This article presents the framework Capability Sensitive Design (CSD), which consists of merging the design methodology Value Sensitive Design (VSD) with Martha Nussbaum's capability theory. CSD aims to normatively assess technology design in general, and technology design for health and wellbeing in particular. Unique to CSD is its ability to account for human diversity and to counter (structural) injustices that manifest in technology design. The basic framework of CSD is demonstrated by applying it to the hypothetical design case of a (...) therapy chatbot for mental health. By applying CSD to a design case, the merits of this new framework over the standard VSD approach become apparent. Also, the application demonstrates what a technology design would look like when attention is paid to capabilities right from the start of the design process. (shrink)

As engineering applications require management of ever larger volumes of data, ontologies offer the potential to capture, manage, and augment data with the capability for automated reasoning and semantic querying. Unfortunately, considerable barriers hinder wider deployment of ontologies in engineering. Key among these is lack of a shared top-level ontology to unify and organise disparate aspects of the field and coordinate co-development of orthogonal ontologies. As a result, many engineering ontologies are limited to their scope, and functionally difficult to (...) extend or interoperate with other engineering ontologies. This paper demonstrates how the use of a top-level ontology, specifically the Basic Formal Ontology (BFO), greatly facilitates interoperability of multiple engineering-related ontologies. We constructed a system of formal linked ontologies by re-engineering legacy ontologies to be conformant with BFO and developing new BFO-conformant ontologies to capture knowledge in the engineering design, enterprise, human factors, manufacturing, and application domain of additive manufacturing. The resulting Integrated Framework for Additively Manufactured Products (IFAMP), including the body knowledge instantiated on its basis, serve as the basis for a proposed Design with Additive Manufacturing Method (DWAM), which we believe can support the design of innovative products with semantically enhanced ideation tools and enhanced access to application domain knowledge. The method and its facilitation through the ontological framework are demonstrated using a case study in medicine. (shrink)

The article maintains that chronic fatigue syndrome can be properly understood only by taking an integrated perspective in which evolutionary, developmental and ecological aspects are considered. The integrative approach, supplemented by a complexity theory and psychoneuroimmunological research, is capable of explaining why there are so few structural aberrations to be found in chronic fatigue syndrome and why specific treatment is so difficult to establish. A major outcome of the investigation, that all individuals with chronic fatigue syndrome are diseased in their (...) own way, emphasises the need to study the development of personalised life histories. It also highlights an ethical dimension; personalised disease defies essentialist thinking on patient management. Another major outcome, which follows from the developmental systems perspective, is the dissolution of ontological mind-body dualism. This in turn allows for a methodological complementation of the biological and phenomenological approaches to knowledge. New research strategies that may help to resolve chronic fatigue syndrome, grounded in the revised perspective on individual development, are suggested. (shrink)

The notion of social belongingness has been applied to different scales, from individual to social processes, and from subjective to objective dimensions. This article seeks to contribute to this multidimensional perspective on belongingness by drawing from the capabilities and subjective wellbeing perspectives. The specific aim is to analyze the relationships between capabilities—including those related to social belongingness—and individual and social subjective wellbeing. The hypotheses are: There is a relationship between capabilities and individual and social subjective wellbeing; The set of capabilities (...) associated to individual subjective wellbeing differs from the set correlated to social subjective wellbeing; The intensity and significance of the correlation between subjective wellbeing and capabilities depends on whether the latter is measured as evaluation or functioning; and The relationships between capabilities and subjective wellbeing are complex and non-linear. Using a nationally representative survey in Chile, multiple linear and dose response matching regressions between capabilities and subjective wellbeing outcomes are estimated, confirming all hypotheses. Subjective evaluations and effective functionings of some capabilities are consistently correlated with both subjective wellbeing outcomes. Others capabilities are correlated with both subjective wellbeing outcomes only when measured as functionings, do not display a systematic pattern of correlation or are not associated with subjective wellbeing. When observed, correlations are sizable, non-linear, and consistent across estimation methods. Moreover, capabilities related to social belongingness such as “social ties” and “feeling recognized and respected” are important by themselves but also are positively correlated to both social and individual subjective wellbeing. These findings underscore the need of a multidimensional perspective on the relationships between capabilities and subjective wellbeing, considering both subjective and objective, as well as individual and social aspects that are relevant to belongingness. These findings also have practical and policy implications, and may inform public deliberation processes and policy decisions to develop capabilities, promote subjective wellbeing, and ultimately promote positive belongingness. (shrink)

