Background and ObjectivesUp to 10% of fathers experience perinatal depression, often accompanied by anxiety, with a detrimental impact on the emotional and behavioural development of infants. Yet, few evidence-based interventions specifically for paternal perinatal depression or anxiety exist, and few depressed or anxious fathers engage with support. This mini-review aims to build on the evidence base set by other recent systematic reviews by synthesising more recently available studies on interventions for paternal perinatal depression and anxiety. Secondarily, we also aimed to (...) identify useful information on key implementation strategies, if any, that increase the engagement of men.MethodsWe drew upon three major previous systematic reviews and performed an updated search of PubMed/Medline; Psycinfo; Cochrane Database; Embase and Cinahl. The search was limited to trials, feasibility studies or pilot studies of interventions published between 2015 and 2020 that reported on fathers' perinatal mental health. We included psychological, educational, psychosocial, paternal, couple-focused, or group therapies, delivered face-to-face, via telephone and/or online that reported on either paternal depression, anxiety or both.ResultsEleven studies satisfied search criteria. The majority were randomised controlled trials. Most interventions incorporated counselling, therapy or psychoeducation and took an indirect approach to perinatal mental health through antenatal or postnatal education and were couple-focused. No studies reported a presence of diagnosed depression or anxiety at baseline, although five studies reported a positive effect on sub-threshold symptoms.DiscussionThere was some evidence that these approaches may be useful in the initial engagement of fathers with perinatal supports and improve depression and anxiety scores. No studies targeted the explicit treatment of clinically depressed or anxious men, and this remains the most substantial gap in the peer-reviewed evidence base. Our results highlight the need to deliver perinatal interventions specifically designed for men and evaluate them in populations with clinical levels of depressive and anxious symptomatology. (shrink)

BackgroundThe emergence of artificial intelligence (AI) in medicine has prompted the development of numerous ethical guidelines, while the involvement of patients in the creation of these documents lags behind. As part of the European PROFID project we explore patient perspectives on the ethical implications of AI in care for patients at increased risk of sudden cardiac death (SCD).AimExplore perspectives of patients on the ethical use of AI, particularly in clinical decision-making regarding the implantation of an implantable cardioverter-defibrillator (ICD).MethodsSemi-structured, future scenario-based (...) interviews were conducted among patients who had either an ICD and/or a heart condition with increased risk of SCD in Germany (n = 9) and the Netherlands (n = 15). We used the principles of the European Commission’s Ethics Guidelines for Trustworthy AI to structure the interviews.ResultsSix themes arose from the interviews: the ability of AI to rectify human doctors’ limitations; the objectivity of data; whether AI can serve as second opinion; AI explainability and patient trust; the importance of the ‘human touch’; and the personalization of care. Overall, our results reveal a strong desire among patients for more personalized and patient-centered care in the context of ICD implantation. Participants in our study express significant concerns about the further loss of the ‘human touch’ in healthcare when AI is introduced in clinical settings. They believe that this aspect of care is currently inadequately recognized in clinical practice. Participants attribute to doctors the responsibility of evaluating AI recommendations for clinical relevance and aligning them with patients’ individual contexts and values, in consultation with the patient.ConclusionThe ‘human touch’ patients exclusively ascribe to human medical practitioners extends beyond sympathy and kindness, and has clinical relevance in medical decision-making. Because this cannot be replaced by AI, we suggest that normative research into the ‘right to a human doctor’ is needed. Furthermore, policies on patient-centered AI integration in clinical practice should encompass the ethics of everyday practice rather than only principle-based ethics. We suggest that an empirical ethics approach grounded in ethnographic research is exceptionally well-suited to pave the way forward. (shrink)

Most models of patient-physician communication take decision-making as a central concept. However, we found that often the treatment course of metastatic cancer patients is not easy to describe in straightforward terms used in decision-making models but is instead frequently more erratic. Our aim was to analyse these processes as trajectories. We used a longitudinal case study of 13 patients with metastatic colorectal and pancreatic cancer for whom palliative chemotherapy was a treatment option, and analysed 65 semi-structured interviews. We analysed three (...) characteristics of the treatment course that contributed to the ‘erraticness’ of the course: (1) The treatment (with or without chemotherapy) contained many options; (2) these options were not stable entities to be decided upon, but changed identity over the course of treatment, and (3) contrary to the closure (option X means no option Y, Z, etc.) a decision implies, the treatment course was a continuous process in which options instead remained open. When the treatment course is characterised by these many and changeable options that do not result in closure, the shared decision-making model should take these into account. More attention needs to be paid to the erratic character of the process in which the doctor has to provide continuous information that is related to the changing situation of the patient; also, flexibility in dealing with protocols is warranted, as is vigilance about the overall direction of the process. (shrink)

Les principales altérations rencontrées sur les vestiges en marbre et en granite de Délos sont décrites et les mécanismes physico-chimiques de leur développement sont expliqués en tenant compte des processus environnementaux qui conditionnent leur formation. Deux facteurs principaux d'altération ont ainsi été mis en évidence : les sels marins et la pollution atmosphérique. Impliqués dans les cycles de dissolution-cristallisation, ces sels forment des desquamations, des désagrégations et des cratères. Ces cycles résultent de l'évaporation des solutions migrant depuis le sol par (...) capillarité et de la solvatation des sels déposés sur les pierres par les embruns. La pollution atmosphérique accentue les processus de dissolution et la formation d'encroûtements bruns. (shrink)

