Medicine - Bibliography - PhilPapers (original) (raw)
Reducing Existential Risk By Reducing The Allure Of Unwarranted Antibiotics: Two low-cost interventions.Nick Byrd & Olivia Parlow - manuscriptdetails Over one million annual deaths have been attributed to bacterial antimicrobial resistance. Although antibiotics have saved countless other lives, overuse and misuse of antibiotics increases this global threat. Developing new antibiotics and retraining clinicians can be undermined by patients who pressure clinicians to prescribe unnecessary antibiotics. So we validated two low-cost, scalable interventions for improving antibiotic decisions in an online randomized control trial and a pre-registered replication (N = 985). Both first-person vignette experiments found that an infographic and text message (...) caused intermediate to large improvements in antibiotic decisions compared to active controls — even when controlling for a dozen confounds. Notably, these educational interventions also reduced trust in a clinician who offered antibiotics for an upper respiratory infection. These data show how low-cost adjustments to existing communication systems can teach people to reduce the existential risks of antibiotic resistance and how inappropriate antibiotic prescribing can erode trust in health systems. (shrink)
Regarding Death.[Tal Doctor Slutzker](/s/Tal%20Doctor Slutzker "View other works by Tal Doctor Slutzker") - manuscriptdetails This is an article about death from a medical point of view.
Forthcoming epidemics, medicine, and trusting medical doctors, nurses, etc.[Terence Rajivan Edward](/s/Terence Rajivan%20Edward "View other works by Terence Rajivan Edward") - manuscriptdetails There is a lot of data nowadays and a need to analyze this data ("this data"? we use data as a mass noun), so one can predict jobs in data analysis and people moving into these jobs. I heard that on an online video, a Youtube video probably, but I did not write down who said it. My apologies. I have also probably heard it in the flesh from two Russian speakers, one an economist and the other a statistician. (The (...) economist once told me "When in Rome do what the Romans do," and I heard no irony, but I inferred it later: a Russian saying that!) Similarly, in an age of epidemics, one can predict more jobs in medicine and more people taking up those jobs. But that is going to generate a problem of trust, I think. When there are just four doctors in a practice, people review all four and say words to the effect, "This is the only one who does the job properly." We know this from fiction and various conversations, involving people of various social classes. But when there are 100 medical doctors and they mostly would not be there but for economic incentives, many people will not look for the exception. They will form a stereotype of the doctor (a standard "image"), expressed in jokes, caricatures, and the like, and the exception will be tarred with it as well. It will be like jokes about lawyers and politicians. I RECOMMEND that the medical system anticipates a crisis of trust from "ordinary" people now (who starts the distrust though and who inflames it?) and works on the topic of trust. Philosophers I have read who work on this: Onora O'Neill, Andrew Kirton (one of my former students, also supervised by Joel Smith and Thomas H Smith), and a European philosopher in the politics discipline area of University of Manchester, or he used to be. (shrink) Remove from this list Export citation Bookmark
Assisted dying, assisted suicide, euthanasia, and the supernatural.[Enrique Martinez Esteve](/s/Enrique%20Martinez Esteve "View other works by Enrique Martinez Esteve") - manuscriptdetails ... having succeeded in protecting and prolonging the life of many around the world for reasons which seem natural and intrinsically good to all, we are once again faced with the dilemma of confronting our patent inability to cure it all. -/- Faced with this recurring predicament, we somehow backtrack in our steps and decide the next best thing to assuage suffering is assisted dying and euthanasia. -/- No matter how many reasons we conjure up in their favour, both assisted (...) dying and euthanasia remain a stab into the unknown, into the supernatural, by patients, by its proponents, and by its practitioners both lay and medical. (shrink)
A Theory of Conscious Experience that Makes a Confirmed Novel Prediction about the Etiology of Autism.[Maxson J. McDowell](/s/Maxson J.%20McDowell "View other works by Maxson J. McDowell") - manuscriptdetails Three important cohort studies recently proved that early exposure to screen time is associated with autism. No currently accepted theory explains these results, but this paper’s theory does. Chalmer’s still unsolved ‘hard problem’ is that physicochemical processing seems unable to account for the subjective experience of consciousness. I show that Holland and Gell-Mann’s new paradigm of complex adaptive systems suggests a solution. We now know that the almost astronomical functional complexity of life is achieved by the self-organization of a hierarchy (...) of complex adaptive systems. At each level of the hierarchy, a unifying, higher-order, more complex system emerges from the spontaneous interactions of component systems that similarly emerged at the previous level. A transition between adjacent levels is sometimes a startling leap into a radically new category of system: a beehive emerges when individual bees interact; an ecosystem emerges from the interactions of varied organisms; verbal language emerges from the interactions of brains, bodies and the environment. This paper argues that, in parallel with language, psychology also emerges from the interactions of brains, bodies and environment. First elemental components emerge (a thought, emotion, perception or the like) and next, from interactions of these, narrative emerges. A narrative is a complex adaptive system that encompasses subjectivity and is expansive enough to do justice to humanity’s grandeur. Finally conscious experience emerges from the interaction of narratives, a transition for which group therapy provides a transparent model. Following Crick’s ‘astonishing hypothesis,’ the four current classes of neuroscientific theories of consciousness (ToC) identified by Seth and Bayne (2023) all seek to explain consciousness by neural functioning. I argue that my alternative hypothesis is more plausible. I also show that Seth and Bayne’s four classes are each, in part, compatible with my ToC. Autism disturbs experience. My ToC generates a confirmed novel prediction about autism, with implications for public health, that Seth and Bayne’s four classes fail to make. This ToC also shows how intersubjective narrative emerges from early nursing, an issue not addressed by the four neuroscientific classes of ToC. In addition, this ToC makes a prediction about dreams that was recently confirmed by experiment, again a prediction the four classes fail to make. This interdisciplinary paper should be accessible to a layperson but should also interest a physician, psychotherapist, philosopher, scientist, or complexity theorist. (shrink)
The Cultural Calibration Gap in AI-Driven Healthcare: A Hidden Barrier to Global Precision Medicine.Ammar Younas & Yi Zeng - manuscriptdetails Artificial intelligence (AI) is increasingly integrated into healthcare systems, offering advances in diagnosis, treatment, and operational efficiency. However, the cultural assumptions embedded in AI training data often misalign with the sociocultural realities of diverse patient populations—a phenomenon we term the Cultural Calibration Gap (CCG). This conceptual paper defines the CCG as a structural and epistemic deficit, distinct from algorithmic bias or dataset shift, that undermines clinical validity, patient trust, and health equity. We analyze how culturally uncalibrated AI systems exacerbate disparities (...) in diagnosis and care, compromise informed consent, and erode trust, particularly in communities with collective, spiritual, or traditional health frameworks. To address the CCG, we propose a three-pronged strategy: epistemic inclusion of diverse knowledge systems and data sources, participatory design grounded in community-based research, and regulatory reform mandating cultural responsiveness in model validation and oversight. We argue that tackling the CCG is not merely an ethical imperative but a scientific necessity, aligning healthcare AI with the evolving vision of human-centric, adaptive Healthcare 5.0. Culturally calibrated AI systems promise not only improved precision and trustworthiness but also more equitable and contextually meaningful care across global health landscapes. (shrink)
Learning community mental health compassion and understanding through theatre: a dramaturgy of ‘fragmentation’ symbolisms in Sarah Kane’s 4.48 Psychosis.[Nicholas Norman Adams](/s/Nicholas Norman%20Adams "View other works by Nicholas Norman Adams") - forthcoming - Under Submission (Preprint).details Sarah Kane’s play 4.48 Psychosis presents a powerful account of mental illness (MI) that spotlights the intense struggles of the play’s protagonist. This work centres on examining mental illness via dramaturgical art, arguing for Kane’s portrayals of MI within 4.48 Psychosis as representing a radical—yet fitting—medium for encouraging societal analysis that shifts MI from an enduringly private sphere into the public, collective domain. 4.48 Psychosis (aka 4.48) as a performance is interrogated through a joint sociological-psychological lens: a Goffmanian analysis bolstered (...) by a philosophical-informed approach. Three interlinked sociopsychology themes are revealed: Isolation, The End, and Distortion and Medicalisation. Employing Foucault’s theories on power, knowledge, and the medical gaze, findings elucidate how medicalised discourses (re)shape and control the experience and treatment of MI. Led by Research in Drama Education’s emphasis on learning through theatre as a socially and emotionally engaged process, practical implications for theatre-art as a critical medium facilitating wider societal recognition and detailed understandings of MI are put forward. And—these are validated through examination of existing community mental health engagement initiatives that have utilised 4.48. Subsequent implications for blended sociopsychology theory and interpretive analysis underpinned by transdisciplinary research approaches are spotlighted for their value in generating new avenues of mental health understandings for the psychology-psychiatry disciplines and beyond. (shrink)