This monograph on the capability approach does two things. First, it provides an advanced introduction to the capability approach, as an account used in philosophy, as well as other disciplines. Second, it provides an account of the capability approach which is able to encompass all existing views and theories on the capability approach, including the writings on the capability approach by Martha Nussbaum and Amartya Sen.

The capability approach constitutes a significant contribution to social theory but its potential is diminished by its insufficient treatment of the social construction of meaning. Social meanings enable people to make value judgements about what they will do and be, and also to evaluate how satisfied they are about what they are able to achieve. From this viewpoint, a person’s state of wellbeing must be understood as being socially and psychologically co-constituted in specific social and cultural contexts. In this light, (...) the telos of ‘living well’ which is at the heart of Sen’s version of the capability approach is inadequate and must be modified to a telos of ‘living well together’ which includes consideration of the social structures and institutions which enable people to pursue individual freedoms in relation to others. The policy significance of the capability approach can be further strengthened by paying greater consideration to the political economy of policy decision-making processes and the ways in which conflicts and distributions of power are institutionalized. (shrink)

Beneficence is a foundational ethical principle in medicine. To provide benefit to a patient is to promote and protect the patient’s wellbeing, to promote the patient’s interests. But there are different conceptions of wellbeing, emphasizing different values. These conceptions of wellbeing are contrary to one another and give rise to dissimilar ideas of what it means to benefit a patient. This makes the concept of beneficence ambiguous: is a benefit related to the patient’s goals and wishes, or is it a (...) matter of objective criteria that constitute wellbeing? This paper suggests a unified conception of wellbeing for use in medicine to determine what counts as a benefit. Two components of wellbeing are identified: (1) objective functioning/health and (2) the patient’s view of her own good. The paper explores how to apply, balance, and weigh these components in clinical situations to determine what counts as a benefit to a patient. (shrink)

Volume 20, Issue 3, March 2020, Page 85-87.

The measurement of wellbeing is among the central aims of the capability approach. I develop one particular challenge to the operationalizability of the approach in the context of wellbeing measurement. I argue that the capability approach is both committed to Individuation of Wellbeing—the view that the wellbeing contribution of different capabilities and functionings is person-dependent—as well as Rejection of Subjectivism—the view that wellbeing should not be conceptualized in terms of subjective judgments of preference-satisfaction or happiness. I argue that there is (...) a tension between these two commitments that cannot be resolved in a viable way. (shrink)

The search for an ontological basis of medical practice is questioned from the viewpoint that ontologies are always related to the interpreting person in his situation, and that the definition of medicine includes a certain choice. This choice-character comes into greater play when ethical proposals are made. A foundation of medical ethics on an ontology of the healthy body or the factual medical practice is a naturalistic fallacy. Prior to an ontological basis, the ethical event of responsibility for the (...) suffering and transcendent other (Levinas) is constitutive for medicine. This event with its dimension of infinity of the other can only be ontologized by a totalitarian act. A philosophy of medicine should start with the heteronomy of the other. (shrink)

Person Centred Medicine is a substantial and contentious view of healthcare that carries both ontological and epistemological presuppositions. This chapter examines two key aspects: that the person is a central, basic irreducible element in ontology and that person-level knowledge is both important and possible. Some reasons for holding both of these are sketched.

