Mental disorders such as depression and anxiety are increasingly common. Yet there are too few specialists to offer help to everyone, and negative attitudes to psychological problems and their treatment discourage people from seeking it. As a result, many people never receive help for these problems. The Oxford Guide to Low Intensity CBT Interventions marks a turning point in the delivery of psychological treatments for people with depression and anxiety. Until recently, the only form of psychological intervention available for patients (...) with depression and anxiety was traditional one-to-one 60 minute session therapy - usually with private practitioners for those patients who could afford it. Now Low Intensity CBT Interventions are starting to revolutionize mental health care by providing cost effective psychological therapies which can reach the vast numbers of people with depression and anxiety who did not previously have access to effective psychological treatment. The Oxford Guide to Low Intensity CBT Interventions is the first book to provide a comprehensive guide to Low Intensity CBT interventions. It brings together researchers and clinicians from around the world who have led the way in developing evidence-based low intensity CBT treatments. It charts the plethora of new ways that evidence-based low intensity CBT can be delivered: for instance, guided self-help, groups, advice clinics, brief GP interventions, internet-based or book-based treatment and prevention programs, with supported provided by phone, email, internet, sms or face-to-face. These new treatments require new forms of service delivery, new ways of communicating, new forms of training and supervision, and the development of new workforces. They involve changing systems and routine practice, and adapting interventions to particular community contexts. The Oxford Guide to Low Intensity CBT Interventions is a state-of-the-art handbook, providing low intensity practitioners, supervisors, managers commissioners of services and politicians with a practical, easy-to-read guide - indispensible reading for those who wish to understand and anticipate future directions in health service provision and to broaden access to cost-effective evidence-based psychological therapies. (shrink)

Theories of consciousness have a long and controversial history. One well-known proposal — integrated information theory — has recently been labeled as ‘pseudoscience’, which has caused a heated open debate. Here we discuss the case and argue that the theory is indeed unscientific because its core claims are untestable even in principle.

In this chapter, we discuss a selection of current views of the neural correlates of consciousness (NCC). We focus on the different predictions they make, in particular with respect to the role of prefrontal cortex (PFC) during visual experiences, which is an area of critical interest and some source of contention. Our discussion of these views focuses on the level of functional anatomy, rather than at the neuronal circuitry level. We take this approach because we currently understand more about experimental (...) evidence at this coarse level and because these results are appropriate for arbitrating between current theoretical frameworks. We discuss the Two-Visual-Systems Hypothesis (Milner & Goodale 1995; 2006), Local Recurrency (Lamme 2010; Lamme 2006), Higher Order (Lau 2008; Lau & Rosenthal 2011) and Global Workspace theories (Baars 1997; Baars 2005; Dehaene & Naccache 2001; Dehaene 2014). Despite the apparent stark differences between conscious and unconscious perceptual processing, available evidence suggests that their neural substrates must be largely shared. This indicates that the difference in neural activity between conscious and unconscious perceptual processing is likely to be subtle and highly specialized. We argue that current experimental evidence about the involvement of specific activity in prefrontal cortex supports the higher order neural theory of consciousness. In consequence, imaging techniques that focus only on marked differences between conscious and unconscious level of activity are likely to be insensitive to the relevant neural activity patterns that underlie conscious experiences. Finally, it follows from the evidence we discuss that the functional advantages of conscious over unconscious perceptual processing may be more limited than commonly thought. (shrink)

Mark Coeckelbergh (Int J Soc Robot 1:217–221, 2009) argues that robot ethics should investigate what interaction with robots can do to humans rather than focusing on the robot’s moral status. We should ask what robots do to our sociality and whether human–robot interaction can contribute to the human good and human flourishing. This paper extends Coeckelbergh’s call and investigate what it means to live with disembodied AI-powered agents. We address the following question: Can the human–AI interaction contribute to our (...) moral development? We present an empirically informed philosophical analysis of how the AI personal assistant Siri changes its users’ way of life, based on the responses obtained from 20 semi-directive individual interviews with Siri users. We identify changes in the users’ social interaction associated with the adoption of Siri. These changes include: (1) the indirect effect of reducing opportunities of human interaction, (2) the second-order effect of diminished expectations toward each other in a community, and (3) the acquired preference to obtain hassle-free interaction with Siri over human interaction. We examine them in relation to concerns that are voiced in the current debates over the rise of AI, namely the suspicion that humans could become overly reliant on AI (Danaher 2019) and the worry that social AI could impede on moral development (Fröding and Peterson, Ethics Inf Technol 23:207–214, 2012; Li, Ethics Inf Technol 23:543–550, 2021). We analyze the ethical costs that come from these changes in light of virtue ethics and address potential objections along the way. We end by offering directions for thinking about how to live with AI personal assistant while preserving favorable conditions for moral development. (shrink)

It was a happy surprise when, overcoming partisan divisions and interest‐group lobbying, Congress enacted the No Surprises Act, which bans unfair out‐of‐network “balance billing.” Although this is only a modest legislative victory, key efforts by the health policy community made a real difference in a time of legislative gridlock.

