Doctors' thinking about the system as a threat to patient safety

‘Systems thinking’ is an important feature of the emerging ‘patient safety’ agenda. As a key component of a ‘safety culture’, it encourages clinicians to look past individual error to recognise the latent factors that threaten safety. This paper investigates whether current medical thinking is commensurate with the idea of ‘systems thinking’ together with its implications for policy. The findings are based on qualitative semistructured interviews with specialist physicians working within one NHS District General Hospital in the English Midlands. It is shown that, rather then favouring a 'person-centred’ perspective, doctors readily identify ‘the system’ as a threat to patient safety. This is not necessarily a reflection of the prevailing safety discourse or knowledge of policy, but reflects a tacit understanding of how services are (dis)organised. This line of thinking serves to mitigate individual wrong-doing and protect professional credibility by encouraging doctors to accept and accommodate the shortcomings of the system, rather than participate in new forms of organisational learning.

La déconstruction de l'onto-théologie par Jacques Derrida : détour littéraire et mise en relief de la matrice langagière comme "différance"

Le mouvement derridien de la différance marque la rupture avec l'affirmation de la métaphysique de la présence, avec l'autorité du signifié transcendantal. Dans cet univers mouvant de signifiants qui se renvoient perpétuellement les uns aux autres, la logique d'univocité se disloque. La "présence" n'est que fantomatique, s'esquissant au sein d'une chaîne ininterrompue de signifiants et se laissant toujours creuser par la marque d'un irréductible manque. Face au logocentrisme, corollaire de l'affirmation de la présence, l'écriture se veut siège et articulation de la trace, d'une origine qui ne peut être que raturée, véhicule d'une irrémédiable fêlure. La volet littéraire de la déconstruction a pour but de mettre en évidence le fonctionnement de l'"indécidabilité" du discours, soit une certaine ambivalence dans la signification qui caractérise tout texte. L'objectif principal de la présente recherche est de fournir une compréhension plus approfondie de la déconstruction en insistant sur l'ancrage langagier de tout texte. Le discours philosophique n'échappe ainsi pas au mécanisme différentiel du langage et de la dérive métaphorique. La parenté entre la perspective déconstructiviste derridienne et la conception mallarméenne du langage poétique semble frappante. La mise en oeuvre, par Mallarmé, d'une dislocation de l'espace textuel, son minutieux "creusement" du vers après renoncement à toute quête d'"Idéal", la mise en relief du leurre de l'appropriation langagière, voilà qui trouve un écho particulier dans les thèses derridiennes. La "mimésis" platonicienne se voit au travers du prisme de la "mimique" mallarméenne. La déconstruction poursuit son travail de "luxation" de l'oreille philosophique, insérant les philosophèmes dans la matrice langagière, les livrant ainsi au hasard du cheminement textuel et les confrontant à l'aporie. La philosophie n'a alors d'autre choix que d'abandonner ses prétentions transcendantales. La marche de la "différance" instaure une inexorable distance qui prive le sujet de tout rapport direct avec une origine assurée et lui ôte toute possibilité de maîtrise sur le monde. Au travers de la langue, se profile la question de l'altérité, de la relation dissymétrique qui nous lie à cet "autre", ce "tout-autre" qui nous fonde et nous constitue. L'accueil inconditionnel de cette altérité nous mènera à l'étude de la "religion", la déconstruction se tournant vers le "religieux" tout en effectuant un "retournement" habile de tout credo essentialiste.

Reasoning over knowledge-based generation of situations in context spaces to reduce food waste

With the ever-growing amount of connected sensors (IoT), making sense of sensed data becomes even more important. Pervasive computing is a key enabler for sustainable solutions, prominent examples are smart energy systems and decision support systems. A key feature of pervasive systems is situation awareness which allows a system to thoroughly understand its environment. It is based on external interpretation of data and thus relies on expert knowledge. Due to the distinct nature of situations in different domains and applications, the development of situation aware applications remains a complex process. This thesis is concerned with a general framework for situation awareness which simplifies the development of applications. It is based on the Situation Theory Ontology to provide a foundation for situation modelling which allows knowledge reuse. Concepts of the Situation Theory are mapped to the Context Space Theory which is used for situation reasoning. Situation Spaces in the Context Space are automatically generated with the defined knowledge. For the acquisition of sensor data, the IoT standards O-MI/O-DF are integrated into the framework. These allow a peer-to-peer data exchange between data publisher and the proposed framework and thus a platform independent subscription to sensed data. The framework is then applied for a use case to reduce food waste. The use case validates the applicability of the framework and furthermore serves as a showcase for a pervasive system contributing to the sustainability goals. Leading institutions, e.g. the United Nations, stress the need for a more resource efficient society and acknowledge the capability of ICT systems. The use case scenario is based on a smart neighbourhood in which the system recommends the most efficient use of food items through situation awareness to reduce food waste at consumption stage.

