ObjectiveCancer researchers have found midlife couples to have poorer outcomes compared to older couples due to the off-time nature of the illness for them. It is unknown if young couples, who are under-represented in cancer studies and overlooked for supportive programs, are at further risk. This study explored the moderating roles of survivor age and sex on the associations between active engagement and protective buffering and depressive symptoms in couples surviving cancer.MethodsThe exploratory study comprised 49 couples 1–3 years post-diagnosis. Multilevel (...) modeling was used to explore the moderating roles of survivor age and sex, controlling for interdependent data.ResultsApproximately, 37% of survivors and 27% of partners met clinical criteria for further assessment of depression, with 50% of couples having at least one member meeting the criteria. Survivors and their partners did not significantly differ on depressive symptoms, active engagement, or protective buffering. Male survivors reported significantly higher levels of active engagement by their partners than female survivors and female survivors reported significantly higher levels of protective buffering by their partners than male survivors. We found some evidence to suggest that survivor age and sex may play moderating roles between active engagement and protective buffering and depressive symptoms. Older partners and female survivors appeared to experience more positive effects from engaging in positive dyadic behaviors than younger partners and male survivors.ConclusionFindings not only confirm the important role of dyadic behaviors for couples surviving cancer together, but also the important roles of survivor age and sex may play in whether such behaviors are associated with lower levels of depressive symptoms. Future research that examines these complex associations over time and across the adult life span in diverse populations is needed. (shrink)

ObjectiveMost young adults diagnosed with breast or gynecologic cancers experience adverse reproductive or sexual health outcomes due to cancer and its treatment. However, evidence-based interventions that specifically address the RSH concerns of young adult and/or LGBTQ+ survivor couples are lacking. Our goal is to develop a feasible and acceptable couple-based intervention to reduce reproductive and sexual distress experience by young adult breast and gynecologic cancer survivor couples with diverse backgrounds.MethodsWe systematically adapted an empirically supported, theoretically grounded couple-based intervention to address (...) the RSH concerns of young couples coping with breast or gynecologic cancer through integration of stakeholder perspectives. We interviewed 11 couples with a history of breast or gynecologic cancer to review and pretest intervention materials. Three of these couples were invited to review and comment on intervention modifications. Content experts in RSH and dyadic coping, clinicians, and community advisors participated throughout the adaptation process.ResultsFindings confirmed the need for an online, couple-based intervention to support young couples experiencing RSH concerns after breast or gynecologic cancer. Qualitative themes suggested intervention preferences for: A highly flexible intervention that can be tailored to couples’ specific RSH concerns; Active steps to help members of a dyad “get on the same page” in their relationship and family building plans; A specific focus on raising partners’ awareness about how cancer can affect body image and physical intimacy; and Accessible, evidence-based information about RSH for both partners. These results, along with feedback from stakeholders, informed adaptation and finalization of the intervention content and format. The resulting virtual intervention, Opening the Conversation, includes five weekly sessions offering training to couples in communication and dyadic coping skills for addressing RSH concerns.ConclusionThe systematic adaptation process yielded a theory-informed intervention for young adult couples facing breast and gynecological cancers, which will be evaluated in a randomized controlled trial. The long-term goal is to implement and disseminate Opening the Conversation broadly to reach young adult couples with diverse backgrounds who are experiencing RSH concerns in cancer survivorship. (shrink)

Background and AimsEnd-of-life discussions can be difficult for seriously ill adolescents and young adults. Researchers aimed to determine whether completing Voicing My CHOiCES —a research-informed advance care planning guide—increased communication with family, friends, or health care providers, and to evaluate the experience of those with whom VMC was shared.MethodsFamily, friends, or HCPs who the AYAs had shared their completed VMC with were administered structured interviews to assess their perception of the ACP discussion, changes in their relationship, conversation quality, and whether (...) the discussion prompted changes in care. Open-ended responses underwent thematic analysis.ResultsOne-month post-completion, 65.1% of AYA had shared VMC completion with a family member, 22.6% with a friend, and 8.9% with an HCP. Among a sample of respondents, family and friends reported a positive change in their relationship with the AYA. Participant descriptions of the experience fell into five themes: positive experience, difficult experience, appreciated a guide to facilitate discussion, provided relief, and created worry/anxiety. Only 1 HCP noted a treatment change. Family, friends, and HCP did not think the AYA would have discussed EoL preferences without completing VMC.ConclusionsVMC has potential to enhance communication about ACP between AYA and their family and friends, though less frequently with HCPs. Participants reported a positive change in their relationship with the AYA after discussing VMC, and described experiencing the conversation as favorable, even when also emotionally difficult. (shrink)

