The increasing availability of passively observed data has yielded a growing interest in “data fusion” methods, which involve merging data from observational and experimental sources to draw causal conclusions. Such methods often require a precarious tradeoff between the unknown bias in the observational dataset and the often-large variance in the experimental dataset. We propose an alternative approach, which avoids this tradeoff: rather than using observational data for inference, we use it to design a more efficient experiment. We consider the case (...) of a stratified experiment with a binary outcome and suppose pilot estimates for the stratum potential outcome variances can be obtained from the observational study. We extend existing results to generate confidence sets for these variances, while accounting for the possibility of unmeasured confounding. Then, we pose the experimental design problem as a regret minimization problem subject to the constraints imposed by our confidence sets. We show that this problem can be converted into a concave maximization and solved using conventional methods. Finally, we demonstrate the practical utility of our methods using data from the Women’s Health Initiative. (shrink)

George Will, the well-known pundit, once observed: “A society's recreation is charged with moral significance. Sport—and a society that takes it seriously—would be debased if it did not strictly forbid things that blur the distinction between the triumph of character and the triumph of chemistry.” In opposition, Dan Duchaine, the highly publicized “steroid guru” and counter-culture columnist, declared: “There comes a time for many in competitive athletics where winning is more important than those initial goals of health, recreation, and (...) relaxation.” The parallels of these two philosophies to life in general are patent simply by substituting “sports” and “winning” for “career” and “success,” respectively.This paper will review the basis for banning anabolic steroids in athletics, and consider especially the recent medical findings that support this prohibition. This survey leads into a discussion of the available deterrents, and the secondary, but essential, role of random drug testing as a final safeguard. (shrink)

George Will, the well-known pundit, once observed: “A society's recreation is charged with moral significance. Sport—and a society that takes it seriously—would be debased if it did not strictly forbid things that blur the distinction between the triumph of character and the triumph of chemistry.” In opposition, Dan Duchaine, the highly publicized “steroid guru” and counter-culture columnist, declared: “There comes a time for many in competitive athletics where winning is more important than those initial goals of health, recreation, and (...) relaxation.” The parallels of these two philosophies to life in general are patent simply by substituting “sports” and “winning” for “career” and “success,” respectively.This paper will review the basis for banning anabolic steroids in athletics, and consider especially the recent medical findings that support this prohibition. This survey leads into a discussion of the available deterrents, and the secondary, but essential, role of random drug testing as a final safeguard. (shrink)

Our think tank tasked by the Dutch Health Council, consisting of Radboud University Nijmegen Honours Academy students with various backgrounds, investigated the implications of Deep Brain Stimulation for psychiatric patients. During this investigation, a number of methodological, ethical and societal difficulties were identified. We consider these difficulties to be a reflection of a still fragmented field of research that can be overcome with improved organization and communication. To this effect, we suggest that it would be useful to found a (...) centralized DBS organization. Such an organization makes it possible to 1) set up and maintain a repository, 2) facilitate DBS studies with a larger sample size, 3) improve communication amongst researchers, clinicians and ethical committees, and 4) improve communication between DBS experts and the public at large. (shrink)

Our think tank tasked by the Dutch Health Council, consisting of Radboud University Nijmegen Honours Academy students with various backgrounds, investigated the implications of Deep Brain Stimulation for psychiatric patients. During this investigation, a number of methodological, ethical and societal difficulties were identified. We consider these difficulties to be a reflection of a still fragmented field of research that can be overcome with improved organization and communication. To this effect, we suggest that it would be useful to found a (...) centralized DBS organization. Such an organization makes it possible to 1) set up and maintain a repository, 2) facilitate DBS studies with a larger sample size, 3) improve communication amongst researchers, clinicians and ethical committees, and 4) improve communication between DBS experts and the public at large. (shrink)

:A common goal of ethics education is to equip students who later become health practitioners to not only know about the ethical principles guiding their practice, but to also autonomously recognize when and how these principles might apply and assist these future practitioners in providing care for patients and families. This article aims to contribute to discussions about ethics education pedagogy and teaching, by presenting and evaluating the use of the visual arts as an educational approach designed to (...) facilitate students’ moral imagination and independent critical thinking about ethics in clinical practice. We describe a sequence of ethics education strategies over a 3 year Doctor of Physiotherapy program, focusing on the final year professional ethics assessment task, which involved the use of visual arts to stimulate the exploration of ethics in healthcare. The data were analyzed using both thematic and content analysis. Two key themes centered on emotional responses and lateral thinking. The use of artwork appeared to facilitate imaginative, emotional, and conceptual thinking about ethics and clinical experience. This study provides some evidence to support the effectiveness of the use of the visual arts in promoting students’ recognition of ethical dimensions within their clinical experience and reflection on their emerging professional identity. As one student noted, she left the museum “somewhat changed.”. (shrink)

