This paper proposes and defends the multifactorial view of stereotyping. According to this view, multiple factors determine whether or not any act of stereotyping increases the chance of an accurate judgment being made about an individual to whom the stereotype is applied. To support this conclusion, various features of acts of stereotyping that can determine the accuracy of stereotyping judgments are identified. The argument challenges two existing views that suggest that it is relatively easy for an act of stereotyping (...) to increase the chance of an accurate judgment being made. In the process, it shows why stereotyping that associates black people more strongly than white people with criminality in the United States cannot be defended, and actions to reduce the stereotyping criticized, on the basis that engaging in this form of stereotyping increases the chance of accurate judgments. As each of these important conclusions is supported by results from empirical psychology, the discussion exemplifies and vindicates the naturalistic approach to epistemology, according to which psychological findings provide an important contribution to understanding the epistemic standing of beliefs. (shrink)

In this article, I will reconstruct the monocausal model and argue that modern 'multifactorial diseases' are not monocausal by definition. 'Multifactorial diseases' are instead defined according to a constitutive disease model. On closer analysis, infectious diseases are also defined using the constitutive model rather than the monocausal model. As a result, our classification models alone cannot explain why infectious diseases have a universal etiology while chronic and noncommunicable diseases lack one. The explanation is instead provided by the nineteenth-century (...) germ theorists. (shrink)

The schematic concept of levels of causal interaction is applied to the relation between genetics and biology. The strength of classical formal genetics lies in its power to proceed directly from observations on an external phenotype, to inferences concerning the nature and properties of the fundamental genetic factors. Its weakness comes from the fact that by short-circuiting the causal chain leading from genotype to phenotype, it creates a divorce between genetics and biology. It is argued that in order to reestablish (...) an articulation of genetics and the biology of whole organisms, it will be necessary to study in detail the entire causal chain leading from a difference in a genetic factor to a difference in a corresponding phenotypic character. This proposal is illustrated by a consideration of multifactorial diseases, which appear to be due to strong interactions between a moderate number of distinct loci; the frequency of abnormal alleles at any given locus may be surprisingly high. (shrink)

This paper examines undergraduate business students' perception of corporate social responsibility in cases in which they have not attended any specific course either dealing with CSR or providing training in ethics. A survey was conducted of 535 Spanish business students as future managers. The results show that the stakeholders' perspective deserves a huge attention for those students considering what the keys of business success are. Significant differences in perception were nevertheless identified when a multifactorial analysis was undertaken. Female students (...) are more concerned about CSR issues. The maximization of value for shareholders is less valued by second- and third-year students than by first-year ones. The findings point to a number of important orientations for the future development of university curriculum. (shrink)

The common autoimmune disease type 1 diabetes provides a paradigm for the genetic analysis of multifactorial disease. Disease occurrence is attributable to the interaction with the environment of alleles at many loci interspersed throughout the genome. Their mapping and identification is difficult because the disease-associated alleles occur almost as commonly in patients as in healthy individuals; even the highest-risk genotypes bestow only modest risks of disease. The identification of common quantitative trait loci (QTL) in autoimmune disease and in other (...) common disorders, therefore,requires a very close marriage of genetics and biology. Two QTLs have been identified in human type 1 diabetes: the major histocompatibility complex HLA class II loci and a promoter polymorphism of the insulin gene. The evidence for their primary roles in disease aetiology demonstrates the necessity of combined studies of genetics and biology. Their functions and interaction underpin an emerging picture of the basic causes of the disease and direct analyses towards other candidate genes and pathways. The genetic tools used for QTL identification include transgenesis and gene knockouts, whole genome scanning for linkage, mouse congenic strains, linkage disequilibrium mapping, and the establishment of ancestral haplotypes among disease-associated chromosomes. BioEssays 1999;21:164–174. © 1999 John Wiley & Sons, Inc. (shrink)

The sense of agency over bodily actions is the feeling that one is the agent of one's actions. In this paper I examine the prospects of Frith and colleagues' influential comparator account of how the sense of agency over one's bodily actions is elicited, in comparison to the multifactorial weighting model advocated by Synofzik and colleagues in response to some problems with this account. I examine two problems for the comparator model. I consider the common objection that the actual (...) sensory consequences of action aren't needed to elicit the sense of agency with a look at the data which most strongly suggests this, namely the preserved sense of agency over phantom limb movements. I consider a problem for the comparator model in the behaviour of normal subjects placed in unusual circumstances, in particular I consider the 'wheel of fortune' studies which some take to be problematic for the comparator model. I argue that neither of these objections are devastating for the comparator model and that the comparator model plus some plausible assumptions can explain these data. However, these assumptions are not part of the original comparator model. In the end we get a version of the comparator model modified to deal with problematic cases in a manner that could be seen as somewhat ad hoc. To deal with this the multifactorial weighting model of Synofzik and colleagues is introduced. Although this model is incomplete a single version can be offered which is naturally constrained by the cases which are problematic for the comparator model. However, it is not clear what, if anything, could count as evidence against the multifactorial weighting model. Despite being generated with the data in mind it may be untestable. I conclude that currently the comparator model has stronger support than the multifactorial weighting model. (shrink)