Principlism and Contemporary Ethical Considers in Transgender Health Care.Luke Allen, Noah Adams, Florence Ashley, Cody Dodd, Diane Ehrensaft, Lin Fraser, Maurice Garcia, Simona Giordano, Jamison Green, Thomas Johnson, Justin Penny, Rachlin Katherine & Jaimie Veale - forthcoming - International Journal of Transgender Health.details Background: Transgender health care is a subject of much debate among clinicians, political commentators, and policy-makers. While the World Professional Association of Transgender Health (WPATH) Standards of Care (SOC) establish clinical standards, these standards contain implied ethics but lack explicit focused discussion of ethical considerations in providing care. An ethics chapter in the SOC would enhance clinical guidelines. Aims: We aim to provide a valuable guide for healthcare professionals, and anyone interested in the ethical aspects of clinical support for gender (...) diverse and transgender people of all ages. Recognizing that the WPATH is a global association, we address broad challenges. We offer a reflection on general ethical principles, providing conceptual tools for healthcare providers, patients, and families to navigate the specific challenges they might encounter in transgender health care, in line with WPATH’s worldwide mission and scope. Method: This article employs a descriptive analysis, and our framework of reference is the four principles of biomedical ethics: respect for autonomy, beneficence, nonmaleficence, and justice. Results: The article presents a discussion on the four ethical principles as applied to transgender health care. We address issues such as respect for patient autonomy in decision-making, the role of beneficence and nonmaleficence in clinical interventions, and the importance of justice in equitable treatment and access to care. Some of the ethical concerns we address in this article pertain to the current sociopolitical climate, where there has been increasing legal interference, internationally, for transgender and nonbinary people, particularly youth, seeking medical care. Discussion: We highlight the interplay between ethical principles and clinical practice, underscoring the need for ethical guidance in addressing the diverse challenges faced by healthcare providers and patients in transgender health care. We advocate for continuous refinement of ethical thinking to ensure that transgender health care is not only medically effective but also ethically sound. (shrink)
Association of Race and Ethnicity With High Longevity Deceased Donor Kidney Transplantation Under the US Kidney Allocation System.Nour Asfour, [Kevin C. Zhang](/s/Kevin C.%20Zhang "View other works by Kevin C. Zhang"), Jessica Lu, [Peter P. Reese](/s/Peter P.%20Reese "View other works by Peter P. Reese"), Milda Saunders, Monica Peek, Molly White, Govind Persad & [William F. Parker](/s/William F.%20Parker "View other works by William F. Parker") - forthcoming - American Journal of Kidney Diseases.details The US Kidney Allocation System prioritizes giving high-longevity, high-quality kidneys to patients on the waiting list who have a high estimated posttransplant survival (EPTS) score. EPTS is calculated based on the patient's age, whether the patient has diabetes, whether the patient has a history of organ transplantation, and the number of years spent on dialysis. Our analyses show that Asian, Black or African American, and Hispanic or Latino patients were less likely to receive high-longevity kidneys compared with White patients, despite (...) having similar or better posttransplant survival outcomes. (shrink)
What Cancer Is Doing While We’re Looking at Cells : A working paper on the gap between the object and the map.Stewart Barteau - forthcoming - Unified Theory of Consciousness: Theories and Applications.details Cancer research has spent a century refining its answers to a question it has not paused to examine: what kind of thing is cancer? The dominant working object — operative in the textbooks, the funding structure, trial design, and regulatory pathway — is a cell whose internal regulatory machinery has failed. The somatic mutation theory has earned its position by working well inside its zone of validity, producing most of what we currently know how to do. It has also been (...) accumulating anomalies it cannot absorb without ad hoc patches. Tissue specificity of identical mutations. Long-term dormancy of mutationally unchanged cells. Spontaneous regression. The non-mutational induction of cancer-like phenotypes through bioelectric perturbation alone. The unintegrated century-old Warburg effect. Cancers with mutational burdens too low to plausibly drive the disease. The recent partial dissolution of Peto’s paradox on better-controlled vertebrate data. The anomalies share a structural feature: each points beyond the cell to the tissue-level conditions in which the cell sits. This paper argues that the partial-seeing frames already at work in the field — tumor microenvironment research, the Seyfried-Warburg metabolic tradition, Soto and Sonnenschein’s Tissue Organization Field Theory, and Levin’s bioelectric and morphogenetic work — are not separate alternatives to the somatic mutation frame. They are different angles on the same unaccounted-for object: the constraint structure by which a tissue maintains itself as a coherent participant in the larger organism. When the constraint structure is intact, even cells with significant genomic damage usually do not produce cancer. When it fails, even genomically intact cells can begin to behave as cancer behaves. A tumor is not a colony of broken cells; it is what tissue does when it has lost the signal that tells it to be tissue. The mutations are the visible trace of a failure that has already happened upstream. The constraint frame yields five testable predictions, presented in descending order of confidence: convergent tissue-level phenotypes from genomically dissimilar cancers; epidemiological dominance of tissue-level risk factors over germline genetic risk; differential success of tissue-level interventions where cell-targeted ones have plateaued; the cancer trial system as a closed loop selecting for its own working object; and the early-onset cancer epidemic as constraint-failure in real time. The paper closes with an analysis of why the assembly of these frames has not happened despite the pieces being visible for years — institutional infrastructure, frame-stickiness, and the genuine difficulty of seeing distributed relational objects with tools designed for isolable substances. The path forward involves funding the partial-seeing frames at the scale of the dominant one, redesigning trials around tissue-level interventions, and letting the field’s working object update without the update becoming a humiliation. The cells are the trace. The disease is upstream. (shrink)
What Alzheimer’s Is Doing While We’re Looking at Plaques : On The Receiver, The Signal, And The Disease That Is Neither.Stewart Barteau - forthcoming - Alzheimer’s Disease as Failure of Coherent Receivership.details Three decades of Alzheimer’s research have been organized around the conviction that the disease is, fundamentally, a problem with what is in the brain. Plaques, tangles, misfolded proteins, lost neurons. The most recent generation of disease-modifying therapies clears the targeted material with measurable success and produces, at best, marginal cognitive benefit. The field has been describing this gap as a problem of timing, dosage, or target refinement. This paper proposes that the gap is structural: the disease is not located where (...) the field has been looking. Alzheimer’s, on the account developed here, is not primarily a failure of substrate. It is a failure of the dynamic operation that the substrate is meant to support — the operation by which a brain remains a coherent receiver of the structure presented to it. The paper installs this alternative frame, walks through the documented phenomena that current models cannot account for, and shows that each falls into place when the unit of analysis shifts from substrate to dynamics. What the disease destroys is not the receiver’s components. It is the receiver’s capacity to lock on. (shrink)
Sundowning as the Receiver Failing on a Temporal Gradient : On Amplitude, The Daily Axis, and What The Disease is Showing Us.Stewart Barteau - forthcoming - Alzheimer’s Disease as Failure of Coherent Receivership.details Sundowning — the pronounced worsening of cognitive coherence in late afternoon and evening among patients with Alzheimer’s disease and related dementias, with partial recovery overnight — is among the most clinically familiar and theoretically embarrassing phenomena in the field. It is directional in time. Substrate damage is not. The standard frame describes sundowning, manages its symptoms, and does not explain why a disease of accumulating neuronal loss should produce a phenomenon that systematically gets worse across the day and partially better (...) across the night. This paper, the second in a trilogy, takes sundowning as the directly observable signature of a disease whose actual operation is amplitude depletion in the dynamics that constitute a coherent receiver. The companion paper installed the receiver model and the geometry that supports it. This paper shows that sundowning is what one would predict that geometry to produce, that its directionality is structural rather than incidental, that sleep’s role is restoration rather than recovery, and that the slope at which overnight restoration becomes insufficient is the slope of disease progression itself. Sundowning is not a complication of the disease. It is the disease, made temporally visible. (shrink)
(1 other version)On the uses and abuses of biomarkers in clinical reasoning.Benjamin Chin-Yee - forthcoming - Studies in History and Philosophy of Science.details Biomarkers are central to the practice of precision oncology, which looks to novel biomarkers to ‘personalize’ cancer care. Philosophers have highlighted epistemic issues surrounding biomarkers but a general account of their role in clinical reasoning is lacking. This article examines biomarker use in clinical reasoning through the lens of abstraction. I propose clinical abstraction as a descriptive and normative account of reasoning with biomarkers that overcomes epistemic and ethical problems raised in the literature.
