The Transition to Noncommunicable Disease: How to Reduce Its Unsustainable Global Burden by Increasing Cognitive Access to Health Self-Management

The global epidemic of noncommunicable diseases (NCDs), such as cardiovascular disease and diabetes, is creating unsustainable burdens on health systems worldwide. NCDs are treatable but not curable. They are less amenable to top-down prevention and control than are the infectious diseases now in retreat. NCDs are mostly preventable, but only individuals themselves have the power to prevent and manage the diseases to which the enticements of modernity and rising prosperity have made them so susceptible (e.g., tobacco, fat-salt-carbohydrate laden food products). Rates of nonadherence to healthcare regimens for controlling NCDs are high, despite the predictable long-term ravages of not self-managing an NCD effectively. I use international data on adult functional literacy to show why the cognitive demands of today’s NCD self-management (NCD-SM) regimens invite nonadherence, especially among individuals of below-average or declining cognitive capacity. I then describe ways to improve the cognitive accessibility of NCD-SM regimens, where required, so that more patients are better able and motivated to self-manage and less likely to err in life-threatening ways. For the healthcare professions, I list tools they can develop and deploy to increase patients’ cognitive access to NCD-SM. Epidemiologists could identify more WHO “best buy” interventions to slow or reverse the world’s “slow-motion disaster” of NCDs were they to add two neglected variables when modeling the rising burdens of disease. The neglected two are both cognitive: the distribution of cognitive capacity levels of people in a population and the cognitive complexity of their health environments.

The Contemplative Mind and Life: First-Person Methods and the Challenge of Pure Consciousness and Phenomenal Selfhood for the “Neurophenomenological” Research Program

<p>A new paradigm in cognitive science has emerged called the “enactive approach”, which has given rise to a research program known as “neurophenomenology”. This research program attempts to calibrate third- and first-person methods to investigate consciousness. In his recent and representative work Mind in Life, Evan Thompson has put forward the thesis that there is a “deep continuity between life and mind”. While I remain sympathetic to the neurophenomenological approach as an exemplar par excellence of how the science of consciousness ought to proceed, I argue against this continuity thesis from three perspectives: (1) the nature and potential of first-person approaches to consciousness; (2) the most fundamental invariant structure of consciousness; (3) the egological or non-egological nature of consciousness and selfhood. My argument begins by laying out the foundations of enactive cognitive science, the continental analysis of time-consciousness and Thompson‟s attempt to close the empirical gap between life and mind with the help of the neurophenomenological bridging strategy (dynamic systems theory). Next, I discuss the phenomenology of different types of (structured) experiences and the fact that continental and contemplative methods share a common logic. I then argue that first-person methods (i) offer prima facie evidence that there are perceptual and non-perceptual types of experience, and (ii) grant us “cognitive access” to both types of experience. Following this, I consider at least one non-perceptual type of experience (pure consciousness) that breaks down the dynamic and relational structure of time-consciousness. I argue that pure consciousness is phenomenally lived-through but without egocentricity (subject-pole). Furthermore, a sophisticated distinction between (i) a minimal, core sense of (ego-) self and (ii) a non-egological but phenomenally lived-through subjectivity, is capable of shedding light on long-lasting debates surrounding the existence and non-existence of self (ātman). This especially holds true with regards to Buddhist philosophy and objectors to the doctrine of not-self (anatta/anātman). Finally, the nature of pure consciousness will lead me to challenge Thompson‟s continuity thesis, on the grounds that phenomenological evidence shows that the contemplative mind (pure consciousness) is decidedly not dynamic and intentional in structure. Thus there is a conceptual discontinuity between the biological domain and the phenomenological domain, being a decisive conceptual disanalogy between the contemplative mind (consciousness proper) and life. I thus conclude that prima facie: (1) first-person methods give us cognitive access to the objective and subjective domain of consciousness; (2) continental phenomenology is mistaken about the most fundamental invariant structure of consciousness; (3) consciousness qua awareness per se is non-egological. Having completed my argument against the continuity thesis, I will briefly recommend specific avenues for future neurophenomenological research to (a) adjudicate between continental and contemplative phenomenological views of consciousness; (b) judge whether or not Thompson‟s continuity thesis can be upheld; and (c) introduce new ways of studying (phenomenal) selfhood. In this way, I hope not only to argue against Thompon‟s continuity thesis, but to also point towards the potential of the neurophenomenological research program to advance our understanding of consciousness and phenomenal selfhood.</p>

