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BackgroundReal-time ecological momentary interventions have shown promising effects in domains other than alcohol use; however, only few studies regarding ecological momentary interventions for alcohol use have been conducted thus far. The increasing popularity of smartphones offers new avenues for intervention and innovation in data collection. ObjectiveWe aimed to test the efficacy of an ecological momentary intervention, comprising mobile Web-based ecological momentary assessments (EMAs) and text messaging (short message service, SMS) brief interventions, delivered during drinking events using participants’ mobile phones. MethodsWe conducted a three-armed randomized controlled trial to assess the effect of a mobile Web-based ecological momentary assessment with texting feedback on self-reported alcohol consumption and alcohol-related harms in young adults. Participants were enrolled from an existing observational cohort study of young adults screened for risky drinking behavior. The intervention group (ecological momentary intervention group) completed repeated ecological momentary assessments during 6 drinking events and received immediate texting-based feedback in response to each ecological momentary assessment. The second group (ecological momentary assessment group) completed ecological momentary assessments without the brief intervention, and the third did not receive any contact during the trial period. Recent peak risky single-occasion drinking was assessed at the baseline and follow-up using telephone interviews. We used a random effects mixed modeling approach using maximum likelihood estimation to provide estimates of differences in mean drinking levels between groups between baseline and 12-week follow-up. ResultsA total of 269 participants were randomized into the 3 groups. The ecological momentary intervention group exhibited a small and nonsignificant increase between baseline and follow-up in (geometric) the mean number of standard drinks consumed at the most recent heavy drinking occasion (mean 12.5 vs 12.7). Both ecological momentary assessment and control groups exhibited a nonsignificant decrease (ecological momentary assessment: mean 13.8 vs 11.8; control: mean 12.3 vs 11.6); these changes did not differ significantly between groups (Wald χ22 1.6; P=.437) and the magnitude of the effects of the intervention were markedly small. No other significant differences between groups on measures of alcohol consumption or related harms were observed. The intervention acceptability was high despite the technical problems in delivery. ConclusionsWith a small number of participants, this study showed few effects of an SMS-based brief intervention on peak risky single-occasion drinking. Nevertheless, the study highlights areas for further investigation into the effects of EMI on young adults with heavy alcohol consumption. Trial RegistrationAustralian New Zealand Clinical Trials Registry ACTRN12616001323415; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=369534 (Archived by WebCite at http://www.webcitation.org/7074mqwcs)

Ends are susceptible to rational criticism on the basis of their associated properties or their compatibility with other desires. An end is desired for itself, whereas a means is desired for some other end. The existence of ends is demonstrated by examples and by an infinite regress argument. Instrumental theories of rationality regard means as rational but not ends. However, the contrast between means and ends on which instrumentalism is based is not always clear.

This article presents a principle identifying a form of internally conditional moral obligation concerning reliance. The need for internal conditionality arises from the generality of the concept of reliance, together with the thesis that "obligated' implies 'can". The principle's conditions include matters upstream from the reliant action (e.g. its being intentionally caused), downstream (harm), and concomitant with it (e.g. the absence of certain adversarial relationships). An epistemic condition straddles those categories. The principle is defended against objections, including the claims that it breaks the link between obligation and action and that reliance is normatively redundant. The principle may be derived from various moral theories, possibly via intermediate principles about harm, respect for autonomy, and the promotion of cooperation. Contrasts are drawn between moral and legal reliance-related obligations. [ABSTRACT FROM AUTHOR]

Reliance is ubiquitous, and is important socially, normatively and philosophically. This paper offers an account of reliance as a four-place relation among agent A, A's action of φing, A's goal P, and the object of reliance Q. I propose, amplify and defend this analysis of action in reliance: A, in φing, relies, for P, on Q if and only if: (1) A φs; (2) A's goal is P; (3) A by φing achieves P only if q; (4) A believes that (3); (5) A believes that q; and (6) (1) because < (2) and (4) and (5) >. [ABSTRACT FROM AUTHOR]

A popular view is that we create our own identities and values. An attractive version of this is the thesis that the creation of values follows from the creation of [...]