Introduction. Eating Disorders (EDs) are serious psychiatric disorders, impacting physical and psychosocial functioning, often with a chronic course and high mortality rates. The two continua model of mental health states that mental health is a complete state, that is not merely the absence of mental illness, but also the presence of mental health. This model was studied among ED patients by comparing the levels of well-being to the Dutch general population and by examining the of well-being and psychopathology. Method. A (...) total of 468 female ED patients participated in this study during application and intake at a specialized ED treatment centre in the Netherlands. They filled out questionnaires about well-being (MHC-SF), general psychopathology (OQ-45), and ED psychopathology (EDE-Q). Categorical and mean well-being levels were calculated. Also, the correlates of these variables were examined with Pearson correlation and multiple hierarchical regression analysis. Results. ED patients showed lower levels of emotional, psychological and social well-being on average compared to the general population. About 26% of the ED patients experienced low levels of well-being (languishing). However, also 13% experienced high levels of well-being (flourishing), varying between 9% in Anorexia Nervosa to 25% in Binge Eating Disorder. ED psychopathology and general well-being showed a moderate negative correlation. For patients with Bulimia Nervosa and Binge Eating Disorder however no such correlation was found. Lower general psychopathology, not having a history of hospitalization for the ED, and adaptive personal functioning were correlated with well-being among ED patients. Conclusion This study shows initial support for the two continua model of mental health among ED patients. Psychopathology and well-being should be considered as related, but distinct dimensions of mental health in ED patients. Further research should focus on the possible reciprocal relationships between psychopathology and well-being during recovery. It is recommended to monitor well-being during treatment and to implement interventions for well-being to realize complete recovery for those patients with inadequate levels of well-being. (shrink)

In 2018-2019, at the Keck School of Medicine of the University of Southern California, we developed and piloted a narrative-based health systems science intervention for patients living with HIV and medical students in which medical students co-wrote patients’ life narratives for inclusion in the electronic health record. The pilot study aimed to assess the acceptability of the “life narrative protocol” from multiple stakeholder positions and characterize participants’ experiences of the clinical and pedagogical implications of the LNP. Students were recruited from (...) KSOM. Patients and staff were recruited from the Maternal, Child, and Adolescent/Adult Center for Infectious Disease and Virology at Los Angeles County+USC Medical Center. Ten patients, seventeen students, and ten MCA staff participated in the pilot study. Qualitative methods were used to gather data from students’, patients’, and staff’s perspectives. Three themes emerged from the thematic analysis: patients’ life narratives conveyed their unique life experiences and voices; the protocol could result in wide-ranging effects on HIV care; the LNP enabled students to contribute value to patients’ healthcare. Across groups, participants considered the LNP an acceptable intervention. The LNP, its limitations, and implications for HIV care, narrative medicine, and health information technology are presented. (shrink)

This paper describes a pilot study of a new model for narrative medicine training, “community-based participatory narrative medicine”, which centers on shared narrative work between healthcare trainees and patients. Nine medical students and eight patients participated in one of two, five-week-long pilot workshop series. A case study of participants’ experiences of the workshop series identified three major themes: the reciprocal and collaborative nature of participants’ relationships; the interplay between self-reflection and receiving feedback from others; and the clinical and pedagogical implications (...) of the CBPNM model. Principles and proposed outcomes of the CBPNM model are presented. (shrink)

The influence of Buddhist philosophy in Vietnamese nation.

