Objectives Prompt Mental Health Care (PMHC) is the Norwegian version of the England’s Improving Access to Psychological Therapies (IAPT). Both programs have been associated with substantial symptom reductions from pre- to post-treatment. The present study extends these findings by investigating symptom levels at 12 months post-treatment, as well as treatment outcome in relation to low- vs. high-intensity treatment forms. Design and Outcome Measures A prospective cohort design was used. All participants ( n = 1530) were asked to complete the Patient (...) Health Questionnaire-9 (PHQ-9) and the Generalized Anxiety Disorder-7 questionnaire (GAD-7) at baseline, before each session during treatment, at final treatment, and at 12 months post-treatment. Cohen’s d was used as effect size measure. Sensitivity analyses were conducted to examine the impact of the high missing data rates at post-treatment (≈44%) and 12 months post-treatment (≈58%). Results A large symptom reduction was seen from baseline to 12 months post-treatment for both PHQ ( d = −0.98) and GAD ( d = −0.94). Improvements observed at post-treatment were largely maintained at 12 months post-treatment (PHQ (Δ d = 0.10) and GAD (Δ d = 0.09). Recovery rates decreased only slightly from 49.5% at post-treatment to 45.0% at follow-up. Both low- and high-intensity treatment forms were associated with substantial and lasting symptoms reductions (−1.26 ≤ d ≤ −0.73). Sensitivity analyses did not substantially alter the main results. Conclusion The findings suggest long-lasting effects of the PMHC program and encourage the use of low-intensity treatment forms in PMHC like settings. (shrink)

Background: Little is known about U.S. healthcare provider views and practices regarding evidence, counseling, and shared decision-making about in-hospital versus out-of-hospital birth settings. Methods: We conducted 19 in-depth, semistructured, qualitative interviews of eight obstetricians, eight midwives, and three pediatricians from across the United States. Interviews explored healthcare providers’ interpretation of the current evidence and their personal and professional experiences with childbirth within the existing medical, ethical, and legal context in the United States. Results: Themes emerged concerning risks and benefits, decision-making, (...) and patient-provider power dynamics. Collectively, the narratives illuminated fundamental ideological tensions between in- and out-of-hospital providers arising from divergent assignment of value to described risks and benefits. The majority of physicians focused on U.S.-specific data demonstrating increased neonatal morbidity and mortality associated with delayed access to hospital-based interventions, thereby justifying hospital birth as the standard of care. By contrast, midwives emphasized data demonstrating fewer interventions and superior maternal and neonatal outcomes in high-income European countries, where out-of-hospital birth is more common for low-risk birthing people. A key gap in counseling was revealed, as no interviewees offered anticipatory counseling regarding birth setting options. Providers directly and indirectly illustrated the propensity for asymmetric power relations between birth providers and pregnant people, especially in hospital settings. Conclusions: The narratives highlight the common goal of optimizing maternal and neonatal outcomes despite tensions arising from divergent prioritization of specific maternal and neonatal risks. Our findings suggest opportunities to foster collaboration and optimize outcomes via mutual respect and improved integration of care. (shrink)

In this response to Jeff Pflug’s review of my dissertation Michael Polanyi’s Integrative Philosophy, I note that Pflug focused on my discussion of possible extension of Polanyi’s epistemology; he has also taken my statements on scientific truth out of context. In addition, he ignored the four major elements of the dissertation, thereby not giving the reader a “map” to the meaning and the rationale of the work – an intellectual biography of Polanyi.

Following promulgation of the Nuremberg code in 1947, the ethics of research on human subjects has been a challenging and often contentious topic of debate. Escalation in the use of research participants in low-income countries over recent decades , has intensified the debate on the ethics of international research and led to increasing attention both to exploitation of vulnerable subjects and to considerations of how the 10:90 gap in health and medical research could be narrowed. In 2000, prompted by the (...) discussions over several years that led to the US NIH launching a capacity building programme on research ethics for members of research ethics committees in developing countries, we advanced a ‘new look’ for the ethics of international research.1 Since then progress has been made on several fronts.First, our ideas—considered somewhat radical and impractical at the time—have been provocatively addressed by scholars who have either contested them or advanced similar conceptions of what obligations international researchers have to research participants and communities in low income countries before, during and after clinical trials. Second, those researchers who have been sympathetic to our ideas have either endeavoured to put these into practice or have investigated the feasibility of doing so. Third, the intractability of the 10/90 gap and the escalation of interest in global health have sensitised many to the need to amplify the uptake of these ideas in practice.Here, we briefly review the conceptual and practical developments in international research ethics. While much conceptual progress has been made (and the concepts are now appearing …. (shrink)