The present study focused on the dynamics and factors underpinning domestic abuse survivors’ decisions to end the abusive relationship. The experiences and opinions of 12 female DA survivors and 18 support workers were examined through in-depth, one-to-one, semi-structured interviews. Hybrid thematic analysis was conducted to retrieve semantic themes and explore relationships among the themes identified and the differences in survivors’ and professionals’ narratives of the separation process. The findings highlighted that separation decisions derived from the joint action of two sets (...) of factors, the “promoters” and the “accelerators.” Whilst the “promoters” are factors leading to the separation from the abuser over time, the “accelerators” bear a stronger and more direct connection with survivors’ decision to end the abusive relationship. Despite their differences, both these factors acted as propelling forces, leading survivors to actively pursue the separation from the perpetrator. To portray the dynamic links among these factors, we propose a conceptualisation drawn from Newton’s laws of motion. Our findings also highlighted important differences in the views of survivors and support workers, as the former conceived themselves as proactive in ending the abuse, whereas the latter described the leaving process as mainly led by authorities and services supporting survivors. This study has potential implications for research, policy and clinical practice, as it suggests that far from being a linear sequence of multiple stages, leaving an abusive relationship results from a complex interplay of factors that facilitate or drastically accelerate the separation process. We argue that future research should aim at improving our current understanding of the subjective and situational factors that can act as “accelerators” or “promoters” for women’s leaving decisions. Moreover, clinicians and policymakers should invest in creating interventions that aid victims to recognise and leverage promoters and accelerators, thus increasing their readiness to end the abuse. (shrink)

This study examined individual, task, and environmental constraints that influence the career progression of youth Brazilian elite basketball players and the probability of reaching Novo Basquete Brasil and to determine if the association of the relative age effect is a key factor in the career progression. The sample consisted of 4,692 male players who were registered to participate in at least one U15, U17, or U22 youth Brazilian basketball championship between 2004 and 2018. Athletes who reached a high-performance level were (...) coded like NBB players. The birthdates, height, body mass, playing position, geographic region, club, competition category, and team performance were retrieved from the official data archive of the Brazilian Basketball Confederation and the National Basketball League. The maturity status was estimated using the predicted age at peak height velocity. A binary logistic regression examined the influence of each characteristic on the probability of a youth Brazilian basketball player to reach the NBB. The receiver operating characteristic curves and the associated area under the curve were used to assess the discriminant ability of the model. The taller and younger players not selected early into national teams, without specialization by playing position, who participated in U22 national championship, migrated to the southeast region, and remained in the formation process over time have a greater chance to reach the NBB. The ROC curve demonstrated an AUC of 93%. A combination of individual, task, and environmental characteristics influences the sport career of a young Brazilian basketball player in reaching the NBB. Further, early-maturing athletes have a greater chance to reach higher performances. RAE influences lower-level categories, but not a “NBB player's” career progression. The coaches, stakeholders, and practitioners should perform a holistic evaluation of sport talent in terms of a constraint-based theoretical model with the aim of avoiding bias produced by the maturational status and RAE in the youth Brazilian elite basketball. (shrink)

I compare Frith and colleagues’ influential comparator account of how the sense of agency is elicited to the multifactorial weighting model advocated by Synofzik and colleagues. I defend the comparator model from the common objection that the actual sensory consequences of action are not needed to elicit the sense of agency. I examine the comparator model’s ability to explain the performance of healthy subjects and those suffering from delusions of alien control on various self-attribution tasks. It transpires that the (...) comparator model needs case-by-case adjustment to deal with problematic data. In response to this, the multifactorial weighting model of Synofzik and colleagues is introduced. Although this model is incomplete, it is more naturally constrained by the cases that are problematic for the comparator model. However, this model may be untestable. I conclude that currently the comparator model approach has stronger support than the multifactorial weighting model approach. (shrink)

Today it is possible to screen for mutated DNA sequences which do not induce any diseases but predispose to develop diseases under certain environmental condition. These latter disorders are called multifactorial since they result from the interplay of genetic and environmental factors. Among multifactorial disorders there are job-related diseases whose genetic component can be identified by genetic screening tests. The use of these tests to predict occupational disorders, to cut down on them, and to save costs—in particular for (...) absenteeism, health care, and lawsuits—is of interest to employers and insurers. As for employees, it could entail an extremely deep invasion of privacy, economic problems and, very likely, a jeopardy of the present position of the individual who may be screened even if his/her potential disease is never developed. (shrink)

