Humans' voice offers the widest variety of motor phenomena of any human activity. However, its clinical evaluation in people with movement disorders such as Parkinson's disease lags behind current knowledge on advanced analytical automatic speech processing methodology. Here, we use deep learning-based speech processing to differentially analyze voice recordings in 14 people with PD before and after dopaminergic medication using personalized Convolutional Recurrent Neural Networks and Phone Attribute Codebooks. p-CRNN yields an accuracy of 82.35% in the binary classification of ON (...) and OFF motor states at a sensitivity/specificity of 0.86/0.78. The PAC-based approach's accuracy was slightly lower with 73.08% at a sensitivity/specificity of 0.69/0.77, but this method offers easier interpretation and understanding of the computational biomarkers. Both p-CRNN and PAC provide a differentiated view and novel insights into the distinctive components of the speech of persons with PD. Both methods detect voice qualities that are amenable to dopaminergic treatment, including active phonetic and prosodic features. Our findings may pave the way for quantitative measurements of speech in persons with PD. (shrink)

Families of children with mental health challenges may have been particularly vulnerable to emotional distress during the COVID-19 pandemic. This cross-sectional study surveyed 81 parents of children ages 6–17 years receiving mental health treatment in an outpatient clinic during the pandemic. We sought to characterize the impact of the pandemic on family relationships and parental well-being. Additionally, regression and ANCOVA models examined associations between four potentially protective factors—parents’ psychological resilience, perceived social support, positive family experiences during the pandemic, and children’s (...) use of cognitive or behavioral coping strategies—with family relationships and parental well-being. Findings suggest that families of children with mental health conditions experienced remarkable challenges to family relationships, parental well-being, and parents’ perceived capacity to support their children’s mental health. Nearly 80% of parents reported a negative impact of the pandemic on their own well-being, and 60% reported reduced ability to support their children’s mental health. Simultaneously, protective factors appeared to mitigate the negative impact of the pandemic. Particularly, support within the family and from external sources were associated with better self-reported well-being for parents and their capacity to support their children. Children’s use of coping tools, likely enhanced by mental health treatment, was also positively related to better family relationships and parental ability to support children with mental health challenges. Our findings highlight the need for enhancing supports for families at multiple levels including individual skill-building, family-based/parenting support, and community-based support. (shrink)

In reference to historical developments, this article introduces the topic of this special issue of Theoretical Medicine and Bioethics, that is, the relationship(s) between theory and practice. The authors emphasize the need for scientific research in this neglected area for the sake of both clinical practice and medical education.

There can be little doubt, I think, that the quality and texture of recent scientific and philosophical thought mark a greater break with the past than any innovations such as were introduced by a Gallileo or a Newton, a Descartes or a Kant. The switch over from the logicality and essential rationality of these men to the irrationalisms, the anti-intellectualisms, and the new logics of the moderns, is not at all on the same footing as that deepening of our concepts (...) of knowledge and reality which we associate with the masters of thought, more particularly with the critical philosophy of Kant. Strong and significant as these earlier changes were, they marked but the onward strides of an art of thinking which remained in its essence the same in spite of them. But the thinkers in the public eye to-day are exploring in unknown regions, and it may turn out that they have got beyond their depth. Whatever their fate, it seems undeniable that the experiments that they have made and are making constitute, at points at least, and for the time being, a veritable revolution. (shrink)

The term metaphysics was formed at a time when physics and the physical categories constituted the whole of natural science and to describe the field of thought beyond physics. With the development of other fields of knowledge such as the biological and the historical, it has of necessity acquired a much broader meaning. It describes a field of speculative thought which lies beyond the categories of any of these sciences. In the present context the metaphysical is the meta-historical.