In this paper, we apply the perspective of intra-organismal ecology by investigating a family of ecological models suitable to describe a gene therapy to a particular metabolic disorder, the adenosine deaminase deficiency (ADA-SCID). The gene therapy is modeled as the prospective ecological invasion of an organ (here, bone marrow) by genetically modified stem cells, which then operate niche construction in the cellular environment by releasing an enzyme they synthesize. We show that depending on the chosen order (a (...) choice that cannot be made on \textit{a priori} assumptions), different kinds of dynamics are expected, possibly leading to different therapeutic strategies. This drives us to discuss several features of the extension of ecology to intra-organismal ecology. (shrink)

Adaptation and stress are two main concepts useful for better understanding the phases of illness and health-related human behavior. The two faces of adaptation, adaptation as a process and adaptation as a product, have raised the question of how long the adaptation process will take in cancer trajectories. The care setting transition from clinical-based into home-based cancer care has stressed the role of family caregivers (FCG) in cancer management. This study examines how types of demanded healthcare information affect the (...) FCG’s role in catalyzing the adaptation of female cancer patients. The mindsponge theory was used in conceptual development and results interpretation. Bayesian Mindsponge Framework (BMF) analytics was used for statistical analysis on a dataset of 48 spouses (husbands) and 12 other family members in five congested communities of Surabaya, Indonesia. Results showed that among the six types of demanded healthcare information, FCGs with a higher tendency to demand cancer-specific information are more likely to need support in catalyzing the adaptation of female cancer patients. Meanwhile, FCGs with a higher demand for information on alternative therapies are less likely to need support in catalyzing cancer adaptation. Other types of healthcare information have ambiguous effects on the need for support in cancer adaptation assistance. This study reveals that the demanded cancer-specific information, e.g., cancer’s prognosis or likely outcome, must be prioritized to assist FCG’s role in catalyzing adaptation among female cancer patients. Cancer prognosis and outcomes reflect the future of cancer care results. (shrink)

Traditionally, the key features of the family system of Eating Disorders have been considered those originally outlined by Minuchin in his description of the "psychosomatic" family patterns of interaction. This controlled study tests two of the principal characteristics of Minuchin's model, namely enmeshment and rigidity, operationalised as extreme cohesion and low adaptability. Perceived and desired cohesion and adaptability, measured with the FACES III, were compared between 30 clinical families and 30 non-clinical families. Differences across ED family members (...) were also considered, as well as differences between ED symptomatological subgroups . High cohesion scores were found in ED families, but similar findings were also reported in control families. Cohesion scores were significantly higher in restricting anorectics than in patients with bulimic symptoms. Adaptability was normal in both ED and control families. This study does not support Minuchin's observations on family enmeshment and rigidity. Although high levels of cohesion were found in ED families, the same relational pattern was found in the control families, suggesting that a tendency to a hyper-involvement of family members might be "normal" in some sociocultural contexts. (shrink)

In the last decade, the cases of breast and cervical cancer have been positioned at the top rank of cancer statistics worldwide. Consequently, many husbands become family caregivers (FCGs) and get the burden of cancer caregiving. Being blind and incompetent, they need supportive care from healthcare professionals (HCPs). To support them, HCPs provide various healthcare information to meet their needs. Further, their demand for a specific type of healthcare information may reflect their need for emotional support from the HCPs (...) to reduce the burden. This study aims to examine the predictors of the need for emotional support among FCGs of female cancer patients by analyzing the demanded healthcare information. The mindsponge theory was used in conceptual development and interpretation. Bayesian Mindsponge Framework (BMF) analytics were used for statistical analysis on a dataset of 48 husbands and 12 significant others in five congested communities of Surabaya, Indonesia. Results showed that among the six types of healthcare information, the demanded cancer-specific information and information on cancer physical needs significantly predict the need for emotional support among respondents. Meanwhile, FCGs with a higher demand for information on alternative therapies are less likely to need emotional support. Other types of information have ambiguous effects on the need for emotional support. This study reveals that the demanded cancer-specific information, e.g., cancer prognosis or likely outcome, and information on cancer physical needs must be prioritized in information disclosure to meet the needs for emotional support among FCGs of female cancer patients. (shrink)

In this paper, we discuss the perspective of intra-organismal ecology by investigating a family of ecological models. We consider two types of models. First order models describe the population dynamics as being directly affected by ecological factors (here understood as nutrients, space, etc). They might be thought of as analogous to Aristotelian physics. Second order models describe the population dynamics as being indirectly affected, the ecological factors now affecting the derivative of the growth rate (that is, the population acceleration), (...) possibly through an impact on non-genetically inherited factors. Second order models might be thought of as analogous to Galilean physics. In the joint paper, we apply these ideas to a situation of gene therapy. (shrink)

This dissertation is an investigation into how scientific values may influence the kinds of theories which are investigated, and in turn which theories become ‘mainstream’. I have focussed on psychedelic therapy as a family of theories, and I identified three main reasons as to why psychedelic therapy is somewhat incompatible with the current psychiatric paradigm: (1) the inability to conduct double-blind trials, (2) The inability to isolate one explanatory variable, and (3) The mystical and spiritual dimensions of (...) the mechanisms of action of psychedelic drugs. Because double-blind randomised controlled trials, isolating one explanatory variable, and neurobiological- style explanations of mechanisms of action are seen as an integral part of good psychiatric research, this means that psychedelic therapy is inherently disadvantaged as a research avenue in the current paradigm. These three things also arguably embody scientific values proposed by Kuhn (1977), such as accuracy, simplicity, and consistency. Helen Longino (1995) argues that Kuhn’s values do not simply increase the likelihood of a theory being true, but in some instances serve to perpetuate discriminatory ideologies. She proposes her own list of values as a route to a more equitable science, and by extension, a more equitable society. Interestingly, psychedelic therapy as a theory embodies many, if not all of the values proposed by Longino. This led me to my conclusion that if the psychiatric paradigm were more feminist according to Longino’s criteria, then psychedelic therapy would be considered a “better” theory. It would therefore be easier to conduct research in this area, and psychedelic therapy would have a better chance at becoming a mainstream treatment. (shrink)

