Both the doctor and the patient have rights to terminate an implantable cardioverter-defibrillator device for reasons of futility or autonomyImplantable devices have a long history in medicine with artificial hips being implanted since 1925, pacemakers since 1957, Starr-Edwards heart valve since 1961, artificial hearts since 1982 and ventricular assist devices since 1991. The ethics of deactivation or removal of these devices were not an issue until the use of implantable cardioverter defibrillator device, as the ICD can produce considerable distress from (...) defibrillation shocks in end-of-life patients. However, development of a clear ethics for ICD is critical as the massive technological advances in implantable heart failure devices will soon produce an epidemic of patients with implanted devices and end-of-life diseases. Should one turn off a biventricular pacer at the request of a patient who is having recurrent disabling heart failure? Should one turn off an AbioCor artificial heart in a patient who developed a severe disabling stroke from the device? Who has the right to turn off the device? Does the doctor have the right to turn it off, against the patient’s wishes, for reasons of futility? Does the patient have the right to turn it off, against the doctor’s wishes, and if so, for what reasons?In this issue of the Journal of Medical Ethics, England et al1 argue that the classification of an implantable device determines the rights of device deactivation. At the one end of the spectrum, there are semi-implanted devices like an intra-aortic balloon pump or a ventilator, where the doctor has the right to turn off the supportive therapy by commission on grounds …. (shrink)

Background: Discussions about medical errors facilitate professional learning for physicians and may provide emotional support after an error, but little is known about physicians’ attitudes and practices regarding error discussions with colleagues.Methods: Survey of faculty and resident physicians in generalist specialties in Midwest, Mid-Atlantic and Northeast regions of the US to investigate attitudes and practices regarding error discussions, likelihood of discussing hypothetical errors, experience role-modelling error discussions and demographic variables.Results: Responses were received from 338 participants . In all, 73% of (...) respondents indicated they usually discuss their mistakes with colleagues, 70% believed discussing mistakes strengthens professional relationships and 89% knew at least one colleague who would be a supportive listener. Motivations for error discussions included wanting to learn whether a colleague would have made the same decision , wanting colleagues to learn from the mistake and wanting to receive support . Given hypothetical scenarios, most respondents indicated they would likely discuss an error resulting in no harm , minor harm or major harm . Fifty-seven percent of physicians had tried to serve as a role model by discussing an error and role-modelling was more likely among those who had previously observed an error discussion .Conclusions: Most generalist physicians in teaching hospitals report that they usually discuss their errors with colleagues, and more than half have tried to role-model discussions. However, a significant number of these physicians report that they do not usually discuss their errors and some do not know colleagues who would be supportive listeners. (shrink)

Collaboration requires agents to coordinate their behavior on the fly, sometimes cooperating to solve a single task together and other times dividing it up into sub‐tasks to work on in parallel. Underlying the human ability to collaborate is theory‐of‐mind (ToM), the ability to infer the hidden mental states that drive others to act. Here, we develop Bayesian Delegation, a decentralized multi‐agent learning mechanism with these abilities. Bayesian Delegation enables agents to rapidly infer the hidden intentions of others by inverse planning. (...) We test Bayesian Delegation in a suite of multi‐agent Markov decision processes inspired by cooking problems. On these tasks, agents with Bayesian Delegation coordinate both their high‐level plans (e.g., what sub‐task they should work on) and their low‐level actions (e.g., avoiding getting in each other's way). When matched with partners that act using the same algorithm, Bayesian Delegation outperforms alternatives. Bayesian Delegation is also a capable ad hoc collaborator and successfully coordinates with other agent types even in the absence of prior experience. Finally, in a behavioral experiment, we show that Bayesian Delegation makes inferences similar to human observers about the intent of others. Together, these results argue for the centrality of ToM for successful decentralized multi‐agent collaboration. (shrink)

