An integrated statement is made concerning the semantic status of nodes in a propositional semantic network, claiming that such nodes represent only intensions. Within the network, the only reference to extensionality is via a mechanism to assert that two intensions have the same extension in same world. This framework is employed in three application problems to illustrate the nature of its solutions.The formalism used here utilizes only assertional information and no structural, or definitional, information. This restriction corresponds to many of (...) the psychologically motivated network models. Some of the psychological implications of network processes called node merging and node splitting are discussed. Additionally, it is pointed out that both our networks and the psychologically based networks are prone to memory confusions about knowing unless augmented by domain‐specific inference processes, or by structural information. (shrink)

We describe a knowledge representation and inference formalism, based on an intensional propositional semantic network, in which variables are structures terms consisting of quantifier, type, and other information. This has three important consequences for natural language processing. First, this leads to an extended, more natural formalism whose use and representations are consistent with the use of variables in natural language in two ways: the structure of representations mirrors the structure of the language and allows re-use phenomena such as pronouns and (...) ellipsis. Second, the formalism allows the specification of description subsumption as a partial ordering on related concepts (variable nodes in a semantic network) that relates more general concepts to more specific instances of that concept, as is done in language. Finally, this structured variable representation simplifies the resolution of some representational difficulties with certain classes of natural language sentences, namely, donkey sentences and sentences involving branching quantifiers. The implementation of this formalism is called ANALOG (A NAtural LOGIC) and its utility for natural language processing tasks is illustrated. (shrink)

Over the past two decades ethics committees have proliferated in healthcare institutions across the country. Catalysts for this growth include the endorsement of ethics committees by the New Jersey Supreme Court in the Quinlan case, by the President's Commission for the Study of Ethical Problems in Medicine and Biomedical Research in its report entitled Deciding to Forgo Life Sustaining Medical Treatment, by the U.S. Department of Health and Human Services in its 1985 “Baby Doe” regulations, by numerous other courts in (...) treatment decisionmaking opinions issued after Quinlan, and more recently by the Joint Commission on Accreditation of Healthcare Organizations. (shrink)

In our article, we share the lessons we have learned after creating and running a successful legal laboratory over the past seven years at Yale Law School. Our legal laboratory, which focuses on the intersection of law and severe brain injury, represents a unique pedagogical model for legal academia, and is closely influenced by the biomedical laboratory.

The number of women living with HIV/AIDS is increasing worldwide, and there is an urgent public health need to develop new user-initiated HIV prevention methods, including microbicides. Although funding for microbicide development has increased since 2000, financial support is provided predominantly by governmental agencies and private foundations. Many donors, including the US Agency for International Development (USAID) and the US National Institutes of Health (NIH), have policies that restrict how research funds may be used. Among these are the now-rescinded Mexico (...) City Policy, elements of the US Foreign Assistance Act, and restrictions on non-study-related care. The effect of these restrictions on the design and conduct of clinical research is poorly understood. As part of a recent mapping exercise conducted by the Global Campaign for Microbicides, we reviewed the impact of donor restrictions on seven HIV prevention trials. We found considerable confusion within the HIV prevention field as to whether and how Mexico City and other policies affect the use of research funds. We also found that these donor-imposed policies limited the level of care provided to trial participants and the types of capacity building projects undertaken. (shrink)

Recently, the U.S. House of Representatives voted, for the second time in two years, to ban all human-cloning research, whether the research involves reproduction or creating cells that might be used to understand and treat disease. As I explain in this article, the proposed legislation has important implications not only for human cloning research but also for research in general.

For over a decade, managed care has profoundly altered how healthcare is delivered in the United States. There have been concerns that the patient-physician relationship may be undermined by various aspects of managed care, such as restrictions on physician choice, productivity requirements that limit the time physicians may spend with patients, and the use of compensation formulas that reward physicians for healthcare dollars not spent. We have previously published data on the effects of managed care on the physician-patient relationship from (...) the physician's perspective. In 1999, we collected data on the impact of managed care arrangements on the physician-patient relationship from the patient's perspective. This article discusses our collective findings. (shrink)

