Critical Remarks on an Interpretation of Reid on Perceptual Apprehension

I argue that Thomas Reid’s theory of perception can be defended against the charges of inconsistency levied against it by Nicholas Wolterstorff. The challenge to be met is roughly that of showing how the Reidian account of perception can avoid being hampered by a descriptive theory of mental reference for perceptual states. First, I will review Reid’s theory of perception and Wolterstorff’s objections to it. Wolterstorff maintains that Reid is committed to an account of perceptual reference according to which mental representations are conceptual intermediaries between the perceiver and the objects of perception. I hope in section III to show that the theory attributed to Reid is unworkable. In the remainder of the paper I will argue that Reid need not be committed to any such view. In sections V through IX, I will sketch an alternative account of perceptual reference that is immediate in the required sense and that can be incorporated into a Reidian account of perception. My proposal will depend crucially on David Kaplan’s account of demonstratives and on mobilizing Kaplan’s semantics for application to the case of perceptual content

The Effects of Berberine vs. Metformin for Decreasing Waist Circumference and Serum Lipid Levels in Women with Polycystic Ovarian Syndrome

Background: Polycystic ovarian syndrome (PCOS) is a highly prevalent disease that effects both metabolic and reproductive systems in women. PCOS is associated with a high incidence of obesity, insulin resistance, hyperandrogenism, hyperlipidemia, menstrual cycle dysfunction, and infertility. Diagnosis is made using the Rotterdam Criteria, and current accepted medical management of PCOS includes lifestyle changes such as diet and exercise, oral contraceptive pills (OCP), metformin (MET), and bariatric surgery. a. The aim of this systematic review is to assess the effect of berberine on waist circumference and cholesterol levels. Methods: A comprehensive literature search was done using Medline, Web of Science, and Clinical key using keywords PCOS or polycystic ovarian syndrome and berberine. Relevant studies were critically assessed using GRADE. Results: Two studies were chosen for this systematic review, one randomized control trial, and one case control study, that adequately assessed the effects of berberine compared to metformin as well as alone for the treatment of PCOS. The RCT showed that BBR appears to have greater effect than metformin on decreasing waist circumference and waist-to-hip ratio, total cholesterol, triglycerides, and low-density lipoprotein after 3 months of treatment. The case control study showed that BBR therapy caused a statistically significant decrease in waist circumference, LDL levels, and triglycerides in women with PCOS after 6 months of treatment. These studies resulted in a low quality of evidence overall. Conclusion: BBR caused a greater decrease in waist circumference and lipid profile than MET. This effect is additive when combined with lifestyle changes such as diet and exercise. More studies are needed to evaluate the long-term efficacy of BBR on weight loss and BMI. Overall as weak recommendation, berberine can be considered as a suitable alternative to metformin for the treatment of polycystic ovarian disease

Mental Health Benefits Associated with Participation in A Dog Training Program at a Psychiatric Facility

Anecdotal reports and preliminary evidence have suggested that psychiatric patients who have participated in animal programs experience wide-ranging benefits, such as decreased psychiatric symptoms, fewer aggressive behavioral demonstrations, and reduced stress. However, there are few high-quality studies that provide quantitative data to support these findings. The purpose of the proposed study was to provide an empirical, quantitative evaluation of the effect of participation in a service dog program at Oregon State Hospital on participants’ mental health, medication use, skill development, and social engagement. This study also aimed to provide an example for how other evaluators could derive meaningful, quantitative data on the impact of psychiatric animal programs on participants. I utilized a quasi-experimental single subject AB design and reported data from three program participants. Cumulative findings indicated some preliminary support for hypothesized gains in subjective mental health and vocational skill development associated with program participation. No clear trends were found in other variables studied relative to participants’ participation (i.e., reduction in medication use or increased social engagement)

“The Sweetest Savor”: Active Male Penetrators and Societal Anxieties in Arthurian Legend

The expected gender dichotomy of medieval European heterosexual relationships was simple. There was an active male penetrator and a passive female acceptor. This dichotomy is supported by court records from late medieval France, analyzed by Joseph Roelens, in which two women are put on trial for female sodomy and much importance is placed on the masculine character of one woman and the submissiveness of the other. In this paper, I examine two different stories from Arthurian Legend, Sir Thomas Malory’s “Morte d’Arthur” and Geoffrey Chaucer’s “The Wife’s Prologue and Tale” from The Canterbury Tales, that depict sexual relationships between the main male and female characters that function within the social norm of the gender dichotomy. In doing so, I argue that these stories use this active and passive gender dichotomy in an attempt to police men’s actions in their sexual relationships with women. I chose to examine these stories because they demonstrate the societal importance placed on this gender dichotomy in a very concrete way. The men in these stories who refuse to become passive, Sir Lancelot being the most prominent among them, are willing to sacrifice not only their life, but the life of the women they love (whether or not the women agree with this decision), in order to avoid breaking the gender dichotomy

