The prospect of dealing with a rapidly and inexorably bleeding patient fills most medical practitioners with alarm. When that patient is a Jehovah's Witness, the knowledge that a blood transfusion is likely to be refused turns that alarm into a state of acute anxiety and conflict. This state is further heightened when the patient is young and otherwise healthy--a situation found particularly in obstetric practice with the occurrence of ante- and post-partum haemorrhage, and ectopic pregnancy. In the last 25 years (...) in England, Wales, Scotland and Northern Ireland, there has been one maternal death in which the refusal to accept a blood transfusion has been considered to be an avoidable factor. In this article I have attempted to identify the magnitude of the problem in obstetric practice and have sought to clarify the moral and legal aspects. (shrink)

Obtaining prospective written consent from women to participate in trials when they are experiencing an obstetric emergency is challenging. Alternative consent pathways, such as gaining verbal consent at enrolment followed, later, by obtaining written consent, have been advocated by some clinicians and bioethicists but have received little empirical attention. We explored women’s and staff views about the consent procedures used during the internal pilot of a trial, where the protocol permitted staff to gain verbal consent at recruitment. Interviews with staff (...) and participating women. Data were analysed thematically and interviews were cross-compared to identify differences and similarities in participants’ views about the consent procedures used. Women and some staff highlighted benefits to obtaining verbal consent at trial enrolment, including expediting recruitment and reducing the burden on those left exhausted by their births. However, most staff with direct responsibility for taking consent expressed extreme reluctance to proceed with enrolment until they had obtained written consent, despite being comfortable using verbal procedures in their clinical practice. To account for this resistance, staff drew a strong distinction between research and clinical care and suggested that a higher level of consent was needed when recruiting into trials. In doing so, staff emphasised the need to engage women in reflexive decision-making and highlighted the role that completing the consent form could play in enabling and evidencing this process. While most staff cited their ethical responsibilities to women, they also voiced concerns that the absence of a signed consent form at recruitment could expose them to greater risk of litigation were an individual to experience a complication during the trial. Inexperience of recruiting into peripartum trials and limited availability of staff trained to take consent also reinforced preferences for obtaining written consent at recruitment. While alternative consent pathways have an important role to play in advancing emergency medicine research, and may be appreciated by potential recruits, they may give rise to unintended ethical and logistical challenges for staff. Staff would benefit from training and support to increase their confidence and willingness to recruit into trials using alternative consent pathways. This qualitative research was undertaken as part of the GOT-IT Trial. Date of registration 26/03/2014. (shrink)

We report three experimental studies of reasoning with double conditionals, i.e. problems based on premises of the form: If A then B. If B then C. where A, B, and C, describe everyday events. We manipulated both the logical structure of the problems, using all four possible arrangements (or “figures” of their constituents, A, B, and C, and the believability of the two salient conditional conclusions that might follow from them, i.e. If A then C, or If C then A. (...) The experiments showed that with figures for which there was a valid conclusion, the participants more often, and more rapidly, drew the valid conclusion when it was believable than when it was unbelievable. With figures for which there were no valid conclusions, the participants tended to draw whichever of the two conclusions was believable. These results were predicted by the theory that reasoning depends on constructing mental models of the premises. (shrink)

