Clark & Thornton's type-1/-2 distinction is not well-defined. The classes of type-1 and type-2 problems are too broad: many nocomputable functions are type-1 and type-2 learnable. They are also too narrow: trivial functions, such as identity, are neither type-1 nor type-2 learnable. Moreover, the scope of type-1 and type-2 problems appears to be equivalent. Overall, this distinction does not appear useful for machine learning or cognitive science.

This article explores through the lens of Type 1 Diabetes what a body in fluctuation feels, and what kind of ecosystem has to be recreated to be able to survive, an ecosystem made of sensations, senses, sensors and more. It investigates the complexity of relying on sensations that appear or disappear, on other beings that have their own agendas, or on machines that could help or kill. It describes the fear of feeling estranged from one’s ‘extended body’ when it (...) functions alone, it tracks the experience of low blood sugar through the memory of the body or the instruments left in its surroundings. It is a story about the fiction of bodily integrity, of the combat between life and death, and of the impossibility of controlling the texture of life. (shrink)

We study type 1 premice equipped with supercomplete extenders. In this paper, we show that such premice are normally iterable and all normal iteration trees of type 1 premice has a unique cofinal branch. We give a construction of an KC type model using supercomplete type 1 extenders.

Many critics of dual-process models have mistaken long lists of descriptive terms in the literature for a full-blown theory of necessarily co-occurring properties. These critiques have distracted attention from the cumulative progress being made in identifying the much smaller set of properties that truly do define Type 1 and Type 2 processing. Our view of the literature is that autonomous processing is the defining feature of Type 1 processing. Even more convincing is the converging evidence that the (...) key feature of Type 2 processing is the ability to sustain the decoupling of secondary representations. The latter is a foundational cognitive requirement for hypothetical thinking. (shrink)

The present study investigates the association between diabetes-related distress and work outcomes among employed people with type 1 diabetes. Employed adults with type 1 diabetes completed an online survey. Measures assessed emotional, social, food- and treatment-related DD, burnout, and job satisfaction, as well as the type of insulin treatment. We conducted multiple regression analyses to test our hypotheses. Emotional DD was significantly and positively associated with burnout. Social DD was significantly and negatively associated with job satisfaction. The (...) type of treatment had no significant effect on the outcomes. This study sets the stage for research on the interactions between working conditions, work outcomes and illness symptoms, and problems of people with type 1 diabetes, and, generally, employees with chronic illnesses. The findings have implications for individual health and illness management, burnout prevention, and occupational health measures. (shrink)

We refine the definition of II-computability of [12] so that oracles have a “consistent”, but natural, behaviour. We prove a Kleene Normal Form Theorem and closure of semi-recursive relations under ∃1. We also show that in this more inclusive computation theory Post's theorem in the arithmetical hierarchy still holds.

Increasing ethical attention and debate is focusing on whether individuals who take part in clinical trials should be given access to post-trial care. However, the main focus of this debate has been upon drug trials undertaken in low-income settings. To broaden this debate, we report findings from interviews with individuals (n = 24) who participated in a clinical trial of a closed-loop system, which is a medical device under development for people with type 1 diabetes that automatically adjusts blood (...) glucose to help keep it within clinically recommended ranges. Individuals were recruited from UK sites and interviewed following trial close-out, at which point the closed-loop had been withdrawn. While individuals were stoical and accepting of the requirement to return the closed-loop, they also conveyed varying degrees of distress. Many described having relaxed diabetes management practices while using the closed-loop and having become deskilled as a consequence, which made reverting back to pre-trial regimens challenging. Participants also described unanticipated consequences arising from using a closed-loop. As well as deskilling, these included experiencing psychological and emotional benefits that could not be sustained after the closed-loop had been withdrawn and participants reevaluating their pre- and post-trial life in light of having used a closed-loop and now perceiving this life much more negatively. Participants also voiced frustrations about experiencing better blood glucose control using a closed-loop and then having to revert to using what they now saw as antiquated and imprecise self-management tools. We use these findings to argue that ethical debates about post-trial provisioning need to be broadened to consider potential psychological and emotional harms, and not just clinical harms, that may result from withdrawal of investigated treatments. We also suggest that individuals may benefit from information about potential nonclinical harms to help make informed decisions about trial participation. (shrink)

