Teoria transcendental de la consciència i filosofia de la ment

[cat] El tema d’aquesta tesi doctoral és l’actualitat d’un model filosòfic inspirat en la filosofia transcendental de Kant. En el capítol 1 identifico dos macro- models hegemònics en la discussió contemporània, realisme cientista i construccionisme social, i apunto com el debat entre ells es manifesta com a conflicte improductiu, en particular en la ciència cognitiva i en l’ètica. Plantejo l’oportunitat d’un model transcendental, alternatiu als esmentats, com a eina conceptual vàlida per a enfrontar els reptes contemporanis (societat tecnològica, crisi ecològica i globalització). En el capítol 2 aprofundeixo en el concepte de model, que relaciono amb la nostra representació del món i de nosaltres mateixos. D’aquí la necessitat de la filosofia com a un tipus peculiar de treball amb models, atent a llur naturalesa representativa, que qüestiona i modifica supòsits bàsics dels models intuïtius i científics. A partir d’un cert grau de generalitat i abstracció, un macro-model filosòfic equival a un paradigma en el sentit de Kuhn. En aquest context, defineixo la filosofia transcendental com a emfasitzant la relació especial del macro-model filosòfic de la realitat amb el model filosòfic de la ment. El capítol 3 és un recorregut per l’evolució del pensament de Kant en el seu context dialògic, des de les primeres obres fins la KrV. Ressegueixo sobretot dues qüestions centrals, íntimament relacionades, en aquesta evolució: 1) la superació del dilema entre metafísica escolar i empirisme, que culminarà en la deducció transcendental de les categories i el Sistema dels principis, i 2) l’elucidació de la relació de lògica i experiència, lògica formal i transcendental, en la deducció metafísica. Situo el desenvolupament d’aquestes qüestions en dos marcs interpretatius més generals. 1) Entendre l’evolució de Kant com el pas d’un projecte precrític, l’intent de compatibilitzar una metafísica leibnitziana modificada amb la ciència newtoniana, a l’abandonament d’aquest projecte, que el condueix a la filosofia transcendental. 2) Concebre aquest gir crític com un modelatge filosòfic de ment i món, del qual en resulta una profunda transformació de les concepcions de la representació i la consciència hegemòniques. En el capítol 4 descric el model de la ment de Kant a la KrV com a un model epigenètic, pel qual el coneixement és fruit de la interacció de dues facultats bàsiques, sensibilitat i enteniment. L’enteniment és una facultat de jutjar, que inclou la formació i ús conceptes, subsumir objectes de la intuïció sota aquests conceptes (Judici), i combinar-los en sil·logismes (raó). La sensibilitat és la capacitat (receptivitat) de rebre impressions sensibles, que estimulen l’activitat unificadora de l’enteniment, i de ser afectada per aital activitat. La imaginació transcendental, la facultat mitjancera entre enteniment i sensibilitat, és l’efecte de l’activitat de l’enteniment en la sensibilitat. Així, fa possible que les formes lògiques que adopta l’activitat de l’enteniment i que li permeten relacionar-se amb objectes, guiïn la síntesi de la multiplicitat sensible de manera que pugui ser analitzada en conceptes, i aquests conceptes subordinats a d’altres conceptes, combinats en judicis i sil·logismes en un sistema del coneixement. La modelització recolza en el caràcter sui generis del Jo de l’apercepció transcendental, entre fenomen i noümen, que permet fer-ne l’objecte d’una reflexió sobre condicions de possibilitat de l’experiència en la subjectivitat (un model filosòfic de la ment), però no incloure’l en un model materialista o funcionalista en el sentit de la IA contemporània. En el capítol 5 comparo el model transcendental proposat al Capítol 4 amb el neokantisme d’Ernst Cassirer, alhora com a proposta filosòfica i com a interpretació de Kant. Argumento que l’avantatge del primer model és que manté l’equilibri de Kant entre sensibilitat i enteniment, receptivitat i activitat, i la seva distinció igualment fonamental entre lògica i experiència, lògica formal i transcendental. Situo aquesta comparació en relació al debat contemporani sobre l’existència de contingut mental no-conceptual, i la interpretació de la posició de Kant sobre aquesta qüestió.[eng] The subject of this doctoral thesis is the contemporary relevance of a philosophical model inspired in Kant’s transcendental philosophy. In Chapter 1 I identify two dominant models in the current theoretical landscape, scientific realism and social constructionism, and describe the conflict between them as sterile, in particular in cognitive science and ethics. I then argue for the opportunity of a transcendental model, as an alternative to both and a sound conceptual device for dealing with contemporary issues (technological divide, ecological crisis and globalization). In Chapter 2 I examine the concept of a model, with respect to our representation of the world and of ourselves. I point out the need for philosophy as a peculiar kind of work with models, focused in their representative nature and that challenges basic assumptions of intuitive and scientific models. From a certain level of generality and abstraction on, a philosophical macromodel is a paradigm in Thomas S. Kuhn’s sense. Then I define transcendental philosophy by its emphasis on the crucial link between the philosophical macromodel of reality and the philosophical model of the mind. Chapter 3 summarizes the evolution of Kant’s thought in its dialogical context, from his early works up to the Critique of Pure Reason. My discussion focuses on two crucial and closely related themes in that evolution: 1) the overcoming of the dilemma between Leibniz-Wolff metaphysics on the one hand and Empiricism on the other, that culminates in the Transcendental Deduction of the Categories and the System of Principles of the first Critique, and 2) the attempt to clarify the relation of logic and experience, of formal and transcendental logic, in the Metaphysical Deduction. I place the analysis of both questions in the wider context of two interpretative frameworks: 1) the construal of Kant’s development as the maturation of a Pre-critical Project, an attempt to combine a modified Leibnizian metaphysics with Newtonian science in a coherent worldview, and the departure from that Project leading to critical philosophy; 2) the conception of this critical turn as a philosophical modeling of mind and world, one that resulted in a radical revision of the dominant views on representation and consciousness. In Chapter 4 I describe Kant’s model of the mind in the first Critique as an epigenetic model, according to which cognition emerges from the interplay of two basic faculties, sensibility and understanding. Understanding is a capacity to judge, and includes concept formation and use, subsuming the objects of intuition under those concepts (Judgment) and combining the resulting judgements in syllogisms (Reason). Sensibility is the capacity of receiving sense impressions, which stimulate the understanding’s unifying activity, and of being affected by that activity. Transcendental imagination, the mediating faculty between understanding and sensibility, is the effect of the understanding’s activity on sensibility. It enables the logical forms adopted by this activity to guide the synthesis of the sensible manifold in a way that it can be further analyzed in concepts, and those concepts connected to other concepts in judgements and syllogisms in a system of knowledge. The modeling itself rests on the unique nature of the I of Transcendental Apperception, between phenomenon and noumenon, construed as a suitable object of a reflection on the conditions for the possibility of experience in subjectivity (a philosophical model of the mind), but not a materialist or functionalist model in the sense of contemporary AI. Finally, in Chapter 5 I compare the transcendental model of Chapter 4 with Ernst Cassirer’s Neokantianism, both as a philosophical proposition and an interpretation of Kant’s thought. I argue that the main advantage of the former in both counts is that it preserves Kant’s critical balance between sensibility and understanding, receptivity and activity, and his equally fundamental distinction of logic and experience, formal and transcendental logic. I present this argument against the background of recent discussions about the existence of non-conceptual mental content, and interpretative issues regarding Kant’s position on that matter

