Diagnostic frameworks are essential to many scientific and technological activities and clinical practice. This study examines the main fundamental aspects of such frameworks. The three components required for all diagnoses are identified and examined, i.e. their normative dimension, temporal nature and structure, and teleological perspective.The normative dimension of a diagnosis is based on (1) epistemic values when associated with Hempel's inductive risk concerning the balance between false‐positive and false‐negative outcomes, leading to probabilistic judgements; and (2) non‐epistemic values when related to (...) ideas such as well‐being, normality, illness, etc, as idealized norms or ideal points of reference.It should be noted that medical diagnoses match the three necessary components, while some essential diagnostic frameworks – the taxonomies ofGordon andNANDA– in nursing lack some components. The main lack is normative as the most popular frameworks in nursing diagnosis seem to be descriptions of observed reality rather than normative and value‐based judgements in which both epistemic and non‐epistemic values may coexist. (shrink)

Diagnosing the Diagnostic and Statistical Manual of Mental Disorders (Karnac, 2014) evaluates the latest edition of the D.S.M.The publication of D.S.M-5 in 2013 brought many changes. Diagnosing the Diagnostic and Statistical Manual of Mental Disorders asks whether the D.S.M.-5 classifies the right people in the right way. It is aimed at patients, mental health professionals, and academics with an interest in mental health. Issues addressed include: How is the D.S.M. affected by financial links with the pharmaceutical industry? To what extent (...) were and should patients involved in revising the classification? How are diagnoses added to the D.S.M.? Does medicalization threaten the idea that anyone is normal? What happens when changes to diagnostic criteria mean that people lose their diagnoses? How important will the D.S.M. be in the future? (shrink)

Diagnostic devices do more than just passively register facts. They intervene in the situations in which they are put to use. The question addressed here is what this general remark may imply in specific cases. To answer this question a specific case is being analysed: that of the blood sugar measurement device that people with diabetes may use to monitor their own blood sugar levels. This device not only allows the patients concerned to better approach normal blood sugar levels, but (...) alters what counts as normal in the first place. Using the device may shift people's attention away from their physical sensations towards the numbers measured, but it may also help them to increase their own physical self-awareness. Self-monitoring finally (something that the devices have made possible) makes patients less dependent on professionals, but it requires them to engage in self-disciplining and binds them to the outcomes of their measurement activities: their own blood sugar levels. (shrink)

Focusing on computational studies of pericyclic reactions from the late twentieth century into the twenty-first century, this paper argues that computational diagnostics is a key methodological development that characterize the management and coordination of plural approximation methods in computational organic chemistry. Predictive divergence between semi-empirical and ab initio approximation methods in the study of pericyclic reactions has issued in epistemic dissent. This has resulted in the use of diagnostics to unpack computational greyboxes in order to critically assess the effect of (...) specific misrepresentations on predictive accuracy given that approximations and idealizations must be made to render computational models tractable. Furthermore, benchmarking is used to determine the applicability of approximation methods depending on how accurate the results need to be in a given research context. The epistemology of benchmarking consists of the co-generation of data sets in a hybrid computational–experimental form used to standardize computational methods but does not determine a unique quantitative method to be used across computational organic chemistry. (shrink)

The purpose of this study is to develop and evaluate two diagnostic classification models (DCMs) for scoring ordinal item data. We first applied the proposed models to an operational dataset and compared their performance to an epitome of current polytomous DCMs in which the ordered data structure is ignored. Findings suggest that the much more parsimonious models that we proposed performed similarly to the current polytomous DCMs and offered useful item-level information in addition to option-level information. We then performed a (...) small simulation study using the applied study condition and demonstrated that the proposed models can provide unbiased parameter estimates and correctly classify individuals. In practice, the proposed models can accommodate much smaller sample sizes than current polytomous DCMs and thus prove useful in many small-scale testing scenarios. (shrink)

