Excessive prescribing of pain medications after surgery has contributed to the epidemic of opioid misuse and diversion in the United States. Pain specialists may be particularly well situated to address these issues. We describe an attempt to reverse the trend at an orthopedic surgical hospital by implementing a peri-operative assessment and treatment service which minimizes preoperative opioid use, when necessary implements addiction treatment, and encourages early tapering from opioids.

The dispute over the exact nature and status of possible worlds in Leibniz’s philosophy has proven difficult to resolve. The standard view, that there is one unique actual world and that possible worlds exist solely as ideas within God’s understanding, sits in tension with important metaphysical and theological components of Leibniz’s system. For example, Leibniz takes possible individuals to have some “essence or reality” in themselves and to strive for existence, which allows him to ground counterfactual claims and to overcome (...) necessitarianism. However, scholars have long seen these claims as being at odds with God’s creation of one unique actual world. Catherine Wilson (2000) challenges the standard view’s claim that possible worlds are substantially different from the actual world, arguing instead that Leibniz’s metaphysical commitments are consistent with there being more than one actual world and that Leibniz has no way to block the claim that God would generate more than one such world. In this paper, I expand on Wilson’s account and argue, contrary to the standard view, that the key theses at the heart of Leibniz’s philosophical system entail modal realism—for Leibniz, there can be no ontological difference between possible and actual worlds. (shrink)

Specialists and primary care physicians play an integral role in treating the twin epidemics of pain and addiction. But inadequate access to specialists causes much of the treatment burden to fall on primary physicians. This article chronicles the differences between treatment contexts for both pain and addiction — in the specialty and primary care contexts — and derives a series of reforms that would empower primary care physicians and better leverage specialists.

When the COVID-19 surge hit New York City hospitals, the Division of Medical Ethics at Weill Cornell Medical College, and our affiliated ethics consultation services, faced waves of ethical issues sweeping forward with intensity and urgency. In this article, we describe our experience over an eight-week period (16 March through 10 May 2020), and describe three types of services: clinical ethics consultation (CEC); service practice communications/interventions (SPCI); and organizational ethics advisement (OEA). We tell this narrative through the prism of time, (...) describing the evolution of ethical issues and trends as the pandemic unfolded. We delineate three phases: anticipation and preparation, crisis management, and reflection and adjustment. The first phase focused predominantly on ways to address impending resource shortages and to plan for remote ethics consultation, and CECs focused on code status discussions with surrogates. The second phase was characterized by the dramatic convergence of a rapid increase in the number of critically ill patients, a growing scarcity of resources, and the reassignment/ redeployment of staff outside their specialty areas. The third phase was characterized by the recognition that while the worst of the crisis was waning, its medium- and long-term consequences continued to pose immense challenges. We note that there were times during the crisis that serving in the role of clinical ethics consultant created a sense of dis-ease as novel as the coronavirus itself. In retrospect we learned that our activities far exceeded the familiar terrain of clinical ethics consultation and extended into other spheres of organizational life in novel ways that were unanticipated before this pandemic. To that end, we defined and categorized a middle level of ethics consultation, which we have termed service practice communication intervention (SPCI). This is an underappreciated dimension of the work that ethics consult services are capable of in times of crisis. We believe that the pandemic has revealed the many enduring ways that ethics consultation services can more robustly contribute to the ethical life of their institutions moving forward. (shrink)

What solutions can we find in the research literature for preventing sexual violence, and what psychological theories have guided these efforts? We gather all primary prevention efforts to reduce sexual violence from 1985 to 2018 and provide a bird’s-eye view of the literature. We first review predominant theoretical approaches to sexual-violence perpetration prevention by highlighting three interventions that exemplify the zeitgeist of primary prevention efforts at various points during this time period. We find a throughline in primary prevention interventions: They (...) aim to change attitudes, beliefs, and knowledge (i.e., ideas) to reduce sexual-violence perpetration and victimization. Our meta-analysis of these studies tests the efficacy of this approach directly and finds that although many interventions are successful at changing ideas, behavior change does not follow. There is little to no relationship between changing attitudes, beliefs, and knowledge and reducing victimization or perpetration. We also observe trends over time, including a shift from targeting a reduction in perpetration to targeting an increase in bystander intervention. We conclude by highlighting promising new strategies for measuring victimization and perpetration and calling for interventions that are informed by theories of behavior change and that center sexually violent behavior as the key outcome of interest. (shrink)

