A probabilistic propositional logic, endowed with a constructor for asserting compatibility of diagonalisable and bounded observables, is presented and illustrated for reasoning about the random results of projective measurements made on a given quantum state. Simultaneous measurements are assumed to imply that the underlying observables are compatible. A sound and weakly complete axiomatisation is provided relying on the decidable first-order theory of real closed ordered fields. The proposed logic is proved to be a conservative extension of classical propositional logic.

BackgroundIn the Canadian Alliance for Healthy Hearts and Minds (CAHHM) cohort, participants underwent magnetic resonance imaging (MRI) of the brain, heart, and abdomen, that generated incidental findings (IFs). The approach to managing these unexpected results remain a complex issue. Our objectives were to describe the CAHHM policy for the management of IFs, to understand the impact of disclosing IFs to healthy research participants, and to reflect on the ethical obligations of researchers in future MRI studies.MethodsBetween 2013 and 2019, 8252 participants (...) (mean age 58 ± 9 years, 54% women) were recruited with a follow-up questionnaire administered to 909 participants (40% response rate) at 1-year. The CAHHM policy followed a restricted approach, whereby routine feedback on IFs was not provided. Only IFs of severe structural abnormalities were reported.ResultsSevere structural abnormalities occurred in 8.3% (95% confidence interval 7.7–8.9%) of participants, with the highest proportions found in the brain (4.2%) and abdomen (3.1%). The majority of participants (97%) informed of an IF reported no change in quality of life, with 3% of participants reporting that the knowledge of an IF negatively impacted their quality of life. Furthermore, 50% reported increased stress in learning about an IF, and in 95%, the discovery of an IF did not adversely impact his/her life insurance policy. Most participants (90%) would enrol in the study again and perceived the MRI scan to be beneficial, regardless of whether they were informed of IFs. While the implications of a restricted approach to IF management was perceived to be mostly positive, a degree of diagnostic misconception was present amongst participants, indicating the importance of a more thorough consent process to support participant autonomy.ConclusionThe management of IFs from research MRI scans remain a challenging issue, as participants may experience stress and a reduced quality of life when IFs are disclosed. The restricted approach to IF management in CAHHM demonstrated a fair fulfillment of the overarching ethical principles of respect for autonomy, concern for wellbeing, and justice. The approach outlined in the CAHHM policy may serve as a framework for future research studies.Clinical trial registrationhttps://clinicaltrials.gov/ct2/show/nct02220582. (shrink)

Patient-reported outcomes are frequently used for medical decision making, at the levels of both individual patient care and healthcare policy. Evidence increasingly shows that PROs may be influenced by patients’ response shifts and dispositions. We identify how response shifts and dispositions may influence medical decisions on both the levels of individual patient care and health policy. We provide examples of these influences and analyse the consequences from the perspectives of ethical principles and theories of just distribution. If influences of response (...) shift and disposition on PROs and consequently medical decision making are not considered, patients may not receive optimal treatment and health insurance packages may include treatments that are not the most effective or cost-effective. We call on healthcare practitioners, researchers, policy makers, health insurers, and other stakeholders to critically reflect on why and how such patient reports are used. (shrink)

Research involving transgender and gender diverse people (TGD) increased in the last years, mostly concerning healthcare associated to this population. Few studies dedicated their analysis to the impact of parental support on transgender people, even though this is an important aspect in creating a safe environment on which these individuals can build their identity. In addition, the link between family support, TGD identity and homelessness is not completely established. Thus, due to the specificities of the family context of TGD individuals, (...) the aim of this study is to investigate the association between family support and TGD in different moments of the process of gender affirmation. In addition, this study also aims to explore the relationship between a lack of social support and low self-esteem, home abandonment, and dwelling in the street. The survey was designed based on the TransPULSE project and was made available in electronic format. The sample was constituted of 423 TGD residents in two Brazilian states. A Structural Equation Model analysis suggested that the impact of gender affirmation status on homelessness was mediated by parental support, through self-esteem, and the need to move from home. The association between the status of the gender affirmation procedures, family support and self-esteem was significant and indicated that the further TGD individuals advanced in gender affirmation, the more self-esteem and family support they would have. The association between family support and self-esteem indicated that family support was associated with higher self-esteem. Low family support was associated with the willingness to move from home due to one’s TGD status and there was also a significant correlation between low self-esteem and the willingness to move from home due to one’s TGD status. Finally, homelessness was associated with the willingness to move with a large effect size. Limitations include the sample that was constituted by individuals with Internet access and who had more contact with TGD communities. The findings indicate directions for interventions involving TGD people and their families, considering the parental relationship as a critical variable to improve TGD quality of life in the process of gender affirmation. (shrink)

