Background: Informed consent in the modern era is a common and important topic both for the well-informed patient and to prevent unnecessary litigation. However, the effectiveness of informed consent in trauma patients is an under-researched area. This paper aims to assess the differences in patient recall of the consent process and desire for information by performing a comparative analysis between orthopaedic trauma and elective patients. Methods: Information from 41 consecutive elective operations and 40 consecutive trauma operations was collected on the (...) first post-operative day. Results: 100% of elective patients and 90% of trauma patients knew what operation they had received (p = 0.06). Overall recall of complications was poor, but was significantly lower in trauma patients compared with elective patients (62% vs 22%, p<0.001). 30% of trauma patients desired more information about their operation compared to 12% of elective patients (p = 0.049), although only 35% of trauma patients wanted written as well as verbal explanations, compared to 85% of elective patients p<0.001). Overall 100% of elective and 90% of trauma patients were happy with the consent process (p = 0.06). Subset analysis of neck of femur compared to other trauma patients showed that the above factors were not significantly different between the two groups. Conclusions: Recall of complications in the trauma patients is significantly lower than in elective patients, although both groups scored poorly overall. Repeated verbal explanations should be reinforced with the option of additional information leaflets for trauma operations. Further research into the usefulness of DVDs for commonly performed operations is warranted, although official internet resources may be more cost-effective. (shrink)

Рассматривается понимание как специфически человеческий способ существования, как первичный, исходный опыт освоения человеком мира, в котором отсутствует субъект-объективная разделенность, лежащая в основе познавательного отношения. Для специалистов.

This essay some first steps toward the naturalization of what I call rational intentionality or alternatively type II intentionality. By rational or type II intentionality, I mean that full combination of rational powers and content-bearing states that is paradigmatically enjoyed by mature intact human beings. The problem I set myself is to determine the extent to which the only currently extant approach to the naturalization of the intentional that has the singular virtue of not being a non-starter can be aggregated (...) up into an account of rational intentionality. I have in mind a broadly defined family of accounts whose main members are the indicator/information-theoretic approach of Dretske (1988), the asymmetric dependence theory of Jerry Fodor (1987, 1990, 1994) and the teleo-semantics of Ruth Millikan (1984, 1993). Somewhat inaccurately, I will call this family of approaches the information-theoretic family. To be sure, there is only a rough family resemblance among the members of the information-theoretic family. Indeed, several intense quarrels divide the members of that family one from another, but the precise outcome of those internecine struggles is not directly relevant to the aims of this essay. ² Taken collectively, the information-theoretic family yields a compelling picture of the place of at least a crude form of intentionality -- what I call frog-like or type I intentionality -- in the natural order. Though frog-like or type I intentionality is, I think, a genuine species of intentionality, it may subsist in the absence of rational powers. It is that species of intentionality enjoyed by irritable creatures who, following Brandom (1994). (shrink)

Part I of this trilogy, Historical and Scientific Setting, set out a general context for selecting a certain subclass of inter-theoretic relations as achieving appropriate explanatory and ontological unification – hence for properly being labelled reductive. Something of the complexity of these relations in real science was explored. The present article concentrates on the role which identity plays in structuring the reduction relation and so in achieving ontological and explanatory unification.

Based on research on the increasingly popular unconscious thought effect (UTE), it has been suggested that physicians might make better diagnostic decisions after a period of distraction than after an equivalent amount of time of conscious deliberation. However, published attempts to demonstrate the UTE in medical decision making have yielded inconsistent results. In the present study, we report the results of a meta-analysis of all the available evidence on the UTE in medical decisions made by expert and novice clinicians. The (...) meta-analysis failed to find a significant contribution of unconscious thought to the accuracy of medical decisions. This result cannot be easily attributed to any of the potential moderators of the UTE that have been discussed in the literature. Furthermore, a Bayes Factor analysis shows that most experimental conditions provide positive support for the null hypothesis, suggesting that these null results do not reflect a simple lack of statistical power. We suggest ways in which new studies could usefully provide further evidence on the UTE. Unless future research shows otherwise, the recommendation of using unconscious thought to improve medical decisions lacks empirical support. (shrink)