Diagnostic errors are more frequently a result of the clinician's failure to combine medical knowledge adequately than of data inaccuracy. Diagnostic reasoning studies are valuable to understand and improve diagnostic reasoning. However, most diagnostic reasoning studies are characterized by some limitations which make these studies seem more simple than diagnostic reasoning in real life situations actually is. These limitations are connected both to the failure to acknowledge components of knowledge used in clinical practice as well as to acknowledge the physician-patient (...) relationship's influence on clinical knowledge and on the reasoning process itself. In addition the modes of reasoning described in these studies frequently is oversimplified. In this paper three simplistic and competing models of diagnostic reasoning are analyzed and criticized, followed by an evaluation of two alternative models proposing a combined view. (shrink)

Diagnostic testing can be used for many purposes, including testing to facilitate the clinical care of individual patients, testing as an inclusion criterion for clinical trial participation, and both passive and active surveillance testing of the general population in order to facilitate public health outcomes, such as the containment or mitigation of an infectious disease. As such, diagnostic testing presents us with ethical questions that are, in part, already addressed in the literature on clinical care as well as clinical research (...) (such as the rights of patients to refuse testing or treatment in the clinical setting or the rights of participants in randomized controlled trials to withdraw from the trial at any time). However, diagnostic testing, for the purpose of disease surveillance also raises ethical issues that we do not encounter in these settings, and thus have not been much discussed. In this paper we will be concerned with the similarities and differences between the ethical considerations in these three domains: clinical care, clinical research, and public health, as they relate to diagnostic testing specifically. Via an examination of the COVID-19 case we will show how an appeal to the concept of diagnostic justice helps us to make sense of the (at times competing) ethical considerations in these three domains. (shrink)

Conversation analysts have noted that, in psychotherapy, formulations of the client's talk can be a vehicle for offering a psychological interpretation of the client's circumstances. But we notice that not all formulations in psychotherapy offer interpretations. We offer an analysis of formulations that are diagnostic: that is, used by the professional to sharpen, clarify or refine the client's account and make it better able to provide what the professional needs to know about the client's history and symptoms. In doing so, (...) these formulations also have the effect of shepherding the client's account towards subsequent therapeutic interpretation. In a coda, we notice that sometimes the formulations are designed discreetly. We examine one such discreet formulation in detail, and show how its very ambiguity can lead to its failure as a diagnostic probe. (shrink)

ObjectiveThis study aimed to develop a diagnostic model of multi-kinematic parameters for patients with amnestic mild cognitive impairment (aMCI).MethodIn this cross-sectional study, 94 older adults were included (33 cognitively normal, CN; and 61 aMCI). We conducted neuropsychological battery tests, such as global cognition and cognitive domains, and collected gait parameters by an inertial-sensor gait analysis system. Multivariable regression models were used to identify the potential diagnostic variables for aMCI. Receiver operating characteristic (ROC) curves were applied to assess the diagnostic accuracy (...) of kinematic parameters in discriminating aMCI from healthy subjects.ResultsMultivariable regression showed that multi-kinematic parameters were the potential diagnostic variables for aMCI. The multi-kinematic parameter model, developed using Timed Up and Go (TUG) time, stride length, toe-off/heel stride angles, one-leg standing (OLS) time, and braking force, showed areas under ROC (AUC), 0.96 [95% confidence interval (CI), 0.905–0.857]; sensitivity, 0.90; and specificity, 0.91. In contrast, a single kinematic parameter’s sensitivity was 0.26–0.95 and specificity was 0.21–0.90. Notably, the separating capacity of multi-kinematic parameters was highly similar to Montreal Cognitive Assessment (MoCA; AUC: 0.96 vs. 0.95). Compared to cognitive domain tests, the separating ability was comparable to Auditory Verbal Learning Test (AVLT) and Boston Naming Test (BNT; AUC: 0.96 vs. 0.97; AUC: 0.96 vs. 0.94).ConclusionWe developed one diagnostic model of multi-kinematic parameters for patients with aMCI in Foshan. (shrink)

