A compendium of strategies to prevent healthcare-associated infections in acute care hospitals: 2014 updates

Since the publication of "A Compendium of Strategies to Prevent Healthcare-Associated Infections in Acute Care Hospitals" in 2008, prevention of healthcare-associated infections (HAIs) has become a national priority. Despite improvements, preventable HAIs continue to occur. The 2014 updates to the Compendium were created to provide acute care hospitals with up-to-date, practical, expert guidance to assist in prioritizing and implementing their HAI prevention efforts. They are the product of a highly collaborative effort led by the Society for Healthcare Epidemiology of America (SHEA), the Infectious Diseases Society of America (IDSA), the American Hospital Association (AHA), the Association for Professionals in Infection Control and Epidemiology (APIC), and The Joint Commission, with major contributions from representatives of a number of organizations and societies with content expertise, including the Centers for Disease Control and Prevention (CDC), the Institute for Healthcare Improvement (IHI), the Pediatric Infectious Diseases Society (PIDS), the Society for Critical Care Medicine (SCCM), the Society for Hospital Medicine (SHM), and the Surgical Infection Society (SIS).

Anthropogenic perturbation of the carbon fluxes from land to ocean

A substantial amount of the atmospheric carbon taken up on land through photosynthesis and chemical weathering is transported laterally along the aquatic continuum from upland terrestrial ecosystems to the ocean. So far, global carbon budget estimates have implicitly assumed that the transformation and lateral transport of carbon along this aquatic continuum has remained unchanged since pre-industrial times. A synthesis of published work reveals the magnitude of present-day lateral carbon fluxes from land to ocean, and the extent to which human activities have altered these fluxes. We show that anthropogenic perturbation may have increased the flux of carbon to inland waters by as much as 1.0 Pg C yr(-1) since pre-industrial times, mainly owing to enhanced carbon export from soils. Most of this additional carbon input to upstream rivers is either emitted back to the atmosphere as carbon dioxide (similar to 0.4 Pg C yr(-1)) or sequestered in sediments (similar to 0.5 Pg C yr(-1)) along the continuum of freshwater bodies, estuaries and coastal waters, leaving only a perturbation carbon input of similar to 0.1 Pg C yr(-1) to the open ocean. According to our analysis, terrestrial ecosystems store similar to 0.9 Pg C yr(-1) at present, which is in agreement with results from forest inventories but significantly differs from the figure of 1.5 Pg C yr(-1) previously estimated when ignoring changes in lateral carbon fluxes. We suggest that carbon fluxes along the land-ocean aquatic continuum need to be included in global carbon dioxide budgets.

A compendium of strategies to prevent healthcare-associated infections in acute care hospitals: 2014 updates.

Since the publication of "A Compendium of Strategies to Prevent Healthcare-Associated Infections in Acute Care Hospitals" in 2008, prevention of healthcare-associated infections (HAIs) has become a national priority. Despite improvements, preventable HAIs continue to occur. The 2014 updates to the Compendium were created to provide acute care hospitals with up-to-date, practical, expert guidance to assist in prioritizing and implementing their HAI prevention efforts. They are the product of a highly collaborative effort led by the Society for Healthcare Epidemiology of America (SHEA), the Infectious Diseases Society of America (IDSA), the American Hospital Association (AHA), the Association for Professionals in Infection Control and Epidemiology (APIC), and The Joint Commission, with major contributions from representatives of a number of organizations and societies with content expertise, including the Centers for Disease Control and Prevention (CDC), the Institute for Healthcare Improvement (IHI), the Pediatric Infectious Diseases Society (PIDS), the Society for Critical Care Medicine (SCCM), the Society for Hospital Medicine (SHM), and the Surgical Infection Society (SIS).

Later Wittgenstein's Anti-Philosophical Therapy

The object of this essay is to discuss Ludwig Wittgenstein's remarks in Philosophical Investigations and elsewhere in the posthumously published writings concerning the role of therapy in relation to philosophy. Wittgenstein's reflections seem to suggest that there is a kind of philosophy or mode of investigation targeting the philosophical grammar of language uses that gratuitously give rise to philosophical problems, and produce in many thinkers philosophical anxieties for which the proper therapy is intended to offer relief. Two possible objectives of later Wittgensteinian therapy are proposed, for subjective psychological versus objective semantic symptoms of ailments that a therapy might address for the sake of relieving philosophical anxieties. The psychological in its most plausible form is rejected, leaving only the semantic. Semantic therapy in the sense defined and developed is more general and long-lasting, and more in the spirit of Wittgenstein's project on a variety of levels. A semantic approach treats language rather than the thinking, language-using subject as the patient needing therapy, and directs its attention to the treatment of problems in language and the conceptual framework a language game use expresses in its philosophical grammar, rather than to soothing unhappy or socially ill-adjusted individual psychologies.