Traditional theory of mind (ToM) accounts for social cognition have been at the basis of most studies in the social cognitive neurosciences. However, in recent years, the need to go beyond traditional ToM accounts for understanding real life social interactions has become all the more pressing. At the same time it remains unclear whether alternative accounts, such as interactionism, can yield a sufficient description and explanation of social interactions. We argue that instead of considering ToM and interactionism as mutually exclusive (...) opponents, they should be integrated into a more comprehensive account of social cognition. We draw on dual process models of social cognition that contrast two different types of social cognitive processing. The first type (labeled Type 1) refers to process es that are fast, efficient, stimulus-driven, and relatively inflexible. The second type (labeled Type 2) refers to processes that are relatively slow, cognitively laborious, flexible, and may involve conscious control. We argue that while interactionism captures aspects of social cognition mostly related to Type 1 processes, ToM is more focused on those based on Type 2 processes. We suggest that real life social interactions are rarely based on either Type 1 or Type 2 processes alone. On the contrary, we propose that in most cases both types of processes are simultaneously involved and that social behavior may be sustained by the interplay between these two types of processes. Finally, we discuss how the new integrative framework can guide experimental research on social interaction. (shrink)

Children diagnosed with type 1 diabetes mellitus (T1DM) are at risk for neurocognitive sequelae, including impaired attention functioning. The specific nature of the cognitive deficit varies; current literature underscores early age of diabetes diagnosis and increased disease duration as primary risk factors for this neurocognitive decline. Forty-three children with T1DM were evaluated for Attention Deficit/Hyperactivity Disorder (ADHD) symptomatology using the MOXO continuous performance test (MOXO-CPT) performed during a routine outpatient evaluation. The study cohort demonstrated a significant decline in all (...) four domains of attention functioning. The effect was most pronounced with early age at T1DM diagnosis, a longer disease duration and with poorer glycemic control (represented by higher HbA1c values). With increased disease duration (of 5 plus years), acute hyperglycemia was associated with inattention in the real-time setting. These findings highlight the need for routine screening of neurocognitive function in children with T1DM so that early intervention can be employed during this crucial period of cognitive development. (shrink)

Spinal muscular atrophy (SMA) type 1 is a genetic neuromuscular disease in children that leads to degeneration of spinal cord motor neurons. This sometimes results in severe muscular paralysis requiring mechanical ventilation to sustain the child’s life. The onset of SMA type 1, the most severe form of the disease, is during the first year of life. These children become severely paralysed, but retain their intellectual capacity. Ethical concerns arise when mechanical ventilation becomes necessary for survival. When professionals (...) assess the resulting life for the child and family, they sometimes fear it will result in unreasonably excessive care. The aim of this article is to present an analysis of ethical arguments that could support or oppose the provision of invasive ventilation in this population. This examination is particularly relevant as France is one of the few countries performing tracheotomies and mechanical ventilation for this condition. (shrink)

BackgroundThe transplantation of porcine islet cells provides a new potential therapy to treat patients with type 1 diabetes mellitus (T1DM). Compared to other biomedical technologies, xenotransplantation stands out in terms of its involvement of animals as graft sources, as well as the possible transmission of infectious diseases. As these aspects are especially relevant for potential xenotransplantation recipients, it is important to assess their opinion regarding this technology, in particular in terms of the requirements that should be met in the (...) informed consent process for xenotransplantation.MethodsWe conducted qualitative interviews with seven T1DM patients to assess their information needs prior to xenotransplantation. Before the interview, the participants received a model informed consent form for a clinical trial with porcine islet cells transplantation. The interviews were transcribed and analysed using qualitative content analysis.ResultsIn the interviews, we identified several requirements that are crucial for patients with T1DM in order to consider xenotransplantation as a potential treatment option: therapy-related requirements, professional care and supervision, successful behaviour and attitude management, improving quality of life, and managing control/self-determination challenges. Regarding the informed consent form, several of the participants’ questions remained open and should be addressed in more detail. The interviewees stressed the importance of personal consultations.ConclusionsTo become a sustainable therapeutic option, patients especially expected an improved diabetes control and a reduction of diabetes-related burdens. Health-related aspects prove to be pivotal for diabetic patients when considering porcine islet cell transplantation. The use of pigs as source for organ retrievals was not considered as problematic. (shrink)