The aim of the article is to show how the use of diagnostic methods allows identifying patterns and problems of corporations functioning, providing identification of directions and strategies for further development of their business. Theoretical and methodological basis of the research is a scientific works of scientists in the field of business diagnostics and strategic development, who studied diagnostics in the system of responding to business development problems, identifying areas for improving strategic management, financial statements of corporations of Daimler Group (...) (Germany), Tesla Motors (USA) and Toyota Motor (Japan) and own research results. The methodological basis of the study is a set of general and special methods used to achieve the goal of the research and includes: theoretical generalization and synthesis – in analyzing the content of scientific works on business diagnostics and strategic management; observation – to obtain primary information about the state of business of automotive companies in the world; indicator and integrated assessment – to assess the state of business and the effectiveness of strategic management of automotive corporations; information and logical analysis – when determining the issues and patterns of business development of corporations; problem-target method – to justify the choice of business development strategies; causation-result method – to obtain definitive conclusions. The results of the study of the state of business of the world's leading automotive corporations revealed the dependence of business efficiency on the degree of efficiency of strategic management of their activities, and identified types of strategies that will promote further development of automotive corporations – integrated, concentrated, diversified or globalized growth. The practical significance of the obtained results lies in their usefulness for strategic management for Daimler Group, Tesla Motors, Toyota Motor Corporation. (shrink)

The complexity of cognitive emulation of human diagnostic reasoning is the major challenge in the implementation of computer-based programs for diagnostic advice in medicine. We here present an epistemological model of diagnosis with the ultimate goal of defining a high-level language for cognitive and computational primitives. The diagnostic task proceeds through three different phases: hypotheses generation, hypotheses testing and hypotheses closure. Hypotheses generation has the inferential form of abduction (from findings to hypotheses) constrained under the criterion of plausibility. Hypotheses testing (...) is achieved by a deductive inference (from generated hypotheses to expected findings), followed by an eliminative induction, constrained under the criterion of covering, which matches expected findings against patient''s findings to select the best explanation. Hypotheses closure is a deductive-inductive type of inference very similar to the inferences operating in hypotheses testing. In this case induction matches the consequences of the generated hypotheses against the patient''s characteristics or preferences under the criterion of utility. By using the language exploited in this epistemological model, it is possible to describe the cognitive tasks underlying the most influential knowledge-based diagnostic systems. (shrink)

Ockham’s razor is the idea that simpler hypotheses are to be preferred over more complex ones. In the context of medical diagnosis, this is taken to mean that when a patient has multiple symptoms, a single diagnosis should be sought that accounts for all the clinical features, rather than attributing a different diagnosis to each. This paper examines whether diagnostic parsimony can be justified by reference to probability theory. I argue that while attempts to offer universal justifications of diagnostic parsimony (...) fail, a more constrained use of this diagnostic principle can be supported. (shrink)

Within child and adolescent psychiatry, there are a number of potential dilemmas pertaining to diagnosis, treatment, the protection of the child, as well as the child's own developing intelligence and moral judgement. Diagnostic Dilemmas in Child and Adolescent Psychiatry is the first in the IPPP series to explore this highly complex topic.

A new diagnostic modeling system for automatically synthesizing a deep‐structure model of a student's misconceptions or bugs in his basic mathematical skills provides a mechanism for explaining why a student is making a mistake as opposed to simply identifying the mistake. This report is divided into four sections: The first provides examples of the problems that must be handled by a diagnostic model. It then introduces procedural networks as a general framework for representing the knowledge underlying a skill. The challenge (...) in designing this representation is to find one that facilitates the discovery of misconceptions or bugs existing in a particular student's encoding of this knowledge. The second section discusses some of the pedagogical issues that have emerged from the use of diagnostic models within an instructional system. This discussion is framed in the context of a computer‐based tutoring/gaming system developed to teach students and student teachers how to diagnose bugs strategically as well as how to provide a better understanding of the underlying structure of arithmetic skills. The third section describes our uses of an executable network as a tool for automatically diagnosing student behavior, for automatically generating “diagnostic” tests, and for judging the diagnostic quality of a given exam. Included in this section is a discussion of the success of this system in diagnosing 1300 school students from a data base of 20.000 test items. The last section discusses future research directions. (shrink)

