Effort expenditure modulates feedback evaluations involving self-other agreement: evidence from brain potentials and neural oscillations.

The influence of effort expenditure on the subjective value in feedback involving material reward has been the focus of previous research. However, little is known about the impact of effort expenditure on subjective value evaluations when feedback involves reward that is produced in the context of social interaction (e.g. self-other agreement). Moreover, how effort expenditure influences confidence (second-order subjective value) in feedback evaluations remains unclear. Using electroencephalography, this study aimed to address these questions. Event-related potentials showed that, after exerting high effort, participants exhibited increased reward positivity difference in response to self-other (dis)agreement feedback. After exerting low effort, participants reported high confidence, and the self-other disagreement feedback evoked a larger P3a. Time-frequency analysis showed that the high-effort task evoked increased frontal midline theta power. In the low (vs. high)-effort task, the frontal midline delta power for self-other disagreement feedback was enhanced. These findings suggest that, at the early feedback evaluation stage, after exerting high effort, individuals exhibit an increased sensitivity of subjective value evaluation in response to self-other agreement feedback. At the later feedback evaluation stage, after completing the low-effort task, the self-other disagreement feedback violates the individuals'high confidence and leads to a metacognitive mismatch.

Learning From Aggregated Opinion.

The capacity to leverage information from others' opinions is a hallmark of human cognition. Consequently, past research has investigated how we learn from others' testimony. Yet a distinct form of social information-aggregated opinion-increasingly guides our judgments and decisions. We investigated how people learn from such information by conducting three experiments with participants recruited online within the United States (N = 886) comparing the predictions of three computational models: a Bayesian solution to this problem that can be implemented by a simple strategy for combining proportions with prior beliefs, and two alternatives from epistemology and economics. Across all studies, we found the strongest concordance between participants' judgments and the predictions of the Bayesian model, though some participants' judgments were better captured by alternative strategies. These findings lay the groundwork for future research and show that people draw systematic inferences from aggregated opinion, often in line with a Bayesian solution.

AI and the nature of disagreement.

Litigation is a creature of disagreement. Our essay explores the potential of artificial intelligence (AI) to help reduce legal disagreements. In any litigation, parties disagree over the facts, the law, or how the law applies to the facts. The source of the parties' disagreements matters. It may determine the extent to which AI can help resolve their disputes. AI is helpful in clarifying the parties' misunderstanding over how well-defined questions of law apply to their facts. But AI may be less helpful when parties disagree on questions of fact where the prevailing facts dictate the legal outcome. The private nature of information underlying these factual disagreements typically fall outside the strengths of AI's computational leverage over publicly available data. A further complication: parties may disagree about which rule should govern the dispute, which can arise irrespective of whether they agree or disagree over questions of facts. Accordingly, while AI can provide clarity over legal precedent, it often may be insufficient to provide clarity over legal disputes. This article is part of the theme issue 'A complexity science approach to law and governance'.

Agreement and disagreement in a non-classical world.

The Agreement Theorem Aumann (1976 Ann. Stat. 4, 1236-1239. (doi:10.1214/aos/1176343654)) states that if two Bayesian agents start with a common prior, then they cannot have common knowledge that they hold different posterior probabilities of some underlying event of interest. In short, the two agents cannot 'agree to disagree'. This result applies in the classical domain where classical probability theory applies. But in non-classical domains, such as the quantum world, classical probability theory does not apply. Inspired principally by their use in quantum mechanics, we employ signed probabilities to investigate the epistemics of the non-classical world. We find that here, too, it cannot be common knowledge that two agents assign different probabilities to an event of interest. However, in a non-classical domain, unlike the classical case, it can be common certainty that two agents assign different probabilities to an event of interest. Finally, in a non-classical domain, it cannot be common certainty that two agents assign different probabilities, if communication of their common certainty is possible-even if communication does not take place. This article is part of the theme issue 'Quantum contextuality, causality and freedom of choice'.

Three- and 5-year-old children know their current belief might be wrong.