Neurofibromatosis type 1 is associated with peripheral and central nervous system tumors. It is noteworthy that the regions in which these tumors frequently arise are the optic pathways and the brainstem. Thus, we decided to trace the procedure of diffusion Magnetic Resonance Imaging alterations along with Short-Wavelength Automated Perimetry examinations of the OPs after surgery and chemotherapy over 1 year, which enabled us to evaluate chemotherapy's efficacy in an NF1 patient with an OP tumor. In this study, a 25-year-old (...) woman with NF1 and left optic radiation glioma underwent surgery to remove the glioma. Immunohistochemistry revealed a Pilocytic Astrocytoma WHO grade I. Post-operation chemotherapy done using nine treatment cycles of administering Temozolomide for 5 days every 4 weeks. Applying the region of interest differential tractography method and SWAP four times every 3 months allowed us to follow the patient's visual acuity alterations longitudinally. The differential deterministic tractography method and statistical analyses enabled us to discover the white matter tracts anisotropy alterations over time. Furthermore, statistical analyses on the SWAP results along time illustrated possible alterations in visual acuity. Then, we could compare and associate the findings with the SWAP examinations and patient symptoms longitudinally. Statistical analyses of SWAP tests revealed a significant improvement in visual fields, and longitudinal differential tractography showed myelination and dense axonal packing in the left OR after 1 year of treatment. In this study, we examined an old hypothesis suggesting that chemotherapy is more effective than radiotherapy for NF1 patients with OP gliomas because of the radiation side effects on the visual field, cognition, and cerebrovascular complications. Our longitudinal clinical case study involving dMRI and SWAP on a single NF1-OPG patient showed that chemotherapy did not suppress the OP myelination over time. However, it should be noted that this is a clinical case study, and, therefore, the generalization of results is limited. Future investigations might focus on genetic-based imaging, particularly in more cases. Further, meta-analyses are recommended for giving a proper Field Of View to researchers as a subtle clue regarding precision medicine. (shrink)

There are approximately one million cases oftype 1 diabetes in the US, and the incidenceis increasing worldwide. Given that two-thirdsof cases present in childhood, it is criticalthat prediction and prevention research involvechildren. In this article, I examine whethercurrent research methodologies conform to theethical guidelines enumerated by the NationalCommission for the Protection of Human Subjectsof Biomedical and Behavioral Research, andadopted into the federal regulations thatprotect research subjects. I then offer twopolicy recommendations to help researchersdesign studies that conform to these ethicalrequirements.

Narcolepsy type 1 deeply impacts on quality of life, especially during adolescence, with NT1 children and adolescents that frequently report difficulties in integration with peers and decreased participation in after-school activities. Here we describe the case of NT1 teenager girl presenting with severe physical and social withdrawal, fulfilling the proposed diagnostic criteria for hikikomori, together with the classic NT1 symptoms. Social withdrawal is an overlooked phenomenon among NT1 children and adolescents that, if present, require a multidisciplinary approach and personalized (...) interventions, but patients can benefit from NT1 pharmacological treatment. (shrink)

Health innovation is mainly envisioned in direct connection to medical research institutions or pharmaceutical and technology companies. Yet, these types of innovation often do not meet the needs and expectations of individuals affected by health conditions. With the emergence of digital health technologies and social media, we can observe a shift, which involves people living with illness modifying and improving medical and health devices outside of the formal research and development sector, figuring both as users and innovators. This patient‐led innovation (...) has been celebrated in innovation studies and economics as a “bottom‐up” type of innovation. In this article, we take a closer look at open‐source patient‐led innovation in the context of type 1 diabetes care. In our inquiry, we pay particular attention to the social and ethical dimensions of this innovation, building on empirical material. Upon exploring the notion of patient‐led innovation and its socio‐political context through the lens of intersectional and global health justice, we argue that a proactive strategy is needed to ensure that open‐source patient‐led innovation will be more globally accessible, center the health needs of the most underserved populations, as well as facilitate equitable and just health benefits. To support this aim, we provide a range of examples of different initiatives addressing the persistent inequalities that have so far inhibited patient‐led innovation from more fully materializing its innovative potential. (shrink)