ABSTRACTThis article describes our experience using art and theatre to engage rural communities in western Cambodia to understand malaria and support malaria control and elimination. The project was a pilot science–arts initiative to supplement existing engagement activities conducted by local authorities. In 2016, the project was conducted in 20 villages, involved 300 community members and was attended by more than 8000 people. Key health messages were to use insecticide-treated bed-nets and repellents, febrile people should attend village malaria workers, (...) and to raise awareness about the risk of forest-acquired malaria. Building on the experience and lessons learnt in the year prior, the 2017 project which was conducted in 15 villages involved 600 community members and attracted more than 12,000 people. In addition to the malaria theme, upon discussion with local health authorities, secondary theme was added to the 2017 project. We learnt the following lessons from our experience in... (shrink)

We describe work in progress to conduct a systematic review of research on effects of arts-based programs for mental health in young people. We are at the stage of searching for relevant studies through major databases and screening extant systematic reviews for additional research which meet our inclusion criteria. At this stage, however, concerns have arisen regarding both the quality of existing primary studies and of recently published systematic reviews in this area of arts and health. (...) As a case in point, in this paper we focus on one research report on art therapy with adolescent girls and its inclusion in three systematic reviews. We demonstrate that the reviews fail to undertake a robust critique of the Bazargan and Pakdaman paper and that the paper and reviews are flawed. Drawing on recent criticisms of systematic reviewing, we consider the value of proceeding with our systematic review as initially planned. (shrink)

As befits an emerging field of enquiry, there is on-going discussion about the scope, role and future of the medical humanities. One relatively recent contribution to this debate proposes a differentiation of the field into two distinct terrains, ‘medical humanities’ and ‘health humanities,’ and calls for a supersession of the former by the latter. In this paper, we revisit the conceptual underpinnings for a distinction between ‘the medical’ and ‘health’ by looking at the history of an analogous debate (...) between ‘medical geography’ and ‘the geographies of health’ that has, over the last few years, witnessed a re-blurring of the distinction. Highlighting the value of this debate within the social sciences for the future development of the medical humanities, we call for scholars to take seriously the challenges of critical and cultural theory, community-based arts and health, and the counter-cultural creative practices and strategies of activist movements in order to meet the new research challenges and fulfill the radical potential of a critical medical humanities. (shrink)

This volume brings together research in the GeoHumanities from various intellectual perspectives to illustrate the benefits of humanities-inspired approaches in understanding and confronting historically entrenched and recently emergent health-related challenges. In three main sections, this volume seeks to foreground the richness of work entangling medicine and health with the concerns of geography and of the Humanities. This volume will be of interest to academics and researchers in the Geographies of health and medicine, social sciences in GeoHumanities, and (...) health humanities, and students in programs focusing on the humanities and health. In the book's first section, Bodies, the authors explore the material, sensory and more than physical capacities of bodies in accounting for experiences of death, air raids, immigration, dance therapy, asthma and blindness. Section two, Voice, addresses the nature of evidence, HIV/AIDS policy, patient voices in animal research, homelessness, and constructions of truth. The final section, Practice, focuses on creative writing, as well as the pedagogic tools of teaching with the asylum, the creative practice of nuclear emergency planning zones, arts-based care for the elderly, and cartographic practices within health research. (shrink)

