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)

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)

Aim: To improve clinical and ethical understanding of patient preferences for information and involvement in decision making.Objectives: To develop and evaluate a clinical tool to elicit these preferences and to consider the ethical issues raised.Design: A before and after study.Setting: Three UK hospices.Participants: Patients with advanced life-threatening illnesses and their doctors.Intervention: Questionnaire on information and decision-making preferences.Main outcome measures: Patient-based outcome measures were satisfaction with the amount of information given, with the way information was given, with family or carer information, (...) and confidence about future decision making. Doctor-based outcome measures were confidence in matching information to patient preference, matching family or carer communication to patient preference, knowing patient preferences and matching future decision making with patient preference.Results: Of 336 admissions, 101 patients completed the study . Patient satisfaction with the way information was given and family communication improved after introduction of the tool. Doctor confidence improved across all outcome measures .Conclusions: Patient satisfaction and doctor confidence were improved by administering the questionnaire, but complex ethical issues were raised by implementing and applying this research. The balance of ethical considerations were changed by advanced life-threatening illness, because there is increased risk of harm through delivery of information discordant with the patient’s own preferences. The importance of truly understanding patient preferences towards the end of life is highlighted by this study. (shrink)

. Analitic Map where explained factors and conditions to facilitate and inhibit the supply development process as well as purchasing strategies, in integrated companies with supply chain management. The research explores the advantages of a supply development straegy in the business world. All common practices in supply development are identified for a succesful implementation, as well as inhibitors to cause failure. Finally comparing theses strategies according to comanies´wealth generating strategies.Keywords. Supplier development, supply chain management, logistics, value chainResumen. El estudio propone (...) un esquema analítico único e integrador, que busca explorar los principales factores que condicionan, facilitan e inhiben el desarrollo de proveedores como estrategia de compras en empresas integradas en una cadena de valor, a fin de que, en una segunda etapa, sea contrastado empíricamente. En este sentido, el estudio pretende explorar las ventajas del desarrollo de proveedores proponiendo un conjunto de variables de análisis fundamentales para una mejor comprensión de los beneficios y alcances de ésta práctica. Para ello se busca identificar en la literatura académica los principales factores que generan la necesidad de recurrir al desarrollo de proveedores, las prácticas de abastecimiento que favorecen una implementación exitosa y sostenible, y los factores inhibidores que limitan el logro de los objetivos esperados, convirtiéndose en un mecanismo válido de generación de valor.Palabras claves. desarrollo de proveedores, cadena de abastecimiento, compras estratégicas, cadena de valor. (shrink)

Synaesthesia is a condition in which one type of stimulation evokes the sensation of another, as when the hearing of a sound produces photisms, i.e. mental percepts of colours. R is a 20 year old colour blind subject who, in addition to the relatively common grapheme-colour synaesthesia, presents a rarely reported cross modal perception in which a variety of visual stimuli elicit aura-like percepts of colour. In R, photisms seem to be closely related to the affective valence of stimuli and (...) typically bring out a consistent pattern of emotional responses. The present case study suggests that colours might be an intrinsic category of the human brain. We developed an empirical methodology that allowed us to study the subject's otherwise inaccessible phenomenological experience. First, we found that R shows a Stroop effect (delayed response due to interference) elicited by photisms despite the fact that he does not show a regular Stroop with real colours. Secondly, by manipulating the colour context we confirmed that colours can alter R's emotional evaluation of the stimuli. Furthermore, we demonstrated that R's auras may actually lead to a partially inverted emotional spectrum where certain stimuli bring out emotional reactions opposite to the normal ones. These findings can only be accounted for by considering R's subjective colour experience or qualia. Therefore the present paper defends the view that qualia are a useful scientific concept that can be approached and studied by experimental methods. (shrink)

In his preface, Hunter explains that this volume is intended to provide for non-mathematicians an introduction to the most important results of modern mathematical logic. The reader will find here the work of Post, Skolem, Gödel, Church, Henkin, and others, presented in a terse and closely-knit style. Though acknowledging the trend toward natural deduction systems, Hunter sticks to more classical axiomatic systems on the grounds that the proofs of metatheorems are simplified by that choice. He begins with a formal system (...) of propositional logic, for which he develops proofs of completeness, consistency, and decidability. Systems of first order predicate logic are then dealt with, and Church's and Gödel's results on undecidability and incompleteness are presented. There is a brief, useful discussion indicating what parts of first order predicate logic are decidable. It is assumed that the reader has some familiarity with elementary formal logic: Hunter develops the set-theoretical results he requires. The compactness of the presentation is facilitated by the use of earlier results for propositional logic to obtain certain results for predicate logic. Especially helpful is Hunter's technique of prefacing each of the longer and more difficult proofs with a section explaining the key ideas and the general method of proof; summaries are also often provided in conclusion. Because of the orientation of the book, a more extensive discussion of the significance of the results obtained and the philosophical issues which have been raised concerning some of them, would have been welcome. Nonetheless, this is a good, concise introduction for those who are not yet prepared to tackle the more technical literature. A bibliography is provided for those interested in pursuing the subject in greater detail.--E. M. F. (shrink)