Freedom and mosquito control: when opting out constitutes a veto of public health interventions.Parker Crutchfield & Casey Chmura - forthcoming - Journal of Medical Ethics.details As the climate continues to change, mosquito-borne illness will spread, especially in temperate areas. The most effective method of disease-preventing mosquito control is the community-wide application of insecticides. Although these chemicals are justifiably believed to be safe, some health agencies allow individuals to opt out of receiving the public health intervention. Unlike other public health interventions which allow opt-outs, we argue that allowing opt-outs may not only undermine the efficacy of the intervention, it may also result in a net loss (...) of freedom. The ability to opt-out should thus be limited in some circumstances, which we describe. (shrink)
Fair Allocation of GLP-1 and Dual GLP-1-GIP Receptor Agonists.[Ezekiel J. Emanuel](/s/Ezekiel J.%20Emanuel "View other works by Ezekiel J. Emanuel"), [Johan L. Dellgren](/s/Johan L.%20Dellgren "View other works by Johan L. Dellgren"), [Matthew S. McCoy](/s/Matthew S.%20McCoy "View other works by Matthew S. McCoy") & Govind Persad - forthcoming - New England Journal of Medicine.details Glucagon-like peptide-1 (GLP-1) receptor agonists, such as semaglutide, and dual GLP-1 and glucose-dependent insulinotropic polypeptide (GIP) receptor agonists, such as tirzepatide, have been found to be effective for treating obesity and diabetes, significantly reducing weight and the risk or predicted risk of adverse cardiovascular events. There is a global shortage of these medications that could last several years and raises questions about how limited supplies should be allocated. We propose a fair-allocation framework that enables evaluation of the ethics of current (...) practices and could guide governments, professional societies, and physicians in allocation decisions. (shrink)
Compassion and decision fatigue among healthcare workers during COVID-19 pandemic in a Colombian sample.Gabriela Fernández-Miranda, Joan Urriago-Rayo, Verónica Akle, Efraín Noguera, Santiago Amaya & William Jiménez-Leal - forthcoming - PLoS ONE.details Being compassionate and empathic while making rational decisions is expected from healthcare workers across different contexts. But the daily challenges that these workers face, aggravated by the recent COVID-19 crisis, can give rise to compassion and decision fatigue, which affects not only their ability to meet these expectations but has a significant negative impact on their wellbeing. Hence, it is vital to identify factors associated to their exhaustion. Here, we sought to describe levels of compassion and decision fatigue during the (...) pandemic, and to identify factors related to these forms of exhaustion. We collected data using self-reported questionnaires to measure compassion fatigue, decision fatigue, and grit in five intervals from April to November, 2020 (N = 856). Our results showed a negative correlation between grit and compassion and decision fatigue. We also found that under the circumstances studied grit tends to be higher in technicians, nurses, other professionals (psychologists, social workers), and workers at the Emergency Room (ER), and lower in general practitioners. Compassion fatigue tend to be higher for technicians, whereas decision fatigue was lower for specialists, general practitioners, and technicians, and higher for those working at private hospitals. (shrink)
Gulliver travels into psychosis - inspired by Jonathan Swift's own experience.Hans Förstl - forthcoming - Neuropsychiatrie.details Background: Jonathan Swift (1667–1745) had long been interested in mental disease, which he also (ab)used for satirical purposes. He characterized various forms of madness in 1704, was elected governor of Bedlam in 1714, and in 1731 decided to dedicate his fortune to the founding of a first lunatic asylum in Ireland. Objective: To identify and consider the nature of neuropsychiatric features described in Gulliver’s Travels. Material & methods: Literary works by and biographies of Jonathan Swift were examined together with the (...) pertinent medical and historical specialist literature. Results: Gulliver’s Travels, primarily a political satire, was published 300 years ago. The adventures of the restless naval surgeon Lemuel Gulliver on various remote islands can be understood as a journey into psychosis with characteristic motor, sensory and cognitive features. After his return home an autistic Gulliver refuses contact with his own species, the Yahoo-like humans, including his family and prefers the company of horses. Seamen and lunatic inpatients apparently shared a number of environmental risk factors and features of scorbutic nostalgia. Conclusion: Caution is advised when making a retrospective diagnosis, even with a fictional character like Lemuel Gulliver. If there were no hints at relevant organic causes — primarily hypovitaminoses —,one might suggest that Swift/Gulliver reported a number of characteristic symptoms of schizophrenia long before they were described in the medical literature. (shrink)
Rethinking Health and Well-Being: A New Philosophical and Methodological Framework.Panagiotis Karadimas - forthcoming - Springer.details This book calls scholars to rethink health and well-being. Doing so, strikes as necessary for a number of aspects related to these topics have not yet been really addressed from a philosophical point of view. For example: can we really speak about facts related to health and well-being? If so, then are value judgments only evaluative tools and not quite inseparable from our descriptions of the world? If the answer to the first question is “no”, then does the rejection of (...) facts leads us necessarily to normative conclusions about health and well-being? In other words, is it possible to have a purely descriptive approach to health and well-being that appreciates the knowledge problems we face? While settling the above can partly refurbish the philosophical landscape, more questions are hovering and are waiting to be unpacked. Since some scholars agree that health and well-being are, one way or another, related at a normative level, then is it possible to be connected in a purely descriptive manner? If so, then what does a conceptual connection say (if anything) about the science of health and well-being? Can we arrive at a philosophical schema that entails a novel conceptualization and a theoretical approach that attempts to refine methodologies related to scientific tasks vis-à-vis health and well-being? -/- All these questions come to challenge one’s mind while searching through the vast literature on health, well-being and on the interconnection between them and so this book is the attempt to discuss these issues and all the byproducts and the implications they carry in some detail. Upon attempting to do so, a new framework to approach health and well-being has been hopefully born. Long story short: Health and well-being are treated as conceptually indistinguishable and a model-theoretic view of health and well-being is presented and which aspires to account for the above questions and their ramifications. Drawing upon the model-theoretic view brings us in an epistemic position to better deal with pesky methodological issues such as establishing causal relations without being prone to selection bias and reversed causality problems, it fascilitates measurement of well-being and it helps improve the chances of successful diagnosis in psychiatry. -/- . (shrink)
The Limitations of Laparoscopic Cholecystectomy and Outcomes of Endoscopic Ultrasound-Guided Gallbladder Drainage.Rowena Kong - forthcoming - Journal of Hepatology and Gastrointestinal Disorders.details Gallbladder disease commonly affects the general population of Western developed nations and the standard surgical treatment of laparoscopic cholecystectomy normally follows severe cases of this condition. However, the negative health and life quality consequences of this standard line of treatment are lesser known and stand the chance of being taken lightly by healthcare professionals. Complications include bile duct injury, dropped gallstones and a second open invasive surgery, of which could be life threatening for some rare cases. It is, therefore, necessary (...) to highlight the limitations of such a procedure and the need for improvement and widening of the range of treatment options for vulnerable members of the patient population. Additionally, here is a brief overview introduction of a new procedure called endoscopic ultrasound guided gallbladder drainage with promising success rates that can be a potentially feasible alternative to traditional surgical procedures to offer gallbladder disease patients. (shrink)
Sanità, scienza e società a Ferrara dal Medioevo all'Ottocento.Rossano Pancaldi - forthcoming - Medicina Nei Secoli.details MALARIA, SCIENCE AND SOCIETY IN FERRARA FROM THE MIDDLE AGES TO THE NINETEENTH CENTURY -/- In this paper it is outlined the history of malaria in Ferrara and its suburbs, from ancient times up to the nineteenth century. It is considered the issue of malaria in Roman times, during the Middle Ages and the Renaissance, the discovery of quinine, the first scientific studies made at the University of Ferrara, the first analysis about the causes and the spread of the disease. (...) The conditions of backwardness of Ferrara society are considered, especially of the people living in the countryside, and the most common medical knowledge. Statistics about the spread of malaria after the unification of Italy are resumed. Problems of environmental recovery are taken into account. Scientific progresses due to positivism and to the doctors who faced the first anti-malarial campaigns, bringing their testimonies. The essay ends up with the reorganization of public health and places of health care in modern hospitals all over the province of Ferrara. (shrink) Remove from this list Export citation Bookmark
