Patient decision aids enable patients to be better informed about the potential benefits and harms of their healthcare options. Certification of patient decision aids at the national level in the United States is a critical step towards responsible governance—primarily as a quality measure that increases patients’ safety, as mandated in the U.S. Patient Protection and Affordable Care Act (PPACA). Certification would provide a verification process to identify conflicts of interest that may otherwise bias the scientific evidence presented in decision aids. (...) Certification also benefits clinicians who may otherwise face malpractice claims based on harm to patients caused by possible reliance on patient decision aids that are inaccurate, incomplete, or presented in a manner that biases the patient’s decision. Existing work by the International Patient Decision Aid Standards Collaboration could guide the establishment of a certification process within the U.S. This article argues for national certification of patient decision aids and discusses how that may be achieved. (shrink)

Promoting patient autonomy has become a key imperative in health service encounters. We will examine the potential negative effects of over-promoting patient autonomy and consider the impact on patient access, their experience and the provision of equitable services by focusing on an extreme manifestation of this trend, i.e. calls for patient involvement in health care decision making to be mandatory. Advocates of mandatory autonomy hold that patients have a duty to themselves, to society and to the medical system to make (...) decisions on their health care independently. Models of mandatory autonomy may be contrasted to those of optional autonomy that seek to ascertain patients’ decisional preferences and to understand wider limitations on their freedom to choose. Where choice as decisional responsibility becomes mandatory it ceases to promote agency and where autonomous choice is understood as an individualistic practice it will contribute to the cultural dominance of Western values. Moreover, taking a view that principlist ethics needs to take account of the social and cultural contexts of individual lives, we argue that if mandatory autonomy were to be over-emphasised as part of an ongoing move towards patient choice in UK National Health Service (NHS), educated and affluent people would be more able to exercise choices at the expense of people who are experienced in asserting preferences and who have the resources to make use of choices. We will argue that the promotion of autonomy needs to be tempered by steps to enable less powerful social, cultural and economic groups to contribute to decision making and to support individuals who may feel abandoned by having decisional responsibility transferred to them. Until constraints on individual choice can be understood and addressed, we advocate the model of optional autonomy used in shared decision making and make recommendations for practice, policy, education and research. (shrink)

I propose in this paper to examine and analyse the concept of śūnyatā as it is expressed in the Hrdaya sūtras of the Buddhist prajñā-pāramitā literature and in the Mū1amadhyamaka-kārikās of Nāgārjuna. I shall attempt to show some of the difficulties involved in seeking an objective referent or counter part for the concept and also in trying to preserve the tension implicit in the affirmation of the middle way. I hope to indicate that the via negativa approach has positive implications (...) for the understanding of śūnyatā and that in the final analysis we may have to look for its meaning in the way it is used. (shrink)

Many variants of categorial grammar assume an underlying logic which is associative and linear. In relation to left extraction, the former property is challenged by island domains, which involve nonassociativity, and the latter property is challenged by parasitic gaps, which involve nonlinearity. We present a version of type logical grammar including ‘structural inhibition’ for nonassociativity and ‘structural facilitation’ for nonlinearity and we give an account of relativisation including islands and parasitic gaps and their interaction.

Category-specific impairments of object recognition and naming are among the most intriguing disorders in neuropsychology, affecting the retrieval of knowledge about either living or nonliving things. They can give us insight into the nature of our representations of objects: Have we evolved different neural systems for recognizing different categories of object? What kinds of knowledge are important for recognizing particular objects? How does visual similarity within a category influence object recognition and representation? What is the nature of our semantic knowledge (...) about different objects? We review the evidence on category-specific impairments, arguing that deficits even for one class of object cannot be accounted for in terms of a single information processing disorder across all patients; problems arise at contrasting loci in different patients. The same apparent pattern of impairment can be produced by damage to different loci. According to a new processing framework for object recognition and naming, the hierarchical interactive theory, we have a hierarchy of highly interactive stored representations. HIT explains the variety of patients in terms of lesions at different levels of processing and different forms of stored knowledge used both for particular tasks and for particular categories of object. Key Words: category-specific deficits; functional imaging; hierarchical models; interactive activation models; neuropsychology; object recognition; perceptual and functional knowledge. (shrink)