By 4 or 5 years of age, children understand when their own past beliefs were incorrect, or when others' current beliefs are incorrect. In the current study, we asked whether young children understand when their own current belief might be incorrect. 3- and 5-year old children (N = 77) made a judgment and then experienced a puppet making a judgment about the same situation. Children of both ages rechecked their evidence more often when the puppet disagreed with them than when it agreed with them (and the nature of their rechecking was different in the two conditions as well). These results suggest that already by 3 years of age children understand that they might currently be wrong, and they know that rechecking the evidence can resolve their uncertainty.

Navigating disagreement and conflict in the context of a brain-based definition of death.

In this paper, we discuss situations in which disagreement or conflict arises in the critical care setting in relation to the determination of death by neurologic criteria, including the removal of ventilation and other somatic support. Given the significance of declaring a person dead for all involved, an overarching goal is to resolve disagreement or conflict in ways that are respectful and, if possible, relationship preserving. We describe four different categories of reasons for these disagreements or conflicts: 1) grief, unexpected events, and needing time to process these events; 2) misunderstanding; 3) loss of trust; and 4) religious, spiritual, or philosophical differences. Relevant aspects of the critical care setting are also identified and discussed. We propose several strategies for navigating these situations, appreciating that these may be tailored for a given care context and that multiple strategies may be helpfully used. We recommend that health institutions develop policies that outline the process and steps involved in addressing situations where there is ongoing or escalating conflict. These policies should include input from a broad range of stakeholders, including patients and families, as part of their development and review.

RéSUMé: Dans cet article, nous discutons des situations dans lesquelles un désaccord ou un conflit survient dans le contexte des soins intensifs en ce qui concerne une détermination de décès selon des critères neurologiques, y compris le retrait de la ventilation et d'autres assistances somatiques. Compte tenu de l'importance pour toutes les personnes impliquées de déclarer une personne décédée, un objectif primordial est de résoudre les désaccords ou les conflits de manière respectueuse et, si possible, de préserver les relations. Nous décrivons quatre catégories différentes de raisons causant ces désaccords ou conflits : 1) le chagrin, des événements inattendus et le besoin de temps pour accepter ces événements; 2) les malentendus; 3) la perte de confiance; et 4) les différences religieuses, spirituelles ou philosophiques. Les aspects pertinents du milieu des soins intensifs sont également identifiés et discutés. Nous proposons plusieurs stratégies pour gérer ces situations, en étant conscients que celles-ci peuvent être adaptées à un contexte de soins donné et que plusieurs stratégies peuvent être utiles à appliquer. Nous recommandons que les établissements de santé élaborent des politiques qui décrivent le processus et les étapes nécessaires pour faire face aux situations où il y a un conflit en cours ou qui s'intensifie. Dans le cadre de leur élaboration et de leur examen, ces politiques devraient inclure les commentaires d'un large éventail d'intervenants, y compris les patients et les familles.

Validity of self-reported hypertension and associated factors among Vietnamese adults: a cross-sectional study.

BACKGROUND: This study aims to determine the validity of self-reported hypertension and identify factors affecting the disagreement between self-reported hypertension and objective measures of blood pressure among adults in Vietnam. MATERIALS AND METHODS: A total of 4,219 people aged 18 and older reported their hypertension status and had their blood pressure measured. The inter-reliability between self-reported and measured hypertension was assessed using Cohen's Kappa statistics. Univariate and multivariate logistic regressions were used to examine the affecting factors of disagreement. RESULT: Self-reported hypertension prevalence was 13.2% (557/4,219), while measured hypertension was 20.9% (881/4,219). An agreement between self-reported and measured data was moderate for the hypertension of participants (κ = 0.39, 95% CI 0.36-0.43). Self-reported hypertension showed high specificity (93.9%) (95% CI 93.0-94.7) but low sensitivity (40.1%; 95 CI 36.8-43.4). The percentage of disagreement in hypertension (number of false positives and false negatives between self-reported and measured data) among adults in Vietnam was 17.3%. CONCLUSION: Our findings showed there was a high disagreement percentage of hypertension between self-reported and measured data. This is the first report of this issue to warn of health risks if high blood pressure is not detected early. The disagreement of hypertension was observed more frequently in men, people older than 40, minority ethnic groups, farmers, and people with a BMI greater than 25 kg/m2.

