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PubMed2001

Bridging the gap between developmental systems theory and evolutionary developmental biology.

Many scientists and philosophers of science are troubled by the relative isolation of developmental from evolutionary biology. Reconciling the science of development with the science of heredity preoccupied a minority of biologists for much of the twentieth century, but these efforts were not corporately successful. Mainly in the past fifteen years, however, these previously dispersed integrating programmes have been themselves synthesized and so reinvigorated. Two of these more recent synthesizing endeavours are evolutionary developmental biology (EDB, or "evo-devo") and developmental systems theory (DST). While the former is a bourgeoning and scientifically well-respected biological discipline, the same cannot be said of DST, which is virtually unknown among biologists. In this review, we provide overviews of DST and EDB, summarize their key tenets, examine how they relate to one another and to the study of epigenetics, and survey the impact that DST and EDB have had (and in future should have) on biological theory and practice.

Animals↗

PubMed2006

Ethical issues in neuroscience.

PURPOSE OF REVIEW: The study gives an overview of ethical questions raised by the progress of neuroscience in identifying and intervening in neural correlates of the mind. RECENT FINDINGS: Ethical problems resulting from brain research have induced the emergence of a new discipline termed neuroethics. Critical questions concern issues, such as prediction of disease, psychopharmacological enhancement of attention, memory or mood, and technologies such as psychosurgery, deep-brain stimulation or brain implants. Such techniques are capable of affecting the individual's sense of privacy, autonomy and identity. Moreover, reductionist interpretations of neuroscientific results challenge notions of free will, responsibility, personhood and the self which are essential for western culture and society. They may also gradually change psychiatric concepts of mental health and illness. These tendencies call for thorough, philosophically informed analyses of research findings and critical evaluation of their underlying conceptions of humans. SUMMARY: Advances in neuroscience raise ethical, social and legal issues in relation to the human person and the brain. Potential benefits of applying neuroimaging, psychopharmacology and neurotechnology to mentally ill and healthy persons have to be carefully weighed against their potential harm. Questions concerning underlying concepts of humans should be actively dealt with by interdisciplinary and public debate.

Brain↗

PubMed2002

The integration of neurology, psychiatry, and neuroscience in the 21st century.

OBJECTIVE: This article examines the historical basis for the divergence of neurology and psychiatry over the past century and discusses prospects for a rapprochement and potential convergence of the two specialties in the next century. METHOD: The author presents a brief historical overview of developments in neurology and psychiatry from the late 19th century. The histories of research and prevailing scientific opinion on two neuropsychiatric disorders, Alzheimer's disease and Tourette's syndrome, are compared to illustrate the effects of viewing a disease process from, respectively, the neurologic/organic and psychiatric/functional perspectives. RESULTS: Research on Alzheimer's disease, because of its early pathologic demonstration, moved rapidly toward identification of associated synaptic abnormalities and genetic mutations. In Tourette's syndrome, the absence of evident brain pathology resulted in vacillation between organic and functional explanations and persistent controversy about the nature of the illness. CONCLUSIONS: Neurology and psychiatry have, for much of the past century, been separated by an artificial wall created by the divergence of their philosophical approaches and research and treatment methods. Scientific advances in recent decades have made it clear that this separation is arbitrary and counterproductive. Neurologic and psychiatric research are moving closer together in the tools they use, the questions they ask, and the theoretical frameworks they employ. The interests of neurology and psychiatry converge within the framework of modern neuroscience. Further progress in understanding brain diseases and behavior demands fuller collaboration and integration of these fields. Leaders in academic medicine and science must work to break down the barriers between disciplines.

Alzheimer Disease↗

PubMed2002

Radically changing the research framework during a health geography study.

