Blood components are a perishable resource that play a crucial role in clinical medicine. The blood component inventory is managed by transfusion services, who ultimately aim to balance supply with demand so as to ensure availability whilst minimising waste. Whilst the blood component inventory problem has been the focus of theoretical approaches for over 50 years, evidence for the direct utilisation of existing models in the day-to-day management of blood stocks in clinical settings is limited. In this study we formulate a discrete mathematical model that describes the main processes in the management of a single population of red blood cells in a clinical setting: ageing, supply and demand. After time averaging the discrete model, a time-delayed integro-partial differential equation model is derived. Steady state analysis yields expressions for: a range of clinically relevant quantities (i.e. age distributions, total stock levels, wastage rates, age of transfused units); key performance indicators; and simple formulae that identify optimal restock thresholds in terms of parameters that are readily available in clinical settings. The approach is validated by testing predictions using data from a Scottish district general hospital. It is envisaged that the proposed methodology can ultimately be used to aid in situ `rule-of-thumb' decision making in clinical laboratory settings.

For Ricœur any study of Freud, or of psychoanalysis more generally, needs to take into account the crucial dimension of the analytic experience itself. Psychoanalysis, as a “mixed discourse,” aims to anticipate questions of meaning and explication alongside technical questions of energies, repression, displacement, and so on. The analytic experience is one which is practical and intersubjective, but which is also guided by various techniques or methods. These techniques, I will argue, should be understood as a type of techne, one which is less concerned with hermeneutic questions of meaning than with quasi-scientific questions of force, feedback, struggle, and process. The practice of psychoanalysis, on the other hand, deals with the ways in which these forces or drives become meaningful for a particular subject, and within a singular context or history. This article will aim to draw out both the interrelationship between techniques and practical understanding, and also the productive incommensurability between the two.

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Résumé de l'articlePoursuivant les récentes discussions concernant les recoupements entre la philosophie de Paul Ricoeur et les éthiques du care, cet article a pour objectif de clarifier le statut de la pratique dans l'oeuvre de Ricoeur. Je soutiendrai que même si la philosophie ricoeurienne est bien marquée par un « désir d'un fondement », ainsi que l'éthicienne du care Joan C. Tronto le souligne, cet objectif repose plus sur un pari que sur un véritable principe, et risque toujours d'être renversé par les pratiques ou d'autres visions du monde. Je démontrerai cela en soutenant trois arguments. 1) L'approche herméneutique de Ricoeur concernant la pratique mène à penser que les méthodes objectives de connaissance et d'explication sont toujours soutenues par une tâche herméneutique plus large de la compréhension pratique et du souci de soi. 2) En ce qui a trait au raisonnement moral, l'analyse de Ricoeur sur le conflit entre le respect de la règle et le respect de la personne accorde la priorité au respect de l'autre singulier plutôt que de la règle universelle. Ainsi, l'autre peut toujours perturber et réorienter l'universel ou les modes fondateurs du raisonnement. 3) Réfléchissant aux relations thérapeutiques (healthcare relations), Ricoeur tend à suggérer une nouvelle compréhension du respect qui se place dans une relation dialectique avec le souci (care). Ces lectures -de l'herméneutique, de la moralité et du respect -orientées vers la pratique ouvrent la voie à un dialogue entre les éthiques du care et des approches philosophiques que l'on considère souvent éloignées de celles-ci. ABSTRACT:Continuing on from recent discussions on the overlap between Paul Ricoeur's philosophy and care ethics, this article will aim to clarify the status of practice in Ricoeur's work. I will argue that even though Ricoeur's philosophy is indeed marked by its "desire for a foundation," as care ethicist Joan Tronto has pointed out, this aim is more of a fragile wager than a principle, and is always at risk of being overturned by practices and other worldviews. I will demonstrate this point by arguing that (1) Ricoeur's hermeneutic approach to practice leads to the view that objective methods of knowledge and explanation are always grounded by the broader hermeneutic task of practical understanding and care for the self; (2) in moral reasoning, Ricoeur's analysis of the conflict between respect for the rule and respect for persons results in his prioritizing of respect for the singular other rather than the universal rule, meaning that the other can always disrupt and reorient universal or foundational modes of reasoning; and finally (3) within healthcare relations Ricoeur aims to develop an alternative understanding of respect that places it in a dialectical relation with care. These practice-oriented readings of hermeneutics, morality, and respect aim to open up a dialogue between care ethics and philosophical approaches that have often been placed outside of care ethics. RÉSUMÉ :Poursuivant les récentes discussions concernant ...