In this article, we present a work developed with palliative patients with the aim of, through art, enabling them to find answers that would help them overcome situations that kept them involved in thoughts, fears, and anxiety that consumed their energy, joy, and will to live. For this purpose, we used a qualitative methodology —research-action— and the attained results revealed how arts can be useful to these patients by providing them, through the work they have developed, with an improvement (...) in self-esteem, disposition, and well-being in disease avoidance and the expression and communication of emotions. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Art and Science, Facts and KnowledgeBengt Brülde (bio)Keywordsart, definitions, epistemology, facts and values, mental disorder, metaphysical realism, nominalism, physical disorder, social constructivismThe main purpose of my original article was to find out how the evaluative content of the concept of mental disorder, i.e. its "value component," should be characterized. Both Tyreman and Ross are focusing on other things, however. Tyreman seems to agree with my analysis, and his primary (...) objective is to find out whether my general analytical approach can be extended to other areas, e.g. whether it can be used to analyze the concept of physical disorder or the concept of art. It is hard to tell whether Ross agrees with my view, since her entire commentary is focused on a few assumptions I made in the beginning of the paper, mainly in passing, to make my evaluative investigation more manageable. In short, the main content of my original paper is never really challenged, and I do not think I have to revise my view on the evaluative content of the concept of mental disorder. Both commentaries give rise to questions that are interesting in their own right, however, e.g. questions about art and science, and about facts and knowledge. This gives me the opportunity to develop my views on a number of topics that I never touched upon in the original article, e.g. the purpose of defining "mental disorder," the factual component of the concept, the connection between ontological and epistemological issues, and the value-neutrality of science. I am very grateful to the editors for allowing me to give such an extensive reply.My Reply to TyremanTyreman wants to know whether the same kind of analysis given in my original paper can be applied just as usefully to other areas of health care. That is, the question is whether the same type of analytical approach can be extended to other areas where evaluative considerations seem to play a crucial part. In his commentary, Tyreman has mainly four areas in mind, namely physical disorder, art, good art, and good (competent) clinical practice. Or more specifically, the question is whether the kind of evaluative analysis I used in my original paper can help us answer the following four questions: (a) How should we define the concept of physical disorder, i.e. according to what criteria should we draw the line between physical disorders and other physical conditions? (b) How should we define the concept of art, i.e. according to what criteria should we draw the line between art and other artifacts and performances? (c) What is good art, i.e. according to what criteria should we evaluate those artifacts (etc.) that we have decided to categorize as works of art? (d) What makes a clinical performance or practice good or competent, according to what criteria should we evaluate such practices?The first two questions are conceptual, i.e. the question is how certain concepts should be [End Page 111] defined, and in what way or ways values enter the picture. The last two questions are straightforwardly evaluative, however, and it goes without saying that we have to rely on value judgments to answer these questions. This difference suggests that the conceptual analyses needed in the first two cases are somewhat different from the evaluative analyses needed in the last two cases. It is also far more likely that my analysis of mental disorder can be extended to the first two cases. After all, my approach is designed to capture the evaluative content of concepts that are not purely evaluative. (We will return to this below.)To see whether my analysis can be of any help in any of Tyreman's four cases, we need to recapitulate what it is all about. The analysis in question is specifically concerned with how the evaluative content of the concept of mental disorder should be characterized, i.e. how and to what extent we have to rely on value judgments to distinguish mental disorders from other conditions. The first part of the analysis consists in the formulation of four questions that any reasonably complete account needs to answer. These questions are: (0... (shrink)

How to engage the public in a reflection on the most pressing ethical issues of our time? What if part of the solution lies in adopting an interdisciplinary and collaborative strategy to shed light on critical issues in bioethics? An example is Art + Bioéthique, an innovative project that brought together bioethicists, art historians and artists with the aim of expressing bioethics through arts in order to convey the “sensitive” aspect of many health ethics issues. The aim of (...) this project was threefold: 1) to identify and characterize mechanisms for the meeting of arts and bioethics; 2) to experiment with and co-construct a dialogue between arts and bioethics; and 3) to initiate a public discussion on bioethical issues through the blending of arts and bioethics. In connection with an exhibition held in March 2016 at the Espace Projet, a non-profit art space in Montréal, the project developed a platform that combined artworks, essays and cultural & scientific mediation activities related to the work of six duos of young bioethics researchers and emerging artists. Each duo worked on a variety of issues, such as the social inclusion of disabled people, the challenges of practical applications of nanomedicine and regenerative medicine, and a holistic approach to contemporary diseases. This project, which succeeded in stimulating an interdisciplinary dialogue and collaboration between bioethics and arts, is an example of an innovative approach to knowledge transfer that can move bioethics reflection into the public space. (shrink)