"Ordinary people only": knowledge, representativeness and the publics of public participation in healthcare

Public involvement in healthcare is a prominent policy in countries across the economically developed world. A growing body of academic literature has focused on public participation, often presenting dichotomies between good and bad practice: between initiatives that offer empowerment and those constrained by consumerism, or between those which rely for recruitment on self-selecting members of the public, and those including a more broad-based, statistically representative group. In this paper I discuss the apparent tensions between differing rationales for participation, relating recent discussions about the nature of representation in public involvement to parallel writings about the contribution of laypeople’s expertise and experience. In the academic literature, there is, I suggest, a thin line between democratic justifications for involvement, suggesting a representative role for involved publics, and technocratic ideas about the potential ‘expert’ contributions of particular subgroups of the public. Analysing recent policy documents on participation in healthcare in England, I seek moreover to show how contemporary policy transcends both categories, demanding complex roles of involved publics which invoke various qualities seen as important in governing the interface between state and society. I relate this to social-theoretical perspectives on the relationship between governmental authority and citizens in late-modern society.

Scedo-Select III: a new semi-selective culture medium for detection of the Scedosporium apiospermum species complex

International audience

O cinema como recurso pedagógico na aula de história

Este estudo pretendeu pesquisar acerca da influência do cinema histórico de ficção na construção do conhecimento histórico de alunos de História A do Ensino Secundário. Foi realizado com uma turma do 10º ano de escolaridade de 20 alunos e foi antecedido de um estudo prévio. O trabalho baseou-se no visionamento do filme "O Gladiador" e na realização de fichas de trabalho: a "Ficha de Enquadramento Histórico do Filme", para contextualizar a época histórica em que decorria o filme; a "Ficha de Análise do Filme”, para recolha de dados e finalmente a "Ficha de Trabalho de Comparação entre Fontes Históricas e o Filme". As respostas fornecidas pelos alunos foram organizadas em categorias. Para as perguntas que pediam uma resposta mais directa e simples foram criadas três categorias: básica primária, básica secundária e definição elaborada. Para as perguntas que exigiam uma resposta mais complexa criaram-se cinco categorias: incoerente, básica primária, básica secundária, definição emergente e definição elaborada. As principais conclusões foram: a) o cinema de ficção desempenha um importante contributo na construção do conhecimento histórico dos alunos do ensino secundário; b) o visionamento de filmes de ficção na aula de História deve ser acompanhado com o confronto de fontes históricas para os alunos distinguirem ficção de conhecimento histórico; c) o cinema desempenha um papel muito importante no desenvolvimento das competências específicas de História do Ensino Secundário e do espírito crítico dos alunos; entre outras. / ABSTRACT: This study aimed to understand the influence of historical fiction movies in historical knowledge of students in History of Secondary Education. The study was conducted with a group of 20 students of the 1O th grade and was preceded by a preliminary study. The work was based on viewing the film Gladiator and on worksheets: A "Historical Background" to contextualize the historical era of the movie, the "The analysis of the Movie" to collect data and finally the “Comparison of Historical Sources and movie” worksheet to analyze distinguish fiction from historical knowledge. The responses given by students were categorized: for questions that asked for a more direct and simple answer were created three categories: Basic; Primary; Definition elaborated. For questions requiring a more complex answer were created five categories Incoherent; Basic; Primary; Emergent and Elaborated. The main conclusions were: a) the film fiction has an important contribution to historical knowledge of secondary school students, b) using films in history lessons should be accompanied with a comparison of historical sources for students to distinguish fiction from historical knowledge, c) the film plays an important role in the development of specific skills for the History of Secondary Education and the students' critical thinking, among others.

