OBJECTIVES: To study whether linguistic analysis and changes in information leaflets can improve readability and understanding. DESIGN: Randomised, controlled study. Two information leaflets concerned with trials of drugs for conditions/diseases which are commonly known were modified, and the original was tested against the revised version. SETTING: Denmark. PARTICIPANTS: 235 persons in the relevant age groups. MAIN MEASURES: Readability and understanding of contents. RESULTS: Both readability and understanding of contents was improved: readability with regard to both information leaflets and understanding with (...) regard to one of the leaflets. CONCLUSION: The results show that both readability and understanding can be improved by increased attention to the linguistic features of the information. (shrink)

Rationing healthcare is a difficult task, which includes preventing patients from accessing potentially beneficial treatments. Proponents of implicit rationing argue that politicians cannot resist pressure from strong patient groups for treatments and conclude that physicians should ration without informing patients or the public. The authors subdivide this specific programme of implicit rationing, or “hidden rationing”, into local hidden rationing, unsophisticated global hidden rationing and sophisticated global hidden rationing. They evaluate the appropriateness of these methods of rationing from the perspectives of (...) individual and political autonomy and conclude that local hidden rationing and unsophisticated global hidden rationing clearly violate patients’ individual autonomy, that is, their right to participate in medical decision-making. While sophisticated global hidden rationing avoids this charge, the authors point out that it nonetheless violates the political autonomy of patients, that is, their right to engage in public affairs as citizens. A defence of any of the forms of hidden rationing is therefore considered to be incompatible with a defence of autonomy. (shrink)

Most commonly, the scientific realism debate is seen as dividing those who do and do not think that the striking empirical and practical successes of at least our best scientific theories indicate with high probability that those theories are ‘approximately true’. But I want to suggest that this characterization of the debate has far outlived its usefulness. Not only does it obscure the central differences between two profoundly different types of contemporary scientific realist, but even more importantly it serves to (...) disguise the most substantial points of actual disagreement between these two kinds of realists and those who instead think the historical record of scientific inquiry itself reveals that such realism is untenable in either form. (shrink)

We analyse the extent of possible computations following Hogarth ([2004]) conducted in Malament–Hogarth (MH) spacetimes, and Etesi and Németi ([2002]) in the special subclass containing rotating Kerr black holes. Hogarth ([1994]) had shown that any arithmetic statement could be resolved in a suitable MH spacetime. Etesi and Németi ([2002]) had shown that some relations on natural numbers that are neither universal nor co-universal, can be decided in Kerr spacetimes, and had asked specifically as to the extent of computational limits there. (...) The purpose of this note is to address this question, and further show that MH spacetimes can compute far beyond the arithmetic: effectively Borel statements (so hyperarithmetic in second-order number theory, or the structure of analysis) can likewise be resolved: Theorem A. If H is any hyperarithmetic predicate on integers, then there is an MH spacetime in which any query ? n H ? can be computed. In one sense this is best possible, as there is an upper bound to computational ability in any spacetime, which is thus a universal constant of that spacetime. Theorem C. Assuming the (modest and standard) requirement that spacetime manifolds be paracompact and Hausdorff, for any spacetime there will be a countable ordinal upper bound, , on the complexity of questions in the Borel hierarchy computable in it. Introduction 1.1 History and preliminaries Hyperarithmetic Computations in MH Spacetimes 2.1 Generalising SADn regions 2.2 The complexity of questions decidable in Kerr spacetimes An Upper Bound on Computational Complexity for Each Spacetime CiteULike Connotea Del.icio.us What's this? (shrink)

This paper examines Hume’s ‘Title Principle’ and its role in a response to one of the ‘manifest contradictions’ he identifies in the conclusion to Book I of A Treatise on Human Nature. This ‘contradiction’ is a tension between two ‘equally natural and necessary’ principles of the imagination, our causal inferences and our propensity to believe in the continued and distinct existence of objects. The problem is that the consistent application of causal reason undercuts any grounds with have for the belief (...) in continued and distinct existence, and yet that belief is as ‘natural and necessary’ as our propensity to infer effects from causes. The TP appears to offer a way to resolve this ‘contradiction’. It statesWhere reason is lively, and mixes itself with some propensity, it ought to be assented to. Where it does not, it never can have any title to operate upon us.’ In brief, if it can be shown that the causal inferences that undermine the belief in external world are not ‘lively’ nor mixed with some propensity’ then we have grounds for think that they have no normative authority. This is in part a response to another ‘manifest contradiction’, namely the apparently self-undermining nature of reason. In this paper I examine the nature and grounds of the TP and its relation to these ‘manifest contradictions’. (shrink)