The elderly face very challenging situations due to their mental and physical conditions. Like the other country in the world, Bangladesh Government has enacted laws to protect the elderly rights. However, the law does not seem to represent what the elderly actually needs. Therefore, 385 elderly people, aged between 60 and 90 years were surveyed to understand their expectations from family, society, and government. There were 57.1% men and 42.9% women. Most of the elderly (80%) were educated. Just over (...) half (53.5%) had ordinary mental and physical health, while a quarter (31.4%) had good status. More than half (53%) of the participants required 2000–5000 BDTK (Bangladeshi Taka) equivalent to $20-50 to cover monthly treatment expenditures. The majority (67.3%) felt government Old Age Allowance should be increased to BDT 5,000 ($50). Of 13.8% of individuals experienced harsh discourse from family because of the cost of therapy. However, 16.9% of people choose not to respond to this question. More than half (57.4%) of the respondents’ thought caregivers were insufficient. One-third felt that legislation should be changed to take care of parents (33.5%) and One-third felt that children should take care of more (33.5%). Some (3.6%) thought that children should act as they did in their childhood respectively. Almost half (44.2%) of respondents did not know that the elderly should receive a separate senior citizen card for preferential treatment, yet 51.9% thought this. Some (44.7%) felt the elderly should get priority in any queue and discounts in Bus/Uber/Rickshaw. Results also showed that expectation is more than the service provided. Further, a one-stop elderly care clinic is required to provide integrated care and support for the quality of life of the elderly. (shrink)

Psoriatic arthritis is a chronic, systemic inflammatory disorder. It has been classified in spondyloarthropathies group which shares clinical, radiologic, serologic features, familial and genetic relationship. Up to 5-30% of patients with psoriasis may go on to develop psoriatic arthritis, usually within 5-10 years. Adalimumab (ADA) is the first human monoclonal antibody against TNF-α. ADA is a biologic agent effective in both skin lesions and joint signs. Anti-TNF agents are powerful immunmodulating drugs with potentially side effects. Our case is 38 years (...) old woman complaining about swelling and pain in hand joints. In physical examination she has asymmetrical arthritis in wrist, proximal (PIP) and distal interphalangeal (DIP) hand joints and right knee joint. In laboratory; sedimentation rate: 80 mm/h, C-reactive protein: 17 mg/l, rheumatoid factor (RF): 8.7 IU/ml and HLA B27 was positive. Radiologically, erosions and narrowing were determined in PIP and DIP hand joints and grade 3 sacroiliitis bilaterally. In clinical monitoring, psoriaform lesions progressed in her scalp, so we diagnosed psoriatic artritis. We started ADA therapy 40 mg subcutaneously every two weeks. She developed periorbital infection in left-sided in tertiary month following. Streptococcal proliferation was seen in lesion culture, so we began amoxicillin-clavulanate therapy. She benefit antibiotic therapy, infectious signs regressed. ADA therapy discontinued, instead of it, etanercept 50 mg twice weekly subcutaneous and methylprednisolone 12 mg/daily oral therapy is started. We purposed to declare our case with literature selection. (shrink)

Among all aspects, the unmet needs of healthcare information from the healthcare and illness-related domains have the potency to predict the unmet needs of emotional support from the emotional and relational domains in this population. The current study aims to examine the predictors of the needs for emotional support among FCGs of cancer patients by analyzing the demanded healthcare information, i.e., cancer-specific information, caregiver-specific information, therapy-specific information, information on cancer physical needs, information on alternative therapies, and information on support (...) services. (shrink)

The current study aims to examine how types of demanded healthcare information affect the FCG’s role in reducing the fear of female cancer patients (i.e., cancer-specific information, caregiver-specific information, therapy-specific information, information on cancer physical needs, information on alternative therapies, and information on support services).

The current study aims to examine how types of demanded healthcare information affect the FCG’s role in catalyzing the adaptation of female cancer patients (i.e., cancer-specific information, caregiver-specific information, therapy-specific information, information on cancer physical needs, information on alternative therapies, and information on support services).

Results: We analyzed 1,402 surveys and 15 in-depth interviews. Many (32%) CL participants reported greater difficulty refilling medications and a minority (14%) reported greater difficulty accessing HIV care during the pandemic. Most (99%) Opt4Mamas participants reported no difficulty refilling medications or accessing HIV/pregnancy care. Among the CL participants, older women were less likely (aOR = 0.95, 95% CI: 0.92–0.98) and women with more children were more likely (aOR = 1.13, 95% CI: 1.00–1.28) to report difficulty refilling medications. Only 2% of (...) CL participants reported greater difficulty managing FP and most (95%) reported no change in likelihood of using FP or desire to get pregnant. Qualitative analysis revealed three major themes: (1) adverse organizational/economic implications of the pandemic, (2) increased importance of pregnancy prevention during the pandemic, and (3) fear of contracting COVID-19. (shrink)

In this chapter, I describe my “post-diagnosis” experiences as the parent of an autistic child, those years in which I tried, but failed, to make sense of the overwhelming and often nonsensical information I received about autism. I argue that immediately after being given an autism diagnosis, parents are pressured into making what amounts to a life-long commitment to a therapy program that (they are told) will not only dramatically change their child, but their family’s financial situation and (...) even their entire mode of existence. Moreover, despite information overload, many treatment programs for autism rely on empty jargon and make completely unrealistic promises, so parents are left feeling overwhelmed and panicked. Even well respected therapy programs encourage parents to spend liberally. Indeed, autistic therapists, who help construct what I refer to as the Culture of Autism, advise parents to commit to a minimum of 35 to 45 hours of intensive therapy every week. The implications are clear: for a parent who works full-time, their autistic child becomes a second full-time job. Autism is big business right now, and therapists are pushing parents to the brink of desperation. So it is not too surprising that there is a desperate cry for a more permanent solution—which is why researchers seek to cure autism. But there are two ways to conceptualize cure. A Therapeutic Cure model (TC) conceives of a cure as a beneficial treatment for the patient that eliminates or ameliorates the harms of the disease or condition. But the notion of a therapeutic cure for autism is highly implausible, given the complexities of autism. Indeed, at this point, the vast majority of researchers have come to the conclusion that the idea of a therapeutic cure for autism is simply a non-starter. Therefore the bulk of research seeking a cure for autism focuses instead on a second approach, which I refer to as the Negative Eugenics Cure model (NEC). With this model, the intention is to eliminate the disease or condition without regard for the health or well-being of the organism carrying the disease or condition. So, with regard to autism, researchers are focusing on identifying genetic markers for autism that can be detected in utero, or in embryos, so that autistic fetuses can be eliminated and autism eradicated by preventing the existence of autistic individuals. I review both models and argue that both fail to provide convincing arguments that the “solution” either offers is desirable. Both rest on the assumption that autism renders a life not worth living which, all things considered, is false. Instead of pushing to cure autism, an idea pervasive in this Culture of Autism, I contend that autistics are individuals with lives worth living. Moreover, rather than expend millions on research to search for the means to eliminate autism, we should instead expend our resources to ensure autistic individuals have access to support they may need. If the phenomenology of autism were better understood and appreciated, the panicked demand for a cure for autism might abate and perhaps autism could be seen as having value in and of its own right. (shrink)