Une théologie de l’intime chez le baby-boomer québécois francophone issu de la tradition catholique : démarche qualitative descriptive

S’il est établi que le baby-boomer québécois francophone issu de la tradition catholique s’est distancié de cette dernière, nous observons aussi qu’il continue à s’y identifier à chaque recensement. Ce mémoire propose une démarche et des outils permettant de décrire l’expérience de foi de celui-ci. Il s’agit de la théologie de l’intime, dont la genèse et son expérimentation sont présentés dans le cadre d’une recherche conduite auprès de sujets appartenant à cette population. Cette approche s’articule à travers trois dialogues complémentaires et interdépendants : la quête de l’essence, la démarche d’incarnation et le défi identitaire. L’expérimentation démontre que le caractère pluridisciplinaire de la théologie de l’intime réussit à décrire de façon congruente l’expérience de foi de baby-boomers dont elle confirme aussi la cohérence, malgré le constat d’un décalage doctrinal avec le catholicisme. Le mémoire conclut en proposant d’autres perspectives d’application de la théologie de l’intime.

A PHENOMENOLOGY OF MIMETIC LEARNING AND MULTIMODAL COGNITION: INTEGRATING EXPERIENTIAL KNOWLEDGE INTO PROGRAMS IN RHETORIC, COMPOSITION, AND TECHNICAL COMMUNICATION

My dissertation emphasizes a cognitive account of multimodality that explicitly integrates experiential knowledge work into the rhetorical pedagogy that informs so many composition and technical communication programs. In these disciplines, multimodality is widely conceived in terms of what Gunther Kress calls “socialsemiotic” modes of communication shaped primarily by culture. In the cognitive and neurolinguistic theories of Vittorio Gallese and George Lakoff, however, multimodality is described as a key characteristic of our bodies’ sensory-motor systems which link perception to action and action to meaning, grounding all communicative acts in knowledge shaped through body-engaged experience. I argue that this “situated” account of cognition – which closely approximates Maurice Merleau-Ponty’s phenomenology of perception, a major framework for my study – has pedagogical precedence in the mimetic pedagogy that informed ancient Sophistic rhetorical training, and I reveal that training’s multimodal dimensions through a phenomenological exegesis of the concept mimesis. Plato’s denigration of the mimetic tradition and his elevation of conceptual contemplation through reason, out of which developed the classic Cartesian separation of mind from body, resulted in a general degradation of experiential knowledge in Western education. But with the recent introduction into college classrooms of digital technologies and multimedia communication tools, renewed emphasis is being placed on the “hands-on” nature of inventive and productive praxis, necessitating a revision of methods of instruction and assessment that have traditionally privileged the acquisition of conceptual over experiential knowledge. The model of multimodality I construct from Merleau-Ponty’s phenomenology, ancient Sophistic rhetorical pedagogy, and current neuroscientific accounts of situated cognition insists on recognizing the significant role knowledges we acquire experientially play in our reading and writing, speaking and listening, discerning and designing practices.

Assessing Decision Making Skill in Complex and Dynamic Environments Using Representative and Simulated Tasks

Traditional decision making research has often focused on one's ability to choose from a set of prefixed options, ignoring the process by which decision makers generate courses of action (i.e., options) in-situ (Klein, 1993). In complex and dynamic domains, this option generation process is particularly critical to understanding how successful decisions are made (Zsambok & Klein, 1997). When generating response options for oneself to pursue (i.e., during the intervention-phase of decision making) previous research has supported quick and intuitive heuristics, such as the Take-The-First heuristic (TTF; Johnson & Raab, 2003). When generating predictive options for others in the environment (i.e., during the assessment-phase of decision making), previous research has supported the situational-model-building process described by Long Term Working Memory theory (LTWM; see Ward, Ericsson, & Williams, 2013). In the first three experiments, the claims of TTF and LTWM are tested during assessment- and intervention-phase tasks in soccer. To test what other environmental constraints may dictate the use of these cognitive mechanisms, the claims of these models are also tested in the presence and absence of time pressure. In addition to understanding the option generation process, it is important that researchers in complex and dynamic domains also develop tools that can be used by `real-world' professionals. For this reason, three more experiments were conducted to evaluate the effectiveness of a new online assessment of perceptual-cognitive skill in soccer. This test differentiated between skill groups and predicted performance on a previously established test and predicted option generation behavior. The test also outperformed domain-general cognitive tests, but not a domain-specific knowledge test when predicting skill group membership. Implications for theory and training, and future directions for the development of applied tools are discussed.

