Movatterモバイル変換

A published case report of an infant who inadvertently developedremission of HIV viral expression has prompted research to determine if this observation is reproducible and can offer a potentially novel clinical approach to inducing sustained viralremission of HIV.Typically HIV-infected mothers receive antiretroviral therapy before delivery and infants receive between one and three drugs at “low doses” for prevention. In the case report, the mother delivered before she could receive ART. The infant was placed on a three-drug (...) approach with “higher” doses by her doctor than are typically used for treatment. When HIV infection was confirmed, the three-drug regimen was continued. For most.. (shrink)

Direct download(3 more)   Export citation   Bookmark  

HIVremission clinical researchers are increasingly seeking study participants who are diagnosed and treated during acute HIV infection—the brief period between infection and the point when the body creates detectable HIV antibodies. This earliest stage of infection is often marked by flu-like illness and may be an especially tumultuous period of confusion, guilt, anger, and uncertainty. Such experiences may present added ethical challenges for HIV research recruitment, participation, and retention. The purpose of this paper is to identify potential ethical (...) challenges associated with involving acutely diagnosed people living with HIV inremission research and considerations for how to mitigate them. We identify three domains of potential ethical concern for clinicians, researchers, and ethics committee members to consider: 1) Recruitment and informed consent; (2) Transmission risks and partner protection; and (3) Ancillary and continuing care. We discuss each of these domains with the aim of inspiring further work to advance the ethical conduct of HIVremission research. For example, experiences of confusion and uncertainty regarding illness and diagnosis during acute HIV infection may complicate informed consent procedures in studies that seek to recruit directly after diagnosis. To address this, it may be appropriate to use staged re-consent procedures or comprehension assessment. Responsible conduct of research requires a broad understanding of acute HIV infection that encompasses its biomedical, psychological, social, and behavioral dimensions. We argue that the lived experience of acute HIV infection may introduce ethical concerns that researchers and reviewers should address during study design and ethical approval. (shrink)

No categories

Direct download(3 more)   Export citation   Bookmark  

Between existenz and a hard-rock place, there is the man, trying to not make the same mistakes of the past and recvonciliate himself with himself, even on liberty or prison. Any conclusion is unnecessary, because life goes on.

Export citation   Bookmark  

The texts of ancient liturgies of the Christian East repeatedly state that activities such as taking eucharist, baptizing, and anointing are for theremission of sin. But how could that be? What could the connection be between the performance of these actions, on the one hand, and the state of enjoyingremission of sin, on the other? The first step toward providing a satisfactory answer to these questions is to note that, in the context of the liturgy, the (...) phrase "remission of sin" is best understood to mean not forgiveness of sin but deliverance from the sin-disorder. With this meaning in mind, I present a model for how rites of certain kinds could be intelligibly understood to be for theremission of sin. (shrink)

No categories

Direct download(2 more)   Export citation   Bookmark  

Direct download(5 more)   Export citation   Bookmark   1 citation  

International child rights law has the potential to change the way children are viewed and engaged by all social actors. It provides a child-centered perspective on all areas of children’s lives, including research with neonates. It differs from some bioethical perspectives by clearly articulating affirmative obligations owed to children and requiring rigorous monitoring mechanisms. The CRC’s focus on affirmative obligations and establishment of monitoring mechanisms provide additional useful elements that are not present in the dominant form of American pediatric bioethics.An (...) in-depth introduction to child rights and the U.N. Convention on the Rights of the Child is presented by Lansdown.. (shrink)

Direct download(6 more)   Export citation   Bookmark  

Direct download(3 more)   Export citation   Bookmark  

K L Kahlbaum published in 1874 the first recorded description of catatonia. Akinetic catatonia is now defined as a neuropsychiatric syndrome principally characterised by akinesia, mutism, stupor, and catalepsy. 1 Even if some advances have been made in the recognition of catatonia, in particular by the development of different rating scales, 1 the pathophysiology of this syndrome is not clearly established. A right handed 14 year old girl presented with akinetic catatonia during an episode of depression in the context of (...) a bipolar type I disorder. Her catatonic status was characterised by akinesia with brief episodic spontaneous stereotyped movements, mutism, no spontaneous oral intake, catalepsy, waxy flexibility, and stupor with brief occasional eye contacts. This corresponded to a total score of 19 on the Northoff Catatonia Scale.1 Electroencephalogram performed one day after onset of symptoms showed diffuse theta activity with sporadic diffuse delta activity. Cerebral magnetic resonance imaging was normal. Brain positron emission tomographies (PET) were obtained on a CTI-Siemens HR+ tomograph. A first PET (PET1) using (18F(- fluorodeoxyglucose (FDG) was performed on day 2 in a drug free state. Thereafter, intramuscular injection of 2 mg of lorazepam induced rapid clinicalremission of the akinetic phase. Oral lorazepam was then given (3.75 mg/day) during five days. On day 8, a second PET with FDG was performed while the patient was treated by olanzapine (15 mg/day) and presented hyperactivity, logorrhoea, and disinhibition characterised by uncontrolled social interactions and physical contacts. Neuropsychological testing performed some days afterremission revealed no apraxia or language disturbances but dysfunction of executive tasks manifested in the revised Wisconsin card sorting, the Tower of London, Stroop, and Trailmaking tests. Voxel based analyses comparing patient’s cerebral glucose metabolism with that of 29 right handed healthy controls (16 women and 13 men, mean age 32) were performed using Statistical Parametric Mapping (SPM99) (Wellcome Department of Cognitive Neurology, London, UK).. (shrink)

