The Burden of Dementia: A Medical and Research Perspective

Alzheimer's disease remains the most common form of dementia. Dementia symptoms vary depending on individual personality, life experience, and social and cultural influences. As dementia progresses, involvement of multi-disciplinary health care professionals is needed to manage the disease. Alzheimer research is progressing rapidly. While 5% of all Alzheimer's disease may be genetically determined, the majority is not. Susceptibility genes can reveal the risk of contracting Alzheimer's disease. Early life risk factors such as education, nutrition, and vascular disease may increase the likelihood of dementia in later life. In the United States, two acetylcholinesterase inhibitors have been approved as cognitive enhancers. Possible prevention and symptomatic treatment interventions have focused on estrogen replacement therapy, antioxidants, and anti-inflammatory medications. Research advances have improved the clinical management of dementia. Ethical implications to the patient, family, and society are multiple and remain challenging.     

The ‘conjunction fallacy’ revisited: how intelligent inferences look like reasoning errors

Findings in recent research on the ‘conjunction fallacy’ have been taken as evidence that our minds are not designed to work by the rules of probability. This conclusion springs from the idea that norms should be content‐blind—in the present case, the assumption that sound reasoning requires following the conjunction rule of probability theory. But content‐blind norms overlook some of the intelligent ways in which humans deal with uncertainty, for instance, when drawing semantic and pragmatic inferences. In a series of studies, we first show that people infer nonmathematical meanings of the polysemous term ‘probability’ in the classic Linda conjunction problem. We then demonstrate that one can design contexts in which people infer mathematical meanings of the term and are therefore more likely to conform to the conjunction rule. Finally, we report evidence that the term ‘frequency’ narrows the spectrum of possible interpretations of ‘probability’ down to its mathematical meanings, and that this fact—rather than the presence or absence of ‘extensional cues’—accounts for the low proportion of violations of the conjunction rule when people are asked for frequency judgments. We conclude that a failure to recognize the human capacity for semantic and pragmatic inference can lead rational responses to be misclassified as fallacies. Copyright © 1999 John Wiley & Sons, Ltd.     

Absolute Probability Functions for Intuitionistic Propositional Logic

Provided here is a characterisation of absolute probability functions for intuitionistic (propositional) logic L, i.e. a set of constraints on the unary functions P from the statements of L to the reals, which insures that (i) if a statement A of L is provable in L, then P(A) = 1 for every P, L's axiomatisation being thus sound in the probabilistic sense, and (ii) if P(A) = 1 for every P, then A is provable in L, L's axiomatisation being thus complete in the probabilistic sense. As there are theorems of classical (propositional) logic that are not intuitionistic ones, there are unary probability functions for intuitionistic logic that are not classical ones. Provided here because of this is a means of singling out the classical probability functions from among the intuitionistic ones.     

Paradigms in Measure Theoretic Learning and in Informant Learning

We investigate many paradigms of identifications for classes of languages (namely: consistent learning, EX learning, learning with finitely many errors, behaviorally correct learning, and behaviorally correct learning with finitely many errors) in a measure-theoretic context, and we relate such paradigms to their analogues in learning on informants. Roughly speaking, the results say that most paradigms in measure-theoretic learning wrt some classes of distributions (called canonical) are equivalent to the corresponding paradigms for identification on informants.     

Conduct Disorder in Girls: A Review of the Literature

The study of Conduct Disorder (CD) has primarily been limited to boys. The lack of research resulted from a premise that CD in girls was rare. However, CD in girls is a relatively common psychiatric diagnosis, and appears to be associated with several serious outcomes, such as Antisocial Personality Disorder and early pregnancy. Understanding gender differences in the course and severity of CD may lead to important information about etiology. Empirical studies on precursors, developmental course, risk factors and treatment for CD in girls are reviewed, while highlighting similarities and differences between girls and boys. Generally, CD symptoms in girls are stable. Precursors to CD in girls probably include Oppositional Defiant Disorder and temperamental factors, but also may include certain negative cognitions. What distinguishes CD in girls is the high risk they have to develop comorbid conditions, especially internalizing disorders. Risk factors for CD in girls partly overlap with those known for boys, but some factors appear to be highly salient for girls. Finally, there may be some significant effects of gender on treatment efficacy. Implications of these findings for future etiologic research are discussed.     