The paper builds on a simply typed term system ${\cal PR}^\omega $ providing a notion of partial primitive recursive functional on arbitrary Scott domains $D_\sigma$ that includes a suitable concept of parallelism. Computability on the partial continuous functionals seems to entail that Kleene's schema of higher type simultaneous course-of-values recursion (SCVR) is not reducible to partial primitive recursion. So an extension ${\cal PR}^{\omega e}$ is studied that is closed under SCVR and yet stays within the realm of subrecursiveness. The (...) twist are certain type 1 Gödel recursors ${\cal R}_k$ for simultaneous partial primitive recursion. Formally, the value ${\cal R}_k\vec{g}\vec{H} x i$ is a function $f_i$ of type $\iota \to \iota$ , however, ${\cal R}_k$ is modelled such that $f_i$ is a finite element of $D_{\iota\to\iota}$ or in other words, a partial sequence. It is shown that the Ackermann function is not definable in ${\cal PR}^{\omega e}$. (shrink)

Advances in genomic medicine have lead to debate about the potential inclusion of genetic tests for susceptibility to common complex disorders in newborn screening programmes. Empirical evidence concerning psychosocial reactions to genetic testing is a crucial component of both ethical debate and policy development, but while there has been much speculation concerning the possible psychosocial impact of screening newborns for genetic susceptibilities, there remains a paucity of data. The aim of the study reported here is to provide some of this (...) missing empirical evidence, using type 1 diabetes as an example of a common disorder with multiple significant genetic contributors to its aetiology. Semi-structured interviews were conducted with 11 parents of babies who had received increased risk results in a study that involved newborn screening for genetic susceptibility to type 1 diabetes. Interpretative phenomenological analysis was used to evaluate the data. The interview data suggest that the probabilistic nature of results of genetic susceptibility tests impacts upon all aspects of parents' psychosocial reactions, resulting in a complex and dynamic process quite different to that described in relation to current newborn screening programmes. While parents generally reported fairly minor levels of concern in response to news of their child's increased genetic risk, these worries frequently recurred, and perception of risk also varied and fluctuated over time. Both individual and contextual factors appeared to interact with the inherent uncertainty of the test result to contribute to the dynamic nature of parental reactions, and their behavioural responses. The implications of these findings for future research and for the debate concerning potential expansion of newborn screening are discussed. (shrink)

Falls are frequent in Myotonic Dystrophy type 1, but the pathophysiology of the balance impairment needs further exploration in this disease. The current work aims to provide a richer understanding of DM1 imbalance. Standing balance in 16 patients and 40 controls was tested in two posturographic tests. In the Sensory Organization Test, standstill balance was challenged by combining visual and environmental conditions. In the “react” test, reflexes induced by sudden shifts in the support base were studied. Oscillations of the (...) body centre of mass were measured. In the SOT, COM sway was larger in patients than controls in any condition, including firm support with eyes open. On sway-tuned support, COM oscillations when standing with closed eyes were larger in patients than controls even after taking into account the oscillations with eyes open. In the “react” paradigm, balance reflexes were delayed in patients. Results in both experimental paradigms are consistent with leg muscle weakness. This, however, is not a sufficient explanation. The SOT test highlighted that patients rely on vision more than controls to maintain static balance. Consistently enough, evidence is provided that an impairment of proprioceptive and vestibular systems contributes to falls in DM1. Rehabilitation programs targeted at reweighting sensory systems may be designed to improve safe mobility in DM1. (shrink)