Thomas Kuhn has argued that scientists never reject a paradigm without simultaneously accepting a new paradigm. Coupled with Kuhn's claim that it is paradigms as a whole, and not individual theories, that are accepted or rejected, this thesis is seen as one of Kuhn's main challenges to the rationality of science. I argue that Kuhn is mistaken in this claim; at least in some instances, science rejects a paradigm despite the absence of a successor. In particular, such a description best (...) fits Kuhn's most discussed example, the Copernican Revolution. By differentiating scientific discoveries into three types, spontaneous, implicit, and directed, we see that Kuhn's thesis holds for spontaneous and implicit discoveries, but not directed discoveries. Directed discoveries must be understood by an alternative account of falsifiability, based on argument by reductio ad absurdum rather than argument by modus tollens as traditional accounts of falsifiability would have it. (shrink)

Cross‐strand disulphides (CSDs) are unusual bonds that link adjacent strands in the same β‐sheet. Their peculiarity relates to the high potential energy stored in these bonds, both as torsional energy in the highly strained disulphide linkage and as deformation energy stored in the sheet itself. CSDs are relatively rare in protein structures but are conspicuous by their presence in proteins that are involved in cell entry. The finding that entry of botulinum neurotoxin and HIV into mammalian cells involves cleavage of (...) CSDs suggests that the activity of other cell entry proteins may likewise involve cleavage of these bonds. We examine emerging evidence of the involvement of these unusual disulphides in cell entry events. BioEssays 26:73–79, 2004. © 2003 Wiley Periodicals, Inc. (shrink)

This essay explores the philosophical relationship of Spinoza and Leibniz. It argues that the relationship is best viewed as three-cornered metaphysical transaction beginning with Spinoza, continuing to Ehrenfried Walther von Tschirnhaus’s exchanges with Spinoza, and leading to reflections by Leibniz on a Spinoza mediated by these exchanges. It focuses on two topics that exemplify this three-cornered relationship: the relationship between God and things, and the derivation of things from God; and the critical Leibnizian topic of possible worlds.

This paper describes and defends the view that minimal chemical life essentially involves the chemical integration of three chemical functionalities: containment, metabolism, and program (Rasmussen et al. in Protocells: bridging nonliving and living matter, 2009a ). This view is illustrated and explained with the help of CMP and Rasmussen diagrams (Rasmussen et al. In: Rasmussen et al. (eds.) in Protocells: bridging nonliving and living matter, 71–100, 2009b ), both of which represent the key chemical functional dependencies among containment, metabolism, and (...) program. The CMP model of minimal chemical life gains some support from the broad view of life as open-ended evolution, which I have defended elsewhere (Bedau in The philosophy of artificial life, 1996 ; Bedau in Artificial Life, 4:125–140, 1998 ). Further support comes from the natural way the CMP model resolves the puzzle about whether life is a matter of degree. (shrink)

The participation of physicians in the atrocities of the Holocaust exposed vulnerabilities in medicine’s moral commitment to patients’ best interests that every health professional should recognize. Teaching about this history is challenging, as it is extremely complex and there are no common standards for what basic historical facts students in health professions training programs should learn. Nor is there guidance on how these historical facts can or should be related to contemporary ethical issues facing health professionals. To address these problems, (...) we propose a set of core historical facts about health professional involvement in the Holocaust that every student in a health professional training program should learn. We then identify three ethical lessons from the Holocaust that are pertinent today as physicians struggle to maintain their moral compass and earn the trust of patients and the public: 1) The lesson of commitment to science; maintaining balance between reason and skepticism in the search for truth, The lesson of clinical detachment; maintaining balance between necessary professional distance with a commitment to humanism and intimacy with patients, and 3) The lesson of competing loyalties; maintaining balance in upholding medicine’s multiple responsibilities, including to individual patients and the larger community. Embedding these facts and lessons into the education of health professionals is challenging yet critically important. Today’s physicians struggle with some of the same ethical tensions as did German physicians in the Nazi era, albeit in a much-attenuated fashion. Awareness of these tensions and taking active measures to maintain them in balance are necessary components of humanistic health care, which should be an integral part of health professional training programs. (shrink)