Local gauge theories are in a complicated relationship with boundaries. Whereas fixing the gauge can often shave off unwanted redundancies, the coupling of different bounded regions requires the use of gauge-variant elements. Therefore, coupling is inimical to gauge-fixing, as usually understood. This resistance to gauge-fixing has led some to declare the coupling of subsystems to be the \textit{raison d'\^etre} of gauge \cite{RovelliGauge2013}. Indeed, while gauge-fixing is entirely unproblematic for a single region without boundary, it introduces arbitrary boundary conditions on the (...) gauge degrees of freedom themselves---these conditions lack a physical interpretation when they are not functionals of the original fields. Such arbitrary boundary choices creep into the calculation of charges through Noether's second theorem, muddling the assignment of physical charges to local gauge symmetries. The confusion brewn by gauge at boundaries is well-known, and must be contended with both conceptually and technically. It may seem natural to replace the arbitrary boundary choice with new degrees of freedom, for using such a device we resolve some of these confusions while leaving no gauge-dependence on the computation of Noether charges \cite{DonnellyFreidel}. But, concretely, such boundary degrees of freedom are rather arbitrary---they have no relation to the original field-content of the field theory. How should we conceive of them? Here I will explicate the problems mentioned above and illustrate a possible resolution: in a recent series of papers \cite{GomesRiello2016, GomesRiello2018, GomesHopfRiello} the notion of a connection-form was put forward and implemented in the field-space of gauge theories. Using this tool, a modified version of symplectic geometry---here called `horizontal'---is possible. Independently of boundary conditions, this formalism bestows to each region a physically salient, relational notion of charge: the horizontal Noether charge. Meanwhile, as required, the connection-form mediates an irenic composition of regions, one compatible with the attribution of horizontal Noether charges to each region. Thes aims of this paper are to highlight the boundary issues in the treatment of gauge, and to discuss how gauge theory may be conceptually clarified in light of a resolution to these issues. (shrink)

As últimas décadas têm testemunhado uma profusão de teorias filosóficas que buscam reconhecer a moralidade de uma categoria tradicionalmente compreendida como neutra: os animais. Destituída de qualquer valor, a existência não-humana senciente foi deixada de lado por grandes nomes da ética ocidental (de Aristóteles a Kant), cujas teorias colocava-os, muitas vezes, sob o mesmo status de mera matéria destituída de vida. Contudo, desde o século XVIII, sobretudo na Inglaterra, os animais passaram a fazer parte do escopo compreendido por um sem-número (...) de teorias éticas comprometidas com o desafio de lidar com a problemática relação imposta entre humanos e animais. Partindo de um postulado comum – um agente é moralmente relevante se dispõe do maquinário biológico necessário para a produção de sensações agradáveis ou desagradáveis – tais percepções falham em reconhecer a existência de outros seres carentes de proteção moral: as árvores, plantas e uma infinidade de organismos com sistema nervoso central particularmente rudimentar para entrar dentro do cálculo utilitarista, cuja existência encontra-se igualmente ameaçada pelo poder de ação humana. Tendo esse desafio como norte, o presente artigo busca, a partir da teoria ética de Hans Jonas voltada aos animais, uma alternativa de proteção da vida extra-humana e da biosfera. Trata-se de uma pesquisa bibliográfica de caráter analítico, cuja fonte principal circula, sobretudo, em torno de duas grandes obras do filósofo: O Princípio Vida e O Princípio Responsabilidade. Assim sendo, pergunta-se: em que medida a teoria da responsabilidade jonasiana oferece fundamentos para pensar uma teoria ética para os animais não-humanos, ao mesmo tempo que não exclui da esfera moral outros seres vivos? Tal problemática certamente precisa operar sob a perspectiva de uma filosofia da natureza, para então estabelecer um alicerce teórico sobre o qual se possa construir uma ética animal. Para tanto, o texto divide-se em três seções: a) primeiro analisa-se a pertença humana no reino natural, possibilitada, segundo Jonas, graças ao sucesso do darwinismo enquanto narrativa descritiva da realidade biológica; b) passa-se então para uma análise da ontologia da natureza de Jonas compreendendo desde a mais primitiva existência unicelular ao mais desenvolvido degrau da vida animal; c) para então desembocar em uma teoria ética da responsabilidade que compreenda tanto a existência humana, quanto a não-humana. Em seu degrau ascendente de valor, a vida reivindica uma responsabilidade em determinados níveis, tendo a existência animal, com o dramático aparecimento das sensações, mobilidade, medo e desejo, uma reivindicação mais ampla em relação aos modos mais primitivos de manifestação da vida. (shrink)