A Meta-Analysis of Adverse Childhood Experiences and Weight-Related Health Outcomes in Adulthood

Three out of every five youth experience one or more traumatic events during childhood, also known as adverse childhood experiences (ACEs; Centers for Disease Control and Prevention, 2015). ACEs are associated with a number of negative health outcomes, including higher odds of disability, risky health behaviors, and morbidity in adulthood even after controlling for related demographic information (Campbell, Walker, & Egede, 2016). To date, meta-analytic research on ACEs has not provided a focused and comprehensive evaluation of weight-related outcomes (i.e., obesity, disordered eating, Type II diabetes, and physical inactivity). The present meta-analysis seeks to fill gaps in the literature and build upon prior research by conducting an exhaustive literature search, focusing on numerous weight-related outcomes, including a larger data pool via less stringent inclusion criteria, including updated research, and including all types of ACEs as predictors. In those reporting at least four ACEs, an increased risk for overweight/obesity, Type II diabetes, and physical inactivity compared to no ACE exposure was found. Results resolved discordant findings in the literature by including updated research and using more comprehensive search methods to better understand the effects of ACEs on adult weight-related health outcomes

The Relationship Between Body Image and Sexual Orientation: A Comparison of Body Image Satisfaction in A Sexual Orientation Minority and Heterosexual Cisgender Sample

Although there is not one singular cause for eating disorders, research has indicated that body image dissatisfaction is one of the most well-established contributing factors to the development of eating disorder symptomatology (National Eating Disorders Association [NEDA], 2018; Stice & Shaw, 2002). Risk factors for body image dissatisfaction can involve a range of biological, psychological, and sociocultural issues (NEDA, 2018). The majority of research on body image satisfaction levels has focused on females of the dominant culture (i.e., heterosexual, cisgender, Caucasian, etc.; Cash & Smolak, 2011). However, recognition of the importance of examining body image dissatisfaction among marginalized groups has increased in recent years (Yean et al., 2013). One of these marginalized groups that has been underrepresented in the literature on body image is the LGB population (Grogan, 2008). Research findings have demonstrated varying results regarding differences in prevalence rates of body image dissatisfaction between LGB and heterosexual individuals (Cochran, Sullivan, & Mays, 2014; Grogan, 2008; Morrison, Morrison, & Sager, 2004). This study sought to fill the gap of limited research on body image satisfaction among the LGB population by exploring differences between cisgender LGB and heterosexual populations. Although individuals who identify as transgender and non-binary were intended to be included in the current study, there was not a large enough sample size of transgender and non-binary participants at the time of analysis. Therefore, the current sample (N = 296) comprised of individuals who specifically identified as cisgender females and males. A unique quality of this study is that all participants identified as a cisgender female or male, which is not apparent in most established research on body image when comparing females and males. Primary hypotheses included: (1) lesbian and bisexual cisgender females would report significantly higher levels of body image satisfaction and body image-related quality of life than heterosexual cisgender females; (2) gay and bisexual cisgender males would endorse significantly lower levels of body image satisfaction and body image-related quality of life than heterosexual cisgender males; and (3) heterosexual, cisgender females would endorse significantly lower levels of body image satisfaction and body image-related quality of life compared to heterosexual cisgender males. All hypotheses also postulated that groups endorsing higher levels of body image satisfaction would endorse lower levels of depressive symptoms. Findings partially supported the hypotheses of this study in that gender moderated the results of the third hypothesis. Specifically, heterosexual cisgender females reported higher levels of body image dissatisfaction than heterosexual cisgender males, but not poorer body image-related quality of life. Depression was significantly correlated to body image-related quality of life for both heterosexual cisgender male and female participants, but it was not associated with specific levels of body image satisfaction, per se. Although sexual orientation did not appear to be significantly related to levels of body image satisfaction, medium to large effect sizes suggest that a larger sample size may have identified a more substantial difference in body image satisfaction between individuals who identify as gay, lesbian, or bisexual as compared to heterosexual cisgender females and males. Additionally, opposing predictions from the first hypothesis, heterosexual cisgender females’ mean scores on body image questionnaires were higher (indicating greater body image satisfaction) than lesbian and bisexual cisgender females. Overall, greater depressive symptoms were generally correlated with lower levels of body image satisfaction and body image-related quality of life with all groups