Currently, documentation on the effects of psychedelics on psychosis appears scarce. In the present case, a higher-dose LSD experience during acute paranoid psychosis before the initiation of antipsychotics induced feelings of love, which resolved the majority of the symptoms of the paranoid psychosis in one session, leading the person to reconnect with his family and seek treatment in a psychiatric hospital. The session did not resolve schizoaffective disorder, however. More than a decade later, while using the antipsychotic aripiprazole, concurrent (...) self-administration of ketamine induced psychedelic effects that appeared to allow for practicing 'grounding' of psychotic thoughts. Immediately afterwards, daily self-administration of psycholytic doses of LSD for four weeks caused a mood-enhancing effect that enabled the patient to successfully discontinue aripiprazole without the return of psychotic symptoms. No psychotic or other noticeable symptoms could be observed during two interviews conducted in the two months following the discontinuation of the antipsychotic. -/- The mechanisms of action remain unexplored, and their possible generalizability to other cases remains unclear, but the observations may serve as a basis for further research. It may, for example, be that chronic use of LSD induces a tolerance to its psychedelic effects but not to its anti-inflammatory or other possibly unknown effects, which may be related to the observed mood-enhancing effect. A preclinical study from 1971 appeared consistent with the claimed effect. -/- In the present case, paranoia, i.e., the hypersensitivity to potential threats, was partly due to childhood trauma, partly intentionally induced by military training, and partly accentuated by war experiences. It could not be 'turned off'. Fear related to the uncertainty of survival formed the core of psychosis; without the fear, psychosis would likely not have existed. Paranoid psychosis presented itself as a biased estimation of probabilities of possible adverse outcomes, as a mismatch between the past and the present. (shrink)

The public health crisis is started with emergence of new coronavirus on 11 February 2020 which triggered as coronavirus disease-2019 (COVID-19) pandemics. The causative agent in COVID-19 is made up of positively wrapped single-stranded RNA viruses ~ 30 kb in size. The epidemiology, clinical features, pathophysiology, and mode of transmission have been documented well in many studies, with additional clinical trials are running for several antiviral agents. The spreading potential of COVID-19 is faster than its two previous families, the severe (...) acute respiratory syndrome coronavirus (SARS-CoV) and the Middle East respiratory syndrome coronavirus (MERS-CoV). Apart from clinical manifestation, comorbid status is playing key role for prevalence of COVID-19 infection and mortalities. The comorbid effects associated with COVID-19 are diabetes, cardiovascular, digestive, hepatitis-B, cerebrovascular, hypertension, liver injury, coronary heart disease, cancer, rheumatoid arthritis, and neurological impairment. Antimalarial drugs (chloroquine and hydroxychloroquine), remdesivir, Tocilizumab, clopinavir/ritonavir, convalescent plasma therapy, spike protein-angiotensin-converting enzyme 2 (ACE2) inhibitors, human monoclonal antibodies, mRNA-1273, mesenchymal stem cells, Indian and Chinese traditional medicine, small molecules antioxidant, natural products and dietary supplements, high doses of vitamin-E, -C, -D, minerals, flavonoids,and IFN-beta are therapeutic intervention running to develop treatment against COVID-19. Although clinical usage of these therapeutic agents against COVID-19 is well documented, cytokine storms, absence of appropriate animal model have limited its therapeutic use. This review explores the clinical information currently available on COVID-19 on the mechanisms of infection, prevention, management, comorbid status, and current drug treatment options. (shrink)

BACKGROUND Patients with chronic pain face significant barriers in finding clinicians to manage long-term opioid therapy (LTOT). For patients on LTOT, it is increasingly common to have them sign opioid treatment agreements (OTAs). OTAs enumerate the risks of opioids, as informed consent documents would, but also the requirements that patients must meet to receive LTOT. While there has been an ongoing scholarly discussion about the practical and ethical implications of OTA use in the abstract, little is known about how (...) clinicians use them and if OTAs themselves modify clinician prescribing practices. OBJECTIVE To determine how clinicians use OTAs and the potential impacts of OTAs on opioid prescribing. DESIGN We conducted qualitative analysis of four focus groups of clinicians from a large Midwestern academic medical center. Groups were organized according to self-identified prescribing patterns: two groups for clinicians who identified as prescribers of LTOT, and two who did not. PARTICIPANTS 17 clinicians from General Internal Medicine, Family Medicine, and Palliative Care were recruited using purposive, convenience sampling. APPROACH Discussions were recorded, transcribed, and analyzed for themes using reflexive thematic analysis by a multidisciplinary team. KEY RESULTS Our analysis identified three main themes: (1) OTAs did not influence clinicians’ decisions whether to use LTOT generally but did shape clinical decision-making for individual patients; (2) clinicians feel OTAs intensify the power they have over patients, though this was not uniformly judged as harmful; (3) there is a potential misalignment between the intended purposes of OTAs and their implementation. CONCLUSION This study reveals a complicated relationship between OTAs and access to pain management. While OTAs seem not to impact the clinicians’ decisions about whether to use LTOT generally, they do sometimes influence prescribing decisions for individual patients. Clinicians shared complex views about OTAs’ purposes, which shows the need for more clarity about how OTAs could be used to promote shared decision-making, joint accountability, informed consent, and patient education. (shrink)