In light of the successful occupation of the term ‘person’ for Personalised Medicine, it is necessary to ask what different notions of personhood practically imply. This article examines two. The first is the reductionist molecular individual, embraced by PM enthusiasts. Here the person is a contradictory dividuum, oscillating between increased autonomy and a new, infantilising tech-paternalism. The second relies on a Christ-analogical distinction of two modes. The dramatic amplitude of personal absence-presence then unfolds throughout time. This provides the logic or (...) spirit of the medical act. Drawing on the ethics of war, it will be recast as an arduous task of mending. (shrink)

The ontology of medicine—the question of whether disease entities are real or not—is an underdeveloped area of philosophical inquiry. This essay explains the primary question at issue in medical ontology, discusses why answering this question is important from both a philosophical and a practical perspective, and argues that the problem of medical ontology is unique, i.e., distinct, from the ontological problems raised by other sciences and therefore requires its own analysis.

Biomedical innovations are making possible the enhancement of human capabilities. There are two philosophical stances on the role that medicine should play in this respect. On the one hand, naturalism rejects every medical intervention that goes beyond preventing and treating disease. On the other hand, welfarism advocates enhancements that foster subjective well-being. We will show that both positions have considerable shortcomings. Consequently, we will introduce a third characterization in which therapies and enhancements can be reconciled with the legitimate objectives of (...) medicine inasmuch as they improve the capabilities that enable the freedom to pursue personal well-being. (shrink)

In reference to the different approaches in philosophy(of medicine) of the nature of (medical) technology,this article introduces the topic of this specialissue of Theoretical Medicine and Bioethics, that is,the way the different forms of medical technologyfunction in everyday medical practice. The authorselaborate on the active role technology plays inshaping our views on disease, illness, and the body,whence in shaping our world.

In this article, I draw on my fieldwork creating protein models of hepatitis B at a biotech laboratory to think through how to approach the body and disease from ontological and phenomenological perspectives. I subsequently draw on Mariella Pandolfi’s work on how bodies can be made to suffer history and Paul Farmer’s work on global tuberculosis disparities to explore ways of analysing embodied activity as a means of identifying and clinically addressing enactments of social inequality and disease. I also introduce (...) Merleau-Ponty’s phenomenological concept of ‘flesh’ as a conceptual heuristic that allows us to understand the meaningful structuring of ontological worlds beyond our own. As I argue, bringing these perspectives together not only allows us to re-envision what an effective disease treatment should be in diverse medical contexts, but also how to better understand health disparities and the nature of disease itself. (shrink)

The interests of a patient are not only related to objective ideas about health, but are also determined by the patient’s own view of the good. To act in the best interests of a patient requires co...

The contemporary moment in rhetoric studies is complex, marked by a number of powerful currents pulling scholarship in new directions. One of those currents is the deepening engagement with science and technology studies through rhetorical investigations of medicine, environmental policy, and science. Another is the increasing experimentation with qualitative methodologies, often called “rhetorical ethnography.” A third is the rapidly developing encounter with interwoven philosophies of speculative realism, object-oriented ontology, and new materialism. If you are interested in any of these, (...) you should absolutely read Scott Graham’s The Politics of Pain Medicine. The title is overly... (shrink)

Kerry et al. criticize our discussion of causal knowledge in evidence-based medicine (EBM) and our assessment of the relevance of their dispositionalist ontology for EBM. Three issues need to be addressed in response: (1) problems concerning transfer of causal knowledge across heterogeneous contexts; (2) how predictions about the effects of individual treatments based on population-level evidence from RCTs are fallible; and (3) the relevance of ontological theories like dispositionalism for EBM.