AimWe aimed to investigate whether the 12-item Multidimensional Scale of Perceived Social Support (MSPSS) constitutes a valid and reliable measure of social support for the general adult Australian population.MethodsData were from Australia’s National Survey of Adult Oral Health 2004–2006 and included 3899 participants aged 18 years old and over. The psychometric properties were evaluated with Bayesian confirmatory factor analysis. One-, two-, and three-factor (Significant Other, Family and Friends) structures were tested. Model fit was assessed with the posterior predictivep-value (PPPχ2), Bayesian (...) root mean square error of approximation (BRMSEA), and Bayesian comparative fit index (BCFI). Dimensionality was tested by comparing competing factorial structures with the Bayes factor (BF). Reliability was evaluated with the Bayesian ΩH. Convergent validity was investigated with the Perceived Stress Scale (PSS) and discriminant validity with the Perceived Dental Control scale (PDC-3).ResultsThe theoretical three-factor model (Significant Other, Family, and Friends) provided a good fit to the data [PPPχ2< 0.001, BRMSEA = 0.089-95% credible interval (CrI) (0.088, 0.089); BCFI = 0.963-95% CrI (0.963, 0.964)]. The BF provided decisive support for the three-factor structure in relation to the other structures. The SO [BΩH= 0.95 - 95% CrI (0.90, 0.99)], FA (BΩH= 0.92 - 95% CrI (0.87, 0.97), and FR (BΩH= 0.92 - 95% CrI (0.88, 0.97)] subscales displayed excellent reliability. The MSPSS displayed initial evidence of convergent and discriminant validity.ConclusionThe MSPSS demonstrated good psychometric properties and excellent reliability in a large Australian sample. This instrument can be applied in national surveys and provide evidence of the role of social support in the Australian population. (shrink)

O pesquisador americano Joseph Banks Rhine (1895 – 1980) e o psiquiatra suíço Carl Gustav Jung (1875 – 1961) foram contemporâneos, o interesse mútuo de pesquisa levou os dois autores a estabeleceram uma troca de correspondências a partir de 1934, que duraria as duas décadas seguintes. A partir desse diálogo importantes repercussões teóricas ocorreram no trabalho dos dois autores, especialmente, em relação a Jung. Em nossa metodologia analisamos as obras de Rhine e de Jung, com destaque para o impacto dos (...) experimentos sobre percepção extrassensorial (PES) sobre o trabalho de Jung de 1952, _Sincronicidade: um princípio de conexões acausais_. Apesar das controvérsias existentes sobre o conceito de sincronicidade, com alguns autores estabelecendo que PES e sincronicidade são eventos distintos, o autor suíço estabelece de forma clara três categorias ou facetas de seu conceito, duas delas incluindo a PES. (shrink)

