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This chapter investigates the conditions for dialogue between science and religion, and asks what makes dialogue possible or desirable. Sometimes, dialogue has simply amounted to theology and religion accommodating themselves to the sciences, and this can serve to reinforce unhelpful ways of categorising science and religion. Different models for dialogue are suggested by past relations between natural philosophy and religion, understood as formative practices (rather than proposition-generating activities). An alternative approach is also suggested by the problem of incommensurability, initially applied in different ways by Thomas Kuhn, Paul Feyerabend, and Alasdair MacIntyre to the relations between competing scientific frameworks, but which is also applicable also to science–religion relations. Thinking of ‘science’ and ‘religion’ in terms of historical traditions, to use MacIntyre’s expression, leads to a different understanding of their possible relationships. Historical and sociological descriptions of scientific and religious practices, in short, should play a more prominent role in our understandings of sciences, religions, and their relations.
This chapter uses historic examples – the Enlightenment origins of modern computing and the methods of medieval painters – to juxtapose the modern and pre-modern everyday experiences of work. It acknowledges that the official (albeit impracticable) disqualification of human intuition, aesthetics and proprioception in the pursuit of modern science has been responsible for significant technical advances. However, it also recognises that exactly the same disqualification also limits the modern scientific worldview, excluding much of what it means to be human. That impact is not restricted to specialist behaviours in the scientific laboratory but also has impoverishing consequences for those who interact with the scientific laboratory’s everyday technological products. It suggests that moving beyond the territorial disputes of ‘science and religion’ will require re-engagement of the whole human in the structured pursuit of material knowledge, methodologically complicating post-modern science but simultaneously enriching post-modern everyday lived experience.
The popular field of 'science and religion' is a lively and well-established area. It is however a domain which has long been characterised by certain traits. In the first place, it tends towards an adversarial dialectic in which the separate disciplines, now conjoined, are forever locked in a kind of mortal combat. Secondly, 'science and religion' has a tendency towards disentanglement, where 'science' does one sort of thing and 'religion' another. And thirdly, the duo are frequently pushed towards some sort of attempted synthesis, wherein their aims either coincide or else are brought more closely together. In attempting something fresh, and different, this volume tries to move beyond tried and tested tropes. Bringing philosophy and theology to the fore in a way rarely attempted before, the book shows how fruitful new conversations between science and religion can at last move beyond the increasingly tired options of either conflict or dialogue.
Savage et al. and Mehr et al. provide well-substantiated arguments that the evolution of musicality was shaped by adaptive functions of social bonding and credible signalling. However, they are too quick to dismiss byproduct explanations of music evolution, and to present their theories as complete unitary accounts of the phenomenon.
Schizophrenia is a severe mental disorder striking mainly young adults and leading to life-long disability in a substantial portion of the sufferers. On the other hand, substantial knowledge about its etiology and pathogenesis is still lacking. Therefore the European Science Foundation (ESF) sponsored a meeting of a panel of European experts on schizophrenia research to discuss the state of art and future perspectives of key topics in this area. The fields covered genetics, epidemiology, animal models, molecular neuropathology and imaging. This was a first step to establish a network of European groups dedicated to Schizophrenia research. The coming calls of the frame work program will be used to strengthen this network in order to achieve substantial progress in understanding and treating this devastating illness.
Approximately 18% of adults with intellectual disabilities living in the community display behaviours that challenge. Intensive support teams (ISTs) have been recommended to provide high-quality responsive care aimed at avoiding unnecessary admissions and reducing lengthy in-patient stays.
Aims
To identify and describe the geographical distribution and characteristics of ISTs, and to develop a typology of IST service models in England.
Method
We undertook a national cross-sectional survey of 73 ISTs. A hierarchical cluster analysis was performed based on six prespecified grouping factors (mode of referrals, size of case-load, use of outcome measures, staff composition, hours of operation and setting of service). A simplified form of thematic analysis was used to explore free-text responses.
Results
Cluster analysis identified two models of IST provision: (a) independent and (b) enhanced provision based around a community intellectual disability service. ISTs aspire to adopt person-centred care, mostly use the framework of positive behaviour support for behaviour that challenges, and report concerns about organisational and wider context issues.
Conclusions
This is the first study to examine the delivery of intensive support to people with intellectual disability and behaviour that challenges. A two-cluster model of ISTs was found to have statistical validity and clinical utility. The clinical heterogeneity indicates that further evaluation of these service models is needed to establish their clinical and cost-effectiveness.
Item 9 of the Patient Health Questionnaire-9 (PHQ-9) queries about thoughts of death and self-harm, but not suicidality. Although it is sometimes used to assess suicide risk, most positive responses are not associated with suicidality. The PHQ-8, which omits Item 9, is thus increasingly used in research. We assessed equivalency of total score correlations and the diagnostic accuracy to detect major depression of the PHQ-8 and PHQ-9.
Methods
We conducted an individual patient data meta-analysis. We fit bivariate random-effects models to assess diagnostic accuracy.
Results
16 742 participants (2097 major depression cases) from 54 studies were included. The correlation between PHQ-8 and PHQ-9 scores was 0.996 (95% confidence interval 0.996 to 0.996). The standard cutoff score of 10 for the PHQ-9 maximized sensitivity + specificity for the PHQ-8 among studies that used a semi-structured diagnostic interview reference standard (N = 27). At cutoff 10, the PHQ-8 was less sensitive by 0.02 (−0.06 to 0.00) and more specific by 0.01 (0.00 to 0.01) among those studies (N = 27), with similar results for studies that used other types of interviews (N = 27). For all 54 primary studies combined, across all cutoffs, the PHQ-8 was less sensitive than the PHQ-9 by 0.00 to 0.05 (0.03 at cutoff 10), and specificity was within 0.01 for all cutoffs (0.00 to 0.01).
Conclusions
PHQ-8 and PHQ-9 total scores were similar. Sensitivity may be minimally reduced with the PHQ-8, but specificity is similar.
Around 60 000 people in England live in mental health supported accommodation. There are three main types: residential care, supported housing and floating outreach. Supported housing and floating outreach aim to support service users in moving on to more independent accommodation within 2 years, but there has been little research investigating their effectiveness.
Aims
A 30-month prospective cohort study investigating outcomes for users of mental health supported accommodation.
Method
We used random sampling, accounting for relevant geographical variation factors, to recruit 87 services (22 residential care, 35 supported housing and 30 floating outreach) and 619 service users (residential care 159, supported housing 251, floating outreach 209) across England. We contacted services every 3 months to investigate the proportion of service users who successfully moved on to more independent accommodation. Multilevel modelling was used to estimate how much of the outcome and cost variations were due to service type and quality, after accounting for service-user characteristics.
Results
Overall 243/586 participants successfully moved on (residential care 15/146, supported housing 96/244, floating outreach 132/196). This was most likely for floating outreach service users (versus residential care: odds ratio 7.96, 95% CI 2.92–21.69, P < 0.001; versus supported housing: odds ratio 2.74, 95% CI 1.01–7.41, P < 0.001) and was associated with reduced costs of care and two aspects of service quality: promotion of human rights and recovery-based practice.
Conclusions
Most people do not move on from supported accommodation within the expected time frame. Greater focus on human rights and recovery-based practice may increase service effectiveness.