Programming artificial intelligence to make fairness assessments of texts through top-down rules, bottom-up training, or hybrid approaches, has presented the challenge of defining cross-cultural fairness. In this paper a simple method is presented which uses vectors to discover if a verb is unfair or fair. It uses already existing relational social ontologies inherent in Word Embeddings and thus requires no training. The plausibility of the approach rests on two premises. That individuals consider fair acts those that they would be willing (...) to accept if done to themselves. Secondly, that such a construal is ontologically reflected in Word Embeddings, by virtue of their ability to reflect the dimensions of such a perception. These dimensions being: responsibility vs. irresponsibility, gain vs. loss, reward vs. sanction, joy vs. pain, all as a single vector. The paper finds it possible to quantify and qualify a verb as fair or unfair by calculating the cosine similarity of the said verb’s embedding vector against FairVec—which represents the above dimensions. We apply this to Glove and Word2Vec embeddings. Testing on a list of verbs produces an F1 score of 95.7, which is improved to 97.0. Lastly, a demonstration of the method’s applicability to sentence measurement is carried out. (shrink)

A principal rationale for public policy is to address market failures. Pareto efficiency is therefore a highly common and relatively non-controversial evaluative criterion for many policy analyses and is discussed at length in policy analysis texts. This makes sense, for Pareto improvements involve making at least one person better off without making anyone worse off. Who could object to that? But does efficiency deserve the prominence it enjoys in public policy? Is one policy option better than another, at least in (...) one respect, simply because it is more Pareto efficient? Or, is efficiency valuable for some other reason? In this chapter, I discuss Pareto efficiency as an evaluative criterion and argue that it is a stand-in for a more foundational criterion: wellbeing. I begin with an overview of Pareto efficiency, discuss the various ways in which it is operationalized to evaluate policy options, and argue that it is valuable insofar as more efficient states of affairs promise more wellbeing than less efficient states of affairs. I then raise questions regarding whether the conception of wellbeing presupposed by Pareto efficiency – preference satisfaction – is a defensible conception of wellbeing. I go on to introduce three alternative conceptions of wellbeing which have been proposed and defended by both philosophers and policy scholars, namely, hedonism, objective goods views, and the capability approach, and suggest ways in which each can be operationalized as an evaluative criterion. I close by discussing four ‘theory-free’ approaches to thinking about the impact of policies on the quality of people’s lives. Such approaches reject the idea that there is one single theory of wellbeing that should be used to evaluate policy options, and instead develop ways to evaluate the impact of policies on people’s lives that are not grounded in a specific theory. (shrink)

A moral problem arises when a patient refuses a treatment that would save her life. Should the patient be treated against her will? According to an influential approach to questions of biomedical ethics, certain considerations pertaining to individual autonomy provide a solution to this problem. According to this approach, we should respect the patient’s autonomy and, since she has made an autonomous decision against accepting the treatment, she should not be treated. This article argues against the view that our answer (...) to the question of whether or not the refusing patient ought to be treated should be based on these kinds of considerations pertaining to individual autonomy and maintains that finding a plausible answer to this question presupposes that we resolve questions concerning subjectivity and objectivity of individual wellbeing. (shrink)

Seemingly distant practices of molecular biology and indigenous Xhosa healing have commonalities that I would like to bring into conversation in this article. The preclinical trial of an indigenous medicine brings them together in a research consortium. In this instance, both sets of experts are meant to collaborate in preparing a wild bush for it to pass the tests of the randomized clinical trial (RCT) and to potentially become a biopharmaceutical to counter the tuberculosis pandemic. I aim to tease out (...) how the two sets of actors and their respective practices converge and diverge in their healing hopes and ways of managing uncertainty. Ultimately, I am interested in understanding how the preferred process of making medicine “work” by each set of actors relies upon particular ways of knowing and not knowing life, bringing some ontologies into being, letting others wither away. The shared ways of knowing life as a movement of opening at the edges of the RCT are proposed as paths of recognition between one and the other practice. (shrink)

Psychological research and practice in New Zealand has a long history of a positivist inspired epistemology and a pragmatic evidence-based approach to therapeutic treatment. There is a growing realization that a more meaningful interface between research and practice is required to accommodate indigenous Maori knowledge of wellbeing and living. The dominant Western psychological view in New Zealand of world, time, illness and wellbeing results in practices that do not make sense in cultural terms. The medicalisation and classification of psychological disorders (...) cannot account for the degree to which cultural and spiritual factors are associated with problems of living. Heidegger’s analysis of Being and his phenomenological method of understanding these matters ontologically reflect a persuasion not dissimilar to the worldview of the Maori and their notion of wellbeing. It offers some direction to the question of how to better integrate psychological research and practice in New Zealand. Indo-Pacific Journal of Phenomenology , September 2008, Volume 8, Edition 2. (shrink)

