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)

A logically complete interpretation of quantum mechanics is given in terms of a theory of quantum processes.

"This volume deals with the question whether quantum mechanics can provide a picture of physical reality. The question is investigated from physical, philosophical, and logical perspectives on the basis of modern views on measurement and open quantum systems"--Back cover.

This paper explores the possibility of an event interpretation of quantum field theory.

The modal completeness proofs of Guaspari and Solovay (1979) for their systems R and R – are improved and the relationship between R and R – is clarified.

To the standard propositional modal system of provability logic constants are added to account for the arithmetical fixed points introduced by Bernardi-Montagna in [5]. 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.

Methods in experimental science assume objective facts, and those effects are generally independent of the observer or experimenter. This objectivity assumption is not warranted in the field of human studies. Results of psychological experiments tend to be dependent on among other things the expectations of the experimenter. The experimenter effect togther with the replication crisis in social psychology are major issues in experimental parapsychology. We use Houtkooper's Hierarchical Observational Theory to look at a model for dealing with this issue, and (...) conclude that multiple-experimenter projects might be able to sort out experimenter effects from intrinisic effects. Keywords: experimenter effect; replication crisis; psi; parapsychology. (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)

This volume is the latest in a series of books and articles stretching back more than three decades on a theme quite startling in its claims and implications: that terrestrial life did not originate on Earth but arrived in the form of cells or bacteria from outer space. The idea of “panspermia,” that the seeds of life are spread from planet to planet, dates to the 19th century with the ideas of Lord Kelvin. It was championed by the Swedish physicist, (...) chemist, and Nobelist Svante Arrhenius at the beginning of the 20th century. Once scientists recognized the difficulties of life surviving in the conditions of interplanetary and interstellar space, by the 1960s a neo-panspermia became popular: not life itself, but prebiotic chemicals were the new seeds of life, made more likely by the discovery of numerous complex organic molecules in meteorites, comets, and interstellar molecular clouds. But the difficulties of synthesizing anything more complicated than amino acids in the wake of the famous Miller-Urey experiment in 1953 kept alive the idea that life itself may be spread throughout the universe. At the center of this work is Chandra Wickramasinghe, a research student of the maverick astronomer Fred Hoyle. In 1962 Hoyle became interested in the origin and nature of interstellar dust, in particular as found in dense molecular clouds, and he and Wickramasinghe set to work on the problem. They became convinced that dust could not form inside molecular clouds, but must have originated in the atmospheres of cool stars, protoplanetary discs, or supernova ejecta, a theory now widely accepted. It was the next steps that became increasingly controversial: that the spectroscopic signature of dust was best explained by complex biomolecules such as cellulose; that biomolecules were assembled into still more complex forms inside comets; and that the living cells and bacteria generated there were responsible for the origin of life on Earth. And not only that: Hoyle and Wickramasinghe argued that the delivery of bacteria from space continues, affecting both the origin and the ongoing evolution of life, and may even be responsible for certain diseases on Earth. These theories were not only reported in reputable scientific journals such as Nature, but also in popular books including Lifecloud (1978), Diseases from Space (1979), and Evolution from Space (1981). Biologists were not impressed; Lynn Margulis, not known for the timidity of her own theories such as endosymbiosis, called the first book “wanton, amusing, promiscuous fiction.”. (shrink)

In the bracket mushroom, Schizophyllum commune, a recessive genetic alteration, mnd, causes abnormally hyperplastic three‐dimensional mounds of hyphae to rise from the surface of both haploid and dikaryotic mycelia. mnd, although not a genetic block in the fruiting body developmental pathway, is at least partially epistatic to fruiting. Within dikaryons containing both mutant and wild‐type nuclei, [mnd + mnd+], a nonreciprocal somatic recombination event can lead to stable conversion of the mnd+ region of the wild‐type nucleus to mnd. This transformation (...) to the homoallelic [mnd + mnd] condition involves no genomic areas other than the mnd region and permanently prevents any further fruiting. Studies relating to the recombination mechanism have ruled out a diploid intermediate state and other concomitants of orthodox somatic recombination, as well as whole chromosome transfer. Instead, a novel form of internuclear genetic transfer is postulated whereby a nearby locus, mob+, controls the mobilization of the mnd chromosomal region alone from one nucleus to the other within the binucleate cells of dikaryotic mycelia. (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 [5]. 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)

Euthanasia and physician-assisted suicide (PAS) by request and/or based on an advance directive are legal in The Netherlands under strict conditions, thus providing options for patients with Huntington's disease (HD) and other neurodegenerative diseases to stay in control and choose their end of life. HD is an inherited progressive disease characterised by chorea and hypokinesia, psychiatric symptoms and dementia. From a qualitative study based on interviews with 15 physicians experienced in treating HD, several ethical issues emerged. Consideration of these aspects (...) leads to a discussion about the professional role of a physician in relation to the personal autonomy of a patient. Such a discussion can raise awareness that talking about end-of-life wishes with an HD patient is part of the legal, professional and moral responsibility of the physician, and that a letter of intent on behalf of the physician can improve active participation in the process. Discussion of these issues can help to advance the debate on euthanasia and PAS in HD and other neurodegenerative diseases. (shrink)