Wrong beliefs, known by some as ‘alternative facts’, have proliferated lately in important areas of human life, including social, political, and public health domains. This can be and has been damaging. This brief article proposes an epistemological category classification of these wrong beliefs, with the following mappings: a) ‘No-Information’ marked by willful blindness produces ‘Empty Beliefs’; b) ‘Mis-Information’ yields ‘Mis(taken) Beliefs’; and c) ‘Dis-Information’ predicated on blatant distortions produces ‘Dis(torted) Beliefs’. This simple classification system, is perhaps epistemologically satisfying, and moreover (...) could have positive policy implications. (shrink)

We present counterexamples to the widespread assumption that Moorean sentences cannot be rationally asserted. We then explain why Moorean assertions of the sort we discuss do not incur the irrationality charge. Our argument involves an appeal to the dual-process theory of the mind and a contrast between the conditions for ascribing beliefs to oneself and the conditions for making assertions about independently existing states of affairs. We conclude by contrasting beliefs of the sort we discuss with the structurally similar but (...) rationally impermissible beliefs of certain psychiatric patients. (shrink)

Our approach is based on a tri-partite method of integrating psychodynamic hypotheses, cognitive subliminal processes, and psychophysiological alpha power measures. We present ten social phobic subjects with three individually selected groups of words representing unconscious conflict, conscious symptom experience, and Osgood Semantic negative valence words used as a control word group. The unconscious conflict and conscious symptom words, presented subliminally and supraliminally, act as primes preceding the conscious symptom and control words presented as supraliminal targets. With alpha power as a (...) marker of inhibitory brain activity, we show that unconscious conflict primes, only when presented subliminally, have a unique inhibitory effect on conscious symptom targets. This effect is absent when the unconscious conflict primes are presented supraliminally, or when the target is the control words. Unconscious conflict prime effects were found to correlate with a measure of repressiveness in a similar previous study (Shevrin et al., 1992, 1996). Conscious symptom primes have no inhibitory effect when presented subliminally. Inhibitory effects with conscious symptom primes are present, but only when the primes are supraliminal, and they did not correlate with repressiveness in a previous study (Shevrin et al., 1992, 1996). We conclude that while the inhibition following supraliminal conscious symptom primes is due to conscious threat bias, the inhibition following subliminal unconscious conflict primes provides a neurological blueprint for dynamic repression: it is only activated subliminally by an individual's unconscious conflict and has an inhibitory effect specific only to the conscious symptom. These novel findings constitute neuroscientific evidence for the psychoanalytic concepts of unconscious conflict and repression, while extending neuroscience theory and methods into the realm of personal, psychological meaning. (shrink)

Freud proposes that in unconscious processing, logical connections are also (heavily) based upon phonological similarities. Repressed concerns, for example, would also be expressed by way of phonologic ambiguity. In order to investigate a possible unconscious influence of phonological similarity, 31 participants were submitted to a tachistoscopic subliminal priming experiment, with prime and target presented at 1ms. In the experimental condition, the prime and one of the 2 targets were phonological reversed forms of each other, though graphemically dissimilar (e.g., “nice” and (...) “sign”); in the control condition the targets were pseudo-randomly attributed to primes to which they don’t belong. The experimental task was to “blindly” pick the choice most similar to the prime. ERPs were measured with a focus on the N320, which is known to react selectively to phonological mismatch in supraliminal visual word presentations. The N320 amplitude-effects at the electrodes on the midline and at the left of the brain significantly predicted the participants’ net behavioral choices more than half a second later, while their subjective experience is one of arbitrariness. Moreover, the social desirability score (SDS) significantly correlates with both the behavioral and the N320 brain responses of the participants. It is proposed that in participants with low SDS the phonological target induces an expected reduction of N320 and this increases their probability to pick this target. In contrast, high defensive participants have a perplexed brain reaction upon the phonological target, with a negatively peaking N320 as compared to control and this leads them to avoid this target more often. Social desirability, which is understood as reflecting defensiveness, might also manifest itself as a defense against the (energy-consuming) ambiguity of language. The specificity of this study is that all of this is happening totally out of awareness and at the level of very elementary linguistic distinctions. (shrink)

(2002). Phantasy and Wish: A Proper Function Account for Human A-Rational Primary Process Mediated Mentation. Australasian Journal of Philosophy: Vol. 80, No. 1, pp. 1-16.

