The last decade has seen an explosion of research on the gut microbiota—the trillions of microorganisms that colonize the human gut. It is now clear that interindividual diversity in microbiota composition plays an important role in determining susceptibility to a wide variety of diseases. However, identifying the precise changes in microbiota composition that play causal roles has remained a largely unrealized goal. Here, we propose that functional classifications of microbes based on their interactions with and effects on the host—particularly the (...) host immune system—will illuminate the role of the microbiota in shaping human physiology. We outline the benefits of “functional” classification compared to phylogenetic classifications, and review current efforts at functional classification of the microbiota. Finally, we outline a theoretical framework for classifying host-microbiota interactions. Future advances enabling broader functional classifications of the microbiota promise to revolutionize our understanding of the role of gut microbes in health and disease. Functional classifications of the human microbiota reveal previously hidden patterns and will be key to cracking the microbiota composition code. This figure shows a theoretical comparison between phylogenetic classification and functional classification of a host-associated microbial community. (shrink)

Justifying involuntary psychiatric treatment on the basis of a judgment that a person lacks capacity is usually expressed in terms of a person’s ability to make a decision about his or her health and treatment. Typically, this relates to the ability to refuse treatment. Exactly what “capacity” means, however, and how one determines when another individual lacks capacity, or lacks sufficient capacity, in this context is particularly controversial, with the United Nations Committee on the Rights of Persons with Disabilities insisting (...) that involuntary treatment be abandoned altogether and capacity tests avoided.Capacity is a concept that has multiple meanings and applications across different disciplines and... (shrink)

The Shadow of God combines history and philosophy in a way that is, unlike Hegel, fundamentally pluralistic. It presents the period of German Idealism as a time when philosophers aimed to bring faith and reason together through the idea of autonomy. At the same time, the tensions endemic in that process led to a transfer of individual hope from an afterlife of reward or punishment to participation in a collective, historical process. This article responds to a series of critical questions: (...) Does the book assimilate consolation and reconciliation? Does it sufficiently distinguish knowledge and justification? Does it open the possibility for a reaffirmation of the individual? Does it underestimate the potential for a secularized Kantian philosophy to bring together equality, justification, and community? Does its interpretation of Kant give a place for his account of historical progress? Is awareness of the way in which theodicy came to be historicized helpful in understanding contemporary democracy and its discontents? (shrink)

The course of German Idealism, which lasted from Kant to Schelling, is one of the most important and influential periods in the history of philosophy. _The Routledge Handbook of German Idealism_ is a superb resource for all students and scholars of the movement. Its twelve specially commissioned thematic chapters, all written by experts in the area, cover the essential aspects of German idealism, including Knowledge, nature, freedom and morality, law, history, religion, art and the European legacy of German idealism. In (...) addition to providing essential background to the thought of the period’s most important philosophers, Kant, Hegel, Fichte and Schelling, it also covers philosophers such as Herder, Holderlin, and Schleiermacher. Clearly written, it is accessible to any student of philosophy as well as those in other disciplines with an interest in German idealism, nineteenth century philosophy and continental philosophy. (shrink)

The course of German Idealism, which lasted from Kant to Schelling, is one of the most important and influential periods in the history of philosophy. _The Routledge Handbook of German Idealism_ is a superb resource for all students and scholars of the movement. Its twelve specially commissioned thematic chapters, all written by experts in the area, cover the essential aspects of German idealism, including Knowledge, nature, freedom and morality, law, history, religion, art and the European legacy of German idealism. In (...) addition to providing essential background to the thought of the period’s most important philosophers, Kant, Hegel, Fichte and Schelling, it also covers philosophers such as Herder, Holderlin, and Schleiermacher. Clearly written, it is accessible to any student of philosophy as well as those in other disciplines with an interest in German idealism, nineteenth century philosophy and continental philosophy. (shrink)

Mirrored-self misidentification is the delusional belief that one's own reflection in the mirror is a stranger. In two experiments, we tested the ability of hypnotic suggestion to model this condition. In Experiment 1, we compared two suggestions based on either the delusion's surface features (seeing a stranger in the mirror) or underlying processes (impaired face processing). Fifty-two high hypnotisable participants received one of these suggestions either with hypnosis or without in a wake control. In Experiment 2, we examined the extent (...) to which social cues and role-playing could account for participants' behaviour by comparing the responses of 14 hypnotised participants to the suggestion for impaired face processing (reals) with those of 14 nonhypnotised participants instructed to fake their responses (simulators). Overall, results from both experiments confirm that we can use hypnotic suggestion to produce a compelling analogue of mirrored-self misidentification that cannot simply be attributed to social cues or role-playing. (shrink)

The authors of the Target article, Shen and colleagues (2024) argue that there is a need for an ethical framework to help analyze when it is appropriate to return individualized research results (I...

