We test people's ability to optimize performance across two concurrent tasks. Participants performed a number entry task while controlling a randomly moving cursor with a joystick. Participants received explicit feedback on their performance on these tasks in the form of a single combined score. This payoff function was varied between conditions to change the value of one task relative to the other. We found that participants adapted their strategy for interleaving the two tasks, by varying how long they spent on (...) one task before switching to the other, in order to achieve the near maximum payoff available in each condition. In a second experiment, we show that this behavior is learned quickly and remained stable for as long as the payoff function did not change. The results of this work show that people are adaptive and flexible in how they prioritize and allocate attention in a dual-task setting. However, it also demonstrates some of the limits regarding people's ability to optimize payoff functions. (shrink)

To describe the content of practice guidelines on euthanasia and assisted suicide (EAS) and to compare differences between settings and guidelines developed before or after enactment of the euthanasia law in 2002 by means of a content analysis. Most guidelines stated that the attending physician is responsible for the decision to grant or refuse an EAS request. Due care criteria were described in the majority of guidelines, but aspects relevant for assessing these criteria were not always described. Half of the (...) guidelines described the role of the nurse in the performance of euthanasia. Compared with hospital guidelines, nursing home guidelines were more often stricter than the law in excluding patients with dementia (30% vs 4%) and incompetent patients (25% vs 4%). As from 2002, the guidelines were less strict in categorically excluding patients groups (32% vs 64%) and in particular incompetent patients (10% vs 29%). Healthcare institutions should accurately state the boundaries of the law, also when they prefer to set stricter boundaries for their own institution. Only then can guidelines provide adequate support for physicians and nurses in the difficult EAS decision-making process. (shrink)

Jules Janssens a construit une œuvre importante, qui, pour de nombreux chercheurs, a ouvert des perspectives de recherches nouvelles et fécondes. Ses travaux ont fait date. Ils portent principalement sur la philosophie d'Avicenne, ses sources, ses rapports avec la pensée musulmane, son influence sur la théologie ash'arite (al-Ghazālī, Fakhr al-Dīn al-Rāzī) et sa réception dans le monde latin. Pour lui rendre hommage, quatorze collègues et amis de renommée internationale se sont réunis pour poursuivre ses réflexions sur ces thèmes. L'ouvrage (...) qui en est issu offre un état des lieux de la recherche contemporaine sur Avicenne et sa postérité arabo-latine. (shrink)

Background: More and more quantitative information is becoming available about the risks of complications arising from medical treatment. In everyday practice, this raises the question whether each and every risk, however low, should be disclosed to patients. What could be good reasons for doing or not doing so? This will increasingly become a dilemma for practitioners.Objective: To report doctors’ views on whether to disclose or withhold information on low risks of complications.Methods: In a qualitative study design, 37 respondents were included. (...) Focus group interviews were held with 22 respondents and individual in-depth interviews with 15.Results: Doctors have doubts about disclosing or withholding information on complication risk, especially in a risk range of 1 in 200 to 1 in 10 000. Their considerations on whether to disclose or to withhold information depend on a complicated mix of patient and doctor-associated reasons; on medical and personal considerations; and on the kind and purpose of intervention.Discussion: Even though the degree of a risk is important in a doctor’s considerations, the severity of the possible complications and patients’ wishes and competencies have an important role as well. Respondents said that low risks should always be communicated when there are alternatives for the intervention or when the patient may prevent or mitigate the risk. When the appropriateness of disclosing risks is doubtful, doctors should always tell their patients that no intervention is without risk, give them the opportunity to gather all the information they need or want, and enable them to detect a complication at an early stage. (shrink)

Reinforcement learning approaches to cognitive modeling represent task acquisition as learning to choose the sequence of steps that accomplishes the task while maximizing a reward. However, an apparently unrecognized problem for modelers is choosing when, what, and how much to reward; that is, when (the moment: end of trial, subtask, or some other interval of task performance), what (the objective function: e.g., performance time or performance accuracy), and how much (the magnitude: with binary, categorical, or continuous values). In this article, (...) we explore the problem space of these three parameters in the context of a task whose completion entails some combination of 36 state–action pairs, where all intermediate states (i.e., after the initial state and prior to the end state) represent progressive but partial completion of the task. Different choices produce profoundly different learning paths and outcomes, with the strongest effect for moment. Unfortunately, there is little discussion in the literature of the effect of such choices. This absence is disappointing, as the choice of when, what, and how much needs to be made by a modeler for every learning model. (shrink)

... Avicenne et Fismaelisme sont comme'eau et le feu. On se souviendra du fameux passage de son autobiographie ou le philosophe coupe court avec toutes les ...