How to engage the public in a reflection on the most pressing ethical issues of our time? What if part of the solution lies in adopting an interdisciplinary and collaborative strategy to shed light on critical issues in bioethics? An example is Art + Bioéthique, an innovative project that brought together bioethicists, art historians and artists with the aim of expressing bioethics through arts in order to convey the “sensitive” aspect of many health ethics issues. The aim of (...) this project was threefold: 1) to identify and characterize mechanisms for the meeting of arts and bioethics; 2) to experiment with and co-construct a dialogue between arts and bioethics; and 3) to initiate a public discussion on bioethical issues through the blending of arts and bioethics. In connection with an exhibition held in March 2016 at the Espace Projet, a non-profit art space in Montréal, the project developed a platform that combined artworks, essays and cultural & scientific mediation activities related to the work of six duos of young bioethics researchers and emerging artists. Each duo worked on a variety of issues, such as the social inclusion of disabled people, the challenges of practical applications of nanomedicine and regenerative medicine, and a holistic approach to contemporary diseases. This project, which succeeded in stimulating an interdisciplinary dialogue and collaboration between bioethics and arts, is an example of an innovative approach to knowledge transfer that can move bioethics reflection into the public space. (shrink)

The following text explores performative art works commissioned within a specific “arts and health” cultural setting, namely that of a medical school within a British university. It examines the degree to which the professional autonomy of the artists was “instrumentalized” and diminished as a result of having to fit into normative frames set by institutional agendas. We ask to what extent do such “entanglements,” feel more like “enstranglements,” suffocating the artist’s capacity to envision the world afresh or any (...) differently? What kinds of pressures allow for certain kinds of “evidence” to be read and made visible,? Are You Feeling Better? was a 2016 programme curated by Frances Williams, challenging simplistic expectations that the arts hold any automatic power of their own to make “things better” in healthcare. It included two performative projects – The Secret Society of Imperfect Nurses, by Anthony Schrag with student nurses at Kings College London, and Hiding in Plain Sight by Becky Shaw with doctoral researchers in nursing and midwifery. These projects were situated in a climate of United Kingdom National Health Service cuts and austerity measures where the advancement of social prescribing looks dangerously like the government abnegating responsibility and offering art as amelioration. The text therefore examines the critical “stage” on which these arts-health projects were performed and the extent to which critical reflection is welcomed within institutional contexts, how learning is framed, expressed aesthetically, as well as understood as art practice. It further examines how artistic projects might offer sites of resistance, rejection and mechanisms of support against constricting institutional norms and practices that seek to instrumentalise artistic works to their own ends. (shrink)

The Scottish Mental Health Arts and Film Festival has seen hundreds of arts, public and community groups coproduce over 300 events to over 25,000 audience members. Integral to this arts-based approach, in contrast to social marketing or public education models, is the notion that mental health is an essentially contested concept whereby meanings are negotiated and debate encouraged. With emerging evidence that the festival is an ef ective way of engaging people intellectually and emotionally, we (...) explore ethical issues, challenges and paradoxes that have emerged as the festival has developed. Consideration is given to issues of power, purpose, opportunity costs, reach, impact, programming risks, and participation from those with experience of mental ill-health. Throughout, we explore practical implications for funding, managing, programming, marketing and evaluation of this and similar endeavours. (shrink)

_Art and Mourning_ explores the relationship between creativity and the work of self-mourning in the lives of 20th century artists and thinkers. The role of artistic and creative endeavours is well-known within psychoanalytic circles in helping to heal in the face of personal loss, trauma, and mourning. In this book, Esther Dreifuss-Kattan, a psychoanalyst, art therapist and artist - analyses the work of major modernist and contemporary artists and thinkers through a psychoanalytic lens. In coming to terms with their own (...) mortality, figures like Albert Einstein, Louise Bourgeois, Paul Klee, Eva Hesse and others were able to access previously unknown reserves of creative energy in their late works, as well as a new healing experience of time outside of the continuous temporality of everyday life. Dreifuss-Kattan explores what we can learn about using the creative process to face and work through traumatic and painful experiences of loss._Art and Mourning _will inspire psychoanalysts and psychotherapists to understand the power of artistic expression in transforming loss and traumas into perseverance, survival and gain. Art and Mourning offers a new perspective on trauma and will appeal to psychoanalysts and psychotherapists, psychologists, clinical social workers and mental health workers, as well as artists and art historians. (shrink)