Buildings are constructed for accommodating living and industrial needs. Floor cleaning robots have been developed to cater to the demand of these buildings. Area coverage and coverage time are crucial performance factors of a floor cleaning robot. Reconfigurable tiling robots have been introduced over fixed shape robots to improve area coverage in floor cleaning applications compared to robots with fixed morphologies. However, area coverage and coverage time of a tiling robot compromised one another. This study proposes a novel concept that (...) considers the ability of a tiling robot to configure both its morphology and size according to the environment. This concept is inspired by the pleomorphism that could be seen in bacteria. In this regard, P-hTetro, a pleomorphic tiling robot that can reconfigure its morphology and size, is considered. A novel coverage strategy for realizing the size reconfiguration is also proposed. According to this strategy, the robot covers obstacle-free areas with its maximum size, while an obstacle cluster is covered after shrinking to an optimum size. The optimum size for reconfiguration is determined by the genetic algorithm based on the arrangement of the environment. The performance and behavior of the proposed P-hTetro have been compared against that of an existing tiling robot which has a fixed size. According to the statistical outcomes, a tiling robot with the ability to reconfigure its size can significantly improve the performance in the aspects of area coverage and coverage time compared to a tiling robot with no ability to reconfigure its size. (shrink)

Restitere primo obstinatis animis; deinde ut obtinentes locum †uires ferebant† audent ultro gradum inferre.

_In the light of Sri Aurobindo's philosophy, this paper looks into some of the problems of contemporary man as an individual, a member of society, a citizen of his country, a component of this world, and of nature itself. Concepts like Science; Nature,;Matter; Mental Being; Mana-purusa; Prana-purusa; Citta-purusa; Nation-ego and Nation-soul; True and False Subjectivism; World-state and World-union; Religion of Humanism are the focus of this paper. Nature: Beneath the diversity and uniqueness of the different elements in Nature there is (...) an essential unity that not only allows for this diversity but even supports it. Nature is both a benefactor and a force: a benefactor, because it acts to carry out the evolution of mankind; a force, because it also supplies the necessary energy and momentum to achieve it. Natural calamities: If mankind can quieten the tsunamis and cyclones and droughts and earthquakes that rage within, and behave with care and compassion towards Nature, not exploiting, denuding, or denigrating it, there is a strong possibility that Nature too will behave with equal care and compassion towards man and spare him the natural calamities than rend him asunder. Science: The limitation of science become obvious, according to Sri Aurobindo, when we realize that it has mastered knowledge of processes and helped in the creation of machinery but is ignorant of the foundations of being and, therefore, cannot perfect our nature or our life. Science and philosophy: The insights of philosophy could become heuristic and algorithmic models for scientific experimentation. Matter: An interesting aspect of Sri Aurobindo's philosophy is his acceptance of the reality of matter even while highlighting its inadequacies; the ultimate goal, according to him, is the divination of matter itself. Purusa: If the mana-purusa (mental being) were to log on to the genuine citta-purusa (psychic formation), without necessarily logging off from the prana-purusa (frontal formation), it may help quieten the turbulences within, which may be a prelude to the quietening of the disturbances without, whether it be physical maladies, cravings (for food, fame, fortune, etc.), destructive competitiveness; or wars, terrorism, ethnic conflicts, communal riots, and the other such social maladies that afflict mankind today. Nation-ego (false subjectivism) and Nation-soul (true subjectivism): Sri Aurobindo considers Nation-ego an example of false subjectivism, in which national identity and pride are stressed to prove one's superiority and suppress or exploit the rest. The Nation-soul, as an example of true subjectivism, attempts to capture one's traditional heritage and values in its pristine form, not as a reaction to hurts and angers or as compensation for real or imagined injuries or indignities of the past. World-state (false subjectivism) and World-union (true subjectivism): Similarly, a World-state founded upon the principle of centralization and uniformity, a mechanical and formal unity, is an example of false subjectivism, while a World-union founded upon the principle of liberty and variation in a free and intelligent unity is an example of true subjectivism Human actualization: Even if two human beings are similar, in so far as they are human beings, there is so much diversity between them. Part of the movement towards human self-actualization lies in the fact that this diversity should not be forcibly curbed, as also the realization that beneath all that appears disparate there is an essential unity. Also, man is not the end product of evolution but an intermediate stage between the animal and the divine. Moreover, he is endowed with consciousness that enables him to cooperate with the forces of evolution and speed up and telescope the next stage of evolution._. (shrink)