Background: Discussing treatment risks has become increasingly important in medical communication. Still, despite regulations, physicians must decide how much and what kind of information to present. Objective: To investigate patients’ preference for information about a small risk of a complication of colonoscopy, and whether medical and personal factors contribute to such preference. To propose a disclosure policy related to our results. Design: Vignettes study. Setting: Department of Gastroenterology, Academic Medical Centre, the Netherlands. Patients: 810 consecutive colonoscopy patients. Intervention: A home-sent (...) questionnaire containing three vignettes. Vignettes varied in the indication for colonoscopy, complication severity and level of risk. Patients were invited to indicate their wish to be informed and the importance of such information. In addition, sociodemograhic, illness-related and psychological characteristics were assessed. Main outcome measurements: Wish to be informed and importance of information. Results: Of 810 questionnaires, 68% were returned. Patients generally wished to be informed about low-risk complications, regardless of the indication for colonoscopy or the severity of the complication. The level of risk did matter, though (OR = 2.48, SE = 0.28, p = 0.001). The information was considered less important if done for population screening purposes or diagnosis of colon cancer, if the complication was less severe (bleeding) and if the risk was smaller (0.01% and 0.1%). Patients’ information preference was also related to age, mood and coping style. Limitations: Difficulty of vignettes. Conclusions: Patients generally wish to be informed about all possible risks. However, this might become uninformative. A stepwise approach is suggested. (shrink)

BackgroundIn the Canadian Alliance for Healthy Hearts and Minds (CAHHM) cohort, participants underwent magnetic resonance imaging (MRI) of the brain, heart, and abdomen, that generated incidental findings (IFs). The approach to managing these unexpected results remain a complex issue. Our objectives were to describe the CAHHM policy for the management of IFs, to understand the impact of disclosing IFs to healthy research participants, and to reflect on the ethical obligations of researchers in future MRI studies.MethodsBetween 2013 and 2019, 8252 participants (...) (mean age 58 ± 9 years, 54% women) were recruited with a follow-up questionnaire administered to 909 participants (40% response rate) at 1-year. The CAHHM policy followed a restricted approach, whereby routine feedback on IFs was not provided. Only IFs of severe structural abnormalities were reported.ResultsSevere structural abnormalities occurred in 8.3% (95% confidence interval 7.7–8.9%) of participants, with the highest proportions found in the brain (4.2%) and abdomen (3.1%). The majority of participants (97%) informed of an IF reported no change in quality of life, with 3% of participants reporting that the knowledge of an IF negatively impacted their quality of life. Furthermore, 50% reported increased stress in learning about an IF, and in 95%, the discovery of an IF did not adversely impact his/her life insurance policy. Most participants (90%) would enrol in the study again and perceived the MRI scan to be beneficial, regardless of whether they were informed of IFs. While the implications of a restricted approach to IF management was perceived to be mostly positive, a degree of diagnostic misconception was present amongst participants, indicating the importance of a more thorough consent process to support participant autonomy.ConclusionThe management of IFs from research MRI scans remain a challenging issue, as participants may experience stress and a reduced quality of life when IFs are disclosed. The restricted approach to IF management in CAHHM demonstrated a fair fulfillment of the overarching ethical principles of respect for autonomy, concern for wellbeing, and justice. The approach outlined in the CAHHM policy may serve as a framework for future research studies.Clinical trial registrationhttps://clinicaltrials.gov/ct2/show/nct02220582. (shrink)