In this article I seek to say what it is for something to count as a neglected disease. I argue that neglect should be defined in terms of efforts at prevention, mitigation and cure, and not solely in terms of research dollars per disability-adjusted life-year. I further argue that the trend towards multifactorialism and risk factor thinking in modern epidemiology has lent credibility to the erroneous view that the primary problem with neglected diseases is a lack of research. A more (...) restrictive contrastive model of disease is endorsed as better suited to the definition of neglected disease. (shrink)

A multifactorial and growing crisis of health care systems in the developed world has affected medicine. In order to provide rational responses, some central concepts of the past, such as the definitions of health and disease, need to be updated. For this purpose physicians should initiate a new debate. As a point of departure the following definitions are proposed: Health is a dynamic state of wellbeing characterized by a physical, mental and social potential, which satisfies the demands of a (...) life commensurate with age, culture, and personal responsibility. If the potential is insufficient to satisfy these demands the state is disease. This term includes sickness, illness, ill health, and malady. The described potential is divided into a biologically given and a personally acquired partial potential. Their proportions vary throughout the life cycle. The proposed definitions render it empirically possible to diagnose persons as healthy or diseased and to apportion some of the responsibility for their state of health to individuals themselves. Treatment strategies should always consider three therapeutic routes: improvements of the biologically given and of the personally acquired partial potentials and adaptations of the demands of life. These consequences favourably contrast with those resulting from the WHO-definition of health. (shrink)

We defend our multifactorial weighting model of the sense of agency and our critique of the comparator model against the critiques that have been brought forward by and . Building on the specification of our model that emerges from this response, we will suggest a distinct mechanism how weighting of different agency factors might work: internal and external agency cues are constantly weighted according to their reliability in a given situation. Thus, the weighting process underlying the sense of agency (...) might follow the principles of optimal cue integration. We review recent empirical evidence for this hypothesis, demonstrating that the multifactorial weighting model is not only testable, but has in fact already received first empirical support. (shrink)

A “multifactorial” model should accommodate a psychological perspective, aiming to relate the phenomenology of complex visual hallucinations not only to neurobiological findings but also an understanding of the patient's psychological problems and situation in life. Greater attention needs to be paid to the role of the “lack of insight” patients may have into their hallucinations and its relationship to cognitive impairment.

Multifactorial analyses of data from representative British and German national contraception surveys were used to examine the principal demographic determinants of contraceptive use by women. Contraceptive use appeared to be determined mainly by reference to ‘reproductive status’. Women who were postponing pregnancies were using oral contraceptives, whereas those who wanted no more children relied more on intrauterine devices or sterilisation. Differences between the countries suggested that the choice of contraceptive method was influenced by health care policy, the organisation of (...) the relevant services and differential provider preferences. The contraceptive method used was also related to having occasional rather than steady sexual partners, lower educational level and frequent church attendance. Contraception decisions appeared to follow a fixed pattern, based more on a couple's demographic situation than on the characteristics of the contraceptive methods. This resulted in an unnecessarily restricted choice of methods. (shrink)

Judo is a multifactorial sport where many variables or key performance indicators such as force-velocity profile, bioenergetic capacity, technical and tactical skills, and cognitive and emotional competence play a role and influence the final result. While there have been many academic studies of these variables, usually in isolation, none have examined KPIs holistically or analyzed their impact on strategic performance. The main objective of the present study, therefore, is to apply a novel and easily replicable methodology to identify and (...) prioritize the main KPIs affecting performance in professional judo. Such a methodology was applied to the High-Performance Judo Centre of Valencia, using a multi-criteria decision aid technique: the analytic network process. The ANP is used to identify and quantify cause and effect relationships not only between KPIs but also between KPIs and performance objectives. Further, the ANP offers effective results when there is a lack of historical KPI data, because it is based on experts' opinions and judgments. A judo expert group comprising elite judo coaches and half-lightweight male judokas applied the methodology to discriminate between the characteristics required when aiming to reach high-level strategic objectives. The JEG, which consisted of five elite judokas, national and international champions, and three Olympic coaches—including a former European champion and silver medalist in a world championship—provided high added value to the study. The main findings were that the KPIs that made the most difference were mostly psychological, specifically motivation, stress, and team cohesion. Of these, motivation was by far the most important KPI for success in our case study, so judokas should make sure that they analyze it properly. Motivation is usually intrinsic to the competitor and should be maintained at a high level, not only during tournaments but also during daily training and lifestyle activities. Physical and other specific forms of training, as well as lifestyle KPIs, are very important for the elite competitor but are not sufficient to reach high-level objectives. The most important of these KPIs were Kumi-Kata, dual career, focus and concentration level, scouting, nutrition, and basic technique. Power and strength were the most important physical KPIs. In general, these are essential for meeting strategic objectives, but they do not make the crucial difference. This suggests that professional psychological support should be provided in daily training and that international team composition and internships should be fostered. (shrink)

As part of a multifactorial approach to address weak incentives for innovative antimicrobial drug development, market entry rewards are an emerging solution. Recently, the Duke-Margolis Center for Health Policy released the Priority Antimicrobial Value and Entry Award proposal, which combines a MER with payment reforms, transitioning from volume-based to “value-based” payments for antimicrobials. Here, the PAVE Award and similar MERs are reviewed, focusing on further refinement and avenues for implementation.