We present work demonstrating that the nature of an object for our visual system depends on the actions we are programming and on the presence of action relations between stimuli. For example, patients who show visual extinction are more likely to become aware of two objects if the objects fall in appropriate visual locations for a common action. This effect of the action relations between objects is modulated both by the familiarity of the positioning of the objects for action, and (...) by the mere possibility of action (the ‘affordance’) between the objects. In addition, the programming of an action to a part of an object alters the representation of that object, making the ‘part’ into the object selected by the visual system. These results point to object coding being a rather flexible process, affected not only by the perceptual properties of stimuli but also by the relations between these properties and action. We discuss the implications for theories of perception as well as considering why action information, in particular, may be important for perception. (shrink)

In this article, we focus on the mentoring process, and we argue that the internal and external pressures extant at research universities may create a research culture that may be antithetical to appropriate mentoring. We developed a scale based on motivation theory to determine the perceived research culture in departments and research laboratories, and a mentoring scale to determine approaches to mentoring graduate students. Participants were 610 faculty members across 49 departments at a research oriented university. The findings were that (...) a mastery-oriented research climate and an outcome-oriented research climate were manifested at the university. More importantly, each research climate had its own unique impact on how the faculty approached mentoring graduate students. A mastery research climate was related to a more supportive approach to mentoring than the outcome research climate. We concluded by suggesting that the outcome research climate may have an adverse effect on effective mentoring and on maintaining research ethics. (shrink)

If all dependent expressions were adjacent some variety of immediate constituent analysis would suffice for grammar, but syntactic and semantic mismatches are characteristic of natural language; indeed this is a, or the, central problem in grammar. Logical categorial grammar reduces grammar to logic: an expression is well-formed if and only if an associated sequent is a theorem of a categorial logic. The paradigmatic categorial logic is the Lambek calculus, but being a logic of concatenation the Lambek calculus can only capture (...) discontinuous dependencies when they are peripheral. In this paper we present the displacement calculus, which is a logic of intercalation as well as concatenation and which subsumes the Lambek calculus. On the empirical side, we apply the new calculus to discontinuous idioms, quantification, VP ellipsis, medial extraction, pied-piping, appositive relativisation, parentheticals, gapping, comparative subdeletion, cross-serial dependencies, reflexivization, anaphora, dative alternation, and particle shift. On the technical side, we prove that the calculus enjoys Cut-elimination. (shrink)

We summarise and respond to the main points made by the commentators on our target article, which concern: whether structural similarity can play a causal role in normal object identification and in neuropsychological deficits for living things, the nature of our structural knowledge of the world, the relations between sensory and functional knowledge of objects, and the nature of our functional knowledge about living things, whether we need to posit a “core” semantic system, arguments that can be marshalled from evidence (...) on functional imaging, the causal mechanisms by which category differences can emerge in object representations, and the nature of our knowledge about categories other than living and nonliving things. We also highlight points raised in our article that seem to be accepted. (shrink)

In this article I introduce a new reading of Jean-Paul Sartre's account of bad faith. The reading contrasts with previous accounts by denying that states of bad faith are exhausted by attitudes towards transcendence and facticity. Instead, I argue that bad faith can involve attitudes to many other aspects of the human being. I also respond to an argument which claims that affirmations of freedom are inconsistent with the motivations behind bad faith. The inconsistency is here resolved by demonstrating how (...) in bad faith we can still affirm a restricted version of freedom which avoids us acknowledging the unpleasant aspects of our full freedom. (shrink)

I discuss the relations between the phenomenon of inattentional blindness and neuropsychological syndromes such as visual neglect, extinction and simultanagnosia. While there are similarities in the types of unconscious processing apparent in inattentional blindness and in these syndromes, there are also differences - for instance, grouping affects the reportability of stimuli in some neuropsychological syndromes but not necessarily in inattentional blindness. The reasons for such discrepancies, and the link between unconscious processing and underlying neural structures are discussed.

\ is a 7000 line Prolog parser/theorem-prover for logical categorial grammar. In such logical categorial grammar syntax is universal and grammar is reduced to logic: an expression is grammatical if and only if an associated logical statement is a theorem of a fixed calculus. Since the syntactic component is invariant, being the logic of the calculus, logical categorial grammar is purely lexicalist and a particular language model is defined by just a lexical dictionary. The foundational logic of continuity was established (...) by Lambek while a corresponding extension including also logic of discontinuity was established by Morrill and Valentín :167–192, 2010). \ implements a logic including as primitive connectives the continuous and discontinuous connectives of the displacement calculus, additives, 1st order quantifiers, normal modalities, bracket modalities, and universal and existential subexponentials. In this paper we review the rules of inference for these primitive connectives and their linguistic applications, and we survey the principles of Andreoli’s focusing, and of a generalisation of van Benthem’s count-invariance, on the basis of which \ is implemented. (shrink)