The authors describe the ethical considerations underlying the inclusion of mental health services into a prioritized health care system. The Oregon Health Plan is a process for defining and delivering basic health services to an entire state. As the plan was developed, the mental health community needed to decide whether or not to participate in the process and, if so, how. Lengthy discussions among mental health consumers, family members, and providers led to a strategy that emphasized the integration of mental (...) health and chemical dependency services into a comprehensive and universal health care program. This approach appears to have achieved relative parity for mental health. (shrink)

Name der Zeitschrift: Frühmittelalterliche Studien Jahrgang: 47 Heft: 1 Seiten: 369-378.

Clinicians, operating within complex systems, make mistakes, as people do in every human endeavor, and when they do, patients are sometimes harmed. One important question is how we as clinicians can find resolution in the wake of an error. The published literature has divided errors into those caused by “systems” and by “individuals.” But whereas both “systems” and “individual” approaches are important in understanding the cause of an error, neither alone can fully lead to resolution once an error has occurred. (...) Instead, both are necessary to understand, resolve, and prevent errors. (shrink)

In THE MISSING MOMENT a distinguished molecular biologist explores the nature of time and argues for a radical rethinking of how time affects our sense of self, our mortality, and the future of science and medicine. Only in the past few years have we learned enough about the brain for this remarkable book to be written. We know now that our brains continually filter the present through memories and emotions of the past. In fact, strictly speaking, we live in the (...) past: since it takes the brain a second to process perceptions, what we think is the present actually happened a second ago. We also know where and how the unconscious operates and how painful memories are repressed; repression is not a psychological defect but an evolutionary necessity for our species. All thought, even the most rational, is permeated with unconscious feelings, fears, and emotions. Scientists, like the rest of us, make choices for reasons they don't understand. Thus the direction of scientific research is driven by private demons, not public needs. We can see this in medical science, where doctors develop the tools to diagnose genetic diseases they cannot cure, bringing pain rather than comfort to patients. Today science can do more good than ever before, and it can also do more harm. The time has come for scientists and others to abandon the notion that there is any such thing as the disinterested pursuit of truth. Instead, they must strive for a therapeutic self-awareness of their unconscious agendas and work for larger goals than personal immortality. (shrink)

The perceived support of supernatural agents has been historically, ethnographically, and theoretically linked with confidence in engaging in violent intergroup conflict. However, scant experimental investigations of such links have been reported to date, and the extant evidence derives largely from indirect laboratory methods of limited ecological validity. Here, we experimentally tested the hypothesis that perceived supernatural aid would heighten inclinations toward coalitional aggression using a realistic simulated coalitional combat paradigm: competitive team paintball. In a between-subjects design, US paintball players recruited (...) for the study were experimentally primed with thoughts of supernatural support using a guided visualization exercise analogous to prayer, or with a control visualization of a nature scene. The participants then competed in a team paintball battle game modeled after “Capture the Flag.” Immediately before and after the battle, participants completed surveys assessing confidence in their coalitional and personal battle performance. Participants assessed their coalition’s prospects of victory and performance more positively after visualizing supernatural aid. Participants primed with supernatural support also reported inflated assessments of their own performance. Importantly, however, covarying increases in assessments of their overall coalition’s performance accounted for the latter effect. This study provided support for the hypothesis that perceived supernatural support can heighten both prospective confidence in coalitional victory and retrospective confidence in the combat performance of one’s team, while highlighting the role of competitive play in evoking the coalitional psychology of intergroup conflict. These results accord with and extend convergent prior findings derived from laboratory paradigms far removed from the experience of combat. Accordingly, the field study approach utilized here shows promise as a method for investigating coalitional battle dynamics in a realistic, experientially immersive manner. (shrink)

Originally published: c2000. With new pref. An award-winning biologist argues that the intersection of scientific creativity and religious insight is a prerequisite for the emergence of a more humane medical science.

