Taking the self out of self-rule

Many philosophers believe that agents are self-ruled only when ruled by their (authentic) selves. Though this view is rarely argued for explicitly, one tempting line of thought suggests that self-rule is just obviously equivalent to rule by the self. However, the plausibility of this thought evaporates upon close examination of the logic of ‘self-rule’ and similar reflexives. Moreover, attempts to rescue the account by recasting it in negative terms are unpromising. In light of these problems, this paper instead proposes that agents are self-ruled only when not ruled by others. One reason for favouring this negative social view is its ability to yield plausible conclusions concerning various manipulation cases that are notoriously problematic for nonsocial accounts of self-rule. A second reason is that the account conforms with ordinary usage. It is concluded that self-rule may be best thought of as an essentially social concept

Where is the ball? Behavioral and neural responses elicited by a magic trick

We present results from two experiments, in which subjects watched continuous videos of a professional magician repeatedly performing a maneuver in which a ball could “magically” appear under a cup. In all cases, subjects were asked to predict whether the ball would appear under the cup or not, while scalp EEG recordings were performed. Both experiments elicited strong and consistent behavioral and neural responses. In the first experiment, we used two blocks of videos with different probabilities of the ball appearing in the cup and found that, first, based on the behavioral responses, the subjects could track this probability change; and second, the different probabilities modulated the neural responses. In the second experiment, we introduced a control condition in which the magician performed the maneuver under the table, out of subjects' view. Comparing the two conditions (i.e., performing the maneuver within or out of the subjects' view), we found that, first, the magic trick dramatically biased the subjects' behavioral responses; and second, the two conditions led to differential neural responses, in spite of the fact that the stimulus triggering the evoked responses (seeing the ball in the cup) was exactly the same. Altogether, our results show how new insights into sensory and cognitive processing can be obtained using adapted magic tricks. Moreover, the approach of analyzing responses to continuous video presentations offers a more ecological setting compared to classic evoked potential paradigms, which are typically based on presenting static images flashed at the center of the screen

Reducing the anticholinergic and sedative load in older patients on polypharmacy by pharmacist-led medication review: A randomised controlled trial

© Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted. Objective To evaluate if a pharmacist-led medication review is effective at reducing the anticholinergic/sedative load, as measured by the Drug Burden Index (DBI). Design Randomised controlled single blind trial. Setting 15 community pharmacies in the Northern Netherlands. Participants 157 community-dwelling patients aged ≥65 years who used ≥5 medicines for ≥3 months, including at least one psycholeptic/psychoanaleptic medication and who had a DBI≥1. Intervention A medication review by the community pharmacist in collaboration with the patient's general practitioner and patient. Primary and secondary outcomes measures The primary outcome was the proportion of patients whose DBI decreased by at least 0.5. Secondary outcomes were the presence of anticholinergic/sedative side effects, falls, cognitive function, activities of daily living, quality of life, hospital admission and mortality. Data were collected at baseline and 3 months follow-up. Results Mean participant age was 75.7 (SD, 6.9) years in the intervention arm and 76.6 (SD, 6.7) years in the control arm, the majority were female (respectively 69.3% and 72.0%). Logistic regression analysis showed no difference in the proportion of patients with a≥0.5 decrease in DBI between intervention arm (17.3%) and control arm (15.9%), (OR 1.04, CI 0.47 to 2.64, p=0.927). Intervention patients scored higher on the Digit Symbol Substitution Test, measure of cognitive function (OR 2.02, CI 1.11 to 3.67, p=0.021) and reported fewer sedative side effects (OR 0.61, CI 0.40 to 0.94, p=0.024) at follow-up. No significant difference was found for other secondary outcomes. Conclusions Pharmacist-led medication review as currently performed in the Netherlands was not effective in reducing the anticholinergic/sedative load, measured with the DBI, within the time frame of 3 months. Preventive strategies, signalling a rising load and taking action before chronic use of anticholinergic/sedative medication is established may be more successful. Trial registration number NCT02317666

Numerical investigation of non-linear deflections of an infinite beam on non-linear and discontinuous elastic foundation

The analysis of static deflections of an infinite beam resting on a non-linear and discontinuous foundation is not trivial. We apply a recently proposed iterative non-linear procedure to the analysis. Mathematical models of the elastic foundation are incorporated into the governing non-linear fourth-order differential equation of the system and then the differential equation is transformed into an equivalent non-linear integral equation using Green's functions. Numerical solutions of the integral equation clearly demonstrate herein that our non-linear iterative numerical method is simple and straightforward for approximate solutions of the static deflection of an infinite beam on a non-linear elastic foundation. Iterative numerical solutions converge fast to corresponding analytic solutions. However, numerical errors are observed in a narrow neighbourhood of material discontinuities of foundations

The efficacy of playing a virtual reality game in modulating pain for children with acute burn injuries: A randomized controlled trial [ISRCTN87413556]

BACKGROUND: The management of burn injuries is reported as painful, distressing and a cause of anxiety in children and their parents. Child's and parents' pain and anxiety, often contributes to extended time required for burns management procedures, in particular the process of changing dressings. The traditional method of pharmacologic analgesia is often insufficient to cover the burnt child's pain, and it can have deleterious side effects [1,2]. Intervention with Virtual Reality (VR) games is based on distraction or interruption in the way current thoughts, including pain, are processed by the brain. Research on adults supports the hypothesis that virtual reality has a positive influence on burns pain modulation. METHODS: This study investigates whether playing a virtual reality game, decreases procedural pain in children aged 5–18 years with acute burn injuries. The paper reports on the findings of a pilot study, a randomised trial, in which seven children acted as their own controls though a series of 11 trials. Outcomes were pain measured using the self-report Faces Scale and findings of interviews with parent/carer and nurses. RESULTS: The average pain scores (from the Faces Scale) for pharmacological analgesia only was, 4.1 (SD 2.9), while VR coupled with pharmacological analgesia, the average pain score was 1.3 (SD 1.8) CONCLUSION: The study provides strong evidence supporting VR based games in providing analgesia with minimal side effects and little impact on the physical hospital environment, as well as its reusability and versatility, suggesting another option in the management of children's acute pain