The Contemplative Mind and Life: First-Person Methods and the Challenge of Pure Consciousness and Phenomenal Selfhood for the “Neurophenomenological” Research Program

<p>A new paradigm in cognitive science has emerged called the “enactive approach”, which has given rise to a research program known as “neurophenomenology”. This research program attempts to calibrate third- and first-person methods to investigate consciousness. In his recent and representative work Mind in Life, Evan Thompson has put forward the thesis that there is a “deep continuity between life and mind”. While I remain sympathetic to the neurophenomenological approach as an exemplar par excellence of how the science of consciousness ought to proceed, I argue against this continuity thesis from three perspectives: (1) the nature and potential of first-person approaches to consciousness; (2) the most fundamental invariant structure of consciousness; (3) the egological or non-egological nature of consciousness and selfhood. My argument begins by laying out the foundations of enactive cognitive science, the continental analysis of time-consciousness and Thompson‟s attempt to close the empirical gap between life and mind with the help of the neurophenomenological bridging strategy (dynamic systems theory). Next, I discuss the phenomenology of different types of (structured) experiences and the fact that continental and contemplative methods share a common logic. I then argue that first-person methods (i) offer prima facie evidence that there are perceptual and non-perceptual types of experience, and (ii) grant us “cognitive access” to both types of experience. Following this, I consider at least one non-perceptual type of experience (pure consciousness) that breaks down the dynamic and relational structure of time-consciousness. I argue that pure consciousness is phenomenally lived-through but without egocentricity (subject-pole). Furthermore, a sophisticated distinction between (i) a minimal, core sense of (ego-) self and (ii) a non-egological but phenomenally lived-through subjectivity, is capable of shedding light on long-lasting debates surrounding the existence and non-existence of self (ātman). This especially holds true with regards to Buddhist philosophy and objectors to the doctrine of not-self (anatta/anātman). Finally, the nature of pure consciousness will lead me to challenge Thompson‟s continuity thesis, on the grounds that phenomenological evidence shows that the contemplative mind (pure consciousness) is decidedly not dynamic and intentional in structure. Thus there is a conceptual discontinuity between the biological domain and the phenomenological domain, being a decisive conceptual disanalogy between the contemplative mind (consciousness proper) and life. I thus conclude that prima facie: (1) first-person methods give us cognitive access to the objective and subjective domain of consciousness; (2) continental phenomenology is mistaken about the most fundamental invariant structure of consciousness; (3) consciousness qua awareness per se is non-egological. Having completed my argument against the continuity thesis, I will briefly recommend specific avenues for future neurophenomenological research to (a) adjudicate between continental and contemplative phenomenological views of consciousness; (b) judge whether or not Thompson‟s continuity thesis can be upheld; and (c) introduce new ways of studying (phenomenal) selfhood. In this way, I hope not only to argue against Thompon‟s continuity thesis, but to also point towards the potential of the neurophenomenological research program to advance our understanding of consciousness and phenomenal selfhood.</p>

Recognition capability of one’s own skilled movement is dissociated from acquisition of motor skill memory

