New Directions in Philosophy of Medicine

The purpose of this chapter is to describe what we see as several important new directions for philosophy of medicine. This recent work (i) takes existing discussions in important and promising new directions, (ii) identifies areas that have not received sufficient and deserved attention to date, and/or (iii) brings together philosophy of medicine with other areas of philosophy (including bioethics, philosophy of psychiatry, and social epistemology). To this end, the next part focuses on what we call the “epistemological turn” in recent work in the philosophy of medicine; the third part addresses new developments in medical research that raise interesting questions for philosophy of medicine; the fourth part is a discussion of philosophical issues within the practice of diagnosis; the fifth part focuses on the recent developments in psychiatric classification and scientific and ethical issues therein, and the final part focuses on the objectivity of medical research

Task-dependent Modulation of Cortical Excitability and Balance Control in Individuals with Post-concussion Syndrome

In most cases, symptoms resolve between 7-10 days post-concussion. However, in 10-15% of the concussed population, symptoms can remain unresolved for months to years following the head injury. The purpose of this thesis was two-fold, and was broken up into two studies, where the same individuals participated in both studies. The purpose of the first study was to quantify the differences in balance control between individuals with PCS (i.e., had been experiencing symptoms for \u3c30 days) and non-concussed individuals during a lower-limb reaching task. Participants completed a static balance assessment before and after a lower-limb reaching task, which incorporated a Go/No-Go paradigm. Results from this study revealed no differences in the static stability assessments, however, individuals with PCS demonstrated increased medial-lateral COP displacement as well as greater trunk pitch during the reaching task. Overall, the findings reveal persistent balance impairments in individuals with PCS, which may put this population at an increased risk of further injury. The purpose of the second study was to assess task-dependent modulation of cortical excitability prior to planned index finger abduction contractions comparing a non-concussed population to a population with PCS. The protocol in this study consisted of both single and paired-pulse transcranial magnetic stimulation (TMS) which was applied prior to the beginning of 3 different tasks (i.e., a rest condition with no plan to contract, a precision contraction, and a powerful contraction). In addition to the three tasks, participants also had to respond to a Go/No-Go cue. The results of this study revealed an increase in excitability prior to a precision contraction in both non-concussed and PCS groups. No differences in task-dependent modulation were found between the two groups with respect to intracortical facilitation and inhibition, however a negative correlation between number of symptoms reported (SCAT3 symptom evaluation) and intracortical facilitation was revealed. The increase in corticospinal excitability prior to a precision contraction was not explained by the two cortical mechanisms we assessed and may therefore be due to spinal modulation or a different cortical mechanism. Overall, based on the results from this thesis, it appears that individuals with PCS have balance impairments, which may be a result of an inability to maximally activate their postural muscles. Furthermore, it appears that those individuals who reported a higher number of symptoms had greater reductions in intracortical facilitation, likely reflecting the heterogeneity of this clinical group

The effects of berry juice on cognitive decline in older adults : a thesis presented in partial fulfilment of the requirements of Master of Arts in Psychology at Massey University, Palmerston North, New Zealand

This study examined the effects of blackcurrant and boysenberry juices on cognitive processes in older adults. Current research suggests that fruits such as these may be able to reverse some of the effects of ageing on cognition. The free radical theory of ageing proposes that individuals age because oxidative damage accumulates in cells and interferes with cell functions. The hardest working tissues such as the brain accumulate the most oxidative damage through respiration. Antioxidants can protect against free radical formation and damage. Anthocyanins can contribute to half of the antioxidant capacity of deeply coloured berry fruit. An increase in dietary antioxidants such as anthocyanins may help to alleviate free radical damage within the brain. Research has shown that oxidative damage within the brain can impair cognitive functioning. Working memory shows age-related decline, along with visuospatial abilities, word retrieval and sustained attention. Some of this decline is thought to be related to oxidative damage of neurotransmitters such as acetylcholine and areas of the brain such as the hippocampus. Past research with humans has shown that some antioxidants can affect cognitive functioning in an older population. Animal studies have also established that diets enriched with anthocyanins can improve memory, motor control and neurotransmitter functioning. The present study involved giving berry juice drinks to 52 older adults that had been assessed as having a mild impairment of cognitive function. The participants were divided into three groups and drank 200mL a day of either blackcurrant juice, boysenberry juice or a placebo for twelve weeks. The participants were assessed at three different times over the course of the experiment using the RBANS. The RBANS is sensitive to small changes in its tests of memory, visuospatial ability, language and attention. The results of this study did not support previous research on antioxidants and cognitive functioning. There were no significant interactions between berry juices and any of the cognitive domains assessed by the RBANS over the course of the experiment. Some of the limitations of the study may be responsible for a lack of effect. The experiment was short with a low dose of antioxidants, and there was little control over the participants altering their own diet after being informed of the reasoning behind the study

Desk study on homeopathy in organic livestock farming: Principles, obstacles and recommendations for practice and research