Over the past several years, healthcare has been profoundly altered by the growth of managed care. Because managed care integrates the financing and delivery of healthcare services, it dramatically alters the roles and relationships among providers, payers, and patients. While analysis of this change has focused on whether and how managed care can control costs, an increasingly important concern among healthcare providers and recipients is the impact of managed care on the physicianpatient relationship, but little data have been collected and (...) analyzed. We designed a survey for distribution to Wisconsin physicians to analyze the prevalence and types of managed care arrangements in the state, and the impact of these arrangements on physicians and their relationships with patients. (shrink)

As the hospice movement continues to grow, caregivers are increasingly required to interact with dying patients for longer periods and in more intimate and more meaningful ways. Practical models of competent and compassionate communication and understanding need to be developed to accommodate the changing environment of the patient and caregiver and their relationship. We therefore: examine current death education trends in hospice care and education; and describe the need for a more expansive and transpersonal view, and ways of fulfilling that (...) need. The aware patient and the aware caregiver can learn much during the dying trajectory. We hope that someday the potential for expansiveness during the dying trajectory will be more commonly recognized and accommodated as a doorway to the transpersonal. (shrink)

Recent data indicate that under a specific posthypnotic suggestion to circumvent reading, highly suggestible subjects successfully eliminated the Stroop interference effect. The present study examined whether an optical explanation could account for this finding. Using cyclopentolate hydrochloride eye drops to pharmacologically prevent visual accommodation in all subjects, behavioral Stroop data were collected from six highly hypnotizables and six less suggestibles using an optical setup that guaranteed either sharply focused or blurred vision. The highly suggestibles performed the Stroop task when naturally (...) vigilant, under posthypnotic suggestion not to read, and while visually blurred; the less suggestibles ran naturally vigilant, while looking away, and while visually blurred. Although visual accommodation was precluded for all subjects, posthypnotic suggestion effectively eliminated Stroop interference and was comparable to looking away in controls. These data strengthen the view that Stroop interference is neither robust nor inevitable and support the hypothesis that posthypnotic suggestion may exert a top-down influence on neural processing. (shrink)

Over the last 20+ years, multinational corporations have been confronted with accusations of abuse of market power and unfair and unethical business conduct especially as it relates to their overseas operations and supply chain management. These accusations include, among others, worker exploitation in terms of unfairly low wages, excessive work hours, and unsafe work environment; pollution and contamination of air, ground water and land resources; and, undermining the ability of natural government to protect the well-being of their citizens. MNCs have (...) responded to these accusations by creating voluntary codes of conduct which commit them to specific standards for addressing these issues. These codes are created at both the industry-wide and the individual company level. Unfortunately, these codes have generated little credibility and public trust because their compliance claims cannot be independently verified, and they lack transparency and full public disclosure. In this article, we present a case study of the voluntary code of conduct by Mattel, Inc., the world’s largest toy company. The code, called the Global Manufacturing Principles, confronts the general criticism leveled against voluntary codes of conduct by creating detailed standards of compliance, independent external monitoring of the company’s compliance with its code of conduct, and making full, and uncensored public disclosure of the audit findings and company’s response in terms of remedial action. We present a detailed account of how Mattel’s voluntary code of conduct was created, implemented, and ultimately abandoned over 9 years. We provide an evaluative analysis of the company’s GMP compliance throughout its life span, which suggests a bell-shaped curve, where early top management commitments were met with pockets of resistance from operational groups, who were concerned about balancing GMP compliance efforts with traditional performance criteria. The early stage response from Mattel’s top management was quick and supported with the requisite resources. As a result, the compliance process accelerated, becoming increasingly more robust and effective. The success of code compliance and increased transparency in public disclosure energized field managers with a sense of professional satisfaction and publicly recognized accomplishments. The decline in GMP compliance was equally steep. When all the easily attainable targets had been reached at the company-operated plants, addressing vendor plants’ compliance presented a new set of challenges, which taxed corporate resources and management commitment. It would seem that value-based and ethics-oriented considerations, i.e., doing the right thing for the right reason, were no longer the driving force for Mattel’s management. Mattel did not see any economic benefit from its proactive stance, when competitors did not seem to suffer adverse consequences for not following suit. The final contributing factor to the code’s abandonment was a widely publicized series of product recalls which absorbed top management’s attention. (shrink)