Programming artificial intelligence to make fairness assessments of texts through top-down rules, bottom-up training, or hybrid approaches, has presented the challenge of defining cross-cultural fairness. In this paper a simple method is presented which uses vectors to discover if a verb is unfair or fair. It uses already existing relational social ontologies inherent in Word Embeddings and thus requires no training. The plausibility of the approach rests on two premises. That individuals consider fair acts those that they would be willing (...) to accept if done to themselves. Secondly, that such a construal is ontologically reflected in Word Embeddings, by virtue of their ability to reflect the dimensions of such a perception. These dimensions being: responsibility vs. irresponsibility, gain vs. loss, reward vs. sanction, joy vs. pain, all as a single vector. The paper finds it possible to quantify and qualify a verb as fair or unfair by calculating the cosine similarity of the said verb’s embedding vector against FairVec—which represents the above dimensions. We apply this to Glove and Word2Vec embeddings. Testing on a list of verbs produces an F1 score of 95.7, which is improved to 97.0. Lastly, a demonstration of the method’s applicability to sentence measurement is carried out. (shrink)

Breeders of purebred dogs usually have several goals they want to accomplish, of which canine wellbeing is one. The purpose of this article is to investigate what we ought to do given this goal. Breeders typically think that they fulfil their wellbeing-related duties by doing the best they can within their breed of choice. However, it is true of most breeders that they could produce physically and mentally healthier dogs if they switched to a healthier breed. There are a few (...) breeds that are healthier than other breeds as well as mutts; we could maximize wellbeing for the next generations by focusing all our breeding resources on those. However, in the long run such a strategy would severely deplete the canine gene pool. If we are to breed for wellbeing in the long run, we must thus weigh the benefits of selection against physical and mental problems against the benefits of genetic diversity. The optimal breeding strategy for canine wellbeing is to preserve many breeds, though not all of them. Furthermore, we ought to combine strict health programs with looser barriers between breeds. Such a policy conflicts with the goal of breed preservation, at least if we think of breeds as populations registered within kennel clubs rather than types of dogs, but not with the goal of producing good working dogs capable of performing various tasks. (shrink)

We propose a definition of capability as a class intermediate between function and disposition as the latter are defined in Basic Formal Ontology (BFO). A disposition inheres in a material entity and is realized in a certain kind of process. An example is the disposition of a glass to break when struck, which is realized when it shatters. A function is a disposition which is (simply put) the rationale for the existence of its bearer. To say for example that (...) a water pump has the function to pump water is to say that the pump exists because something was needed that would pump water. Capabilities are a special sort of disposition in that that, like functions, they can be evaluated on the basis of how well they are realized. They differ from functions in that their realizations are not the rationale – not the primary reason – for the existence of their bearers. Thus, a water pump may have many capabilities, including to be weatherproof, to run without lubricant, and so forth, but only one function. All functions are capabilities on the view we defend, but not all capabilities are functions. We develop a series of axioms to distinguish capabilities formally from both dispositions and functions and provide examples of the use of ‘capability’ in a variety of domains. (shrink)