Wittgensteins Grammatikbegriff ist eigentümlich weit gefasst, das heißt er beinhaltet nicht nur die Regeln für die Anordnung von Wörtern, sondern letztlich alles, was zur Bedeutung eines Begriffes beiträgt. Wittgenstein sieht Grammatik als gleichermaßen mit Willkürlichem und mit Nicht-Willkürlichem verwandt an, wobei der Willkür durch die menschliche Natur und soziale Praktiken Grenzen gesetzt sind. Dieses Buch untersucht genau diese Grenzen mit den Mitteln und Ergebnissen der neuesten linguistischen und kognitionswissenschaftlichen Forschung näher, um die zunächst recht spekulativ anmutenden Argumente Wittgensteins für die (...) Möglichkeit alternativer Grammatiken in Bereichen wie den Farben, der Arithmetik u.a. zu prüfen und über deren Ergebnisse Rückschlüsse zu ziehen auf Grammatiken allgemein und deren Willkürlichkeit. (shrink)

The premodern history of the European university can be divided into two triads of three centuries: the medieval university and the ‘medieval’ university of the sixteenth, seventeenth and eighteenth centuries. During these last three centuries Europe’s Christian university was a ‘confessional’ university: the catholic, Lutheran, reformed and Anglican university and the dissenter university of New England. The reformed university of these centuries offered a distinctive way of systematic thought. A specific doctrine of God was connected with a distinct ontology and (...) this combination constituted the theoretical framework of its philosophy and theology. What are the main distinctive features of this scholastic way of thought and can a specific traditionhistorical background be identified ? I– The key concept of this systematic way of thought is God’s free knowledge . This free knowledgeis here understood to be God’s knowledge of future states of affairs – see section 7 for the main lines of Turrettini’s doctrine of God. This free knowledge of future states of affairs is also called definite , because future states of affairs are definite on the basis of God’s certain will. Thus God’s free knowledge is partly based on divine will, but the other pillar of God’s free knowledge is that divine knowledge which is structurally prior to an act of divine will: God’s ‘natural’ knowledge . This natural or necessary knowledge of God encompasses all possible states of affairs. This structure turning around the notion of scientia libera is vital for understanding Western thought, because Aristotelianism and latin Averroism, Thomism and nominalism do not dispose of this notion of scientia libera. Such a free knowledge doctrine of God is married to a specific type of ontology, namely a contingency ontology– see section 8. This type of ontology centres on the notion of fundamental possibility. All possible states of affairs enjoy the status of possibility . This status of possibility is constituted by logical possibility. Turrettini joins Duns Scotus in defining the logicum possibile: If a state of affairs is possible, then it is not inconsistent that it obtains. Therefore, the twin concept of fundamental possibility is logical IMpossibility: What is logically impossible, is inconsistent and self-contradictory, because it includes contradictory predicates. This approach leads to the central ontological notion of synchronic contingency. Turrettini’s key term is even almost the same as this modern invention to name this crucial device: simultas potentiae. When is an event contingent in this sense? An event e is synchronically contingent at time t, if e is the case at time t – therefore eis possible – while it is possible too that e is not the case at the same time t. Because of the simultaneity of the possibility of the opposite, reality is not necessary. It is open. Thus, the tool of implicative necessity is essential to Turrettini’s methodology. It does not only govern his doctrine of God, but also his theory of true freedom of the human will. II – In contrast to traditional descriptions of reformed scholasticism, Turrettini’s theology is a theology of will and radical contingency in general and a theology of freedom and grace in particular. I have already indicated that Turrettini followed Scotism in vital respects and Duns Scotus stood on the shoulders of Henry of Ghent and of Bonaventure . The ontological infrastructure was delivered by Duns Scotus’ way of thinking structured by synchronic contingency, but the basics of this type of doctrine of God’s knowledge are already conspicuous in the so-called Summa fratris Aleandri . Thomas Aquinas substantially borrowing from Aristotle consciously deviates from this tradition built on the legacy of Augustine and Anselm, the Victorines and Alexander of Hales by ignoring the new theory of divine knowledge put forward by John of La Rochelle. This new approach develops a new relationship between God’s notitia simplex and notitia visionis on the one hand and his potentia absoluta and potentia ordinata on the other hand. (shrink)