We investigated people's ability to infer others’ mental states from their emotional reactions, manipulating whether agents wanted, expected, and caused an outcome. Participants recovered agents’ desires throughout. When the agent observed, but did not cause the outcome, participants’ ability to recover the agent's beliefs depended on the evidence they got. When the agent caused the event, participants’ judgments also depended on the probability of the action ; when actions were improbable given the mental states, people failed to recover the agent's (...) beliefs even when they saw her react to both the anticipated and actual outcomes. A Bayesian model captured human performance throughout, consistent with the proposal that people rationally integrate information about others’ actions and emotional reactions to infer their unobservable mental states. (shrink)

Wisdom is a multi-component trait that is important for mental health and well-being. In this study, we sought to understand gender differences in relative strengths in wisdom. A total of 659 individuals aged 27–103 years completed surveys including the 3-Dimensional Wisdom Scale and the San Diego Wisdom Scale. Analyses assessed gender differences in wisdom and gender’s moderating effect on the relationship between wisdom and associated constructs including depression, loneliness, well-being, optimism, and resilience. Women scored higher on average on the 3D-WS (...) but not on the SD-WISE. Women scored higher on compassion-related domains and on SD-WISE Self-Reflection. Men scored higher on cognitive-related domains and on SD-WISE Emotion Regulation. There was no impact of gender on the relationships between wisdom and associated constructs. Women and men have different relative strengths in wisdom, likely driven by sociocultural and biological factors. Tailoring wisdom interventions to individuals based on their profiles is an important next step. (shrink)

The Featurally Underspecified Lexicon theory predicts that [coronal] is the language universal default place of articulation for phonemes. This assumption has been consistently supported with adult behavioral and event-related potential data; however, this underspecification claim has not been tested in developmental populations. The purpose of this study was to determine whether children demonstrate [coronal] underspecification patterns similar to those of adults. Two English consonants differing in place of articulation, [labial] /b/ and [coronal] /d/, were presented to 24 children characterized by (...) either a typically developing phonological system or a phonological disorder. Two syllables, /bɑ/ and /dɑ/, were presented in an ERP oddball paradigm where both syllables served as the standard and deviant stimulus in opposite stimulus sets. Underspecification was examined with three analyses: traditional mean amplitude measurements, cluster-based permutation tests, and single-trial general linear model analyses of single-subject data. Contrary to previous adult findings, children with PD demonstrated a large positive mismatch response to /bɑ/ while the children with TD exhibited a negative mismatch response ; significant group differences were not observed in the /dɑ/ responses. Moreover, the /bɑ/ deviant ERP response was significantly larger in the TD children than in the children with PD. At the single-subject level, more children demonstrated mismatch responses to /dɑ/ than to /bɑ/, though some children had a /bɑ/ mismatch response and no /dɑ/ mismatch response. While both groups of children demonstrated similar responses to the underspecified /dɑ/, their neural responses to the more specified /bɑ/ varied. These findings are interpreted within a proposed developmental model of phonological underspecification, wherein children with PD are functioning at a developmentally less mature stage of phonological acquisition than their same-aged TD peers. Thus, phonological underspecification is a phenomenon that likely develops over time with experience and exposure to language. (shrink)

Cooper proved in [S.B. Cooper, Strong minimal covers for recursively enumerable degrees, Math. Logic Quart. 42 191–196] the existence of a c.e. degree with a strong minimal cover . So is the greastest c.e. degree below . Cooper and Yi pointed out in [S.B. Cooper, X. Yi, Isolated d.r.e. degrees, University of Leeds, Dept. of Pure Math., 1995. Preprint] that this strongly minimal cover cannot be d.c.e., and meanwhile, they proposed the notion of isolated degrees: a d.c.e. degree is isolated (...) by a c.e. degree if is the greatest c.e. degree below , and we also say that isolates . In [G. Wu, Bi-isolation in the d.c.e. degrees, J. Symbolic Logic 69 409–420], Wu extended Cooper–Yi’s notion and proved that there are intervals of d.c.e. degrees containing exactly one c.e. degree . Following Cooper and Yi’s notion, is called a bi-isolating degree. The bi-isolating degrees are dense in the high c.e. degrees. Arslanov asked whether the bi-isolating degrees occur in every jump class. In this paper, we prove that there are low bi-isolating degrees, providing a partial solution to Arslanov’s question. (shrink)