Discerning the decisionmaking of Kim Jong-Un and the North Korean regime on issues of peaceful engagement and warlike actions endures as a mighty challenge for U.S. intelligence analysts and policymakers. In this report, we seek to inform analysis of Democratic People’s Republic of Korea (DPRK) leadership decisionmaking. To do so, we use three discussion papers that were written to facilitate discussion of an interagency working group. The three papers are assembled here in a single report. The first discussion paper describes (...) decisionmaking among different authoritarian regimes, including North Korea, and the opening up of those economies to outside engagement. The second paper outlines two different scenarios that might occur when conventional deterrence on the Korean Peninsula breaks down and the resulting decisions that North Korea’s leadership could face. The third paper assesses DPRK decisionmaking about nuclear weapon use. The report concludes with some observations, drawn from the issues covered in these three discussion papers, about DPRK decisionmaking and stability on the Korean Peninsula. (shrink)

In her book Specifications Grading, Linda B. Nilson advocates for a grading regimen she claims will save faculty time, increase student motivation, and improve the quality and rigor of student work. If she is right, there is a strong case for many faculty to adopt some version of the system she recommends. In this paper, we argue that she is mostly right and recommend that faculty move away from traditional grading. We begin by rehearsing the central features of specifications (...) grading and providing two examples of how to implement it in philosophy classes. In light of the examples, we argue that specifications grading fulfills two of Nilson’s central desiderata but not the third. Since specifications grading generates two benefits that when combined increase student learning, without adding or increasing burdens, we conclude that student learning increases when courses are revised to include aspects of specifications grading. (shrink)

This essay constitutes an attempt to probe the very idea of a saying/showing distinction of the kind that Wittgenstein advances in the Tractatus—to say what such a distinction consists in, to say what philosophical work it has to do, and to say how we might be justified in drawing such a distinction. Towards the end of the essay the discussion is related to Wittgenstein’s later work. It is argued that we can profitably see this work in such a way that (...) a saying/showing distinction arises there too. In particular, in the final sub-section of the essay, it is suggested that we can see in Wittgenstein’s later work an inducement to say what we are shown. (shrink)

There is a current debate about the grammar of intention: do I intend to φ, or that I φ? The equivalent question in Aristotle relates especially to choice. I argue that, in the context of practical reasoning, choice, as also wish, has as its object an act. I then explore the role that this plays within his account of the relation of thought to action. In particular, I discuss the relation of deliberation to the practical syllogism, and the thesis that (...) the conclusion of the second is an action. (shrink)

How do artifacts get their functions? It is typically thought that an artifact’s function depends on its maker’s intentions. This chapter argues that this common understanding is fatally flawed. Nor can artifact function be understood in terms of current uses or capacities. Instead, it proposes that we understand artifact function on the etiological model that Ruth Millikan and others have proposed for the biological realm. This model offers a robustly normative conception of function, but it does so naturalistically by employing (...) our best scientific theories, in particular natural selection. To help make this case, it proposes “living artifacts” (organisms designed for human purposes through artificial selection) as a bridge between the artifactual and the biological realms. (shrink)

It is argued that, although there are no ineffable truths, the concept of ineffability nevertheless does have application—to certain states of knowledge. Towards the end of the essay this idea is related to religion: it is argued that the language that results from attempting (unsuccessfully) to put ineffable knowledge into words is very often of a religious kind. An example of this is given at the very end of the essay. This example concerns the Euthyphro question: whether what is right (...) is right because God wills it, or whether God wills it because it is right. (shrink)