Medicine, Science and Society in Ferrara from the Middle Ages to the Nineteenth Century.Rossano Pancaldi - forthcoming - Medicina Nei Secoli.details MALARIA, SCIENCE AND SOCIETY IN FERRARA FROM THE MIDDLE AGES TO THE NINETEENTH CENTURY -/- In this paper it is outlined the history of malaria in Ferrara and its suburbs, from ancient times up to the nineteenth century. It is considered the issue of malaria in Roman times, during the Middle Ages and the Renaissance, the discovery of quinine, the first scientific studies made at the University of Ferrara, the first analysis about the causes and the spread of the disease. (...) The conditions of backwardness of Ferrara society are considered, especially of the people living in the countryside, and the most common medical knowledge. Statistics about the spread of malaria after the unification of Italy are resumed. Problems of environmental recovery are taken into account. Scientific progresses due to positivism and to the doctors who faced the first anti-malarial campaigns, bringing their testimonies. The essay ends up with the reorganization of public health and places of health care in modern hospitals all over the province of Ferrara. (shrink) Remove from this list Export citation Bookmark
On ‘masculine armour’: social conditioning, trauma, and staying intact in the therapeutic space.[Nicholas Norman Adams](/s/Nicholas Norman%20Adams "View other works by Nicholas Norman Adams") - 2026 - The Psychologist (TBC [Online First]):TBC [Online First].details This article, published in The Psychologist (British Psychological Society) online on 8 May 2026, explores how dominant masculine norms shape men’s experiences of trauma, emotional distress, and therapeutic engagement. Drawing on over a decade of qualitative and ethnographic research in male-dominated environments, the article examines how emotional containment and stoicism can function both as protective strategies and as barriers to recovery. The paper argues that trauma may be experienced by many men as a disruption to masculine identity itself, and advocates (...) for therapeutic approaches that work alongside, rather than against, masculine identity structures. (shrink)
The modern microbiota revolution.Mohammed Eissa - 2026 - arXiv 326 (How to benefit from microbes and):17-19. Translated by Mohamed Issa.details In this research, I present a comprehensive and novel vision of the "Modern Microbiota Revolution," where microorganisms are transformed from mere vital elements in nature, of which humans have no benefit, into intelligent engineering systems capable of tangibly improving human life. This vision relies on utilizing the biological principles of microorganisms, such as metabolism and excretion, while integrating a small amount of environmentally friendly, inexpensive, and sustainable technology into fields such as paints, asphalt, water pipes, and modern automotive systems. The (...) theory Is based on developing self-healing materials and systems in paints, asphalt, and water pipes that are environmentally friendly and efficient in transmitting energy and information. In modern automotive systems, through the integration of: bacteria that precipitate calcium carbonate Biological energy-transporting systems inspired by chloroplasts, which efficiently transfer energy between their protein compounds; and protective living layers in water networks and infrastructure, this research opens new horizons for designing sustainable technologies that reduce resource consumption and protect the environment, while enhancing performance and efficiency in cars and public utilities. This vision for infrastructure goes beyond the theoretical level, proposing innovative application mechanisms to serve as a cornerstone for a future that benefits humanity even more than it does today In infrastructure, including modern cars. This involves integrating microorganisms as practical and intelligent elements in infrastructure and modern technologies, achieving an integration of microbial vitality, sustainability, and efficiency -/- . (shrink)
The life and death of Professor Kurt Albrecht, the last chair of the German Charles University Department of Psychiatry and Neurology in Prague.Petra Havrankova, Hans Förstl & Evzen Ruzicka - 2026 - Česká a Slovenská Neurologie a Neurochirurgie 88 (5):316-324.details The Department of Psychiatry and Neurology of the German Charles University in Prague was among the leading medical institutions in Central Europe in the early 20th century. In October 1939, Professor Kurt Albrecht, a Berlin neurologist and member of both the NSDAP and the SS, was appointed head of the department. During his tenure, he secured a separate building for the neurological section and held senior academic offices, including dean of the medical faculty, and ultimately, the last rector of the (...) German Charles University. Albrecht's death at the end of the Second World War remains surrounded by uncertainty. Contemporary accounts differ, some attributing it to suicide, and others to his death in armed resistance. While his career is inseparably linked with the Nazi regime, he remains part of the lineage of chiefs of the department, which history forms a broader professional tradition beyond political entanglements. In re-examining the circumstances of his death, we combined established sources with newly identified unpublished archival materials from Prague and Berlin, as well as testimonies of contemporaries from the German University milieu in Prague. These findings contribute to a more nuanced portrait of Albrecht and his era, inviting interpretations that extend beyond narrow national frameworks or the postwar order's perspective. (shrink) Remove from this list Export citation Bookmark
Autonomy, oppression and genetic enhancements.Sinead Prince - 2026 - Jme Practical Bioethics 2 (1):1-11.details Genetic enhancement technologies are rapidly evolving, but discussions about their use for human enhancement are largely abstract and removed from the socioeconomic environments in which they would be administered. While some scholars engage in discussions about the fairness of distributing genetic enhancements, I argue that the oppressive social structures in which genetic enhancements will be administered categorically undermine our capacities to autonomously value and pursue such technologies. I will draw on long-standing feminist debates around the oppressive and empowering uses of (...) cosmetic enhancements by women to argue that the oppressive nature of patriarchal beauty norms creates a social environment in which women are generally not free to autonomously evaluate their desires for and values of cosmetic enhancements. I then address the concern that declaring such a proposition is itself an unethical restriction on women’s autonomy and that cosmetic enhancements are generally, or presumptively, empowering. I conclude that, like cosmetic enhancements, genetic enhancements are morally harmful insofar as they are not categorically autonomously valued by people. (shrink)
Why Asking About “Critical Abilities” Is Misguided: Lessons Learned from the Updated Serious Illness Conversation Guide.[Joel Michael Reynolds](/s/Joel Michael%20Reynolds "View other works by Joel Michael Reynolds") & Michael Pottash - 2026 - Journal of General Internal Medicine 41 (1).details The first version of the widely used Serious Illness Care Guide produced by Ariadne Labs prompted clinicians to ask their patients: “What abilities are so critical to your life that you can’t imagine living without them?” In 2023, the program updated their guide, removing this “critical abilities” question in part due to pushback from the disability community and disability researchers. This viewpoint briefly reviews the history of serious illness communication to understand why the question originally appeared in the guide and (...) why it was removed. Through the lens of disability bioethics, we then explore concepts such as the ableist conflation and disability paradox to understand why human flourishing may transcend the notion of ability. We end by describing a more humane approach to serious illness care communication. (shrink)
Conflictos éticos asociados al diagnóstico serológico anticipado en la enfermedad de Alzheimer.Javier Silva-Silva & [Elsa González San Martín](/s/Elsa%20González San Martín "View other works by Elsa González San Martín") - 2026 - Revista Médica de Chile 154 (3):423-429.details Los conflictos éticos implicados en la indicación médica del diagnóstico serológico anticipado en la enfermedad de Alzheimer en contextos clínicos donde se requiera una indicación médica para realizar la intervención, han sido escasamente analizados. Hipótesis: La prescripción del diagnóstico serológico anticipado en la enfermedad de Alzheimer vulnera más principios éticos de los que respalda. Objetivo: Realizar un análisis respecto a los conflictos éticos asociados a la indicación del diagnóstico serológico anticipado de la enfermedad de Alzheimer y ofrecer una recomendación de (...) práctica clínica basada en dicho análisis. Métodos: Análisis ético, en el cual se expondrán l as consecuencias lógicas de la prescripción del diagnóstico serológico anticipado en cuanto a los principios éticos de autonomía, justicia, beneficencia y no-maleficencia. Resultados: La intervención presenta marginal beneficio en cuanto a autonomía y beneficencia, mientras que viola los principios de beneficencia, no-maleficencia y justicia. Conclusiones: La intervención no es éticamente recomendada. Ello podría cambiar si disminuye su costo y si se desarrollan tratamientos modificadores de enfermedad con un perfil de seguridad adecuado. (shrink)