Export citation   Bookmark  

BackgroundThe Coronavirus 2019 outbreak has led to a considerable proportion of adverse psychological symptoms in different subpopulations. This study aimed to investigate the status of anxiety and depression and their associated factors in the adult, working-age population in Mainland China at the earlyremission stage of the COVID-19 pandemic.MethodsAn online study was conducted among 1,863 participants in 29 provinces in Mainland China from March 23 to 31, 2020. Their mental health was evaluated by the generalized anxiety disorder scale and (...) the patient health questionnaire. Descriptive analysis, Chi-square, and multiple logistic regressions were applied.ResultsAbout 44.5% of the participants had anxiety, 49.2% had depression, and 37.9% showed a combination of depression and anxiety. Around 83.7% of the participants claimed that the pandemic had a negative impact on their medical needs, which was the primary predictor of mental health, the degree of impact being positively related to the prevalence of anxiety and depression. More chronic diseases, moderate to bad self-rated health, severe perceived infection risk, and younger age group were the common risk factors for anxiety and depression. Having no children, unemployment, and a college-level educational background were associated with higher anxiety prevalence, whereas unmarried participants were correlated with higher depression prevalence.ConclusionThe working-age population showed a relatively high risk of anxiety and depression in Mainland China at the earlyremission stage of the pandemic. To improve medical services capacity for routine and delayed medical service needs should be a part of policy-makers’ priority agenda during this period of crisis. (shrink)

Direct download(2 more)   Export citation   Bookmark  

Direct download   Export citation   Bookmark   4 citations  

The metaphysics underlying differences in degree of qualitative intensity was widely debated in the medieval period. Medieval Aristotelians agreed that subjects possess qualities in virtue of inherent accidental forms. Yet, there was considerable disagreement about what happens at the level of form when a quality increases or decreases in its intensity. For instance, what happens when a pot of water on the stove gets hotter? Is the water’s previous form of heat replaced by a new one, or does the same (...) form of heat persist? Does the form of heat itself undergo a change, or does only the water undergo a change? While there have been several important studies on the medieval debate about the “intension andremission of forms,” little attention has been paid to Thomas Aquinas’s intriguing theory. Aquinas claims that a subject’s quality increases in intensity in virtue of the subject “participating” more perfectly in an invariable form. This paper examines Aquinas’s conception of the participation relationship between a substance and its accidental forms; and his metaphysical analysis of changes of intensification. (shrink)

Direct download(2 more)   Export citation   Bookmark  

More instability (MSSD) and variability (SD) of negative affect (NA) have been related to current and future depressive symptoms. We investigated whether NA instability and variability were predictive of the rate of symptom improvement during treatment and of reachingremission status. Forty-six individuals with major depressive disorder completed six days of ecological momentary assessments (10 beeps/day) before starting a combination of pharmacotherapy and supportive therapy. During and after treatment, the Hamilton Depression Rating Scale (HDRS) diagnostic interview was performed monthly (...) for 18 months. The rate of change in HDRS scores over five months (during treatment) andremission status (HDRS ≤ 7) over eighteen months were predicted by the SD, MSSD and Mean of NA, and relevant baseline predictors. Higher Mean NA and baseline symptom severity, but not NA variability or instability, predicted stronger depressive symptom reduction during treatment. Higher odds of remitting were only associated with lower Mean NA. Higher mean NA may indicate more room for improvement and thus for a steeper rate of symptom change, while lower mean NA levels may imply thatremission status is more readily reached. To resolve the inconclusive findings for instability and variability as predictors of symptom improvement replication in larger samples is required. (shrink)

Direct download(2 more)   Export citation   Bookmark  

Direct download(6 more)   Export citation   Bookmark   8 citations  

Export citation   Bookmark  

ABSTRACTMajor depressive disorder is a prevalent condition with high relapse rates. There is evidence that cognitive reactivity is an important vulnerability factor for the recurrence of depression. Mindfulness-based interventions are designed to reduce relapse rates, with cognitive reactivity as one of the proposed working mechanisms. In a randomised controlled trial we compared the effect of mindfulness-based cognitive therapy with treatment-as-usual on cognitive reactivity in recurrently depressed patients. Depressive symptoms, cognitive reactivity, and mindfulness skills were assessed pre and post treatment. Patients (...) in the MBCT group reported a significantly greater reduction in cognitive reactivity than those in the TAU group. The reduction of cognitive reactivity appeared to mediate the association between MBCT/TAU and decrease of depressive symptoms, using pre and post scores. The current study provides evidence that MBCT reduces cognitive reactivity and preliminar... (shrink)

Direct download(4 more)   Export citation   Bookmark  

The number of people who survive critical illness is increasing. In parallel, a growing body of literature reveals a broad range of side-effects following intensive care treatment. Today, more attention is needed to improve the quality of survival. Based on nine individual stories of illness experiences given by participants in two focus groups and one individual interview, this paper elaborates how former critically ill patients craft and recraft their personal stories throughout their illness trajectory. The analysis was conducted from a (...) phenomenological perspective and led to the meaning structure; a quest to find oneself after critical illness. In this structure, illness represented a breakdown of the participants’ lives, forcing them to develop a new understanding of themselves. Despite acute illness, they felt safe in hospital. Coming home, however, meant a constant balancing between health and illness, and being either in or out of control. To gain a deeper understanding of the participants’ narratives of survival, the meaning structure was developed from a phenomenological life world perspective, Heidegger’s concept of homelikeness and Arthur Frank’s typologies of illness narratives. In conclusion listening to and acknowledging the patients’ lived experiences of critical illness may support the patient efforts to establish the newly defined self and hence be vital for recovery. Phenomenology is one approach facilitating care tailored to the patients’ lived experience of critical illness and its aftermaths. (shrink)