People are using innovative internet of things technologies to gain individualised management of their type 1 diabetes. The #WeAreNotWaiting movement supports them to build their own hybrid closed loop systems and access their real time blood sugar data via any web connected device. A small number of parents in Australia use such DIY looping systems to manage their child’s type 1 diabetes, but these systems have not been approved by the Therapeutic Goods Administration in Australia, creating ethical dilemmas (...) for clinicians about how to respond to the use of medical devices that are not registered on the Australian Register of Therapeutic Goods. This article considers whether the use of DIY looping is in the best interests of the child and, if not, whether intervention in parental decision making is justified to prevent harm to the child. It addresses the ongoing duty of healthcare professionals to provide care to children who are ‘looping.’ Reference is made to findings from a study, Personalised Closed Loop Systems for Childhood Diabetes, to illustrate stakeholders’ perceptions of benefits and harms of DIY looping systems. I conclude that the decision of parents to use DIY looping technology could be considered to be in a child’s best interests, broadly defined, and falls within the Zone of Parental Discretion, however healthcare practitioners who support parents may have professional concerns in doing so. (shrink)

In this article, we use noise as a metaphor for the overload of information – embodied, technological and online social – that characterizes life with type 1 diabetes. Noise illustrates embodied sensations of fluctuating blood glucose, measurement problems and alarms from digital self-care devices and irrelevant or emotionally disturbing posts on Facebook. Attunement is crucial to the quality of self-care achieved by individuals and comprises: (1) developing skills to receive clear signals from the body, (2) adjusting and individualizing self-care (...) technologies to bodies and daily lives and (3) discerning appropriate distracting and unhelpful self-care information. Ideally, life with type 1 diabetes is harmonious, with clear messages from bodies, technologies and Facebook that enable better self-care. (shrink)

The common autoimmune disease type 1 diabetes provides a paradigm for the genetic analysis of multifactorial disease. Disease occurrence is attributable to the interaction with the environment of alleles at many loci interspersed throughout the genome. Their mapping and identification is difficult because the disease-associated alleles occur almost as commonly in patients as in healthy individuals; even the highest-risk genotypes bestow only modest risks of disease. The identification of common quantitative trait loci (QTL) in autoimmune disease and in other (...) common disorders, therefore,requires a very close marriage of genetics and biology. Two QTLs have been identified in human type 1 diabetes: the major histocompatibility complex HLA class II loci and a promoter polymorphism of the insulin gene. The evidence for their primary roles in disease aetiology demonstrates the necessity of combined studies of genetics and biology. Their functions and interaction underpin an emerging picture of the basic causes of the disease and direct analyses towards other candidate genes and pathways. The genetic tools used for QTL identification include transgenesis and gene knockouts, whole genome scanning for linkage, mouse congenic strains, linkage disequilibrium mapping, and the establishment of ancestral haplotypes among disease-associated chromosomes. BioEssays 1999;21:164–174. © 1999 John Wiley & Sons, Inc. (shrink)

Due to the potential ethical and psychological implications of screening, and especially inregard of screening on children without available and acceptable therapeutic measures, there is a common view that such procedures are not advisable. As part of an independent research- and bioethical case study, our aim was therefore to explore and describe bioethical issues among a representative sample of participant families (n = 17,055 children) in the ABIS (All Babies In South-east Sweden) research screening for Type 1 diabetes (IDDM).The (...) primary aim is the identification of risk factors important for the development of diabetes and other multifactorial immune-mediated diseases. Four hundred, randomly chosen, participant mothers were asked to complete a questionnaire exploring issues of information, informed consent, bio-material, confidentiality and autonomy, and of prevention/intervention. 293 completed the questionnaire, resulting in a response rate of 73.3%. The majority of questions had the form of 6-point Likert-type response scales (1–6).We found that the majority of respondents felt calm in regard of samples and written material, and also concerning the possibility of their child in the future being identified as having high risk of developing Type 1 diabetes. An important finding concerning access and control of mainly biological data was indicated, with the respondents expressing concern for potential future use. We believe our findings indicate that this kind of empirical studies can substantially contribute to our understanding of bioethical issues of medical research involving genetics. Issues, such as safeguards ensuring theethical criteria of autonomy and respect, were emphasised by our respondents. We believe theissues brought up may promote further discussion, and do suggest issues for consideration by, among others, researchers, bioethicists and Institutional Review Boards. (shrink)

