Most models of patient-physician communication take decision-making as a central concept. However, we found that often the treatment course of metastatic cancer patients is not easy to describe in straightforward terms used in decision-making models but is instead frequently more erratic. Our aim was to analyse these processes as trajectories. We used a longitudinal case study of 13 patients with metastatic colorectal and pancreatic cancer for whom palliative chemotherapy was a treatment option, and analysed 65 semi-structured interviews. We analysed three (...) characteristics of the treatment course that contributed to the ‘erraticness’ of the course: (1) The treatment (with or without chemotherapy) contained many options; (2) these options were not stable entities to be decided upon, but changed identity over the course of treatment, and (3) contrary to the closure (option X means no option Y, Z, etc.) a decision implies, the treatment course was a continuous process in which options instead remained open. When the treatment course is characterised by these many and changeable options that do not result in closure, the shared decision-making model should take these into account. More attention needs to be paid to the erratic character of the process in which the doctor has to provide continuous information that is related to the changing situation of the patient; also, flexibility in dealing with protocols is warranted, as is vigilance about the overall direction of the process. (shrink)
In this paper we explore the extent to which implicit learning is subtended by somatic markers, as evidenced by skin conductance measures. On each trial subjects were asked to decide which ‘word’ from a pair of ‘words’ was the ‘correct’ word. Unknown to subjects, each ‘word’ of a pair was constructed using a different set of rules (grammar ‘A’ and grammar ‘B’). A (monetary) reward was given if the subject choose the ‘word’ from grammar ‘A’. Choosing the grammar ‘B’ word (...) resulted in (monetary) punishment. Skin conductance was measured during each of 100 trials. After each set of 10 trials subjects were asked how they selected the ‘correct word’. Task performance increased long before the subjects could even formulate a single relevant rule. In this ‘pre-conceptual’ phase of the experiment, skin conductance was larger before incorrect than before correct choices. Thus it was shown that artificial grammar learning is accompagnied by a somatic marker, possibly ‘warning’ the subject for the incorrect decision. (shrink)
This volume deals with the question of whether quantum mechanics can provide a picture of physical reality. This question is investigated from physical, philosophical, and logical perspectives on the basis of modern views on measurement and open quantum systems. New ways are found of respecting the rules of classical logic in quantum mechanics, by developing a formalization of the concept of a `context' within a modularized version of modal logic. Various applications are given, both within and outside quantum theory. A (...) `contextual quantum process theory' is presented as a general framework for further interpretation. Several such interpretations are outlined, and ensuing problems of completeness and locality are discussed. A special chapter is devoted to a manifestly covariant relativistic interpretation in terms of `quantum events'. This book will be of interest to experts on quantum theory, but it will also appeal to a wider public of physicists, philosophers and logicians. (shrink)
To the standard propositional modal system of provability logic constants are added to account for the arithmetical fixed points introduced by Bernardi-Montagna in . With that interpretation in mind, a system LR of modal propositional logic is axiomatized, a modal completeness theorem is established for LR and, after that, a uniform arithmetical (Solovay-type) completeness theorem with respect to PA is obtained for LR.
To the standard propositional modal system of provability logic constants are added to account for the arithmetical fixed points introduced by Bernardi-Montagna in . With that interpretation in mind, a system LR of modal propositional logic is axiomatized, a modal completeness theorem is established for LR and, after that, a uniform arithmetical completeness theorem with respect to PA is obtained for LR.
In this paper, we study IL(), the interpretability logic of . As is neither an essentially reflexive theory nor finitely axiomatizable, the two known arithmetical completeness results do not apply to : IL() is not or . IL() does, of course, contain all the principles known to be part of IL, the interpretability logic of the principles common to all reasonable arithmetical theories. In this paper, we take two arithmetical properties of and see what their consequences in the modal logic (...) IL() are. These properties are reflected in the so-called Beklemishev Principle , and Zambella’s Principle , neither of which is a part of IL. Both principles and their interrelation are submitted to a modal study. In particular, we prove a frame condition for . Moreover, we prove that follows from a restricted form of . Finally, we give an overview of the known relationships of IL() to important other interpretability principles. (shrink)
First published in 1912, and originally intended as a textbook for students in secondary school, this book gives an overview of the human and physical geography of the occupied areas of the earth's surface. The text is richly illustrated with diagrams, tables, and contemporary photographs of places of interest. Although in general Dicks manages to rise above the colonial viewpoint prevalent at the time, certain aspects of the text are reflective of racial attitudes during this period of the twentieth century. (...) This book will be of value to anyone with an interest in the history of education. (shrink)
While the contemporary biomimicry movement is associated primarily with the idea of taking Nature as model for technological innovation, it also contains a normative or ethical principle—Nature as measure—that may be treated in relative isolation from the better known principle of Nature as model. Drawing on discussions of the principle of Nature as measure put forward by Benyus and Jackson, while at the same time situating these discussions in relation to contemporary debates in the philosophy of biomimicry : 364–387, 2011; (...) Dicks in Philos Technol, doi: 10.1007/s13347-015-0210-2, 2015; Blok and Gremmen in J Agric Environ Ethics 29:203–217, 2016), the aim of this paper is to explore the relation between the principle of Nature as measure and environmental ethics. This leads to the argument that mainstream formulations of environmental ethics share the common trait of seeing our ethical relation to Nature as primarily involving duties to protect, preserve, or conserve various values in Nature, and that, in doing so, they problematically either overlook or dismiss as anthropocentric the possibility that Nature may provide measures, understood in terms of ecological standards, against which our own practices, or at least some of them, may be judged—a way of thinking I call “biomimetic ethics”. The practical consequences of this argument are significant. Whereas mainstream environmental ethics has been applied above all to such issues as wilderness preservation, natural resource management, and animal rights and welfare, biomimetic ethics is applicable rather to the question of how we produce, use, and consume things, and, as such, may potentially provide the basic ethical framework required to underpin the transition to a circular, bio-based, solar economy. (shrink)