It describes and explains the patient-centered model examining and evaluating qualitative and quantitative research. It comprehensively covers the evolution and the six interactive components of the patient-centered clinical method, taking the reader through the relationships between the patient and doctor and the patient and clinician. All the editors are professors in the Department of Family Medicine at the University of Western Ontario, London, Canada.

ABSTRACT: It is characteristic of a continuum that it be “all of one piece”, in the sense of being inseparable into two (or more) disjoint nonempty parts. By taking “part” to mean open (or closed) subset of the space, one obtains the usual topological concept of connectedness . Thus a space S is defined to be connected if it cannot be partitioned into two disjoint nonempty open (or closed) subsets – or equivalently, given any partition of S into two open (...) (or closed) subsets, one of the members of the partition must be empty. This holds, for example, for the space R of real numbers and for all of its open or closed intervals. Now a truly radical condition results from taking the idea of being “all of one piece” literally, that is, if it is taken to mean inseparability into any disjoint nonempty parts, or subsets, whatsoever . A space S satisfying this condition is called cohesive or indecomposable. While the law of excluded middle of classical logic reduces indecomposable spaces to the trivial empty space and one-point spaces, the use of intuitionistic logic makes it possible not only for nontrivial cohesive spaces to exist, but for every connected space to be cohesive.In this paper I describe the philosophical background to cohesiveness as well as some of the ways in which the idea is modelled in contemporary mathematics. (shrink)

Axioms for the continuum, or smooth real line R. These include the usual axioms for a commutative ring with unit expressed in terms of two operations + and i , and two distinguished elements 0 ≠ 1. In addition we stipulate that R is a local ring, i.e., the following axiom: ∃y x i y = 1 ∨ ∃y (1 – x) i y = 1. Axioms for the strict order relation < on R. These are: 1. a < b (...) and b < c implies a < c. 2. ¬(a < a) 3. a < b implies a + c < b + c for any c. ≤ 4. a < b and 0 < c implies acbc.. (shrink)