Revisiting the Ethics of Urate-Lowering Therapy Clinical Trials for Gout Management.Lisa Stamp, Dien Ho & Nicola Dalbeth - 2026 - Arthritis and Rheumatology:1-4.details The early 2000s saw a wave of randomized controlled trials (RCTs) of new urate-lowering therapies (ULTs) used in the management of gout. These trials compared the novel medications with placebo or relatively low doses of allopurinol. In 2016, Shmerling raised concerns about the design of these trials, advocating for more ethical gout trials that “i) limit enrolment to individuals with gout refractory to appropriately dosed conventional therapies, ii) eliminate placebo arms, iii) routinely provide anti-inflammatory prophylaxis to reduce gout flares, and (...) iv) allow appropriate up-titration of urate-lowering treatments in comparator arms.” In this viewpoint, we revisit ethical principles and standards for contemporary phase III and IV ULT clinical trials. (shrink)
(1 other version)The Concept of Personal Utility in Genomic Testing: Three Ethical Tensions.[Gabriel John Watts](/s/Gabriel John%20Watts "View other works by Gabriel John Watts") & [Ainsley J. Newson](/s/Ainsley J.%20Newson "View other works by Ainsley J. Newson") - 2026 - American Journal of Bioethics 26 (5).details Health Technology Assessment (HTA) has traditionally focused on efficacy, safety, and cost-effectiveness. There has long been concern, however, that this is determined by the goals of healthcare providers/payers, not patients. As a result, HTA arguably fails to reflect the overall value of health technologies—including their “non-clinical” or “personal” utility to patients and their families. The use of genomic testing in clinical care is one domain where this problem is evident, as the personal utility of results is often especially significant. As (...) such, there are growing calls for HTA frameworks to adopt personal utility as a distinct element of value when assessing clinical genomic tests. We agree that personal utility is important to HTA in clinical genomics. However, against a trend toward comprehensive conceptions of personal utility within HTA, we advocate for a restrictive approach to assessing the value of personal utility in the case of clinical genomic testing. (shrink)
The Conundrum of Antidepressant-Induced Anhedonia: A Blended Patient–Psychologist Perspective.[Nicholas Norman Adams](/s/Nicholas Norman%20Adams "View other works by Nicholas Norman Adams") - 2025 - Journal of Patient Experience 12 ([Online]):1-4.details This article constitutes a Patient Perspective, grounded in lived experience, its primary aim is to enhance awareness of anti- depressant-induced anhedonia by providing experience-based insights, relevant to clinicians, researchers, and caregivers. My own experiences with treatment-resistant depression-anxiety have been significant and long-lasting. In my 22-year-plus jour- ney of illness experience—and having taken over 23 antidepressant medications—emotional-blunting, anhedonia, and mania have all, at times, been side-effect-related factors. This work explores the conundrum of antidepressant-induced anhedonia, developing an in-depth patient perspective useful for (...) mental health practitioners, psychiatrists, psychologists, and for wider formal professional and informal nonprofessional caring actors. I write this via a reflexive lens as a long-term mental health patient, while also recognizing my dual-positionality as a Chartered Psychologist and an academic with a PhD working in the field of mental health. Thus, my dual-perspective provides a unique lens useful for translating the patient experience to a wider caregiving audience: fostering understanding and deepened awareness of the anhedonia experience. Implications for patient care are discussed. (shrink)
Sincronização de Estro Para Inseminação Artificial Em Tempo Fixo Em Vacas de Corte.[Í. A. M. Amaral](/s/Í. A. M.%20Amaral "View other works by Í. A. M. Amaral") & [L. C. Pereira](/s/L. C.%20Pereira "View other works by L. C. Pereira") - 2025 - Repositório Institucional 3 (2):1-7.details Resumo A bovinocultura de corte atualmente no Brasil é fundamental para o PIB, e dessa forma para que o ciclo da pecuária se torne completo e cada vez mais eficiente o início da maturidade sexual bovina precoce. Associado ao manejo adequado e a realização frequente da sincronização de estro em fêmeas de corte, obtivemos boas taxas de concepção no rebanho e provocando a heterose entre o zebuíno e o taurino. A eficiência reprodutiva se dá por meio da sincronização do cio, (...) que ocorre por meio do uso de hormônios nos protocolos de inseminação artificial, além de sêmen de touros bem avaliados e uma equipe especializada junto ao médico veterinário. O presente relato utilizou oitenta animais sendo cinquenta vacas e trinta novilhas, taxas de concepção em novilhas de 66% e nas primíparas 84%. Concluindo que é uma técnica eficiente para ganho genético rápido no rebanho. Palavras-Chave: bovinocultura; maturidade sexual; puberdade; sincronização de estro; hormônios. Abstract Beef cattle farming is currently essential for the GDP in Brazil, and thus, for the livestock cycle to become complete and increasingly efficient, early bovine sexual maturity begins. Associated with adequate management and frequent estrus synchronization in beef females, we obtained good conception rates in the herd and caused heterosis between zebu and taurine. Reproductive efficiency is achieved through estrus synchronization, which occurs through the use of hormones in artificial insemination protocols, in addition to semen from well-evaluated bulls and a specialized team together with the veterinarian. This report used eighty animals, fifty cows and thirty heifers, with conception rates in heifers of 66% and in primiparous cattle of 84%. Concluding that it is an efficient technique for rapid genetic gain in the herd. Keywords: bovine species; sexual maturiy; puberty; synchronize estrus; hormones. (shrink)
Epistemic health, epistemic self-trust, and bipolar disorder: a case study.Simon Barker - 2025 - Synthese 205 (1):1-28.details The symptoms and associated features of mental disorders can include profound and often debilitating effects on behaviour, mood and attitude, social interactions, and engagement with the world more generally. One area of living that is closely tied to mental disorder is that of our intellectual lives, pursuits, and projects. If the symptoms and features of mental disorders can have significance when it comes to intellectual activity, however, it is plausible that they can also have significance when it comes to epistemic-normative (...) questions. I.e., questions concerning whether a person conducts their intellectual activities as they should and what is the normative status of the outputs of those activities. In this paper, I introduce the concepts of _epistemic health_ and _epistemic disorder_ as tools to examine and help understand the relationship between mental health, mental disorders, and epistemic agency. To do so, I explore the connections between a key aspect of our epistemic lives, _epistemic self-trust_ and its associated maladjustments, _self-distrust_ and _excess self-trust_, and a specific mental disorder, _bipolar disorder_. Drawing upon empirical work on metacognition and extracts from Kay Redfield Jamison’s bipolar memoir An Unquiet Mind, I argue that there is a significant association between bipolar disorder, the symptoms of depression and mania, and the risk of self-distrust and excess self-trust. In this light, I suggest that consideration of this relationship helps us to recognise how self-trust can be the site of a significant vulnerability with respect to one’s epistemic agency that merits the label of an epistemic disorder. (shrink)
Xenotransplantation as a business solution to the organ shortage.Christopher Bobier, [Richard B. Gibson](/s/Richard B.%20Gibson "View other works by Richard B. Gibson"), Anthony Merlocco, Daniel Rodger & [Daniel J. Hurst](/s/Daniel J.%20Hurst "View other works by Daniel J. Hurst") - 2025 - Bioethics 39 (5):503-511.details Xenotransplantation has the potential to alter the U.S. transplant system in profound ways. However, this emerging “spare parts” solution spearheaded by biotechnology companies raises concerns about its impact on the organ shortage, healthcare systems, population health, and health inequalities. We contend that xenotransplantation may have limited benefits in improving health, could prove prohibitively expensive for many, and may divert resources away from proven public health measures. Additionally, it carries the risk of perpetuating stigma. Xenotransplantation may thereby exacerbate existing healthcare inequities (...) across racial, ethnic, socio‐economic, and geographic lines. To mitigate these risks, we contend that public health expert input is integral for xenotransplant policy development and outreach and that this underscores the importance of federal government investment in transplant infrastructure. (shrink)
Totalitarian Technics: The Hidden Cost of AI Scribes in Healthcare.Hugh Brosnahan - 2025 - Medicine, Health Care and Philosophy.details Artificial intelligence (AI) scribes—systems that record and summarise patient–clinician interactions—are promoted as solutions to administrative overload. This paper argues that their significance lies not in efficiency gains but in how they reshape medical attention itself. Offering a conceptual analysis, it situates AI scribes within a broader philosophical lineage concerned with the externalisation of human thought and skill. Drawing on Iain McGilchrist’s hemisphere theory and Lewis Mumford’s philosophy of technics, the paper examines how technology embodies and amplifies a particular mode of (...) attention. AI scribes, it contends, exemplify the dominance of a left-hemispheric, calculative mindset that privileges the measurable and procedural over the intuitive and relational. As this mode of attention becomes further embedded in medical practice, it risks narrowing the field of care, eroding clinical expertise, and reducing physicians to operators within an increasingly mechanised system. (shrink)
