Alcohol calculations and their uncertainty.

A dilution model is widely used to link blood alcohol concentration and the quantity of alcohol consumed. Whilst some authors use the total body water formulation of that model, others use the Widmark Factor formulation. A paper by Forrest gave a table of example values of the Widmark Factor and Barbour, based on Forrest's work and using Forrest's computer program, subsequently presented Forrest's results by way of a chart. Whilst the results of Forrest and Barbour are often used interchangeably, there is a significant difference between them on the factors for women. This paper examines the source of the unexpected discrepancy. It is essential to quote an error range, in blood alcohol concentration calculations, for the results. The extent of that error range was investigated by Gullberg who also employed the Widmark Factor formulation. Gullberg concluded that when reporting a calculated blood alcohol concentration, a coefficient of variation of ± 21% should be applied. Similarly, Gullberg concluded that when calculating the volume of drink, a coefficient of variation of 12½ % should be applied. The present paper derives and publishes the formulae for calculating this coefficient of variation. It is then shown that Gullberg's conclusions are mistaken: the coefficient of variation is not some fixed percentage but must be calculated in each case.

Theory of mind and Darwin's legacy.

We do not have an adequate theory of consciousness. Both dualism and materialism are mistaken because they deny consciousness is part of the physical world. False claims include (i) behaviorism, (ii) computationalism, (iii) epiphenomenalism, (iv) the readiness potential, (v) subjectivity, and (vi) materialism. Ontological subjectivity does not preclude epistemic objectivity. Observer relative phenomena are created by consciousness, but consciousness is not itself observer relative. Consciousness consists of feeling, sentience, or awareness with (i) qualitativeness, (ii) ontological subjectivity, (iii) unified conscious field, (iv) intentionality, and (v) intentional causation. All conscious states are caused by lower level neurobiological processes in the brain, and they are realized in the brain as higher level features. Efforts to get a detailed scientific account of how brain processes cause consciousness are disappointing. The Darwinian revolution gave us a new form of explanation; two levels were substituted: a causal level, where we specify the mechanism by which the phenotype functions, and a functional level, where we specify the selectional advantage that the phenotype provides. Sociobiology attempted to explain general features of human society, ethics, etc. It failed. For the incest taboo, it confuses inhibition with prohibition. It did not explain the moral force of the taboo. To explain the function of consciousness we cannot ask, "What would be subtracted if we subtracted consciousness but left everything else the same?" We cannot leave everything else the same because consciousness is necessary for higher functions of human and animal life. The unified conscious field gives the organism vastly increased power.

Levels and predictors of exercise referral scheme uptake and adherence: a systematic review.

BACKGROUND: The effectiveness of exercise referral schemes (ERS) is influenced by uptake and adherence to the scheme. The identification of factors influencing low uptake and adherence could lead to the refinement of schemes to optimise investment. OBJECTIVES: To quantify the levels of ERS uptake and adherence and to identify factors predictive of uptake and adherence. METHODS: A systematic review and meta-analysis was undertaken. MEDLINE, EMBASE, PsycINFO, Cochrane Library, ISI WOS, SPORTDiscus and ongoing trial registries were searched (to October 2009) and included study references were checked. Included studies were required to report at least one of the following: (1) a numerical measure of ERS uptake or adherence and (2) an estimate of the statistical association between participant demographic or psychosocial factors (eg, level of motivation, self-efficacy) or programme factors and uptake or adherence to ERS. RESULTS: Twenty studies met the inclusion criteria, six randomised controlled trials (RCTs) and 14 observational studies. The pooled level of uptake in ERS was 66% (95% CI 57% to 75%) across the observational studies and 81% (95% CI 68% to 94%) across the RCTs. The pooled level of ERS adherence was 49% (95% CI 40% to 59%) across the observational studies and 43% (95% CI 32% to 54%) across the RCTs. Few studies considered anything other than gender and age. Women were more likely to begin an ERS but were less likely to adhere to it than men. Older people were more likely to begin and adhere to an ERS. LIMITATIONS: Substantial heterogeneity was evident across the ERS studies. Without standardised definitions, the heterogeneity may have been reflective of differences in methods of defining uptake and adherence across studies. CONCLUSIONS: To enhance our understanding of the variation in uptake and adherence across ERS and how these variations might affect physical activity outcomes, future trials need to use quantitative and qualitative methods.

Biomedical informatics: changing what physicians need to know and how they learn.

The explosive growth of biomedical complexity calls for a shift in the paradigm of medical decision making-from a focus on the power of an individual brain to the collective power of systems of brains. This shift alters professional roles and requires biomedical informatics and information technology (IT) infrastructure. The authors illustrate this future role of medical informatics with a vignette and summarize the evolving understanding of both beneficial and deleterious effects of informatics-rich environments on learning, clinical care, and research. The authors also provide a framework of core informatics competencies for health professionals of the future and conclude with broad steps for faculty development. They recommend that medical schools advance on four fronts to prepare their faculty to teach in a biomedical informatics-rich world: (1) create academic units in biomedical informatics; (2) adapt the IT infrastructure of academic health centers (AHCs) into testing laboratories; (3) introduce medical educators to biomedical informatics sufficiently for them to model its use; and (4) retrain AHC faculty to lead the transformation to health care based on a new systems approach enabled by biomedical informatics. The authors propose that embracing this collective and informatics-enhanced future of medicine will provide opportunities to advance education, patient care, and biomedical science.

Dualism revisited.

The problem of consciousness should eventually receive a scientific solution, but there are a number of scientific and philosophical obstacles along the way. I offer solutions to the philosophical problems and proposals for approaching the scientific problems.