Two of Quine's most familiar doctrines are: that there is a distinction between underdetermination and indeterminacy; and that there is no distinction between analytic and synthetic truths. An argument is given that these two doctrines are incompatible. In terms wholly acceptable to Quine and based on the underdetermination/indeterminacy distinction, an exhaustive and exclusive distinction is drawn between two kinds of true sentences, which, it is argued, corresponds to the traditional analytic/synthetic distinction. An appendix is used to develop one aspect of (...) the underdetermination/indeterminacy distinction, as construed here, and to discuss, in passing, some of Quine’s more general views on truth. (shrink)

In this essay, we aim to provide an overview of the political and philosophical issues pertaining to asexuality. The first section, “What Is Asexuality?,” offers an account of asexuality. The second section, “Asexuality as a Unique Sexual Orientation,” argues that asexuality should be understood as a unique sexual orientation. The third section, “Asexuality and Oppression,” discusses the various forms of oppression facing asexual persons today. The fourth section, “The Goods of Asexuality,” articulates some goods that asexuality brings to human lives, (...) and we do this with an eye toward conceiving of asexuality as something other than a mere deficit. (shrink)

[A. W. Moore] Criteria of ineffability are presented which, it is claimed, preclude the possibility of truths that are ineffable, but not the possibility of other things that are ineffable—not even the possibility of other things that are non-trivially ineffable. Specifically, they do not preclude the possibility of states of understanding that are ineffable. This, it is argued, allows for a reappraisal of the dispute between those who adopt a traditional reading of Wittgenstein’s Tractatus and those who adopt the new (...) reading recently championed by Cora Diamond, James Conant, and others. By maintaining that what the nonsense in the Tractatus is supposed to convey is ineffable understanding, rather than ineffable truth, we can do considerable justice to each of these readings. We can also do considerable justice to the Tractatus. /// [Peter Sullivan] Moore proposes to cut between 'traditional' and 'new' approaches to the Tractatus, suggesting that Wittgenstein's intention is to convey, through the knowing use of nonsense, ineffable understanding. I argue, first, that there is indeed room for a proposal of Moore's general kind. Secondly, though, I question whether Moore's actual proposal is not more in tune with Wittgenstein's later thought than with the attitude of the Tractatus. (shrink)

How, if at all, are we to distinguish between the works that we call ‘art’ and those that we call ‘pornography’? This question gets a grip because from classical Greek vases and the frescoes of Pompeii to Renaissance mythological painting and sculpture to Modernist prints, the European artistic tradition is chock-full of art that looks a lot like pornography. In this paper I propose a way of thinking about the distinction that is grounded in art historical considerations regarding the function (...) of erotic images in 16 th -century Italy. This exploration suggests that the root of the erotic art/pornography distinction was—at least in this context—class: in particular, the need for a special category of unsanctioned illicit images arose at the very time when print culture was beginning to threaten elite privilege. What made an erotic representation exceed the boundaries of acceptability, I suggest, was not its extreme libidinosity but, rather, its widespread availability and, thereby, its threat to one of the mechanisms of sustaining class privilege. (shrink)

It is argued that the use/mention distinction, if it is to be a clear-cut one, cannot have the significance that it is usually thought to have. For that significance attaches to the distinction between employing an expression in order to draw attention to, or to talk about, some aspect of the world, as determined by the expression’s meaning, and employing it in order to draw attention to, or to talk about, the expression itself—and this distinction is not a clear-cut one. (...) In the final section of the essay this argument is extended to cast doubt on a rather glib appeal to the use/mention distinction that is frequently made in the philosophy of language. (shrink)

This essay is concerned with six linguistic moves that we commonly make, each of which is considered in turn. These are: stating rules of representation; representing things categorically; mentioning expressions; saying truly or falsely how things are; saying vaguely how things are; and stating rules of rules of representation. A common-sense view is defended of what is involved in our doing each of these six things against a much more sceptical view emanating from the idea that linguistic behavior is fundamentally (...) messy. Both the fifth move and the sixth move involve vague concepts, and much of the essay is concerned with developing an approach to various problems and puzzles that attach to such concepts, most notably the sorites paradoxes. (shrink)