In their article on the limited duty to reinterpret genetic variants, Watts and Newson argue that clinical labs are not morally obligated to conduct routine reinterpretation despite its potential clinical and personal value.1 We endorse the authors’ argument for a circumscribed duty to reclassify genomic variants in certain cases, including to promote diagnostic equity for racial and ethnic minority populations that have been historically excluded from and exploited by genomic research and medicine. However, given the history and resilience of scientific (...) racism, the use of socially constructed racial and ethnic categories to enhance diagnostic equity raises several ethical and practical challenges. In the short term, using socially constructed racial and ethnic categories to identify patients for variant reclassification is a practical approach for addressing concerns of diagnostic equity. In contrast, diagnostic accuracy depends on patients’ genetic similarity to reference genomes, rather than their socially determined race or ethnicity.2 Thus, in the long term, securing both diagnostic equity and diagnostic accuracy through targeted variant reclassification will require a shift away from relying on race and ethnicity and towards assessing genetic similarity. Critically, the identification of patients for genomic variant reclassification using socially constructed race or ethnicity runs the risk of perpetuating the harmful …. (shrink)

The mortality rate of patients affected with oral squamous cell carcinoma has been stable in recent decades due to several factors, especially diagnostic delay, which is often associated with a late stage diagnosis and poor prognosis. The aims of this paper were to: analyze diagnostic delay in OSCC and to discuss the various psychological factors of patients with OSCC, with particular attention to the patient’s fear of receiving news regarding their health; and the professional dynamics related to the decision-making processes (...) in cases of suspected OSCC. A preliminary review of literature focusing on OSCC diagnostic delay was performed. Seven articles were included with the diagnostic delay ranging from 45 days to approximately 6 months. Patients’ fears and, to a lesser degree, the concerns of dentists, were found to be still poorly investigated. On the basis of the authors’ professional experience, the development of oral lesions of unknown origin may generate different behaviors in the decision-making processes by patients and clinicians, and fear may play a key role in the distinct steps of this process. It is crucial to increase awareness and inform patients about the onset of OSCC, and contemporaneously encourage experimental studies on patients’ fear and professional behaviors with respect to communication regarding OSCC. (shrink)

Next SectionThe current focus on early intervention trials in Alzheimer's disease research raises particular ethical issues. These arise out of problems of validating study results and translating them into general practice for one thing and out of unwanted effects of an uncertain diagnosis for diagnosed people for another. The first addresses the demands of scientific research compared to those of medical practice, questioning how the medical value of clinical trials is evaluated. The second relates the scientific and medical value of (...) early intervention trials to the normative value of an uncertain diagnosis. Are people who are diagnosed with a potential early form of AD in clinical studies patients proper—although they would not have been diagnosed with the given “disease” in non-research-oriented medical settings? The very problem of framing this question in terms of diagnostic misconceptions connects conceptual with ethical issues of research into preclinical stages of neurodegenerative diseases. (shrink)

Background Most studies on medical reasoning focus on contemporary allopathic practitioners. Here, the significance of diagnostic sense in Nizāmī ‘Arūzī’s Four Discourses (Chahār Maqāle), an influential text that circulated widely throughout the Islamic world, is explored. Methods After a brief introduction, key passages are translated on how doctors should cultivate analytical skills. Results Nizāmī ‘Arūzī cites three sources of diagnostic authority: (1) education in the texts of medical experts, (2) formal logic and (3) belief in the power of God. Conclusions (...) ‘Arūzī’s methods, though rooted in a religious faith that may seem foreign to contemporary doctors and educators, has much to recommend regarding its clarity of approach, its high ethical standards and expectations of doctors, and its commitment to best practices for the patient. Crosscultural studies of medical education and professionalism can offer valuable insights by demonstrating how doctors across history and geography have grappled with the common concerns of diagnosis and treatment. (shrink)