Researchers often ask people to answer questions about their own health problems, such as high blood pressure, to study the effects of these conditions. People often provide self-reported information in response to this inquiry. However, this information might not be accurate. Therefore, it is preferable to use biological data, which involves having blood pressure checked by a machine.In this study, the self-reported hypertension of adults in Vietnam was compared to measured blood pressure data. We found that, whereas only 13.2% of respondents reported having high blood pressure, the measured blood pressure by machine revealed that 20.9% of respondents had the condition. The study also discovered that some elements, including age, gender, ethnicity, BMI, smoking status, and drinking, were associated with the discrepancy between self-reported and measured hypertension among participants.This study demonstrates that it is unreliable to estimate the prevalence of high blood pressure in Vietnam using self-reported data. According to the study, including biological tests in social surveys can increase data accuracy and clarify societal health disparities. The study suggests that to avoid and identify these health issues early, people should obtain more health education and undergo routine physicals.

Two years of ethics reflection groups about coercion in psychiatry. Measuring variation within employees' normative attitudes, user involvement and the handling of disagreement.

BACKGROUND: Research on the impact of ethics reflection groups (ERG) (also called moral case deliberations (MCD)) is complex and scarce. Within a larger study, two years of ERG sessions have been used as an intervention to stimulate ethical reflection about the use of coercive measures. We studied changes in: employees' attitudes regarding the use of coercion, team competence, user involvement, team cooperation and the handling of disagreement in teams. METHODS: We used panel data in a longitudinal design study to measure variation in survey scores from multidisciplinary employees from seven departments within three Norwegian mental health care institutions at three time points (T0-T1-T2). Mixed models were used to account for dependence of data in persons who participated more than once. RESULTS: In total, 1068 surveys (from 817 employees who did and did not participate in ERG) were included in the analyses. Of these, 7.6% (N = 62) responded at three points in time, 15.5% (N = 127) at two points, and 76.8% (N = 628) once. On average, over time, respondents who participated in ERG viewed coercion more strongly as offending (p < 0.05). Those who presented a case in the ERG sessions showed lower scores on User Involvement (p < 0.001), Team Cooperation (p < 0.01) and Constructive Disagreement (p < 0.01). We observed significant differences in outcomes between individuals from different departments, as well as between different professions. Initial significant changes due to frequency of participation in ERG and case presentation in ERG did not remain statistically significant after adjustment for Departments and Professions. Differences were generally small in absolute terms, possibly due to the low amount of longitudinal data. CONCLUSIONS: This study measured specific intervention-related outcome parameters for describing the impact of clinical ethics support (CES). Structural implementation of ERGs or MCDs seems to contribute to employees reporting a more critical attitude towards coercion. Ethics support is a complex intervention and studying changes over time is complex in itself. Several recommendations for strengthening the outcomes of future CES evaluation studies are discussed. CES evaluation studies are important, since-despite the intrinsic value of participating in ERG or MCD-CES inherently aims, and should aim, at improving clinical practices.

Disagreement about perceptions of patient disability between the stroke patient and caregiver: a cross sectional study exploring the association to patient and caregiver quality of life.

OBJECTIVES: This study explored the association of disagreement in the perception of patient disability between patients and family caregivers with physical and psychological quality of life (QOL) in both parties. METHODS: A cross-sectional analysis of data collected from male stroke patients and family caregivers was conducted. Physical and psychological QOL in patients and caregivers were measured using the WHOQOL BREF. Perceptions of patient disability were measured using the 12-item WHO Disability Assessment Schedule 2.0 (DAS). Using DAS scores reported independently by patients and caregivers, dyads were categorized into one of four groups representing agreement or disagreement about patient disability. Generalized estimating equations were used to examine the associations between WHOQOL scores in patients and caregivers and these four groups. RESULTS: Among 56 dyads enrolled, approximately 52% were categorized into 'agreement' groups and 48% were categorized into 'disagreement' groups. The disagreement in perception about patient disability were significantly associated with poor patient physical QOL. However, the disagreement in perception were not significantly associated with caregiver QOL. CONCLUSION: Findings suggest the association of disagreement with QOL differs between patients and caregivers. Further research is needed to carefully appraise the relationship and interaction between patient and caregiver.