This essay is concerned with Graham Bird’s treatment, in The Revolutionary Kant, of Kant’s mathematical antinomies. On Bird’s interpretation, our error in these antinomies is to think that we can settle certain issues about the limits of physical reality by pure reason whereas in fact we cannot settle them at all. On the rival interpretation advocated in this essay, it is not true that we cannot settle these issues. Our error is to presuppose that the concept of the unconditioned has (...) application to physical reality. Once this presupposition has been abandoned, we can retrieve sound arguments from the antinomies, not indeed to demonstrate that the views originally being defended are correct, but to demonstrate that the views originally being attacked are incorrect. The essay concludes with some comments concerning how this disagreement relates to a broader disagreement about the best way to understand Kant. (shrink)

This essay appeared as a contribution to a special issue of European Journal of Philosophy to mark the fiftieth anniversary of the publication of P. F. Strawson’s The Bounds of Sense. In that book Strawson asks whether we should agree with Kant's claim, in his Critique of Pure Reason, that there can be only one world. What Kant means by this claim is that the four-dimensional realm that we inhabit must constitute the whole of empirical reality. Strawson gives reasons for (...) challenging this claim. This essay raises the question whether, even if Strawson is right, we may nevertheless have reason to believe that there can be only one world on a broader understanding of ‘world’. The aim is as much to clarify the issue as to settle it, although an attempt is made to motivate the view that there can indeed be only one world on this broader understanding. (shrink)

This essay involves exploration of certain repercussions of Bernard Williams’ view that there is, in Wittgenstein’s later work, a transcendental idealism akin to that found in the Tractatus—sharing with it the feature that it cannot be satisfactorily stated. It is argued that, if Williams is right, then Wittgenstein’s later work precludes a philosophically substantial theory of meaning; for such a theory would force us to try to state the idealism. In a postscript written for the reprint of the essay, reasons (...) are given for thinking that Williams is not right: Wittgenstein’s later work actually helps us to repudiate as ill-conceived all those questions whose answers invite us to embrace any such idealism. But the main thesis of the essay remains intact. Indeed the idea that Wittgenstein’s later work precludes a philosophically substantial theory of meaning is reinforced. (shrink)

This essay is concerned with solipsism, understood as the extreme sceptical view that I have no knowledge except of my subjective state. A less rough formulation of the view is mooted, inspired by a Quinean combination of naturalism and empiricism. An objection to the resultant position is then considered, based on Putnam’s argument that we are not brains in vats. This objection is first outlined, then pitted against a series of counter-objections. Eventually it is endorsed, but only at the price (...) of exposing the formulation of solipsism in question as not, after all, a satisfactory formulation. This leads to further speculation about the status of solipsism itself. Two of the possibilities that are considered are, firstly, that it is incoherent and, secondly, that it is inexpressible. (shrink)

In the last two decades, the term “quality-of-life” has become popular in medicine and health care. There are, however, important differences in the meaning and the use of the term. The message of all quality-of-life talk is that medicine and health care are not valuable in themselves. They are valuable to the extent that they contribute to the quality of life of patients. The ultimate aims of medicine and health care are not health or prolongation of life as such, but (...) preservation or improvement of the quality of life. The primary aims of medicine and health care, such as the prolongation of life, can – but need not always – come into conflict with the ultimate ones: medical treatments do not always benefit a patient. In this article I will, first, summarize the results of my explorations of the use and the meaning of the term “quality-of-life.” The use and the meaning of the term turn out to depend on the contexts of medical decisionmaking in which it is used. I will show that there are at least three different concepts of quality-of-life. Second, I will argue that the different concepts of quality-of-life are not unrelated. They point to different components of and/or conditions for happiness. Third, I will analyze the relation between the three concepts of qualityof-life, health and happiness. (shrink)