Traditionally, psychoanalytically oriented clinicians have eschewed a direct focus on symptoms, viewing it as superficial turning away from underlying psychopathology. But this assumption is an artifact of a dated classical approach; it should be reexamined in the light of contemporary relational thinking. So argues Mary Connors in _Symptom-Focused Dynamic Psychotherapy_, an integrative project that describes cognitive-behavioral techniques that have been demonstrated to be empirically effective and may be productively assimilated into dynamic psychotherapy. What is the warrant for symptom-focused interventions in (...) psychodynamic treatment? Connors argues that the deleterious impact of symptoms on the patient's physical and emotional well being often impedes psychodynamic engagement. Symptoms associated with addictive disorders, eating disorders, OCD, and posttraumatic stress receive special attention. With patients suffering from these and other symptoms, Connors finds, specific cognitive-behavior techniques may relieve symptomatic distress and facilitate a psychodynamic treatment process, with its attentiveness to the therapeutic relationship and the analysis of transference-countertransference. Connors' model of integrative psychotherapy, which makes cognitive-behavioral techniques responsive to a comprehensive understanding of symptom etiology, offers a balanced perspective that attends to the relational embeddedness of symptoms without skirting the therapeutic obligation to alleviate symptomatic distress. In fact, Connors shows, active techniques of symptom management are frequently facilitative of treatment goals formulated in terms of relational psychoanalysis, self psychology, intersubjectivity theory, and attachment research. A discerning effort to enrich psychodynamic treatment without subverting its conceptual ground, _Symptom-Focused Dynamic Psychotherapy_ is a bracing antidote to the timeworn mindset that makes a virtue of symptomatic suffering. (shrink)

The law has traditionally been, and will remain, a fundamental tool for addressing health care reform in the United States. With this premise in mind, the “Legal Solutions in Health Reform” project was initiated. The project overview provides a broad understanding of the purpose and layout of the project; the formulation and definition of key legal issues; a brief review of each of the topics covered in the project; a survey of current health statistics in the United States; a discussion (...) of the role of the federal versus state roles in health reform; a review of agencies and committees with jurisdiction over health reform issues; and a survey of means of enforcing health reform efforts. (shrink)

The American public has increasingly identified health care as a key issue of concern. In order to address the multiple problems relating to the access and affordability of health care, President Obama and federal lawmakers across the political spectrum continue to call for major health reform. In any debate on health reform, a predictable set of complex policy, management, economic, and legal issues is likely to be raised. Due to the diverse interests involved, these issues could lead to a series (...) of high-stakes policy debates. Therefore, it is critical that advocates of reform strategies anticipate such issues in order to decrease the likelihood that legally resolvable questions become barriers to substantive health reform. In an effort to frame and study legal challenges and solutions in advance of the heat of political debate, the O’Neill Institute for National and Global Health Law at Georgetown University and the Robert Wood Johnson Foundation have crafted the “Legal Solutions in Health Reform” project. (shrink)

It has been argued by Hull and others that a remnant of essentialism impeded taxonomic progress until systematists abandoned attempting to define taxa on the basis of characters necessary and sufficient for group membership. The advent of cladistics suggests instead that it is an essentialistic view of characters, not of taxa, that should be abandoned, and that only a transformational view of characters allows evolutionary novelties to be identified, much less explained. Conventional Darwinian explanations are not tautologous but are difficult (...) to test and scarcely explain evolutionary novelties, probably because of their emphasis on genetic rather than epigenetic (developmental) processes. (shrink)

Edmund D. Pellegrino and David C. Thomasma analyze the virtues that are especially relevant to the practice of good medicine. Their account of the virtues and medicine is complemented by Alasdair MacIntyre’s recent analysis of human development and the acquisition of the moral and intellectual virtues. These two accounts contribute toward analyzing the historical constitution of social practices and relationships in medicine. In particular, the moral and intellectual virtues characteristic of good medicine are acquired and exercised within those healing relationships (...) featured in Pellegrino’s and Thomasma’s phenomenology of medicine. Examining their account of medical practice in light of MacIntyre’s more recent work suggests, however, that their theory of the good of the patient and their understanding of the relation of virtue to altruism and self-interest stand in need of further development. (shrink)

Despite a recent wave in global recognition of the rights of transgender and gender-diverse populations, referred to in this text by the umbrella label of trans*, international law continues to presume a cisgender binary definition of gender — dismissing the lived realities of trans* individuals throughout the world. This gap in international legal recognition and protection has fundamental implications for health, where trans* persons have been and continue to be subjected to widespread discrimination in health care, longstanding neglect of health (...) needs, and significant violations of bodily autonomy. (shrink)