Discordance between patient-reported and objectively measured internal rotation after reverse shoulder arthroplasty.

BACKGROUND: Patient satisfaction after reverse shoulder arthroplasty (RSA) partly relies on restoring functional internal rotation (IR). Although postoperative assessment of IR includes objective appraisal by the surgeon and subjective report from the patient, these evaluations may not vary together uniformly. We assessed the relationship between objective, surgeon-reported assessments of IR and subjective, patient-reported ability to perform IR-related activities of daily living (IRADLs). METHODS: Our institutional shoulder arthroplasty database was queried for patients undergoing primary RSA with a medialized-glenoid lateralized-humerus design between 2007-2019 and minimum 2-year follow-up. Patients who were wheelchair bound or had a preoperative diagnosis of infection, fracture, and tumor were excluded. Objective IR was measured to the highest vertebral level reached with the thumb. Subjective IR was reported based on patients' rating (normal, slightly difficult, very difficult, or unable) of their ability to perform 4 IRADLs (tuck in shirt with hand behind back, wash back or fasten bra, personal hygiene, and remove object from back pocket). Objective IR was assessed preoperatively and at latest follow-up and reported as median and interquartile ranges. RESULTS: A total of 443 patients were included (52% female) at a mean follow-up of 4.4 ± 2.3 years. Objective IR improved pre- to postoperatively from L4-L5 (buttocks to L1-L3) to L1-L3 (L4-L5 to T8-T12) (P < .001). Preoperatively reported IRADLs of "very difficult" or "unable" significantly decreased postoperatively for all IRADLs (P ≤ .004) except those unable to perform personal hygiene (3.2% vs. 1.8%, P > .99). The proportions of patients who improved, maintained, and lost objective and subjective IR was similar between IRADLs; 14%-20% improved objective IR but lost or maintained subjective IR and 19%-21% lost or maintained the same objective IR but improved subjective IR depending on the specific IRADL assessed. When ability to perform IRADLs improved postoperatively, objective IR also increased (P < .001). In contrast, when subjective IRADLs worsened postoperatively, objective IR did not significantly worsen for 2 of 4 IRADLs assessed. When examining patients who reported no change in ability to perform IRADLs pre- vs. postoperatively, statistically significant increases in objective IR were found for 3 of 4 IRADLs assessed. CONCLUSIONS: Objective improvement in IR parallels improvements in subjective functional gains uniformly. However, in patients with worse or equivalent IR, the ability to perform IRADLs postoperatively does not uniformly correlate with objective IR. When attempting to elucidate how surgeons can ensure patients will have sufficient IR after RSA, future investigations may need to use patient-reported ability to perform IRADLs as the primary outcome measure rather than objective measures of IR.

Abortion, euthanasia, and the limits of principlism.

Principlism is an ethical framework that has dominated bioethical discourse for the past 50 years. There are differing perspectives on its proper scope and limits. In this article, we consider to what extent principlism provides guidance for the abortion and euthanasia debates. We argue that whilst principlism may be considered a useful framework for structuring bioethical discourse, it does not in itself allow for the resolution of these neuralgic policy discussions. Scholars have attempted to use principlism to analyse the ethics and legality of abortion and euthanasia; but such efforts are methodologically problematic. We close with a consideration of the proper scope of principlism in bioethics-a vision that is more modest than the manner in which principlism is often deployed in contemporary academic bioethics and medical education.

Metrics of student dissatisfaction and disagreement: longitudinal explorations of a national survey instrument.