How are the contemporary conceptions of the living body and health related to numerical systems? Addressing the contemporary practice of quantification of bodies and health, such a question is bound to arise. As a discipline historically positioned amidst natural sciences, technology, and art, medicine has always been sensitive to theories and apparatuses able to quantify and reshape the living body, as well as to the practical possibility of operating on it. This is why, in the era where telecommunication, (...) algorithmic information technology, and data-driven decision making are reaching their apex, new forms of medical practice, and new alliances between medicine and technology are emerging as a direct consequence of the evolution of technology. This is what was particularly aimed at by the International Congress "The Quantification of Bodies. Organism, Health, and Representation", which took place at the University of Coimbra on 28-29 November 2019, organized by the IEF - Institute for Philosophical Studies. The present book collects some of the papers presented there, selected according to their interdisciplinary approach and/or to their more informative nature, suitable even for non-specialist readers. A collection that reflects, in a fragment, many of the potentialities opened by this new field of studies. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Art and the Educated AudienceJames O. Young (bio)1. IntroductionWhen writing about art, aestheticians tend to focus on the work of art and on the artist who produces it. When they refer to audiences, they typically speak only of the effect that the artwork has on its audience. Aestheticians pay little, if any, attention to the important active role that an audience plays in the workings of a healthy art (...) world. My goal in this essay is to do something to end the neglect of the audience. I will focus on the role of the informed or, as I will call it, educated audience. I begin by subjecting the concept of an audience to some old-fashioned conceptual analysis. Once we are clearer about what an audience is and, in particular, what an educated audience is, we can begin to determine what it can do. In my view, an educated audience can play an important role in encouraging the production of artworks with high aesthetic value. Indeed, highly valuable artworks are unlikely to be produced without a broad educated audience to whom artists are responsive. Consequently, the aesthetic education of audiences is crucial to the health of an art world.2. What Is an Audience?In its original sense, the noun "audience" refers to the people within earshot of some speaker: one held forth to an audience. In connection with the arts, "audience" was first used in something very like this original sense. It referred to those who heard actors perform plays or those who heard the recitation of poetry. Soon the concept of an audience also applied to those who heard the performance of musical works. By the mid-nineteenth century, the concept of an audience had been broadened. It came to apply to the readers of a novel or other works of literature. More recently, the concept of an audience has been applied to those who view paintings, sculptures, and films. [End Page 29] Now an audience consists of people who experience artworks of any sort. Having an experience of an artwork is a necessary condition of being part of an audience. This condition is, however, far from being sufficient.Some people experience works of art but are not part of an audience. Consider, for example, ushers in a concert hall or theater and guards in art museums. An usher hears the play or the concerto but may not regard it as an aesthetic object. Similarly, a guard sees the paintings (and so in this sense experiences them) but does not, perhaps, attend to them as aesthetic objects. Or consider a person who arranges to meet a friend in a gallery. He almost certainly sees the paintings, but he will not count as part of an audience if he is completely intent on looking for his friend. It seems, then, that members of an audience do not simply experience artworks. They must experience artworks in a certain way.Audience members experience an artwork in such a way that they are able to benefit from its aesthetic value. When I speak of "aesthetic value," I mean the value an artwork possesses in virtue of its sensuous properties. I will not here take a stand on the nature of experience of aesthetic value. Some writers have suggested that the contemplation of art involves a distinctive sort of experience. Perhaps it does. (It has been suggested, for example, that audience members must have a measure of "psychical distance" from some object if they are to have an aesthetic experience of it.) I simply hold that audience members experience an artwork in whatever way makes it possible for them to benefit from its aesthetic value. If aesthetic value causes pleasure (or "aesthetic emotion," understanding, or anything else) then audience members can have pleasure caused in them by an artwork's aesthetic value. The capacity to benefit from the aesthetic value of an artwork is a necessary condition of being part of the work's audience.Notice that not just anyone can be part of the audience for a given work of art. Audience members must possess certain capacities. In the most basic sense of the word, an audience is composed... (shrink)

The essay seeks to bring William James into dialogue with Friedrich Nietzsche around the issue of the nature of sickness, and its overcoming or convalescence. It is, at first glance, folly to reconcile religious rebirth with the convalescence that led Nietzsche to the “great health.” To try and see beyond this folly, we will consider carefully the site in which health emerges for both thinkers. This discussion is further motivated by an interest in the prospects for religion after (...) the death of God. (shrink)

