The prevalence and nature of prescribing and monitoring errors in English general practice – a retrospective case note review

Objective To determine the prevalence and nature of prescribing and monitoring errors in general practices in England. Design Retrospective case note review of unique medication items prescribed over a 12 month period to a 2% random sample of patients. Mixed effects logistic regression was used to analyse the data. Setting Fifteen general practices across three primary care trusts in England. Data sources Examination of 6048 unique prescription items prescribed over the previous 12 months for 1777 patients. Main outcome measures Prevalence of prescribing and monitoring errors, and severity of errors, using validated definitions. Results Prescribing and/or monitoring errors were detected in 4.9% (296/6048) of all prescription items (95% confidence interval 4.4 - 5.5%). The vast majority of errors were of mild to moderate severity, with 0.2% (11/6048) of items having a severe error. After adjusting for covariates, patient-related factors associated with an increased risk of prescribing and/or monitoring errors were: age less than 15 (Odds Ratio (OR) 1.87, 1.19 to 2.94, p=0.006) or greater than 64 years (OR 1.68, 1.04 to 2.73, p=0.035), and higher numbers of unique medication items prescribed (OR 1.16, 1.12 to 1.19, p<0.001). Conclusion Prescribing and monitoring errors are common in English general practice, although severe errors are unusual. Many factors increase the risk of error. Having identified the most common and important errors, and the factors associated with these, strategies to prevent future errors should be developed based on the study findings.

Post-normal science and the art of nature conservation

Nature conservation may be considered a post-normal science in that the loss of biodiversity and increasing environmental degradation require urgent action but are characterised by uncertainty at every level. An ‘extended peer community’ with varying skills, perceptions and values are involved in decision-making and implementation of conservation, and the uncertainty involved limits the effectiveness of practice. In this paper we briefly review the key ecological, philosophical and methodological uncertainties associated with conservation, and then highlight the uncertainties and gaps present within the structure and interactions of the conservation community, and which exist mainly between researchers and practitioners, in the context of nature conservation in the UK. We end by concluding that an openly post-normal science framework for conservation, which acknowledges this uncertainty but strives to minimise it, would be a useful progression for nature conservation, and recommend ways in which knowledge transfer between researchers and practitioners can be improved to support robust decision making and conservation enactment.

On the quasi-periodic nature of magnetopause flux transfer events

The recurrence rate of flux transfer events (FTEs) observed near the dayside magnetopause is discussed. A survey of magnetopause observations by the ISEE satellites shows that the distribution of the intervals between FTE signatures has a mode value of 3 min, but is highly skewed, having upper and lower decile values of 1.5 min and 18.5 min, respectively. The mean value is found to be 8 min, consistent with previous surveys of magnetopause data. The recurrence of quasi-periodic events in the dayside auroral ionosphere is frequently used as evidence for an association with magnetopause FTEs, and the distribution of their repetition intervals should be matched to that presented here if such an association is to be confirmed. A survey of 1 year's 15-s data on the interplanetary magnetic field (IMF) suggests that the derived distribution could arise from fluctuations in the IMF Bz component, rather than from a natural oscillation frequency of the magnetosphere-ionosphere system.

Experimental philosophy of language

Experimental philosophy of language uses experimental methods developed in the cognitive sciences to investigate topics of interest to philosophers of language. This article describes the methodological background for the development of experimental approaches to topics in philosophy of language, distinguishes negative and positive projects in experimental philosophy of language, and evaluates experimental work on the reference of proper names and natural kind terms. The reliability of expert judgments vs. the judgments of ordinary speakers, the role that ambiguity plays in influencing responses to experiments, and the reliability of meta-linguistic judgments are also assessed.

Conjecture, proof, and sense in Wittgenstein's philosophy of mathematics

One of the key tenets in Wittgenstein’s philosophy of mathematics is that a mathematical proposition gets its meaning from its proof. This seems to have the paradoxical consequence that a mathematical conjecture has no meaning, or at least not the same meaning that it will have once a proof has been found. Hence, it would appear that a conjecture can never be proven true: for what is proven true must ipso facto be a different proposition from what was only conjectured. Moreover, it would appear impossible that the same mathematical proposition be proven in different ways. — I will consider some of Wittgenstein’s remarks on these issues, and attempt to reconstruct his position in a way that makes it appear less paradoxical.

Applied philosophy of language

This chapter explores the extent to which philosophy of language can be considered an applied discipline. I consider, first, ways in which sub-sections of philosophy of language may be considered as applied in terms of their subject matter and/or the kinds of questions being addressed (e.g. philosophy of language which deals with derogatory or inflammatory uses of language, or the role of philosophy of language within feminist philosophy). Then, in the second part of the chapter, I turn to consider a more general (and perhaps more controversial) conception of philosophy of language as applied, which arises from the methodology adopted and the relationship of the discipline to empirical data.