COMORBIDITY AND MULTIMORBIDITY IN MEDICINE TODAY: CHALLENGES AND OPPORTUNITIES FOR BRINGING SEPARATED BRANCHES OF MEDICINE CLOSER TO EACH OTHER

Comorbidity and multimorbidity represent one of the greatest chalenge to academic medicine. Many disorders are often comorbidly expressed in diverse combinations. In clinical practice comorbidity and multimorbidity are underrecognized, underdiagnosed, underestimated and undertreated. So that one can speak about comorbidity and multimorbidity anosognosia. Comorbidities and multimorbidities are indifferent to medical specializations, so the integrative and complementary medicine is an imperative in the both education and practice. Shifting the paradigm from vertical/mono-morbid interventions to comorbidity and multimorbidity approaches enhances effectiveness and efficiency of human resources utilization. Comorbidity and multimorbidity studies have been expected to be an impetus to research on the validity of current diagnostic systems as well as on establishing more effective and efficient treatment including individualized and personalized pharmacotherapy

PROFESSIONALISM IN CONTEMPORARY MEDICINE: IF IT IS AN IMPORTANT ACADEMIC ISSUE, THEN SURELY IT IS A “HOT” ISSUE AS WELL

Professionalism has been a hot topic in medical education and in medicine in general. Professionalism in medicine embodies the relationship between medicine and society as it forms the basis of patient-physician relationships and the mutual expectations patients and physicians have of each other. Education on professionalism in medicine and professionalism in medical education are two important liasions. Increasing efforts have focused on fostering professionalism in medical education. Medical faculties have long taught the theoretical and technical aspects of medicine, but teaching professionalism in medicine and healing qualities has been a recent trend. The concept of professionalism has evolved over time by a process of exploration and reflection. It seems that medical professionalism has been changing from paternalism to partnership with patients and mutuality, from tribalism to collegiality, and from self-sacrifice to shared responsibility. There is still no consensus on how professionalism in medicine should be defined as and about the best methods for teaching medical professionalism. The aim of this "landscape” review is to promote the complete integration of a culture of professionalism into the educational and research body, including staff, faculty, residents and students

COMORBIDITY AND MULTIMORBIDITY IN MEDICINE TODAY: CHALLENGES AND OPPORTUNITIES FOR BRINGING SEPARATED BRANCHES OF MEDICINE CLOSER TO EACH OTHER

Comorbidity and multimorbidity represent one of the greatest chalenge to academic medicine. Many disorders are often comorbidly expressed in diverse combinations. In clinical practice comorbidity and multimorbidity are underrecognized, underdiagnosed, underestimated and undertreated. So that one can speak about comorbidity and multimorbidity anosognosia. Comorbidities and multimorbidities are indifferent to medical specializations, so the integrative and complementary medicine is an imperative in the both education and practice. Shifting the paradigm from vertical/mono-morbid interventions to comorbidity and multimorbidity approaches enhances effectiveness and efficiency of human resources utilization. Comorbidity and multimorbidity studies have been expected to be an impetus to research on the validity of current diagnostic systems as well as on establishing more effective and efficient treatment including individualized and personalized pharmacotherapy

PROFESSIONALISM IN CONTEMPORARY MEDICINE: IF IT IS AN IMPORTANT ACADEMIC ISSUE, THEN SURELY IT IS A “HOT” ISSUE AS WELL

Professionalism has been a hot topic in medical education and in medicine in general. Professionalism in medicine embodies the relationship between medicine and society as it forms the basis of patient-physician relationships and the mutual expectations patients and physicians have of each other. Education on professionalism in medicine and professionalism in medical education are two important liasions. Increasing efforts have focused on fostering professionalism in medical education. Medical faculties have long taught the theoretical and technical aspects of medicine, but teaching professionalism in medicine and healing qualities has been a recent trend. The concept of professionalism has evolved over time by a process of exploration and reflection. It seems that medical professionalism has been changing from paternalism to partnership with patients and mutuality, from tribalism to collegiality, and from self-sacrifice to shared responsibility. There is still no consensus on how professionalism in medicine should be defined as and about the best methods for teaching medical professionalism. The aim of this "landscape” review is to promote the complete integration of a culture of professionalism into the educational and research body, including staff, faculty, residents and students

PERSON-CENTERED MEDICINE AND GOOD CLINICAL PRACTICE: DISEASE HAS TO BE CURED, BUT THE PATIENT HAS TO BE HEALED

Contemporary medicine has been in the process of a paradigm shift. Instead of relatively broad pathological entities, populationbased risk assesments, and non-specific „one-size-fits-all“ therapies, a new paradigm of predictive, individualized and personalized care and targeted therapy is rolling on the horizon. Person-centered medicine is a term with different meanings which competes in some way to other terms like medicine of the person, patient-centered medicine, personalized and individualzed medicine, integrative and holistic medicine. Clear definition of theoretical framework and clinical practice of person-centered medicine is urgent to prevent dangereous increasing confusion