Maria Triassi,1 Elena Giancotti,2 Antonio Nardone,1 Giulia Mancini,3 Fabiana Rubba1 1Public, Preventive and Social Medicine School, University Federico II of Naples, Naples, Italy; 2Procurement and Transplantation Coordination, Naples, Italy; 3Sociology Unit, G D'annunzio University, Chieti-Pescara, Italy Introduction: The growing disparity between organ availability for transplantation and the number of patients in need has challenged the donation and transplantation community to develop innovative processes, ideas, and techniques to bridge this gap. Advances in the sharing of best practices in the donation community (...) have contributed greatly to this aim over the past 5 years. Studies published during the past five years were analyzed to gain insight on the evolving organizational areas and tools that the procurement and transplantation pathways have been focused on. The hypothesis assessed is that networking and efficacious handling of this complex path may be ameliorated by an adaptive organizational toolbox. Methods: A thorough search has been conducted using various databases, ie, Cochrane library, PubMed, EMBASE, Federico II University Open Archive. The evidence was considered following the Effective Practice and Organization of Care Group checklist. Prevalent organizational attitudes and areas were assessed, and various scenarios were analyzed. Initially, all titles and abstracts were screened. In the next phase, the full text of all abstracts considered potentially relevant by at least one of the reviewers was evaluated. Inconsistencies in decision-making within this second phase were solved based on consensus between both reviewers. In this phase, for every study we defined whether the organization was considered relevant and what the scenario was. The information was extracted from each study based on bibliographic details. As many as 1,071 studies were analyzed, and 81 were selected as potentially relevant. Results: We found three prevalent areas of interest focused on organizational elements: global organizational strategies scenario, clinical hospital organization, and citizenship and social scenario. Conclusion: We reached the conclusion that organization has a central role in different scenarios of procurement and transplantation in a continuum from government to hospital and finally among citizens. A standardized hospital pathway definitely remains the essential step in order to ameliorate either procurement or transplantation. Keywords: transplant procurement, management, organizational tool, network. (shrink)

We give a review of recent progress on the application of the relativistic chiral SU(3) Lagrangian to meson–baryon scattering. It is shown that a combined chiral and 1/Nc expansion of the Bethe–Salpeter interaction kernel leads to a good description of the kaon–nucleon, antikaon–nucleon and pion–nucleon scattering data typically up to laboratory momenta of p lab ≃500 MeV. We solve the covariant coupled channel Bethe–Salpeter equation with the interaction kernel truncated to chiral order Q 3 where we include only those terms (...) which are leading in the large Nc limit of QCD. (shrink)

Many researchers in moral psychology approach the topic of moral judgment in terms of value—assessing outcomes of behaviors as either harmful or helpful which makes the behaviors wrong or right, respectively. However, recent advances in motivation science suggest that other motives may be at work as well—namely truth (wanting to establish what is real) and control (wanting to manage what happens). In this review, we argue that the epistemic experiences of observers of (im)moral behaviors, and the perceived epistemic experiences of (...) those observed, serve as a groundwork for understanding how truth and control motives are implicated in the moral judgment process. We also discuss relations between this framework and recent work from across the field of moral psychology, as well as implications for future research. (shrink)

Recent research in moral psychology has highlighted how the current internal states of observers can influence their moral judgments of others’ actions. In this article, we argue that an important internal state that serves such a function is the sense of control one has over one’s own actions. Across four studies, we show that an individual’s own current sense of control is positively associated with the intensity of moral judgments of the actions of others. We also show that this effect (...) extends not only to judgments of rightness and wrongness (Study 1), but also to assignments of reward and punishment (Study 2). Finally, we demonstrate that this effect is based on the current experience of control by showing a moderation of the effect via motivational states (promotion; prevention) that either lead one to incorporate or disregard internal states when making judgments (Study 3) and by subtly manipulating participants’ sense of control (Study 4). (shrink)

M. F. Burnyeat taught for 14 years in the Philosophy Department of University College London, then for 18 years in the Classics Faculty at Cambridge, 12 of them as the Laurence Professor of Ancient Philosophy, before migrating to Oxford in 1996 to become a Senior Research Fellow in Philosophy at All Souls College. The studies, articles and reviews collected in these two volumes of Explorations in Ancient and Modern Philosophy were all written, and all but two published, before that decisive (...) change. Whether designed for a scholarly audience or for a wider public, they range from the Presocratics to Augustine, from Descartes and Bishop Berkeley to Wittgenstein and G. E. Moore. Their subject-matter falls under four main headings: 'Logic and Dialectic' and 'Scepticism Ancient and Modern', which make up the first volume, with 'Knowledge' and 'Philosophy and the Good Life' contained in this, the second volume. The title 'Explorations' well expresses Burnyeat's ability to discover new aspects of familiar texts, new ways of solving old problems. In his hands the history of philosophy becomes itself a philosophical activity. (shrink)