A cost-benefit analysis of demand for food.

Laboratory studies of consumer demand theory require assumptions regarding the definition of price in the absence of a medium of exchange (money). In this study we test the proposition that the fundamental dimension of price is a cost-benefit ratio expressed as the effort expended per unit of food value consumed. Using rats as subjects, we tested the generality of this "unit price" concept by varying four dimensions of price: fixed-ratio schedule, number of food pellets per fixed-ratio completion, probability of reinforcement, and response lever weight or effort. Two levels of the last three factors were combined in a 2 x 2 x 2 design giving eight groups. Each group was studied under a series of six FR schedules. Using the nominal values of all factors to determine unit price, we found that grams of food consumed plotted as a function of unit price followed a single demand curve. Similarly, total work output (responses x effort) conformed to a single function when plotted in terms of unit price. These observations provided a template for interpreting the effects of biological factors, such as brain lesions or drugs, that might alter the cost-benefit ratio.     

Risk perception and the location of a repository for spent nuclear fuel

This study investigates lay people's reactions to a repository for nuclear waste. Risk perception is seen as a complex concept, comprising both affective and cognitive components. Attitude towards nuclear power and trust in experts and authorities had a substantial impact on risk perception, while personal knowledge about nuclear waste disposal had no effect. Thus, the more positive one's attitude towards nuclear power is and the more trust one has in experts and authorities, the lower one's risk perception is. Also, reactions were expected to vary with distance between the home district and the location of a repository. These variations differed in nature for people with alternative levels of risk judgement. The distance between the home and a repository affected approval of the proposed site. Distance between home and repository also had an effect on risk feelings and somewhat less on beliefs about consequences. Estimated total risk was directly mediated by beliefs about consequences, but even more so by risk feelings. With regard to risk, one can conclude that it is important to make a distinction between an emotional and a cognitive component of risk perception.     

An evidential support accumulation model of subjective probability

A model of cue-based probability judgment is developed within the framework of support theory. Cue diagnosticity is evaluated from experience as represented by error-free frequency counts. When presented with a pattern of cues, the diagnostic implications of each cue are assessed independently and then summed to arrive at an assessment of the support for a hypothesis, with greater weight placed on present than on absent cues. The model can also accommodate adjustment of support in light of the baserate or prior probability of a hypothesis. Support for alternatives packed together in a "residual" hypothesis is discounted; fewer cues are consulted in assessing support for alternatives as support for the focal hypothesis increases. Results of fitting this and several alternative models to data from four new multiple-cue probability learning experiments are reported.     

Probability, logic and the cognitive foundations of rational belief

Since Pascal introduced the idea of mathematical probability in the 17th century discussions of uncertainty and “rational” belief have been dogged by philosophical and technical disputes. Furthermore, the last quarter century has seen an explosion of new questions and ideas, stimulated by developments in the computer and cognitive sciences. Competing ideas about probability are often driven by different intuitions about the nature of belief that arise from the needs of different domains (e.g., economics, management theory, engineering, medicine, the life sciences etc). Taking medicine as our focus we develop three lines of argument (historical, practical and cognitive) that suggest that traditional views of probability cannot accommodate all the competing demands and diverse constraints that arise in complex real-world domains. A model of uncertain reasoning based on a form of logical argumentation appears to unify many diverse ideas. The model has precursors in informal discussions of argumentation due to Toulmin, and the notion of logical probability advocated by Keynes, but recent developments in artificial intelligence and cognitive science suggest ways of resolving epistemological and technical issues that they could not address.     

医疗风险防范与化解新趋向

新的《医疗事故处理条例》实施以后,患者的自我保护意识不断增强、高精尖医疗器械的应用、新技术的不断开展等均增加了医疗行为的风险,医疗风险管理显示出日益重要的作用。新形势下医疗风险管理的新趋向是建立自愿的医疗责任保险、组织患者参加医疗风险保险、建立强制性医疗责任保险制度、卫生行政部门代理保险业务、建立医疗援助基金等方式,提出了在风险控制的基础上,加强风险融资的措施。