Summary Background. Aims. Sample. Method. Results. Conclusion. The paper considers aberrant behaviour in the context of cognitive style with reference to both diagnosis and treatment. The aims of the study were to investigate whether the style of pupils with behaviour problems was different from that of children with no reported problems, and also to consider how pupils of different style manifested their problem behaviours. The sample comprised 83 male pupils aged 10?18 years from two residential special schools. The sample were (...) given the Cognitive Styles Analysis to assess their positions on the Wholist?Analytic and Verbal?Imagery style dimensions. The pupil records of the special school pupils who were at the extreme of the style dimensions were also examined. When their style characteristics were contrasted with a Comparison Sample of 413 12?16?year?old males attending 10 secondary schools, the special school pupils had a significantly higher proportion of both Wholists and Verbalisers, than the Comparison Group. Further, the inspection of the records indicated that the types of social behaviour and behaviour problems exhibited varied with style, and particularly on the Wholist?Analytic dimension. The results were considered to have implications for the origins and treatment of problem behaviour. (shrink)

Summary This study was conducted in Slovenia, and explored the views of a sample of 226 pupils (aged 14?15 years) regarding their motivation to learn English and the views of a sample of 95 student teachers regarding their motivation to become a teacher of English. The data consisted of two questionnaires. The first questionnaire asked the pupils to rate the importance of each of 15 reasons for wanting to learn English. The most frequent reasons given by pupils were ?Because English (...) is an international language?, ?Because English helps me with advanced study? and ?Because English will help me with my future career?. The second questionnaire asked the student teachers to rate the importance of each of 20 reasons in influencing their decision to become a teacher of English. The most frequent reasons given by the student teachers were ?I enjoy the subject I will teach?, ?English is important to me? and ?I want to help children succeed?. The findings are further explored in terms of the relative importance of the different types of motivation involved. (shrink)

Due to the potential ethical and psychological implications of screening, and especially inregard of screening on children without available and acceptable therapeutic measures, there is a common view that such procedures are not advisable. As part of an independent research- and bioethical case study, our aim was therefore to explore and describe bioethical issues among a representative sample of participant families (n = 17,055 children) in the ABIS (All Babies In South-east Sweden) research screening for Type 1 diabetes (IDDM).The (...) primary aim is the identification of risk factors important for the development of diabetes and other multifactorial immune-mediated diseases. Four hundred, randomly chosen, participant mothers were asked to complete a questionnaire exploring issues of information, informed consent, bio-material, confidentiality and autonomy, and of prevention/intervention. 293 completed the questionnaire, resulting in a response rate of 73.3%. The majority of questions had the form of 6-point Likert-type response scales (1–6).We found that the majority of respondents felt calm in regard of samples and written material, and also concerning the possibility of their child in the future being identified as having high risk of developing Type 1 diabetes. An important finding concerning access and control of mainly biological data was indicated, with the respondents expressing concern for potential future use. We believe our findings indicate that this kind of empirical studies can substantially contribute to our understanding of bioethical issues of medical research involving genetics. Issues, such as safeguards ensuring theethical criteria of autonomy and respect, were emphasised by our respondents. We believe theissues brought up may promote further discussion, and do suggest issues for consideration by, among others, researchers, bioethicists and Institutional Review Boards. (shrink)

Microsomal glucose‐6‐phosphatase catalyses the last step in liver glucose production. Glucose‐6‐phosphatase deficiency, now termed type 1 glycogen storage disease, was first described almost 40 years ago but until recently very little was known about the molecular basis of the various type 1 glycogen storage diseases. Recently we have shown that at least six different proteins are needed for normal glucose‐6‐phosphatase activity in liver. Four of the proteins have been purified and three cloned. Study of the type 1 (...) glycogen storage diseases has stimulated investigations of the mechanisms of small molecule transport across the endoplasmic reticulum membrane and demonstrated the existence of novel endoplasmic reticulum transport proteins for glucose and phosphate. (shrink)