Direct download(3 more)   Export citation   Bookmark  

Direct download(3 more)   Export citation   Bookmark   5 citations  

Direct download(2 more)   Export citation   Bookmark  

Direct download(5 more)   Export citation   Bookmark  

Direct download(2 more)   Export citation   Bookmark   3 citations  

No categories

Direct download   Export citation   Bookmark   2 citations  

No categories

Direct download(2 more)   Export citation   Bookmark  

Résumé Cet article rend compte d’une recherche sur le vécu des couples confrontés au cancer. La qualité de vie du patient et de son entourage devient de plus en plus cruciale au fur et à mesure que s’accroît l’espérance de vie des personnes atteintes. Le couple constitue une entité psychique spécifique qui résulte de la dynamique intersubjective entre conjoints. Cette entité peut être atteinte en cas de maladie grave. L’étude servant d’appui à cet article porte sur l’annonce de la maladie, (...) la période des traitements et la rémission. Il est ainsi mis en évidence que le « syndrome de Lazare » ne concerne pas que la personne malade, mais également le conjoint et que l’homéostasie du couple est perturbée bien au-delà de l’annonce de la rémission. (shrink)

Direct download(3 more)   Export citation   Bookmark   4 citations  

The world is experiencing a cataclysmically increasing burden from chronic illnesses. Chronic diseases are on the advance worldwide and treatment strategies to counter this development are dominated by symptom control and polypharmacy. Thus, chronic conditions are often considered irreversible, implying a slow progression of disease that can only be hampered but not stopped. The current plant-based movement is attempting to alter this way of thinking. Applying a nutrition-first approach, the ultimate goal is either diseaseremission or reversal. Hereby, ethical (...) questions arise as to whether physicians’ current understanding of chronic illness is outdated and morally reprehensible. In this case, physicians may need to recommend plant-based diets to every patient suffering from chronic conditions, while determining what other socioecological factors and environmental aspects play a role in the chronic disease process. This article provides insights to aspects of diet and chronic illness and discusses how the plant-based movement could redefine current understanding of chronic disease. The ethical justifications for recommending of a plant-based diet are analyzed. The article concludes that not advocating for plant-based nutrition is unethical and harms the planet and patients alike. (shrink)

Direct download(2 more)   Export citation   Bookmark   4 citations  

La sexualité préoccupe le Moyen Âge occidental : miroir de la nature peccamineuse de l’homme, elle en révèle le meilleur (tempérance, renoncement) et le pire (appétit, violence). Envisagée dans le seul mariage chrétien, elle est hors de ce cadre adultère, condamnée (juridiquement, judiciairement) et expose les individus à la vindicte populaire. Les lettres de rémission (grâce royale des crimes) des xiv e et xv e siècles témoignent de façon originale de l’impact que le type de conjugalité vécu peut avoir sur (...) les violences sexuelles faites aux femmes. Si les sources sont muettes et absentes sur les violences matrimoniales, isolement, célibat laïc, séparation et adultère exposent les femmes médiévales au viol. Mariée, la femme est appropriée, son corps territorialisé, gardé ; seule ou concubine, elle est mal famée et son corps à prendre. C’est dans ce paradigme que la question du couple et des violences sexuelles se pose alors. (shrink)

Direct download(3 more)   Export citation   Bookmark   2 citations  

En este artículo, partiendo de la crítica que hace Gadamer en Verdad y Método al concepto de autosignificatividad de la percepción de Richard Hamann, queremos mostrar lo abstracto de la pretensión de una percepción pura y cómo ella siempre remite a generalidades más amplias. Para reforzar esta perspectiva recurrimos a Martin Heidegger en Ser y tiempo con el fin de entender el concepto de ser-a-la-mano y todo el conjunto de remisiones que lo conforman. Con éste concluiremos sobre la necesidad de (...) suponer contextos relacionales más amplios y fundamentales como base de abstracciones particulares como la obra de arte y el dato empírico en la ciencia. Critique of pure perception. A phenomenological and hermeneutic approach In this article, based on the critique of Gadamer in Truth and Method to Richard Hamman’s concept of “autosignificance” of perception, we want show how abstract the assertion of a pure perception is and how it always refers to broader generalities. To reinforce this perspective we turn to Martin Heidegger’s Being and time in order to understand the concept of ready-to-hand and the whole set of remissions it comprises. With this we conclude on the need to assume broader, more fundamental relational contexts as the basis of particular abstractions such as works of art and the empirical datum in science. (shrink)

Export citation   Bookmark  

I would be scandalously remiss were I not to preface my remarks on translation with two expressions of gratitude to the Franciscan Institute. First of all, I am very pleased to have been invited to participate in this celebration of Ockham, not merely for professional reasons but also because I have thereby been afforded the opportunity to return to the Southerntier, as this part of New York State is known to those of us who trace our roots to the Buffalo (...) area. In my all too distant youth I worked for several years as a camp counsel lor down the road in Allegany State Park, and yesterday's drive through the Allegany River valley rekindled my love for this enchanting region and occasioned many fond memories as well. Second, I feel obligated to acknowledge publicly my own deep personal debt to those who have labored so diligently to produce the critical edition of Ockham's works. It is remarkable, indeed well-nigh astonishing, that the critical edition of Ockham's.. (shrink)