David Malament argued that Hartry Field's nominalisation program is unlikely to be able to deal with non-space-time theories such as phase-space theories. We give a specific example of such a phase-space theory and argue that this presentation of the theory delivers explanations that are not available in the classical presentation of the theory. This suggests that even if phase-space theories can be nominalised, the resulting theory will not have the explanatory power of the original. Phase-space theories thus raise problems for (...) nominalists that go beyond Malament's initial concerns. Thanks to Mark Steiner, Jens Christian Bjerring, Ben Fraser, John Mathewson, and two anonymous referees for helpful comments on an earlier draft of this paper. CiteULike Connotea Del.icio.us What's this? (shrink)

A main thread of the debate over mathematical realism has come down to whether mathematics does explanatory work of its own in some of our best scientific explanations of empirical facts. Realists argue that it does; anti-realists argue that it doesn't. Part of this debate depends on how mathematics might be able to do explanatory work in an explanation. Everyone agrees that it's not enough that there merely be some mathematics in the explanation. Anti-realists claim there is nothing mathematics can (...) do to make an explanation mathematical ; realists think something can be done, but they are not clear about what that something is. I argue that many of the examples of mathematical explanations of empirical facts in the literature can be accounted for in terms of Jackson and Pettit's [1990] notion of program explanation, and that mathematical realists can use the notion of program explanation to support their realism. This is exactly what has happened in a recent thread of the debate over moral realism. I explain how the two debates are analogous and how moves that have been made in the moral realism debate can be made in the mathematical realism debate. However, I conclude that one can be a mathematical realist without having to be a moral realist. (shrink)

Some have argued that chance and determinism are compatible in order to account for the objectivity of probabilities in theories that are compatible with determinism, like Classical Statistical Mechanics (CSM) and Evolutionary Theory (ET). Contrarily, some have argued that chance and determinism are incompatible, and so such probabilities are subjective. In this paper, I argue that both of these positions are unsatisfactory. I argue that the probabilities of theories like CSM and ET are not chances, but also that they are (...) not subjective probabilities either. Rather, they are a third type of probability, which I call counterfactual probability. The main distinguishing feature of counterfactual-probability is the role it plays in conveying important counterfactual information in explanations. This distinguishes counterfactual probability from chance as a second concept of objective probability. (shrink)

The Snowden revelations about National Security Agency surveillance, starting in 2013, along with the ambiguous complicity of internet companies and the international controversies that followed provide a perfect segue into contemporary conundrums of surveillance and Big Data. Attention has shifted from late C20th information technologies and networks to a C21st focus on data, currently crystallized in “Big Data.” Big Data intensifies certain surveillance trends associated with information technology and networks, and is thus implicated in fresh but fluid configurations. This is (...) considered in three main ways: One, the capacities of Big Data intensify surveillance by expanding interconnected datasets and analytical tools. Existing dynamics of influence, risk-management, and control increase their speed and scope through new techniques, especially predictive analytics. Two, while Big Data appears to be about size, qualitative change in surveillance practices is also perceptible, accenting consequences. Important trends persist – the control motif, faith in technology, public-private synergies, and user-involvement – but the future-orientation increasingly severs surveillance from history and memory and the quest for pattern-discovery is used to justify unprecedented access to data. Three, the ethical turn becomes more urgent as a mode of critique. Modernity's predilection for certain definitions of privacy betrays the subjects of surveillance who, so far from conforming to the abstract, disembodied image of both computing and legal practices, are engaged and embodied users-in-relation whose activities both fuel and foreclose surveillance. (shrink)