BackgroundTo assess ethical concerns associated with participation in a financial incentive programme to help adolescents with type 1 diabetes improve diabetes self-management.MethodsFocus groups with 46 adolescents with type 1 diabetes ages 12–17 and 38 of their parents were conducted in the Seattle, Washington metropolitan area. Semistructured focus group guides addressed ethical concerns related to the use of FI to promote change in diabetes self-management. Qualitative data were analysed and emergent themes identified.ResultsWe identified three themes related to the ethical (...) issues adolescents and parents anticipated with FI programme participation. First, FI programmes may variably change pressure and conflict in different families in ways that are not necessarily problematic. Second, the pressure to share FIs in some families and how FI payments are structured may lead to unfairness in some cases. Third, some adolescents may be likely to fabricate information in any circumstances, not simply because of FIs, but this could compromise the integrity of FI programmes relying on measures that cannot be externally verified.ConclusionsMany adolescents with type 1 diabetes and their parents see positive potential of FIs to help adolescents improve their self-management. However, ethical concerns about unfairness, potentially harmful increases in conflict/pressure and dishonesty should be addressed in the design and evaluation of FI programmes. (shrink)

What is medical progress? The answer to this question is often associated with advances in diagnostic technology, with greater understanding of disease or pathological mechanisms particularly at the molecular level, or with the discovery of drugs and the developmental of surgical procedures to treat diseases. However, this facile answer can be problematic. In a New York Times Magazine article, for example, Lisa Sanders (2003) recounts a lecture delivered to her first-year class, at a "white-coat" ceremony, by the medical school dean. (...) Half of what we—the faculty—teach you—the students—is nonsense, she was told, but we don't know which half. She illustrates what the dean said, with the following change in advice for .. (shrink)

We describe an infinitary logic for metric structures which is analogous to Lω1,ω. We show that this logic is capable of expressing several concepts from analysis that cannot be expressed in finitary continuous logic. Using topological methods, we prove an omitting types theorem for countable fragments of our infinitary logic. We use omitting types to prove a two-cardinal theorem, which yields a strengthening of a result of Ben Yaacov and Iovino concerning separable quotients of Banach spaces.

This paper is a response to the opening of new lines of research on CSR and SMEs (Thompson & Smith, 1991; Spence, 1999; Moore & Smith, 2006; Spence, 2007). It seeks to explore the business case for CSR in this corporate segment. The paper, which is based on four case studies of medium-sized firms in the automotive sector, took the distinctive approach of trying to understand the nature of CSR-like activities developed not by best-in-class CSR-driven companies but by purely competitiveness-driven (...) firms. The case studies provide explicit evidence that the CSR activities of SMEs and the notion of social capital are interrelated, turning social capital into a powerful instrument to better explain what academic literature has called silent CSR practices . The analysis that follows questions some of the basic tenets that underpin the branch of business ethics that deals with the nature of SMEs' approach to CSR. Four basic concerns, which take the form of propositions for further research, serve as the basis for this analysis: a) A definition of CSR that includes most of the actions taken by all companies in the territory contributes no academic value to the discipline b) Any study of the motivation behind these CSR actions must reflect their essentially pragmatic nature. Actions are linked to social values but also, more importantly, to the nature of the competitive environment c) Business ethics must seek common ground with other more sociological disciplines if it is to explain the reasons behind this type of action d) Any study of this kind of practice requires a dual approach: a) normative when using tools developed by CSR; and b) descriptive and instrumental using the notion of social capital. (shrink)

The distinction between a type and its tokens is a useful metaphysical distinction. In §1 it is explained what it is, and what it is not. Its importance and wide applicability in linguistics, philosophy, science and everyday life are briefly surveyed in §2. Whether types are universals is discussed in §3. §4 discusses some other suggestions for what types are, both generally and specifically. Is a type the sets of its tokens? What exactly is a word, a symphony, (...) a species? §5 asks what a token is. §6 considers the relation between types and their tokens. Do the type and all its tokens share the same properties? Must all the tokens be alike in some or all respects? §7 explains some problems for the view that types exist, and some problems for the view that they don't. §8 elucidates a distinction often confused with the type-token distinction, that between a type (or token) and an occurrence of it. It also discusses some problems that occurrences might be thought to give rise to, and one way to resolve them. (shrink)

