Regional Office and Newborns Vietnam. Outstanding Questions: • What is the impact of the package of early essential newborn care interventions on newborn mortality? • What are the total direct and indirect cost savings of early essential newborn care implementation? • What is the cost effectiveness of kangaroo mother care for preterm and low birth weight babies? • What strategies can help reduce unnecessary cesarean sections in hospitals? Keywords: Early essential newborn care, Neonatal care unit, Newborn health outcomes, Clinical practice, Quality of care, Viet Na