We demonstrate a method for optimizing desired functionality in real complex chemical systems, using a genetic algorithm. The chemical systems studied here are mixtures of amphiphiles, which spontaneously exhibit a complex variety of self-assembled molecular aggregations, and the property optimized is turbidity. We also experimentally resolve the fitness landscape in some hyper-planes through the space of possible amphiphile formulations, in order to assess the practicality of our optimization method. Our method shows clear and significant progress after testing only 1 % (...) of the possible amphiphile formulations. (shrink)

Health care reform is being assaulted from all sides. In January, the House of Representatives voted to repeal The Patient Protection and Affordable Care Act (the "Affordable Care Act"). For now, that effort will not succeed, owing to Democratic control of the Senate and the presidential veto. But conservative lawmakers in the House threaten to withhold key funding for implementation, and we can expect ongoing efforts to enact various partial amendments.Meanwhile, a core component of the reform law is running the (...) gauntlet of constitutional challenges in dozens of courts.1 So far, two federal district judges—in Richmond, Virginia, and Pensacola, Florida—have declared the individual mandate unconstitutional, as .. (shrink)

Anthropology is a significant matter within the church. A person's doctrine of humanity will inevitably shape the way a person thinks about the church, salvation, and in part, God. This dissertation is written out of concern for the potential harm that a faulty anthropology may do to the church. This study is concerned with exposing an approach to leadership within the church that is based on a faulty anthropology. Servant leadership has been hailed as the answer to the leadership crisis (...) that has plagued businesses, political offices, and churches. It is said that the authoritarian, monarchical style of leadership in the twentieth century no longer meets the needs of the current setting. In 1970 Robert K. Greenleaf---the chief advocate of servant leadership---proposed servant leadership as the emerging style that was prepared to address the social unrest of the 1960's and 1970's. He argued that the current leadership style must change---adapt to the emerging needs of the people. Greenleaf developed his ideas on servant leadership in the context of his reading of Hermann Hesse and Albert Camus. The repercussions of Robert K. Greenleaf's anthropology are evident in his view of human transformation. ;This study exposes the philosophical and theological underpinnings of Greenleaf's work on servant leadership as a distortion of the nature of humanity to the point that it leaves the doctrines of sin and salvation bereft of Christian significance. Since many within the church have used Greenleaf in their search for a biblical leadership paradigm, a Christian theological response to Greenleaf's assessment of humanity and human transformation will conclude this study. (shrink)

Therehasbeenevidencefortheverybrief,temporalquantizationofperceptualexperienceatregularintervalsbelo w100msforseveraldecades.Webrieflydescribehowearlierstudiesledtotheconceptof“psychologicalmoment”ofbe tween50and60msduration.Accordingtohistoricaltheories,withinthepsychologicalmomentalleventswouldbepro cessedasco-temporal.Morerecently,alinkwithphysiologicalmechanismshasbeenproposed,accordingtowhichthe 50–60mspsychologicalmomentwouldbedefinedbytheupperlimitrequiredbyneuralmechanismstosynchronizeandthe rebyrepresentasnapshotofcurrentperceptualeventstructure.However,ourownexperimentaldevelopmentsalsoid entifyamorefine-scaled,serializedprocessstructurewithinthepsychologicalmoment.Ourdatasuggeststhatnot alleventsareprocessedasco-temporalwithinthepsychologicalmomentandinstead,someareprocessedsuccessivel y.Thisevidencequestionstheanalogrelationshipbetweensynchronizedprocessandsimultaneousexperienceandop ensdebateontheontologyandfunctionof“moments”inpsychologicalexperience.

Driven by the demographic tsunami of a rapidly aging population, costs of universal healthcare in Japan have grown at an unprecedented rate. These trends are mirrored elsewhere, so industrialized countries are asking if Japan will become a global test case for healthcare delivery.

Over the history of the study of visual perception there has been great success at discovering countless visual illusions. There has been less success in organizing the overwhelming variety of illusions into empirical generalizations (much less explaining them all via a unifying theory). Here, this article shows that it is possible to systematically organize more than 50 kinds of illusion into a 7 × 4 matrix of 28 classes. In particular, this article demonstrates that (1) smaller sizes, (2) slower speeds, (...) (3) greater luminance contrast, (4) farther distance, (5) lower eccentricity, (6) greater proximity to the vanishing point, and (7) greater proximity to the focus of expansion all tend to have similar perceptual effects, namely, to (A) increase perceived size, (B) increase perceived speed, (C) decrease perceived luminance contrast, and (D) decrease perceived distance. The detection of these empirical regularities was motivated by a hypothesis, called “perceiving the present,” that the visual system possesses mechanisms for compensating neural delay during forward motion. This article shows how this hypothesis predicts the empirical regularity. (shrink)