Psychiatric disorders present distinct clinical challenges which are partly attributable to their multifactorial aetiology and the absence of laboratory tests that can be used to confirm diagnosis or predict risk. Psychiatric disorders are highly heritable, but also polygenic, with genetic risk conferred by interactions between thousands of variants of small effect that can be summarized in a polygenic risk score. We discuss four areas in which the use of polygenic risk scores in psychiatric research and clinical contexts could have (...) ethical implications. First, there is concern that clinical use of polygenic risk scores may exacerbate existing health inequities. Second, research findings regarding polygenic risk could be misinterpreted in stigmatising or discriminatory ways. Third, there are concerns associated with testing minors as well as eugenics concerns elicited by prenatal polygenic risk testing. Fourth, potential challenges that could arise with the feedback and interpretation of high polygenic risk for a psychiatric disorder would require consideration. While there would be extensive overlap with the challenges of feeding back genetic findings in general, the potential clinical use of polygenic risk scoring warrants discussion in its own right, given the recency of this possibility. To this end, we discuss how lay interpretations of risk and genetic information could intersect. Consideration of these factors would be necessary for ensuring effective and constructive communication and interpretation of polygenic risk information which, in turn, could have implications for the uptake of any therapeutic recommendations. Recent advances in polygenic risk scoring have major implications for its clinical potential, however, care should be taken to ensure that communication of polygenic risk does not feed into problematic assumptions regarding mental disorders or support reductive interpretations. (shrink)

In a recent article, Ratcliffe and Byrne (2022) propose a multifactorial phenomenological account of the influence of narrative on grief. Specifically, they argue that certain kinds of narrative can help navigate and negotiate the phenomenological disturbance of practical identity associated with bereavement. In this critical note, I identify and discuss two problems of their account. First, Ratcliffe and Byrne’s (2022) considerations rest on conceptually ambiguous distinctions between different narrative categories (the conceptual ambiguity problem). Second, their account appears to neglect (...) the variability of both grief experiences and different kinds of narrative engagement (the variability problem). These problems need to be resolved to make progress in understanding the influence (if any) of narrative engagements on the phenomenology of grief. (shrink)

Since the late 1980s, the human genetics and genomics research community has been promising to usher in a “new paradigm for health care”—one that uses molecular profiling to identify human genetic variants implicated in multifactorial health risks. After the completion of the Human Genome Project in 2003, a wide range of stakeholders became committed to this “paradigm shift,” creating a confluence of investment, advocacy, and enthusiasm that bears all the marks of a “scientific/intellectual social movement” within biomedicine. Proponents of (...) this movement usually offer four ways in which their approach to medical diagnosis and health care improves upon current practices, arguing that it is more “personalized,” “predictive,” “preventive,” and “participatory” than the medical status quo. Initially, it was personalization that seemed to best sum up the movement's appeal. By 2012, however, powerful opinion leaders were abandoning “personalized medicine” in favor of a new label: “precision medicine.” The new label received a decisive seal of approval when, in January 2015, President Obama unveiled plans for a national “precision medicine initiative” to promote the development and use of genomic tools in health care. (shrink)

There is an increasing amount of empirical work investigating the sense of agency, i.e. the registration that we are the initiators of our own actions. Many studies try to relate the sense of agency to an internal feed-forward mechanism, called the ‘‘comparator model’’. In this paper, we draw a sharp distinction between a non-conceptual level of feeling of agency and a conceptual level of judgement of agency. By analyzing recent empirical studies, we show that the comparator model is not able (...) to explain either. Rather, we argue for a two-step account: a multifactorial weighting process of different agency indicators accounts for the feeling of agency, which is, in a second step, further processed by conceptual modules to form an attribution judgement. This new framework is then applied to disruptions of agency in schizophrenia, for which the comparator model also fails. Two further extensions are discussed: We show that the comparator model can neither be extended to account for the sense of ownership (which also has to be differentiated into a feeling and a judgement of ownership) nor for the sense of agency for thoughts. Our framework, however, is able to provide a unified account for the sense of agency for both actions and thoughts. (shrink)

The sense of agency is a central aspect of human self-consciousness and refers to the experience of oneself as the agent of one’s own actions. Several different cognitive theories on the sense of agency have been proposed implying divergent empirical approaches and results, especially with respect to neural correlates. A multifactorial and multilevel model of the sense of agency may provide the most constructive framework for integrating divergent theories and findings, meeting the complex nature of this intriguing phenomenon.