Organic livestock farming has its own concept of health and welfare. The approach to health can be characterised by the key words human, preventive, self-regulating and holistic (Chapter 1). This has consequences for the way we deal with diseases and problems, the nature of the solutions and the use of medication, among other things. In terms of therapeutic and regulatory measures this health concept is based primarily on natural food supplements and homeopathic remedies, which in view of their origin fit in well with the natural character of organic agriculture (Verhoog et al., 2002). Apart from various forms of potentised remedies (classic, clinical, anthroposophic, isopathic; Chapter 2) and all manner of applications within phytotherapy (Bach flower, aromatherapy), there is interest in organic livestock farming in complementary health treatments other than acupuncture. We also need more detailed research into the practical implications of possible self-medication by animals (Engel, 2001). Complementary medicine demands a new type of knowledge in relation to its working mechanism, testing for authenticity and the way it is used (Chapter 3). The thinking behind the use of homeopathic remedies often based on a preventive approach to health. With the aid of these remedies the doctor seeks to create a more balanced environment in and around the animal and to improve the animal’s resistance to infections (Baars en Ellinger, 1997). Striezel (2001) calls homeopathy a regulatory therapy, which heals the body by stimulating the individual immune system and regulating the metabolism. The use of homeopathic remedies is still limited in practice, partly due to a lack of suitably trained veterinary practitioners (Chapter 4). In the elaboration of the research questions the authors discovered that the use of homeopathic remedies meets with particular resistance which can be traced back to philosophical assumptions (sections 4.1-4.3). As the research is fleshed out it is therefore important that it is not simply carried out in conformity with currently valid scientific standards. The research design must also be in line with the philosophy of homeopathy in terms of both quantity and quality (Chapter 5). This is particularly important for homeopathy because its therapeutic methods are based on principles which do not fit in with conventional notions about life. The similia principle (law of similars) is an important feature of homeopathy and homeopathy shares the second key concept of potentisation with anthroposophy (Chapter 2). There is limited acceptance of homeopathic remedies in particular, despite the fact that there is some empirical evidence for the efficacy of homeopathic treatments. Both outcome research into homeopathic treatments of humans and animals and fundamental empirical research into the validity of the similia law and the efficacy of high dilutions produce results which tend to bear this out. However, it is rejected out of hand on ontological grounds and because of the assumed working mechanism. Follow-up research into homeopathic remedies is desirable, but must be in line with the underlying complementary health and welfare concept of organic agriculture, which includes treatment with veterinary medicines. Randomised Clinical Trials are thus only of limited use, since they disregard the individually tailored nature of the treatment. In practice however, sufficient alternative therapies have been developed which can be used in outcome research. The researchers propose a graduated structure for the outcome research (Chapter 6). The first step is to join in with the monitoring of experience in practice, and follow this with casuistic outcome research

A heuristic mathematical model for the dynamics of sensory conflict and motion sickness

The etiology of motion sickness is now usually explained in terms of a qualitatively formulated sensory conflict hypothesis. By consideration of the information processing task faced by the central nervous system in estimating body spatial orientation and in controlling active body movement using an internal model referenced control strategy, a mathematical model for sensory conflict generation is developed. The model postulates a major dynamic functional role for sensory conflict signals in movement control, as well as in sensory motor adaptation. It accounts for the role of active movement in creating motion sickness symptoms in some experimental circumstances, and in alleviating them in others. The relationship between motion sickness produced by sensory rearrangement and that resulting from external motion disturbances is explicitly defined. A nonlinear conflict averaging model describes dynamic aspects of experimentally observed subjective discomfort sensation, and suggests resulting behavior

Suspicious minds : the dramatisation of paranoia in Victorian poetry : a thesis presented in partial fulfilment of the requirements for the degree of Master of Arts in English at Massey University

This thesis contains readings of a number of Victorian poems by Alfred Tennyson, Robert Browning and Dante Gabriel Rossetti which dramatise paranoia and jealousy. A range of twentieth-century theories of paranoia (including clinical, Freudian and Lacanian) have been used as explanatory tools for interpreting the representations of paranoia in the poems. The reading of Tennyson's Maud is based on Freud's theory of homoerotic motives. The reading of Browning's "'Childe Roland to the Dark Tower Came'" is based on the Lacanian concepts of foreclosure and the Name-of-the-Father. The readings of the jealousy poems are based on both theories, and this section includes a discussion of the limitations of the theories as explanatory tools. The general approach has been to apply clinical and psychoanalytical constructs and explanations to each poem separately, although there is some discussion involving the comparison of paranoid behaviours and motives across all the poems. Areas for further research are suggested in the concluding chapter

Final report on the farmer's aid in plant disease diagnoses

This report is the final report on the FAD project. The FAD project was initiated in september 1985 to test the expert system shell Babylon by developing a prototype crop disease diagnosis system in it. A short overview of the history of the project and the main problems encountered is given in chapter 1. Chapter 2 describes the result of an attempt to integrate JSD with modelling techniques like generalisation and aggregation and chapter 3 concentrates on the method we used to elicit phytopathological knowledge from specialists. Chapter 4 gives the result of knowledge acquisition for the 10 wheat diseases most commonly occurring in the Netherlands. The user interface is described briefly in chapter 5 and chapter 6 gives an overview of the additions to the implementation we made to the version of FAD reported in our second report. Chapter 7, finally, summarises the conclusions of the project and gives recommendations for follow-up projects

Mindfulness-based interventions for anxiety and depression

Published in final edited form as: Psychiatr Clin North Am. 2017 December ; 40(4): 739–749. doi:10.1016/j.psc.2017.08.008.This article reviews the ways in which mindfulness practices have contributed to cognitive and behavioral treatments for depression and anxiety. Research on mindfulness-based interventions (MBIs) has increased rapidly in the past decade. The most common include mindfulness-based stress reduction and mindfulness-based cognitive therapy. MBIs are effective in reducing anxiety and depression symptom severity in a range of individuals. MBIs consistently outperform non-evidence-based treatments and active control conditions, such as health education, relaxation training, and supportive psychotherapy. MBIs also perform comparably with cognitive behavior therapy (CBT). The treatment principles of MBIs for anxiety and depression are compatible with standard CBT.R01 AT007257 - NCCIH NIH HH