Effects of feed management on performance, carcass characteristics and meat quality of Boer goats.[Emanuel Isaque Cordeiro da Silva](/s/Emanuel Isaque%20Cordeiro da Silva "View other works by Emanuel Isaque Cordeiro da Silva") & [Eduarda Carvalho da Silva Fontain](/s/Eduarda Carvalho da Silva%20Fontain "View other works by Eduarda Carvalho da Silva Fontain") - 2025 - Revista de Ciências Agroveterinárias 24 (3):552-574.details Goat farming is one of the fastest growing activities in terms of quality of its products. In this scenario, the Boer breed is the most important for the goat meat industry worldwide as it specializes in the production of quality meat, where the animals are slaughtered early and with satisfactory zootechnical indexes. Considering this favorable scenario, it was decided to evaluate the quality characteristics of the carcass and meat of these animals; then, 20 Boer goats were housed and distributed in (...) groups where one group received a diet based on hay ad libitum and fixed amounts of corn meal and soybean meal in compliance with the requirements of maintenance and weight gain; the other group was housed in different paddocks daily and received only the roughage present in the pasture. It was observed that the animals tended to present larger posterior cuts (loin and leg) with no significant difference between the feeding regimes. The animals fed with concentrate accumulated more subcutaneous fat compared to the animals under grazing. The meat of grazing animals showed higher glycolytic potential and shear force (FC), however, it had lower final pH than the meat of animals fed with concentrate. It was also possible to verify a ratio of fatty acids from intramuscular fat 4 times higher in the carcass of animals under concentrated regime in comparison to the carcass of animals under rotational grazing. With this study, it can be stated that, through the adopted feed management, the quality characteristics of the carcass and meat and, consequently, their organoleptic attributes, can be influenced, having effects on the goat meat market. (shrink)
Torção Uterina Em Vaca – Relato de Caso.[M. P. da Silva](/s/M. P.%20da Silva "View other works by M. P. da Silva") - 2025 - Dissertation, Universidade Federal da Paraíbadetails RESUMO A torção uterina é uma complicação séria que ocorre quando o corno uterino gestante se torce sobre o útero, impedindo seu retorno à posição normal. É mais frequente em vacas, sendo uma das principais causas de distocia. Os sinais clínicos dependem da intensidade do problema, mas incluem desconforto abdominal, dificuldade para respirar, batimentos cardíacos acelerados e, em situações extremas, até a morte do tecido uterino. A escolha da melhor conduta terapêutica depende do estágio da gestação, do grau da torção (...) e da condição geral da vaca e do bezerro. Deste modo relata-se o caso de um acompanhamento da técnica de cesariana em uma fêmea com distocia devido à torção uterina. Foi atendida no Hospital Universitário Veterinário (HUV) da Universidade Federal da Paraíba (UFPB), uma vaca apresentando sinais de distocia. Após exame clínico e palpação transretal constatou-se que o feto se encontrava sem vida. O tratamento consistiu na utilização de anti-inflamatórios, antibióticos e cesariana. Após 48 dias de sua entrada no hospital, o animal obteve alta médica. Diante do exposto, conclui-se que a intervenção cirúrgica imediata, aliada ao tratamento clínico adotado, foi essencial para o sucesso terapêutico. Palavras-Chave: cesariana; distocia; torção uterina. ABSTRACT Uterine torsion is a serious complication that occurs when the pregnant uterine horn twists over the uterus, preventing it from returning to its normal position. It is more common in cows and is one of the main causes of dystocia. Clinical signs depend on the severity of the problem, but include abdominal discomfort, difficulty breathing, rapid heartbeat and, in extreme cases, even death of uterine tissue. The choice of the best therapeutic approach depends on the stage of pregnancy, the degree of torsion and the general condition of the cow and calf. Thus, we report the case of a follow-up of the cesarean section technique in a female with dystocia due to uterine torsion. A cow presenting signs of dystocia was treated at the Veterinary University Hospital (HUV) of the Federal University of Paraíba (UFPB). After clinical examination and transrectal palpation, it was found that the fetus was dead. Treatment consisted of the use of anti-inflammatories, antibiotics and cesarean section. After 48 days of admission to the hospital, the animal was discharged. Given the above, it is concluded that immediate surgical intervention, combined with the clinical treatment adopted, was essential for therapeutic success. Keywords: cesarean section; dystocia; uterine torsion. (shrink)
Entrevista a José Rafael Díaz Rudas. Canalización y transmisión del conocimiento médico.[Jesús Miguel Delgado Del Aguila](/s/Jesús Miguel%20Delgado Del Aguila "View other works by Jesús Miguel Delgado Del Aguila") - 2025 - Revista de Investigación Docencia y Extensión de la Universidad de Los Andes 15 (15):90-104.details Esta entrevista realizada a José Rafael Díaz Rudas, especialista en Medicina, está orientada a que se conozca cómo es la formación universitaria de esta carrera en el Perú y de qué manera las relaciones internacionales son de ayuda para complementar esos conocimientos. Asimismo, en la conversación, se recalca la predominancia de incentivar la investigación médica a medida que se avanza en los estudios de esta disciplina. Tomando en cuenta esa formación académica, una vía de las múltiples que existen para poder (...) plasmar esos saberes a la sociedad será la docencia. Ante ello, es neurálgico que se consolide y se propicie en el estudiante el tener un criterio concomitante, como cuando en vez de recetar un medicamento será más conveniente fomentar el tratamiento no farmacológico, que podría resultar en algunos casos más saludable para el organismo, sin exposición a una secuela contraproducente o un riesgo. (shrink)
Navigating Pluralism in Medicine: Healthcare Practices Among Older Adults in West Manggarai, Indonesia.[Puri Swastika Gusti Krisna Dewi](/s/Puri Swastika Gusti Krisna%20Dewi "View other works by Puri Swastika Gusti Krisna Dewi") & Fajar Nurcahyo - 2025 - Digital Press Social Sciences and Humanities 12:00004.details This study examines the pluralism model in healthcare practices among older adults in West Manggarai, East Nusa Tenggara, Indonesia. Due to limited access to modern healthcare, many older adults in rural areas rely on traditional medicine. Consequently, this research investigates how they integrate traditional and modern practices to meet their health needs. A qualitative approach was used, involving semi-structured interviews with 10 older adults from Pantar village, selected through purposive sampling. The data were thematically analyzed to identify patterns in healthcare-seeking (...) behavior and the perceived effectiveness of traditional versus modern healthcare options. This study reveals a complex and dynamic relationship between conventional and traditional healthcare practices among older adults in West Manggarai. Many older adults use a hybrid approach, relying on conventional medicine for acute or emergency conditions, while traditional medicine—such as herbal remedies and spiritual healing—are often preferred for initial treatment and prevention. Trust in ancestral wisdom, accessibility, and cultural beliefs significantly influence healthcare decisions. Conventional care is often perceived as distant and impersonal, strengthening reliance on traditional practices. In conclusion, healthcare pluralism in this region is shaped by accessibility, cultural beliefs, and perceived efficacy of various medical systems. The study highlights the need to integrate traditional knowledge with conventional practices to foster more inclusive and effective health services for older adults in rural Indonesia and improve health outcomes in aging populations. (shrink)
Race in Medicine.[M. A. Diamond-Hunter](/s/M. A.%20Diamond-Hunter "View other works by M. A. Diamond-Hunter") - 2025 - In Alex Broadbent, Oxford Handbook of Philosophy of Medicine. Oxford University Press. pp. 325-350.details This chapter aims to be a comprehensive (yet non-exhaustive) overview of the ways the concept of race appears across medical practice - including historical uses, patient–physician interactions, pharmaceutical development, the use of machine learning tools in clinical settings, the recording of medical statistics, the controversial and continued use of race norming in medicine, and the ways in which racism affects patient diagnoses and outcomes. The focus on the ways that the concept is used in medical practice is to illustrate that (...) an anti-realist ontological position (rather than a biological realist or a social constructionist one) is the best way to have a logically consistent position that can accommodate the empirical examples discussed in the chapter. The chapter concludes with a sketch of how to best deal with these issues with an eye toward future developments in medicine. (shrink)