This study explores dissatisfaction and neutrality metrics from 12 years of a national-level undergraduate student survey. The notion of dissatisfaction is much less prevalent in the narratives surrounding student survey outcomes, and the underpinning metrics are seldom considered. This is despite an increasingly vociferous debate about 'value for money' of higher education and the positioning of students as consumers in a marketised sector. We used machine learning methods to explore over 2.7 million national survey outcomes from 154 institutions to describe year-on-year stability in the survey items that best predicted dissatisfaction and neutrality, together with their similarity to known metric predictors of satisfaction. The widely publicised annual increases in student 'satisfaction' are shown to be the result of complex reductions in the proportions of disagreement and neutrality across different survey dimensions. Due to the widespread use of survey metrics in university league tables, we create an anonymised, illustrative table to demonstrate how UK institutional rankings would have differed if dissatisfaction metrics had been the preferred focus for reporting. We conclude by debating the tensions of balancing the provision of valuable information about dissatisfaction, with perpetuating negative impacts that derive from this important subset of the survey population.

[An Alternative Interpretation of Conflict Management: Interpersonal Conflicts and Doctor (Nurse)/Patient Communications].

In this paper, interpersonal conflict is redefined to highlight the conflict dimension, which is ignored in traditional definitions of this term. In this new definition, the "no conflict" situation refers to unnoticed differences, disagreements, or dissatisfaction that are accommodated or negotiated prior to being noticed. An essential element of conflict management is identifying the ideal time to express and respond to questions/complaints/disagreement. Communicative efforts for conflict management include increasing (affective) motives related to expressing and responding to disagreement; increasing (cognitively) confidence and competencies in managing interactive flows, and (behaviorally) engaging in communicative actions.

The cognitive map debate in insects: A historical perspective on what is at stake.

Though well established in mammals, the cognitive map hypothesis has engendered a decades-long, ongoing debate in insect navigation studies involving many of the field's most prominent researchers. In this paper, I situate the debate within the broader context of 20th century animal behavior research and argue that the debate persists because competing research groups are guided by different constellations of epistemic aims, theoretical commitments, preferred animal subjects, and investigative practices. The expanded history of the cognitive map provided in this paper shows that more is at stake in the cognitive map debate than the truth value of propositions characterizing insect cognition. What is at stake is the future direction of an extraordinarily productive tradition of insect navigation research stretching back to Karl von Frisch. Disciplinary labels like ethology, comparative psychology, and behaviorism became less relevant at the turn of the 21st century, but as I show, the different ways of knowing animals associated with these disciplines continue to motivate debates about animal cognition. This examination of scientific disagreement surrounding the cognitive map hypothesis also has significant consequences for philosophers' use of cognitive map research as a case study.

Rationally irresolvable disagreement.

The discussion about deep disagreement has gained significant momentum in the last several years. This discussion often relies on the intuition that deep disagreement is, in some sense, rationally irresolvable. In this paper, I will provide a theory of rationally irresolvable disagreement. Such a theory is interesting in its own right, since it conflicts with the view that rational attitudes and procedures are paradigmatic tools for resolving disagreement. Moreover, I will suggest replacing discussions about deep disagreement with an analysis of rationally irresolvable disagreement, since this notion can be more clearly defined than deep disagreement and captures the basic intuitions underlying deep disagreement. I will first motivate this project by critically assessing the current debate about deep disagreement. I then detail the notions of rationality and resolvable disagreement which are crucial for a suitable theory of rationally irresolvable disagreement before sketching various instances of rationally irresolvable disagreement. Finally, I argue for replacing theories of deep disagreement with theories of rationally irresolvable disagreement, an approach that has significant advantages over existing theories of deep disagreement which focus on hinge propositions or fundamental epistemic principles.

Democracy, Agony, and Rupture: A Critique of Climate Citizens' Assemblies.