We explore Boolean-valued models of set theory with a class of urelements. In an existing construction, which we call UB, every urelement is its own B-name. We prove the fundamental theorem of UB in the context of ZFUR (i.e., ZF with urelements formulated with Replacement). In particular, UB is shown to preserve Replacement and hence ZFUR. Moreover, UB can both destroy axioms, such as the DCω1-scheme, and recover axioms, such as the Collection Principle. One drawback of UB is that it (...) does not permit mixing names, resulting in a lack of fullness. To address this, we introduce a new construction, UB‾, which is closed under mixtures. We prove that there is an elementary embedding from UB to UB‾. Over ZFUR with the Axiom of Choice, UB‾ is full for every complete Boolean algebra B just in case the Collection Principle holds. (shrink)

Say that a nonzero c. e. degree b is a quasi-complement of a c. e. degree a if a ∩ b = 0 and a ∪ b is high. It is well-known that each cappable degree has a high quasi-complement. However, by the existence of the almost deep degrees, there are nonzero cappable degrees having no low quasi-complements. In this paper, we prove that any nonzero cappable degree has a low2 quasi-complement.

Humans regularly pursue activities characterized by dramatic success or failure outcomes where, critically, the chances of success depend on the time invested working toward it. How should people allocate time between suchmake‐or‐breakchallenges and safe alternatives, where rewards are more predictable (e.g., linear) functions of performance? We present a formal framework for studying time allocation between these two types of activities, and we explore optimal behavior in both one‐shot and dynamic versions of the problem. In the one‐shot version, we illustrate striking (...) discontinuities in the optimal time allocation policy as we gradually change the parameters of the decision‐making problem. In the dynamic version, we formulate the optimal strategy—defined by agiving‐upthreshold—which adaptively dictates when people should stop pursuing the make‐or‐break goal. We then show that this strategy is computationally inaccessible for humans, and we explore boundedly rational alternatives. We compare the performance of the optimal model against (a) a myopic giving‐up threshold that is easier to compute, and even simpler heuristic strategies that either (b) only decide whether or not to start pursuing the goal and never give up or (c) consider giving up at a fixed number of control points. Comparing strategies across environments, we investigate the cost and behavioral implications of sidestepping the computational burden of full rationality. (shrink)

Lachlan observed that the infimum of two r.e. degrees considered in the r.e. degrees coincides with the one considered in the ${\Delta_2^0}$ degrees. It is not true anymore for the d.r.e. degrees. Kaddah proved in (Ann Pure Appl Log 62(3):207–263, 1993) that there are d.r.e. degrees a, b, c and a 3-r.e. degree x such that a is the infimum of b, c in the d.r.e. degrees, but not in the 3-r.e. degrees, as a < x < b, c. In (...) this paper, we extend Kaddah’s result by showing that such a structural difference occurs densely in the r.e. degrees. Our result immediately implies that the isolated 3-r.e. degrees are dense in the r.e. degrees, which was first proved by LaForte. (shrink)

Say that a d.c.e. degree d is isolated by a c.e. degree b, if bMathematics Subject Classification (2000): 03D25, 03D30, 03D35 RID=""ID="" Key words or phrases: Computably enumerable (...) set – d.c.e. degree – Isolation – High/low hierarchy RID=""ID="" Ishmukhametov's research is supported by RFBR grant 01-01-00733, and Wu's research is supported by the Marsden Fund of New Zealand. Wu would like to thank his supervisor, Prof. Rod Downey, for his many helpful suggestions and comments. (shrink)