Direct download(2 more)   Export citation   Bookmark  

In At the Will of the Body , Arthur Frank told the story of his own illnesses, heart attack and cancer. That book ended by describing the existence of a "remission society," whose members all live with some form of illness or disability. The Wounded Storyteller is their collective portrait. Ill people are more than victims of disease or patients of medicine they are wounded storytellers. People tell stories to make sense of their suffering when they turn their diseases (...) into stories, they find healing. Drawing on the work of authors such as Oliver Sacks, Anatole Broyard, Norman Cousins, and Audre Lorde, as well as from people he met during the years he spent among different illness groups, Frank recounts a stirring collection of illness stories, ranging from the well-known--Gilda Radner's battle with ovarian cancer--to the private testimonials of people with cancer, chronic fatigue syndrome, and disabilties. Their stories are more than accounts of personal suffering: they abound with moral choices and point to a social ethic. Frank identifies three basic narratives of illness in restitution, chaos, and quest. Restitution narratives anticipate getting well again and give prominence to the technology of cure. In chaos narratives, illness seems to stretch on forever, with no respite or redeeming insights. Quest narratives are about finding that insight as illness is transformed into a means for the ill person to become someone new. (shrink)

Direct download   Export citation   Bookmark   216 citations  

Direct download(3 more)   Export citation   Bookmark   1 citation  

Some early phase clinical studies of candidate HIV cure andremission interventions appear to have adverse medical risk–benefit ratios for participants. Why, then, do people participate? And is it ethically permissible to allow them to participate? Recent work in decision theory sheds light on both of these questions, by casting doubt on the idea that rational individuals prefer choices that maximise expected utility, and therefore by casting doubt on the idea that researchers have an ethical obligation not to enrol (...) participants in studies with high risk–benefit ratios. This work supports the view that researchers should instead defer to the considered preferences of the participants themselves. This essay briefly explains this recent work, and then explores its application to these two questions in more detail. (shrink)

Direct download(6 more)   Export citation   Bookmark   11 citations  

Depression is a highly recurrent disorder with limited treatment alternatives for reducing risk of subsequent episodes. Acceptance and commitment therapy (ACT) and attention bias modification (ABM) separately have shown some promise in reducing depressive symptoms. This study investigates (a) if group-based ACT had a greater impact in reducing residual symptoms of depression over a 12-month follow-up than a control condition, and (b) if preceding ACT with ABM produced added benefits. This multisite study consisted of two phases. In phase 1, participants (...) with a history of depression, currently inremission (N= 244), were randomized to either receive 14 days of ABM or a control condition. In phase 2, a quasi- experimental design was adopted, and only phase-1 participants from the Sørlandet site (N= 124) next received an 8-week group-based ACT intervention. Self-reported and clinician-rated depression symptoms were assessed at baseline, immediately after phase 1 and at 1, 2, 6, and 12 months after the conclusion of phase 1. At 12-month follow-up, participants who received ACT exhibited fewer self-reported and clinician-rated depressive symptoms. There were no significant differences between ACT groups preceded by ABM or a control condition. There were no significant differences between ACT groups preceded by ABM or a control condition. Group-based ACT successfully decreased residual symptoms in depression over 12 months, suggesting some promise in preventing relapse. (shrink)

Direct download(3 more)   Export citation   Bookmark   1 citation  

There is a widely held concern that using war and sport metaphors to describe argument contributes to the breakdown of argumentative processes. The thumbnail version of this worry about such metaphors is that they promote adversarial conceptions of argument that lead interlocutors with those conceptions to behave adversarially in argumentative contexts. These actions are often aggressive, which undermines argument exchange by either excluding many from such exchanges or turning exchanges more into verbal battles. These worries are legitimate as far as (...) they go, and given that well-run argumentation is a good thing, we would be remiss not to consider whether our vocabulary inhibits argument's proper functioning. .. (shrink)

No categories

Direct download(7 more)   Export citation   Bookmark   26 citations  

In lieu of an abstract, here is a brief excerpt of the content:Religion, Psychiatry, and “Radical” Epistemic InjusticesRosa Ritunnano, MD (bio) and Ian James Kidd, PhD (bio)Hermeneutical injustice as a concept has evolved since its original formulation by Miranda Fricker (2007). The concept has been taken up in psychiatry, with its moral, epistemic and clinical premium on the interpretation of extremely complex and difficult experiences (Kidd et al., 2022). There are many varieties of hermeneutical injustice with different forms, sources, degrees, (...) effects, and interpersonal and socio-structural aspects (Medina, 2017). José Eduardo Porcher has proposed the addition of a new form of ‘radical’ hermeneutical injustice, with a case study of psychotic symptoms involving religious content.He offers different characterizations of this injustice:a particularly radical form of injustice, namely, having their own interpretation of their experiences unjustifiably undermined.a form of hermeneutical injustice that occurs when a patient diagnosed with psychosis is denied the opportunity of interpreting their own experiences within their own religious framework.These are different things. Denying someone the opportunity to interpret their experiences in their own, preferred framework is one way of undermining their interpretations. Another is forcing someone to use your own preferred framework and then belittling their own, which seems doubly wrong. Misusing some preferred interpretive framework can be as unjust as not using it. The two definitions could be combined, but then much will depend on what it means to undermine someone’s interpretation of an experience. We think there is a form of radical hermeneutical injustice—different to the one described by Porcher. Some interpretations of kinds of experience with religious content can be undermined if one is committed to a metaphysical naturalism. In these cases, one person cannot regard someone’s interpretive framework as coherent or intelligible (one that involves supernatural entities, for instance).Most discussions of hermeneutical injustice focus on social structures. Fricker notes structural dimensions to hermeneutical injustice. In a standard case, a group has unequal participation in collective practices for making and using interpretive resources (Ritunnano, 2022). In a rich analysis, José Medina describes four ‘axes’ or dimensions for distinguishing forms of hermeneutical injustice [End Page 235] (Medina, 2017). The source of these injustices can be semantic or performative. The dynamics may be structural or interpersonal, or both. Moreover, there are different degrees of breadth and depth, defined here in terms of the ‘reach’ of the injustice across one’s life, and the depth of damage to one’s hermeneutic agency, respectively (Medina, 2017, p. 45). On this model, what might count as ‘radical’ hermeneutical injustices? Deep and broad hermeneutical injustices can be radical when they are very broad in scope and very deeply damaging. This might be what Porcher has in mind. But we think there is a further option, relevant to his case study.Porcher focuses on a case where individuals experience unusual beliefs and perceptions with religious content receive a ‘psychosis’ diagnosis. The alleged injustice is that the possibility of a genuine religious experience is not recognized and validated. The example is Femi, a young man with Christian background, who enters the mental health system following the onset of psychotic ‘symptoms’. After being found “disoriented and depleted in public” – tired and undernourished—Femi is compulsorily admitted to hospital, explaining he undertook fasting and isolation in response to orders from God. During this time, Femi devoted himself to Bible reading and stopped going to work. In hospital, where the authenticity of God’s voice is challenged by clinicians, Femi is treated for acute psychosis with pharmacotherapy. Whileremission of symptoms follow, there is no functional recovery, and Femi is described as “unmotivated and apathetic”.Femi interpreted his experiences in religious terms, but this interpretation is not accepted or pursued by the clinicians. Is this a hermeneutical injustice? If so, is it a ‘radical’ one? Granted, Femi’s religious interpretation may be psychologically adaptive—enhancing his sense of life as meaningful (Ritunnano & Bortolotti, 2022). But this is consistent with it being a hermeneutical injustice. Plus, a religious framing may be conducive to his functional recovery after being discharged, especially in conjunction with a supportive religious community, able to help him articulate, understand, and respond to those religious experiences (see Cottingham, 2005; Wynn, 2005). However, none of... (shrink)

