Background: Informed consent is regarded as a contract between autonomous and equal parties and requires the elements of information disclosure, understanding, voluntariness and consent. The validity of informed consent for critically ill patients has been questioned. Little is known about how these patients experience the process of consent.Objective: The aim of this study was to explore critically ill patients’ experience with the principle of informed consent in a clinical trial and their ability to give valid informed consent.Design: 11 stroke patients (...) who had been informed about thrombolytic treatment and had been through the process of deciding whether or not to participate in a thrombolysis trial went through repeated qualitative semistructured interviews.Results: None of the patients had any clear understanding of the purpose of the trial. Neither did they understand the principles of randomisation and voluntariness. Reasons for giving or not giving consent were trust, conceptions of benefits and risks and altruism. Several patients found it immoral to involve patients in the consent procedure and argued that this was the doctors’ responsibility. Others argued that it is a duty to question patients and perceived it as a sign of being treated with respect and dignity. A majority of the patients found the consent process vague and ambiguous.Conclusions: The results indicate that the principle of informed consent from critically ill patients cannot be seen as a contract between equal and autonomous parties. Further studies are needed to explore critically ill patients’ experiences with the process of informed consent. (shrink)

This article considers how legislators should respond to evidence that identifies a common and widely accepted parental practice as a potential source of harm to children, using domestic exposure to environmental tobacco smoke as a test case. It is claimed that children are parties to the Harm Principle, and that the State has an obligation to protect children from exposure to harm. Parental prerogative is limited by the need to avoid harming children. That said, there is considerable uncertainty about what (...) is harmful to children. Several sources of uncertainty, both empirical and conceptual, are explored, in order to demonstrate the complexity of the task legislators face. Seven considerations that are relevant to decisions about legislation of harmful parental practices are outlined, and these considerations are then employed to assess the case in favour of legislating to prohibit the exposure of children to environmental tobacco smoke in domestic settings. (shrink)

Atiyah and Sutcliffe made a number of conjectures about configurations of N distinct points in hyperbolic 3-space, arising from ideas of Berry and Robbins. In this paper we prove all these conjectures, purely geometrically, but we also provide a physical interpretation in terms of Electrons.

This paper takes the case of the proposed building of the Traveston dam on the Mary River in Australia to examine the ways postcolonial power relations are played out in city/regional relationships to further the interests of the city. Postcolonialism is concerned with unravelling multiple histories of colonialism, and identifying the reproduction, contestation, ambivalence and transformation of modes of domination and subordination in colonial relations. Political contingencies and contestations by residents, farmers, traditional Indigenous owners and environmentalists seeking to protect endangered (...) species are examined to highlight the dominance of Western anthropocentric, technocentric, and eurocentric epistemologies in political, ecological, environmental, biotheical debates. (shrink)

Task unrelated thought (TUT) refers to thought directed away from the current situation, for example a daydream. Three experiments were conducted on healthy participants, with two broad aims. First, to contrast distributed and encapsulated views of cognition by comparing the encoding of categorical and random lists of words (Experiments One and Two). Second, to examine the consequences of experiencing TUT during study on the subsequent retrieval of information (Experiments One, Two, and Three). Experiments One and Two demonstrated lower levels of (...) TUT and higher levels of word-fragment completion whilst encoding categorical relative to random stimuli, supporting the role of a distributed resource in the maintenance of TUT. In addition the results of all three experiments suggested that experiencing TUT during study had a measurable effect on subsequent retrieval. TUT was associated with increased frequency of false alarms at retrieval (Experiment One). In the subsequent experiments TUT was associated with no advantage to retrieval based on recollection, by manipulating instructions at encoding (Experiment Two), and/or at retrieval (Experiment Three). The implications of the results of all three experiments are discussed in terms of recent accounts of memory retrieval and conscious awareness. (shrink)

There is general acknowledgement that both the anterior cingulate and orbitofrontal cortex are implicated in reinforcement-guided decision making, and emotion and social behaviour. Despite the interest that these areas generate in both the cognitive neuroscience laboratory and the psychiatric clinic, ideas about the distinctive contributions made by each have only recently begun to emerge. This reflects an increasing understanding of the component processes that underlie reinforcement- guided decision making, such as the representation of reinforcement expectations, the exploration, updating and representation (...) of action values, and the appreciation that choices are guided not just by the prospect of reward but also by the costs that action entails. Evidence is emerging to suggest that the anterior cingulate and orbitofrontal cortex make distinct contributions to each of these aspects of decision making. (shrink)

Routley- Meyer type relational complete semantics are constructed for intuitionistic contractionless logic with reductio. Different negation completions of positive intuitionistic logic without contraction are treated in a systematical, unified and semantically complete setting.

This paper discusses some engineering considerations that should be taken into account when building a knowledge based system, and recommends isomorphism, the well defined correspondence of the knowledge base to the source texts, as a basic principle of system construction in the legal domain. Isomorphism, as it has been used in the field of legal knowledge based systems, is characterised and the benefits which stem from its use are described. Some objections to and limitations of the approach are discussed. The (...) paper concludes with a case study giving a detailed example of the use of the isomorphic approach in a particular application. (shrink)

We formulate and analyze the dynamics of an influenza pandemic model with vaccination and treatment using two preventive scenarios: increase and decrease in vaccine uptake. Due to the seasonality of the influenza pandemic, the dynamics is studied in a finite time interval. We focus primarily on controlling the disease with a possible minimal cost and side effects using control theory which is therefore applied via the Pontryagin’s maximum principle, and it is observed that full treatment effort should be given while (...) increasing vaccination at the onset of the outbreak. Next, sensitivity analysis and simulations (using the fourth order Runge-Kutta scheme) are carried out in order to determine the relative importance of different factors responsible for disease transmission and prevalence. The most sensitive parameter of the various reproductive numbers apart from the death rate is the inflow rate, while the proportion of new recruits and the vaccine efficacy are the most sensitive parameters for the endemic equilibrium point. (shrink)