Ultrasound has become a widely available imaging modality for the investigation of patients with a variety of clinical conditions. Concerns have been raised by clinicians and government alike that a sizeable proportion of this imaging may be unnecessary, inappropriate or of inadequate quality for patient management. This study aims to prospectively evaluate the opinions of treating vascular clinicians as to whether the vascular ultrasound imaging studies that patients bring with them when initially referred are necessary, and technically adequate to permit clinical decision-making for the patient’s management. Vascular clinicians Australia-wide were invited to participate in the study in April 2003. They were asked to recruit their next 50 consecutive new patients, eligible to be enrolled in the study, who presented with ultrasound scans organized by their referring doctor. The clinicians were asked to fill out a two-page proforma detailing the diagnosis, if known, and their opinion regarding the study and report, whether they required further information, and what investigations they would have ordered if seeing the patient for the first time, in a primary setting. 17 vascular clinicians Australia-wide agreed to participate in the study and to recruit their next 50 patients referred to them with vascular ultrasound imaging performed prior to specialist consultation. 473 Proformas were returned for analysis. Of all studies performed, 19 percent were judged unnecessary. Studies that were considered necessary however, were, in some cases, technically inaccurately or inadequately reported in 27 percent of cases, and 67 percent of these studies were then repeated. The NATAVUS Study has demonstrated that a significant percentage of ultrasound imaging performed by referring clinicians to vascular specialists is unnecessary, and that necessary imaging does not, in a large percentage of cases, provide accurate and adequate data to allow for specialist clinical decision-making. The data from this study has the potential to develop guidelines for appropriate use of vascular ultrasound imaging for various vascular conditions. If the results of this study were to be duplicated in a larger study, development and adoption of such guidelines would have the potential to generate significant cost savings to the health system by the elimination of some unnecessary testing. This is of particular relevance with Australia’s ageing population.

Thesis (M.A.)--Trinity Evangelical Divinity School, 1987. / Abstract. Includes bibliographical references (leaves 230-237).

Thesis (Ph. D.)--University of Notre Dame, 2009. / Thesis directed by Alfred Freddoso for the Department of Philosophy. "January 2009." Includes bibliographical references (leaves 161-171).

Thesis (doctoral)--Universität Erlangen.

Thesis (M.S.)--West Virginia University, 2006. / Title from document title page. Document formatted into pages; contains xvii, 239 p. : ill. (some col.), map (part col.). Includes abstract. Includes bibliographical references.

Aristotle endorses a very striking doctrine connecting necessity with what seems to be a non-modal notion -- that of 'being or happening always'. He also forges a connection between the idea of 'happening by chance' and 'happening neither always nor for the most part'. These two connections form the subject of this essay. My guiding aim is to provide an account of what the 'always/necessary' doctrine involves and of why Aristotle might have held it. Reflection on the nature of the connection between 'by chance' and 'neither always nor for the most part' throws light on what Aristotle means by 'happening always', and, in consequence, on the nature of the link between 'always' and 'necessary'; it also suggests that the basis of this link is to be found in Aristotle's general conception of the natural world as the object of explanation and knowledge. The primary texts upon which discussion of these connections must focus are <u>De Caelo</u> I. 12 and the analysis of chance in <u>Physics</u> II. 4—6. I discuss these two texts in turn, after a opening chapter which surveys the evidence for Aristotle's acceptance of the 'always/necessary‘ doctrine and considers the nature of the restrictions which he places on it. Chapter 2 comprises a translation of and commentary on <u>Cael.</u> I. 12, together with a translation and discussion of its companion chapter, I. 10. In Chapter 3, I examine the nature of Aristotle's argument in I. 12, and criticise various interpretations which see it as evidence that Aristotle's 'always/necessary' doctrine rests on a distinctive conception of possibility. The translation of and commentary on <u>Phys.</u> II. 4-6 (Chapter 4) are followed in Chapter 5 by a discussion of issues relating to the association of chance with 'neither always nor for the most part'. The final chapter returns to the question of the connection between 'always' and 'of necessity'.