Why do staff and family think differently about quality of life in dementia? A qualitative study exploring perspectives in care homes

Background: Quality of life is important especially in incurable illness. In dementia, we often need proxy reports of quality of life, but we know little about how individuals make their judgements. In care homes, proxies may be staff providing care or relatives, but staff rate quality of life differently to family. To our knowledge, no one has explored this qualitatively, so we used qualitative interviews to explore why staff and family think differently about quality of life. Methods: We interviewed 12 staff and 12 relatives who had provided proxy ratings of quality of life for people living with dementia in care homes in the Managing Agitation and Raising Quality of life (MARQUE) study. We asked why they had rated the resident's quality of life as “Very Good, Good, Fair, or Poor.” Using thematic analysis, we compared staff and relatives' proxy responses. Results: For staff, the concept of quality of life was often viewed synonymously with quality of care, influenced by their sense of responsibility and informed by their professional understanding. For relatives, quality of life was often judged in relation to how the person with dementia lived before diagnosis and was influenced by their perception of loss for the person with dementia and their own adjustment. Conclusions: Proxy reports were influenced by rater's own contexts and experiences. This can enhance our understanding of widely used research tools, aid the evaluation of intervention outcomes, and indicate possible targets for improving perceived and actual quality of life of people with dementia

Importância da psicoeducação em grupos de dependentes químicos: relato de experiência