An interpretation of Kant's first antinomy is defended whereby both its thesis and its antithesis depend on a common basic principle that Kant endorses, namely that there cannot be an ‘infinite contingency’, by which is meant a contingent fact about how an infinite region of space or time is occupied. The greatest problem with this interpretation is that Kant explicitly declines to apply counterparts of the temporal arguments in the antinomy to the world’s future, even though, if the interpretation is (...) correct, such arguments are clearly there to be applied. This problem, it is argued, is surmountable. (shrink)

The aim of this essay is to characterize the issue whether tense is real. Roughly, this is the issue whether, given any tensed representation, its tense corresponds in some suitably direct way to some feature of reality. The task is to make this less rough. Eight characterizations of the issue are considered and rejected, before one is endorsed. On this characterization, the unreality of tense is equivalent to the unity of temporal reality. The issue whether tense is real, so characterized, (...) is then related to Kant’s deduction of the categories in his Critique of Pure Reason. It is argued that Kant’s deduction does not provide the argument for the unreality of tense that it may appear to. The conclusion drawn at the end of the essay is that the unreality of tense cannot be argued for—not because tense is real, but because, even if it is unreal, its unreality is basic. (shrink)

In this essay I focus on the idea of the univocity of being, championed by Duns Scotus and given prominence more recently by Deleuze. Although I am interested in how this idea can be established, my primary concern is with something more basic: how the idea can even be properly thought. In the course of exploring this issue, which I do partly by borrowing some ideas about logical syntax from Wittgenstein's Tractatus, I try to show how there can be dialogue (...) between analytic philosophers and those of other traditions. (shrink)

This essay is a critical notice of Thomas Nagel’s The Last Word. Though the essay evidences broad sympathy with the spirit of Nagel’s book, its main burden is to query the letter of the book. Nagel’s defence of the view that there are certain beliefs and ways of thinking that are not from any point of view, or that are ‘objective’ in his own terms, is criticized on the grounds that it is too facile. It is also criticized for not (...) being pitted against a critique of beliefs and ways of thinking that are from some point of view, or that are ‘subjective’ in his terms. (shrink)

This essay is a contribution to a symposium on Barry Stroud’s book The Quest for Reality. It exploits various analogies between tense and colour to defend the idea, about which Stroud is deeply sceptical, that we can successfully undertake what Stroud calls ‘the philosophical quest for reality’—more specifically, to defend the idea that we can do this by arguing that any fact can be represented from no point of view.

Disaster response is a highly collaborative and critical process that requires the involvement of multiple emergency responders (ERs), ideally working together under a unified command, to enable a rapid and effective operational response. Following the 9/11 and 11/13 terrorist attacks and the devastation of hurricanes Katrina and Rita, it is apparent that inadequate communication and a lack of interoperability among the ERs engaged on-site can adversely affect disaster response efforts. Within this context, we present a scenario-based terrorism case study to (...) highlight the challenges of operational disaster command and response. In this article, which is based on the French emergency response doctrine, we outline a semantics-based common operational command system that is designed to guarantee an efficient information flow among ERs. Our focus is on offering to all ERs, a real-time operational picture of the situation in order to enable multilevel coordination among firefighters, police, healthcare units, public authorities, and other stakeholders. Our approach consolidates information to promote timely sharing of data among ERs. The proposed system is based on an ontology that has been developed to represent the different types of knowledge on the part of ERs, providing a shared vocabulary that covers a variety of interoperability concerns. (shrink)

