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Healthcare provider hands are an important source of intraoperative bacterial transmission events associated with postoperative infection development.
To explore the efficacy of a novel hand hygiene improvement system leveraging provider proximity and individual and group performance feedback in reducing 30-day postoperative healthcare-associated infections via increased provider hourly hand decontamination events.
Randomized, prospective study.
Dartmouth-Hitchcock Medical Center in New Hampshire and UMass Memorial Medical Center in Massachusetts.
Patients undergoing surgery.
Operating room environments were randomly assigned to usual intraoperative hand hygiene or to a personalized, body-worn hand hygiene system. Anesthesia and circulating nurse provider hourly hand decontamination events were continuously monitored and reported. All patients were followed prospectively for the development of 30-day postoperative healthcare-associated infections.
A total of 3,256 operating room environments and patients (1,620 control and 1,636 treatment) were enrolled. The mean (SD) provider hand decontamination event rate achieved was 4.3 (2.9) events per hour, an approximate 8-fold increase in hand decontamination events above that of conventional wall-mounted devices (0.57 events/hour); P<.001. Use of the hand hygiene system was not associated with a reduction in healthcare-associated infections (odds ratio, 1.07 [95% CI, 0.82–1.40], P=.626).
The hand hygiene system evaluated in this study increased the frequency of hand decontamination events without reducing 30-day postoperative healthcare-associated infections. Future work is indicated to optimize the efficacy of this hand hygiene improvement strategy.
In this paper, I argue that Hume's solution to a problem that contemporary metaphysicians call “the problem of universals” would be rather tropetheoretical than some other type of nominalism. The basic idea in different trope theories is that particular properties, i.e., tropes are postulated to account for the fact that there are particular beings resembling each other. I show that Hume's simple sensible perceptions are tropes: simple qualities. Accordingly, their similarities are explained by these tropes themselves and their resemblance. Reading Hume as a trope nominalist sheds light on his account of general ideas, perceptions, relations and nominalism.
I consider some ways in which the Copy Principle (CP) and Hume's nominalism impinge on one another, arguing for the following claims. First, Hume's argument against indeterminate ideas isn't cogent even if the CP is accepted. But this does not vindicate Locke: the imagistic conception of ideas, presupposed by the CP, will force Locke to accept something like Hume's view of the way general terms function, the availability of abstract ideas notwithstanding. Second, Hume's discussion of nominalism provides support for the “old Hume” interpretation, that which takes the CP to be a criterion of meaningfulness, as against the “new Hume” reading, according to which it constrains what we can know. Finally, nominalism forces Hume to adopt a more complicated theory of ideas.
Many commentators propose that Hume thinks that we are not or should not be motivated to perform naturally virtuous actions from moral sentiments. I take issue with this interpretation in this paper, arguing that Hume fully incorporates the moral sentiments into his understanding of how human beings act when it comes to the natural virtues and that he does not see the moral sentiments as a problematic kind of motivation that threatens or weakens the virtuous status of the action.
This paper argues that the Cambridge Platonists had stronger philosophical links to Scottish moral philosophy than the received history allows. Building on the work of Michael Gill who has demonstrated links between ethical thought of More, Cudworth and Smith and moral sentimentalism, I outline some links between the Cambridge Platonists and Scottish thinkers in both the seventeenth century (e.g., James Nairn, Henry Scougal) and the eighteenth century (e.g., Smith, Blair, Stewart). I then discuss Hume's knowledge of Cudworth, in Enquiry concerning the Principles of Morals, Enquiry concerning Human Understanding, The Natural History of Religion and Dialogues concerning Natural Religion.
This is a reply to Willem Lemmens’ discussion of my interpretation of the Dialogues on Natural Religion in my 2000 collection Themes from Hume: Self, Will, Religion. I use Lemmens’ careful textual analysis to clarify my considered position and to further the reading of Part 12 of the Dialogues.
According to Terence Penelhum, Philo's confession in the last part of Hume's Dialogues Concerning Natural Religion reveals on the side of the author a reconciliatory and pacifying attitude towards the liberal moderate clergy of his days. This article investigates whether another reading of this intriguing text is not more appropriate. It defends the idea that Philo's speeches and Cleanthes’ reactions to it in the last part of the Dialogues reveal on Hume's side an attitude of mild despair and isolation towards the religious culture of eighteenth-century Scotland, in both its orthodox and more moderate form.
Terence Penelhum has written extensively about the role of the idea of the self in Hume's account of the emotional and moral life of persons. Penelhum fails to notice, however, a change that takes place in the way that the idea of the self functions in Hume's account of the passions as that account evolved after the Treatise. This paper charts part of that evolution, and reflects on its significance for Hume's moral psychology.