We report three experimental studies of reasoning with double conditionals, i.e. problems based on premises of the form: If A then B. If B then C. where A, B, and C, describe everyday events. We manipulated both the logical structure of the problems, using all four possible arrangements (or ''figures" of their constituents, A, B, and C, and the believability of the two salient conditional conclusions that might follow from them, i.e. If A then C , or If C then (...) A . The experiments showed that with figures for which there was a valid conclusion, the participants more often, and more rapidly, drew the valid conclusion when it was believable than when it was unbelievable. With figures for which there were no valid conclusions, the participants tended to draw whichever of the two conclusions was believable. These results were predicted by the theory that reasoning depends on constructing mental models of the premises. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:BOOK REVIEWS 495 Perhaps a word should be added about those who deny that Sein und Zeit (or any of Heidegger's later work) has any bearing on theology. Both K. LOwith and H. Jonas claim that Heidegger operates under certain ontic-ontological presuppositions that are taken from and lead to an ontic negation of theology.'2 In a lecture delivered at Drew University Jonas even accused Heidegger of paganism and (...) fatalism.'3 Anybody familiar with Heidegger's thinking knows, of course, how wrong this is. In an interview Heidegger granted to the magazine der Spiegel in 1966, mainly to clarify his political activity during the Nazi period, the question of God entered into the discussion. (The interview was published only after his death in 1976 as Heidegger had stipulated.) In connection with the dangers involved in our technological society Heidegger said, "Only a God may save us. For us there remains the only possible way to prepare, through thinking and poeticizing, a readiness for the appearance of God or the absence of God [and our] doom: that we will perish in the face of the absent God.",4 These are only a few examples of the many authors Siefert discusses in her instructive book. The language is complicated, but the richness of the material as well as Siefert's keen insight reward the reader. An extensive bibliography and an index are added. ELISABETHFE1STHIRSCH Trenton State College On Materialism. By Sebastiano Timpanaro. (London: NLB, 1975. Pp. 254. $15.50) Sebastiano Timpanaro has published as a classical philologist, has been a militant member of Italian socialist parties since 1945, and has been most influenced by Leopardi, a nineteenthcentury Lucretian hedonist and materialist. His socialist and Leopardian interests are brought together in this work, which is a criticism of the tendencies in Western European Marxism (dominated by the Frankfurt school, existentialists, and structuralists) toward idealism and humanism, and their "erroneous rejection" of the biological and physical aspects of Marxism, to leave only historical materialism. Timpanaro claims that the interpretations of the Frankfurt school and Althusser "allow very little of Marxism to survive"; they are falsely antiscientific and adopt a Platonistic conception of science. From materialism he takes as his own point of departure certain hedonistic and pessimistic themes (is that the genuine Marxism?) that reached their height in Leopardi: a social and historical optimism regarding "communism as a now certain goal of human history" (in this he ignores that Marx in the Manuscripts said that communism is not the goal of, but only a stage in, human history); and "pessimism with respect to nature's oppression of man, which would continue to be a cause of unhappiness even in communist society." Again Timpanaro ignores the Manuscripts and Grundrisse where Marx reminds us that nature is our body with which we are in interaction. Timpanaro's pessimism can be understood as a result of the alienation we experience because of the attitudes of conquest and domination of nature--attitudes still endorsed by him in his claim that the animal merely uses nature, while man, who can set goals for himself and use means to his ends, can master nature. But we are in a position, historically, where our very survival depends on our moving back into harmony with nature, by overcoming that alienation. Timpanaro is not yet free of that outdated, bourgeois worldview; his is in accord with the view of capitalism, of which the final contradiction may be the ecological crisis of pollution and the depletion of resources in the name of "necessary" growth. Leopardi's materialist pessimism predicated human solidarity 12On LOwithsee Siefert, pp. 173-180. "On Jonas see Siefert, pp. 180-184,esp. p. 181 n. where Siefert refers to Father Richardson's answer to Jonas. 14May 31, 1976, p. 209. 496 HISTORY OF PHILOSOPHY upon the foundation of the struggle against nature, whereas Marx based the overcoming of our alienation from nature on the reestablishment of an equilibrium and solidarity with nature, our body. In his treatment of structuralism, Timpanaro is not only wallowing in his nineteenthcentury worldview, but he stoops to the lowest level of labeling and name calling, often without supporting arguments, of which dogmatic Marxists are... (shrink)

In a previous work [the second and the third author, “On paraconsistent deontic logic”, Philosophia 16, 293-303 (1986)] investigated certain systems of paraconsistent deontic in order to investigate the problem of contradiction in the domain of ethics. This paper continues this line of research, studying some paraconsistent systems containing alethic and deontic modalities. This approach allows us to treat the principles of Kant (OA→ \diamond A) and Hintikka (\square A → OA) from the classical and from the paraconsistent point of (...) view, and to propose systems in which either, both, or neither of these principles is valid. (shrink)

Aim of the study was to analyze the posttraumatic stress disorder risk nurses, detecting the relationship between distress experience and personality dimensions in Italian COVID-19 outbreak. A cross-sectional study was conducted based on 2 data detection. Mental evaluation was carried out in Laboratory of Clinical Psychology on n.69 nurses in range age 22–64 years old. Measurement was focused on symptoms anxiety, personality traits, peritraumatic dissociation and post-traumatic stress for all participants. No online screening was applied. Comparisons within the various demographic (...) characteristics demonstrated few significant differences between groups on DASS-21, PDEQ, and ISE-R scores. Correlation analysis was performed among PDEQ, DASS-21, BFI-10 and IES-R and confirmed between anxiety and peritraumatic dissociation and post-traumatic stress; then anxiety is positively correlated to agreeableness variable of BFI-10 test. The emotional distress was protracted overtime but in long-term personality traits resulted mediator facing subjective stress. Our finding drew details for protective and predictive risk factors as well as mental health issues of nurses dealing with pandemic: healthcare workers faced the protracted challenge caring COVID-19 patients over and over again: in short time the impact was relevant, and the prolonged exposition to the stressor was tackled by personal resources such as personality traits. (shrink)

Interactive narratives are inextricable from the way that we understand our encounters with digital technology. This is based upon the way that these encounters are processually formed into a narrative of episodic events, arranged and re-arranged by various levels of agency. After describing past research conducted at the iCinema Research Centre at the University of New South Wales, this paper sets out a framework within which to build a relational theory of interactive narrative formation, outlining future research in the area.