Evolutionary fitness threats and rewards are associated with subjectively unpleasant and pleasant sensations, respectively. Initially, these correlations appear explainable via adaptation by natural selection. But here I analyse the major metaphysical perspectives on consciousness – physicalism, dualism, and panpsychism – and conclude that none help to understand the adaptive-seeming correlations via adaptation. I also argue that a recently proposed explanation, the phenomenal powers view, has major problems that mean it cannot explain the adaptive-seeming correlations via adaptation either. So the mystery (...) – call it the evolutionary paradox of consciousness – remains. Some have used this mystery to argue for non-naturalistic (e.g. theistic) explanations. But I propose a naturalistic, non-adaptive explanation of the adaptive-seeming correlations: namely, ‘sensational associative learning’ during development. In this perspective, pairing of particular sensations with unconditioned stimuli – fitness rewards or threats – cause the sensations themselves to come to be interpreted as good or bad, respectively. Sensations, like colours, that are not reliably paired with either fitness rewards or threats remain largely unvalenced. Sensational associative learning also provides explanations for adaptive-seeming structural aspects of sensations, such as the observation that sounds of different pitch are experienced as ordinal in correspondence to their wavelengths while the same is not true of colours of different hue. The sensational associative learning perspective appears compatible with physicalism, panpsychism, and dualism (though not epiphenomenalism). (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Hume Studies Volume 29, Number 1, April 2003, pp. 125-141 Dr. George Cheyne, Chevalier Ramsay, and Hume's Letter to a Physician JOHN P. WRIGHT The publication of a new intellectual biography of George Cheyne1 provides a "propitious" occasion for "a thoroughly skeptical review"2 of the question which has long exercised Hume scholars, whether Cheyne was the intended recipient of David Hume's fascinating pie-Treatise Letter to a Physician,3 the letter (...) which describes his own hypochondriacal physical and mental symptoms and gives an account of his early philosophical development.4 Hume's nineteenth-century biographer, John Hill Burton, argued that Hume was probably writing to Cheyne,5 while Ernest Mossner claimed to definitively refute that hypothesis in an article entitled "Hume's Epistle to Dr. Arbuthnot," published in 1944.6 Anita Guerrini's intellectual biography does not discuss Cheyne as a possible recipient of Hume's letter, but she does present a well-rounded picture of this interesting eighteenth-century physician from which we can judge his appropriateness as its addressee. In the following discussion I will make use of the biographical material found in this new biography of Cheyne, as well as other sources, to show that Mossner's arguments are less than definitive, and that it would be wrong to dismiss the possibility that the letter was sent to George Cheyne.7 This is a possibility that, for reasons that I will make clear, makes good biographical and philosophical sense. At the same time, it is important to keep a proper suspense of judgment as Burton did, for the evidence that the letter was either intended for or actually sent to Cheyne is not definitive. John P. Wright is Professor of Philosophy, Central Michigan University, Mt. Pleasant, MI 48859, USA. e-mail: [email protected] 126 John P. Wright Burton, who first published the autobiographical letter of the 22-yearold Hume in 1846, narrowed down the possible addressees of Hume's letter to either Cheyne or John Arbuthnot. He also pointed out that it is possible that the letter was never sent, and that the ten and a half page manuscript is only a neatly written draft, rather than a fair copy of an actual letter. Nevertheless, Burton thought he could identify the unnamed addressee on the basis of the internal evidence of the manuscript and the records of Scottish physicians practicing in England at the time. In the letter, Hume refers to the intended recipient as his "Countryman, a Scotchman [,]... a skilful Physician, a man of Letters, of Wit, of Good Sense, & of great Humanity."8 Further he writes that he is consulting him because he is a person "of great Learning beyond [his]... own Profession" who is acquainted with the "Motions of the Mind" he has described in his letter, and that "Fame pointed [him]... out as the properest person to resolve my Doubts..." about the cure of his disorder.9 Burton tells us that "the first name that suggested itself... was Arbuthnot, whose fine genius was just then flickering in the socket."10 (John Arbuthnot had been ill for some time, and died a year later.) But he then added that "a more full consideration showed to my satisfaction that it must have been destined for Dr. George Cheyne." His main reason for settling on Cheyne was that Cheyne's immensely popular The English Malady (1733) had recently been published, and that "there is a certain unison of tone between Hume's letter and this book." Burton quotes a portion of Cheyne's own long autobiographical account of his own disease in The English Malady. Cheyne's autobiography begins with the claim that "I passed my Youth in close study, and almost constant Application to the abstracted Sciences, (wherein my chief pleasure consisted) and consequently in great Temperance and a Sedentary Life"; it is followed by the reflection that any overindulgence in food or drink led to physical and psychological problems.11 He goes on to describe these in great detail for 39 pages, along with a history of his life. Burton also quotes a section of the book in which Cheyne describes how a studious and sedentary life causes the symptoms... (shrink)

Problem: Ernst von Glasersfeld’s radical constructivism has been highly influential in the fields of mathematics and science education. However, its relevance is typically limited to analyses of classroom interactions and students’ reasoning. Methods: A project that aims to support improvements in the quality of mathematics instruction across four large urban districts is framed as a case with which to illustrate the far-reaching consequences of von Glasersfeld’s constructivism for mathematics and science educators. Results: Von Glasersfeld’s constructivism orients us to question the (...) standard view of policy implementation as a process of travel down through a system and to conceptualize it instead as the situated reorganization of practice at multiple levels of a system. In addition, von Glasersfeld’s constructivism orients us to understand rather than merely evaluate policies by viewing the actions of the targets of policies as reasonable from their point of view. Implications: The potential contributions of von Glasersfeld’s constructivism to mathematics and science education have been significantly underestimated by restricting the focus to classroom actions and interactions. The illustrative case of research on the application of these ideas also indicates the relevance of constructivism to researchers in educational policy and educational leadership. (shrink)