A significant portion of the scholarship in analytic philosophy of psychiatry has been devoted to the problem of what kind of kind psychiatric disorders are. Efforts have included descriptive projects, which aim to identify what psychiatrists in fact refer to when they diagnose, and prescriptive ones, which argue over that to which diagnostic categories should refer. In other words, philosophers have occupied themselves with what I call “diagnostic kinds”. However, the pride of place traditionally given to diagnostic kinds in psychiatric (...) research has recently come under attack, most notably by a recent initiative of the National Institute of Mental Health, the Research Domain Criteria Project, that seeks to exclude diagnostic categories from experimental designs and focus on other sorts of psychiatric kinds. I argue that philosophical accounts privileging diagnostic kinds must respond to this new line of criticism, and conclude that philosophers need to either counter psychiatrists’ growing suspicion about the hegemony of diagnostic categories in the clinic and the laboratory, or join in redirecting their efforts toward the development of robust accounts of other sorts of psychiatric objects and processes. (shrink)

In most areas of medicine, the physician's primary task is to diagnose the patient's presenting problem by correctly identifying the underlying pathology causing that problem. Diagnoses are established through a process of correlating the information obtained from an interview with the patient about his history of illness and circumstances, with additional evidence of the underlying disease derived from physical examination findings and/or the results of laboratory investigations and diagnostic imaging. In contemporary health care, various movements that call for a shift (...) in clinical care away from underlying disease pathology toward understanding people and their experience of disease are receiving growing... (shrink)

Global Cancer Diagnostics Market Size research report offers in-depth assessment of revenue growth, market definition, segmentation, industry potential, influential trends for understanding the future outlook and current prospects for the market. -/- Cancer diagnostic services are useful in recognizing and distinguishing numerous types of cancer. The demand for this service is poised to surge over the coming years with an escalation of the cancer. By 2050, the number of new cancer cases across the globe is set to touch 35 million, (...) depicting a 77% rise from 20 million in 2022, cites the World Health Organization. -/- Drivers & Restraints -/- The global cancer diagnostics market size was valued at USD 15.13 billion in 2023. The market is slated to expand from USD 16.12 billion in 2024 to USD 31.00 billion by 2032, exhibiting a CAGR of 8.5% during the projection period. -/- This study provides information about the sales and revenue during the historic and forecasted period of (2024 to 2030). Understanding the segments helps in identifying the importance of different factors that aid market growth. Estimations about the CAGR value for specific forecast period, market drivers, market restraints, and competitive strategies are assessed in this Cancer Diagnostics Market report. -/- This report focuses on Cancer Diagnostics Market volume and value at the global level, regional level and company level. From a global perspective, this report represents overall Cancer Diagnostics Market market size by analysing historical data and future prospect. Regionally, this report focuses on several key regions: North America, Europe, Asia-Pacific, Latin America and Middle East and Africa. -/- Competitive Strategic Window: -/- The Competitive Strategic Window analyses the competitive landscape in terms of markets, applications, and geographies to help the vendor define an alignment or fit between their capabilities and opportunities for future growth prospects. It describes the optimal or favorable fit for the vendors to adopt successive merger and acquisition strategies, geography expansion, research & development, and new product introduction strategies to execute further business expansion and growth during a forecast period. -/- An Overview of the Impact of COVID-19 on this Market: -/- The advancement of COVID-19 has conveyed the world to a stop. We fathom that this prosperity crisis amazingly influences associations across ventures. Nevertheless, everything fortunate or unfortunate should reach a conclusion. There are a couple of organizations that are fighting and some are thriving. By and large, essentially every region is relied upon to be impacted by the pandemic. -/- We are advancing incessant endeavors to help your business support and create during COVID-19 pandemics. Considering our experience and expertise, we will offer you an impact examination of Covid episode across ventures to help you with preparing for what's to come. -/- Key players covered in the global Cancer Diagnostics Market research report: -/- Hoffmann-La Roche Ltd (Switzerland) Thermo Fisher Scientific Inc. (U.S.) Abbott (U.S.) Illumina, Inc. (U.S.) GE Healthcare (U.S.) BD (U.S.) bioMérieux SA (France) Myriad Genetics, Inc (U.S.) Bio-Rad Laboratories, Inc. (U.S.) QIAGEN (Germany). (shrink)