continent. 1.4 (2011): 286—310. This mad play of writing —Stéphane Mallarmé Somewhere in between mathematics and theory, light and dark, physicality and projection, oscillates the poetry of Alessandro De Francesco. The texts hold no periods or commas, not even a capital letter for reference. Each piece stands as an individual construction, and yet the poetry flows in and out of the frame. Images resurface from one poem to the next, haunting the reader with reincarnations of an object lost in the (...) grass or a representation of a pear in a Dutch still life, embedded in cycles of cinematic close ups and multiple dimensions. As a whole, De Francesco’s oeuvre suggests, to use the title of one of his works, a redefinition —linguistic, epistemological, personal. The poem The End (un’agenda) (The End (an agenda)) opens with a quote by literary theorist Maurice Blanchot, which may be translated as follows: Speaking is not seeing. Speaking frees thought from this optical imperative that in the Western tradition, for thousands of years, has subjugated out approach to things, and induced us to think under the guaranty of light or under the threat of its absence.[1] In writing, De Francesco seeks to redefine our approach to things. His poems, like Blanchot’s writings, speak to both illuminate and to obscure. The reader hangs in an absence of reality within language that necessitates an attempt at interpretation, yet renders such a search ultimately futile. De Francesco draws the anonymous images that appear in this poem from the city of Paris, his current home. The fragmented narrative depicts an inner doubt of realness, calling for a confirmation of a physical existence beyond verbalization and cogitation. Cyclical references to film throw into question the reliability of the reality he creates. The light, sometimes red and safe, other times absent and murky, cannot necessarily be trusted as a guaranteed means of illumination. Blanchot’s distinction between language and visualization, and the relationship of each to reality, though linked specifically to The End (un’agenda) , can be a lens through which to read any of the three works that follow. assente obliqua (absent oblique) is composed of descriptions of six still life paintings, ranging from Dutch masterpieces of the seventeenth century to 1960s minimalism. The actual images of the paintings are absent, and the text is the sole source and object of a virtual reality created around the artwork. “Absent oblique” refers to the light source placed outside of the frame, which both informs and distracts viewing of the scene. Although mere description can be unreliable and unsatisfying in its necessary limitation, the representational act of description is shown as more than just a human want. It is a need, a means by which to grapple with an unsure reality. As the illustrations progress, they descend into abstraction and chaos. The precariously placed plate triggers the movement: the bottle bursts and the objects collapse into the movement of a tracking film camera. corpo estraneo in moto ascensionale (foreign body in ascending motion) is prose poetry in action. Its objective tone of description is skewed by the subjectivity of the narrative as horrific images are relayed in fragmented but matter-of-fact manner. A “foreign body” is both a mass of cancerous cells, and a corporeal description, and the poem takes the reader on a journey back and forth between the two, destination unclear. Beyond a questioning of the real, corpo estraneo in moto ascensionale is an examination of the possible. De Francesco’s poetry becomes a camera obscura through which to observe the constant flux of light and dark that blurs our reality. His work is colored by the idea of apo koinou , a Greek term meaning “from the common” that involves a construction of two clauses with a shared word or phrase. Through such melting of meaning, De Francesco creates a fluid ambiguity that is nonetheless grounded in bodily concepts. In assente obliqua , the reader is confronted with a description of a still life that rapidly transforms into a more chilling scene: the membrane of the mushroom in the basket emerges behind the white cloth a body could hide itself that asks for help In the realm of pure description, there is a mushroom that peeks out from behind a white cloth in a basket. Behind the white cloth, too, there could be a body, hiding, asking for help. Such an elision elicits disorienting mistrust in temporality, but also expands the planar possibilities of syntactical meaning. A white cloth is not merely a construct in still life painting, but veil that both shields and reveals potential mysteries. It is a proposed alternative to a traditional Western binary of subjectivity and objectivity. The apo koinou construction is rare in modern English, having slipped out of use after its resurgence in Old English poetry. De Francesco reintroduces this blur of object and subject relations into a modern light. He draws inspiration from a device used by Gruppo 63 founder and avant-garde poet Antonio Porta tended toward repetition of phrases in third person perspective. In Italian, it is perfectly grammatically correct to omit the subject, including only a verb conjugation. Gender, even humanity unknown, the subject dissolves into the action, thus giving to the poetry the power to change the reader’s perception of who or what is actually acting. To further push the relative boundaries of experience, De Francesco expands his written poetry into what he calls “reading environments.” In these sound experiments, De Francesco’s voice reading his poetry is manipulated by real time digital voice processing. The written is transformed to the spoken, and then injected with currents of electric sound. “At each activation of word in the darkness,” (from The End (un’agenda) ) language is permutated into a nonphysical yet all-encompassing being. In these projects, realized all over Europe, De Francesco continues his examination of the word’s potency beyond the page and into an “n-dimensional space,” where the lines between nature and affect are intertwined. To publish excerpts of De Francesco’s oeuvre is to show screen shots of full-length film, to read pull quotes from a philosophy treatise. In these poems, there are questions, not to be answered, but to be questioned again. The words will oscillate in and out of the square construction found in his poems, out of the borders of the page, out of the rectangle of the laptop screen. NOTES (1) Blanchot, Maurice. The Infinite Conversation . Trans. Susan Hanson. Minneapolis: University of Minnesota Press, 1993. 27. EDITORS' NOTE The .pdf above contains about twenty pages of translation and the original Italian poetry. Below we provide only a brief account. The End (an agenda) Parler, ce n’est pas voir. Parler libère la pensée de cette exigence optique qui, dans la tradition occidentale, soumet depuis des millénaires notre approche des choses et nous invite à penser sous la garantie de la lumière ou sous la menace de l’absence de lumière. —Maurice Blanchot in this n-dimensional space i could spy on myself from the cracks while going back and forth from the summer to the wardrobe from the night to the parking lot but something filters in through the half-closed shutters becomes an event enunciation we stay without explanation like parallel curves on the back of a solid growing older she enters the garden always repeats certain phrases the elevator to be redone the neighbor’s music the steps the pavement furls like the leaves of a fern when touched she is framed from behind while she moves rocking she covers distances slowly a bag overflows from the wardrobe something stirs inside but then the suitcase comes open not even by my hand it’s the objects that are starting to filter out the little red haired monster watches idling the appointments written on one of your agendas two years old still seem urgent each letter holds itself upright on the page with flourishes and arabesques each angle has its own geography i’m trying to describe the path the fingers trace on the carpet the zipper takes the opposite route we are suspended on the stairs above the water in the center is the summer seen from above the darkness of the city passes from one headlight to the next the surfaces of our arms cohere and are shiny underneath the blinking of a sign each pore is an open expanse the body dreams the hair gives form to the possible some daring swimmers were throwing themselves into the seine they swam upstream up to the first quay look there could exist behind the screen a room where even when the lamp is out and the curtains drawn even when the suitcase wasn’t closed everything seemed red everything calm construction of a four-dimensional tetrahedron by R. Courant – H. Robbins, What is Mathematics? Oxford University Press, 1941  . (shrink)