The dead donor rule states that organ donors must be declared dead before any vital organs are removed. Recently, scholars and physicians have argued for the abandonment of the dead donor rule, based on the rule’s supposed connection with the concept of brain death, which they view as a conceptually unreliable definition of death. In this essay, I distinguish between methods of death determination and the question of whether or not the dead donor rule should be a guiding principle of (...) organ transplant ethics. In principle, the dead donor rule does not rely on any one definition of death, but only prohibits the taking of vital organs before a patient is declared dead. In light of this distinction, I argue that even if the dead donor rule is tied to brain death in practice, conceptual disagreement about brain death does not provide grounds for rejection of this rule. I then present evidence in support of the consistency and reliability of the diagnosis of brain death. I show that, when performed carefully and under specific clinical circumstances, the diagnosis of brain death is considered by most neurologists to be reliable. Finally, I argue that, without the dead donor rule, organ transplantation programs would become susceptible to violations of the ethical principle of respect for persons. (shrink)

The paper presents evidence in bacteria for the utility of Godfrey-Smith’s environmental complexity thesis, using certain kinds of signal transduction systems as proxies for cognitive/behavioral complexity. Microbiologists already accept that the number of signal transduction proteins in a bacterial genome indicates the level of ecological complexity to which the organism is subject: the more signalling proteins, the greater the complexity. Sheer numbers are not always a reliable indicator of behavioral complexity, however. The paper proposes a new, ECT-based procedure for identifying, (...) from genomic sequence and signalling repertoire, novel bacterial candidates likely to exhibit behavioral complexity in response to a complex ecological niche. (shrink)

This paper studies the relationship between labelled and nested calculi for propositional intuitionistic logic, first-order intuitionistic logic with non-constant domains and first-order intuitionistic logic with constant domains. It is shown that Fitting’s nested calculi naturally arise from their corresponding labelled calculi—for each of the aforementioned logics—via the elimination of structural rules in labelled derivations. The translational correspondence between the two types of systems is leveraged to show that the nested calculi inherit proof-theoretic properties from their associated labelled calculi, such as (...) completeness, invertibility of rules and cut admissibility. Since labelled calculi are easily obtained via a logic’s semantics, the method presented in this paper can be seen as one whereby refined versions of labelled calculi (containing nested calculi as fragments) with favourable properties are derived directly from a logic’s semantics. (shrink)

Dummett's output has been prolific and highly influential, but not always as accessible as it deserves to be. This book sets out to rectify this situation.

This thesis introduces the "method of structural refinement", which serves as a means of transforming the relational semantics of a modal and/or constructive logic into an 'economical' proof system by connecting two proof-theoretic paradigms: labelled and nested sequent calculi. The formalism of labelled sequents has been successful in that cut-free calculi in possession of desirable proof-theoretic properties can be automatically generated for large classes of logics. Despite these qualities, labelled systems make use of a complicated syntax that explicitly incorporates the (...) semantics of the associated logic, and such systems typically violate the subformula property to a high degree. By contrast, nested sequent calculi employ a simpler syntax and adhere to a strict reading of the subformula property, making such systems useful in the design of automated reasoning algorithms. However, the downside of the nested sequent paradigm is that a general theory concerning the automated construction of such calculi (as in the labelled setting) is essentially absent, meaning that the construction of nested systems and the confirmation of their properties is usually done on a case-by-case basis. The refinement method connects both paradigms in a fruitful way, by transforming labelled systems into nested (or, refined labelled) systems with the properties of the former preserved throughout the transformation process. To demonstrate the method of refinement and some of its applications, we consider grammar logics, first-order intuitionistic logics, and deontic STIT logics. The introduced refined labelled calculi will be used to provide the first proof-search algorithms for deontic STIT logics. Furthermore, we employ our refined labelled calculi for grammar logics to show that every logic in the class possesses the effective Lyndon interpolation property. (shrink)

It is usually supposed that the central limit theorem explains why various quantities we find in nature are approximately normally distributed—people's heights, examination grades, snowflake sizes, and so on. This sort of explanation is found in many textbooks across the sciences, particularly in biology, economics, and sociology. Contrary to this received wisdom, I argue that in many cases we are not justified in claiming that the central limit theorem explains why a particular quantity is normally distributed, and that in some (...) cases, we are actually wrong. 1 Introduction2 Normal Distributions and the Central Limit Theorem2.1 Normal distributions2.2 The central limit theorem2.3 Terminology3 Explaining Normality3.1 Loaves of bread3.2 Varying variances and probability densities3.3 Tensile strengths and problems with summation3.4 Products of factors and log-normal distributions3.5 Transforming factors and sub-factors3.6 Transformations of quantities3.7 Quantitative genetics3.8 Inference to the best explanation4 Maximum Entropy Explanations5 Conclusion. (shrink)