After severe brain injury, one of the key challenges for medical doctors is to determine the patient’s prognosis. Who will do well? Who will not do well? Physicians need to know this, and families need to do this too, to address choices regarding the continuation of life supporting therapies. However, current prognostication methods are insufficient to provide a reliable prognosis. -/- Functional Magnetic Resonance Imaging (MRI) holds considerable promise for improving the accuracy of prognosis in acute brain injury patients. Nonetheless, (...) research on functional MRI in the intensive care unit context is ethically challenging. These studies raise several ethical issues that have not been addressed so far. In this article, Prof. Charles Weijer and his co-workers provide a framework for researchers and ethics committees to design and review these studies in an ethically sound way. (shrink)

The Psychology of Juvenile Delinquency: Understanding Causes and Solutions -/- Juvenile delinquency is a major societal concern, as it involves young individuals engaging in criminal or antisocial behavior. The study of its psychology seeks to understand why adolescents commit crimes, what factors influence their actions, and how society can prevent and rehabilitate them. This essay explores the psychological theories behind juvenile delinquency, the causes that contribute to it, and the possible interventions to reduce its occurrence. -/- Psychological Theories of Juvenile (...) Delinquency -/- Psychologists have developed various theories to explain why some juveniles engage in delinquent behavior. These theories provide insight into the mental and social processes that lead to criminal tendencies. -/- 1. Psychodynamic Theory (Freud) -/- Sigmund Freud proposed that early childhood experiences shape personality and behavior. If a child experiences neglect, abuse, or trauma, unresolved conflicts in the unconscious mind can lead to delinquent actions. -/- A weak superego (the moral part of the mind) may result in impulsive and criminal behavior due to a lack of guilt or moral reasoning. -/- 2. Behavioral Theory (Skinner) -/- B.F. Skinner’s behavioral theory suggests that actions are learned through reinforcement and punishment. -/- If a juvenile receives rewards (such as money, respect, or approval) from criminal behavior, they are likely to repeat it. -/- If punishment is inconsistent or absent, delinquency may continue. -/- 3. Social Learning Theory (Bandura) -/- Albert Bandura’s theory states that children learn by observing others. If they grow up in environments where crime is normalized, they may imitate criminal behavior. -/- Role models, such as parents, peers, or media figures, significantly influence a child’s behavior. -/- 4. Cognitive Theories -/- These theories focus on how juveniles process information and make decisions. -/- Some youth develop faulty thinking patterns, such as blaming others for their mistakes or justifying criminal actions. -/- Poor problem-solving skills and impulsivity also contribute to delinquency. -/- Causes of Juvenile Delinquency -/- Understanding the causes of juvenile delinquency is crucial in addressing and preventing it. Multiple factors contribute to criminal behavior among young individuals. -/- 1. Family Factors -/- A broken home, neglect, or abusive parenting can push children toward delinquency. -/- Children who experience harsh discipline, lack of supervision, or parental criminal behavior may develop antisocial tendencies. -/- 2. Peer Influence -/- Adolescents are highly influenced by their peers. If they associate with delinquent peers, they are more likely to engage in criminal behavior. -/- Gangs provide a sense of identity and belonging, but they also promote illegal activities. -/- 3. Socioeconomic Factors -/- Poverty, unemployment, and lack of educational opportunities can push juveniles toward crime. -/- In disadvantaged neighborhoods, exposure to drugs, violence, and criminal role models increases the likelihood of delinquency. -/- 4. Psychological and Biological Factors -/- Some juveniles have low self-control, high aggression, or mental health disorders (such as ADHD or conduct disorder), which increase the risk of delinquency. -/- Studies suggest that genetics and brain development also play a role in impulsive and violent behavior. -/- 5. School and Community Factors -/- Academic failure, dropping out of school, and negative school experiences can contribute to delinquency. -/- Weak social institutions and a lack of recreational activities lead to boredom, making crime an appealing alternative. -/- Prevention and Rehabilitation -/- To reduce juvenile delinquency, a combination of early intervention, education, family support, and rehabilitation is necessary. -/- 1. Family Interventions -/- Parents should receive training on effective discipline, supervision, and communication skills. -/- Family counseling can help resolve conflicts and strengthen relationships. -/- 2. School-Based Programs -/- Early education programs can improve academic skills and social behavior, reducing the risk of delinquency. -/- Schools should implement anti-bullying programs and mentorship initiatives to create a positive environment. -/- 3. Community Programs -/- After-school activities, sports, and vocational training can provide alternatives to crime. -/- Rehabilitation centers should focus on therapy, skill development, and reintegration into society. -/- 4. Legal and Social Policies -/- The justice system should prioritize rehabilitation over punishment for juvenile offenders. -/- Policies that address poverty, inequality, and access to education can reduce crime incentives. -/- Conclusion -/- Juvenile delinquency is a complex issue influenced by psychological, social, and environmental factors. Understanding the psychological roots of delinquent behavior can help in creating effective prevention and rehabilitation programs. By strengthening families, improving education, and providing positive social influences, society can reduce juvenile crime and help young individuals develop into responsible citizens. Addressing juvenile delinquency is not just about punishing offenders but also about addressing the underlying causes and guiding youth toward a better future. -/- . (shrink)

5-MeO-DMT is a psychedelic substance with a short duration of action and intensive effects. Its therapeutic efficacy and practicality may significantly surpass those of classical psychedelics such as ayahuasca and LSD. -/- This retrospective ethnographic inquiry features a woman in her mid-thirties who witnessed her mother's violent suicide and its bloody aftermath at the age of three. Before and after that, her childhood was characterized by domestic violence and sexual abuse perpetrated by several members of her family and extended (...) family. In her twenties and thirties, she dated a member of the local mafia with the intention of asking him to kill her father, who had been the main perpetrator of the sexual abuse and violence. This plan was eventually not carried out, but it reflected her deep bitterness and wrath. -/- A process initiated in her early thirties involving four 5-MeO-DMT sessions and a few additional sessions with psilocybin and ayahuasca in the course of two years completely resolved her symptoms related to the abuses, to the extent that she could rebuild a functional relationship with her father and feel love and compassion towards him. This outcome, i.e., the complete reversal of her attitude and emotions towards her father, appeared highly unusual. For the last three years, the outcome had remained stable. -/- The article also presents the perspective of a female facilitator of this treatment process. The article contributes to a better understanding of the use of 5-MeO-DMT in severe traumatization as well as exemplifies the possible positive contributions of actors who are not medical professionals in resolving deep collective traumatization in societies. (shrink)