This volume presents a colourful and entertaining overview of German intellectual history by a central figure in its development. Heinrich Heine, famous poet, journalist, and political exile, studied with Hegel and was personally acquainted with the leading figures of the most important generation of German writers and philosophers. In his groundbreaking History he discusses the history of religion, philosophy, and literature in Germany up to his time, seen through his own highly opinionated, politically aware, philosophically astute, and always ironic perspective. (...) This work, and other writings focussing especially on Heine's rethinking of Hegel's philosophy, are presented here in a new translation by Howard Pollack-Milgate. The volume also includes an introduction by Terry Pinkard which examines Heine both in relation to Hegel and Nietzsche and as a thinker in his own right. (shrink)

Take memorable photos of the most popular attractions in the Big Apple! Whether using a point-and-shoot or a high-end dSLR, this companion guide provides you with detailed information for taking amazing shots of one of one of the world's most photographed cities. Whether you aim to capture the regal Empire State Building, vibrant Times Square, historic Grand Central Station, massive Central Park, or one of New York City's many other landmarks, this portable resource goes where you go and walks you (...) through valuable tips and techniques for taking the best shot possible. You'll discover suggested locations for taking photos, recommended equipment, what camera settings to use, best times of day to photograph specific attractions, how to handle weather challenges, and more. In addition, beautiful images of New York City's most breathtaking attractions and recognizable landmarks serve to both inspire and assist you as you embark on an amazing photographic adventure! Elevates your photography skills to a new level with photography secrets from professional photographer and SmugMug COO, Andy Williams Presents clear, understandable tips and techniques that span all skill levels, using all types of digital cameras, from full-featured compact cameras to high end DSLRs Features New York City's main attractions in alphabetical order as well as thumb tabs on the pages so you can quickly and easily access the information you are looking for Shares detailed information and insight on critical topics, such as ideal locations to photograph from, the best time of day to shoot, camera equipment to have handy, weather conditions, and optimal camera settings to consider Whether you're a local familiar with the territory or a visitor seeing the Big Apple for the first time, this handy guide will help you capture fantastic photos! (shrink)

This paper contributes to the foundations of a theory of rational choice for artificial agents in dynamic environments. Our work is developed within a theoretical framework, originally due to Bratman, that models resource-bounded agents as operating against the background of some current set of intentions, which helps to frame their subsequent reasoning. In contrast to the standard theory of rational choice, where options are evaluated in isolation, we therefore provide an analysis of situations in which the options presented to an (...) agent are evaluated against a background context provided by the agent’s current plans—commitments to future activities, which may themselves be only partially specified. The interactions between the new options and the background context can complicate the task of evaluating the option, rendering it either more or less desirable in context than it would have been in isolation.  2001 Elsevier Science B.V. All rights reserved. (shrink)

The Affordable Care Act is an essential first step toward making health insurance more affordable for lower and moderate income Americans. It has accomplished historic reductions in the proportion of Americans who are uninsured. The number of Americans reporting delaying medical care for financial reasons has declined by approximately one-third since 2010. Medicaid expansions, in particular, have significantly reduced financial burdens and accompanying anxieties experienced by low-income Americans in states that have embraced this opportunity. Consistent with these finding, one recent (...) analysis of credit report data finds that Medicaid expansion was associated with between a $600 and $1000 decline in collection balances among individuals who gained coverage. Notwithstanding these gains, premiums and cost-sharing are still too high for many Americans. And cost-sharing has continued to edge higher for the majority of Americans who have coverage through employer-based plans. Measures to address these challenges must build on the ACA to provide greater protection to millions of Americans and to address continued dissatisfaction with our health care financing system among middle-income Americans. (shrink)

It would seem, on the surface, logical that entrepreneurs would treat stakeholders with honesty and respect. However, this is not always the case—at times, entrepreneurs lie to stakeholders in order to take a step closer to achieving legitimacy. It is these legitimacy lies that are the focus of the current work. Overall, while we know that legitimacy lies are told, we know very little about the psychological processes at work that may make it more likely for someone to tell a (...) legitimacy lie. Thus, we theorize about the pressure to pursue legitimacy, the situational and individual factors that affect this pursuit, as well as how this context can lead to moral disengagement and the telling of legitimacy lies. Our theorizing advances the existing literature and provides a dynamic framework by which future research can delve more deeply into the nuanced context that breeds the escalation of legitimacy lies. (shrink)