O uso de substâncias psicoativas é um grave problema de saúde pública. A terapia cognitivo-comportamental apresenta diversas formas de tratamento para a dependência química, utilizando-se de diversas técnicas, sendo a psicoeducação uma intervenção técnica valiosa nessa área. Este estudo teve como objetivo fazer um levantamento acerca de aspectos relevantes que ocorreram ao longo de sessões de psicoeducação em uma comunidade terapêutica. A partir dos relatórios feitos a cada sessão foram verificados os aspectos mais importantes para serem descritos neste estudo. Pode- se verificar que a experiência foi extremamente rica para os pacientes. Através do entendimento da doença, bem como esclarecimento de dúvidas, os pacientes se sentiam melhor compreendidos o que possibilitava uma maior consciência, motivação e esperança para a realização de um tratamento eficaz e com maior chance de sucesso. Salienta-se a importância da psicoeducação em grupo como técnica para engajar os pacientes no tratamento bem como ampliar o sentimento de mútua ajuda entre eles

Neuropsychological Assessment of Older Adults With Virtual Reality: Association of Age, Schooling, and General Cognitive Status

The development of neuropsychological assessment methods using virtual reality (VR) is a valid and promising option for the detection of cognitive impairment in the older people, focusing on activities composed of tasks of multiple demands. This study verified the association of age, schooling, and general cognitive status on the performance of neurologically healthy older adults in ECO-VR, a VR task of multiple demands for neuropsychological assessment. A total of 111 older adults answered a sociodemographic questionnaire, the Mini Mental State Examination, the Vocabulary subtest of the Wechsler Intelligence Scale for Adults (third edition), and the ECO-VR. Correlation analyses, multiple linear regression, and comparisons between groups (effects by age and schooling groups) were used to evaluate the results. The ECO-VR total score was significantly associated with age, years of education, MMSE, and Vocabulary subtest. The linear regression models identified that age was the main predictor for total score and rule breaking of ECO-VR. According to the univariate analysis, it was identified the main effect of age group and schooling group in the total ECO-VR score, but there was no interaction effect. The results are discussed in order to understand the role of sociodemographic characteristics in the performance of older adults in a VR task of multiple demands. It was also verified the possibility use of VR for neuropsychological assessment of older adults

Terapia Cognitivo-Comportamental nos transtornos alimentares: uma abordagem familiar para intervenção em crise

Os transtornos alimentares são caracterizados por uma grave perturbação do comportamento alimentar, acompanhada por distorção da imagem corporal, com conseqüências clínicas e emocionais tanto para a pessoa que sofre deste transtorno quanto para seus familiares. A terapia familiar é uma das indicações para o tratamento dos transtornos alimentares, uma vez que os conflitos familiares ou são causadores destes transtornos ou conseqüências dos mesmos. O objetivo deste artigo é a descrição de um plano de tratamento familiar para tais pacientes, seguindo o modelo de terapia cognitivo-comportamental. A terapia de família é um recurso terapêutico com o objetivo central de melhorar as relações e conflitos existentes, promovendo, deste modo, a melhora do prognóstico do transtorno alimentar

A diabetes mellitus causa deterioro cognitivo em idosos? Um estudo de revisão

Diabetes Mellitus (DM) refers to a metabolic syndrome, with physical, social and psychological damages for those who had it. The disease has a strong genetic component and is subdivided into Diabetes Mellitus Type 1 (DM1) and Diabetes Mellitus Type 2 (DM2). The DM2 is associated with cognitive deficits and also with functional deficits. Previous research showed that the executive functions in elderly with DM are more impaired than those without this disease. For this reason, this study aimed to conduct a systematic literature review of indexed publications in the last eight years that addressed the relationships between DM2 and poor cognitive function in the elderly (cognitive flexibility, mental flexibility, deterioration and executive functions). The studies reviewed showed a degree of impairment related to cognitive functions, mainly in thought flexibility, attention, working memory, suggesting that DM2 accelerates the cognitive deterioration, increasing the chances to develop dementia. The prevalence of depression is higher in elderly patients with DM2, affecting many functions and occur also in addition to other physical complications. These findings indicate impaired cognitive functioning in elderly patients with DM2, which emphasizes the urgency to develop prevention and intervention programsLa diabetes mellitus (DM) se refiere a un síndromemetabólico que conlleva cambios físicos, sociales ypsicológicos en quienes lo padecen. La enfermedadposee un fuerte componente genético y se subdive entipos 1 (DM1) y 2 (DM2). La DM2 está asociada adéficits funcionales y cognoscitivos. Las investigacionesrevelan que las funciones ejecutivas de los adultosmayores con DM se encuentran más perjudicadas encomparación con adultos mayores que no padecen estaenfermedad. Con el objetivo de profundizar este tema,este estudio realiza una revisión sistemática de la literatura,a través de publicaciones indexadas en los últimosocho años que abordan la relación entre DM2 y aspectosdel deterioro cognoscitivo en ancianos (flexibilidadcognoscitiva, flexibilidad mental y del pensamiento enfunciones ejecutivas). En los estudios revisados, la mayoríamostró un grado de compromiso relacionado conlas funciones ejecutivas: flexibilidad del pensamiento,atención o memoria de trabajo, sugiriendo incluso quela DM2 acelera el proceso de deterioro, aumentando laposibilidad de desarrollo de la demencia. La prevalenciade depresión es más elevada en ancianos con DM2, conel compromiso de múltiples funciones y otras complicacionesfísicas identificadas. Los hallazgos muestran unfuncionamiento cognoscitivo perjudicado en ancianoscon DM2 lo que enfatiza la necesidad del desarrollo deprogramas de prevención e intervención.A Diabetes Mellitus (DM) refere-se a uma síndrome metabólica, com prejuízos físicos, sociais e psicológicos naqueles que a possuem. A doença tem um forte componente genético, e é subdividida em Diabetes Mellitus Tipo 1 (DM1), e Diabetes Mellitus Tipo 2 (DM2). A DM2 está associada a déficits funcionais e também cognitivos. Pesquisas revelam que as funções executivas dos idosos com DM encontram-se mais prejudicadas do que naqueles sem DM. Com o objetivo de aprofundar esta temática, esse estudo realiza uma revisão sistemática da literatura, através de publicações indexadas nos últimos oito anos, que abordam a relação entre DM2 e aspectos do deterioro cognitivo em idosos (flexibilidade cognitiva, flexibilidade mental e do pensamento e funções executivas). Nos estudos revisados, a maioria mostrou um grau de comprometimento relacionado com as funções cognitivas: flexibilidade do pensamento, atenção, memória de trabalho, sugerindo, inclusive, que a DM2 acelera o processo de deterioro, aumentando a possibilidade de desenvolvimento de demência. A prevalência de depressão é mais elevada em idosos com DM2, com comprometimento em muitas funções, além de outras complicações físicas identificadas. Os achados apontam para funcionamento cognitivo prejudicado em idosos com DM2, o que enfatiza a necessidade de desenvolvimento de programas de prevenção e intervenção