The high prevalence of cardiovascular diseases demands a reliable and sensitive risk assessment technique. In order to develop a fast and label-free immunosensor for C-reactive protein, a risk factor for this condition, anti-CRP antibodies were physically adsorbed to the hydrogen -terminated surface of nanocrystalline diamond. An Enzyme-Linked ImmunoSorbent Assay reference technique showed that this was a suitable substrate for antibody-antigen recognition reactions. Electrochemical Impedance Spectroscopy was used to electronically detect CRP recognition. The specificity of the immunosensor was demonstrated by incubation (...) with CRP and plasminogen as reference molecule. A different impedance behavior was observed in real-time after CRP addition as compared to plasminogen addition: the impedance increased only during CRP incubation. Fitting the data showed that this corresponded with a decrease in capacitance of the molecular layer due to its increased thickness by specific CRP recognition. Sensitivity experiments in real-time showed a clear discrimination between 1 μM, 100 nM, and 10 nM of CRP after 10 min at 100 Hz. Since, 10 nM of CRP was still clearly distinguishable from buffer solution, our CRP-directed immunosensor prototype reaches a sensitivity that is within the physiologically relevant concentration range of this biomarker in healthy controls and CVD patients. Moreover, this prototype displayed real-time discriminating power between spiked and unspiked serum, and thus also shows its applicability in this biological matrix. © 2011 Elsevier B.V. All rights reserved. (shrink)

Si l’héroïsme médiéval s’élabore avant tout, dans sa composante guerrière, au masculin singulier, la tradition narrative française prévoit néanmoins quelques espaces à l’expression de la prouesse féminine. Du xiie au xve siècle, les romans illustrent plusieurs figures d’amazones ou de veuves viriles. Cependant, cette promotion à l’héroïsme semble difficile à concevoir dans le cas de personnages féminins assumant le rôle d’épouse ou d’amante. Pour vérifier cette constatation, l’enquête se tourne vers les romans idylliques qui ont connu un certain succès au (...) Moyen Age. La relation d’amour réciproque et relativement égalitaire pourrait nous laisser croire que les jeunes amants sont susceptibles de partager le renom de leurs aventures. L’analyse de plusieurs romans montre qu’il n’en est rien. Une exception cependant permet de distinguer le Roman de Floriant et Florete et surtout sa source directe, Erec et Enide de Chrétien de Troyes comme ferment possible d’un héroïsme de l’épouse. (shrink)

Ce volume offre l'édition critique de la traduction latine médiévale (partielle) de la troisième partie de la Physique du Shif?' d'Avicenne. Pour l'édition de la peine première partie traduite à Tolède, qui couvre le prologue et le début du premier chapitre, les mêmes principes ont été maintenus que pour l'édition du second traité. Quant à l'édition de la majeure partie, qui fut traduite à Burgos quasiment un siècle après la tolédane et qui n'a été conservée que dans un seul témoin, (...) les cas où la traduction latine ne correspond pas à la lecture du texte arabe sont analysés de façon particulière et, autant que possible, expliqués sur la base de considérations philologiques et/ou doctrinales. En outre, dans la mesure du possible, les sources historiques des doctrines évoquées par Avicenne dans l'ensemble de ces chapitres ont été précisés. (shrink)

English summary: This Arabic edition and French translation of Avicennas commentary on Aristotles Lambda offers a clear opportunity to better understand the Greek philosophers influence on medieval Arabic philosophy, especially concerning the hierarchy of the universe. French description: Ce texte d'Avicenne est l'un des seuls commentaires sur Aristote laisses par le philosophe persan. Il s'attaque au noyau theologique de la Metaphysique du Stagirite, les chapitres 6 a 10 du livre Lambda. Avicenne depend d'une tradition greco-arabe (Alexandre d'Aphrodise, Themistius, l'ecole "peripateticienne" (...) de Bagdad). La tradition arabe a aussi attribue a Aristote plusieurs oeuvres d'origine neoplatonicienne, notamment une Theologie adaptee de Plotin, et un Livre du Bien pur, adaptation des Elements de Theologie de Proclus. Le Dieu d'Aristote est ainsi pour Avicenne la Cause premiere efficiente de l'etre. La structure hierarchique de l'univers resulte de l'emanation produite par l'autointelligence du premier Principe. Il ne fait pas de doute, pour Avicenne, que ces doctrines aient ete celles du Stagirite. (shrink)