Doctrine and Tradition in Benjamin's early Thought : A relegated Chapter in the Study of his Reception of Kant

En el presente trabajo indagamos el significado de los conceptos de "doctrina" y "tradición" en las reflexiones de Benjamin hacia 1917, íntimamente vinculados con su recepción de Kant. Los escasos análisis de tal recepción relegan este aspecto. Intentamos mostrar que estos conceptos expresan un interés por la idea kantiana de unidad sistemática del conocimiento, y sostenemos que Benjamin reinterpreta tal unidad en términos mesiánicos: ya no como un supuesto necesario, sino como una exigencia de redención. Finalmente, exhibimos de qué modo estas nociones se hallan implícitas en el escrito "Sobre el programa de una filosofía futura"

Doctrine and Tradition in Benjamin's early Thought : A relegated Chapter in the Study of his Reception of Kant

En el presente trabajo indagamos el significado de los conceptos de "doctrina" y "tradición" en las reflexiones de Benjamin hacia 1917, íntimamente vinculados con su recepción de Kant. Los escasos análisis de tal recepción relegan este aspecto. Intentamos mostrar que estos conceptos expresan un interés por la idea kantiana de unidad sistemática del conocimiento, y sostenemos que Benjamin reinterpreta tal unidad en términos mesiánicos: ya no como un supuesto necesario, sino como una exigencia de redención. Finalmente, exhibimos de qué modo estas nociones se hallan implícitas en el escrito "Sobre el programa de una filosofía futura"

Une théologie de l’intime chez le baby-boomer québécois francophone issu de la tradition catholique : démarche qualitative descriptive

S’il est établi que le baby-boomer québécois francophone issu de la tradition catholique s’est distancié de cette dernière, nous observons aussi qu’il continue à s’y identifier à chaque recensement. Ce mémoire propose une démarche et des outils permettant de décrire l’expérience de foi de celui-ci. Il s’agit de la théologie de l’intime, dont la genèse et son expérimentation sont présentés dans le cadre d’une recherche conduite auprès de sujets appartenant à cette population. Cette approche s’articule à travers trois dialogues complémentaires et interdépendants : la quête de l’essence, la démarche d’incarnation et le défi identitaire. L’expérimentation démontre que le caractère pluridisciplinaire de la théologie de l’intime réussit à décrire de façon congruente l’expérience de foi de baby-boomers dont elle confirme aussi la cohérence, malgré le constat d’un décalage doctrinal avec le catholicisme. Le mémoire conclut en proposant d’autres perspectives d’application de la théologie de l’intime.

WIPO and the Reinforcement of the Nagoya Protocol: Towards Effective Implementation of an Access and Benefit Sharing Regime for the Protection of Traditional Knowledge Associated with Genetic Resources

Traditional knowledge associated with genetic resources (TKaGRs) is acknowledged as a valuable resource. Its value draws from economic, social, cultural, and innovative uses. This value places TK at the heart of competing interests as between indigenous peoples who hold it and depend on it for their survival, and profitable industries which seek to exploit it in the global market space. The latter group seek, inter alia, to advance and maintain their global competitiveness by exploiting TKaGRs leads in their research and development activities connected with modern innovation. Biopiracy remains an issue of central concern to the developing world and has emerged in this context as a label for the inequity arising from the misappropriation of TKaGRs located in the South by commercial interests usually located in the North. Significant attention and resources are being channeled at global efforts to design and implement effective protection mechanisms for TKaGRs against the incidence of biopiracy. The emergence and recent entry into force of the Nagoya Protocol offers the latest example of a concluded multilateral effort in this regard. The Nagoya Protocol, adopted on the platform of the Convention on Biological Diversity (CBD), establishes an open-ended international access and benefit sharing (ABS) regime which is comprised of the Protocol as well as several complementary instruments. By focusing on the trans-regime nature of biopiracy, this thesis argues that the intellectual property (IP) system forms a central part of the problem of biopiracy, and so too to the very efforts to implement solutions, including through the Nagoya Protocol. The ongoing related work within the World Intellectual Property Organization (WIPO), aimed at developing an international instrument (or a series of instruments) to address the effective protection of TK, constitutes an essential complementary process to the Nagoya Protocol, and, as such, forms a fundamental element within the Nagoya Protocol’s evolving ABS regime-complex. By adopting a third world approach to international law, this thesis draws central significance from its reconceptualization of biopiracy as a trans-regime concept. By construing the instrument(s) being negotiated within WIPO as forming a central component part of the Nagoya Protocol, this dissertation’s analysis highlights the importance of third world efforts to secure an IP-based reinforcement to the Protocol for the effective eradication of biopiracy.