The Transamazon (Br-230) Highway in the state of Pará has had its image frozen for decades: themuddy road, the cars stopped or tractors tearing down a forest, empty of people, opening the amazonianspace to a project of an authoritarian modernization. Reproduced by and reproductive of the teachingsof geography – including for children and teenagers who live on the edge of the road, in settlements andcommunities on the sideroads (vicinais) – in textbooks and discourses that frame regional scale (astotalizing and explanatory) (...) instead of scales emplaced in situ. The result of such dinamics is not restricted to a gap between what one experiences as a phenomenon and what one learns as a concept,it goes towards the reproducibility of an “unexistance of the creative potential” of the people living onthe sideroads, places of the construction of a geography, as well as mapping, that, from there, push usto rethink the unwavering foundations of such frosen images , of the generalistic maps and theirstandardizing projections, scales and simbology. To do so, we have, along with students and teachersof 2 schools on the sideroads of the municipality of Pacajá (PA), in the period of the beggining of 2016to 2019, done several geocartographic exercises: mind maps developped with students about the past,present and the future of the vicinal (sideroad). That is, an attempt to provoque the body into the mapand the map into the body in a context of a limit situation of existance, given the precarious schoolconditions as well as the diferent challenges lived by students and teachers. Such corporal engagementas an attempt to think the sideroads as a location in construction and, from there, a situated opening tothe world, is what gives meaning to geocartography. It is possible to conclude that: a) facing thesedimentary representations paralysing and overview of the Transamazon in the state of Pará , thephenomenological exercise of reactivation of geocartogrphying provoques the emergence of asubjective significance that does not separate the emotional and symbolic perspectives on creatingmaps; b) the corporal engagement and the situated perspective of students and teachers, not only hasthe value of a totalyzing exemple, but that of an opening to what is new as they bring up a simbologythat reveals the need to build a dialogical bridge between what is lived on the sideroads and the worldthat classifies it as “unexisting”. (shrink)

The literature has indicated some approximations between Skinner’s and Wittgenstein’s proposals, such as a critical standpoint on traditional psychological language conceptions. For Wittgenstein, the critique refers to the impossibility of a private language. On the other hand, Skinner’s critique culminates in defense of the concept of private events. However, this concept seems inconsistent with Wittgenstein’s proposal. Based on this assumption, this paper aims to reevaluate the role of the concept of ‘private events’ in Skinnerian behaviorism in the light of Wittgenstein’s (...) critical discussions. For this, Wittgenstein’s and Skinner’s proposals were systematically compared. It is concluded that the concept of private events is not to escape Wittgenstein’s criticisms of the traditional psychological language. (shrink)

The physician charter on medical professionalism creates standards of ethical behaviour for physicians and has been endorsed by professional organisations worldwide. It is based on the cardinal principles of the primacy of patient welfare, patient autonomy, and social welfare. There has been little discussion in the bioethics community of the doctrine of the charter and none from a Jewish ethical perspective. In this essay the authors discuss the obligations of the charter from a Jewish ethical viewpoint and call on other (...) cultures to develop their own unique perspectives on this important document. (shrink)

Ii is a well-known fact that the men of the Macedonian phalanx under Philip and Alexander were known collectively asor ‘foot companions’. Our first reference to the name comes from Demosthenes, who in his second Olynthiac tries unconvincingly to disparage the fighting qualities of Philip's mercenaries andDemosthenes adds no explanation, and it was left to commentators and lexicographers to unearth a relevant fragment from thePhilippicaof Anaximenes of Lampsacus.

A highly ordered universe is described in terms of neutrino and electrino alone as basic particles, and length and time alone as dimensional units. New theories are obtained of particles, nuclides, atomic spectra, general relativity, and gravitation.