This paper attempts to explore a number of conceptual issues surrounding genetic testing. It looks at the meaning of the terms, genetic information and genetic testing in relation to the definition set out by the Advisory Committee on Genetic Testing in the UK, and by the Task Force on Genetic Testing in the USA. It argues that the special arrangements that may be required for the regulation of genetic tests should not be determined by reference to the nature or technology (...) of the test, but by considering those morally relevant features that justify regulation. Failure to do so will lead to the regulation of genetic tests that need not be regulated, and would fail to cover other tests which should be regulated. The paper also argues that there is little in the nature of the properties of gene tests, using DNA or chromosomes, that in itself justifies a special approach. (shrink)

This paper provides a method for characterizing space events using the framework of conceptual spaces. We focus specifically on estimating and ranking the likelihood of collisions between space objects. The objective is to design an approach for anticipatory decision support for space operators who can take preventive actions on the basis of assessments of relative risk. To make this possible our approach draws on the fusion of both hard and soft data within a single decision support framework. Contextual data is (...) also taken into account, for example data about space weather effects, by drawing on the Space Domain Ontologies, a large system of ontologies designed to support all aspects of space situational awareness. The framework is coupled with a mathematical programming scheme that frames a mathematically optimal approach for decision support, providing a quantitative basis for ranking potential for collision across multiple satellite pairs. The goal is to provide the broadest possible information foundation for critical assessments of collision likelihood. (shrink)

Background Psychiatric electroceutical interventions (PEIs) use electrical or magnetic stimulation to treat mental disorders and may raise different ethical concerns than other therapies such as medications or talk therapy. Yet little is known about stakeholders’ perceptions of, and ethical concerns related to, these interventions. We aimed to better understand the ethical concerns of a variety of stakeholder groups (patients with depression, caregivers of patients, members of the public, and psychiatrists) regarding four PEIs: electroconvulsive therapy (ECT), repetitive transcranial magnetic stimulation (rTMS), (...) deep brain stimulation (DBS), and adaptive brain implants (ABI).Methods We conducted a national survey of these four stakeholder groups, using an embedded video vignette experiment depicting a patient with treatment-resistant depression and her psychiatrist discussing the possibility of treatment with one of the four PEIs.Results Participants’ ethical concerns varied by stakeholder group, by PEI, and by the interaction of the two. The three non-clinician groups tended to have similar ethical concerns, but to differ from psychiatrists. Similar concerns were raised with regard to the two implantable technologies, DBS and ABI. Overall, there was relatively little concern about the involuntary use of PEIs, though some expressed concern about the adequacy of information provided during the consent process. There was also significant concern that patients may not receive helpful therapies.Conclusions To our knowledge, this is the first national survey that includes multiple stakeholder groups and multiple PEI modalities. A better understanding of the ethical concerns of stakeholders can help to shape clinical practice and health care policy regarding PEIs. (shrink)

Deaths of Despair (DoD), or mortality resulting from suicide, drug overdose, and alcohol-related liver disease, have been rising steadily in the United States over the last several decades. In 2020, a record 186,763 annual despair-related deaths were documented, contributing to the longest sustained decline in US life expectancy since 1915–1918. This forum feature considers how health humanities disciplines might fruitfully engage with this era-defining public health catastrophe and help society better understand and respond to the crisis.