Brain-computer interfaces (BCIs) have been successfully used by adults, but little information is available on BCI use by children, especially children with severe multiple impairments who may need technology to facilitate communication. Here we discuss the challenges of using non-invasive BCI with children, especially children who do not have another established method of communication with unfamiliar partners. Strategies to manage these challenges require consideration of multiple factors related to accessibility, cognition, and participation. These factors include decisions regarding where (home, clinic, (...) or lab) participation will take place, the number of sessions involved, and the degree of participation necessary for success. A strategic approach to addressing the unique challenges inherent in BCI use by children with disabilities will increase the potential for successful BCI calibration and adoption of BCI as a valuable access method for children with the most significant impairments in movement and communication. (shrink)

Scientists know that human activities, primarily fossil fuel combustion, are causing Earth’s temperature to increase. Yet in 2021, only 60% of the US population understood that human activities are the primary cause of global warming. We experimentally test whether information about the human causes of global warming influences Americans’ beliefs and concerns about global warming and support for climate policies. We find that communicating information about the human-causes of global warming increases public understanding that global warming is human-caused. This information, (...) both alone and with additional information about climate impacts and policy solutions, also increases public concern about global warming and support for climate policies, although the effects on climate concern and policy support are smaller. Importantly, the treatment effects are consistent across political party, with no backlash effects among Republicans. This suggests that when informed about climate change causes, impacts and solutions, most Americans can update their own climate change beliefs, risk perceptions, and policy support. (shrink)

The second issue of Ordo IV of the Amsterdam edition of the Latin texts of Erasmus comprises the Querela Pacis and Erasmus’ Latin translations of some of Plutarch’s Moralia . The Complaint of Peace deals with peace and war, and the tension between love of one’s country and St. Paul’s admonishment to unity in Christianity.

Evolutionary activity statistics and their visualization are introduced, and their motivation is explained. Examples of their use are described, and their strengths and limitations are discussed. References to more extensive or general accounts of these techniques are provided.

The National Science Foundation's Second Merit Criterion, or Broader Impacts Criterion , was introduced in 1997 as the result of an earlier Congressional movement to enhance the accountability and responsibility as well as the effectiveness of federally funded projects. We demonstrate that a robust understanding and appreciation of NSF BIC argues for a broader conception of research ethics in the sciences than is currently offered in Responsible Conduct of Research training. This essay advocates augmenting RCR education with training regarding broader (...) impacts. We demonstrate that enhancing research ethics training in this way provides a more comprehensive understanding of the ethics relevant to scientific research and prepares scientists to think not only in terms of responsibly conducted science, but also of the role of science in responding to identified social needs and in adhering to principles of social justice. As universities respond to the mandate from America COMPETES to “provide training and oversight in the responsible and ethical conduct of research”, we urge institutions to embrace a more adequate conception of research ethics, what we call the Ethical Dimensions of Scientific Research, that addresses the full range of ethical issues relevant to scientific inquiry, including ethical issues related to the broader impacts of scientific research and practice. (shrink)

Philosophy as criticism of categories, by A. Seth.--The relation of philosophy to science, by R. B. Haldane and J. S. Haldane.--Logic as the science of knowledge, by B. Bosanquet.--The historical method, by W. R. Sorley.--The rationality of history, by D. G. Ritchie.--The philosophy of art, W. P. Ker.--The social organism, by H. Jones.--The struggle for existence, by J. Bonar.--Pessimism and the religious consciousness, by T. B. Kilpatrick.

ObjectiveTo examine measurement agreement between a vocabulary test that is administered in the standardized manner and a version that is administered with a brain-computer interface.MethodThe sample was comprised of 21 participants, ages 9–27, mean age 16.7 years, 61.9% male, including 10 with congenital spastic cerebral palsy, and 11 comparison peers. Participants completed both standard and BCI-facilitated alternate versions of the Peabody Picture Vocabulary Test - 4. The BCI-facilitated PPVT-4 uses items identical to the unmodified PPVT-4, but each quadrant forced-choice item (...) is presented on a computer screen for use with the BCI.ResultsMeasurement agreement between instruments was excellent, including an intra-class correlation coefficient of 0.98, and Bland-Altman plots and tests indicating adequate limits of agreement and no systematic test version bias. The mean standard score difference between test versions was 2.0 points.ConclusionThese results demonstrate that BCI-facilitated quadrant forced-choice vocabulary testing has the potential to measure aspects of language without requiring any overt physical or communicative response. Thus, it may be possible to identify the language capabilities and needs of many individuals who have not had access to standardized clinical and research instruments. (shrink)

Man's place in the cosmos.--The present position of the philosophical sciences.--The "new" psychology and automatism.--A new theory of the absolute.--Mr. Balfour and his critics.