Dysfunctional body- and shape-related attentional biases are involved in the aetiology and maintenance of eating disorders (ED). Various studies suggest that women, particularly those with ED diagnoses, focus on negatively evaluated parts of their own body, which leads to an increase in body dissatisfaction. The present study aims to empirically test the hypothesis that non-ED women show an attentional bias towards negative body parts, and that the focus on positive and negative parts of one’s own body can be modified by (...) attentional bias modification training based on a dot-probe task. Although several studies have measured body-related attentional biases by using pictures of participants’ own bodies, the approach of investigating attentional bias via a dot-probe task while presenting pictures of the participants’ own body parts and modifying the biased attention using such pictures is novel. Women (n = 60) rank-ordered ten parts of their own body regarding their attractiveness. To examine and modify the attentional focus, pictures of the self-defined positive and negative parts of one’s own body were presented by means of a dot-probe task. A paired-sample t-test revealed no difference between reaction times to negative compared to positive body parts, indicating no attentional bias towards negative parts of one’s own body. A two-way ANOVA revealed a main effect of time for pictures of positive and negative parts of one’s own body, with a decrease in reaction times from pre- to post-training. However, there was no significant interaction between time and training condition concerning reaction times to positive and negative body parts. Our findings replicate previous evidence of a balanced attentional pattern regarding one’s own body in women without ED diagnoses. However, the dot-probe task failed to modify the attentional focus. As the modifiability of state body image increases with more pronounced body dissatisfaction, the next step would be to test this approach in clinical samples of women with ED diagnoses. (shrink)

Michael Peters, Sonja Arndt & Marek TesarThis is a collective writing experiment of PESA members, including its Executive Committee, asking questions of the Philosophy of Education in a New Key. Co...

Laland and colleagues have sought to challenge the proximate–ultimate distinction claiming that it imposes a unidirectional model of causation, is limited in its capacity to account for complex biological phenomena, and hinders progress in biology. In this article the core of their argument is critically analyzed. It is claimed that contrary to their claims Laland et al. rely upon the proximate–ultimate distinction to make their points and that their alternative conception of reciprocal causation refers to phenomena that were already accounted (...) for by standard theory. (shrink)

Objective To determine the attitudes of Egyptian patients regarding their participation in research and with the collection, storage and future use of blood samples for research purposes. Design Cross-sectional survey. Study population Adult Egyptian patients (n=600) at rural and urban hospitals and clinics. Results Less than half of the study population (44.3%) felt that informed consent forms should provide research participants the option to have their blood samples stored for future research. Of these participants, 39.9% thought that consent forms should (...) include the option that future research be restricted to the illness being studied. A slight majority (66.2%) would donate their samples for future genetic research. Respondents were more favourable towards having their blood samples exported to other Arab countries (62.0%) compared with countries in Europe (41.8%, p<0.001) and to the USA (37.2%, p<0.001). Conclusions This study shows that many individuals do not favour the donation of a blood sample for future research. Of those who do approve of such future research, many favour a consent model that includes an option restricting the future research to the illness being studied. Also, many Egyptians were hesitant to have their blood samples donated for genetic research or exported out of the Arab region to the USA and European countries. Further qualitative research should be performed to determine the underlying reasons for many of our results. (shrink)