Background: Research involving adults lacking mental capacity relies on the involvement of a proxy or surrogate, although this raises a number of ethical concerns. Empirical studies have examined attitudes towards proxy decision-making, proxies’ authority as decision-makers, decision accuracy, and other relevant factors. However, a comprehensive evidence-based account of proxy decision-making is lacking. This systematic review provides a synthesis of the empirical data reporting the ethical issues surrounding decisions made by research proxies, and the development of a conceptual framework of proxy (...) decision-making for research. Methods: A systematic review was conducted according to PRISMA guidelines. Databases including MEDLINE, EMBASE, and CINAHL were searched using a combination of search terms, and empirical data from eligible studies were retrieved. The review followed the framework synthesis approach to refine and develop a conceptual framework. Results: Thirty-four studies were included in the review. Two dimensions of proxy decision-making emerged. The ethical framing criteria of decision-making used by proxies: use of a substituted judgement, use of a best interests approach, combination of substituted judgement and best interests, and ‘something else’, and the active elements of proxy decision-making: ‘knowing the person’, patient-proxy relationship, accuracy of the decision, and balancing risks, benefits and burdens, and attitudes towards proxy decision-making. Interactions between the framing criteria and the elements of decision-making are complex and contextually-situated. Conclusions: The findings from this systematic review challenge the accepted reductionist account of proxy decision-making. Decision-making by research proxies is highly contextualized and multifactorial in nature. The choice of proxy and the relational features of decision-making play a fundamental role: both in providing the proxy’s authority as decision-maker, and guiding the decision-making process. The conceptual framework describes the relationship between the framing criteria used by the proxy, and the active elements of decision-making. Further work to develop, and empirically test the proposed framework is needed. (shrink)

While life in general can be explained by the mechanisms of physics, chemistry and biology, to many scientists and philosophers it appears that when it comes to explaining consciousness, there is what the philosopher Joseph Levine called an “explanatory gap” between the physical brain and subjective experiences. Here we deduce the living and neural features behind primary consciousness within a naturalistic biological framework, identify which animal taxa have these features (the vertebrates, arthropods, and cephalopod molluscs), then reconstruct when consciousness first (...) evolved and consider its adaptive value. We theorize that consciousness is based on all the complex system features of life, plus the even more complex features of elaborate brains. We argue that the main reason why the explanatory gap between the brain and experience has been so refractory to scientific explanation is that it arises from both life and from varied and diverse brains and brain regions, so bridging the gap requires a complex, multifactorial account that includes the great diversity of consciousness, its personal nature that stems from embodied life, and the special neural features that make consciousness unique in nature. (shrink)

Collaborations in global health research are on the rise because they enhance productivity, facilitate capacity building, accelerate output and make tackling big, multifactorial research questions possible. In this paper, I examine the concepts of trust and reliance in scientific collaborations in general, but also in the particular context of collaborations in global health research between high‐income countries and low‐and‐middle income countries (LMIC). I propose and defend the argument that given the particular characteristics of collaborations and demands of trust relationships, (...) reliance is a better relational mode for successful collaborations. Although reliance can be difficult to establish in situations where asymmetry of power exists, trust should not be the only relational mode available to LMIC researchers because of the type of vulnerability it introduces to the relationship. I conclude that the promotion of good collaborations requires addressing the power imbalances between partners, and establishing an even playing field in global health research. (shrink)

The success of medicine in the treatment of patients brings with it new challenges. More people live on to suffer from functional, chronic or multifactorial diseases, and this has led to calls for more complex analyses of the causal determinants of health and illness. Philosophical analysis of background assumptions of the current paradigmatic model. While these factors do not require a radical paradigm shift, they do give us cause to develop a new narrative, to add to existing narratives that (...) frame our thinking about medical care. In this paper we argue that the increased focus on lifestyle and shared decision making requires a new narrative of agency, to supplement the narrative of “the patient”. This narrative is conceptually linked to the developing philosophy of person-centred care. If patients are seen also as “agents” this will result in a substantial shift in practical decisions: The development and adoption of this narrative will help practitioners work with patients to their mutual benefit, harnessing the patients’ motivation, shifting the focus from treatment to prevention and preventing unnecessary and harmful treatments that can come out of our preoccupation with the patient narrative. It will also help to shift research efforts, conceptual and empirical, from “treating” and “battling” diseases and their purported “mechanisms” to understanding complex contributing factors and their interplay. (shrink)

The problems of racism and racially motivated violence in predominantly African American communities in the United States are complex, multifactorial, and historically rooted. While these problems are also deeply morally troubling, bioethicists have not contributed substantially to addressing them. Concern for justice has been one of the core commitments of bioethics. For this and other reasons, bioethicists should contribute to addressing these problems. We consider how bioethicists can offer meaningful contributions to the public discourse, research, teaching, training, policy development, (...) and academic scholarship in response to the alarming and persistent patterns of racism and implicit biases associated with it. To make any useful contribution, bioethicists will require preparation and should expect to play a significant role through collaborative action with others. (shrink)