This paper focuses on the issue of how a research project can shift from a positivist to a nonpositivist framework. Specific attention is given to changes in research methods and philosophical paradigm that emerged while conducting a study on the replacement of immigrant physicians in rural America. In its original conceptualization, the study was expected to yield a simple, right answer. Specifically, one or more types of health professionals (e.g., nurse practitioners, National Health Service Corps physicians) would be identified as expected replacements in the event of a cutback on immigrant physicians. However, as the research progressed, the quest for a simple, right answer became less realistic. The theoretical framework, methods, and research question changed, thereby allowing for greater complexity and ambiguity than anticipated at the outset of the study. What had been a positivist, statistical study was now a nonpositivist, qualitative study, and the research question shifted to include individual perspectives. An overview of such transitions leads to a discussion of the importance of context and ambiguity in research.

Decision Making↗

PubMed2000

The development of Māori primary care services.

This paper provides a broad overview of the development of Māori primary care services over the last decade and an outline of the current scope of Māori primary care services. The paper also récognizes the number of challenges and opportunities that face Māori providers and will briefly discuss three that are relevant to all providers: frameworks, information and effectiveness. Developing frameworks for contract specification and performance criteria that reflect Māori models of health and well-being, intersectoral approaches and the use of kaupapa and tikanga Māori in service development and delivery is a major challenge. Current approaches, while acknowledging these areas, for example in contracts, are based within the frameworks of a Western medical model. We have yet to clearly identify how we can meaningfully incorporate these philosophical and practical approaches to providing services into contractual arrangements. Providers have identified a need for information. The providers pass significant amounts of information to the funding agency, however many feel that very little information is returned from the funding agencies to the provider organizations. These providers could well use information feedback from the funding agency when they are reviewing and developing their services. There are also other types of information, for example having access to detailed local epidemiological and demographic information, that would be very useful to providers who are reviewing existing programs and developing new services. The third 'universal' challenge is the need to begin to collect information about how effective current Māori health strategies are, and how effectively services are caring for Māori clients. Developing information on effectiveness could utilize a multi-faceted approach, with information being collected at the provider level as well as at population level. Other questions relate to the effectiveness of our health promoting, disease preventing or disease management interventions. These points are relevant to all providers, but information on the effectiveness of mainstream health services is just as limited. The disparity between Māori and non-Maori health status however, suggests that these services (both public and personal health services) have not been as effective as they could have been.

Attitude to Health↗

PubMed2003

People with cognitive disabilities: the Argument from Marginal Cases and social work ethics.

A primary argument used by animal rights advocates to engage the public in questioning our maltreatment of animals is the Argument from Marginal Cases (AMC). It is important that social workers are aware of this argument, because it has the potential to diminish our consideration of people with severe cognitive disabilities. This article provides a brief overview of the argument, followed by a description of the means by which people with cognitive disabilities have been denigrated over the past century through animalistic rhetoric and negative comparisons with animals. The "animalization" of marginalized groups of all types has often served to reinforce and justify dehumanizing treatment of group members. Questions related to the logic of the AMC are raised, and the importance of the argument for the social work community is discussed.

Animal Rights↗

PubMedDate not supplied

Natural capital in ecology and economics: an overview.

The Brundtland Commission report, Our Common Future, defined sustainable development as development that meets the needs of the present without compromising the ability of future generations to meet their own needs. Although the idea of sustainable development has been widely accepted, it has proved difficult to identify and implement policies and practices that promote sustainable economic growth. Some economists, environmental scientists and policy analysts believe that they can transform the consensus about sustainability into manageable practices. They propose to accomplish this feat with a set of new ideas about the relationships between the economy and the environment offered under the banner of 'natural capital'. An ideal account of natural capital would be one or more standard measures or models that would allow the direct comparison of environmental goods, like forests, fresh water and clean air, with economic goods, like money, capital and productivity. By bringing economic science and environmental science to an objective common ground, a natural capital model has the potential to provide a concrete means of comparing the economic and ecological costs and benefits of particular policies and programmes. This paper offers a survey and analysis of several new contributions to the formation of the natural capital concept from economists, ecologists, policy analysts, biometricians, foresters and a philosopher. The paper concludes that existing microeconomic theory may be 'ungreenable', if it is not reformulated. While macroeconomic approaches to natural capital have beenmore successful, they share the limitation that ecosystems and species are valued solely in monetary terms. These problems are taken to suggest that the development of a successful natural capital model may require economic theory to be recast to include non-monetary social preferences and values.

