Simultaneity of consciousness with physical reality: the key that unlocks the mind-matter problem.

The problem of explaining the relationship between subjective experience and physical reality remains difficult and unresolved. In most explanations, consciousness is epiphenomenal, without causal power. The most notable exception is Integrated Information Theory (IIT), which provides a causal explanation for consciousness. However, IIT relies on an identity between subjectivity and a particular type of physical structure, namely with an information structure that has intrinsic causal power greater than the sum of its parts. Any theory that relies on a psycho-phyiscal identity must eventually appeal to panpsychism, which undermines that theory's claim to be fundamental. IIT has recently pivoted towards a strong version of causal emergence, but macroscopic structures cannot be stronger causally than their microphysical parts without some new physical law or governing principle. The approach taken here is designed to uncover such a principle. The decisive argument is entirely deductive from initial premises that are phenomenologically certain. If correct, the arguments prove that conscious experience is sufficient to create additional degrees of causal freedom independently of the content of experience, and in a manner that is unpredictable and unobservable by any temporally sequential means. This provides a fundamental principle about consciousness, and a conceptual bridge between it and the physics describing what is experienced. The principle makes testable predictions about brain function, with notable differences from IIT, some of which are also empirically testable.

Evaluating case studies of community-oriented integrated care.

This paper summarises a ten-year conversation within London Journal of Primary Care about the nature of community-oriented integrated care (COIC) and how to develop and evaluate it. COIC means integration of efforts for combined disease-treatment and health-enhancement at local, community level. COIC is similar to the World Health Organisation concept of a Community-Based Coordinating Hub - both require a local geographic area where different organisations align their activities for whole system integration and develop local communities for health. COIC is a necessary part of an integrated system for health and care because it enables multiple insights into 'wicked problems', and multiple services to integrate their activities for people with complex conditions, at the same time helping everyone to collaborate for the health of the local population. The conversation concludes seven aspects of COIC that warrant further attention.

The use of case studies to drive bottom-up leadership in community-oriented integrated care and health promotion (COIC).

London Journal of Primary Care is supporting a collaborative network of multidisciplinary colleagues with an interest in community-oriented health care and health promotion (COIC). Case study methodology is well suited to generating knowledge from the frontline of health and social care service delivery and is a much under-developed resource. It is most effective when dealing with wicked problems, namely, the sort of complex, entangled and multi-faceted problems that successful COIC programmes must overcome. Used collaboratively, it supports effective networking across professional and community boundaries.