In his preface, Hunter explains that this volume is intended to provide for non-mathematicians an introduction to the most important results of modern mathematical logic. The reader will find here the work of Post, Skolem, Gödel, Church, Henkin, and others, presented in a terse and closely-knit style. Though acknowledging the trend toward natural deduction systems, Hunter sticks to more classical axiomatic systems on the grounds that the proofs of metatheorems are simplified by that choice. He begins with a formal system (...) of propositional logic, for which he develops proofs of completeness, consistency, and decidability. Systems of first order predicate logic are then dealt with, and Church's and Gödel's results on undecidability and incompleteness are presented. There is a brief, useful discussion indicating what parts of first order predicate logic are decidable. It is assumed that the reader has some familiarity with elementary formal logic: Hunter develops the set-theoretical results he requires. The compactness of the presentation is facilitated by the use of earlier results for propositional logic to obtain certain results for predicate logic. Especially helpful is Hunter's technique of prefacing each of the longer and more difficult proofs with a section explaining the key ideas and the general method of proof; summaries are also often provided in conclusion. Because of the orientation of the book, a more extensive discussion of the significance of the results obtained and the philosophical issues which have been raised concerning some of them, would have been welcome. Nonetheless, this is a good, concise introduction for those who are not yet prepared to tackle the more technical literature. A bibliography is provided for those interested in pursuing the subject in greater detail.--E. M. F. (shrink)

There is general acknowledgement that both the anterior cingulate and orbitofrontal cortex are implicated in reinforcement-guided decision making, and emotion and social behaviour. Despite the interest that these areas generate in both the cognitive neuroscience laboratory and the psychiatric clinic, ideas about the distinctive contributions made by each have only recently begun to emerge. This reflects an increasing understanding of the component processes that underlie reinforcement- guided decision making, such as the representation of reinforcement expectations, the exploration, updating and representation (...) of action values, and the appreciation that choices are guided not just by the prospect of reward but also by the costs that action entails. Evidence is emerging to suggest that the anterior cingulate and orbitofrontal cortex make distinct contributions to each of these aspects of decision making. (shrink)

Background: Informed consent is regarded as a contract between autonomous and equal parties and requires the elements of information disclosure, understanding, voluntariness and consent. The validity of informed consent for critically ill patients has been questioned. Little is known about how these patients experience the process of consent.Objective: The aim of this study was to explore critically ill patients’ experience with the principle of informed consent in a clinical trial and their ability to give valid informed consent.Design: 11 stroke patients (...) who had been informed about thrombolytic treatment and had been through the process of deciding whether or not to participate in a thrombolysis trial went through repeated qualitative semistructured interviews.Results: None of the patients had any clear understanding of the purpose of the trial. Neither did they understand the principles of randomisation and voluntariness. Reasons for giving or not giving consent were trust, conceptions of benefits and risks and altruism. Several patients found it immoral to involve patients in the consent procedure and argued that this was the doctors’ responsibility. Others argued that it is a duty to question patients and perceived it as a sign of being treated with respect and dignity. A majority of the patients found the consent process vague and ambiguous.Conclusions: The results indicate that the principle of informed consent from critically ill patients cannot be seen as a contract between equal and autonomous parties. Further studies are needed to explore critically ill patients’ experiences with the process of informed consent. (shrink)

We give a review of recent progress on the application of the relativistic chiral SU(3) Lagrangian to meson–baryon scattering. It is shown that a combined chiral and 1/Nc expansion of the Bethe–Salpeter interaction kernel leads to a good description of the kaon–nucleon, antikaon–nucleon and pion–nucleon scattering data typically up to laboratory momenta of p lab ≃500 MeV. We solve the covariant coupled channel Bethe–Salpeter equation with the interaction kernel truncated to chiral order Q 3 where we include only those terms (...) which are leading in the large Nc limit of QCD. (shrink)

New class of therapies, including bipolar therapies (BPT) and paradoxical unipolar therapies (PUT) were firstly proposed in relation to a clinical insight and to some results of biological investigations, then they gave rise to mathematical modeling which brought a justification of these therapies, at least from a theoretical point of view. After recalling the mathematical model for the regulation of agonistic antagonistic couples, and reporting the fundamental types of control simulation by means of it, we point out the validity of (...) therapeutical applications inferred from this model. These therapy modalities, including BPT and PUT, now concern the following diseases: astrocytomas, epilepsia and trials on multiple sclerosis. Even if such attempts are in their early stage, noticeably for the last case where biological changes have mainly been studied, it seems that a large span of treatments is open to BPT and PUT. Improvement of these techniques in the future depends, in our opinion, on a parallel working on the dynamics of the mathematical model and the dynamics, perceived by clinical insight and confirmed by biological investigations, of the body reactions to such strategies. Justification of BPT and PUT was given, by resorting to the notion of pathological homeostasis which, too often, intervenes in order to nullify the effects of unilateral (not paradoxical) therapies. This research has elicited some therapies which use two agents with antagonistic effects or only an agent with effects similar to the agent already in excess in the body - in both cases at nearly physiological doses. (shrink)

Aim: To improve clinical and ethical understanding of patient preferences for information and involvement in decision making.Objectives: To develop and evaluate a clinical tool to elicit these preferences and to consider the ethical issues raised.Design: A before and after study.Setting: Three UK hospices.Participants: Patients with advanced life-threatening illnesses and their doctors.Intervention: Questionnaire on information and decision-making preferences.Main outcome measures: Patient-based outcome measures were satisfaction with the amount of information given, with the way information was given, with family or carer information, (...) and confidence about future decision making. Doctor-based outcome measures were confidence in matching information to patient preference, matching family or carer communication to patient preference, knowing patient preferences and matching future decision making with patient preference.Results: Of 336 admissions, 101 patients completed the study . Patient satisfaction with the way information was given and family communication improved after introduction of the tool. Doctor confidence improved across all outcome measures .Conclusions: Patient satisfaction and doctor confidence were improved by administering the questionnaire, but complex ethical issues were raised by implementing and applying this research. The balance of ethical considerations were changed by advanced life-threatening illness, because there is increased risk of harm through delivery of information discordant with the patient’s own preferences. The importance of truly understanding patient preferences towards the end of life is highlighted by this study. (shrink)