Knowledge has almost always been treated as good, better than mere true belief, but it is remarkably difficult to explain what it is about knowledge that makes it better. I call this “the value problem.” I have previously argued that most forms of reliabilism cannot handle the value problem. In this article I argue that the value problem is more general than a problem for reliabilism, infecting a host of different theories, including some that are internalist. An additional problem is (...) that not all instances of true belief seem to be good on balance, so even if a given instance of knowing p is better than merely truly believing p, not all instances of knowing will be good enough to explain why knowledge has received so much attention in the history of philosophy. The article aims to answer two questions: What makes knowingp better than merely truly believing p? The answer involves an exploration of the connection between believing and the agency of the knower. Knowing is an act in which the knower gets credit for achieving truth. What makes some instances of knowing good enough to make the investigation of knowledge worthy of so much attention? The answer involves the connection between the good of believing truths of certain kinds and a good life. In the best kinds of knowing, the knower not only gets credit for getting the truth but also gets credit for getting a desirable truth. The kind of value that makes knowledge a fitting object of extensive philosophical inquiry is not independent of moral value and the wider values of a good life. (shrink)

Persons are thought to have a special kind of value, often called "dignity," which, according to Kant, makes them both infinitely valuable and irreplaceably valuable. The author aims to identify what makes a person a person in a way that can explain both aspects of dignity. She considers five definitions of "person": (1) an individual substance of a rational nature (Boethius), (2) a self-conscious being (Locke), (3) a being with the capacity to act for ends (Kant), (4) a being with (...) the capacity to act for another (Kant), and (5) an incommunicably unique subject (Wojtyla). She argues that none is capable of grounding both aspects of dignity since they are incompatible kinds of value; it is impossible for the same thing to ground both. Human persons are infinitely valuable in virtue of shareable qualities of their nature, whereas they are irreplaceably valuable because of a nonqualitative feature of their personhood. (shrink)

Noncompete agreements are among the most commonly used methods to restrict employment. Upwards of 38% of American workers, many of which are low-wage workers, have signed noncompete agreements. These agreements effectively hold those workers hostage to their current employer. This project analyzes the use of noncompete clauses in employment contracts with low-wage workers. We show that noncompetes with low-wage workers are not enforceable in the U.S.; employers nevertheless continue to include noncompete clauses in employment contracts with low-wage workers. We survey (...) states’ attempts to regulate the use of (even unenforceable) noncompetes and argue that current legislation is ineffective at preventing employers from including noncompetes in low-wage worker contracts. We argue that employers’ use of (even unenforceable) noncompete agreements with low-wage workers is wrongfully exploitative of those workers, and we provide suggestions for how states can effectively regulate the use of noncompetes, and thus protect low-wage workers from exploitation, using Virginia’s recently passed noncompete bill as a model. (shrink)

This article develops a detailed, empirically driven analysis of the nature of the transition costs incurred in becoming disabled. Our analysis of the complex nature of these costs supports the claim that it can be wrong to cause disability, even if disability is just one way of being different. We also argue that close attention to the nature of transition costs gives us reason to doubt that well-being, including transitory impacts on well-being, is the only thing that should determine the (...) wrongness of causing or removing disability. Non-welfare considerations also defeat the claim that it is always wrong to cause disability. The upshot of these conclusions is that closer attention to the nature of transition costs supports disabled people who strenuously contest the assumption that their well-being is lower than nondisabled people. It also suggests that, in addition, disabled people should contest their opponents’ narrow account of how we should make ethical decisions regarding causing or failing to prevent disability. (shrink)

Abstract: In this essay I outline a radical kind of virtue theory I call exemplarism, which is foundational in structure but which is grounded in exemplars of moral goodness, direct reference to which anchors all the moral concepts in the theory. I compare several different kinds of moral theory by the way they relate the concepts of the good, a right act, and a virtue. In the theory I propose, these concepts, along with the concepts of a duty and of (...) a good life, are defined by reference to exemplars, identified directly through the emotion of admiration, not through a description. It is an advantage of the theory that what makes a good person good is not given a priori but is determined by empirical investigation. The same point applies to what good persons do and what states of affairs they aim at. The theory gives an important place to empirical investigation and narratives about exemplars analogous to the scientific investigation of natural kinds in the theory of direct reference. (shrink)