Stymied by preoccupation with short-term interests of individualist consumers, democratic institutions seem unable to generate sustained political commitment for tackling climate change. The citizens' assembly (CA) is promoted as an important tool in combatting this "democratic myopia." The aim of a CA is to bring together a representative group of citizens and experts from diverse backgrounds to exchange their different insights and perspectives on a complex issue. By providing the opportunity for inclusive democratic deliberation, the CA is expected to educate citizens, stimulate awareness of complex issues, and produce enlightened and legitimate policy recommendations. However, critical voices warn about the simplified and celebratory commentary surrounding the CA. Informed by agonistic and radical democratic theory, this paper elaborates on a particular concern, which is the orientation toward consensus in the CA. The paper points to the importance of disagreement in the form of both agony (from inside) and rupture (from outside) that, it is argued, is crucial for a democratic, engaging, passionate, creative, and representative sustainability politics.

Catholic Hospitals Should Permit Physicians to Provide Emergency Contraception to Rape Victims as an Act of Conscientious Provision.

While many Catholic hospitals permit the prescription of the emergency contraception drug levonorgestrel for rape victims, some continue to prohibit this practice as a matter of institutional conscience. While the standard approach to this issue has been to offer an argument that levonorgestrel either is or is not morally permissible, we have taken a different tack. We begin by briefly describing and acknowledging that reasonable disagreement exists on this question (part one), and then arguing that the reasonable disagreement itself can serve as a compelling basis for Catholic leadership at hospitals that prohibit emergency contraception for rape victims to accommodate physicians who wish to provide levonorgestrel as a matter of conscience (part two). We end by anticipating and responding to some objections.

Is Circumcision "Necessary" in Islam? A Philosophical Argument Based on Peer Disagreement.

In recent years, there has been a resurgence in debates on the ethics of child genital cutting practices, both female and male, including within a Muslim context. Opponents of female genital cutting sometimes assert that the practice is not mentioned explicitly in the Qur'an as a way of implying that it does not have any religious standing within Islam. However, neither is male genital cutting mentioned explicitly in the Qur'an, and yet most people accept that it is a Muslim religious practice. Both practices, however, are mentioned in secondary sources of Islamic jurisprudence, with disagreement among religious authorities about the status or authenticity of some of these sources. This paper considers the religious status of both female and male genital cutting practices within Islam and employs a philosophical argument based on "peer disagreement" to ask whether either practice is necessary (i.e., religiously required) for a devout Muslim to endorse.

Epistemic neighbors: trespassing and the range of expert authority.

The world is abuzz with experts who can help us in domains where we understand too little to help ourselves. But sometimes experts in one domain carry their privileged status into domains outside their specialization, where they give advice or otherwise presume to speak authoritatively. Ballantyne (in: Knowing our limits. Oxford University Press, New York, 2019) calls these boundary crossings "epistemic trespassing" and argues that they often violate epistemic norms. In the few cases where traveling in other domains is permissible, Ballantyne suggests there should be regulative checks ("easements") for the experts who are crossing domain boundaries. I argue that boundary crossing is warranted more often than Ballantyne allows. And while Ballantyne argues that boundary crossing is prima facie epistemically problematic, I contend that many cases of boundary crossing are not properly instances of "trespassing," and, therefore, raise no prima facie epistemic concerns. I further argue that identifying cases of what I call "epistemic neighborliness" bolsters Ballantyne's project, making it easier for novices and other experts to identify epistemic trespassing along with its epistemic problems.

Intra-Family End-Of-Life Conflict: Findings of a Research Investigation to Identify Its Incidence, Cause, and Impact.

With few investigations of intra-family end-of-life conflict, this study sought to identify its incidence, cause, and impacts. A questionnaire was completed by 102 hospice/palliative nurses, physicians, and other care providers in Alberta, a Canadian province. Participants reported on how often they had observed intra-family conflict when someone in the family was dying, and the impacts of that conflict. 12 survey participants were then interviewed about the intra-family conflict that they had encountered, with interviews focused on why conflict occurred and what the impacts (if any) were. Nearly 80% of families were thought to experience end-of-life conflict, periodically or continuously, among various family members. The interviews confirmed three reasons for intra-family end-of-life conflict and three conflict outcomes that were revealed in a recent literature review. The findings indicate routine assessments for intra-family end-of-life conflict are advisable. Attention should be paid to preventing or mitigating this conflict for the good of all.