Suppose COVID-19 is the runaway tram in the famous moral thought experiment, known as the “Bystander at the Switch.” Consider the two differentiated responses of governments around the world to this new threat, namely the option of quarantine/lockdown and herd immunity. Can we contrast the hypothetical with the real scenario? What do the institutional decisions and strategies for dealing with the virus, in the beginning of 2020, signify in a normative moral framework? This paper investigates these possibilities in order to (...) highlight the similarities and, more importantly, the differences that exist between utilitarianism and Kantian ethics. Analysis shows that the hypothetical scenario can never be fully compared to the complex multifactorial nature of the real world. But if a comparison is attempted, the most obvious difference between the two governmental strategies is the concept of duty within the Kantian perspective. Ultimately, it is a matter of comparing freedom and life. Attributing a moral “priority ticket” to one or the other can be analysed through interpersonal aggregation. (shrink)

Biomedical research is an increasingly multidisciplinary activity bringing together a range of different academic fields and forms of expertise to investigate diseases that are increasingly understood to be complex and multifactorial. Recently the discipline of ethics has been starting to find a place in large-scale biomedical collaborations. In this article we draw from our experience of working with the Malaria Genomic Epidemiology Network and other research projects to reflect upon the integration of ethics into biomedical research. We examine the (...) way in which ethics input may be valuable to research, the forms it tends to take, and also the problems and limitations of such collaborations. (shrink)

BackgroundThe success of medicine in the treatment of patients brings with it new challenges. More people live on to suffer from functional, chronic or multifactorial diseases, and this has led to calls for more complex analyses of the causal determinants of health and illness.MethodsPhilosophical analysis of background assumptions of the current paradigmatic model.ResultsWhile these factors do not require a radical paradigm shift, they do give us cause to develop a new narrative, to add to existing narratives that frame our (...) thinking about medical care. In this paper we argue that the increased focus on lifestyle and shared decision making requires a new narrative of agency, to supplement the narrative of “the patient”. This narrative is conceptually linked to the developing philosophy of person-centred care.ConclusionsIf patients are seen also as “agents” this will result in a substantial shift in practical decisions: The development and adoption of this narrative will help practitioners work with patients to their mutual benefit, harnessing the patients’ motivation, shifting the focus from treatment to prevention and preventing unnecessary and harmful treatments that can come out of our preoccupation with the patient narrative. It will also help to shift research efforts, conceptual and empirical, from “treating” and “battling” diseases and their purported “mechanisms” to understanding complex contributing factors and their interplay. (shrink)

The Coronavirus Disease 2019 pandemic, now a global health crisis, has surprised health authorities around the world. Recent studies suggest that the measures taken to curb the spread of the COVID-19 outbreak have generated issues throughout the population. Thus, it is necessary to establish and identify the possible risk factors related to the psychosocial and psychophysiological strain during the COVID-19 outbreak. The present extensive literature review assesses the social, psychological, and physiological consequences of COVID-19, reviewing the impact of quarantine measures, (...) isolation, vast human loss, social and financial consequences in the family’s economies, and its impact on the psychological health of the population. We also discussed the effect of psychophysiological factors, considering the impact of physical inactivity and modifications in nutritional habits, at psychological and physiological levels. The present review includes an actualized to date bibliography, articles for which were methodologically analyzed to verify they met the standards of quality and scientific accuracy. Authors understand the pandemic as a multifactorial event for which only a profound and extensive analysis would lead to better compression and efficient intervention in the near future. (shrink)

As far as we are aware, this study presents the first comparative analysis of the stock picking and market timing abilities of managers of conventional and socially responsible (SR) pension funds, and of their use of superior information. For the United Kingdom, the results obtained show a slight stock picking ability on the part of SR pension fund managers (although it disappears if multifactorial models are considered), and a negative market timing ability on the part of both SR and (...) conventional pension fund managers (these results hold for multifactorial models controlled by home bias). In relation to the management styles, both conventional and SR pension funds usually invest in small cap and growth values, although it is the SR pension funds that are the most exposed to these styles. We also observed that, while conventional pension fund managers make certain use of superior information to follow stock picking strategies, managers of SR pension funds use superior information to follow market timing strategies. (shrink)