On savait que c’était l’entité la plus complexe de l’univers connu. Mais le feu d’artifice de découvertes récentes dépasse l’entendement et fait exploser tous les schémas. Votre cerveau est (beaucoup) plus fabuleux que vous le croyez. Il est : totalement élastique, même âgé, handicapé, voire amputé de plusieurs lobes, le système nerveux central peut se reconstituer et repartir à l’assaut des connaissances et de l’action sur le monde ; totalement social, un cerveau n’existe jamais seul, mais toujours en résonance avec (...) d’autres. Mieux : nous sommes neuronalement constitués pour entrer en empathie avec autrui et aller à son secours. Ce livre aborde ces questions passionnantes avec cinq spécialistes. (shrink)

Le grand humaniste, Andrea Alpago, médecin et philosophe, fut aussi un traducteur notoire. Parmi ses traductions d’œuvres arabes en Latin figure une œuvre de jeunesse d’Avicenne, le Kitāb fī l-nafs ‘alā sunnat al-ikhtiṣār. Mais il ne se contenta pas de traduire simplement ce traité. Il ajouta à sa traduction un commentaire suivi. Même si tout indique que ce commentaire ne fut pas entièrement achevé, il mérite l’attention. En effet, on n’y trouve pas seulement l’expression de la façon dont Alpago a (...) compris ce texte, mais aussi des indications concernant les motifs qui l’ont poussés à le traduire, ainsi qu’à traduire d’autres textes avicenniens en relation avec l’âme. Comme la compréhension d’un texte est inévitablement liée à la façon dont celui-ci a été traduit, l’analyse du commentaire est précédée par une brève étude de la méthode de traduction d’Alpago, en prêtant particulièrement attention à ce qui en constitue les points forts, mais aussi les points faibles. (shrink)

In 1901 Russell had envisaged the new analytic philosophy as uniquely systematic, borrowing the methods of science and mathematics. A century later, have Russell’s hopes become reality? David Lewis is often celebrated as a great systematic metaphysician, his influence proof that we live in a heyday of systematic philosophy. But, we argue, this common belief is misguided: Lewis was not a systematic philosopher, and he didn’t want to be. Although some aspects of his philosophy are systematic, mainly his pluriverse of (...) possible worlds and its many applications, that systematicity was due to the influence of his teacher Quine, who really was an heir to Russell. Drawing upon Lewis’s posthumous papers and his correspondence as well as the published record, we show that Lewis’s non- Quinean influences, including G.E. Moore and D.M. Armstrong, led Lewis to an anti- systematic methodology which leaves each philosopher’s views and starting points to his or her own personal conscience. (shrink)