Abstract: Lung cancer is the top reason of cancer-associated deaths globally. Surgery is the typical treatment for early-stage non-small cell lung cancer (NSCLC). Advancement in the knowledge of the biology of non-small cell lung cancer has shown molecular evidence used for systemic cancer therapy aiming metastatic disease, with a significant impact on patients’ overall survival (OS) and eminence of life. Though, a biopsy of overt metastases is an invasive technique restricted to assured positions and not effortlessly satisfactory in the (...) clinic. The examination of peripheral blood samples of cancer patients embodies a new basis of cancer-derived material, recognized as liquid biopsy, and its constituents (circulating tumour cells (CTCS), circulating free DNA (cfDNA), exosomes, and tumour-educated platelets (TEP)) may be gotten from nearly any body liquids. These constituents have shown to imitate features of the status of both the primary and metastatic diseases, aiding the clinicians to go towards a tailored medicine. In this paper, the reasons of lung cancer will be recognized and the risk elements that initiated the increase of infection, for instance Smoking, Disclosure to secondhand smoke, Disclosure to radon gas, Disclosure to asbestos and other compounds, Family past history of lung cancer, and decrease of the spread of disease and approaches of handling and prevention of lung cancer. (shrink)

The articles presents my journey with "Live Poetry" a participatory poetry methods created by Luis Enrique Amaya in Perù. This journey is marked by three encounters I had, that convinced me of the depth of the beauty and healing this journey can bring. The first occurs in Cali, Colombia, in a vast set of working-class neighbourhoods called Distrito de Agua Blanca. This area is dominated by drug trafficking and invisible borders between rival gangs. Teenagers experience a daily life of violence (...) and neglect. In this neighbourhood, I meet Luis Enrique Amaya, poet and social activist from Lima, Peru. Today, Luis will lead a poetry workshop with teenagers in the neighbourhood. It is based on a community poetry method he created years before with his collaborators. The workshop today will have two phases. In the first phase, the poet interviews a passer-by, a member of the community, and asks them to talk about someone important to her or him (a family member, a friend, a lover). In the second phase, the poet asks the interviewee to wait for few minutes. Then the poet sits alone for about ten minutes and composes a poem dedicated to the person chosen by the interviewee. When he has finished, the poet gives the poem to the interviewee as a gift saying: “After listening to you, I composed this poem and I give it to you as a gift. But beware: it is not for you. It is to invite you give it as a gift to the person you told me about”. (shrink)

An important strand of current experimental philosophy promotes a new kind of methodological naturalism. This chapter argues that this new ‘metaphilosophical naturalism’ is fundamentally consistent with key tenets of Wittgenstein’s metaphilosophy, and can provide empirical foundations for therapeutic conceptions of philosophy. Metaphilosophical naturalism invites us to contribute to the resolution of philosophical problems about X by turning to scientific findings about the way we think about X – in general or when doing philosophy. This new naturalism encourages us to use (...) resources from psychology that can empirically vindicate precisely some of the most controversial aspects of Wittgenstein’s conception of philosophy: They can establish the need, and provide key tools, for something worth calling ‘therapy’, in philosophy. As ‘pudding proof’ this chapter shows how methods and findings from psycholinguistics motivate and facilitate a therapeutic approach to a characteristically philosophical problem: ‘the problem of perception’. (shrink)

The paper clarifies therapeutic ideas about philosophical method which Wittgenstein puts forward in his "Big Typescript". It does so by analysing how Wittgenstein treats the question 'What is meaning?', in that part of the same work from which the opening sections of his "Philosophical Investigations" derive. On this basis, the paper explains why Wittgenstein set himself a therapeutic goal, why this is reasonable, and how he sought to attain that goal without 'pronouncing new truths about the subject of the investigation', (...) viz. meaning. (shrink)

Ronald Dworkin argued that Advance Directives informed by a principle of autonomy ought to guide decisions in relation to the treatment of those in care for dementia. The principle of autonomy in play presupposes a form of competence that is tied to the individual person making the Directive. This paper challenges this individualist assumption. It does so by pointing out that the competence of a patient is inherently relational, and the key illustrative case to make this point is the case (...) of music therapy. In music therapy, a relatively recent treatment modality in aged care, patients previously thought to be permanently unresponsive are shown on the contrary to be capable of significant levels of social agency. The conclusion to draw is that Advance Directives that fail to acknowledge the real possibility of such relational competence are misapplied. (shrink)

This book is a critical analysis of Australian family policy issues. The argument of the book rests on three cardinal principles. The first is that the family is a miniature society, a social unit. The second is that in producing, caring for, and educating children the family contributes to the good of the wider society. The third is that in caring for dependants – young or old – the family is a welfare institution. The general thrust (...) of the book is in favour of the principle of financial support for families with children, but with equity between separated and divorced families and intact families. (shrink)

The Confucian family, not only in its historical manifestations but also in the imagination of the Confucian founders, was the locus of misogynist norms and practices that have subjugated women in varying degrees. Therefore, advancing women’s well-being and equality in East Asia may seem to require radically transforming the Confucian family to approximate alternative ideal conceptions of the family in the West. This article opposes such a stance by arguing that (1) Western conceptions of the family (...) may be neither plausible nor feasible in traditionally Confucian societies and (2) the Confucian family, once reconstructed in line with Confucianism’s core ideas and values, can be conducive to a feminist future in East Asia that is uniquely Confucian. In order to support my position, not only influential contemporary Western ideal conceptions of the family from the justice perspective and care ethics, but also different interpretations of the Confucian family will be carefully examined. (shrink)

Family has always been an important unit of analysis in an effort to improve and understand human development. Studying the changes in the institution of family and households keeping in view the demographic, social, and economic transitions also becomes imperative. So far, in our knowledge, there are very few studies based in India have investigated the household size and family formation patterns, while a few of them have looked into its possible causes or associations and demographic, economic, (...) and social repercussions. In particular, as per our knowledge, there is no evidence on who is losing and who is gaining among family members due to the unprecedented transition in family forms in India. This paper serves a twofold purpose as first it seeks to explore and enrich the field of family demography in India by studying the existing evidence in the field as well as allied fields to understand how family serves as the nuclei directing individuals and communities toward certain behaviors and choices which consequently translate into larger social, economic and demographic transitions. Second, it also discusses the missing links and scope in the field of family demography in India as compared to the developed societies to provide future research prospects in this area. (shrink)