Mass Distribution of Azithromycin Reduces Mortality in African Children

Background: Sub-Saharan Africa remains the region with the highest child mortality rate in the world. Most commonly, pneumonia, diarrhea, and malaria rank among the leading causes of preventable deaths in this population. The World Health Organization (WHO) recommends mass drug administration (MDA) of azithromycin, a broadspectrum macrolide antibiotic, for the treatment of trachoma. Some studies suggest that MDA of azithromycin for this purpose has the added benefit of protection against other illnesses including malaria, diarrheal episodes, and respiratory infections. The aim of this review is to investigate the effect of MDA of azithromycin on mortality rates in African children. Methods: An exhaustive search of available medical literature was performed using MEDLINE-Ovid, CINHAL, and Web of Science databases. Relevant search terms included ‘azithromycin,’ ‘child*,’ ‘mortality,’ and ‘mass.’ The quality of relevant articles was assessed using the GRADE Working Group guidelines. Results: A total of 3 studies, 2 randomized control trials (RCT) and 1 observational analysis, were included in this review. One RCT conducted in Malawi, Niger, and Tanzania showed that all-cause mortality rates declined in children ages 1-59 months after azithromycin administration, with the greatest benefit seen in children ages 1-5 months. Another RCT revealed similar findings, with decreased all-cause mortality rates in children ages 1-9 years in Ethiopia after MDA of azithromycin. A retrospective observational analysis also suggested reduced all-cause and infectious mortality rates in children ages 1-5 years in Ethiopia after azithromycin treatment. Conclusion: MDA of azithromycin in African communities decreases all-cause mortality rates in children ages 1-5 years. Additional studies are needed to assess short and long-term adverse outcomes of MDA and the effect of MDA on antibiotic resistance

Predictors of Surgical Outcome in Patients with Median Arcuate Ligament Syndrome

Background: The median arcuate ligament is a normal anatomical feature of the aortic hiatus, attached to the posteromedial aspect of the diaphragm. Median arcuate ligament syndrome (MALS), also known as celiac artery compression syndrome (CACS), is a presumed rare congenital defect thought to cause compression of the celiac trunk, in addition to possible impingement of the celiac plexus. Symptomatic patients, depending on age and stage of disease complain of post-prandial abdominal pain, post-exertional abdominal pain, nausea, vomiting, and weight loss. Due to rarity of the disease in conjunction with vague physical complaints and unclear etiology, a universal method for surgical screening has not been developed and predictors of surgical outcome are not widely understood. This systematic review addresses how providers can determine surgical candidacy based upon outcome predictors and symptomatology. Methods: A search was conducted using Google Scholar, MEDLINE via PubMed, ScienceDirect, and CINAHL via Ebsco. Keywords included were median arcuate ligament syndrome, celiac artery compression syndrome, predict*, and outcomes. Studies were assessed for quality using GRADE criteria. Results: This systematic review includes 3 studies that discuss predictive models for screening MALS surgical candidates. One study evaluated the surgical outcomes of MAL decompression in 42 patients using SF-36 to evaluate symptom improvement and resolution, and it was deduced that age and baseline celiac artery expiratory velocity served as predictors of positive surgical outcome. Another study evaluated 67 patients instead using SF-12 and the Visick score as symptom questionnaires. This study found that pre-operative post-exertional abdominal pain suggested a positive surgical outcome, and vomiting and unprovoked pain were associated with negative surgical outcomes. A prospective study was lastly analyzed. This study, which included 135 patients, determined that the development and grade at which collateral circulation was formed within the abdomen correlated with increasingly negative surgical outcomes. Conclusion: Surgical decompression of the celiac artery is often successful, despite pre-operational predictors that might suggest incomplete symptom resolution. Predictors of positive surgical outcomes include post-exertional pain, low age of diagnosis, and reduced development of collateral circulation. Predictors of negative surgical outcome include vomiting, unprovoked pain, and increased formation of collateral circulation

Promotion of Early Detection of Lung Cancer in Primary Care

Lung cancer has the highest mortality rate of any cancer in the United States, and is increasing in developed countries throughout the world. Lung cancer is typically diagnosed at stage III or IV due to presentation of non-specific symptoms and a lack of awareness by patients and providers alike. However, diagnosis at stage I or II significantly increases one’s survival rate. Screening for lung cancer is difficult with tests that are expensive, potentially harmful, or ineffective