Nella seconda parte del _Libro della condanna dello status e dell’ostentazione_ il ventottesimo libro della sua opera principale, _La rinascita delle scienze religiose_ – al-Ghazālī trae molta ispirazione da al-Muhāsibī, soprattutto dalla sua opera _al-Ri’āya al-huqūq Allāh _(_L’osservanza dei diritti di Dio_). Il fatto che al-Ghazālī menziona esplicitamente il nome di al-Muhāsibī non meno di quattro volte in questa sezione testimonia la sua ammirazione profonda per questo grande mistico delle origini. Un attento esame di questi riferimenti e del loro contesto (...) rivela una grande familiarità e un ampio uso della _Ri’āya_, così come un accesso diretto a un’altra grande opera di al-Muhāsibī, cioè il _Kitāb al-Wasāya_ (_Il Libro dei Comandamenti_). Inoltre, la scelta di al-Ghazālī di specifici versetti coranici e delle Tradizioni, sia profetiche che di storie, è molto debitrice della _Ri’āya_, come diventa chiaro sulla base di un esame del primo capitolo di questa seconda parte che consiste interamente in citazioni di versetti coranici e delle Tradizioni riguardanti la questione dell’ostentazione. Per quanto riguarda il secondo capitolo, che si concentra sui modi usati per attirare l’attenzione della gente su di sé sia negli atti religiosi che in quelli verbali, esso condivide molte caratteristiche con l’esposizione di al-Muhāsibī nella _Ri’āya_, compresa la copia quasi letterale di alcuni passaggi. Infine, l’uso che al-Ghazālī fa della _Ri’āya_ in ciascuno degli altri capitoli è brevemente indicato. Questo studio mostra che al-Muhāsibī non era solo una fonte importante per al-Ghazālī – un fatto già noto da quasi un secolo – ma _la_ fonte principale, almeno per questa sezione della sua _Rinascita_. Tuttavia, allo stesso tempo, questo studio chiarisce che al-Ghazālī non è colpevole di cieco plagio. In the second part of the _Book of the Condemnation of Status and Ostentation_ – the twentieth-eight book of his major work, _The Revival of the Religious Sciences_ – al-Ghazālī draws much inspiration from al-Muhāsibī, above all from his work _al-Ri’āya al-huqūq Allāh_ (_Eyeservice to God’s Laws_). The very fact that al-Ghazālī explicitly mentions al-Muhāsibī’s name no less than four times throughout this section clearly testifies to his profound admiration for this great early mystic. A close examination of these references and their context reveals a great familiarity with and an extensive use of the _Ri’āya_, as well as a direct access to another major work of al-Muhāsibī, i.e., _Kitāb al-Wasāya_ (_The Book of Commandments_). Moreover, al-Ghazālī’s choice of specific Qur’anic verses and of Traditions, both prophetic and stories, is much indebted to the _Ri’āya_, as becomes clear on the basis of an examination of the first chapter of this second part which consisting entirely of quotations of Qur’anic verses and Traditions concerning the issue of ostentation. As to the second chapter, which focuses on the ways used to draw people’s attention to oneself both in religious as well as in wordly acts, it shares many features with al-Muhāsibī’s exposition in the _Ri’āya_, including the almost verbatim copying of some passages. Finally, al-Ghazālī’s use of the _Ri’āya_ in each of the other chapters is briefly indicated. This study shows that al-Muhāsibī was not just a major source for al-Ghazālī – a fact already known for nearly a century – but _the_ major source, at least for this section of his _Revival_. However, at the same time, this study makes clear that al-Ghazālī is not guilty of blind plagiarism. (shrink)

Les décisions politiques sur les risques environnementaux complexes font fréquemment intervenir des éléments scientifiques contestés. Il n’y a généralement pas de « faits » qui conduisent à une politique correcte unique. Les éléments de preuve qui sont intégrés dans les avis scientifiques destinés à une décision politique nécessitent une évaluation de leur qualité. En 2003, l’Agence néerlandaise d’évaluation environnementale a adopté une méthode standardisée, désignée sous le nom de « guide », dans le cadre de laquelle les principaux aspects de (...) la production et de l’utilisation des connaissances sont présentés grâce à une liste de contrôle visant à l’évaluation et à la communication des incertitudes. Dans cet article, nous présentons des résultats de l’application de ce guide à la controverse sur les risques des particules en suspension. La délibération active sur l’incertitude dans un contexte d’expertise entraîne un processus d’apprentissage commun entre les experts et les décideurs politiques, ce qui conduit à une meilleure prise de conscience du phénomène d’incertitude et de ses implications politiques.Policy decisions on complex environmental risks often involve disputed science. Typically, there are no “ facts” to support a single unequivocally correct policy. The evidence provided in scientific studies for policy-making decisions requires high-quality assessment. In 2003, the Netherlands Environmental Assessment Agency adopted a standardized method, referred to as “guidelines”, whereby key quality aspects of knowledge production and use are presented in the form of a checklist for uncertainty assessments and communication. In this article, we present the outcomes of applying the guidelines in controversies on the risks of ambient particulate matter. In the policy–advisory context, active deliberation on uncertainty produces a common learning process for advisors and policy makers, which leads to a deeper understanding and increased awareness of the phenomenon of uncertainty and its policy implications. (shrink)

In the present paper it is shown that al-Ämidî has tried to integrate somehow pilosophy into theology in way that reveals closer to al-Ghazâlî's than to F.D. al-Râzî's way of combining both currents of thought. Based on an analysis of several ideas taken from different works it is shown that al-Ämidî not only accepts the logic of the philosophers, but also their views that may be considered as scientifically established beyond any reasonable doubt.