An introductory text describing the author’s approach to epistemology in terms of self-referential argumentation and self-validating proofs. The text emphasizes a skill-based, rather than content-based, approach to the study of epistemology. The book is a simply stated, basic text whose purpose is to introduce students to the technical approach to epistemology developed by the author in other publications. ●●●●● -/- 2022 UPDATE: The approach of this book has been updated and developed further in the author’s 2021 book _Critique of Impure (...) Reason: Horizons of Possibility and Meaning_. The book is available both in a printed edition (under ISBN 978-0-578-88646-6 from Barnes & Noble, Amazon, and other booksellers) and an Open Access eBook edition (available through Philpapers under the book’s title and other philosophy online archives). (shrink)

In this opinion piece we propose the investigation of psychedelic-assisted psychotherapy for the treatment of body dysmorphic disorder (BDD). BDD is a psychiatric disorder characterised by appearance-based preoccupations and accompanying compulsions. While safe and effective treatments for BDD exist, non-response and relapse rates remain high. Therefore, there is a need to investigate promising new treatment options for this highly debilitating condition. Preliminary evidence suggests safety, feasibility, and potential efficacy of psychedelic treatments in disorders that share similar psychopathological mechanisms with BDD. (...) Drawing on this evidence, as well as on relevant qualitative reports and theoretical proposals, we argue that it would be worthwhile to conduct a phase 2a study aimed at assessing the safety and feasibility of psychedelic-assisted psychotherapy in BDD. We also offer some suggestions for how future research ought to proceed. (shrink)

Sports physicians are continuously confronted with new biotechnological innovations. This applies not only to doping in sports, but to all kinds of so-called enhancement methods. One fundamental problem regarding the sports physician's self-image consists in a blurred distinction between therapeutic treatment and non-therapeutic performance enhancement. After a brief inventory of the sports physician's work environment I reject as insufficient the attempts to resolve the conflict of the sports physician by making it a classificatory problem. Followed by a critical assessment of (...) some ideas from the US President's Council on Bioethics, the formulation of ethical codes and attempts regarding a moral topography, it is argued that the sports physician's conflict cannot be resolved by the distinction between therapy and enhancement. Instead, we also have to consider the possibility that the therapy-based paradigm of medicine cannot do justice to the challenges of the continuously increasing technical manipulability of the human body and even our cognitive functions as well. At the same time we should not adhere to transhumanist ideas, because non-therapeutic interventions require clear criteria. Based on assistive technologies an alternative framework can be sketched that allows for the integration of therapeutic and non-therapeutic purposes. After a thorough definition of standards and criteria, the role of the sports physician might be defined as that of an assistant for enhancement. Yet the process of defining such an alternative framework is a societal and political task that cannot be accomplished by the sports physicians themselves. Until these questions are answered sports physicians continue to find themselves in a structural dilemma that they partially can come to terms with through personal integrity. (shrink)

The family poses problems for liberal understandings of social justice, because of the ways in which it bestows unearned privileges. This is particularly stark when we consider inter-generational inequality, or ‘class fate’ – the ways in which inequality is transmitted from one generation to the next, with the family unit ostensibly a key conduit. There is a recognized tension between the assumption that families should as far as possible be autonomous spheres of decision-making, and the assumption that we (...) should as far as possible equalize the life chances of all children, regardless of background. In this article I address this tension by way of recent liberal egalitarian literature, and consideration of the different dimensions of class fate. I argue, firstly, that the tension may not be of the a priori nature which liberals have tended to identify – and secondly, that as well as distributive and recognition-based aspects, the notion of contributive justice provides a particularly illuminating way of analyzing what is wrong about class fate, and the role of the family in promoting it. (shrink)

What would the institution of the family look like, if it were reformed according to republican desiderata? Would it even survive such re-shaping?

Desire is an important philosophical topic that deeply impacts everyday life. Philosophical practice is an emerging trend that uses philosophical theories and methods as a guide to living a eu‐ daimonic life. In this paper, we define desire philosophically and compare different theories of desire in specific Eastern and Western traditions. Based on the Lacanian conceptual–terminological triad of “Need‐Demand‐Desire”, the research of desire is further divided into three dimensions, namely, the subject of desire, the object of desire, and the desire (...) itself. The concept of desire is then an‐ alyzed from this triad and these three dimensions through different philosophical theories. This paper selects Buddhism as the representative of Eastern tradition, and Stoicism as the representative of the West, paying special attention to Stoicism’s “spiritual exercises” following Pierre Hadot. By exploring and comparing the Buddhist paths to liberation from suffering (i.e., the Four Noble Truths and the Noble Eightfold Path) and the two theoretical pillars in Stoicism (i.e., the notions of “living according to nature” and “the dichotomy of control”), practical guidance is then provided for un‐ derstanding and regulating desire in times of crisis. This understanding and regulation of desire constitutes a philosophical therapy for today’s troubles, particularly those caused by excessive or irrational desires. (shrink)

In his article Banicki proposes a universal model for all forms of philosophical therapy. He is guided by works of Martha Nussbaum, who in turn makes recourse to Aristotle. As compared to Nussbaum’s approach, Banicki’s model is more medical and less based on ethical argument. He mentions Foucault’s vision to apply the same theoretical analysis for the ailments of the body and the soul and to use the same kind of approach in treating and curing them. In his interpretation (...) of philosophical therapy, there are, however, some controversial issues, to which we would like to call attention: -/- Is restoring health by a philosophical method of treatment – health understood as a person’s ability to reach his/her vital goals – a convincing explication of philosophical therapy in general? In order to answer this question, it may be useful to look at Plato. It is not only Platonism (and especially Neo-platonism since Plotinus) that questions the idea that therapy is necessarily connected with „vital goals“. Buddhist and Gnostic philosophies are questioning „the vital“ in general. The immense effort in the history of philosophy to liberate the mind from the body casts doubt on the project to explain philosophical therapy solely in analogy to medical therapy. -/- According to Banicki a therapeutic philosophy has to identify the diseases it attempts at curing. There are, however, reasons for associating the term therapy with suffering/risk rather than disease. If a therapy aims at reducing the fear of death, as for example many classical philosophical therapies do, then there is no disease to be cured. A model based on chances and risks also has the advantage that the Buddhist and Stoic reinterpretation of desires/emotions as “diseases” can be dropped in contemporary philosophical therapy. -/- Banicki mentions the comparison of therapies as one of the primary goals of modelling. Methods should be verified by a statistical correlation between method and therapeutic success and/or by a theory which justifies the method. Some forms of therapies, however, avoid theory-specific terms and concepts in favor of an unprejudiced interpretation of the patient’s statements. Others share the (Nietzschean) aspiration to explore and change measures of value. If the therapeutic process is seen as a unique phenomenon, then there can be no theory and no statistics with co-occurrences. -/- According to Banicki philosophical therapy has to describe techniques which qualify as genuinely philosophical. Techniques like maieutics and hermeneutics, however, are antique philosophical “inventions”, which were later adopted by psychotherapy. If meditation is accepted as a therapeutic tool – as it was in ancient times – then there is not only a methodical but also an emotional relation to religion. If finally, the Socratic search for a good life is seen as one of the characteristics of philosophical therapy, then delimitation even turns into a criterion for non-philosophical therapies. The search for a good life requires an interdisciplinary approach. -/- For the concretization of the formal structure, we suggest a typology of therapies, which is based on chances and risks. Such a typology has the advantage, that it can model conflicting (and even opposing) forms of therapies. The variety of therapeutic goals and methods is a consequence of the historical development towards conceptual freedom. (shrink)