Much innovation has taken place in the development of medical schools and licensure exam processes across the African continent. Still, little attention has been paid to education that enables the multidisciplinary, critical thinking needed to understand and help shape the larger social systems in which health care is delivered. Although more than half of medical schools in Canada, the United Kingdom, and the United States offer at least one medical humanities course, this is less common in Africa. We report (...) on the “liberal arts approach” to medical curricula undertaken by the University of Global Health Equity beginning in 2019. The first six-month semester of the curriculum, called Foundations in Social Medicine, includes courses in critical thinking and communication, African history and global political economy, medical anthropology and social medicine, psychology and health, gender and social justice, information technology and health, and community-based training. Additionally, an inquiry-based pedagogy with relatively small classes is featured within an overall institutional culture that emphasizes health equity. We identify key competencies for physicians interested in pursuing global health equity and how such competencies relate to liberal arts integration into the African medical school curriculum and pedagogical approach. We conclude with a call for a research agenda that can better evaluate the impact of such innovations on physicians’ education and subsequent practices. (shrink)

Mental health has become a key concern within social discourse in recent years, and with it, the discussion about the lived experience of pain. In dealing with this experience there has been a shift away from merely relying on medical care towards more holistic approaches involving community support, public awareness, and social change. However, little if any attention has been paid in this context to the contribution of aesthetic experience engendered by art that expresses and publicly shares with others (...) the lived experience of pain. With reference to Phantom Limb, an art exhibition curated by Euan Grey and held at the Victoria Galleries and Museum Liverpool in 2016, I argue that aesthetic experience plays a crucial role in making sense of pain and suffering, thus breaking new ground in the appreciation of the significance of art for public mental health and holistic approaches towards patients. (shrink)

The nature and scope of medical humanities are under debate. Some regard this field as consisting of those parts of the humanistic sciences that enhance our understanding of clinical practice and of medicine as historical phenomenon. In this article it is argued that aesthetic experience is as crucial to this project as are humanistic studies. To rightly understand what medicine is about we need to acknowledge the equal importance of two modes of understanding, intertwined and mutually reinforcing: the mode of (...) aesthetic imagination and the mode of analytical reflection. (shrink)

Theatre-based health policy research is an emerging field, and this article investigates the work of one of its leaders. In 2005, prominent medical geneticist and playwright Jeff Nisker and his collaborators produced Orchids, his play concerning pre-implantation genetic diagnosis, to research theatre as a tool for engaging citizens in health policy development. Juxtaposing Orchids with a concurrent disability theatre production in Vancouver entitled Ugly, I argue that disability theatre suggests important means for building inclusiveness in this kind of (...) research and complicates Nisker’s own call for international guidelines to delimit how journalists, playwrights, filmmakers, physicians and other media authors share genetics-based narratives in public. (shrink)

This collection comprises ten essays authored or co-authored by Allen Buchanan. They concern issues that are of great importance: public and private health care, the problem of rationing and the existence and scope of the right to health care, among many others. In general, Buchanan is a clear and careful analyst. He is a pluralist, not an apologist for a specific normative theory, such as utilitarianism or the Rawlsian theory of justice. He defends and practises the art of (...) producing considered judgements from a plurality of intuitively plausible normative bases, proceeding in a way that is informed by the economic context in which health care decisions arise. (shrink)

A company called Biojewellery has proposed to take a sample of bone tissue from a couple and to grow this sample into wedding rings. One of the ethical problems that such a proposal faces is that it implies surgery without medical need. To this end, only couples with a prior need for surgery are being considered. This paper examines the question of whether such a stipulation is necessary. It is suggested that, though medical need and the provision of health (...) and wellbeing is overwhelmingly the warrant for surgical intervention, there is no reason in principle why other, non-medical, projects such as jewellery creation might not also warrant surgical intervention. Implicitly, this line of thought forces us to consider the proper place of surgical intervention—that is, to ask what surgeons are for. (shrink)

In the first collection of his essays to be published, Jeremy Holmes discusses the wider application of psychotherapy within psychiatry and suggests that psychoanalysis needs to escape from its esotericism by taking into account contemporary advances in cognitive science, family therapy and the realities of psychiatric work in a public health setting. Illustrating his arguments with literary as well as clinical examples, he emphasizes the importance of creativity in psychotherapy and the connections between the artistic and psychotherapeutic impulse.