The Dangers of ‘Best Practices’: Against Supposedly Revolutionary Theories of Evidence in Medicine.[Charles M. Djordjevic](/s/Charles M.%20Djordjevic "View other works by Charles M. Djordjevic") - 2025 - In Uri D. Leibowitz, Klodian Coko & Isaac Nevo, Philosophical Theorizing and Its Limits: Anti-Theory in Ethics and Philosophy of Science. Cham: Springer.details Pain is a refractory problem in healthcare. One proposed solution is to promulgate best practices derived from the highest quality evidence stipulating how to assess pain and which treatment interventions are the most efficacious. Such a solution seamlessly integrates into evidence-based medicine, the dominant ‘revolutionary paradigm’ in healthcare. This paper argues that such a ‘revolutionary’ approach is theoretically untenable and ethically abhorrent. Section 1 adumbrates the evidence-based medicine framework, how best practices are often formulated under its auspices, and which methods (...) it might use to address pain. Section 2 points out that this approach faces profound theoretical issues when applied to pain, even by its own lights. Section 3 argues that attempts to use such best practices in the clinic generate grave ethical problems. Finally, Sect. 4 briefly sketches a different form of medicine, one that casts evidence as a helpful handmaiden of medicine, instead of a domineering mistress. (shrink)
Tension between the need for certainty and numerous uncertainties – A focus group study on various perspectives on a potential genomic newborn screening program in Germany.[Elena Sophia Doll](/s/Elena Sophia%20Doll "View other works by Elena Sophia Doll"), Julia Mahal, Karla Alex, [Seraina Petra Lerch](/s/Seraina Petra%20Lerch "View other works by Seraina Petra Lerch"), Stefan Kölker, [Christian P. Schaaf](/s/Christian P.%20Schaaf "View other works by Christian P. Schaaf"), [Eva C. Winkler](/s/Eva C.%20Winkler "View other works by Eva C. Winkler") & Beate Ditzen - 2025 - Journal of Genetic Counseling 34 (3):e70004.details The advancement of genome sequencing technology and its potential application in newborn screening is being discussed in various countries. Genomic newborn screening (gNBS) can provide parents with information about their child's genetic susceptibility for known disorders. However, it also presents ethical and psychosocial challenges. This study was carried out with a view toward the possible introduction of gNBS in Germany. Due to the existing challenges, it is crucial to understand different perspectives of relevant groups in Germany before implementing gNBS. Four (...) online focus groups were conducted with parents, patient representatives, and healthcare professionals to explore perceived opportunities and challenges, as well as needs regarding a potential gNBS program. Discussions with altogether 24 participants were semi-structured using a pre-defined interview guide. Sessions were audio-visually recorded and transcripts were analyzed using a structuring qualitative content analysis combining both deductive and inductive methods. Participants expressed positive views about gNBS but also reservations about a gNBS program and posed requirements for operating conditions. One salient theme that emerged was hope for certainty through gNBS in the face of numerous uncertainties. The study complements the perspective of patient representatives, providing further insight into the subject matter. This is a valuable contribution as they possess a comprehensive understanding of the medical, psychological, and ethical considerations involved. Patient representatives placed particular emphasis on the advantages of avoiding a diagnostic odyssey and the significance of support systems. The results provide first insights into different views on gNBS in Germany. These views can inform the potential preparation of a gNBS program in Germany, particularly with regard to information and consent requirements. Implications for practice, such as informing and educating parents about gNBS during pregnancy, can be derived from the study. WHAT IS KNOWN ABOUT THIS TOPIC: Previous studies have indicated that there is significant public and—more particularly parental—interest in genomic newborn screening (gNBS). However, discrepancies exist regarding preferences for the scope of reported results, including differences between the views of healthcare professionals, parents, and the public. WHAT THIS PAPER ADDS TO THE TOPIC: This study offers insights into various perspectives on the potential implementation of gNBS in Germany, highlighting divergent views of healthcare professionals and parents, while also introducing a novel and valuable contribution by including the viewpoints of patient representatives. (shrink)
The limitations of narrative medicine.Rajeev Dutta - 2025 - Theoretical Medicine and Bioethics 46 (3):247-264.details Narrative medicine has emerged over the past few decades as an exciting approach to medical practice, interweaving the practice of medicine with the practices of literary analysis and reflective writing. It is often claimed that narrative medicine enables practitioners to understand and empathize with patient stories, effectively ‘joining’ patients in illness. However, I argue that there are reasons to be suspicious of narrative medicine’s ability to promote patient-centered care. I begin by questioning the distinctiveness of narrative knowledge, suggesting that it (...) is neither able to be propositional knowledge (‘knowledge-that’) nor phenomenal/experiential knowledge (‘knowledge-what-it’s-like’). Then, I consider an alternative reading of narrative medicine, by which narratives are simply ways to structure patient information so that a physician can more readily empathize with the patient. I dismiss this alternative as unsatisfactory given that it depends on either all patients building narratives or physicians imposing narrative structure(s) where one does not inherently exist, thus overriding patients. Finally, I provide possible supplements and alternatives to narrative medicine, proposing that active listening and the removal of systemic barriers to physicians’ abilities to provide humanistic care (e.g., lower administrative, profit, and documentation burdens) may be a first step to putting empathetic patient care on the forefront. Ultimately, I think that these efforts (while their fruition may present difficulty), rather than sifting through patient information to construct and elevate narratives, present the opportunity to accurately refocus patient-centered care. (shrink)
Cisto Ovariano em Vacas: Uma Revisão de Literatura.[A. C. P. Fernandes](/s/A. C. P.%20Fernandes "View other works by A. C. P. Fernandes"), [N. M. L. Fernandes](/s/N. M. L.%20Fernandes "View other works by N. M. L. Fernandes"), [M. F. L. Valentim](/s/M. F. L.%20Valentim "View other works by M. F. L. Valentim"), [S. H. Santos](/s/S. H.%20Santos "View other works by S. H. Santos"), [L. F. G. Moreira](/s/L. F. G.%20Moreira "View other works by L. F. G. Moreira"), [K. E. S. Ferreira](/s/K. E. S.%20Ferreira "View other works by K. E. S. Ferreira"), [A. C. M. Lopes](/s/A. C. M.%20Lopes "View other works by A. C. M. Lopes"), [F. M. Freitas](/s/F. M.%20Freitas "View other works by F. M. Freitas"), [M. E. Oliveira](/s/M. E.%20Oliveira "View other works by M. E. Oliveira") & [F. G. H. Oliveira](/s/F. G. H.%20Oliveira "View other works by F. G. H. Oliveira") - 2025 - Medicina Veterinária e Engenharia Sanitária: Desafios e Inovações – Vol. 2.details Resumo: Este estudo tem como objetivo revisar a literatura acerca do cisto ovariano em vacas. O cisto ovariano em bovinos é um folículo anovulatório com diâmetro superior a 25 mm, que persiste nos ovários por mais de 10 dias sem a presença de um corpo lúteo funcional, causando infertilidade ao interromper os ciclos estrais. Os cistos podem ser classificados como foliculares ou lúteos, sendo difícil diferenciá-los pela palpação retal, mas a dosagem de progesterona (P4) no plasma ou leite e a (...) ultrassonografia podem ajudar no diagnóstico. A etiologia do cisto ainda não é totalmente compreendida, mas fatores como a condição corporal no pós-parto, número de lactações e desordens no período pós-parto são considerados fatores de risco. A principal causa está relacionada a desequilíbrios hormonais, especialmente na liberação de LH, prejudicando a ovulação. Palavras-chave: cisto ovariano; cistos lúteos; cistos foliculares; folículo anovulatório; reprodução. -/- Abstract: Ovarian cysts in cattle are characterized as an anovulatory follicle with a diameter greater than 25 mm, which persists in the ovaries for more than 10 days without the presence of a functional corpus luteum, causing infertility by interrupting the estrous cycles. Cysts can be classified as follicular or luteal, and while it is difficult to differentiate them through rectal palpation, the measurement of progesterone (P4) in plasma or milk and ultrasonography can aid in diagnosis. The etiology of the cyst is not fully understood, but factors such as body condition postpartum, number of lactations, and disorders in the postpartum period are considered risk factors. The main cause is related to hormonal imbalances, particularly in the release of LH, impairing ovulation Keywords: ovarian cyst; luteal cyst; follicular cyst; anovulatory follicle; reproduction. (shrink)
Gulliver's Struldbruggs Revisited.Hans Förstl - 2025 - Psychotherapie Im Alter 22 (3):325-328.details Attitudes towards sickness, aging and death may have changed from satirical fatalism to what has already been achieved and what may one day become feasible. One fundamental problem, however, remains the same: In the end we will die. It was easy for the clergyman Jonathan Swift to look down on humanity's vain hope of immortality here on earth with such disdain, almost misanthropy. For him, life ultimately did not appear to end with death. Remove from this list Export citation Bookmark