Computable Diagonalizations and Turing’s Cardinality Paradox

A. N. Turing’s 1936 concept of computability, computing machines, and computable binary digital sequences, is subject to Turing’s Cardinality Paradox. The paradox conjoins two opposed but comparably powerful lines of argument, supporting the propositions that the cardinality of dedicated Turing machines outputting all and only the computable binary digital sequences can only be denumerable, and yet must also be nondenumerable. Turing’s objections to a similar kind of diagonalization are answered, and the implications of the paradox for the concept of a Turing machine, computability, computable sequences, and Turing’s effort to prove the unsolvability of the Entscheidungsproblem, are explained in light of the paradox. A solution to Turing’s Cardinality Paradox is proposed, positing a higher geometrical dimensionality of machine symbol-editing information processing and storage media than is available to canonical Turing machine tapes. The suggestion is to add volume to Turing’s discrete two-dimensional machine tape squares, considering them instead as similarly ideally connected massive three-dimensional machine information cells. Three-dimensional computing machine symbol-editing information processing cells, as opposed to Turing’s two-dimensional machine tape squares, can take advantage of a denumerably infinite potential for parallel digital sequence computing, by which to accommodate denumerably infinitely many computable diagonalizations. A three-dimensional model of machine information storage and processing cells is recommended on independent grounds as better representing the biological realities of digital information processing isomorphisms in the three-dimensional neural networks of living computers.

Newton’s Metaphysics of Space as God’s Emanative Effect

In several of his writings, Isaac Newton proposed that physical space is God’s “emanative effect” or “sensorium,” revealing something interesting about the metaphysics underlying his mathematical physics. Newton’s conjectures depart from Plato and Aristotle’s metaphysics of space and from classical and Cambridge Neoplatonism. Present-day philosophical concepts of supervenience clarify Newton’s ideas about space and offer a portrait of Newton not only as a mathematical physicist but an independent-minded rationalist philosopher.

Intentionality in Reference and Action

This essay asks whether there is a relation between action-serving and meaning-serving intentions. The idea that the intentions involved in meaning and action are nominally designated alike as intentionalities does not guarantee any special logical or conceptual connections between the intentionality of referential thoughts and thought-expressive speech acts with the intentionality of doing. The latter category is typified by overt physical actions in order to communicate by engaging in speech acts, but also includes at the origin of all artistic and symbolic expression such cerebral and linguistic doings as thinking propositional thoughts. There are exactly four possibilities by which meaning and action intentionalities might be related to be systematically investigated. Meaning-serving and action-serving intentionalities, topologically speaking, might exclude one another, partially overlap with one another, or subsume one in the other or the other in the one. The theoretical separation of the two ostensible categories of intendings is criticized, as is their partial overlap, in light of the proposal that thinking and artistic and symbolic expression are activities that favor the inclusion of paradigm meaning-serving intentions as among a larger domain of action-serving intentions. The only remaining alternative is then developed, of including action-serving intentions reductively in meaning-serving intentions, and is defended as offering in an unexpected way the most cogent universal reductive ontology in which the intentionality of doing generally relates to the specific intentionality of referring in thought to the objects of predications, and of its artistic and symbolic expression.

Socrates on the Moral Mischief of Misology

In Plato’s dialogues, the Phaedo, Laches, and Republic, Socrates warns his interlocutors about the dangers of misology. Misology is explained by analogy with misanthropy, not as the hatred of other human beings, but as the hatred of the logos or reasonable discourse. According to Socrates, misology arises when a person alternates between believing an argument to be correct, and then refuting it as false. If Socrates is right, then misanthropy is sometimes instilled when a person goes from trusting people to learning that others sometimes betray our reliance and expectations, and finally not to placing any confidence whatsoever in other people, or, in the case of misology, in the correctness or trustworthiness of arguments. A cynical indifference to the soundness of arguments generally is sometimes associated with Socrates’ polemical targets, the Sophists, at least as Plato represents Socrates’ reaction to these itinerant teachers of rhetoric, public speaking and the fashioning of arguments suitable to any occasion. Socrates’ injunctions against misology are largely moral, pronouncing it ‘shameful’ and ‘very wicked’, and something that without further justification we must ‘guard against’, maintaining that we will be less excellent persons if we come to despise argument as lacking the potential of leading to the truth. I examine Socrates’ moral objections to misology which I show to be inconclusive. I consider instead the problem of logical coherence in the motivations supposedly underlying misology, and conclude that misology as Socrates intends the concept is an emotional reaction to argumentation on the part of persons who have not acquired the logical dialectical skills or will to sort out good from bad arguments. We cannot dismiss argument as directed toward the truth unless we have a strong reason for doing so, and any such argument must itself presuppose that at least some reasoning can be justified in discovering and justifying belief in interesting truths. The relevant passages from Socrates’ discussion of the soul’s immortality in the Phaedo are discussed in detail, and set in scholarly background against Socrates’ philosophy more generally, as represented by Plato’s dialogues. I conclude by offering a suggestive list of practical remedies to avoid the alienation from argument in dialectic with which Socrates is concerned.

Against Logically Possible World-Relativized Existence

The thesis that entities exist in, at, or in relation to logically possible worlds is criticized. The suggestion that actually nonexistent fictional characters might nevertheless exist in nonactual merely logically possible worlds runs afoul of the most general transworld identity requirements. An influential philosophical argument for the concept of world-relativized existence is examined in Alvin Plantinga’s formal development and explanation of modal semantic relations. Despite proposing an attractive unified semantics of alethic modality, Plantinga’s argument is rejected on formal grounds as supporting materially false actual existence assertions in the case of actually nonexistent objects in the framework of Plantinga’s own underlying classical predicate-quantificational logic.