The feminist movement was from its start in the 19th century involved in the struggle for better health care for women. The first feminists aimed at better information on birth control and sexuality. The second feminist wave focused on the unequal division of power roles between men and women. A lot of the problems women experienced could be seen as a consequence of their subordinate role in society. At the end of the 1980s and in the 1990s, the discipline (...) women and health or women and medicine was developed. In this introduction to the theme, the developments in this discipline are described. The starting points of the new discipline followed the principles of ‘women’s health care’. These principles can be summarized as the emphasis on control and autonomy by the patient, demedicalization, the importance of the psychosocial context of complaints, empowerment of women and good information and communication. The central issue of the article is: what is the actual scientific state of the art and what important changes have been made on the subject gender and health? The article ends with ideas for future research. (shrink)

An analytical overview of researches carried out abroad, where the relationship between individual’s assertiveness and their psychological health, depression and dangerous addictions were studied, is given in the article. It is stated that assertiveness supports psychological health, psychological maturity, adequate self-esteem; it helps to get rid of low self-reliance; decreases anxiety level and fears; boosts self-esteem and self-respect; protects from emotional problems; helps to overcome stress, to give up smoking and generally to be more successful and less prone (...) to depression. For medical workers, it helps to improve treatment of their patients. (shrink)

Spiritualist mediums are sought out from a variety of cultures for their advanced spirit communication healing techniques. Otherworldly spirits use mediums to create spirit art, which guides an individual to discover their authentic self and work through self‐limiting beliefs. To serve as a bridge for the spirit world, the medium develops an ability to enter an altered state of consciousness and use a multisensory embodied language to communicate with spirits. I describe this language as “dancing with spirits.” To investigate this (...) language, I use my own spirit art as an innovative experiential ethnographic tool that blends auto‐ethnographic perceptions of spirits with sensory and artistic ethnography, and cultural healing techniques. I provide three case studies of how my spirit art provides unique insights into the less explored experiential dimensions of spirit communication. I layer my experimental ethnographic approach with Deleuze and Guattari's “rhizome” to show that spirit communication overcomes limitations of normal linguistic models. The spirit language serves as a rupture for unconscious forces to offer individually tailored healing and insight to a recipient through heightened sensory and physiological phenomena. Art, altered states of consciousness, and anomalous sensory experiences may offer insights to address a pressing global challenge, mental ill‐health. (shrink)

In the Nicomachean Ethics, Aristotle places the art of medicine alongside other examples of technē. According to Gadamer, however, medicine is different because in medicine the physician does not, properly speaking, produce anything. In The Enigma of Health, rather than introducing Aristotle’s intellectual virtue of phronēsis (practical wisdom) as a way of understanding medical practice, Gadamer focuses on how medicine is a technē “with a difference”. In this paper, I argue that, despite the richness of his insights, this focus (...) prevents Gadamer from reaching an adequate account of health and the practice of medicine, and I demonstrate how making phronēsis central via a phenomenological description furthers our understanding of the art of healing in important ways. The paper begins with an exploration of Gadamer’s understanding of phronēsis and technē (via Heidegger) to provide a foundation for a phenomenological analysis of the art of healing. After considering the shortcomings of Gadamer’s analyses, I introduce a working definition of “health” that both captures the spirit of Gadamer’s insights and prepares the ground for a phenomenological description. Finally, I introduce concepts from Merleau-Ponty in order to establish an adequate account of the relation between technē and phronēsis and a more nuanced understanding of experience as unfolding within the expressive trajectories forged by bodies that are subject to the weight of the past and the weight of the ideal. The art of medicine, I argue, needs to be understood as expressive behavior in the context of historically and socially situated individuals, institutions, and open trajectories of sense. (shrink)

This essay re-examines the disability critique of prenatal and pre-implantation screening in light of evidence about the larger context in which fertility and reproductive healthcare is rendered in the U.S. It argues that efforts to identify acceptable criteria for trait-based selection or otherwise impose reasons-based limitations on reproductive choice should be avoided because such limitations tend to perpetuate the discrimination encountered by adults with disabilities seeking fertility and reproductive health services.