The case of Andrew Gobea, the first child to receive experimental gene therapy for SCID, and a reflection on the associated ethical implications of gene therapy research.

The U.S. FDA has issued emergency use authorizations for monoclonal antibodies for non-hospitalized patients with mild or moderate COVID-19 disease and for individuals exposed to COVID-19 as post-exposure prophylaxis. One EUA for an oral antiviral drug, molnupiravir, has also been recommended by FDA’s Antimicrobial Drugs Advisory Committee, and others appear likely in the near future. Due to increased demand because of the Delta variant, the federal government resumed control over the supply and asked states to ration doses. As future variants (...) with increased infectivity and/or severity emerge, further rationing may be required. We identify relevant ethical principles and priority groups for access to therapies based on an integrated approach to population health and medical factors. Using priority categories to allocate scarce therapies effectively operationalizes important ethical values. This strategy is preferable to the current approach of categorical rules based on vaccination, immunocompromise status, or older age, or the ad hoc consideration of clinical risk factors. (shrink)

The concept of work–family balance was introduced in the 1970s in the United Kingdom based on a work–leisure dichotomy, which was invented in the mid-1800s. It is usually related to the act of balancing of inter-role pressures between the work and family domains that leads to role conflict. The conflict is driven by the organizations’ views of the “ideal worker” as well as gender disparities and stereotypes that ignore or discount the time spent in the unpaid work of (...) family and community. Solutions for balance include legislation, flexible workplace arrangements, and the market care services. (shrink)

The most common approach to the problem of requests for futile treatment – the hospital futility policy – rests on the assumption that demands for futile treatment are both intractable and irrational. But there is another approach to the futility problem, an approach that would be dialogic, piecemeal, and case-by-case. This is the only approach that attempts to deal with both the hospital’s problem and the patient’s or family’s problem that motivates the request/demand for futile treatments. As such, it (...) holds the promise of resolving the problem of demands for futile treatment in a way that does not generate anger and ill will at the hospital staff for what will inevitably strike patients and their families as a blatant assertion of the hospital’s power. (shrink)

The so-called ‘‘species problem’’ has plagued evolution- ary biology since before Darwin’s publication of the aptly titled Origin of Species. Many biologists think the problem is just a matter of semantics; others complain that it will not be solved until we have more empirical data. Yet, we don’t seem to be able to escape discussing it and teaching seminars about it. In this paper, I briefly examine the main themes of the biological and philosophical liter- atures on the species problem, (...) focusing on identifying common threads as well as relevant differences. I then argue two fundamental points. First, the species problem is not primarily an empirical one, but it is rather fraught with philosophical questions that require—but cannot be settled by—empirical evidence. Second, the (dis-)solution lies in explicitly adopting Wittgenstein’s idea of ‘‘family resemblance’’ or cluster concepts, and to consider spe- cies as an example of such concepts. This solution has several attractive features, including bringing together apparently diverging themes of discussion among bio- logists and philosophers. The current proposal is con- ceptually independent (though not incompatible) with the pluralist approach to the species problem advocated by Mishler, Donoghue, Kitcher and Dupre ́, which implies that distinct aspects of the species question need to be emphasized depending on the goals of the researcher. From the biological literature, the concept of species that most closely matches the philosophical discussion pre- sented here is Templeton’s cohesion idea. (shrink)

Families play an essential role in deceased organ procurement. As the person cannot directly communicate his or her wishes regarding donation, the family is often the only source of information regarding consent or refusal. We provide a systematic description and analysis of the different roles the family can play, and actions the family can take, in the organ procurement process across different jurisdictions and consent systems. First, families can inform or update healthcare professionals about a person’s donation (...) wishes. Second, families can authorize organ procurement in the absence of deceased’s preferences and the default is not to remove organs, and oppose donation where there is no evidence of preference but the default is to presume consent; in both cases, the decision could be based on their own wishes or what they think the deceased would have wanted. Finally, families can overrule the known wishes of the deceased, which can mean preventing donation, or permitting donation when the deceased refused it. We propose a schema of 4 levels on which to map these possible family roles: no role, witness, surrogate, and full decisional authority. We conclude by mapping different jurisdictions onto this schema to provide a more comprehensive understanding of the consent system for organ donation and some important nuances about the role of families. This classificatory model aims to account for the majority of the world’s consent systems. It provides conceptual and methodological guidance that can be useful to researchers, professionals, and policymakers involved in organ procurement. (shrink)

2022 UPDATE: The approach of this paper has been updated and developed further in the author’s 2021 book _Critique of Impure Reason: Horizons of Possibility and Meaning_. The book is available both in a printed edition (under ISBN 978-0-578-88646-6 from Barnes & Noble, Amazon, and other booksellers) and an Open Access eBook edition (available through Philpapers under the book’s title and other philosophy online archives). ●●●●● The author distinguishes between the “information-oriented” approach of conservative, traditional philosophy, and an approach to (...) philosophy as “conceptual therapy.” The former emphasizes scholarship, textual explication and criticism, and, in general, a knowledge of the views of traditional thinkers. Philosophy as conceptual therapy, on the other hand, seeks an improvement of intellectual skills, and fosters a therapy for concepts and, by inference, a therapy for thinkers. The major concern of the paper is to argue that the traditional information-oriented approach to philosophy does not help its students effectively to develop intellectual skills, and that a conception of philosophy as conceptual therapy can provide a valuable contribution to the teaching and to the subject-matter of philosophy. (shrink)