An attempt is made to show that Wittgenstein's later philosophy of logic is not the kind of conventionalism which is often ascribed to him. On the contrary, Wittgenstein gives expression to a “mixed” theory which is not only interesting but tends to resolve the perplexities usually associated with the question of the a priori character of logical truth. I try to show that Wittgenstein is better understood not as denying that there are such things as “logical rules” nor as denying (...) that the results of applying such rules are “logically necessary,” but as trying to understand what it is to appeal to a logical rule and what it means to say that the results of applying such a rule are “necessary.” He is not so much overthrowing standard accounts of logical necessity as discovering the limits of the concept. (shrink)

William of Malmesbury's Regesta Regum Anglorum is one of the great histories of England, and one of the most important historical works of the European Middle Ages. Although its focus is national, its scope encompasses most of Western Europe and beyond, providing a full-scale account of the First Crusade. Apart from its formidable learning, it is characterized by narrative skill and entertainment value - with topics including unpowered flight and Henry I's zoo. This edition in the Oxford Medieval Texts series (...) is the first modern translation and edition. A full historical introduction is supplied in Volume II. (shrink)

Moral distress is one of the core topics of clinical ethics. Although there is a large and growing empirical literature on the psychological aspects of moral distress, scholars, and empirical investigators of moral distress have recently called for greater conceptual clarity. To meet this recognized need, we provide a philosophical taxonomy of the categories of what we call ethically significant moral distress: the judgment that one is not able, to differing degrees, to act on one’s moral knowledge about what one (...) ought to do. We begin by unpacking the philosophical components of Andrew Jameton’s original formulation from his landmark 1984 work and identify two key respects in which that formulation remains unclear: the origins of moral knowledge and impediments to acting on that moral knowledge. We then selectively review subsequent literature that shows that there is more than one concept of moral distress and that explores the origin of the values implicated in moral distress and impediments to acting on those values. This review sets the stage for identifying the elements of a philosophical taxonomy of ethically significant moral distress. The taxonomy uses these elements to create six categories of ethically significant moral distress: challenges to, threats to, and violations of professional integrity; and challenges to, threats to, and violations of individual integrity. We close with suggestions about how the proposed philosophical taxonomy of ethically significant moral distress sheds light on the concepts of moral residue and crescendo effect of moral distress and how the proposed taxonomy might usefully guide prevention of and future qualitative and quantitative empirical research on ethically significant moral distress. (shrink)

Aim: Patients with advanced cancer need information about end-of-life treatment options in order to make informed decisions. Clinicians vary in the frequency with which they initiate these discussions.Patients and methods: As part of a long-term longitudinal study, patients with an expected 2-year survival of less than 50% who had advanced gastrointestinal or lung cancer or amyotrophic lateral sclerosis were interviewed. Each patient’s medical record was reviewed at enrollment and at 3 months for evidence of the discussion of patient wishes concerning (...) ventilator support, artificial nutrition and hydration , resuscitation and hospice care. A Kaplan–Meier analysis was also performed and 2-year survival calculated.Results: 60 cancer and 32 ALS patients were enrolled. ALS patients were more likely than cancer patients to have evidence of discussion about their wishes for ventilator support , ANH , DNR and hospice care . At 6 months, 91% of ALS patients were alive compared with 62% of cancer patients; at 2 years, 63% of ALS patients were alive compared with 23% of cancer patients .Conclusions: Cancer patients were less likely than ALS patients to have had documented advanced care planning discussions despite worse survival. This may reflect perceptions that ALS has a more predictable course, that advanced cancer has a greater number of treatment options, or differing views about hope. Nevertheless, cancer patients may be less adequately prepared for end-of-life decision-making. (shrink)

There are many people in the world who want to be Somebody. Let us describe someone as Somebody who comes to believe that, in one or more respects, he or she is a special or significant person and who succeeds, through whatever means, in acquiring some sort of reputation and some sort of fame. People want to become Somebody because they believe that unless they succeed in that respect they will turn out to be a mere mediocrity, or worse still, (...) to be thought of as a mere mediocrity. People want to leave some sort of mark in this world before they die. They do not want their passage through this world to be utterly ineffectual. This, I think, is the seed from which the ideal of being Somebody emerges. (shrink)

A new theory of particles proposed in an earlier paper is now applied to explain energy. Having earlier derived the Rydberg formula for atomic spectra without using the Pauli principle, the authors now derive the photoelectric effect, deflection of light by gravitation, and Planck's law for blackbody radiation without using Planck's assumption on energy quanta or Einstein's theory of general relativity.