BackgroundComorbidity between diabetes mellitus and depression is highly prevalent. The risk of depression in a person with diabetes is approximately twice that of a person without this disease. Depression has a major impact on patient well-being and control of diabetes. However, despite the availability of effective and specific therapeutic interventions for the treatment of depression in people with diabetes, 50% of patients do not receive psychological treatment due to insufficient and difficult accessibility to psychological therapies in health systems. The use (...) of information and communication technologies has therefore been proposed as a useful tool for the delivery of psychological interventions, but it continues to be a field in which scientific evidence is recent and controversial. This systematic review aims to update the available information on the efficacy of psychological interventions delivered through ICTs to improve depressive symptomatology in patients with diabetes.MethodsA systematic review of the literature was performed following the PRISMA guidelines and using MEDLINE, Embase, PubMed, Web of Science, PsycINFO, Scopus, and Cochrane Library databases to search for randomized clinical trials of eHealth treatments for patients with diabetes and comorbid depression from 1995 through 2020. In addition, studies related to follow-up appointments were identified. Inclusion criteria were as follows: randomized clinical trials ; patients with type 1 and type 2 diabetes; adult population over 18 years of age; presence of depressive symptomatology assessed with standardized instruments; treatments for depression based on established psychotherapeutic techniques and principles; delivered through eHealth technologies. We did not limit severity of depressive symptomatology, delivery setting or comparison group. Two coauthors independently reviewed the publications identified for inclusion and extracted data from the included studies. A third reviewer was involved to discuss discrepancies found. The PEDro scale was used to assess the quality of the RCTs. No meta-analysis of the results was performed. The protocol used for this review is available in PROSPERO.ResultsThe initial search identified 427 relevant scientific publications. After removing duplicates and ineligible citations, a total of 201 articles were analyzed in full text. Ten articles met the criteria of this review and were included, obtaining very good scientific quality after evaluation with the PEDro scale. The main results show that the eHealth psychological intervention for depression in patients with diabetes showed beneficial effects both at the end of treatment and in the short and long term for the improvement of depressive symptomatology. The methodology used was very heterogeneous. However, all studies were based on cognitive-behavioral tools and used standardized assessment instruments to evaluate depressive symptomatology or diagnosis of MDD. Glycemic control was assessed by glycosylated hemoglobin, but no benefits were found in improving glycemic control. Only four studies included psychoeducational content on diabetes and depression, but none used tools to improve or enhance adherence to medical prescriptions or diabetes self-care.ConclusionsICT-based psychological interventions for the treatment of depression in people with diabetes appear to be effective in reducing depressive symptomatology but do not appear to provide significant results with regard to glycemic control. Nonetheless, the scientific evidence reported to date is still very limited and the methodology very diverse. In addition, no studies have implemented these systems in routine clinical practice, and no studies are available on the economic analysis of these interventions. Future research should focus on studying and including new tools to ensure improvements in diabetes outcomes and not only on psychological well-being in order to advance knowledge about these treatments. Economic evaluations should also be undertaken to analyze whether these treatment programs implemented using eHealth technologies are cost-effective. (shrink)

Commitments of “getting to zero” or becoming a regenerative company are raising investor, customer, and employee expectations at a time when businesses are struggling just to reduce negative impacts. Executives are increasingly caught between wanting to build a better world and the reality of managing value‐add activities that continue to harm people and the environment.Businesses need to distinguish between three types of innovation impacts to maintain their credibility and legitimacy. The first is doing less harm, where the goal is to (...) minimize social wrongs and reduce ecological footprints. The second is incremental positive impact, where the goal is to increase prosperity, regenerate nature, and improve wellbeing through initiatives that are typically of limited scope. The third is system‐wide positive impact, where scalable business innovations have a discernible capacity to “move the needle” on social and global challenges such as climate change and social equity.This conceptual paper provides a framework for assessing business innovations by type of impact and the high‐leverage points needed to create desired change at the scale of the whole. (shrink)