What should be the role of an institutional ethics committee in resolving conflict concerning patient care decisions in the neonatal intensive care unit? This question takes on added importance in light of recent court decisions which suggest that IEC deliberations may serve as persuasive evidence in court, of proposed state regulations that would establish an IEC as an alternative to judicial review, and of recent Joint Commission on Accreditation of Healthcare Organizations guidelines that require an institutional policy on limitation or (...) withdrawal of treatment to include a specified mechanism for resolving conflict. Unfortunately, despite these developments, prospective case consultation remains one of the most controversial and poorly understood aspects of IEC functions. Questions and concerns persist about the relation the IEC has and should have to actual decisions in specific cases.We briefly examine the clinical, organizational, and regulatory complexity of the NICU environment and suggest five potential sources of uncertainty, disagreement, and conflict among parent and NICU staff. (shrink)

Michael Lynch’s Truth as One and Many is a contribution to the large body of philosophical literature on the nature of truth. Within that genre, advocates of truth-as-correspondence, advocates of truth-as-coherence, and the like, all hold that truth has a single underlying metaphysical nature, but they sharply disagree as to what this nature is. Lynch argues that many of these views make good sense of truth attributions for a limited stretch of discourse, but he adds that each of the contenders (...) also faces a ‘scope problem’, in that none of them makes sense of all legitimate truth attributions. Some deflationists make similar observations – usually less concessive – and conclude that truth simply has no substantial, underlying nature. There is nothing for the philosopher to articulate and defend. Lynch agrees with deflationists that the realm of discourse is too diverse for any single ‘first-level’ property, such as correspondence or coherence, to fully characterize it, but against deflationism, he holds that truth does have a nature. He presents a functionalist theory. The definition is this: x is true if, and only if, x has a property that plays the truth-role. According to Lynch, the truth-role is given in terms of what he calls the ‘core truisms’ of the folk concept of truth. These are platitudes that hold of the everyday notion, and are such that anyone who denies all of them can be accused of changing the subject – of not talking about truth. A given property T plays the truth-role for a batch of propositions, just in case, for any proposition P in the batch: P is T if, and only if, where P is believed, things are as they are believed to be; other things being equal, it is a worthy goal …. (shrink)

The purpose of this article is show that second-order logic, as understood through standard semantics, is intimately bound up with set theory, or some other general theory of interpretations, structures, or whatever. Contra Quine, this does not disqualify second-order logic from its role in foundational studies. To wax Quinean, why should there be a sharp border separating mathematics from logic, especially the logic of mathematics?

What should be the role of an institutional ethics committee in resolving conflict concerning patient care decisions in the neonatal intensive care unit? This question takes on added importance in light of recent court decisions which suggest that IEC deliberations may serve as persuasive evidence in court, of proposed state regulations that would establish an IEC as an alternative to judicial review, and of recent Joint Commission on Accreditation of Healthcare Organizations guidelines that require an institutional policy on limitation or (...) withdrawal of treatment to include a specified mechanism for resolving conflict. Unfortunately, despite these developments, prospective case consultation remains one of the most controversial and poorly understood aspects of IEC functions. Questions and concerns persist about the relation the IEC has and should have to actual decisions in specific cases.We briefly examine the clinical, organizational, and regulatory complexity of the NICU environment and suggest five potential sources of uncertainty, disagreement, and conflict among parent and NICU staff. (shrink)

Draws upon Taoist wisdom and photographic artistry to provide insight into creativity, spirituality, and awareness training, with black-and-white photographs, passages from ancient Taoist writings, and practical exercises to explain the fundamentals of Taoist photography.

Recent data indicate that under a specific posthypnotic suggestion to circumvent reading, highly suggestible subjects successfully eliminated the Stroop interference effect. The present study examined whether an optical explanation could account for this finding. Using cyclopentolate hydrochloride eye drops to pharmacologically prevent visual accommodation in all subjects, behavioral Stroop data were collected from six highly hypnotizables and six less suggestibles using an optical setup that guaranteed either sharply focused or blurred vision. The highly suggestibles performed the Stroop task when naturally (...) vigilant, under posthypnotic suggestion not to read, and while visually blurred; the less suggestibles ran naturally vigilant, while looking away, and while visually blurred. Although visual accommodation was precluded for all subjects, posthypnotic suggestion effectively eliminated Stroop interference and was comparable to looking away in controls. These data strengthen the view that Stroop interference is neither robust nor inevitable and support the hypothesis that posthypnotic suggestion may exert a top-down influence on neural processing. (shrink)