Enduring intolerable suffering, an essential eligibility criterion in Medical Assistance in Dying (MAiD) in Canada and elsewhere, is a contradiction in terms, in that suffering must be tolerable to be endured. Cases of people who were approved for MAiD but who elected to die naturally, thus tolerating their suffering, bear out the unreliability of this central safeguard. The clinical assessment of intolerable suffering may be strengthened by adopting a definition of intolerable suffering centred on clinically evidenced physical and psychological decompensation. (...) This argument also raises important questions about the risks of MAiD clinicians subjectively defining, approving and providing MAiD in ways that deviate from accepted legal and clinical concepts and ethics. Examples show some prolific clinicians describe MAiD in terminology that differs from such norms, as a personal mission, as personally pleasurable, and as a rights-based service. These alternative views are explored for their risks in assessing and providing MAiD for intolerable suffering. This further demonstrates the need for conceptual clarity in legislation, improved vetting and monitoring of clinicians, and a different assessment process to protect patients and clinicians. (shrink)

It is natural to think of precise probabilities as being special cases of imprecise probabilities, the special case being when one’s lower and upper probabilities are equal. I argue, however, that it is better to think of the two models as representing two different aspects of our credences, which are often vague to some degree. I show that by combining the two models into one model, and understanding that model as a model of vague credence, a natural interpretation arises that (...) suggests a hypothesis concerning how we can improve the accuracy of aggregate credences. I present empirical results in support of this hypothesis. I also discuss how this modeling interpretation of imprecise probabilities bears upon a philosophical objection that has been raised against them, the so-called inductive learning problem. (shrink)

We provide a direct method for proving Craig interpolation for a range of modal and intuitionistic logics, including those containing a "converse" modality. We demonstrate this method for classical tense logic, its extensions with path axioms, and for bi-intuitionistic logic. These logics do not have straightforward formalisations in the traditional Gentzen-style sequent calculus, but have all been shown to have cut-free nested sequent calculi. The proof of the interpolation theorem uses these calculi and is purely syntactic, without resorting to embeddings, (...) semantic arguments, or interpreted connectives external to the underlying logical language. A novel feature of our proof includes an orthogonality condition for defining duality between interpolants. (shrink)

The Canadian approach to assisted dying, Medical Assistance in Dying (MAiD), as of early 2024, is assessed for its ability to protect patients from criminal healthcare serial killing (HSK) to evaluate the strength of its safeguards. MAiD occurs through euthanasia or self-administered assisted suicide (EAS) and is legal or considered in many countries and jurisdictions. Clinicians involved in HSK typically target patients with the same clinical features as MAiD-eligible patients. They may draw on similar rationales, e.g., to end perceived patient (...) suffering and provide pleasure for the clinician. HSK can remain undetected or unconfirmed for considerable periods owing to a lack of staff background checks, poor surveillance and oversight, and a failure by authorities to act on concerns from colleagues, patients, or witnesses. The Canadian MAiD system, effectively euthanasia-based, has similar features with added opportunities for killing afforded by clinicians’ exemption from criminal culpability for homicide and assisted suicide offences amid broad patient eligibility criteria. An assessment of the Canadian model offers insights for enhancing safeguards and detecting abuses in there and other jurisdictions with or considering legal EAS. Short of an unlikely recriminalization of EAS, better clinical safeguarding measures, standards, vetting and training of those involved in MAiD, and a radical restructuring of its oversight and delivery can help mitigate the possibility of abuses in a system mandated to accommodate homicidal clinicians. (shrink)

Volume 3, Issue 1, March 2019, Page 86-89.

The classic Lewis-Stalnaker semantics for counterfactuals captures that Sobel sequences are consistent sequences, for example: a.If Sophie had gone to the parade, she would have seen Pedro dance. b.But if Sophie had gone to the parade and been stuck behind someone tall, she would not have seen Pedro dance. But reverse a sequence like this one and it no longer sounds so good, which is surprising on the classic semantics. This observation motivated Kai von Fintel and Thony Gillies to propose (...) dynamic semantic accounts of counterfactual conditionals. Subsequently, Sarah Moss defended the classic semantics against the charge that it need be abandoned in the face of these order effects, arguing that the infelicity of the reverse sequences is pragmatic. I argue that both accounts are ultimately untenable, but each account has strengths. Seeing what works and what doesn't in each account points the way to the right positive view. With this in mind, I defend a contextualist account of counterfactuals that takes conversational relevance to play a central role. (shrink)

First Published in 1999. Routledge is an imprint of Taylor & Francis, an informa company.