What does it mean to be a good thinker? Which virtues work together in someone who possesses good intellectual character? Although recent research on virtues has highlighted the benefits of individual intellectual virtues, being an excellent thinker is likely a function of possessing multiple intellectual virtues. Specifically, a good thinker would both recognize one’s intellectual shortcomings and possess an eagerness to learn driven by virtues such as love of knowledge, curiosity, and open-mindedness. Good intellectual character may only successfully manifest when (...) individuals possess not just one or a few intellectual virtues, but a larger set of such virtues to different degrees. However, little is currently known about what combination of virtues are necessary for good thinking. We argue that it is important to identify and clarify the nature of the good thinker and outline a profile methodology for achieving this goal. This approach characterizes the good thinker in terms of a profile of multiple intellectual virtues. Understanding this profile can allow greater insight into the extent to which people possess such a profile, and the potential for societal benefits of educating for these qualities. (shrink)

Mr D. H. Mellor, in his article of this title in Religious Studies , Vol. 5 , distinguishes three senses of words such as ‘probable’ which might be used in a religious context, especially in that of attempted theistic proofs: statistical, subjective, and inductive probability. In each case he concludes that it is misleading to use these words in such contexts at all. With his discussion of the second I do not wish to quarrel; but there seem to me to (...) be serious defects in his discussions of the first and third. (shrink)

Words have determinable sense only within a complex of unstated assumptions, and all interpretation must therefore go beyond the given material. This book addresses what is man's place in the Aristotelian world. It also describes man's abilities and prospects in managing his life, and considers how far Aristotle's treatment of time and history licenses the sort of dynamic interpretation of his doctrines that have been given. The ontological model that explains much of Aristotle's conclusions and methods is one of life-worlds, (...) in which the material universe of scientific myth is no more than an abstraction from lived reality, not its transcendent ground. (shrink)

This paper challenges historically preconceived notions surrounding a minor’s ability to make medical decisions, arguing that federal health law should be reformed to allow minors with capacity as young as age 12 to consent to their own Centers for Diseases Control and Prevention (CDC)-approved COVID-19 vaccinations. This proposal aligns with and expands upon current exceptions to limitations on adolescent decision-making. This analysis reviews the historic and current anti-vaccination sentiment, examines legal precedence and rationale, outlines supporting ethical arguments regarding adolescent decision-making, (...) and offers rebuttals to anticipated ethical counterarguments. (shrink)

When philosophers approach philosophy of religion, they typically ask two questions: are there any sound arguments to prove the existence of God; and is talk about God even rationally intelligible? Theologians, for their part, primarily expound the meaning and relevance of Christianity. I am by profession a philosopher, but apart from Secs. VI and VII I am here writing as a puzzled twentieth-century man. My prime worry is whether we philosophers and theologians are beginning with the right questions.

A number of public controversies have emerged around forensic DNA testing backlogs at crime laboratories in the United States. This study provides a first look at public responses to such backlogs, using a controversy in the state of Wisconsin as a case study. First, it builds on research about public understandings of DNA and the “CSI effect” to develop a theoretical framework. Next, it explores news coverage of the Wisconsin backlog. It then uses survey data to show that public understandings (...) of DNA, media use, and demographic factors were related to how closely respondents followed the story about the backlog and/or how much they supported increased spending on DNA testing at the crime lab. Self-reported understanding of DNA predicted following the backlog, whereas perceived reliability of DNA evidence predicted both following the backlog and support. Total television viewing was not related to either following the backlog or support, but watching crime television predicted following the backlog. Reading a newspaper and watching local TV news each predicted following the backlog; reading a newspaper also predicted support. These results suggest a number of theoretical insights into how members of the public may reason about and draw on media messages regarding DNA and DNA testing in responding to forensic DNA testing backlogs. (shrink)