© 2015, Springer-Verlag Berlin Heidelberg.Genetic studies have identified single nucleotide polymorphisms associated with the risk of prostate cancer. It remains unclear whether such genetic variants are associated with disease aggressiveness. The NCI-SPORE Genetics Working Group retrospectively collected clinicopathologic information and genotype data for 36 SNPs which at the time had been validated to be associated with PC risk from 25,674 cases with PC. Cases were grouped according to race, Gleason score and aggressiveness. Statistical analyses were used to compare the frequency (...) of the SNPs between different disease cohorts. After adjusting for multiple testing, only PC-risk SNP rs2735839 was significantly and inversely associated with aggressive and high-grade disease in European men. Similar associations with aggressive and high-grade disease were documented in African-American subjects. The G allele of rs2735839 was associated with disease aggressiveness even at low PSA levels in both European and African-American men. Our results provide further support that a PC-risk SNP rs2735839 near the KLK3 gene on chromosome 19q13 may be associated with aggressive and high-grade PC. Future prospectively designed, case-case GWAS are needed to identify additional SNPs associated with PC aggressiveness. (shrink)

This article reads Cherokee academic/author Thomas King’s “The One About Coyote Going West” and Okanagan writer Jeannette Armstrong’s “This is a Story” to question whether these Aboriginal creation tales subvert the referential race codes and the kinds of hierarchical exclusion that take place in Caucasian discourses about Homo sapiens. To do so, it draws links between Slavoj Zizek’s post identity theories, and post-colonial and Indigenous literary and nationalist epistemologies, to challenge the implications of how the Coyote narratives transformation the (...) hegemony, or “the big Other.”. (shrink)

Recueil de textes écrits par des intimes du philosophe, à l'occasion du dixième anniversaire de sa mort : Jeannette Colombel, Jean-Pierre Faye, Jean-Luc Nancy ou encore Jacques Derrida, Roger-Pol Droit, Fanny Deleuze...

Entrer dans la pensée de François Jullien -- L'ailleurs chinois -- Tribulations d'un jeune philosophe en Chine -- La langue-pensée chinoise -- Une stratégie philosophique -- Dissidence -- De la cohérence au concept -- D'un dérangement l'autre -- Vivre en existant -- Une philosophie du vivre -- La ressource de l'intime -- De la dé-coïncidence -- L'inouï -- Une pensée du politique -- Un chantier politique -- Du dialogue des cultures -- L'Europe en panne d'idéal -- L'identité culturelle en question.

This collection of articles pays homage to the creativity and scientific rigor Jerome Singer has brought to the study of consciousness and play. It will interest personality, social, clinical and developmental psychologists alike.

Comment témoigner d’une espérance religieuse dans le droit contemporain ? Par l’obéissance et l’humilité de l’inculturation, ou par l’objection et la résistance propre au signe de contradiction ? Si les périodes barbares du XXe siècle ont relancé l’analyse théologique de la tension entre ces deux voies, qu’en est-il aujourd’hui des contextes apparemment pacifiés de nos droits démocratiques ? Si le moment juridique y colonise progressivement la société, c’est au nom de sa nature de « droit commun » qu’il estime acquérir (...) de sa prétention croissante à la « neutralité ». À cet égard, la prise de parole religieuse dans l’espace public est aujourd’hui vivement débattue. Il serait cependant erroné de n’y viser que le seul moment de l’élaboration formelle de la loi. Cette prise de parole peut aussi viser les modalités d’application et de mise en contexte du droit. Cet article entend montrer l’importance de ce nouveau moment pour une prise de parole religieuse, entendue comme une troisième voie : celle de l’attestation évangélique au cœur de la pratique du droit. (shrink)

Responding to potential hazards is likely to require precaution-related recalibration, the extensive integration of complex variables related to inferred risk and fitness. By swamping working memory with goal-demoted actions and focusing recalibration on the inferred threat, ritualized behaviors may serve to increase the efficacy of precaution-related recalibration. This benefit may be an important mechanism maintaining non-pathological ritualized behavior. (Published Online February 8 2007).

La metodologia empirica di Christian Wolff -- Vernunft und Erfahrung. Zur Entwicklung der empirischen Methodologie in der Rationalistischen Tradition des 17. und 18. Jahrhunderts -- Wahrscheinlichkeit und wahrscheinliches Wissen in der Philosophie von Christian Wolff -- Wolff, Bolzano e la probabilita -- Fondamento razionale e fondamento empirico della dimonstrazione: un'alternativa sei-settecentesca -- Christian Wolff e l'ermeneutica filosofica dell'Illuminismo tedesco -- Le origini dell'ermeneutica filosofica -- Teoria e critica della ragione nella filosofia di Christian Wolff -- Proposizioni indubitate e giudizi sintetici (...) a priori -- Rezenzionen. (shrink)

The medieval fascination with the mysterious language of Dionysius the Areopagite is nowhere more evident than in the thirteenth-century textbook edition of his treatise on liturgical rites. Dionysius employed unfamiliar Greek to describe people, actions, and texts that would have been perfectly familiar to his readers. The Latin translation used in the thirteenth-century textbook strives to preserve this unfamiliarity, but commentaries are introduced between its lines and paragraphs, disrupting its ability to bewilder and surprise. These commentaries make the Dionysian text (...) less mysterious, while also slightly altering its meaning. In the hands of the commentators, Dionysius becomes less interested in the aesthetic mystery of the liturgy, and more interested in credal orthodoxy. To read text and commentary together is to confront seven hundred years of competing voices speaking on the nature and purpose of the Christian church. (shrink)