FOIS is the flagship conference of the International Association for Ontology and its Applications, a non-profit organization which promotes interdisciplinary research and international collaboration at the intersection of philosophical ontology, linguistics, logic, cognitive science, and computer science. This book presents the papers delivered at FOIS 2023, the 13th edition of the Formal Ontology in Information Systems conference. The event was held as a sequentially-hybrid event, face-to-face in Sherbrooke, Canada, from 17 to 20 July 2023, and online from (...) 18 to 20 September 2023. In total, 62 articles from 19 different countries were submitted, out of which 25 were accepted for inclusion in the conference and for publication; corresponding to an acceptance rate of 40 percent. The contributions are separated into the book’s three sections: (1) Foundational ontological issues; (2) Methodological issues around the development, alignment, verification and use of ontologies; and (3) Domain ontologies and ontology-based applications. In these sections, ontological aspects from a wide variety of fields are covered, primarily from various engineering domains including cybersecurity, manufacturing, petroleum engineering, and robotics, but also extending to the humanities, social sciences, medicine, and dentistry. A noticeable trend among the contributions in this edition of the conference is the recognition that improving the tools to analyze, align, and improve ontologies is of paramount importance in continuing to advance the field of formal ontology. The book will be of interest to all formal and applied ontology researchers, and to those who use formal ontologies and information systems as part of their work. (shrink)

Whether animals fare well or not is of ethical significance. For this reason, their capacity for wellbeing, i.e., how good or bad the lives of animals can go, is of ethical significance as well. I assume that the wellbeing of most animals is mainly determined by their phenomenally conscious experiences. If consciousness differences between species determine wellbeing differences, then the kinds of conscious experience species are capable of may entail that some species systematically (can) have higher or lower wellbeing than (...) others. Then, I argue that not all phenomenally conscious states contribute to wellbeing equally. I discuss which features of consciousness are constituents of wellbeing and which can, for ethical purposes, be ignored. In addition, I scrutinize how much different features of experience contribute to wellbeing and how their presence can be detected empirically. This way, this paper exemplifies a novel consciousness-centered approach for the empirical investigation of animal wellbeing. The strengths and weaknesses of this approach are analyzed. While subsequent research is needed to refine the framework, I already note some preliminary implications for animal ethics. (shrink)

We propose capability as a universal or type intermediate between function and disposition. A capability is, broadly speaking, a disposition that is of a type whose instances can be evaluated on the basis of how well they are realized. A function, on the view we are proposing, is a capability the possession of which is the rationale for the existence of its bearer. To say for example that a water pump has the function to pump water is to say that (...) the pump exists because something was needed that would pump water. A water pump may have many capabilities, including: to be weatherproof, to run without lubricant, to be transportable, and so forth. But its function is to pump water. We focus here on capabilities possessed by humans – such as piano playing or language using – and we explore the relation between capabilities of these sorts and structures in the brain. (shrink)

Ontology is the philosophical discipline which aims to understand how things in the world are divided into categories and how these categories are related together. This is exactly what information scientists aim for in creating structured, automated representations, called 'ontologies,' for managing information in fields such as science, government, industry, and healthcare. Currently, these systems are designed in a variety of different ways, so they cannot share data with one another. They are often idiosyncratically structured, accessible only to those (...) who created them, and unable to serve as inputs for automated reasoning. This volume shows, in a nontechnical way and using examples from medicine and biology, how the rigorous application of theories and insights from philosophical ontology can improve the ontologies upon which information management depends. (shrink)

Participatory action research (PAR) is a form of community-driven qualitative research which aims to collaboratively take action to improve participants’ lives. This is generally achieved through cognitive, reflexive learning cycles, whereby people ultimately enhance their wellbeing. This approach builds on two assumptions: (1) participants are able to reflect on and prioritize difficulties they face; (2) collective impetus and action are progressively achieved, ultimately leading to increased wellbeing. This article complicates these assumptions by analyzing a two-year PAR project with mothers of (...) disabled children from a South African urban settlement. Participant observation notes, interviews, and a group discussion served as primary data. We found that mothers’ severe psychological stress and the strong intersectionality of their daily challenges hampered participation. Consequently, mothers considered the project ‘inactionable’. Yet, many women quickly started expressing important individual and collective wellbeing transformations. To understand these ‘unlikely’ transformations, a feminist relational account, in particular, that of relational wellbeing, proves essential. We reflect on the consequences of these findings for the dominant PAR methodology and operationalization, and propose to sensitize future PAR with marginalized women by employing relational wellbeing as an overarching ontological awareness. (shrink)