Diferenças Quanto ao Desempenho na Atenção Concentrada de Crianças e Adolescentes com e sem TDAH

A atenção é um processo neuropsicológico complexo que tem a função de facilitar a atividade mental selecionando estímulos mais importantes, dentre outros que estão ocorrendo no mesmo momento, de acordo com a necessidade do organismo. Algumas dificuldades encontradas em relação à atenção se referem à distração, esquecimentos, repetição de erros e necessidade de perguntar mais de uma vez a mesma coisa. O objetivo deste estudo é avaliar as diferenças quanto a atenção concentrada através do D2 Teste de Atenção Concentrada em 60 crianças e adolescentes, com e sem TDAH, com idade entre 9 e 15 anos. Os achados mostram que o D2  é um instrumento sensível para avaliar essa função na população investigada, porém sugere-se um estudo envolvendo uma amostra maior. O estudo também mostrou que existem diferenças significativas entre os grupos, que o grupo com TDAH apresentou um pior desempenho

Comparing genomic variant identification protocols for Candida auris.

Genomic analyses are widely applied to epidemiological, population genetic and experimental studies of pathogenic fungi. A wide range of methods are employed to carry out these analyses, typically without including controls that gauge the accuracy of variant prediction. The importance of tracking outbreaks at a global scale has raised the urgency of establishing high-accuracy pipelines that generate consistent results between research groups. To evaluate currently employed methods for whole-genome variant detection and elaborate best practices for fungal pathogens, we compared how 14 independent variant calling pipelines performed across 35 Candida auris isolates from 4 distinct clades and evaluated the performance of variant calling, single-nucleotide polymorphism (SNP) counts and phylogenetic inference results. Although these pipelines used different variant callers and filtering criteria, we found high overall agreement of SNPs from each pipeline. This concordance correlated with site quality, as SNPs discovered by a few pipelines tended to show lower mapping quality scores and depth of coverage than those recovered by all pipelines. We observed that the major differences between pipelines were due to variation in read trimming strategies, SNP calling methods and parameters, and downstream filtration criteria. We calculated specificity and sensitivity for each pipeline by aligning three isolates with chromosomal level assemblies and found that the GATK-based pipelines were well balanced between these metrics. Selection of trimming methods had a greater impact on SAMtools-based pipelines than those using GATK. Phylogenetic trees inferred by each pipeline showed high consistency at the clade level, but there was more variability between isolates from a single outbreak, with pipelines that used more stringent cutoffs having lower resolution. This project generated two truth datasets useful for routine benchmarking of C. auris variant calling, a consensus VCF of genotypes discovered by 10 or more pipelines across these 35 diverse isolates and variants for 2 samples identified from whole-genome alignments. This study provides a foundation for evaluating SNP calling pipelines and developing best practices for future fungal genomic studies