Public discourse is often caustic and conflict-filled. This trend seems to be particularly evident when the content of such discourse is around moral issues (broadly defined) and when the discourse occurs on social media. Several explanatory mechanisms for such conflict have been explored in recent psychological and social-science literatures. The present work sought to examine a potentially novel explanatory mechanism defined in philosophical literature: Moral Grandstanding. According to philosophical accounts, Moral Grandstanding is the use of moral talk to seek social (...) status. For the present work, we conducted six studies, using two undergraduate samples (Study 1, N = 361; Study 2, N = 356); a sample matched to U.S. norms for age, gender, race, income, Census region (Study 3, N = 1,063); a YouGov sample matched to U.S. demographic norms (Study 4, N = 2,000); and a brief, one-month longitudinal study of Mechanical Turk workers in the U.S. (Study 5, Baseline N = 499, follow-up n = 296), and a large, one-week YouGov sample matched to U.S. demographic norms (Baseline N = 2,519, follow-up n = 1,776). Across studies, we found initial support for the validity of Moral Grandstanding as a construct. Specifically, moral grandstanding motivation was associated with status-seeking personality traits, as well as greater political and moral conflict in daily life. (shrink)

This paper argues that an emotion is a state of affectively perceiving its intentional object as falling under a "thick affective concept" A, a concept that combines cognitive and affective aspects in a way that cannot be pulled apart. For example, in a state of pity an object is seen as pitiful, where to see something as pitiful is to be in a state that is both cognitive and affective. One way of expressing an emotion is to assert that the (...) intentional object of the emotion falls under the thick affective concept distinctive of the emotion. I argue that the most basic kind of moral judgment is is this category. It has the form "That is A" (pitiful, contemptible, rude, etc.). Such judgments combine the features of cognitivism and motivational judgment internalism, an advantage that explains why we find moral weakness problematic in spite of its ubiquity. I then outline a process I call "thinning" the judgment, which explains how moral strength, weakness, and apathy arise. I argue that this process is necessary for moral reasoning and communication, in spite of its disadvantage in disengaging the agent's motivating emotion from the judgment. (shrink)

This chapter describes the potential far‐reaching consequences of contemplative higher education for the fields of science and medicine.

There is growing interest in the use of technology to enhance the tracking and quality of clinical information available for patients in disaster settings. This paper describes the design and evaluation of the Wireless Internet Information System for Medical Response in Disasters (WIISARD).

Results: We analyzed 1,402 surveys and 15 in-depth interviews. Many (32%) CL participants reported greater difficulty refilling medications and a minority (14%) reported greater difficulty accessing HIV care during the pandemic. Most (99%) Opt4Mamas participants reported no difficulty refilling medications or accessing HIV/pregnancy care. Among the CL participants, older women were less likely (aOR = 0.95, 95% CI: 0.92–0.98) and women with more children were more likely (aOR = 1.13, 95% CI: 1.00–1.28) to report difficulty refilling medications. Only 2% of (...) CL participants reported greater difficulty managing FP and most (95%) reported no change in likelihood of using FP or desire to get pregnant. Qualitative analysis revealed three major themes: (1) adverse organizational/economic implications of the pandemic, (2) increased importance of pregnancy prevention during the pandemic, and (3) fear of contracting COVID-19. (shrink)

Stephen L. Pepper argues that lawyers and clients often act together in ways that their moral convictions would prevent them from acting individually. In an attempt to address this problem, I explore the nature of the attorney's responsibility to help her client reach autonomous decisions. To do this, I review the work of some prominent medical ethicists on a parallel to Pepper's problem in doctor-patient relationships.