Objectives To conduct an independent evaluation of the first phase of the Health Foundation’s Safer Patients Initiative (SPI), and to identify the net additional effect of SPI and any differences in changes in participating and non-participating NHS hospitals. Design Mixed method evaluation involving five substudies, before and after design. Setting NHS hospitals in the United Kingdom. Participants Four hospitals (one in each country in the UK) participating in the first phase of the SPI (SPI1); 18 control hospitals. Intervention The SPI1 (...) was a compound (multi-component) organisational intervention delivered over 18 months that focused on improving the reliability of specific frontline care processes in designated clinical specialties and promoting organisational and cultural change. Results Senior staff members were knowledgeable and enthusiastic about SPI1. There was a small (0.08 points on a 5 point scale) but significant (P<0.01) effect in favour of the SPI1 hospitals in one of 11 dimensions of the staff questionnaire (organisational climate). Qualitative evidence showed only modest penetration of SPI1 at medical ward level. Although SPI1 was designed to engage staff from the bottom up, it did not usually feel like this to those working on the wards, and questions about legitimacy of some aspects of SPI1 were raised. Of the five components to identify patients at risk of deterioration—monitoring of vital signs (14 items); routine tests (three items); evidence based standards specific to certain diseases (three items); prescribing errors (multiple items from the British National Formulary); and medical history taking (11 items)—there was little net difference between control and SPI1 hospitals, except in relation to quality of monitoring of acute medical patients, which improved on average over time across all hospitals. Recording of respiratory rate increased to a greater degree in SPI1 than in control hospitals; in the second six hours after admission recording increased from 40% (93) to 69% (165) in control hospitals and from 37% (141) to 78% (296) in SPI1 hospitals (odds ratio for “difference in difference” 2.1, 99% confidence interval 1.0 to 4.3; P=0.008). Use of a formal scoring system for patients with pneumonia also increased over time (from 2% (102) to 23% (111) in control hospitals and from 2% (170) to 9% (189) in SPI1 hospitals), which favoured controls and was not significant (0.3, 0.02 to 3.4; P=0.173). There were no improvements in the proportion of prescription errors and no effects that could be attributed to SPI1 in non-targeted generic areas (such as enhanced safety culture). On some measures, the lack of effect could be because compliance was already high at baseline (such as use of steroids in over 85% of cases where indicated), but even when there was more room for improvement (such as in quality of medical history taking), there was no significant additional net effect of SPI1. There were no changes over time or between control and SPI1 hospitals in errors or rates of adverse events in patients in medical wards. Mortality increased from 11% (27) to 16% (39) among controls and decreased from 17% (63) to 13% (49) among SPI1 hospitals, but the risk adjusted difference was not significant (0.5, 0.2 to 1.4; P=0.085). Poor care was a contributing factor in four of the 178 deaths identified by review of case notes. The survey of patients showed no significant differences apart from an increase in perception of cleanliness in favour of SPI1 hospitals. Conclusions The introduction of SPI1 was associated with improvements in one of the types of clinical process studied (monitoring of vital signs) and one measure of staff perceptions of organisational climate. There was no additional effect of SPI1 on other targeted issues nor on other measures of generic organisational strengthening. (shrink)

Buddhist ethics on environment protection.

For many commentators, Confucian ethics is a kind of virtue ethics. However, there is enough textual evidence to suggest that it can be interpreted as an ethics based on rules, consequentialist as well as deontological. Against these views, I argue that Confucian ethics is based on the roles that make an agent the person he or she is. Further, I argue that in Confucianism the question of what it is that a person ought to do cannot be separated from the (...) question of what it is to be a person, and that the latter is answered in terms of the roles that arise from the network of social relationships in which a person stands. This does not mean that Confucian ethics is unlike anything found in Western philosophy. Indeed, I show that many Western thinkers have advanced a view of ethics similar to the Confucian ethics as I interpret it. (shrink)

Design research programs attempt to bring together the properties of available materials and the demands derived from intended applications. The logic of problem states and state transitions in such programs, including assessment criteria and heuristic principles, is described in settheoretic terms, starting with a naive model comprising an intended profile and the operational profile of a prototype. In a first concretization the useful distinction between structural and functional properties is built into the model. In two further concretizations the inclusion of (...) potential applications is motivated and described for the case of drug research as well as the inclusion of potential realizations for the case of complex products. Next, another line of concretization of the naive model, the incorporation of potentially relevant properties, is sketched. Then the partial analogy between product- and truth-approximation is indicated. We conclude with some remarks about the usefulness of our models for products reaching the market in comparison to the the so-called social construction of technology approach. (shrink)