This article presents a theoretical framework that views interpersonal power as interdependent with broader structures of gender and class inequalities. In contrast to oversimplified, gender-neutral or gender-static approaches, this approach illuminates the ways that structures of inequality are expressed in ideological hegemonies, which enhance, legitimate, and mystify the interpersonal power of privileged men relative to lower-status men and women in general. The discussion centers on how the relational construction of ascendant and subordinated masculinities provide men with different modes of interpersonal (...) power that, when exercised, construct and reaffirm interclass male dominance. Examples of how the construction of femininity can undermine women's interpersonal power and implications for other forms of masculinities and femininities are discussed. Examples are drawn from an analysis of conjugal power in the accounts of remarried individuals' first and second marriages to illustrate the main points of this perspective. (shrink)

In this article I try to give an account of the meaning of phrases of the form ‘A causes B’ as they are most usefully used in everyday life and the applied sciences. This account covers narrower uses of such phrases, but we find that in our usage of the term, ‘A causes B’ neither entails nor is entailed by ‘A is always followed by B’. Logically necessary and sufficient conditions of this general term can be given, however, by reference (...) to particular cases of causation. The analysis of these is shown to be irreducibly counter-factual, i.e. such phrases are not definable in terms of statements describing those observable occurrences which constitute the relevant verificationary processes. Some objections to the analysis are considered, and it is tested against various examples. * Received 6.xii.65 1 This article is an expanded version of a paper read to the British Society for the Philosophy of Science at Bristol in September 1964. I have greatly benefited from criticisms and suggestions by members of the philosophy seminar of the University of Durham, especially Dr Doreen Bretherton, and also by Professor J. L. Mackie and the editor and referees of this Journal. (shrink)

In the philosophy of probability there are two central questions we are concerned with. The first is: what is the correct formal theory of probability? Orthodoxy has it that Kolmogorov’s axioms are the correct axioms of probability. However, we shall see that there are good reasons to consider alternative axiom systems. The second central question is: what do probability statements mean? Are probabilities “out there”, in the world as frequencies, propensities, or some other objective feature of reality, or are probabilities (...) “in the head”, as subjective degrees of belief? We will survey some of the answers that philosophers, mathematicians and physicists have given to these questions. (shrink)

Empirical work on and common observation of the emotions tells us that our emotions sometimes key us to the presence of real and important reason-giving considerations without necessarily presenting that information to us in a way susceptible of conscious articulation and, sometimes, even despite our consciously held and internally justified judgment that the situation contains no such reasons. In this paper, I want to explore the implications of the fact that emotions show varying degrees of integration with our conscious agency—from (...) none at all to quite substantial—for our understanding of our rationality, and in particular for the traditional assumption that weakness of the will is necessarily irrational. (shrink)

What is cognition? It is now common knowledge that, so far, no one has a ready answer. It is much less generally acknowledged that this is a matter of strong concern when it comes to the further development of the cognitive sciences. We discuss how cognitivism provided a strongly human orientation on cognition, which hindered the development of the standard piecemeal approach, which has been so extremely successful in the biological sciences more generally: first study simple cases and then move (...) onward to more difficult ones. (shrink)

The traditional structure of medical school curriculum in the United States consists of 2 years of pre-clinical study followed by 2 years of clinical rotations. In this essay, I propose that this curricular approach stems from the understanding that medicine is both a science, or a body of knowledge, as well as an art, or a craft that is practiced. I then argue that this distinction between science and art is also relevant to the field of medical ethics, and that (...) this should be reflected in ethics curriculum in medical education. I introduce and argue for virtue ethics as the best opportunity for introducing practical ethical knowledge to medical trainees. (shrink)

_ Source: _Volume 62, Issue 1, pp 1 - 25 This paper aims to articulate Aristotle’s general account of vice, an account that applies to all special vices, regardless of their spheres of action and emotion, and whether they are states of excess or deficiency. Vice is ignorance in the decision : the paper explains what this means.