Conservation of Natural Resources↗

PubMed1999

[Scientific knowledge and the methodologic problem of pain in medicine].

The paper discusses the epistemological question of pain and the way this concept forms part of scientific knowledge. The first part gives a rapid overview of the main aspects of modern scientific knowledge. In earlier times Bacon, Galileo and Descartes felt that the new form of knowledge could head to a knowledge of truth and certainty. Today, these ideals have proved unattainable and science only takes the form of well founded, rigorous and objective knowledge. Moreover, the objectivity of science is based on intersubjectivity. The second part of the paper examines pain and underlines that it is a subjective phenomenon which cannot be ascertained by the doctor in the same way as commonplace anatomic and physiological phenomena. Our scientific knowledge of pain is based on operations for which it is possible to achieve an intersubjective knowledge: these operations constitute the protocol criteria on which it is possible to base a scientific knowledge of pain. In the last part of this paper, having stressed that pain is a concept belonging to many disciplines--scientific, psychological, philosophical, religious--the emphasis is placed on pain itself as opposed to suffering. While the former is a concept that belongs to scientific medicine, the latter belongs to that area of medicine which lies beyond the boundaries of science and concerns the activity of a man who helps a fellow human who is suffering.

History, 15th Century↗

PubMed2006

A conceptual model for program evaluation in graduate medical education.

The author provides (1) a brief overview of the literature concerning program evaluation as applied to medical education, (2) a task-oriented conceptual model for use by residency directors in planning for program evaluation of graduate medical education training programs, (3) an explanation of the term "outcomes evaluation" including distinguishing between types of educational outcomes, and (4) a description of a five-step process of implementing the conceptual model.Recent accreditation standards for graduate medical education programs require a shift from a process-oriented to an outcomes-oriented model of evaluation. Accordingly, residency program directors must ensure compliance by undertaking comprehensive program evaluation procedures that demonstrate educational outcomes. Such procedures include attention to the need and focus of the evaluation; the evaluation methods to be used; and the documentation and presentation of evaluation results to key constituents. Involving teaching faculty and residents in developing a comprehensive evaluation program is vital to success. Regardless of philosophic debates pertaining to the appropriateness of the outcomes model for medical education, this approach appears likely to predominate in the foreseeable future particularly as related to the six general competencies of the physician. A practical, task-oriented approach will assist program directors in ensuring compliance with program evaluation standards.

Education, Medical, Graduate↗

PubMed2001

Implications of the human genome for understanding human biology and medicine.

Clinical researchers, practicing physicians, patients, and the general public now live in a world in which the 2.9 billion nucleotide codes of the human genome are available as a resource for scientific discovery. Some of the findings from the sequencing of the human genome were expected, confirming knowledge presaged by many decades of research in both human and comparative genetics. Other findings are unexpected in their scientific and philosophical implications. In either case, the availability of the human genome is likely to have significant implications, first for clinical research and then for the practice of medicine. This article provides our reflections on what the new genomic knowledge might mean for the future of medicine and how the new knowledge relates to what we knew in the era before the availability of the genome sequence. In addition, practicing physicians in many communities are traditionally also ambassadors of science, called on to translate arcane data or the complex ramifications of biology into a language understood by the public at large. This article also may be useful for physicians who serve in this capacity in their communities. We address the following issues: the number of protein-coding genes in the human genome and certain classes of noncoding repeat elements in the genome; features of genome evolution, including large-scale duplications; an overview of the predicted protein set to highlight prominent differences between the human genome and other sequenced eukaryotic genomes; and DNA variation in the human genome. In addition, we show how this information lays the foundations for ongoing and future endeavors that will revolutionize biomedical research and our understanding of human health.

Clinical Medicine↗

PubMed2003

[A brief overview of the history of the Institute of Human Studies in Medicine at the First Medical Faculty of Charles University in Prague].