En la actualidad se habla de la anomalía dentomaxilofacial como una enfermedad inherente a la civilización, cuya prevalencia varia en las distintas partes del mundo, el alto índice se relaciona a la heterogeneidad genética. Estas anomalías tienen una etiología multifactorial donde intervienen diversos factores internos o externos, que provocan variabilidad en su forma de presentación; cada una tiene características muy particulares y diversos grados de complejidad a la hora de ser tratadas, sin embargo poseen un aspecto común, afectan por (...) lo general la estética y la psiquis de los pacientes que las padecen. Con el objetivo de determinar afectaciones psicológicas en niños y adolescentes con anomalías dentomaxilofaciales se realizó un estudio no experimental descriptivo transversal. Se ejecutó en dos etapas y se emplearon métodos empíricos la recolección de la información a través de interrogatorio y examen clínico, incluido el Test Auto reporte vivencial para determinar la afectación psicológica del niño o adolescente. Se evidenció que los adolescentes resultaron ser afectados psicológicamente en presencia de anomalías de origen dentario. Presently, while prevalence varies in different parts of the world, dentomaxillofacial anomaly is regarded as a disease of our civilization. Its high rate is related to genetic heterogeneity. These anomalies have a multifactorial etiology since various internal or external factors that cause variability in its presentation are involved. Each of these anomalies has unique characteristics and varying degrees of complexity when being treated. However, they have a common feature: they usually affect the aesthetics and psyche of patients who suffer from them. In order to determine the psychological effects of dentomaxillofacial anomalies in children and adolescents, a non-experimental, descriptive, cross-sectional study was conducted. It was carried out in two stages and empirical methods were used for collecting information through interview and clinical examination, including Experiential Self-Report to determine the psychological effects in the child or adolescent. Through this study, adolescents were found to be affected psychologically in the presence of anomalies of dental origin. (shrink)

Addiction is compulsive need for and use of a habit-forming substance. It is accepted as a mental illness in the diagnostic nomenclature and results in substantial health, social and economic problems. In the diagnostic nomenclature, addiction was originally included in the personality disorders along with other behaviours considered deviant. But it is now considered a clinical syndrome. Addiction is multifactorially determined, with substantial genetic influence. The development of addictions is also influenced by environmental factors, and an interplay between the two. (...) In the clinical context, addiction puts problem substance use on the agenda, and helps focus on the difficulties associated with drug use. But the concept of addiction is also used to distance the user from addicts, and in this way, may be counter-therapeutic. The addiction concept has also had a substantial influence on policy. The almost universal prohibition against drugs such as opiates, cocaine, cannabis and amphetamine has much support. But unfortunately, it has not been able to hinder the development of substance use problems. Optimism is fostered by the development of respectful ways of thinking about people with addictions, in particular, from advocates of motivational interviewing. (shrink)

Frailty is a complex geriatric syndrome with multifactorial associated mechanisms that need to be examined more deeply to help reverse the adverse health-related outcomes. Specific inflammatory and physical health markers have been associated with the onset of frailty, but the associations between these factors and psycho-social health outcomes seem less studied. This systematic review aimed to identify, in the same study design, the potential associations between frailty and markers of inflammation, and physical or psycho-social health. A literature search was (...) performed from inception until March 2021 using Medline, Psycinfo, and EMBASE. Three raters evaluated the articles and selected 22 studies, using inclusion and exclusion criteria. Regarding biomarkers, 95% of the included studies showed significant links between inflammation [especially the higher levels of C-reactive protein and interleukin-6 ], and frailty status. Approximately 86% of the included studies showed strong links between physical health decline, and frailty status. At most, 13 studies among the 22 included ones evaluated psycho-social variables and mixed results were observed regarding the relationships with frailty. Results are discussed in terms of questioning the medical perception of global health, centering mostly on the physical dimension. Therefore, the development of future research studies involving a more exhaustive view of frailty and global health is strongly encouraged. (shrink)

El resultado investigativo se centra en una de las prioridades de la línea del polo científico territorial y nacional: la necesidad de rescatar el papel de la intelectualidad cubana durante la República. Se analiza el papel de la cultura y la cubanía en la cosmovisión filosófica de Juan Marinello. El método empleado presupone un análisis dialéctico de la realidad, sustentado en una perspectiva crítica que permite interpretar y enriquecer la concepción sobre los hechos y procesos históricos. Desde una visión holística (...) del pensamiento filosófico cubano se revela la complejidad de un fenómeno multifactorial, la cubanía, como construcción cultural, a partir de la articulación de la concepción martiana y marxista de la cultura y los valores, lo que constituye un acierto del quehacer teórico - práctico marinelliano. El conocimiento de esta perspectiva enriquece los estudios sobre la obra de este intelectual y contribuye a dilucidar el devenir ideo-artístico y cultural cubano. The result of the research focuses on one of the priorities of the territorial and national scientific pole line: the need to recover the role of Cuban intellectuals during the Republic. The role of culture and Cubanism in Juan Marinello's philosophical world view is analyzed. The method used presupposes a dialectical analysis of reality, based on a critical perspective which allows to interpret and enrich the understanding of events and historical processes. From a holistic point of view of the Cuban philosophical thinking, Cubanism, a complex multifactorial phenomenon, is revealed as a cultural construction, starting from the articulation of Marti's and Marx's conception of culture and values, which is a good result of Marinello's theoretical-practical work. The knowledge of this perspective enriches the studies on the work of this intellectual and contributes to the clarification of the Cuban ideo-artistic and cultural evolution. (shrink)