Conventional wisdom suggests that dishonesty on the part of an organization's employees has a negative effect on the organization's reputation. However, many organizations condone (or even require) dishonesty under certain circumstances. In this research of 128 airline passengers, we examine situations in which employees are perceived to be dishonest within one such industry, the international airlines, and examine the impact of this dishonesty on organizational reputation and customer satisfaction. We found that the reputation of the firm was most damaged when (...) the lie benefited the company or the employee, rather than the passenger. In addition, the view of the airline significantly decreased when the lie caused a high amount of harm (compared with a low amount) to the passenger. (shrink)

In the second edition of this highly successful text, postmodernity is seen as the social condition of the twenty-first century, in which some of the most familiar features of the modern world are not only called into question, but actually undermined by novel trends. The key carriers of the postmodern--new technologies and consumerism--emerged in thoroughly modern contexts, but so profoundly affect everyday social life that modernity itself is changing shape. Postmodernity is a way of describing a new society-in-the-making without supposing (...) that modernity has been entirely left behind. While some dub these changes as "high" or "late" modern, this book argues that "postmodernity" best captures today's transformations or modernity. (shrink)

Feelings of gratitude toward the natural environment are problematic because gratitude seems to be an appropriate response to someone’s intentional decision to benefit us, and ecosystems that sustain human life do not choose to do so. In accordance with one defense of the rationality and appropriateness of gratitude toward nature, intentional action can be regarded as not being a necessary condition for feelings of gratitude. Instead, gratitude toward an entity can be considered both rational and appropriate when (1) that entity (...) is the source of a valuable and unearned benefit and (2) the benefit did not result from some accidental and/or regrettable feature of that entity’s character. According to this analysis, we can provide a rational ground for gratitude to particular ecosystems by citing the valuable and unearned benefits that we receive from those systems and by demonstrating that these benefits result from elements within the ecosystems that are neither regrettable nor accidental. (shrink)

Roughly 20 percent of organic cropland wasdevoted to produce compared to only 3 percent forconventional agriculture in 1995. At the otherextreme, only 6 percent of organic cropland was incorn production while 25 percent of all croplandproduced corn. Only 30 percent of all organicfarmland was in pasture and rangeland compared to 66percent of all farmland. Clearly, these differencesreflect the greater importance of meat and dairyproduction in agriculture overall than in the organicsubsector. In recent years, the organic industry hasgrown not only in (...) volume but in products offered,moving well beyond fresh produce into dairy, snacks,and frozen foods. The estimated growth in retail salesof organic foods averaged over 20 percent a year forthe last eight years compared to only two percent inthe food industry overall, reaching an estimated $4.5billion in 1998. The mix of commodities produced atthe farm level have and will continue to change inresponse to several dynamic forces, including consumerdemand, regulation, and consolidations, mergers, andmainstream entrants at the farm, manufacturing, andretail levels. Consumer demand for organic foods hasbeen spurred by a number of factors including concernsover pesticide residues on foods, food produced usinggenetically modified organisms (GMOs), and hormones indairy and meat products. These concerns coupled withthe overall increase in demand for convenience foodsexplain the phenomenal recent growth of over 70 percent in sales of organic snacks, candy, and frozenfoods. The result has been increased demand forGMO-free grains for snacks, cereals, soy products, andfeed for dairy cows. The recent allowance by USDA forthe labeling of meat and poultry as organic willaccelerate already heightened demand for organic grainand feed from the organic dairy industry. Although thefastest growth in organic foods has been in categoriesother than produce, clearly produce plays an importantrole in the consumers decision on where to shop, anddemand should increase with the overall increase inthe number of organic consumers. Market outlets nowinclude sophisticated natural food store chains,gourmet specialty stores, and e-commerce, allowing fora broadened array of products. Mainstream agriculturalproducers, manufacturers, and supermarket chains haveentered the organic marketplace at a time of lowprices for commodities at the farm gate, fiercecompetition for retail shelf space, and increasinglysophisticated targeting of consumers. Inevitably,these changes in food products offered and in retailoutlets will lead to an organic agriculture thatincreasingly resembles the conventional foodindustry. (shrink)