Direct download(2 more)   Export citation   Bookmark  

Physicians who care for critically ill people with opioid use disorder frequently face medical, legal, and ethical questions related to the provision of life-saving medical care. We examine a complex medical case that illustrates these challenges in a person with relapsing injection drug use. We focus on a specific question: Is futility an appropriate and useful standard by which to determine provision of life-saving care to such individuals? If so, how should such determinations be made? If not, what alternative decisionmaking (...) framework exists? We determine that although futility has been historically utilized as a justification for withholding care in certain settings, it is not a useful standard to apply in cases involving people who use injection drugs for non-medical purposes. Instead, we are welladvised to explore each patient's situation in a holistic approach that includes the patient, family members, and care providers in the decision-making process. The scope of the problem illustrated demonstrates the urgent need to definitively improve outcomes in people who use injection drugs. Increasing access to high quality medication-assisted treatment and psychiatric care for individuals with opioid use disorder will help our patients achieve a sustainedremission and allow us to reach this goal. (shrink)

No categories

Direct download(2 more)   Export citation   Bookmark   1 citation  

Previously, the author tried to show that some arguments in one of the two versions of Nicholas of Autrecourt’s Quaestio de intensione visionis are taken almost verbatim from the anonymous Tractatus de sex inconvenientibus. This paper concentrates on the arguments themselves in order to consider two main issues: the ‘translatability’ of limit decision problems, manifest in Autrecourt’s juxtaposition of questions de maximo et minimo, de primo et ultimo instanti, and the intension andremission of forms; the importance of Parisian (...) discussions of limit decision problems prior to the adoption of the new analytical languages developed at Oxford. Thus, the paper is divided in two sections, the first concerning some arguments of Autrecourt’s question, the second focusing on the link between one of Autrecourt’s arguments and the medieval tradition of commentaries on Aristotle’s De caelo, in which it is possible to find some antecedents of the analytical approach that later Parisian scholars would apply to these problems. (shrink)

Direct download(5 more)   Export citation   Bookmark   1 citation  

In lieu of an abstract, here is a brief excerpt of the content:What Now?Mike AbellThe cry broke the church’s uncomfortable silence. It actually was more of a moan than a cry. It was deeper, coming from her core. I’d heard it only once before and knew it as a sound caused by a loss that will never be recovered. No one in the church had to turn to discover its source. We all knew the mother had entered to say goodbye (...) to her 19–month–old son.We watched as the now composed mother, along side her husband, followed the small casket—a family rendered incomplete. As they passed our pew, my wife clutched my arm and we wept tears of sympathy, guilt and fear.Just 15 months earlier our now, 2–and ½–year–old son, Jun, had been diagnosed with a brain tumor not dissimilar from the child in the casket. The tumor has a different name, but it’s equally complicated, and comparably rare and aggressive.Over nine months, Jun endured two craniotomies, three rounds of induction chemo, three rounds of high dose chemo with stem cell rescue, 28 days of proton radiation, a sub–dural shunt placement, a port placed and removed, a broviac placed and removed and many, many blood and [End Page 16] platelet transfusions. As of his last scan, there was no evidence of tumor.Jun has now been out of treatment for six months. His hair has grown back. He’s stronger. The meals have stopped arriving. And we no longer are the recipients of sad eyes at playgrounds and restaurants.In many ways we have returned to a somewhat normal life. If you didn’t know Jun was inremission for a brain tumor, you wouldn’t know. Despite all this, cancer still strangles us with fear.Brain tumors often come back. Too often. We’ve heard a few different numbers on the likelihood. And while we’ve never paid too much attention to statistics, they are too scary to ignore. Especially knowing that should it recur, there is no cure. This is our day–to–day reality.A lot of our time is spent analyzing, over analyzing and obsessing. We watch him closely. Every time he stumbles, coughs, or sleeps fifteen minutes longer than normal, we wonder if it’s something more. I’ve called our oncologist about a 99–degree temperature. Something I wouldn’t have done during treatment (I usually waited to 100). I’ve questioned whether hiccups are a sign of recurrence. Admittedly, I’ve even Googled that last one just to be sure.All the anxiety builds the closer you get to an MRI date. My son has scans every three months so I’m beginning to recognize the cycle. It starts a couple weeks out. Normally it begins as a twinge the moment the date is set. But each day it grows, occupying more and more of my mind. This is not to say, I don’t think about it everyday. I do. But the thoughts become more paranoid and frequent. Worst–case scenarios play out. It’s different from the time during treatment. We always had the comfort of knowing that there is still more treatment.By the time we reach MRI day, bring Jun back to the machine room, watch the anesthesiologist put him under, and leave him to be scanned for the next two and half hours, I feel close to nauseas. In my mind, at this point, someone knows. I know they may be a technician and are not necessarily trained to read an MRI. But they know. They’ve seen it before.There usually is a waiting period between the time of the scan and the time you can meet with your oncologist or someone else qualified to read and interpret the scan. I do whatever I can to make that window as narrow as possible. I leave radiology with a disc in hand and head directly to the clinic to pass it off. I’ve heard of people waiting days for an appointment. That’s not an option for me. There would be no eating, no sleeping, and no resting heart rate without knowing. Fortunately, our oncologist is... (shrink)