Experimental philosophy’s much-discussed ‘restrictionist’ program seeks to delineate the extent to which philosophers may legitimately rely on intuitions about possible cases. The present paper shows that this program can be (i) put to the service of diagnostic problem-resolution (in the wake of J.L. Austin) and (ii) pursued by constructing and experimentally testing psycholinguistic explanations of intuitions which expose their lack of evidentiary value: The paper develops a psycholinguistic explanation of paradoxical intuitions that are prompted by verbal case-descriptions, and presents two (...) experiments that support the explanation. This debunking explanation helps resolve philosophical paradoxes about perception (known as ‘arguments from hallucination’). (shrink)

Terms such as open source and various modifications including open content and more generally openness have been mobilized with increasing frequency in recent years to describe many different collaborative and not-for-profit projects, products, services, and business models. Typically associated with the computer and internet industry, openness has in recent years assumed something of the status of a nascent movement. Whatever this movement is, whatever qualities it embodies and possibilities it enables, it is still in the process of its emergence. This (...) presents particular difficulties for understanding openness insofar as emergent practices are by definition not yet stabilized. This paper is an attempt to discern the nascent forms of stability already extant in the emerging world of openness. We begin with a brief history culminating in the near future. We then summarize the limited conclusions of an initial inquiry into these emerging openness practices which we have conducted in the context of an orientation for inquiry recently put forward by Paul Rabinow and Gaymon Bennett. The bulk of the paper is devoted to elaborating openness equipment in terms of the analytic and synthetic categories made available by Rabinow and Bennett's Diagnostic of Equipmental Platforms. On the basis of this inquiry we return in the final section to reflection on the Diagnostic itself in an attempt to critically delineate its positive and negative usages for our inquiry. (shrink)

Two facets of diagnostic reasoning related to scientific thinking are recognizing the difference between confounded and unconfounded evidence and selecting appropriate interventions that could provide learners the evidence necessary to make an appropriate causal conclusion (i.e., the control-of-variables strategy). The present study investigates both these abilities in 3- to 6-year-old children (N= 57). We found both competence and developmental progress in the capacity to recognize that evidence is confounded. Similarly, children performed above chance in some tasks testing for the selection (...) of a controlled test of a hypothesis. However, these capacities were unrelated, suggesting that preschoolers’ nascent understanding of the control-of-variables strategy may not be driven by a metacognitive understanding that confounded evidence does not support a unique causal conclusion, and requires further investigation. (shrink)

The dispute over Socrates’ apparent endorsement of hedonism in the Protagoras has persisted for ages among scholars and students of Plato’s work. The solution to the query concerning the seriousness and sincerity of Socrates’ argument from hedonism established in the dialogue is of considerable importance for the interpretation of Plato’s overall moral theory, considering how blatantly irreconcilable the defense of this doctrine is with Plato’s other early dialogues. In his earlier works, Socrates puts supreme importance on virtue and perfection of (...) the soul, so the puzzle apparent in the Protagoras merits a thorough examination.Several scholars have argued that, since Socrates’ defense of hedonism in this work clashes significantly with his views on morality in other dialogues, Socrates must only have been defending hedonism ironically, or with the intention of “diagnosing” his opponent’s point of view. In this paper, I examine the approaches according to which Socrates didn’t in fact mean to defend hedonism, but merely used it as a diagnostic tool; I argue that there is no compelling evidence for this resolution of Socrates’ defense of hedonism, and that the views that attempt to defend it really have no convincing grounds for it apart from the desire to reconcile the Protagoras with other Socratic dialogues. (shrink)

“Geneticization” is a term used to describe the ways in which the science of genetics is influencing society at large and medicine in particular; it has important implications for the process of diagnostics. Because genetic diagnostics produces knowledge about genetic disease and predisposition to disease, it is essentially influenced by these innovations in the disease concept. In this paper, I argue that genetic diagnostics presents new ethical challenges not because the diagnostic process or method in genetic diagnostics is ethically different (...) in kind from traditional medical diagnostics, but because it relies on a neo-ontological concept of disease in a context of genetic reductionism. Geneticization has not produced a radically new concept of disease, however, but has introduced innovations into the classical ontological concept of disease. When this new concept of disease is held in tandem with genetic reductionism, we are led to the absurd conclusion that disease is the very essence of the human being. I argue that neither the neo-ontological concept of disease nor genetic reductionism is necessary for a proper understanding of genetic diagnostics. (shrink)