In Being and Time, Martin Heidegger introduces a unique interpretation of death as a kind of world-collapse or breakdown of meaning that strips away our ability to understand and make sense of who we are. This is an ‘ontological death’ in the sense that we cannot be anything because the intelligible world that we draw on to fashion our identities and sustain our sense of self has lost all significance. On this account, death is not only an event that we (...) can physiologically live through; it can happen numerous times throughout the finite span of our lives. This paper draws on Arthur Frank’s (At the will of the body: reflections on illness. Houghton, Boston, 1991) narrative of critical illness to concretize the experience of ‘ontological death’ and illuminate the unique challenges it poses for health care professionals. I turn to Heidegger’s conception of ‘resoluteness’ (Entschlossenheit) to address these challenges, arguing for the need of health care professionals to help establish a discursive context whereby the critically ill can begin to meaningfully express and interpret their experience of self-loss in a way that acknowledges the structural vulnerability of their own identities and is flexible enough to let go of those that have lost their significance or viability. (shrink)

The Salivaomics Knowledge Base (SKB) is designed to serve as a computational infrastructure that can permit global exploration and utilization of data and information relevant to salivaomics. SKB is created by aligning (1) the saliva biomarker discovery and validation resources at UCLA with (2) the ontology resources developed by the OBO (Open Biomedical Ontologies) Foundry, including a new Saliva Ontology (SALO). We define the Saliva Ontology (SALO; http://www.skb.ucla.edu/SALO/) as a consensus-based controlled vocabulary of terms and relations dedicated (...) to the salivaomics domain and to saliva-related diagnostics following the principles of the OBO (Open Biomedical Ontologies) Foundry. The Saliva Ontology is an ongoing exploratory initiative. The ontology will be used to facilitate salivaomics data retrieval and integration across multiple fields of research together with data analysis and data mining. The ontology will be tested through its ability to serve the annotation ('tagging') of a representative corpus of salivaomics research literature that is to be incorporated into the SKB. Background Saliva (oral fluid) is an emerging biofluid for non-invasive diagnostics used in the detection of human diseases. The need to advance saliva research is strongly emphasized by the National Institute of Dental and Craniofacial Research (NIDCR), and is included in the NIDCR's 2004- 2009 expert panel long-term research agenda [1]. The ability to monitor health status, disease onset, progression, recurrence and treatment outcome through noninvasive means is highly important to advancing health care management. Saliva is a perfect medium to be explored for personalized individual medicine including diagnostics, offering a non-invasive, easy to obtain means for detecting and monitoring diseases. Saliva testing potentially allows the patient to collect their own saliva samples at home, yielding convenience for the patient and savings in health costs, and facilitating multiple sampling. Specimen collection is less objectionable to patients and easier in children and elderly individuals. Due to these advantages. (shrink)

Precision medicine and digital phenotyping are two prominent data-based approaches within digital medicine. While precision medicine historically used primarily genetic data to find targeted treatment options, digital phenotyping relies on the usage of big data deriving from digital devices such as smartphones, wearables and other connected devices. This paper first focusses on the aspect of data type to explore differences and similarities between precision medicine and digital phenotyping. It outlines different ways of data collection and production and the consequences thereof. (...) Second, it shows how these sorts of data influence dominant beliefs in the field: The field of precision medicine relying on the dominant understanding of ‘genetic determinism’ imported from genetics, digital phenotyping building on the logic of ‘data fundamentalism’. In the end, the analysis shows how digital data informs potentials as well as challenges of precision medicine and digital phenotyping: a better health care for individuals connected with individualisation and responsibilisation for all, with a prognosed shift from reactive to preventive medicine. Additionally, data-based approaches might facilitate epistemological and ontological redirections for the whole field of medicine that will also affect knowledge production and a reassessment of the value of different types of knowledge with all its consequences. Institutionally, it might lead to shifts in distribution of power to experts in big data related technologies, i.e. private companies. (shrink)