No categories

Direct download(3 more)   Export citation   Bookmark  

Increasing prevalence of depression poses a huge challenge to the healthcare systems, and the success rates of current standard therapies are limited. While 30% of treated patients do not experience a fullremission after treatment, more than 75% of patients suffer from recurrent depressive episodes. Eye Movement Desensitization and Reprocessing therapy represents an emerging treatment option of depression, and preliminary studies show promising effects with a probably higherremission rate when compared to control-therapies such as cognitive behavioral therapy. (...) In the present study, 49 patients with severe depression were treated with an integrated systemic treatment approach including EMDR therapy that followed a specific protocol with a treatment algorithm for depression in a naturalistic hospital setting. Following their discharge from the hospital, the patients were followed up by a structured telephone interview after 3 and 12 months. 27 of the 49 patients fulfilled the Beck’s depression criteria of a fullremission when they were discharged. At the follow-up interview, 12 months after discharge, 7 of the 27 patients reported a relapse, while the remaining 20 patients had stayed relapse-free. The findings of our observational study confirm reports of earlier studies in patients with depression, showing that EMDR therapy leads to a high rate ofremission, and is associated with a decreased number of relapses. Patients with depression receiving EMDR treatment may be more resilient to stressors. (shrink)

Direct download(2 more)   Export citation   Bookmark  

Selective mutism (SM) is a developmental disorder characterized by a child’s inability to speak in certain contexts and/or in the presence of unfamiliar interlocutors. This work proposes a critical discussion of the most recent studies on SM, with respect to clinical and diagnostic features, as well as the etiology and treatment of this disorder. At present, all research work supports the hypothesis that SM is a complex anxiety disorder with multifactorial etiology (interaction among biological and environmental causes). The latest edition (...) of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5; American Psychiatric Association, 2013) places SM mutism among “Anxiety Disorders”, and no longer among “Other Childhood, Infant and Adolescent Disorders” (as in DSM-IV). Other important aspects relate to cognitive biases and emotional states at the base of SM, which partly explain the disorder’s persistence and represent an important objective of intervention work. No data in the literature point to a totalremission of SM, but good results are achieved with cognitive behavior intervention and multimodal therapy (MMT) involving a variety of child interaction contexts. (shrink)

Direct download(3 more)   Export citation   Bookmark  

ObjectiveOverweight and obesity [body mass index ≥ 25 kg/m2] are associated with poorer prognosis among women with breast cancer, and weight gain is common during treatment. Symptoms of depression and anxiety are also highly prevalent in women with breast cancer and may be exacerbated by post-diagnosis weight gain. Altered brain function may underlie psychological distress. Thus, this secondary analysis examined the relationship between BMI, psychological health, and resting state functional connectivity among women with breast cancer.MethodsThe sample included 34 post-menopausal women (...) newly diagnosed with Stage 0-IIa breast cancer who were enrolled in a 6-month randomized controlled trial of aerobic exercise vs. usual care. At baseline prior to randomization, whole-brain analyses were conducted to evaluate the relationship between BMI and seed-to-voxel rsFC of the hippocampus and amygdala. Connectivity values from significant clusters were then extracted and examined as predictors of self-reported depression and anxiety.ResultsMean BMI was in the obese range. For both seeds examined, higher BMI was associated with lower rsFC with regions of prefrontal cortex, including ventrolateral PFC, dorsolateral PFC, and superior frontal gyrus. Hippocampal connectivity with the vlPFC was negatively correlated with self-reported anxiety.ConclusionHigher BMI was associated with lower hippocampal and amygdala connectivity to regions of PFC implicated in cognitive control and emotion regulation. BMI-related differences in hippocampal and amygdala connectivity following a recent breast cancer diagnosis may relate to future worsening of psychological functioning during treatment andremission. Additional longitudinal research exploring this hypothesis is warranted. (shrink)