Diagnostic self-testing devices are being developed for many illnesses, chronic diseases and infections. These will be used in hospitals, at point-of-care facilities and at home. Designed to allow earlier detection of diseases, self-testing diagnostic devices may improve disease prevention, slow the progression of disease and facilitate better treatment outcomes. These devices have the potential to benefit both the individual and society by enabling individuals to take a more proactive role in the maintenance of their health and by helping society improve (...) health and reduce health costs. However, the full implications of future home-based diagnostic technology for individuals and society remain unclear due to their novelty. We argue that the development of diagnostic tools, especially for home use, will heighten a number of ethical challenges. This paper will explore some of the ethical implications of home-based self-testing diagnostic devices for the autonomous and relational dimensions of the person. This will be facilitated by examining the impact of diagnostic devices for individual autonomy, for the delivery of accurate diagnosis and for the personal significance of the information for the user. The latter will be examined using Charles Taylor's view of personhood and his emphasis on human agency and interpretation. While the ethical issues are not necessarily new, the development of home-based self-testing diagnostic devices will make issues regarding autonomy, accuracy of information and personal significance more and more demanding. This will be the case particularly when an individual's autonomous choices come into conflict with the person's relational responsibilities. (shrink)

With regard to facial emotion recognition, previous studies found that specific facial regions were attended more in order to identify certain emotions. We investigated whether a preferential search for emotion-specific diagnostic regions could contribute toward the accurate recognition of facial emotions. Twenty-three neurotypical adults performed an emotion recognition task using six basic emotions: anger, disgust, fear, happiness, sadness, and surprise. The participants’ exploration patterns for the faces were measured using the Moving Window Technique (MWT). This technique presented a small window (...) on a blurred face, and the participants explored the face stimuli through a mouse-controlled window in order to recognize the emotions on the face. Our results revealed that when the participants explored the diagnostic regions for each emotion more frequently, the correct recognition of the emotions occurred at a faster rate. To the best of our knowledge, this current study is the first to present evidence that an exploration of emotion-specific diagnostic regions can predict the reaction time of accurate emotion recognition among neurotypical adults. Such findings can be further applied in the evaluation and/or training (regarding emotion recognition functions) of both typically and atypically developing children with emotion recognition difficulties. (shrink)

People with mental illnesses have higher prevalence and mortality rates with regard to common somatic diseases and causes of death, such as cardio-vascular conditions or cancer. One factor contributing to this excess morbidity and mortality is the sub-standard level of physical healthcare offered to the mentally ill. In particular, they are often subject to diagnostic overshadowing: a tendency to attribute physical symptoms to a pre-existing diagnosis of mental illness. This might be seen as an unfortunate instance of epistemic bad luck, (...) where particular features of a group of patients make a timely and correct diagnosis unlikely. While this can explain some cases of diagnostic overshadowing, I argue that in other cases, epistemic injustice is involved. Analyzing the case of diagnostic overshadowing, I distinguish two kinds of testimonial injustice. For one, there are classic cases of transactional testimonial injustice resulting from prejudices against the mentally ill. In addition, there are cases of structural testimonial injustice resulting from features of health care systems. To overcome diagnostic overshadowing, remedies on the individual as well as structural level are thus needed. (shrink)

The foundations of psychoanalysis in the German idealist concepts of the reflexive human self have been the subject of detailed investigations devoted to the intertwined processes of introspection,...