Effects of CLA, Soybean Oil, and Used Soybean Oil from Fish Friers in Sheep Diets on Milk Lipids and Lamb Tissues.I. Gasperin-López, [J. M. Pinos-Rodríguez](/s/J. M.%20Pinos-Rodríguez "View other works by J. M. Pinos-Rodríguez"), [J. G. Vicente-Martínez](/s/J. G.%20Vicente-Martínez "View other works by J. G. Vicente-Martínez"), S. López-Aguirre, [A. T. Estrada-Coates](/s/A. T.%20Estrada-Coates "View other works by A. T. Estrada-Coates") & G. Contreras-Hernández - 2025 - Animals 15 (4):551.details The use of omega fatty acids during pregnancy and lactation could be a beneficial strategy to improve health and production in ruminants. In this study, the effect of the dietary addition of c9, t11 and t10, c12 isomers of conjugated linoleic acid (CLA) in pure soybean oil (T1) was compared with pure soybean oil (T2) and soybean oil discarded after frying fish (Centropomus undecimalis, Pagrus pagrus, and Caranx crysos; T3) on the fatty acid profile in ewe milk and the tissues (...) of their lambs. Forty-five multiparous ewes (East Friesian × Katahdin), 32 to 35 months old, 70 days pregnant, were randomly assigned to one of the three experimental diets. The fatty acid profile, total solids, fat, protein, and lactose in milk were determined 14 days postpartum. Fifteen lambs from each treatment were sacrificed at 70 days of age, and the fatty acid profiles in perirenal fat, muscle, and brain were determined. In milk, fat and total solids content were lower with T1. On the other hand, linoleic acid content, the sum of omega-6 and DHA were higher in T1 compared to other groups (p < 0.05). In the brain, stearic acid and linoleic acid concentration increased with T1; eicosapentaenoic acid decreased and omega-3s increased with T3, while DHA was lower in T2 (p < 0.05). The addition of CLA isomers or discarded soybean oil in ewe diet from pregnancy to lactation is advantageous for the ewe since less energy in the form of milk fat is lost. In addition, increasing the concentration of omega fatty acids in ewe diet to improve omega fatty acids in lamb’s brain could be a feed strategy to increase their productivity and health. (shrink)
Comparison between recombinant bovine somatotropin and equine chorionic gonadotropin in timed artificial insemination protocols in Bos indicus cows under low body condition score.G. Gassenferth, [V. M. Valle](/s/V. M.%20Valle "View other works by V. M. Valle"), [F. A. Souza](/s/F. A.%20Souza "View other works by F. A. Souza"), [M. G. T. Gomes](/s/M. G. T.%20Gomes "View other works by M. G. T. Gomes"), [A. Gassenferth Júnior](/s/A.%20Gassenferth Júnior "View other works by A. Gassenferth Júnior"), [G. V. A. Rosa](/s/G. V. A.%20Rosa "View other works by G. V. A. Rosa"), A. Bragato, E. Nogueira & [L. E. Kozicki](/s/L. E.%20Kozicki "View other works by L. E. Kozicki") - 2025 - Arquivo Brasileiro de Medicina Veterinária E Zootecnia 77 (2):1-12.details ABSTRACT This study aimed to evaluate the efficiency of recombinant bovine somatotropin (rbST) on pregnancy rate (PR), dominant follicle diameter (DFD) pre-ovulatory follicle diameter (DFPO), and follicular growth rate (FGR) in Bos indicus cows with low body condition score (BCS; mean = 2.3) subjected to fixed-time artificial insemination (FTAI) protocols. The females were divided into four groups: rbST group day zero (GbSTd0; n=31) received a progesterone (P4) intravaginal device + estradiol benzoate + rbST on d0 of the protocol; on d8, (...) P4 was removed and PGF2???? + estradiol cypionate were administered; on d10, FTAI was performed; GbSTd8; n=31) received the same treatment as GbSTd0, except rbST administration on d8; the control group (GC; n=42) received the same treatment as GbSTd0 but without rbST; equine chorionic gonadotropin group (eCGG; n=46) received the same treatment as GC + eCG on d8. Ovarian follicles were evaluated by ultrasonography (US) on d0, d8, and d10 of the protocols. PRs (at d35) and FGR between d8 and d10 of the protocol were calculated. PRs resulted 16.1%, 19.4%, 30.9%, and 43.4% in GbSTd0, GbSTd8, GC, and GeCG, respectively. eCGG PR differed significantly (P<0.05) from rbST groups but not to the GC; no difference was observed between rbST groups and GC. eCGG resulted in larger DFPO (11.2±1.5 vs. 9.6±0.5 in GbSTd0; 9.9±0.8 in GbSTd8; 10.1±1.3 in GC; P=0.0001) and greater FGR (2.20±1.03 vs. 0.93±0.50 in GbSTd0; 0.94±0.52 in GbSTd8; 1.17±0.64 in GC) (P<0.0001). It was concluded that rbST groups resulted in lower PR, FGR, and DFPO compared to eCGG in cows with reduced BCS; therefore, eCG is recommended for use in cows with low BCS in FTAI programs. Keywords: recombinant bovine somatotropin, equine chorionic gonadotropin, Bos indicus, follicular dynamics, FTAI RESUMO O estudo objetivou verificar a eficiência da somatotrofina recombinante bovina (rbST) sobre a taxa de prenhez (TP), o diâmetro do folículo dominante (DFD) e do pré-ovulatório (DFPO) e a taxa de crescimento folicular (TCF) de vacas Bos indicus com baixo escore corporal (ECC médio=2,3) submetidas a protocolos de inseminação artificial em tempo fixo (IATF). As fêmeas foram distribuídas em quatro grupos: grupo bST dia zero (GbSTd0; n=31) recebeu, no d0 do protocolo, um dispositivo intravaginal com progesterona (P4) + benzoato de estradiol + rbST; no d8, houve a remoção da P4 e foi aplicado PGF2???? + cipionato de estradiol; no d10, executou-se a IATF; GbSTd8 (n=31) recebeu idêntico tratamento ao GbSTd0, exceto a aplicação da rbST no d8; grupo controle (GC; n=42) recebeu o idêntico tratamento ao GbSTd0, exceto a não aplicação da rbST; grupo gonadotrofina coriônica equina (GeCG;n=46) recebeu idêntico tratamento ao GC + eCG no d8. Os folículos ovarianos foram avaliados por exames de ultrassonografia (US) em d0, d8 e d10 dos protocolos. Foram calculadas as TPs (no d35) e a TCF entre d8 e d10 do protocolo. As TPs resultaram respectivamente em 16,1%; 19,4%; 30,9% e 43,4% nos GbSTd0, GbSTd8, GC e GeCG. As TPs do GeCG mostraram diferença (P<0,05) em relação aos grupos da rbST, mas não ao GC; não houve diferença entre os grupos rbST e o GC. A eCG resultou em maior DFPO (11,2±1,5 vs. 9,6±0,5 do GbSTd0; 9,9±0,8 do GbSTd8 e 10,1±1,3 do GC; P=0,0001) e maior TCF (2,20±1,03 vs. 0,93±0,50 do GbSTd0; 0,94±0,52 do GbSTd8, 1,17±0,64 do GC) (P<0,0001). Concluiu-se que os grupos rbST resultaram em menor TP, TCF e DFPO que a eCG, em vacas com reduzido escore ECC; recomenda-se o emprego da eCG em vacas com baixo ECC em programas de IATF. Palavras-chave: somatotrofina recombinante bovina, gonadotrofina coriônica equina, Bos indicus, dinâmica folicular, IATF. (shrink)
A Commentary on "Does Black Box AI In Medicine Compromise Informed Consent".Luke Golemon - 2025 - Philosophy and Technology.details A recent series of papers have challenged whether black box AI challenges informed consent. Director has most recently argued that the explicit canonical view of informed consent and the implicit view held by bioethicists neglects a crucial distinction between first-order and higher-order evidence needed to show that black box AI does not threaten efficacious consent. I believe a charitable reconstruction of the canonical view and the implicit view held by bioethicists does not neglect the crucial distinction and, indeed, many clear (...) cases of informed consent involve a notable lack of first-order information but a wealth of second-order information. Thus, it most reasonable to interpret the ‘informed’ portion of ‘informed consent’ as (i) relative to what we know, and (ii) inclusive of both first- and higher-order information. This strengthens the argument for Director’s conclusions about black box AI: its purported threat to informed consent are instead worries about the reliability of black box AI. (shrink)
Apneas del sueño y depresión: la posibilidad de un error diagnóstico.[Elsa González San Martín](/s/Elsa%20González San Martín "View other works by Elsa González San Martín") & Javier Silva-Silva - 2025 - Revista Confluencia 8.details El síndrome de apnea obstructiva del sueño y el trastorno depresivo mayor comparten una cantidad significativa de síntomas, de tal forma que es posible plantear la posibilidad que haya personas con diagnóstico de depresión que padecen de un síndrome de apnea obstructiva del sueño no diagnosticado como causa de sus síntomas psiquiátricos. En este manuscrito se presentan argumentos sobre cómo una persona con apneas del sueño satisface criterios diagnósticos de depresión, y que un médico que no las considera como hipótesis (...) puede realizar un diagnóstico erróneo. Dado que el tratamiento para ambas patologías es distinto, se concluye que es importante incorporar en los algoritmos diagnósticos de depresión la búsqueda de apneas del sueño y de estudiar su incidencia en la población con síntomas depresivos. (shrink)
Hope in Ancient Greece and Rome.[G. Scott Gravlee](/s/G. Scott%20Gravlee "View other works by G. Scott Gravlee") - 2025 - In Anthony Scioli & Steven C. van den Heuvel, The Oxford Compendium of Hope. New York: Oxford University Press. pp. 43-59.details This chapter examines a range of ancient Greek and Roman views regarding hope, developing themes drawn from philosophical sources—including Plato, Aristotle, and the Stoic and Epicurean schools—and discussing approaches and applications in the narratives of Thucydides and in ancient Greek medicine. Selected references to Greek and Roman literature and cultural practices are also included. Together, these ancient sources reveal complex human attitudes about the future, and the chapter considers various criteria used to make judgments about the value of hope. Themes (...) include the relationships of hope to fear and courage, rationality and memory, emotion and pleasure, and human agency and well-being. Throughout, connections are made with current philosophical literature on hope, in the belief that familiarity with the variety and nuance of ancient attitudes can promote a deeper understanding of our own notions of hope. (shrink)