In this paper, we suggest that affect meets the traditional definition of “cognition” such that the affect–cognition distinction is phenomenological, rather than ontological. We review how the affect–cognition distinction is not respected in the human brain, and discuss the neural mechanisms by which affect influences sensory processing. As a result of this sensory modulation, affect performs several basic “cognitive” functions. Affect appears to be necessary for normal conscious experience, language fluency, and memory. Finally, we suggest that understanding the differences between (...) affect and cognition will require systematic study of how the phenomenological distinction characterising the two comes about, and why such a distinction is functional. (shrink)

The philosophical radicals.--Mr. Kidd on Western civilization.--Martineau's philosophy.--Herbert Spencer; the man and his work.--Reviews: Jones's Philosophy of Lotze (1893) Dewey's Studies in logical theory (1904) M'Taggart's Some dogmas of religion (1906)--Reprints: The philosophy of religion in Kant and Hegel (1882) Philosophy as criticism of categories (1883).

Plato, Allan Bloom wrote, is "the most erotic of philosophers," and his Symposium is one of the greatest works on the nature of love ever written. This new edition brings together the English translation of the renowned Plato scholar and translator, Seth Benardete, with two illuminating commentaries on it: Benardete's "On Plato's _Symposium_" and Allan Bloom's provocative essay, "The Ladder of Love." In the _Symposium,_ Plato recounts a drinking party following an evening meal, where the guests include the poet (...) Aristophanes, the drunken Alcibiades, and, of course, the wise Socrates. The revelers give their views on the timeless topics of love and desire, all the while addressing many of the major themes of Platonic philosophy: the relationship of philosophy and poetry, the good, and the beautiful. (shrink)

Understanding human behaviour, thoughts, and emotional expressions can be challenging in the global context. Due to cultural differences, the study of psychology cannot be de-contextualised. This calls for unearthing of the explanatory systems that exist in Africa to understand and account for behaviour, emotions, and cognition of Africans. This call is addressed through the emergence of African Psychology (AP) or Indigenous Psychology in Africa (IPA) as a legitimate science of human experience. This Element discusses the motivations for AP, centrality of (...) culture, demarcations of AP, and the different strands within AP. It highlights issues related to African philosophy, African cultural anthropology, African philosophy of science, and suitable methodological approaches for AP research. It also discusses some selected theoretical contributions and applications of AP. The Element concludes that AP researchers and practitioners need to pursue interdisciplinarity and avoid meaningless rejection of good ideas from other cultural settings. (shrink)

Which systems/organisms are conscious? New tests for consciousness (‘C-tests’) are urgently needed. There is persisting uncertainty about when consciousness arises in human development, when it is lost due to neurological disorders and brain injury, and how it is distributed in nonhuman species. This need is amplified by recent and rapid developments in artificial intelligence (AI), neural organoids, and xenobot technology. Although a number of C-tests have been proposed in recent years, most are of limited use, and currently we have no (...) C-tests for many of the populations for which they are most critical. Here, we identify challenges facing any attempt to develop C-tests, propose a multidimensional classification of such tests, and identify strategies that might be used to validate them. (shrink)

In the pediatric heart-failure population, severity of illness often forces therapeutic decisions to be made under time-pressure, such that mechanical circulatory support (MCS) can be offered as a...

This book synthesizes Jacques Derrida’s hauntology and spectrality with affect theory, in order to create a rhetorical framework analyzing the felt absences and hauntings of written and oral texts. The book opens with a history of hauntology, spectrality, and affect theory and how each of those ideas have been applied. The book then moves into discussing the unique elements of the rhetorical framework known as the rhetorrectional situation. Three case studies taken from the Christian tradition, serve to demonstrate how spectral (...) rhetoric works. The first is fictional, C.S. Lewis ’The Great Divorce. The second is non-fiction, Tim Jennings ’The God Shaped Brain. The final one is taken from homiletics, Bishop Michael Curry’s royal wedding 2018 sermon. After the case studies conclusion offers the reader a summary and ideas future applications for spectral rhetoric. (shrink)