ABSTRACT The article examines Old English claims to catholic ‘liberty of conscience’ and the way in which this engendered a discussion of English liberties in Ireland. Old English representatives sought to ground their claims to ‘liberty of conscience’ in established practice, custom and law. Their claims to ‘liberty of conscience’ also brought into play the vocabulary of corporate and parliamentary liberty. In response, New English protestants turned to ideas of duty and citizenship, which were equally embedded in conceptions of English (...) liberties. They argued that a catholic ‘conscience’ sat in opposition to ideas of duty to the king and the commonwealth. In doing so, the New English questioned both the basis and extent of the liberties possessed by the Old English. Such an exchange, this article argues, is illustrative of the way in which an English pairing of liberties, with ideas of duty and active citizenship, opened up an area of dispute involving a shared set of political concepts and vocabulary. (shrink)

Exploring mysteries that have evoked wonder and consternation for millennia, this handbook covers topics such as the nature of divinity and humanity, the legitimacy of religious experience, the possibility of miracles, and idea of life after death. As a reference volume and introductory text, this is an essential resource for students and scholars.

“Unconscionable.” “Outrageous.” “Indefensible.” These are just some of the tamer descriptions for the billing practices of most hospitals, and also many physicians, that have recently come to the public's attention. Earlier this year, Time magazine published an extraordinary 24,000‐word exposé—the longest article it has ever published—detailing how even charitable hospitals routinely price‐gouge their patients.1 With characteristic flare for telling details, journalist Steven Brill documented ten‐fold markups of charges over costs at some prominent hospitals for common services like X rays and (...) lab tests, and one‐hundred‐fold mark‐ups on mundane supplies such as gauze pads and generic aspirin. Just as the buzz from Brill's article was abating, the Centers for Medicare & Medicaid Services released a comprehensive data set in May that galvanized local and national media across the country. This news tsunami caught hospital managers flat‐footed and tongue‐tied. Typical responses conceded that hospitals’ pricing practices are based neither on actual cost structures nor rational marketplace dynamics. Instead, hospitals attempted to deflect blame by noting that hardly anyone actually pays list prices, and they characterized their indefensible pricing as a symptom of a broken system that is beyond them to fix. There are two glaring faults in these standard defenses. (shrink)

Physicians' duties to their patients traditionally have been construed narrowly in time and scope to focus on the specific episode of care or clinical encounter. Physicians generally have had no ethical or legal duty to notify patients about new medical information discovered after a visit, notwithstanding the health care benefits to patients that might flow from receiving the information. The rule was based on the relatively high burdens that notification would impose on physicians compared with the likelihood of benefits to (...) patients. This established view, however, no longer may be appropriate in light of new physician-patient relationships and the reduced burden of patient notification using new types of health information technology. This article explores the duty to inform patients and former patients about relevant, medical developments subsequent to their episode of care. It concludes by recommending the recognition in ethics and law of a limited, ongoing duty to notify patients of significant information relevant to their health. (shrink)

Judged by the key measures of morbidity and mortality, the United States has been very fortunate in the Ebola outbreak so far. We have had a limited number of cases and only a few fatalities. As of this writing, all of the health care workers who became infected in the United States have recovered, and none of the other nonhealth care contacts of Ebola patients has become infected. Yet by almost any other measure, the response to Ebola in the United (...) States has been a disaster. Among other things, there has been a wealth of misinformation, politicization of public health, public panic, and unnecessary quarantine. There is plenty of blame to go around. But one often overlooked factor that complicated the response to Ebola is American public health law. (shrink)

If there is to be a natural theory of consciousness that would satisfy both philosophers and scientists, it must be based on naturalistic data and minimal clutter accumulated from semantic arguments. Carruthers offers a 'natural' theory of consciousness that is rather myopic. To explore the evolutionary basis of consciousness, a natural theory should include comparative psychological and neurological data that encompass nonlinguistic measures. Such an approach could provide a clearer picture of the adaptive function, mechanisms, and origins of consciousness.

Many employers faced with rising health care costs have adopted “voluntary” wellness programs that urge employees to engage in various health-promotion activities, such as smoking cessation and weight reduction. In the proper setting, measures to promote a more healthful lifestyle are difficult to question, but there is little compelling evidence that workplace wellness programs have significant, sustained health benefits or substantially reduce health care costs other than through cost-shifting to unhealthy employees. Congressional support for workplace wellness programs has persisted on (...) a bipartisan basis for the last twenty years, and the incentives that current statutes allow employers to offer employees have become strong enough that the voluntariness of the programs has been called into question. In recent months, the battleground has shifted to the courts, where federal regulations and employer practices have been challenged. Three recent or pending cases raise questions about whether the incentives are coercing employees into the programs. (shrink)