Direct download(2 more)   Export citation   Bookmark  

IntroductionResponsive neurostimulation is an evolving therapeutic option for patients with treatment-refractory epilepsy. Open-loop, continuous stimulation of the anterior thalamic nuclei is the only approved modality, yet chronic stimulation rarely induces complete seizureremission and is associated with neuropsychiatric adverse effects. Accounts of off-label responsive stimulation in thalamic nuclei describe significant improvements in patients who have failed multiple drug regimens, vagal nerve stimulation, and other invasive measures. This systematic review surveys the currently available data supporting the use of responsive thalamic (...) neurostimulation in primary and secondary generalized, treatment-refractory epilepsy.Materials and MethodsA systematic review was performed using the following combination of keywords and controlled vocabulary: OR ) OR [responsive neurostimulation AND thalamus AND ]. In addition, a search of the publications listed under the PubMed “cited by” tab was performed for all publications that passed title/abstract screening in addition to manually searching their reference lists.ResultsTen publications were identified describing a total of 29 subjects with a broad range of epilepsy disorders treated with closed-loop thalamic neurostimulation. The median age of subjects was 31 years old. Of the 29 subjects, 15 were stimulated in the anterior, 11 in the centromedian, and 3 in the pulvinar nuclei. Excluding 5 subjects who were treated for 1 month or less, median time on stimulation was 19 months. Of these subjects, 17/24 experienced greater than or equal to 50%, 11/24 least 75%, and 9/24 at least 90% reduction in seizures. Although a minority of patients did not exhibit significant clinical improvement by follow-up, there was a general trend of increasing treatment efficacy with longer periods on closed-loop thalamic stimulation.ConclusionThe data supporting off-label closed-loop thalamic stimulation for refractory epilepsy is limited to 29 adult and pediatric patients, many of whom experienced significant improvement in seizure duration and frequency. This encouraging progress must be verified in larger studies. (shrink)

Direct download(2 more)   Export citation   Bookmark  

Although the AGM theory established a paradigm for the theory of belief revision, which is generally regarded as a kind of standard in the field, it is also frequently criticized as inadequate because it neglects justificational structures. Other theories of belief revision are similarly remiss in this regard. So far, little has been done to address this shortcoming. This paper aims to fill this gap. Following a critical analysis of the AGM theory, a justification operator is introduced as a formal (...) means to incorporate justificational structures into a belief revision theory. An AGM style belief revision theory is proposed that is based on such a justification operator. The theory is presented in an axiomatic form. Representation theorems link the axioms with constructive belief change mechanisms. The proposed theory addresses the problems of the AGM theory and similar approaches that neglect justificational structures. (shrink)

No categories

Direct download(2 more)   Export citation   Bookmark  

Le vécu dont je tire ce récit est mon expérience d'homme vivant avec une maladie chronique, l'asthme, dont les périodes alternées, plus ou moins longues, de crise et de rémission me donnèrent envie d'extrapoler sur le thème plus large du plaisir et de la douleur, retenant déjà comme titre provisoire de mon ouvrage Le plaisir et l'ennui, ces deux termes visant une extension de l'analyse au-delà des seules questions de santé et de maladie, incluant par conséquent, leurs équivalents et synonymes (...) dans la vie individuelle et collective. Entre-temps, mes enfants qui n'ont connu que deux de leurs grands-parents, sur le tard, et presque rien de la vie au Fouta alors que nos références familiales et nos évocations quotidiennes en sont remplies ; qui m'ont vu entrer dans la vie active et m'engager politiquement sans en comprendre toujours les tenants et les aboutissants, revinrent plusieurs fois à la charge pour me suggérer d'écrire sur la famille, sur ma petite expérience d'enseignant et d'homme politique, sur les hommes et les femmes qui m'ont marqué et, surtout, sur la place que j'accorde à l'amitié, à la fraternité et à la solidarité, trois notions qu'ils m'ont entendu évoquer souvent et qui, à ce qu'il leur semblait, importent, aujourd'hui, plus aux yeux des jeunes qu'à ceux des adultes. (shrink)

No categories

Direct download   Export citation   Bookmark  

PurposeThis study systematically evaluates the effect of mindfulness meditation on depression during pregnancy. We provide evidence-based suggestions for preventing and reducing depression during pregnancy by exploring the most effective intervention mode, cycle, and frequency of mindfulness meditation.MethodsRecords were retrieved from PubMed, Web of Science, EBSCO, and Science Direct. A total of 1,612 randomized controlled trial studies on the effect of mindfulness meditation on pregnancy depression were collected. 10 studies with 658 subjects meeting the inclusion criteria were extracted and analyzed by (...) Revman 5.3 to evaluate study qualities. Stata 12.0 was used for the meta-analysis.ResultsMindfulness meditation had a positive effect on depression during pregnancy [standardized difference of the mean = −0.786, 95% confidence interval, P 75%]. This may be caused by variance in measurement tools, among which Beck Depression Inventory-II was a significant source of heterogeneity.ConclusionMindfulness meditation can improve the prevention,remission, and reduction of depression during pregnancy and can be used as an auxiliary measure for the clinical treatment of pregnancy depression. (shrink)

Direct download(2 more)   Export citation   Bookmark  

I am grateful to Philip Quinn for his thorough and penetrating critique of my paper on classical theism and pantheism. He has given me much to think about, and it would be philosophically remiss of me not to acknowledge that – in the light of his remarks – the argument which I employed in defence of the thesis that classical theism implies a version of pantheism might well benefit from some amendment. However, the purpose of this brief counter-rejoinder is to (...) establish that the nexus of my argument has emerged from his commentary in reasonably robust health, i.e., to demonstrate that if the argument of my former paper is to be rejected, it will take something more than Professor Quinn's critique to make that clear. Very concisely, then, my response is as follows: At a preliminary point, Professor Quinn claims that my argument ‘merits careful scrutiny’ because, if it succeeds, ‘something shockingly at variance with received views’ will have been established . I find this to be somewhat odd. For it seems clear that St Paul was a ‘classical theist’, indeed a very special one in so far as the shaping of Christian theism is concerned. And while his famous and oftcited dictum that God is the One in Whom ‘we live, move, and have our being’ may be such that it is permissible to construe it in ways which do not imply any version of pantheism, it clearly seems unjustified to maintain that pantheistic doctrines are ‘shockingly at variance’ with that most intriguing statement of St Paul's. (shrink)