This article concerns the ongoing neo-logicist program in the philosophy of mathematics. The enterprise began life, in something close to its present form, with Crispin Wright’s seminal [1983]. It was bolstered when Bob Hale [1987] joined the fray on Wright’s behalf and it continues through many extensions, objections, and replies to objections . The overall plan is to develop branches of established mathematics using abstraction principles in the form: Formula where a and b are variables of a given type , (...) Σ is a higher-order operator denoting a function from items of the given type to objects in the range of the first-order variables, and E is an equivalence relation over items of the given type. In what follows, I will sometimes omit the initial quantifiers.Frege [1884, 1893] himself employed three abstraction principles. One of them, used for illustration, comes from geometry: "The direction of l1 is identical to the direction of l2 if and only if l1 is parallel to l2."Call this the direction principle. The second was dubbed N= in [Wright, 1983] and is now called Hume’s principle: Formula where F≈G is an abbreviation of the second-order statement that there is a one-to-one relation mapping the F’s onto the G’s. In words, states that the number of F is identical to the number of G if and only if F is equinumerous with G. Unlike the direction-principle, the relevant variables, F, G here are second-order. Georg Cantor …. (shrink)

Political representation lies at the core of modern politics. Democracies, with their vast numbers of citizens, could not operate without representative institutions. Yet relations between the democratic ideal and the everyday practice of political representation have never been well defined and remain the subject of vigorous debate among historians, political theorists, lawyers, and citizens. In this volume, an eminent group of scholars move forward the debates about political representation on a number of fronts. Drawing on insights from political science, history, (...) political theory, economics, and anthropology, the authors provide much-needed clarity to some of the most vexing questions about political representation. They also reveal new and enlightening perspectives on this fundamental political practice. Topics discussed include representation before democracy, political parties, minorities, electoral competition, and ideology. This volume is essential reading for anyone interested in the ideal and the reality of political representation. (shrink)

Stewart Shapiro's aim in Vagueness in Context is to develop both a philosophical and a formal, model-theoretic account of the meaning, function, and logic of vague terms in an idealized version of a natural language like English. It is a commonplace that the extensions of vague terms vary with such contextual factors as the comparison class and paradigm cases. A person can be tall with respect to male accountants and not tall with respect to professional basketball players. The main (...) feature of Shapiro's account is that the extensions of vague terms also vary in the course of a conversation, even after the external contextual features, such as the comparison class, are fixed. A central thesis is that in some cases, a competent speaker of the language can go either way in the borderline area of a vague predicate without sinning against the meaning of the words and the non-linguistic facts. Shapiro calls this open texture, borrowing the term from Friedrich Waismann.The formal model theory has a similar structure to the supervaluationist approach, employing the notion of a sharpening of a base interpretation. In line with the philosophical account, however, the notion of super-truth does not play a central role in the development of validity. The ultimate goal of the technical aspects of the work is to delimit a plausible notion of logical consequence, and to explore what happens with the sorites paradox.Later chapters deal with what passes for higher-order vagueness - vagueness in the notions of 'determinacy' and 'borderline' - and with vague singular terms, or objects. In each case, the philosophical picture is developed by extending and modifying the original account. This is followed with modifications to the model theory and the central meta-theorems.As Shapiro sees it, vagueness is a linguistic phenomenon, due to the kinds of languages that humans speak. But vagueness is also due to the world we find ourselves in, as we try to communicate features of it to each other. Vagueness is also due to the kinds of beings we are. There is no need to blame the phenomenon on any one of those aspects. (shrink)

© 2014 Shapiro, Tassone, Choudhary and Simon.Chromosome 22q11.2 Deletion Syndrome is caused by the most common human microdeletion, and it is associated with cognitive impairments across many domains. While impairments in cognitive control have been described in children with 22q11.2DS, the nature and development of these impairments are not clear. Children with 22q11.2DS and typically developing children were tested on four well-validated tasks aimed at measuring specific foundational components of cognitive control: response inhibition, cognitive flexibility, and working memory. Molecular (...) assays were also conducted in order to examine genotype of catechol-O-methyltransferase, a gene located within the deleted region in 22q11.2DS and hypothesized to play a role in cognitive control. Mixed model regression analyses were used to examine group differences, as well as age-related effects on cognitive control component processes in a cross-sectional analysis. Regression models with COMT genotype were also conducted in order to examine potential effects of the different variants of the gene. Response inhibition, cognitive flexibility, and working memory were impaired in children with 22q11.2DS relative to TD children, even after accounting for global intellectual functioning. When compared with TD individuals, children with 22q11.2DS demonstrated atypical age-related patterns of response inhibition and cognitive flexibility. Both groups demonstrated typical age-related associations with working memory. The results of this cross-sectional analysis suggest a specific aberration in the development of systems mediating response inhibition in a sub-set of children with 22q11.2DS. It will be important to follow up with longitudinal analyses to directly examine these developmental trajectories, and correlate neurocognitive variables with clinical and adaptive outcome measures. (shrink)