The neuropathologies of the self are disorders of the self and identity that occur in association with neuropathology and include perturbations of the bodily, relational, and narrative self. Right, especially medial-frontal and orbitofrontal lesions, are associated with these conditions. The ego disequilibrium theory proposes this brain pathology causes a disturbance of ego boundaries and functions and the emergence of developmentally immature styles of thought, ego functioning, and psychological defenses including denial, projection, splitting, and fantasy that the NPS patient has in (...) common with the child. I hypothesize that during brain development between approximately ages 3 and 7 immature defensive functions and fantasies tend to be replaced by mature defenses and the inhibition of fantasy a process that depends upon maturational processes within the right hemisphere. I propose a four-tiered model of the NPS that emphasizes a multifactorial approach and includes both negative and positive, bottom up and top down, and neuropsychological and psychological factors. (shrink)

Current local and national demographic trends have deepened the existing and formed new global demographic processes that have received a new historical reasoning that requires deep scientific research taking into account the influence of the multifactorial global dimension of the modern society development. The purpose of the article is to study the development of global demographic processes and to define the causes of their occurrence, manifestations, implications and prospects for implementation in the first half of the 21st century. The (...) authors have identified and characterized four global demographic processes, namely population growth, migration, increase of tourism, and change in population structure. It is projected that in the 30’s of the 21st century, the number and growth rates of the world population will reach the objective growth and these dynamics over the next two decades will begin to change in the direction of reducing the growth rates, which will lead to gradual stabilization, and eventually reduce the size of the world population. By the middle of the 21st century, one can observe the preservation of the growth rates of international and domestic migration, the growth of international migration flows from the South to the North and from the East to the West, the strengthening of new economically developed centers of gravity (Canada, Australia and New Zealand), the increase in migration of rural population to cities, as well as urbanization and activation of the metropolises development. The share of international tourists in comparison with the world population will be constantly increasing, and the annual growth rate of the number of international tourists will significantly depend on the world economy and may vary at the several percent level. Permanent change will occur in the age, religious-cultural and socio-economic structure of the population. (shrink)

Many philosophers have come to believe there is no single criterion by which one can distinguish between a science and a pseudoscience. But it need not follow that no distinction can be made: a multifactorial account of what constitutes a pseudoscience remains possible. On this view, knowledge-seeking activities fall on a spectrum, with the clearly scientific at one end and the clearly non-scientific at the other. When proponents claim a clearly non-scientific activity to be scientific, it can be described (...) as a pseudoscience. One feature of a scientific theory is that it forms part of a research tradition being actively pursued by a scientific community. If a theory lacks this form of epistemic warrant, this is a pro tanto reason to regard it as pseudoscientific. (shrink)

Evidence-Based Medicine has little consideration for mechanisms and philosophers of science and medicine have recently made pleas to increase the place of mechanisms in the medical evidence hierarchy. However, in this debate the notions of mechanisms seem to be limited to 'mechanistic processes' and 'complex-systems mechanisms,' understood as 'componential causal systems'. I believe that this will not do full justice to how mechanisms are used in biological, psychological and social sciences and, consequently, in a more biopsychosocial approach to medicine. Here, (...) I propose, following (Kuorikoski, 2009), to pay more attention to 'abstract forms of interaction' mechanisms. The present work scrutinized review articles on depression and medically unexplained pain, which are considered to be of multifactorial pathogenesis, for their use of mechanisms. In review articles on these disorders there seemed to be a range of uses between more 'abstract forms of interaction' and 'componential causal system' mechanisms. I therefore propose to expand the notions of mechanisms considered in medicine to include that of more 'abstract forms of interaction' to better explain and manage biopsychosocial disorders. (shrink)

Two experiments report on the construction of the Sense of Agency Rating Scale (SOARS), a new measure for quantifying alterations to agency. In Experiment 1, 370 participants completed a preliminary version of the scale following hypnosis. Factor analysis revealed two underlying factors: Involuntariness and Effortlessness. In Experiment 2, this two factor structure was confirmed in a sample of 113 low, medium and high hypnotisable participants. The two factors, Involuntariness and Effortlessness, correlated significantly with hypnotisability and pass rates for ideomotor, challenge (...) and cognitive items. Twelve week test-retest correlations showed that Involuntariness was highly stable, but Effortlessness only moderately stable. Analysis of the combined datasets from Experiments 1 and 2 showed both SOARS scores were significantly related to the derived factors of Woody, Barnier, and McConkey's (2005) 4-factor model of hypnotisability. This scale clarifies conceptual confusion around agentive action and provides empirical support for a multifactorial account of sense of agency. (shrink)