A cross-sectional study to ascertain what the Singapore population would regard as material risk in the anaesthesia consent-taking process and identify demographic factors that predict patient preferences in medical decision-making to tailor a more patient-centered informed consent. A survey was performed involving patients 21 years old and above who attended the pre-operative evaluation clinic over a 1-month period in Singapore General Hospital. Questionnaires were administered to assess patients’ perception of material risks, by trained interviewers. Patients’ demographics were obtained. Mann–Whitney U (...) test and Kruskal-Wallis one-way analysis of variance was used. Statistical significance was taken at p < 0.05. Four hundred fourteen patients were eligible of which 26 refused to participate and 24 were excluded due to language barrier. 364 patients were recruited. A higher level of education, being employed and younger age group are factors identified in patients who wanted greater participation in medical decisions. Gender, marital status, type of surgery, and previous surgical history did not affect their level of participation. The complications most patients knew about were Nausea, Drowsiness and Surgical Wound Pain. Patients ranked Heart Attack, Death and Stroke as the most significant risks that they wanted to be informed about in greater detail. Most patients wanted to make a joint decision with the anaesthetist, instead of letting the doctor decide or deciding for themselves. Discussion with the anaesthetist is the preferred medium of communication compared to reading a pamphlet or watching a video. Age and educational level can influence medical decision-making. Despite the digital age, most patients still prefer a clinic consult instead of audio-visual multimedia for pre-operative anaesthetic counselling. The local population appears to place greater importance on rare but serious complications compared to common complications. This illustrates the need to contextualize information provided during informed consent to strengthen the doctor-patient relationship. (shrink)

Two classic learning situations are critically reviewed and interpreted from a synergetic point of view: human learning of complex skills, and animal discrimination learning. Both show typical characteristics of nonlinear phase transitions: instability, fluctuations, critical slowing down and reorganisation. Plateaus in the acquisition curves of complex skills can be viewed as phases of arrested progress in which a reorganisation of simple skills is necessary before their integration into complex units is possible. Fluctuations and critical slowing down are expressed in instances (...) of "vicarious trial-and-error," which describe the oscillating behavior of rats at a choice point that is shown only just before discrimination learning is completed. It is concluded that education might pay more attention to the role of individual learning rhythms. (shrink)

It is shown that an approach to quantum phenomena in which charged particles are treated as macroscopically extended periodic disturbances in a nonlinear c-number field, interacting with each other via massless excitations of that field, leads almost uniquely to the five basic equations of classical electrodynamics: the Lorentz force law and Maxwell's equations. The fundamental electromagnetic quantity in this approach is the 4-vector potential Aα—interpreted absolutely as a measure of the local shift of each particle off its mass shell—rather than (...) theE andB fields, and it thus provides a new viewpoint on the questions of Aharonov-Bohm phase shifts, the existence of magnetic monopoles, and the role of gauge invariance. (shrink)

In the opening sections of his Brahma-sutra-bhasya , Ramanuja makes a very forceful assault on Sankara's Advaita theory. This assault anticipates in a striking way modern western attacks on metaphysical religious positions, attacks which stem from Hume and are associated today with names like A. J. Ayer and Antony Flew. In this paper I wish to argue that certain aspects of Sankara's position, as enunciated in his Brahma-sutra-bhasya , suggest that Ramanunja's assault, and therefore by implication a modern western attack (...) on Sankara also, depends for its success on a misinterpretation of Sankara's views. I wish then to suggest a possible alternative interpretation of Sankara's Advaita in terms viable for today, drawing, though indirectly, on such writers as R. B. Braithwaite and R. M. Hare. An incidental implication of this paper is that these two philosophers of religion would meet less opposition from the religious if they were Hindu rather than Christian! A more important implication is that light could be thrown on the present religious controversy in the west by a study of Indian philosophy of religion, if only we were more disposed to treat it as a living tradition which might teach us something, rather than as an antique. (shrink)