Direct download(3 more)   Export citation   Bookmark  

By his own admission, Roland Barthes was seemingly remiss in not placing Georges Bataille within his account of ‘zero degree’ writing. This article draws inference from this fact, but specifically examines commonalities between Bataille’s heterology and Barthes’ late project on the Neutral. The article works through Barthes’ two key articles on Bataille, ‘The Metaphor of the Eye’ and ‘Outcomes of the Text’, and also considers Bataille’s statement on informe, a concept that can be said to resonate with Barthes’ use of (...) the Neutral. Neither term refers to specific ‘forms’, but rather an ‘operation’ of writing, as a means of undoing knowledge without its disavowal. An account is given of the commonalities of Bataille’s ‘general economy’ and what might be termed Barthes’ Neutral economy. Emphasis is placed upon their practice of writing as ethical responses in the ‘preparations’ of knowledge: to be judicious to what forms in and around knowledge, allowing as much for pauses as the possibilities of thought. (shrink)

No categories

Direct download   Export citation   Bookmark   2 citations  

The problem of the intensification andremission of qualities was a crux for philosophical, theological, and scientific thought in the Middle Ages. It was raised in Antiquity with this remark of Aristotle: some qualities, as accidental beings, admit the more and the less. Admitting more and less is not a trivial property, since it belongs neither to every category of being, nor to every quality. Rather it applies only to states and dispositions such as virtue, to affections of bodies (...) such as heat and sweetness, and to affections of soul such as anger. However, the property of admitting more and less was a matter of importance for the qualitative physics that had reigned up to about the time of Descartes, a physics which was concerned with concepts such as heat, coldness, lightness, heaviness, and so on. (shrink)

Direct download(5 more)   Export citation   Bookmark   9 citations  

Major depression is associated with a decrease of 1st person visual perspective in autobiographical memory, even after fullremission. This study aimed to examine visual perspective in healthy never-depressed subjects presenting with either genetic or psychological vulnerability for depression. Sixty healthy participants performed the Autobiographical Memory Test with an assessment of visual perspective. Genetic vulnerability was defined by the presence of at least one S or LG allele of the polymorphism of the serotonin-transporter-linked promoter region . Psychological vulnerability was (...) defined by high scores of harm avoidance measured by the Temperament and Character Inventory. Life stress exposure, depressive mood, rumination, and familial history of depression were assessed through standardized procedures. Visual perspective for positive memories was independently predicted by both harm avoidance and a gene by environment interaction between the 5-HTTLPR polymorphism and life stress exposure. Visual perspective and vulnerability for depression may share some biological bases. (shrink)

Direct download(4 more)   Export citation   Bookmark   9 citations  

Despite the remarkable achievements of novel targeted anti‐cancer drugs, most therapies only produceremission for a limited time, resistance to treatment, and relapse, often being the ultimate outcome. Drug resistance is due to highly efficient adaptive strategies utilized by cancer cells. Exogenous and endogenous stress stimuli are known to induce first‐line responses, capable of re‐establishing cellular homeostasis and determining cell fate decisions. Cancer cells may also mount second‐line adaptive strategies, such as the mutator response. Hypermutable subpopulations of cells may (...) expand under severe selective stress, thereby accelerating the emergence of adapted clones. As with first‐line protective responses, these strategies appear highly conserved, and are found in yeasts and bacteria. We hypothesize that evolutionarily conserved programs rheostatically regulate mutability in fluctuating environments, and contribute to drug resistance in cancer cells. Elucidating the conserved genetic and molecular mechanisms may present novel opportunities to increase the effectiveness of cancer therapies. (shrink)

Direct download(2 more)   Export citation   Bookmark   6 citations  

The received view about depression in the philosophical literature is that it is defined, in part, by epistemic irrationality. This status is undeserved. The received view does not fully reflect current clinical thinking and is motivated by an overly simplistic, if not false, account of depression’s phenomenal character. Equally attractive, if not more so, is a view that says depression can be instantiated either rationally or irrationally. This rival view faces challenges of its own: it appears to entail that there (...) are situations when not being depressed is rationally sub-optimal and that resilience to, and healthy coping strategies for avoiding, depression can be rationally remiss. I criticise an existing reply to these challenges before motivating a better one from the perspective of epistemic consequentialism. (shrink)

Direct download(3 more)   Export citation   Bookmark  

Body dysmorphic disorder (BDD) poses a significant challenge to an individual’s mental well-being. The obsessive preoccupation with perceived defects in one’s appearance affects individuals’ daily functioning and can result in serious risks, including suicidal ideation and self-surgery. While treatments such as cognitive behavioural therapy and serotonin reuptake inhibitors can provide relief, they do not achieve completeremission. It has been suggested that therapy should not only interrupt the harmful behaviour, but should also address their sense of self, and that (...) after addressing their internalised values, individuals with BDD will be able to incorporate their perceived defect in a manner similar to how individuals with real deformities often do. Phenomenology of psychopathology analyses subjectivity in cases of pathology, and analyses of BDD show that the perceived defect has become a locus of shame. This implies that individuals with BDD have permanently incorporated the gaze of the Other and constantly experience their body as a body-for-others. This paper further explores the sense of self in individuals with BDD through Jenny Slatman’s interpretation of bodily integrity: bodily integrity as a never-ending process of identification. By comparing the experiences of individuals with BDD to those with real deformities and to those who have undergone cosmetic surgery, I will show that re-identification does not occur in individuals with BDD. This suggests that their bodily integrity is fundamentally disturbed and that addressing their internalised values alone will probably not be sufficient for the disorder to go intoremission. (shrink)

Direct download   Export citation   Bookmark