When we have rehearsed a movement using an object, we can reproduce the movement without holding the object. However, the reproduced movement sometimes differs from the movement holding a real object, likely because movement recognition is inaccurate. In the present study, we tested whether the recognition capability was dissociated from the acquisition of motor skill memory. Twelve novices were asked to rotate two balls with their right hand as quickly as possible; they practiced the task for 29 days. To evaluate recognition capability, we calculated the difference in coordination pattern of all five digits between the ball-rotation movement and the reproduced movement without holding balls. The recognition capability did not change within the first day, but improved after one week of practice. On the other hand, performance of the ball rotation significantly improved within the first day. Since improvement of performance is likely associated with acquisition of motor skill memory, we suggest that recognition capability, which reflects the capability to cognitively access motor skill memory, was dissociated from the acquisition of motor skill memory. Therefore, recognition of one’s own skilled movement would rely on a hierarchical structure of acquisition of motor skill memory and cognitive access to that memory.

Common Ground in Demonstrative Reference: The Case of Mano (Mande)

That demonstratives often have endophoric functions marking referents outside the physical space of interaction but accessible through cognition, especially memory, is well-known. These functions are often classified as independent from exophoric ones and are typically seen as secondary with respect to spatial deixis. However, data from multiple languages show that cognitive access to referents functions alongside of perceptual access, including vision. Cognitive access is enabled by prior interactions and prior familiarity with the referents. As a result of such interactions, the interlocutors share a great deal of knowledge about the referents, which facilitates reference to objects in the interactive field. The centrality of common ground in reference to an object at the interactive scene challenges the often assumed classification of demonstrative reference into exophoric and endophoric. I illustrate this idea throughout the paper by using first-hand data from Mano, a Mande language of Guinea. Adding another argument in favor of viewing demonstrative reference as a social, interactive process, the Mano data push the idea of salience of non-spatial parameters further and emphasizes the importance of short and long-term interactional history and cultural knowledge both for the choice of demonstratives in exophoric reference and for the structuring of the demonstrative paradigm.

Exploring Kogi epistemic marking in interactional elicitation tasks: A report from the field

This paper discusses methods to investigate epistemic marking in Kogi, a Chibchan language of Colombia. The type of epistemic marking prominent in Kogi grammar belongs to the recently proposed category of engagement, which is concerned with signaling shared vs. non-shared access to a discourse object between the speech-act participants. This is manifested on the one hand in an (ad)nominal demonstrative that is licensed by shared visual or cognitive access to a referent, and on the other hand, in a set of verbal prefixes that reflect (a)symmetries in access to states of affairs. Given the relatively abstract meaning of epistemic markers as well as their particular context sensitivity, the study of such forms comes with certain challenges such as, for example, their elusiveness to semantic elicitation or relative scarcity in naturally occurring speech. The present study aims to circumvent these pitfalls by employing methods that constitute a middle ground between controlled elicitation and spontaneous speech, namely stimuli-based, interactional elicitation tasks, in which participants are asked to collaboratively solve a problem or develop a narrative. In addition to the description of the materials and procedures, the tasks are discussed with regard to the occurrence of engagement forms in the obtained data.

Consciousness can overflow report: novel evidence from attribute amnesia of a single stimulus

Subjective report has been used as a measurement of consciousness. However, we usually experience seeing much more than what can be reported. This relates to a long-standing controversy regarding the nature of visual consciousness; that is, whether it is confined to cognitive access and can be directly measured by reportability, or whether it is rich and overflows report. Most debate previously concentrated on the unattended information, but acquiesced that information under attentional focus would reach consciousness and be reportable. This study sought to further address the debate from a new perspective, through directly testing whether fully attended supraliminal information is necessarily reportable with a variant of attribute amnesia. Participants were asked to judge the parity of a single number (Experiments 1 &amp; 3) or whether a Chinese character referred to furniture (Experiments 2 &amp; 4). After several trials, they were unexpectedly asked to report the target identity. The results consistently showed that participants could not correctly report the target identity, indicating that fully attended information that was consciously perceived could sometimes overflow report. These findings not only provide novel evidence for the overflow argument, but also have crucial implications in the relationship between consciousness and working memory.