Hoc tempore velut per universum orbem Romanum, bellicum canentibus bucinis, excitae gentes saevissimae, limites sibi proximos persultabant. Gallias Raetiasque simul Alamanni poputabantur; Sarmatae Pannonias et Quadi; Picti Saxonesque et Scotci, et Attacotti Brittanos aerumnis vexavere continuis; Austoriani Mauricaeque aliae gentes, Africam solito acrius incursabant; Thracias et diripiebant praedatorii globi Gothorum. Persarum rex manus Armeniis iniectabat, eos in suam dicionem ex integro vocare vi nimia properans, sed iniuste, causando, quod post Ioviani excessum, cum quo foedera firmarat et pacem, nihil obstare debebit, (...) quo minus ea recuperaret, quae antea ad maiores suos pertinuisse monstrabat. (shrink)

In 1931 the mathematical logician Kurt Godel published a revolutionary paper that challenged certain basic assumptions underpinning mathematics and logic. A colleague of Albert Einstein, his theorem proved that mathematics was partly based on propositions not provable within the mathematical system and had radical implications that have echoed throughout many fields. A gripping combination of science and accessibility, Godel’s Proof by Nagel and Newman is for both mathematicians and the idly curious, offering those with a taste for logic and philosophy (...) the chance to satisfy their intellectual curiosity. (shrink)

Die Wissenschaftspsychologie wird als ein Gebiet interdisziplinärer Forschungen an der Grenze zwischen Psychologie und allgemeiner Theorie und Geschichte der Wissenschaft erörtert und ihr Verhältnis zu den anderen Richtungen der Wissenschaftsforschung, insbesondere zur Logik der Wissenschaftsentwicklung und zur Wissenschaftssoziologie dargestellt. Dabei heben die Autoren hervor, daß die Ausarbeitung jeder dieser Disziplinen eine Umgestaltung ihrer Ausgangsbegriffe und -methoden voraussetzt, was der Natur der Wissenschaft als spezifischen Systems und als besonderer sich historisch entwickelnder Tätigkeitsform entspricht. Als Grundprobleme werden u.a. behandelt: Kreativität, Motivation und (...) Schaffensdynamik des Wissenschaftlers, das Verhältnis von Persönlichkeit und Kollektiv in der modernen Wissenschaft und das Funktionieren "kleiner Gruppen". (shrink)

It is a well-established fact that most new, non-traditional religious groups are treated negatively in the mass media. However, Falun Gong, the qi gong group that was banned in China in 1999, is a marked exception to this general tendency. Why should this be the case? In the present paper, we examine the various factors that combine to make Falun Gong the exception to the rule. We also call attention to this organization’s pattern of attacking critics, as well as their (...) pattern of attacking anyone who offers an interpretation of events that is at odds with Falun Gong’s interpretation. However, this heavy-handed tactic has the potential to backfire, and to prompt the media to reperceive them as a bully rather than as an innocent victim. (shrink)

The blinkered debate on organ donation neglects the widening gap between the developed and developing worldsThe current debate about organ donation and the associated advocacy for selling kidneys, while laudable for its concern about increasing the ability to save the lives of some people with chronic renal failure, is characterised by four features that locate the reasoning process within a narrow and inadequate framework. Firstly, the focus on saving lives is myopic, with the lives of the most privileged in the (...) world receiving most attention. Secondly, the debate is firmly set within a value system in which market values dominate. Thirdly, health is considered from a highly individualistic perspective with little understanding of the importance of social solidarity in health. Finally, a constricted moral vocabulary is used to discuss the ethics of organ sales.MYOPIC CONCERN FOR SAVING LIVESMany articles making pleas for more organs begin by describing the number of people waiting for donated organs, the number of donors who could give organs but are not doing so, and how many lives could be saved if more organs could be made available. Great concern is expressed about a few thousand …. (shrink)