The concept of measurement is fundamental to a whole range of different disciplines, including not only the natural and engineering sciences, but also laboratory medicine and certain branches of the social sciences. This being the case, the concept of measurement has a particular relevance to the development of top-level ontologies in the area of knowledge engineering. For this reason, the present paper is concerned with ontological aspects of measurement. We are searching for a list of concepts that are apt to (...) characterize measurement methods in a general manner. To establish such means of characterization, we will primarily deal with the semantics of measurement values. (shrink)

Advanced old age has been characterized as a biologically highly vulnerable life phase. Biological, morbidity-, and cognitive impairment-related factors play an important role as mortality predictors among very old adults. However, it is largely unknown whether previous findings confirming the role of different wellbeing domains for mortality translate to survival among the oldest-old individuals. Moreover, the distinction established in the wellbeing literature between hedonic and eudaimonic wellbeing as well as the consideration of within-person variability of potentially relevant mortality predictors has (...) not sufficiently been addressed in prior mortality research. In this study, we examined a broad set of hedonic and eudaimonic wellbeing indicators, including their levels, their changes, as well as their within-person variability, as predictors of all-cause mortality in a sample of very old individuals. We used data from the LateLine study, a 7-year longitudinal study based on a sample of n = 124 individuals who were living alone and who were aged 87–97 years at baseline. Study participants provided up to 16 measurement occasions between 2009 and 2016. Dates of death were available for 118 individuals who had deceased between 2009 and 2021. We ran longitudinal multilevel structural equation models and specified between-person level differences, within-person long-term linear change trends, as well as the “detrended” within-person variability in three indicators of hedonic and four indicators of eudaimonic wellbeing as all-cause mortality predictors. Controlling for age, gender, education, and physical condition and testing our sets of hedonic and eudaimonic indictors separately in terms of their mortality impact, solely one eudaimonic wellbeing indicator, namely, autonomy, showed significant effects on survival. Surprisingly, autonomy appeared “paradoxically” related with mortality, with high individual levels and intraindividual highly stable perceptions of autonomy being associated with a shorter residual lifetime. Thus, it seems plausible that accepting dependency and changing perceptions of autonomy over time in accordance with objectively remaining capabilities might become adaptive for survival in very old age. (shrink)

Current approaches to formal representation in biomedicine are characterized by their focus on either the static or the dynamic aspects of biological reality. We here outline a theory that combines both perspectives and at the same time tackles the by no means trivial issue of their coherent integration. Our position is that a good ontology must be capable of accounting for reality both synchronically (as it exists at a time) and diachronically (as it unfolds through time), but that these (...) are two quite different tasks, whose simultaneous realization is by no means trivial. The paper is structured as follows. We begin by laying out the methodological and philosophical background of our approach. We then summarize the structure and elements of the Basic Formal Ontology on which it rests, in particular the SNAP ontology of objects and the SPAN ontology of processes. Finally, we apply the general framework to the specific domain of biomedicine. (shrink)

We describe a prototype ontology-driven information system (ODIS) that exploits what we call Portion of Reality (POR) representations. The system takes both sensor data and natural language text as inputs and composes on this basis logically structured POR assertions. The goal of our prototype is to represent both natural language and sensor data within a single framework that is able to support both axiomatic reasoning and computation. In addition, the framework should be capable of discovering and representing new kinds (...) of situations and thematic roles, (e.g., roles such as agent, patient and instrument), based on new compositions of existing representations. We applied our prototype in an intelligence analysis use case to test the hypothesis that a framework of this sort can produce usefully structured information from combined natural language and sensor data inputs. We further tested our hypothesis by adding an enhanced US Air Force ontology framework to our ODIS in order to (1) process a collection of sensor data, intel reports, and mission plans; (2) build composite POR representations from these data; and (3) machine analyze the fused results to infer mission threats. (shrink)