The Institute of Human Studies in Medicine (UHSL) was initiated at the First Medical Faculty of Charles University (1. LF UK) in Prague in 1989. At the beginning, the Institute drew upon the ideas and work of a number of medical professionals who were dealing with the issues of their discipline in a wider context. Thus, they created a foundation for current disciplines such as medical ethics, the philosophy of medicine, psychology, psychotherapy and others. These scholars included, for example: prof. Mihajlo Rostohar, prof. MUDr. Vladimír Vondrácek, prof. MUDr. Zdenek Myslivecek, doc. MUDr. Jaroslav Dobrý, CSc., doc. Nikolaj Jevgrafovic Osipov, prof. MUDr. Bohuslav Boucek, and prof. MUDr. Ferdinand Knobloch, CSc. UHSL was first listed in the Curriculum of the 1. LF UK (Karolinka) in the school year 1991-1992. In the following years, the Institute underwent rapid changes such as personnel structure, areas of specification, and educational programs. The structure of UHSL was divided into the following departments: the Department of Medical Ethics and Anthropology, the Department of Psychology, Psychotherapy, and Psychosomatics, the Department of Public Health and Social Medicine, since the school year 1996-1997 the Department of Psychotherapy and Psychology and Psychotherapy Counselling Office. In 1998, UHSL was assigned the project "Goals of Medicine: Quality of Life", which required the participation of doctors, philosophers, psychologists, theologians, historians, mathematicians and others. The decisive factor for UHSL was the appointiment of the dean of the 1. LF UK on January 24, 2002, and thus establishing UHSL as a separate institution with its own organizational structure and fields of study. Later, UHSL was divided into two independent institutions: UHSL, and the Institute for Social Medicine and Public Health (USMVZ). The history of UHSL is documented by the facts about its directors, professors and doctors, visits of foreign specialists, international cooperation, study guidelines and library information, available to UHSL scholars.

Academies and Institutes↗

PubMed1995

The principlism debate: a critical overview.

Clouser and Gert's 'A Critique of Principlism' (1990) has ignited debate over the adequacy of substituting principlism for moral theory as a means for dealing with biomedical dilemmas. Clouser and Gert argue that this sort of substitution is not adequate to the task. I examine their argument in light of recent defences of principlism on this score, those of B. Andrew Lustig (1992), David Degrazia (1992), and Beauchamp and Childress (1994). I argue that both sides in the debate have assumed differing conceptions of a moral theory that virtually guarantee their respective conclusions. These differing conceptions are motivated by antecedent epistemological commitments. The present debate over principlism is therefore inconclusive. Future discussion should focus on the underlying epistemological issues.

Bioethics↗

PubMed2003

50 years of the Institute for Laboratory Animal Research (ILAR): 1953-2003.

The history of the Institute for Laboratory Animal Research (ILAR) begins, as does all of laboratory animal science, with the ancient philosophers, anatomists, and physiologists whose work presaged the use of animals in biomedical research and the institutions that arose due to this use. Modern laboratory animal science and medicine began in the late 1940s and early 1950s as five Chicago-area institutions hired veterinarians to manage their animal facilities. Each of these men became instrumental in the founding of the organizations that collectively make up the laboratory animal science and medicine organizations. Nathan Brewer, one of the "Chicago five," was particularly influential in the founding of ILAR. His boss at the University of Chicago, Dr. Paul Weiss, a member of the National Academy of Sciences (NAS), asked him to help establish a committee with the stated purpose of preparing recommendations to the NAS to develop an office to obtain information on sources of supply for research animals. This office became ILAR, and Brewer was chairman of its first report on the diseases of laboratory animals. He was also a founding diplomat and first president of the American College of Laboratory Animal Medicine. This history recognizes the thoughtful and energetic contributions of scientists and veterinarians to ILAR. It provides a 50-year overview of the programs and reports of ILAR and highlights examples where these reports have been adopted by scientists and federal agencies and incorporated into national laws and policies governing the use of animals in research both in the United States and in other countries.

Academies and Institutes↗