Cholak, Groszek and Slaman proved in J Symb Log 66:881–901, 2001 that there is a nonzero computably enumerable (c.e.) degree cupping every low c.e. degree to a low c.e. degree. In the same paper, they pointed out that every nonzero c.e. degree can cup a low2 c.e. degree to a nonlow2 degree. In Jockusch et al. (Trans Am Math Soc 356:2557–2568, 2004) improved the latter result by showing that every nonzero c.e. degree c is cuppable to a high c.e. degree (...) by a low2 c.e. degree b. It is natural to ask in which subclass of low2 c.e. degrees can b in Jockusch et al. (Trans Am Math Soc 356:2557–2568, 2004) be located. Wu proved in Math Log Quart 50:189–201, 2004 that b can be cappable. We prove in this paper that b in Jockusch, Li and Yang’s result can be noncuppable, improving both Jockusch, Li and Yang, and Wu’s results. (shrink)

Workplace stressors were identified to have critical impacts on employee creativity. However, little is known about how and when involuntary citizenship behavior (i.e., compulsory citizenship behavior, CCB)-induced stress might exert influence on employee creativity. To fill this void, the present study firstly develops a moderated mediation model to investigate the CCB—employee creativity association as well as the underling mechanism and contextual condition of this relationship. By integrating social cognitive theory such as self-efficacy theory and conservation of resources (COR) theory, we (...) propose that CCB predicts employee creativity through the mediating role of creative self-efficacy (CSE), with the individual characteristics (i.e., personality traits) of negative affect acting as a boundary condition. Using two-wave time-lagged survey data collected from a sample of 251 front-line employees in 10 manufacturing firms in Southern China, the results show that: (a) CSE mediates the negative relationship between CCB and employee creativity; (b) negative affect moderates the relationship between CCB and CSE; (c) negative affect moderates the indirect influence of CCB on employee creativity through CSE. As the level of negative affect rises, this indirect relationship is stronger. Finally, important theoretical and managerial implications and promising avenues for future research are addressed. (shrink)

Visual research methods like photography and digital storytelling are increasingly used in health and social sciences research as participatory approaches that benefit participants, researchers, and audiences. Visual methods involve a number of additional ethical considerations such as using identifiable content and ownership of creative outputs. As such, ethics committees should use different assessment frameworks to consider research protocols with visual methods. Here, we outline the limitations of ethics committees in assessing projects with a visual focus and highlight the sparse knowledge (...) on how researchers respond when they encounter ethical challenges in the practice of visual research. We propose a situated approach in relation to visual methodologies that encompasses a negotiated, flexible approach, given that ethical issues usually emerge in relation to the specific contexts of individual research projects. Drawing on available literature and two case studies, we identify and reflect on nuanced ethical implications in visual research, like tensions between aesthetics and research validity. The case studies highlight strategies developed in-situ to address the challenges two researchers encountered when using visual research methods, illustrating that some practice implications are not necessarily addressed using established ethical clearance procedures. A situated approach can ensure that visual research remains ethical, engaging, and rigorous. (shrink)

This paper draws from the turnover and emotions literatures to explore how job embeddedness, in the context of abusive supervision, can impact job frustration, citizenship withdrawal, and employee deviance. Results indicate that employees with abusive supervisors were more likely to be frustrated with their jobs and engage in more deviance behaviors. And yet, the relationship between abusive supervision and job frustration was moderated by job embeddedness such that the relationship was weaker and negative for those higher in job embeddedness and (...) stronger and positive for those lower in job embeddedness. In other words, contrary to our original predictions, individuals who were more embedded in their jobs with an abusive supervisor were actually less likely to experience job frustration or engage deviance behaviors. Important implications for management research and practice are discussed. (shrink)

The operational definition of a weak value for a quantum mechanical system involves the limit of the weak measurement strength tending to zero. I study how this limit compares to the situation for the undisturbed system. Under certain conditions, which I investigate, this limit is discontinuous in the sense that it does not merge smoothly to the Hilbert space description of the undisturbed system. Hence, in these discontinuous cases, the weak value does not represent the undisturbed system. As a result, (...) conclusions drawn from such weak values regarding the properties of the studied system cannot be upheld. Examples are given. (shrink)