Knowledge and writing in school mathematics : a communicational approach

This thesis is about young students’ writing in school mathematics and the ways in which this writing is designed, interpreted and understood. Students’ communication can act as a source from which teachers can make inferences regarding students’ mathematical knowledge and understanding. In mathematics education previous research indicates that teachers assume that the process of interpreting and judging students’ writing is unproblematic. The relationship between what students’ write, and what they know or understand, is theoretical as well as empirical. In an era of increased focus on assessment and measurement in education it is necessary for teachers to know more about the relationship between communication and achievement. To add to this knowledge, the thesis has adopted a broad approach, and the thesis consists of four studies. The aim of these studies is to reach a deep understanding of writing in school mathematics. Such an understanding is dependent on examining different aspects of writing. The four studies together examine how the concept of communication is described in authoritative texts, how students’ writing is viewed by teachers and how students make use of different communicational resources in their writing. The results of the four studies indicate that students’ writing is more complex than is acknowledged by teachers and authoritative texts in mathematics education. Results point to a sophistication in students’ approach to the merging of the two functions of writing, writing for oneself and writing for others. Results also suggest that students attend, to various extents, to questions regarding how, what and for whom they are writing in school mathematics. The relationship between writing and achievement is dependent on students’ ability to have their writing reflect their knowledge and on teachers’ thorough knowledge of the different features of writing and their awareness of its complexity. From a communicational perspective the ability to communicate [in writing] in mathematics can and should be distinguished from other mathematical abilities. By acknowledging that mathematical communication integrates mathematical language and natural language, teachers have an opportunity to turn writing in mathematics into an object of learning. This offers teachers the potential to add to their assessment literacy and offers students the potential to develop their communicational ability in order to write in a way that better reflects their mathematical knowledge.

Layered Information Modeling and a Knowledge Organization Paradigm: Inherent Classification and the Design of Interoperable Systems

In knowledge technology work, as expressed by the scope of this conference, there are a number of communities, each uncovering new methods, theories, and practices. The Library and Information Science (LIS) community is one such community. This community, through tradition and innovation, theories and practice, organizes knowledge and develops knowledge technologies formed by iterative research hewn to the values of equal access and discovery for all. The Information Modeling community is another contributor to knowledge technologies. It concerns itself with the construction of symbolic models that capture the meaning of information and organize it in ways that are computer-based, but human understandable. A recent paper that examines certain assumptions in information modeling builds a bridge between these two communities, offering a forum for a discussion on common aims from a common perspective. In a June 2000 article, Parsons and Wand separate classes from instances in information modeling in order to free instances from what they call the “tyranny” of classes. They attribute a number of problems in information modeling to inherent classification – or the disregard for the fact that instances can be conceptualized independent of any class assignment. By faceting instances from classes, Parsons and Wand strike a sonorous chord with classification theory as understood in LIS. In the practice community and in the publications of LIS, faceted classification has shifted the paradigm of knowledge organization theory in the twentieth century. Here, with the proposal of inherent classification and the resulting layered information modeling, a clear line joins both the LIS classification theory community and the information modeling community. Both communities have their eyes turned toward networked resource discovery, and with this conceptual conjunction a new paradigmatic conversation can take place. Parsons and Wand propose that the layered information model can facilitate schema integration, schema evolution, and interoperability. These three spheres in information modeling have their own connotation, but are not distant from the aims of classification research in LIS. In this new conceptual conjunction, established by Parsons and Ward, information modeling through the layered information model, can expand the horizons of classification theory beyond LIS, promoting a cross-fertilization of ideas on the interoperability of subject access tools like classification schemes, thesauri, taxonomies, and ontologies. This paper examines the common ground between the layered information model and faceted classification, establishing a vocabulary and outlining some common principles. It then turns to the issue of schema and the horizons of conventional classification and the differences between Information Modeling and Library and Information Science. Finally, a framework is proposed that deploys an interpretation of the layered information modeling approach in a knowledge technologies context. In order to design subject access systems that will integrate, evolve and interoperate in a networked environment, knowledge organization specialists must consider a semantic class independence like Parsons and Wand propose for information modeling.