Early in Book 1 of Herodotus' Histories, Solon speaks to Croesus about the jealousy of the gods and the ephemeral nature of human happiness . Since Solon's speech is so prominently placed, and since it introduces themes that recur throughout the Histories, it has traditionally been seen as programmatic, i.e., as expressing Herodotus' own views about the gods and human happiness. Although the assumption that Solon speaks for Herodotus has long been the standard view, it has recently been challenged on (...) the grounds that Herodotus himself never directly affirms his agreement with what Solon says. On the other hand, many scholars have noted that Herodotus does not always state his views directly: he often uses literary devices such as analogy, juxtaposition, and the repetition of narrative patterns to indicate his views. After isolating the three main principles of Solon's speech , this paper examines the direct and indirect evidence for Herodotus' acceptance of these principles. After examining the evidence in Books 1-9 of the Histories, the paper concludes that Herodotus does indeed agree with the views of his character Solon, and that he makes his agreement clear both explicitly and implicitly, through analogy, repetition, and juxtaposition. Moreover, the position of Solon's speech indicates that Herodotus meant it to be programmatic, setting forth basic assumptions about the nature of human life and its relation to the gods which could then provide a philosophical framework for the Histories as a whole. (shrink)

I review the recent case of Edna Folz, a 73 year-old woman who was suffering through the end stages of very advanced Alzheimer's dementia when her case was adjudicated by the Wisconsin Supreme Court. I consider this case as an example of how courts are increasingly misinterpreting the ethical and legal decision-making standards known as substituted judgment and best interests and thereby threatening individuals' treatment decision-making rights as developed by other courts over the past two decades and creating serious roadblocks (...) to health-care providers' ability to render appropriate patient care. The Wisconsin Supreme Court held that Edna's legal guardian could not authorize withdrawal of Edna's treatment, ruling that as a matter of law, if an incompetent person is not in a persistent vegetative state, it is not in his or her best interests for life-sustaining treatment to be withdrawn unless (s)he has executed an advance directive or other statement clearly indicating his or her desires. (shrink)

Recent studies have exposed the startling inadequacy of health care providers knowledge about and practice of effective pain management. For example, in one study, it was reported that 79 percent of a random sample of 454 medical-surgical inpatients experienced pain during hospitalization, and that 58 percent of patients with pain considered the pain horrible or excruciating. In another study, 67 percent of 2,415 randomly selected hospitalized patients had pain during the twenty-four hours prior to being interviewed, and 50 percent reported (...) pain at the time of the interview. In a study of seriously ill hospitalized patients reported in 1996, half of the patients complained of pain, and one-sixth reported that they experienced extremely severe pain at least half the time. According to one literature review, 75 percent of cancer patients have reported suffering pain, and one study estimates that 25 percent of cancer patients die with severe unrelieved pain. Chronic nonmalignant pain has been described as an extremely prevalent problem, and over two-thirds of nursing home residents experience serious pain. (shrink)

Recent studies have exposed the startling inadequacy of health care providers knowledge about and practice of effective pain management. For example, in one study, it was reported that 79 percent of a random sample of 454 medical-surgical inpatients experienced pain during hospitalization, and that 58 percent of patients with pain considered the pain horrible or excruciating. In another study, 67 percent of 2,415 randomly selected hospitalized patients had pain during the twenty-four hours prior to being interviewed, and 50 percent reported (...) pain at the time of the interview. In a study of seriously ill hospitalized patients reported in 1996, half of the patients complained of pain, and one-sixth reported that they experienced extremely severe pain at least half the time. According to one literature review, 75 percent of cancer patients have reported suffering pain, and one study estimates that 25 percent of cancer patients die with severe unrelieved pain. Chronic nonmalignant pain has been described as an extremely prevalent problem, and over two-thirds of nursing home residents experience serious pain. (shrink)