I shall argue that, with a proper realignment of core Confucian values, an explicitly feminist reading of Confucianism—a conception of Confucian feminism—could be constructed to promote the feminist goal of gender equality in contemporary Confucian societies. My paper proceeds in the following order: first, I shall identify two aspects of Confucianism implicated in the Confucian subjugation of women: li and family. Given the centrality of both li and family in Confucianism, it may seem that Confucianism is inherently antagonistic (...) to the feminist goal of gender equality. In order to determine whether this is the case, I shall reconstruct the valuational system of Confucianism and examine the proper locations of li and family within it. I shall argue that Confucian ethics promotes women’s self-cultivation on a par with men’s and that Confucian emphases on li and family do not necessitate the subjugation of women. However, some may worry that the importance of family in Confucianism may require the undivided attention of at least one parent, which in reality would be mostly the mother. To alleviate this worry, I shall argue that a democratic Confucian welfare state, entailed by the Confucian thought system, ought to pick up the responsibility of providing comprehensive assistance to families so that families can thrive in the Confucian polity. (shrink)

The wishes of registered organ donors are regularly set aside when family members object to donation. This genuine overruling of the wishes of the deceased raises difficult ethical questions. A successful argument for providing the family with a veto must (a) provide reason to disregard the wishes of the dead, and (b) establish why the family should be allowed to decide. One branch of justification seeks to reconcile the family veto with important ideas about respecting property (...) rights, preserving autonomy, and preventing harm. These arguments are ultimately unsuccessful. Another branch of arguments is consequentialist, pointing out the negative consequences of removing the veto. Whether construed as concerning family distress or as a potential drop in the organs available, these arguments are unsuccessful; the first fails to recognize the tremendous distress associated with waiting for an organ, while the second has little supporting evidence. A final section considers and rejects whether combining some of the arguments just examined could justify the family veto. We should thus remove the family veto in organ donation. (shrink)

Adoption may be defined as ‘the legal process through which the state establishes a parental relationship, with all its attendant rights and duties, between a child and a (set of) parent(s) where there exists no previous procreative relationship’ . In adoptions from care, state intervention effectively converts an established, or nascent, adult– child relationship into ‘family’ in the legal sense. From the state’s perspective, adoption thus entails the transfer of parental responsibilities for a child in public care to a (...) private family unit, enabling the state to permanently delegate its duties towards a child to this new unit. This seemingly straightforward legal act raises deeper philosophical questions relating to such state ‘family creation’, particularly when the child’s perspective is taken. Such a child- centric approach normatively regards children as equal moral beings, who ought to be included in actions concerning them, regardless of their capacity to form and express an opinion. Accordingly, adoption from care can be described as a moral decision, aimed at doing what is in the child’s best interests. The purpose of this chapter is to explore a suspicion of a lack of child- centrism in adoption from care practice, and to illustrate how adopted children’s rights are inferior to those of their non- adopted peers. This will shed light on a practice currently lacking transparency and accountability and will increase our understanding of how we fail to treat children as equal moral individuals in decision- making that severely impacts children’s lives. (shrink)

A number of bioethicists have been critical of the power of the family to “veto” a patient’s decision to posthumously donate her organs within opt-in systems of organ procurement. One major objection directed at the family veto is that when families veto the decision of their deceased family member, they do something wrong by violating or failing to respect the autonomy of that deceased family member. The goal of this paper is to make progress on answering (...) this objection. I do this in two stages. First, I argue that the most plausible interpretation of what happens when a person registers as an organ donor in an opt-in system is that she gives her consent to the state to posthumously remove her organs for transplantation purposes. Call this the Authorization Account. Second, given the Authorization Account, I argue by analogy that when families veto an individual’s decision to donate and the individual’s organs are not in the end removed, neither the doctors nor the family violate the individual’s autonomy in any morally objectionable sense. Call this the Nonremoval Thesis. I argue that since the Nonremoval Thesis is true, we do not violate or fail to respect the autonomy of registered donors when we fail to remove their organs because their family has objected. (shrink)

Contemporary research offers a more compelling account on the complex emotion of envy than the traditional view of envy as simply something bad. This essay explains how Logic-Based Therapy can use this account to coach individuals struggling with negative species of envy. Given that jealousy and envy are often equated, the essay differentiates the two; explains the conditions that make the four species of envy possible; identifies cardinal fallacies associated with negative species of envy; proposes counteractive virtues, and describes (...) ways to help people struggling with negative species of envy acquire these virtues. (shrink)

Medium-sized language communities face competition between local and global languages such as Spanish, Russian, French and, above all, English. The various regions of Spain where Catalan is spoken, Denmark, the Czech Republic, and Lithuania show how their medium-sized languages (a term used to distinguish them as much from minority codes as from more widely-spoken codes) coexist alongside or struggle with their big brothers in multilingual families. This comparative analysis offers unique insight into language contact in present-day Europe.

Sound is one of the types of waves that can be felt by the sense of hearing (ears). In physics, the definition of sound is something that is produced from objects that vibrate. Objects that produce sound are called sound sources. The sound source that vibrates will vibrate the molecules into the air around it. Sound is mechanical compression or longitudinal waves that propagate through the medium. This medium or intermediate agent can be liquid, solid, gas. So, sound waves can (...) propagate for example in water, coal, or air. Most sounds are a combination of various vibratory signals composed of harmonic waves, but pure sound can theoretically be explained by oscillating vibrational speed or frequency measured in Hertz (Hz) vibration units and amplitude or loudness of sound with measurements in decibels (dB). The effect sounds can have on us humans is simply astounding. While everyday life becomes stressful, overcrowded and increasingly hectic, we seek ways for inner peace and balance. The power of music, felt through overtone-rich sound therapy and sound massage, can be a solution. No matter how much scientific explanation is behind it, healing through music remains fascinating, even magical. This paper introduces a new field called cymatics and sound healing with their plausible impact to spirituality and consciousness research. (shrink)