This work is an investigation into the notion of truth. More specifically, this thesis deals with how to account for the main features of truth, with the interaction between truth and fundamental linguistic elements such as connectives and quantifiers, and with the analysis and the solution of truth-theoretic paradoxes. In the introductory Chapter 1, I describe and justify the approach to truth I adopt here, giving some general coordinates to contextualize my work. In Part I, I examine some theories of truth that fall under the chosen approach. In Chapter 2, I discuss a famous theory of truth developed by Saul Kripke. Some difficulties of Kripke's theory led several authors, notably Hartry Field, to emphasize the importance of a well-behaved conditional connective in conjunction with a Kripkean treatment of truth. I articulate this idea in a research agenda, which I call Field's program, giving some conditions for its realizability. In Chapter 3, I analyze the main theory of truth proposed by Field to equip Kripke's theory with a well-behaved conditional, and I give a novel analysis of its shortcomings. Field's theory is remarkably successful but is technically and intuitively very complex, and it is unclear whether Field's conditional is a plausible candidate for a philosophically useful conditional. Moreover, Field's treatment of "determinate truth" and his handling of many kinds of paradoxes is not fully satisfactory. In Part II, I develop some new theories that capture the main aspects of the notion of truth and, at the same time, give a philosophically interesting meaning to connectives and quantifiers - in particular, they yield a strong and conceptually significant conditional. The theory proposed in Chapter 4 extends the inductive methods employed in Kripke's theory, showing how to adapt them to non-monotonic connectives as well. There, I also develop and defend a new, theoretically fruitful notion of gappiness. The theory proposed in Chapter 5 (and discussed further in Chapter 6), instead, employs some graph-theoretic intuitions and tools to provide a new model-theoretic construction. The resulting theory, I argue, provides a nice framework to account for the interaction between truth, connectives, and quantifiers, and it is flexible enough to be applicable to several interpretations of the logical vocabulary. Some new technical results are established with this theory as well, concerning the interplay between every Lukasiewicz semantics and some interpretations of the truth predicate, and concerning the handling of determinate truth. Finally, the theory developed in Chapter 5 provides articulate and telling solutions to truth-theoretical paradoxes.

This thesis concerns the source of modal truth. I aim to answer the question: what is it in virtue of which there are truths concerning what must have been the case as a matter of necessity, or could have been the case but isn't. I begin by looking at a dilemma put forward by Simon Blackburn which attempts to show that any realist answer to this question must fail, and I conclude that either horn of his dilemma can be resisted. I then move on to clarify the nature of the propositions whose truth I am aiming to find the source of. I distinguish necessity de re from necessity de dicto, and argue for a counterpart theoretic treatment of necessity de re. As a result, I argue that there is no special problem concerning the source of de re modal facts. The problem is simply to account for what it is in virtue of which there are qualitative ways the world could have been, and qualitative ways it couldn't have been. I look at two ways to answer this question: by appealing to truthmakers in the actual world, or by appealing to non-actual ontology. I develop a theory of truthmakers, but argue that it is unlikely that there are truthmakers for modal truths among the ontology of the actual. I look at the main possibilist ontology, David Lewis' modal realism, but argue that warrant for that ontology is unobtainable, and that we shouldn't admit non-actual possibilia into our ontology. I end by sketching a quasi-conventionalist approach to modality which denies that there are modal facts, but nevertheless allows that we can speak truly when we use modal language.

I find that a bad reputation is not necessarily bad for business. I argue that a bad corporate reputation is less likely to hurt sales of tangible goods than intangible services, because assessing quality for the latter is inherently difficult and customers often rely on seller reputation to choose providers. I also argue that a necessary product is less likely to be adversely impacted than a discretionary one because in many cases the customers cannot avoid purchase of the product. I find that product necessity strongly affects consumer opinions and behavior. I argue that consumers “like” firms that offer products they want more than firms that offer products they need but that these opinions do not necessarily drive purchase behavior. I partition firms included in a well-established, corporate reputational survey into those that offer basic needs, perceived necessities and discretionary products. I find that consumers rate firms that offer discretionary products higher than firms that offer necessary products. Despite this tendency, firms that offer discretionary products and necessary products have similar profitability. Lastly, while consumers dislike price increases, they are more likely to repurchase basic needs than perceived necessities or discretionary products, arguably because they have no choice for the former. / Business Administration/Interdisciplinary

Use of firearm for the necessity defense This thesis is focused on conditions when a gun can be used for necessity defense under the current Czech legislation. The work is divided into five chapters. In the first chapter a gun legislation that allows citizens of Czech Republic to obtain and keep firearms is briefly mentioned with emphasis on the definition of firearm and overall description of conditions to obtain, carry and use it according to the gun legislation. The second chapter presents a general introduction into problems of circumstances that excludes the illegality. An institute of extreme emergency, a justification of gun use and so called civil detention are there more specified. The third chapter includes a detailed analysis of general characteristics of the necessity defense. This chapter further describes the issues of excess and fail in the necessity defense and some changes in legislation that were proposed in the past. The main part is the chapter four, which is focusing on use of firearms for the necessity defense itself. In the beginning of this chapter the characteristics of firearm use as a mean of ultima ratio defense are defined, with a brief excursion into firearm injuries, followed by the analysis of judicature that relates to the situation of gun use for necessity defense....