Abstract In light of the complexity of unfolding disasters, the diversity of rapidly evolving events, the enormous amount of generated information, and the huge pool of casualties, emergency responders (ERs) may be overwhelmed and in consequence poor decisions may be made. In fact, the possibility of transporting the wounded victims to one of several hospitals and the dynamic changes in healthcare resource availability make the decision process more complex. To tackle this problem, we propose a multicriteria decision support service, based (...) on the Analytic Hierarchy Process (AHP) method, that aims to avoid overcrowding and outpacing the capacity of a hospital to effectively provide the best care to victims by finding out the most appropriate hospital that meets the victims’ needs. The proposed approach searches for the most appropriate healthcare institution that can effectively deal with the victims’ needs by considering the availability of the needed resources in the hospital, the victim’s wait time to receive the healthcare, and the transfer time that represents the hospital proximity to the disaster site. The evaluation and validation results showed that the assignment of hospitals was done successfully considering the needs of each victim and without overwhelming any single hospital. (shrink)

Understanding the autonomic nervous system and homeostatic changes associated with emotions remains a major challenge for neuroscientists and a fundamental prerequisite to treat anxiety, stress, and emotional disorders. Based on recent publications, the inter-relationship between respiration and emotions and the influence of respiration on autonomic changes, and subsequent widespread membrane potential changes resulting from changes in homeostasis are discussed. We hypothesize that reversing homeostatic alterations with meditation and breathing techniques rather than targeting neurotransmitters with medication may be a superior method (...) to address the whole body changes that occur in stress, anxiety, and depression. Detrimental effects of stress, negative emotions, and sympathetic dominance of the autonomic nervous system have been shown to be counteracted by different forms of meditation, relaxation, and breathing techniques. We propose that these breathing techniques could be used as firstline and supplemental treatments for stress, anxiety, depression, and some emotional disorders. (shrink)

Respiration influences various pacemakers and rhythms of the body during inspiration and expiration but the underlying mechanisms are relatively unknown. Understanding this phenomenon is important, as breathing disorders, breath holding, and hyperventilation can lead to significant medical conditions. We discuss the physiological modulation of heart rhythm, blood pressure, sympathetic nerve activity, EEG, and other changes observed during inspiration and expiration. We also correlate the intracellular mitochondrial respiratory metabolic processes with real-time breathing and correlate membrane potential changes with inspiration and expiration. (...) We propose that widespread minor hyperpolarization occurs during inspiration and widespread minor depolarization occurs during expiration. This depolarization is likely a source of respiratory drive. Further knowledge of intracellular and extracellular ionic changes associated with respiration will enhance our understanding of respiration and its role as a modulator of cellular membrane potential. This could expand treatment options for a wide range of health conditions, such as breathing disorders, stress-related disorders, and further our understanding of the Hering–Breuer reflex and respiratory sinus arrhythmia. (shrink)

Pranayamic breathing, defined as a manipulation of breath movement, has been shown to contribute to a physiologic response characterized by the presence of decreased oxygen consumption, decreased heart rate, and decreased blood pressure, as well as increased theta wave amplitude in EEG recordings, increased parasympathetic activity accompanied by the experience of alertness and reinvigoration. The mechanism of how pranayamic breathing interacts with the nervous system affecting metabolism and autonomic functions remains to be clearly understood. It is our hypothesis that voluntary (...) slow deep breathing functionally resets the autonomic nervous system through stretchinduced inhibitory signals and hyperpolarization currents propagated through both neural and non-neural tissue which synchronizes neural elements in the heart, lungs, limbic system and cortex. During inspiration, stretching of lung tissue produces inhibitory signals by action of slowly adapting stretch receptors (SARs) and hyperpolarization current by action of fibroblasts. Both inhibitory impulses and hyperpolarization current are known to synchronize neural elements leading to the modulation of the nervous system and decreased metabolic activity indicative of the parasympathetic state. In this paper we propose pranayama’s physiologic mechanism through a cellular and systems level perspective,involving both neural and non-neural elements. This theoretical description describes a common physiological mechanism underlying pranayama and elucidate the role of the respiratory and cardiovascular system on modulating the autonomic nervous system. Along with facilitating the design of clinical breathing techniques for the treatment of autonomic nervous system and other disorders, this model will also validate pranayama as a topic requiring more research. (shrink)