SCIENCE AND PSEUDOSCIENCE IN MEDICINE: EVIDENCE-BASED VS. EVIDENCE-BIASED MEDICINE

The concept of evidence-based medicine (EBM), as the highest standard of health care, came into existence in 1990s to promote a systematic approach to helping clinicians in their practice to be guided by the best available scientific evidence. However, there has been an increasing number of warning reports “that in modern research, misrepresented, false and unuseful findings may be the majority or even the vast majority of published research claims In spite of the huge scientific progress, pseudoscience and associated evidence biased medicine represent a serious threat to the concept of the EBM. Effective education in medicine, proper research motivation, sound systems and creative thinking and culture of scientific dialogue may significantly contribute to better science and evidence-based medicine. The seven key words of good science, research and publishing are: integrity, motivation, capacity, understanding, knowledge, experience, and creativity

SCIENCE AND PSEUDOSCIENCE IN MEDICINE: EVIDENCE-BASED VS. EVIDENCE-BIASED MEDICINE

The concept of evidence-based medicine (EBM), as the highest standard of health care, came into existence in 1990s to promote a systematic approach to helping clinicians in their practice to be guided by the best available scientific evidence. However, there has been an increasing number of warning reports “that in modern research, misrepresented, false and unuseful findings may be the majority or even the vast majority of published research claims In spite of the huge scientific progress, pseudoscience and associated evidence biased medicine represent a serious threat to the concept of the EBM. Effective education in medicine, proper research motivation, sound systems and creative thinking and culture of scientific dialogue may significantly contribute to better science and evidence-based medicine. The seven key words of good science, research and publishing are: integrity, motivation, capacity, understanding, knowledge, experience, and creativity

Methodological and Conceptual Issues in Studying the Evolution of Social Behaviour: The Case of Cooperative Problem-Solving

Jedno je od glavnih istraživačkih područja u socijalnoj kogniciji životinja kooperativno rješavanje problema, tj. kognicija kod međusobne suradnje životinja. Smatra se da je socijalna kognicija evoluirala zbog zahtjeva koje donosi život u grupama i često se drži adaptacijom za takav život. Analiza socijalnoga učenja, drugoga istraživačkog područja unutar socijalne kognicije, pokazala je da je ta pretpostavka u literaturi prouzročila dva problema. Prvo, postoji pristranost prema testiranju socijalnih vrsta, i drugo, postoji a priori pretpostavka da je socijalno učenje kvalitativno drugačije od individualnoga. Ta dva problema nisu nužno ograničena na socijalno učenje, nego mogu biti prisutna i u drugim poljima unutar istraživanja socijalne kognicije. Primjena slične analize na kooperativno rješavanje problema ukazuje da i u tome području postoje oba problema. Prvo, empirijska se istraživanja provode ponajprije na vrstama koje su socijalne i na onima koje pokazuju kooperativna ponašanja u divljini. Drugo, pretpostavka da se kooperativno rješavanje problema temelji na specifično socijalnim kognitivnim sposobnostima implicirana je u velikome dijelu literature. Moguće je da je to rezultat miješanja različitih komponenti unutar kognitivnoga procesa: koja je informacija potrebna za uspješnu kooperaciju i kako se ta informacija stječe. Dok prva komponenta mora uključivati informaciju o drugome pojedincu, ne postoji indikacija da se druga komponenta mora razlikovati od već poznatih, općenamjenskih mehanizama. Ta dva problema sprečavaju sistematsko ispitivanje razlika između vrsta i ometaju istraživanje evolucije kooperativnoga rješavanja problema.A major research area in non-human social cognition is the investigation of cooperative problem-solving, i.e. the cognition involved in situations when animals cooperate with each other. Social cognition is thought to have evolved due to the demands of social living and is often thought to present an adaptive specialisation for living in groups. A previous analysis of social learning, another area of social cognition, has highlighted how this has consequently led to two overarching biases in the literature: firstly, a bias towards testing only social species, and secondly, an a priori assumption that social learning is qualitatively different from learning involved in non-social situations. The problem of these biases may not be restricted only to social learning but it may also be present in other areas of social cognition research. Applying an equivalent analysis to cooperative problem-solving shows that here too both biases are present. Firstly, empirical studies on cooperative problem-solving were primarily conducted with social species and species that exhibit cooperative behaviours in the wild. Secondly, the assumption that cooperative problem-solving relies on a distinctly social cognitive ability can, at least implicitly, be observed throughout the literature. This may be the result of confounding different components of the cognitive process involved in cooperation: what information is required to successfully cooperate and how this information is acquired. While the former needs to involve information about another individual, there is no indication that the latter is required to differ from any known, domain-general cognitive mechanism. These two biases make it difficult to systematically test whether and how cooperation differs between species, and as such impede investigations into the evolution of cooperative problem-solving