PurposeEven low intensity exercise bouts of at least 15 min can improve feelings of energy and reduce systolic blood pressure. However, little is known about the psychological outcomes of briefer exercise bouts, particularly for modes of exercise that are more intense than level walking, and readily available to many working adults. This study assessed the effects of a 4-min bout of stair walking on FOE and feelings of fatigue.MethodsThirty-six young adult participants were randomized to either stair walking or seated control (...) groups. All participants walked on level-ground from a laboratory to a nearby stairwell and were seated for 4 min before beginning their experimental condition. Stair-walking participants walked up and down one flight of 16 stairs at their own pace for 4 min, while control participants remained seated during that time. Participants walked back to the laboratory for post-condition assessments. Measures of blood pressure, heart rate, rated perceived exertion, and the intensity of feelings of mental energy, mental fatigue, physical energy, and physical fatigue were assessed pre-and post-condition. Separate one-way ANOVAs were conducted on change scores for all variables.ResultsThe stair climbing group experienced significant increases in heart rate [F = 13.167, p < 0.001] and RPE [F = 93.844, p < 0.001] that were not observed in the seated control group. Four minutes of self-paced stair climbing resulted in small changes and non-significant differences within and between groups in blood pressure as well as FOE and FOF.ConclusionAlthough a 4-min self-paced exercise bout can convey short-term physiological health benefits, a 4-min bout of self-paced indoor stair walking in a stairwell was insufficient to lower blood pressure or change subjective FOE and fatigue in a sample that exhibited better than typical FOE and FOF at the pre-test. (shrink)

Generalizing the work of Einstein and Mayer, it is assumed that at each point of space-time there exists an N-dimensional linear vector space with N≥5. This space is decomposed into a four-dimensional tangent space and an (N - 4)-dimensional internal space. On the basis of geometric considerations, one arrives at a number of fields, the field equations being derived from a variational principle. Among the fields obtained there are the electromagnetic field, Yang-Mills gauge fields, and fields that can be interpreted (...) as describing matter. As a simple example, the case N=6 is considered. (shrink)

Despite spending more on health care than every other industrialized country, the U.S. ranks 37th in health outcomes. These differences cannot be explained away with differences in age and income, or even with quality of care. And, the rate of growth in health care spending in the U.S. continues to increase. The share of the Gross Domestic Product attributable to health care grew from 9% in 1980 to more than 17% in 2011. Health care costs are projected to account for (...) more than one-fifth of our economy by 2021. Despite spending more and more, the U.S. does not have better health outcomes than other countries. Worse, our increasing spending is largely attributable to preventable conditions. More than 85 cents of every dollar spent on health in the U.S. are spent on the treatment and management of chronic diseases, such as those caused by preventable conditions related to obesity and tobacco use. (shrink)

Background: Despite an increase in health research conducted in Africa, there are still inadequate human resources with research ethics training and lack of local long-term training opportunities in research ethics. A research ethics training program named United States-Mali Research Ethics Training Program (US-Mali RETP) was established through a partnership between the George Washington University Milken Institute School of Public Health (GWSPH), USA and University of Sciences, Techniques & Technologies of Bamako (USTTB), to address the critical need for improved bioethics training, (...) leadership, and policy in Mali. Methods: The aims of the capacity building programme are achieved by leveraging US and Africa-based expertise to strengthen research ethics education and capacity through: (1) intensive faculty development to design ethics training curricula; (2) development of a research ethics specialization within the existing Masters of Public Health program (MPH); and (3) establishing professional development courses through short-term training workshops and webinars to address research and professional needs in ethics. Results: The program will strengthen USTTB’s capacity of research ethics by training at least 15 MPH students over 5 years to prepare the next generation of ethics researchers. During the first two years of the program, a new ethics training curricula was developed, two cohorts of Master’s students were enrolled, and a series of webinars and workshops were conducted with participation of Malian and international researchers. Conclusions: US-Mali RETP will promote a sustainable bioethics enterprise at USTTB, and enable dissemination of research ethics training to increase health research capacity in Mali. (shrink)