BackgroundThe present study aimed at assessing the diagnostic properties of the Montreal Cognitive Assessment in non-demented ALS patients and at exploring the MoCA administrability according to motor-functional status.MaterialsN = 348 patients were administered the MoCA and Edinburgh Cognitive and Behavioural ALS Screen. Administrability rates and prevalence of defective MoCA scores were compared across King’s and Milano-Torino clinical stages. Regression models were run to test whether the non-administrability of the MoCA and a defective score on it were predicted, net of the (...) ECAS-Total, by disease duration, ALS Functional Rating Scale-Revised and progression rate, computed as /disease duration. Intrinsic and post-test diagnostics were tested against a below-cut-off ECAS-total score.ResultsThe 79.9% of patients successfully underwent the MoCA, whose administrability rates decreased with advanced clinical stages, at variance with its defective score prevalence. The probability of the FAB not being administrable was predicted only by lower ALSFRS-R-bulbar and-upper-limb scores; no motor features, but the ECAS-Total, predicted a defective MoCA performance. The MoCA showed high accuracy and good intrinsic and post-test properties—being slightly more specific than sensitive.DiscussionIn non-demented ALS patients, the MoCA is featured by optimal diagnostics as a screener for cognitive impairment, especially for ruling-out its occurrence, as long as patients are in the early stages of the disease and have sufficiently spared bulbar and upper-limb functions. (shrink)

These two companion volumes provide a comprehensive review and critical evaluation of the major DSM-III and DSM-III-R child disorders. Their major goal is to provide diagnostic and assessment guidelines that are based on scientific literature in specific clinical domains. Each chapter contains a discussion of the historical background of a particular diagnosis, definitional issues, a critical but selective review of the literature addressing the diagnosis in question, proposed changes in the diagnostic criteria based on the available literature, and proposed assessment (...) models and methods based on the designated criteria. Given the scientific bases for many of these discussions of diagnostic criteria, these two volumes will serve professionals and graduate students in a wide variety of fields: clinical child psychology, child psychiatry, pediatrics, pediatric and school psychology, special education, social work, and other child mental health specialties. (shrink)

This essay offers a diagnosis of what may be at stake in the current preoccupation with defining science‐based educational research. The diagnosis unfolds in several readings: The first is a charitable and considerate appraisal that draws attention to the fact that advocating experimental methods as important to a science of educational research is not an inherently evil thing to do. Subsequent readings are grimmer, suggesting more deleterious consequences of the science‐based research movement for the entire enterprise of educational practice and (...) research. The central thesis of the essay is that making arguments about method and science the focal point in the current quarrel may be largely beside the point. Instead, educational researchers should join the political and public conversation about the place of educational science in society and about how science is both implicated in and confronts the politics of what counts as knowledge. (shrink)

The term diagnostic odyssey refers to patients' difficult journeys to obtain a diagnosis, particular in the case of rare or contested illnesses. This paper describes the diagnostic odyssey of patients with New Daily Persistent Headache (NDPH), a rare headache disorder notable for its persistence, resistance to treatment, and impact on quality of life. Studies conducted to date have taken a medical perspective focusing on characterizing NDPH as opposed to patient construction of the illness experience. This study fills that gap by (...) analyzing 17 semi-structured interviews with participants with NDPH, using the McGill Illness Narrative Interview (MINI). Their narratives detail significant moments of headache onset and when they realized that their condition was called NDPH. Thematic analysis identified themes including relief and devastation upon receiving a diagnosis, the importance of headache as singular, negative and positive experiences with providers, the impact of online support group, choosing friends with complex medical conditions, the cyclical nature of treatment, and maintaining hope. Participants utilized social media and social networks to navigate their illness experiences. Numerous participants also reported negative experiences with providers, which created opportunities for reinforcing identity through social networks, and cyclical interactions when medicalization of their condition was necessary for access to treatments and services. This paper advances narrative bioethics scholarship on diagnostic odysseys by arguing that social networks and cyclical engagement with medical systems support patient autonomy in terms of decision-making around uncertain treatments. It concludes with implications for physician-patient relationships that create epistemic justice for all patients, including patients with NDPH. (shrink)

I attended the NSIGHT Ethics and Policy Advisory Board's meeting on sequencing newborns as a research associate in a joint apprenticeship between the University of California, San Francisco, Institute for Human Genetics and the university's Program in Bioethics. But I also came to the meeting with a deeply personal perspective: I had spent nearly my entire childhood in search of a diagnosis and therefore was eager to hear the board's discussion on how to ethically include genomic sequencing early in life. (...) Genomic sequencing in the newborn period could have helped me avoid my diagnostic odyssey by revealing the cause of my condition shortly after birth. (shrink)