Louveau, A., S. Shelah and B. Velikovi, Borel partitions of infinite subtrees of a perfect tree, Annals of Pure and Applied Logic 63 271–281. We define a notion of type of a perfect tree and show that, for any given type τ, if the set of all subtrees of a given perfect tree T which have type τ is partitioned into two Borel classes then there is a perfect subtree S of T such that all subtrees of S of type (...) τ belong to the same class. This result simultaneously generalizes the partition theorems of Galvin-Prikry and Galvin-Blass. The key ingredient of the proof is the theorem of Halpern-Laüchli on partitions of products of perfect trees. (shrink)

Um bei einer Wertung der Faktoren, die das Wachstum einer Population beeinflussen, zu einer richtigen Einsicht zu gelangen, empfiehlt es sich, nicht den relativen Wert dieser Faktoren in Bezug auf die in Rede stehende Insektenpopulation auszudrücken, sondern ihre absolute Grösse in Faktoreinheiten zum Ausdruck zu bringen — wie: Wärme in Grad Celsius, Luftfeuchtigkeit in Prozenten, Zahl der im Bevölkerungsmilieu vorgefundenen Raubinsekten oder Parasiten. Auf dieser Grundlage liessen sich Faktoren in folgender Weise aufteilen: Faktoren ersten Grades : Allgemeine Faktoren : Unabhängige (...) Faktoren : nicht mechanische Klimaeinflüsse , chemische Faktoren, Güte der Nahrung. Abhängige Faktoren : die internen Faktoren, die bei einer Zunahme der Dichtigkeit einen Rückgang des Zuwachses bewirken, mit Ausnahme des Kannibalismus, ferner die Menge der Nahrung. Selektive Faktoren : Unabhängige Faktoren : unersättliche Faktoren : mechanische Klimaeinflüsse, weitere mechanische Faktoren, Parasiten und Raubfeinde, die nicht mit töten aufhören, wenn sie gesättigt sind, insofern ihre Bevölkerungsdichte nicht durch die des fraglichen Insektes bedingt wird. ersättliche Faktoren: restliche Raubinsekten und Parasiten, insofern ihre Bevölkerungsdichte nicht durch die des fraglichen Insektes bedingt wird. Abhängige Faktoren : Kannibalismus. Wandelbare Faktoren : Raubinsekten und Parasiten, welche diesem Erfordernis entsprechen, pathogene Pilze und Bakterien. Faktoren zweiten Ranges . Faktoren des dritten Ranges .Afin d'obtenir une notion exacte de la valeur des facteurs qui influencent la croissance d'une population, il vaudra mieux ne pas exprimer ces facteurs en leur valeur relative quant à la population d'insectes en question, mais en unités de facteurs: degrés Celsius, pourcentage de l'humidité de l'air, nombre d'ennemis ou de parasites qui sont présents dans le milieu de la population. Sur cette base on pourra répartir les facteurs de la façon suivante: Facteurs du 1er ordre : Facteurs généraux : influences climatiques non mécaniques , facteurs chimiques, qualité de la nourriture. Facteurs dépendants : les facteurs internes qui font de sorte que la densité de la population diminue quand se présente une plus forte densité, en exceptant le cannibalisme, la quantité de nourriture. Facteurs selectifs ; seule une partie des individus est exposée à leur action; les animaux touchés sont mécaniquement endommagés et, dans la règle, tués. Facteurs indépendants : facteurs insatiables : des influences climatiques mécaniques, d'autres facteurs mécaniques, des parasites et des ennemis qui ne s'arrêtent pas de tuer quand ils sont rassasiés, pour autant que l'intensité de la population de l'insecte en question. facteurs rassasiables: autres ennemis et parasites pour autant que l'intensité de leur population ne se modifie pas sous l'influence de la densité de la population de l'insecte en question. Facteurs indépendants : cannibalisme. Facteurs modifiables : ennemis et parasites qui satisfont à cette exigence, champignons pathogènes, bactéries. Facteurs du 2ième ordre . Facteurs du 3iéme ordre. (shrink)