Cognitive neuroscience has inspired a number of methodological advances to extract the highest signal-to-noise ratio from neuroimaging data. Popular techniques used to summarize behavioral data include sum-scores and item response theory. While these techniques can be useful when applied appropriately, item dimensionality and the quality of information are often left unexplored allowing poor performing items to be included in an itemset. The purpose of this study is to highlight how the application of two-stage approaches introduces parameter bias, differential item functioning (...) can manifest in cognitive neuroscience data and how techniques such as the multiple indicator multiple cause model can identify and remove items with DIF and model these data with greater sensitivity for brain–behavior relationships. This was performed using a simulation and an empirical study. The simulation explores parameter bias across two separate techniques used to summarize behavioral data: sum-scores and IRT and formative relationships with those estimated from a MIMIC model. In an empirical study participants performed an emotional identification task while concurrent electroencephalogram data were acquired across 384 trials. Participants were asked to identify the emotion presented by a static face of a child across four categories: happy, neutral, discomfort, and distress. The primary outcomes of interest were P200 event-related potential amplitude and latency within each emotion category. Instances of DIF related to correct emotion identification were explored with respect to an individual’s neurophysiology; specifically an item’s difficulty and discrimination were explored with respect to an individual’s average P200 amplitude and latency using a MIMIC model. The MIMIC model’s sensitivity was then compared to popular two-stage approaches for cognitive performance summary scores, including sum-scores and an IRT model framework and then regressing these onto the ERP characteristics. Here sensitivity refers to the magnitude and significance of coefficients relating the brain to these behavioral outcomes. The first set of analyses displayed instances of DIF within all four emotions which were then removed from all further models. The next set of analyses compared the two-stage approaches with the MIMIC model. Only the MIMIC model identified any significant brain–behavior relationships. Taken together, these results indicate that item performance can be gleaned from subject-specific biomarkers, and that techniques such as the MIMIC model may be useful tools to derive complex item-level brain–behavior relationships. (shrink)

Generalizing the work of Einstein and Mayer, it is assumed that at each point of space-time there exists a vector-spinor space with Nv vector dimensions and Ns spinor dimensions, where Nv=2k and Ns=2 k, k⩾3. This space is decomposed into a tangent space with4 vector and4 spinor dimensions and an internal space with Nv−4 vector and Ns−4 spinor dimension. A variational principle leads to field equations for geometric quantities which can be identified with physical fields such as the electromagnetic field, (...) Yang-Mills gauge fields, and wave functions of bosons and fermions. (shrink)

The protection of employee rights in the workplace is one of the fundamental ethical questions facing organizations today. Organizations differ in the extent to which they protect the rights of both employees and themselves as employers, yet little research has examined the types of organizations that have rights protection policies. Instead of the classic normative approach to ethical issues, this study took a contextual approach to the management of rights in the workplace through human resource policies. Associations were found between (...) the organizational characteristics of size, industry, unionization, business condition, and the existence of employee and employer rights policies. Additional analyses revealed underlying dimensions in right policies and the relationship of organizational characteristics to these aspects of rights management were examined. The results are discussed in terms of understanding human resource rights management within an organizational context. (shrink)

We are currently facing global healthcare crisis that has placed unprecedented stress on healthcare workers as a result of the coronavirus disease 2019. It is imperative that we develop novel tools to assist healthcare workers in dealing with the significant additional stress and trauma that has arisen as a result of the pandemic. Based in research on the effects of immersive environments on mood, a neuroscience research laboratory was rapidly repurposed using commercially available technologies and materials to create a nature-inspired (...) relaxation space. Frontline healthcare workers were invited to book 15-min experiences in the Recharge Room before, during or after their shifts, where they were exposed to the immersive, multisensory experience 496 Recharge Room users completed a short survey about their experience during an unselected, consecutive 14-day period. Average self-reported stress levels prior to entering the Recharge Room were 4.58/6. After a single 15-min experience in the Recharge Room, the average user-reported stress level was significantly reduced 1.85/6. Net Promoter Score for the experience was 99.3%. Recharge Rooms such as those described here produce significant short-term reductions in perceived stress, and users find them highly enjoyable. These rooms may be of general utility in high-stress healthcare environments. (shrink)

The “scarred villain” trope, where facial differences like scars signify moral corruption, is ubiquitous in film (e.g., Batman’s The Joker). Strides by advocacy groups to undermine the trope, however, suggest cinematic representations of facial differences could be improving with time. This preregistered study characterized facial differences in film across cultures (US vs. India) and time (US: 1980-2019, India: 2000-2019). Top-grossing films by country and decade were screened for characters with facial differences. We found that the scarred villain trope has actually (...) worsened with time, although in tandem with progress in also representing non-villainous characters with facial anomalies. Country of origin did not predict the presence of facial differences in villains or heroes. “Action” and “fantasy” movies were the most likely genres to depict villains with facial differences. Finally, villains’ facial differences crossed more facial subunits and were more likely to involve lips, chin, and mandible than when present in heroes. Our findings underscore the need for critical reflection on the role of cultural practices—even when seemingly innocuous—in shaping and maintaining negative biases against already stigmatized groups. (shrink)