ObjectiveThe coronavirus pandemic affects all areas of life. Performing arts and music studies have also experienced considerable changes, with university closures and a fluctuating return to normal and more limited operations. Prior studies detail the impact of the pandemic on college students, but we do not yet know what specific consequences it has for music students. The aim of this study is to examine the impact of the coronavirus pandemic on music students’ health, practicing behavior, and everyday life.MethodsIn (...) July 2020, we conducted an online survey of 80 students enrolled in performance and music education programs at a German music university and compared these data with data from a survey of 75 students at the same music university carried out in summer 2019.ResultsThe survey revealed that the coronavirus pandemic led to a decrease in practicing hours and an increase of stressful thoughts and feelings. Students were mostly satisfied with Corona-measures taken by the university. Of analyzed determinants, only general fear of health problems was identified as a significant predictor of mental health status. Mental health status did not significantly differ between students surveyed in 2019 and 2020.ConclusionKnowledge about the specific challenges the pandemic poses for music students can help conservatories to better respond to the needs of their students. Specifically, this study will inform future measures supporting music students in coping with difficult situations like a pandemic. (shrink)

This paper represents a preliminary investigation relating Bernard Lonergan’s thought to health science and the healing arts. First, I provide background for basic elements of Lonergan’s theoretical terminology that I employ. As inquiry is the engine of Lonergan’s method, next I specify two questions that underlie medical insights and define several terms, including health, disease, and illness, in relation to these questions. Then I expand the frame of reference to include all disciplines involved in the cycle of (...) clinical interaction under the heading health science and the healing arts. Finally, I analyze the cycle of clinical interaction in terms of Lonergan’s cognitive theory. I compare and contrast my analysis, based on Lonergan, with that of Pellegrino, Thomasma and Sulmasy as I proceed. In closing, I comment briefly on the next stage of this project regarding Lonergan’s theory of the human good in relation to the practice of the healing arts. (shrink)

In May 1973 a new collaboration between NASA, the Indian Health Service, and the Lockheed Missiles and Space Company promised to transform the way members of the Papago (now Tohono O’odham) Tribe of southern Arizona accessed modern medicine. Through a system of state-of-the-art microwave relays, slow-scan television links, and Mobile Health Units, the residents of the third-largest American Indian reservation began to access physicians remotely via telemedical encounters instead of traveling to distant hospitals. Examining the history of the (...) STARPAHC (Space Technology Applied to Rural Papago Advanced Health Care) project from the perspective of NASA and its contractors, from the perspective of the Indian Health Service, and from the perspective of O’odham engineers and health professionals offers a new focus, emphasizing the American Indian reservation as a site of medical research and technological development in the late twentieth century, with specific attention to the promise of information technology to address health disparities and the role of American Indians as actors in the late twentieth-century history of science, technology, and medicine. (shrink)

The paper uses two historical examples, public health (1840-1880) and town planning (1945-1975) in Britain, to analyse the challenges faced by goal-driven research, an increasingly important trend in science policy, as exemplified by the prominence of calls for addressing Grand Challenges. Two key points are argued. (1) Given that the aim of research addressing social or global problems is to contribute to improving things, this research should include all the steps necessary to bring science and technology to fruition. This (...) need is captured by the idea of practical integration, which brings this type of research under the umbrella of collective practical reason rather than under the aegis of science. Achieving practical integration is difficult for many reasons: the complexity of social needs, the plurality of values at stake, the limitation of our knowledge, the elusive nature of the skills needed to deal with uncertainty, incomplete information and asymmetries of power. Nevertheless, drawing from the lessons of the case studies, it is argued that (2) practical integration needs a proper balance between values, institutions and knowledge: i.e. a combination of mutual support and mutual limitation. Pursuing such a balance provides a flexible strategy for approximating practical integration. (shrink)

Information entities are used in ontologies to represent engineering technical specifications, health records, pictures or librarian data about, e.g., narrative fictions, among others. The literature in applied ontology lacks a comparison of the state of the art, and foundational questions on the nature of information entities remain open for research. The purpose of the paper is twofold. First, to compare existing ontologies with both each other and theories proposed in philosophy, semiotics, librarianship, and literary studies in order to understand (...) how the ontologies conceive and model information entities. Second, to discuss some open research challenges that can lead to principled approaches for the treatment of information entities, possibly by getting into account the variety of information entity types found in the literature. (shrink)