Robert Nozick addresses the idea of egalitarian redistribution in an argument standardly considered original: the “Wilt Chamberlain Argument”. However, this argument (without reference to Wilt Chamberlain) is found in David Hume's An Enquiry Concerning the Principles of Morals, first published in 1751. Placing this argument within a Humean and Hayekian, rather than a Lockean or Kantian, perspective radically changes its import for issues of economic justice. Rather than vindicating the radical individualism of Nozick and other libertarians, applied to our circumstances using Hume's conventionalist and evolutionary account of justice, Hume's Wilt Chamberlain argument vindicates moderate redistribution constrained by the rule of general laws and the goal of fostering innovation and industriousness.
Jane McIntyre's authoritative presentation of the changes Hume makes in the Second Enquiry and the Dissertation on the Passions to the role of sympathy show that he has there left behind the centrality of the idea of the self in the Treatise, and made his philosophy less systematic but more comprehensive.
Hume views the passions as having both intentionality and qualitative character, which, in light of his Separability Principle, seemingly contradicts their simplicity. I reject the dominant solution to this puzzle of claiming that intentionality is an extrinsic property of the passions, arguing that a number of Hume's claims regarding the intentionality of the passions (pride and humility in particular) provide reasons for thinking an intrinsic account of the intentionality of the passions to be required. Instead, I propose to resolve this tension by appealing to Hume's treatment of the ‘distinctions of reason’, as explained by Garrett (Cognition and Commitment in Hume's Philosophy, Oxford: Oxford University Press, 1997).
Many of the central theses of Hume's philosophy – his rejection of real relations, universals, abstract objects and necessary causal relations – had precedents in the later medieval nominalist tradition. Hume and his medieval predecessors developed complex semantic theories to show both how ontologies are apt to become inflated and how, if we understand carefully the processes by which meaning is generated, we can achieve greater ontological parsimony. Tracing a trajectory from those medieval traditions to Hume reveals Hume to be more radical, particularly in his rejection of abstraction and abstract ideas. Hume's denial of general, abstract ideas is consistent with his philosophical principles but fails to appreciate the more sophisticated nominalist approaches to abstraction, the result of which is a theoretically impoverished account of our capacity for generalization.
Hume argues against the seventeenth-century rationalists that reason is impotent to motivate action and to originate morality. Hume's arguments have standardly been considered the foundation for the Humean theory of motivation in contemporary philosophy. The Humean theory alleges that beliefs require independent desires to motivate action. Recently, however, new commentaries allege that Hume's argument concerning the inertness of reason has no bearing on whether beliefs can motivate. These commentaries maintain that for Hume, beliefs about future pleasurable and painful objects on their own can produce the desires that move us to action. First, I show that this reading putsHumeat odds withHumeans, since the latter are committed, not only to the view that beliefs and desires are both necessary to action, but also to the view that beliefs do not produce desires. Second, I review textual, philosophical and historical grounds for my interpretation of Hume's argument for the inertness of reason. I argue that the new line on Hume, while consistent with a certain reading of the Treatise, is not supported by the Dissertation on the Passions and the second Enquiry, where Hume argues that all motivation has an origin in “taste”, which I take to be different from belief. Thus, Hume's arguments do support the contemporary Humean theory of motivation.
Where Terence Penelhum sees a deep continuity between John Locke's theory of ideas and David Hume's theory of perceptions, I argue that the two philosophers disagree over some fundamental issues in the philosophy of mind. While Locke treats ideas as imagistic objects that we recognize as such by a special kind of inner consciousness, Hume thinks that we do not normally recognize the imagistic content of our perceptions, and instead unselfconsciously take ourselves to sense a shared public world. My disagreement with Penelhum over Hume's debt to Locke helps to explain our disagreement over the nature of Hume's scepticism.
This paper argues that Hume can account for character traits as lasting mental qualities without violating his reductionist account of the mind as a changing bundle of ideas and impressions. It argues that a trait is a disposition to act according to certain passions or motivations, explained entirely with reference to the ideas and impressions constituting one's current self. This account is consistent with Hume's view of the mind, and relies solely on his accounts of the association of impressions and ideas, and of the relationship between belief and passion, to establish relations that can properly be called lasting mental qualities.
Most philosophers agree that an argument's presentation is relevant to its philosophical merit. This paper explains why David Hume considered presentation philosophically important. On Hume's epistemology, presentation is closely connected with two principal aims of philosophical arguments: persuasion and epistemic justification. Hume's views imply that presentation is a factor determining an argument's persuasiveness and that, by philosophical standards of justification, presentation is also a factor determining the extent to which an argument's conclusion is justified.
This is a reply to Donald Ainslie's discussion of Terence Penelhum's work on Hume, Locke and the nature of consciousness; although agree on many points about the differences between Locke and Hume, I take issue with Ainslie's views about the epistemic status Hume accords to introspective acts.