Une grande partie du livre Kitāb al-inṣāf d’Avicenne ne nous est pas parvenue. Toutefois, le «paraphrase-commentaire » ayant trait à la Métaphysique d’Aristote, livre Lambda, chapitres 6-10 a été conservé dans deux manuscrits. En 1948 Badawi avait fourni une édition du texte arabe, qui, malgré ses mérites, est ouverte à des corrections importantes, comme le démontrent quelques exemples. En outre, une attention particulière est payée au problème de l’identification de la traduction utilisée par Avicenne. Un examen, bien que non exhaustif, (...) de différents cas donne à penser qu’il s’agit d’une version révisée de la traduction d’Usāth. Mais il est à noter qu’Avicenne n’hésite pas de modifier de temps à temps la terminologie en fonction de sa propre pensée. Enfin, des éléments novateurs se font jour, dont au moins deux s’expliquent par les particularités de la traduction arabe. Au niveau doctrinal, trois éléments de telle sorte ressortissent : 1. le rejet d’inclure l’argument du Premier moteur immobile comme preuve de Dieu dans un contexte métaphysique ; 2. la qualification de la dépendance de l’univers envers le Premier Principe en termes de « don d’être » , non de mouvement ; enfin, 3. l’affirmation que l’auto-connaissance du Premier Principe inclut la connaissance de toutes les choses.A large part of Avicenna’s Kitāb al-inṣāf has been lost. However, the section containing a « paraphrasis-commentary » of Aristotle’s Metaphysics, book Lambda, chapters 6-10, has reached us in two manuscripts. Badawi, in 1948, has offered a printed edition that notwithstanding its merits is open to serious improvement as shown by several examples. Furthermore, the problem of which of the old Arabic translation Avicenna has used is dealt with in detail. The examined cases, although limited in number, point to a revised version of Ustāth’s translation. But it has to be noted that Avicenna now and then changes the terminology consciously in view of his own ideas. Finally, some innovative elements come to the fore, two of which, at least, are due to particularities of the Arabic translation. From the doctrinal point of view, three ideas do strike: 1. the fact that the proof of the Unmoved Mover is unacceptable in a metaphysical context; 2. the qualification of the dependence of the Universe on the First Principle as a “Gift of Being” , not as a motion; 3. the inclusion of the knowledge of all things in God’s self-knowledge. (shrink)

Al-Ghazzālī a toujours utilisé les travaux de ses prédécesseurs. Le Mi‘yār al-‘ilm fī fann, sorte de manuel de logique aristotélicienne adaptée au droit et à la théologie islamiques, contient ainsi une grande variété d’écrits avicenniens, du K. jusqu’à certaines parties du Šifā’. Mais quelques écrits farabiens, en particulier al-Qiyās et al-Maqūlāt, y sont mêlés. C’est la première et, à notre connaissance, la seule fois qu’al-Ghazzālī combine ainsi des éléments empruntés à ces deux grands maîtres.

À partir de deux vignettes a priori sans rapport, l’auteur se propose de réfléchir aux effets des transformations sociales sur le rapport que les individus entretiennent avec la parentalité. Revendication d’autonomie, création et utilisation d’un réseau « coparental » autour de l’enfant ; il sera question de mesurer l’intérêt dans un cadre clinique de porter attention aux modalités de rencontre, ou de non-rencontre, entre la créativité des parents et leur environnement. L’auteur en arrivera à paraphraser D.W. Winnicott en proclamant qu’« (...) un parent, ça n’existe pas! ». (shrink)