In his thesis Para uma Teoria Geral dos Homomorfismos (1944), the Portuguese mathematician José Sebastião e Silva constructed an abstract or generalized Galois theory, that is intimately linked to F. Klein’s Erlangen Program and that foreshadows some notions and results of today’s model theory; an analogous theory was independently worked out by M. Krasner in 1938. In this paper, we present a version of the theory making use of tools which were not at Silva’s disposal. At the same time, we (...) tried to keep in mind, so much as possible, the gist of his standpoint. (shrink)

A short review is given of the Nuffield Council’s report on behavioural genetics. This review is used as an entry point to a discussion of the factors that influence the presentation of behavioural genetics in the media and in the popular scientific press. It is argued that our interest in formulating narrative explanations of our individual lives puts pressure on publishers and editors to present behavioural genetics in a selective, misleading, way. Some other influences on presentation are discussed and it (...) is suggested that the Nuffield report is particularly useful in so far as it lacks these distorting influences. (shrink)

Philosophers, especially in recent years, have engaged in reflection upon the nature of experience. Such reflections have led them to draw a distinction between conscious and unconscious mentality in terms of whether or not it is like something to have a mental state. Reflection upon the history of psychology and upon contemporary cognitive science, however, identifies the distinction between conscious and unconscious mental states to be primarily one which is drawn in epistemic terms. Consciousness is an epistemic notion marking the (...) special kind of first-person knowledge we have of our own mental states. Psychologists have found it expedient, for explanatory reasons, to ignore or reject the assumption that we have exhaustive first-person knowledge of our mental states and, in doing so, use the term 'unconscious' to indicate the peculiar epistemic status of certain mental states.It is argued that epistemic consciousness is distinct from the subjective-experiential notion of consciousness, from 'access-consciousness' and from higher-order thought conceptions of mental state consciousness, and that epistemic consciousness has an important role to play in philosophy of mind and in the history of psychology. (shrink)

S. Jakowski introduced the discussive prepositional calculus D 2as a basis for a logic which could be used as underlying logic of inconsistent but nontrivial theories (see, for example, N. C. A. da Costa and L. Dubikajtis, On Jakowski's discussive logic, in Non-Classical Logic, Model Theory and Computability, A. I. Arruda, N. C. A da Costa and R. Chuaqui edts., North-Holland, Amsterdam, 1977, 37–56). D 2has afterwards been extended to a first-order predicate calculus and to a higher-order logic (cf. the (...) quoted paper). In this paper we present a natural version of D 2, in the sense of Jakowski and Gentzen; as a consequence, we suggest a new formulation of the discussive predicate calculus (with equality). A semantics for the new calculus is also presented. (shrink)

The capacity to be creative, to produce new concepts, ideas, inventions, objects or art, is perhaps the most important attribute of the human brain. We know very little, however, about the nature of creativity or its neural basis. Some important questions include how should we define creativity? How is it related (or unrelated) to high intelligence? What psychological processes or environmental circumstance cause creative insights to occur? How is it related to conscious and unconscious processes? What is happening at the (...) neural level during moments of creativity? How is it related to health or illness, and especially mental illness? This paper will review introspective accounts from highly creative individuals. These accounts suggest that unconscious processes play an important role in achieving creative insights. Neuroimaging studies of the brain during "REST" (random episodic silent thought, also referred to as the default state) suggest that the association cortices are the primary areas that are active during this state and that the brain is spontaneously reorganising and acting as a self-organising system. Neuroimaging studies also suggest that highly creative individuals have more intense activity in association cortices when performing tasks that challenge them to "make associations." Studies of creative individuals also indicate that they have a higher rate of mental illness than a noncreative comparison group, as well as a higher rate of both creativity and mental illness in their first-degree relatives. This raises interesting questions about the relationship between the nature of the unconscious, the unconscious and the predisposition to both creativity and mental illness. (shrink)

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The traditional verbal/nonverbal dichotomy is inadequate for completely describing cerebral lateralization. Musical functions are not necessarily mediated by the right hemisphere; evidence for a specialist left-hemisphere mechanism dedicated to the encoded speech signal is weakening, and the right hemisphere possesses considerable comprehensional powers. Right-hemisphere processing is often said to be characterized by holistic or gestalt apprehension, and face recognition may be mediated by this hemisphere partly because of these powers, partly because of the right hemisphere's involvement in emotional affect, and (...) possibly through the hypothesized existence of a specialist face processor or processors in the right. The latter hypothesis may, however, suffer the same fate as the one relating to a specialist encodedness processor for speech in the left. Verbal processing is largely the province of the left because of this hemisphere's possession of sequential, analytic, time-dependent mechanisms. Other distinctions are special cases of an analytic/holistic dichotomy. More fundamentally, however, the left hemisphere is characterized by its mediation of discriminations involving duration, temporal order, sequencing, and rhythm, at thesensory level, and especially at themotorlevel. Spatial aspects characterize the right, the mapping of exteroceptive body space, and the positions of fingers, limbs, and perhaps articulators, with respect to actual and target positions. Thus there is a continuum of function between the hemispheres, rather than a rigid dichotomy, the differences being quantitative rather than qualitative, of degree rather than of kind. (shrink)