Stephen Wilkinson
- Published in print:
- 2010
- Published Online:
- May 2010
- ISBN:
- 9780199273966
- eISBN:
- 9780191706585
- Item type:
- book
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780199273966.001.0001
- Subject:
- Philosophy, Moral Philosophy, Political Philosophy
To what extent should parents be allowed to use selection technologies (such as preimplantation genetic diagnosis) to determine the characteristics of their children? And is there something morally ...
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To what extent should parents be allowed to use selection technologies (such as preimplantation genetic diagnosis) to determine the characteristics of their children? And is there something morally wrong with parents who wish to do this? Choosing Tomorrow's Children provides answers to these questions. In particular, the book applies the techniques of philosophical bioethics to address issues raised by selective reproduction, the practice of choosing between different possible future persons by selecting or deselecting (for example) embryos, eggs, and sperm. It offers answers to questions including the following. Do children have a ‘right to an open future’ and, if they do, what moral constraints does this place upon selective reproduction? Under what circumstances (if any) should sex selection be allowed? Should we ‘screen out’ as much disease and disability as possible before birth, or would that be an objectionable form of eugenics? Is it acceptable to create or select a future person (a ‘saviour sibling’) in order to provide life-saving tissue for an existing relative? Is there a moral difference between selecting to avoid disease and selecting to produce an ‘enhanced’ child? And should we allow deaf parents to use reproductive technologies to ensure that they have a deaf child? The book does not provide one overarching conclusion but rather assesses each argument-type on its merits. Insofar as it is possible to generalise though, Choosing Tomorrow's Children concludes that most of the arguments usually provided against selective reproduction are flawed in one way or another.Less
To what extent should parents be allowed to use selection technologies (such as preimplantation genetic diagnosis) to determine the characteristics of their children? And is there something morally wrong with parents who wish to do this? Choosing Tomorrow's Children provides answers to these questions. In particular, the book applies the techniques of philosophical bioethics to address issues raised by selective reproduction, the practice of choosing between different possible future persons by selecting or deselecting (for example) embryos, eggs, and sperm. It offers answers to questions including the following. Do children have a ‘right to an open future’ and, if they do, what moral constraints does this place upon selective reproduction? Under what circumstances (if any) should sex selection be allowed? Should we ‘screen out’ as much disease and disability as possible before birth, or would that be an objectionable form of eugenics? Is it acceptable to create or select a future person (a ‘saviour sibling’) in order to provide life-saving tissue for an existing relative? Is there a moral difference between selecting to avoid disease and selecting to produce an ‘enhanced’ child? And should we allow deaf parents to use reproductive technologies to ensure that they have a deaf child? The book does not provide one overarching conclusion but rather assesses each argument-type on its merits. Insofar as it is possible to generalise though, Choosing Tomorrow's Children concludes that most of the arguments usually provided against selective reproduction are flawed in one way or another.
Nikolas Rose and Joelle M. Abi-Rached
- Published in print:
- 2013
- Published Online:
- October 2017
- ISBN:
- 9780691149608
- eISBN:
- 9781400846337
- Item type:
- chapter
- Publisher:
- Princeton University Press
- DOI:
- 10.23943/princeton/9780691149608.003.0005
- Subject:
- Neuroscience, Development
This chapter focuses on the question of diagnosis of psychiatric disorders and examines the relationship between neuroscience and psychiatry from this perspective. Despite the penetrating gaze of ...
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This chapter focuses on the question of diagnosis of psychiatric disorders and examines the relationship between neuroscience and psychiatry from this perspective. Despite the penetrating gaze of neuroscience, which has opened up the brain to vision in so many ways, psychiatric classification remains superficial. This neuromolecular vision seems incapable of grounding the clinical work of psychiatry in the way that has become routine in other areas of medicine. Despite the conviction of most practitioners that they deal with conditions that have a corporeal seat in the brain of the afflicted individual, psychiatry has failed to establish the bridge that, from the nineteenth century on, underpinned the epistemology of modern clinical medicine—the capacity to link the troubles of the troubled and troubling individuals who are its subjects with the vital anomalies that underpin them.Less
This chapter focuses on the question of diagnosis of psychiatric disorders and examines the relationship between neuroscience and psychiatry from this perspective. Despite the penetrating gaze of neuroscience, which has opened up the brain to vision in so many ways, psychiatric classification remains superficial. This neuromolecular vision seems incapable of grounding the clinical work of psychiatry in the way that has become routine in other areas of medicine. Despite the conviction of most practitioners that they deal with conditions that have a corporeal seat in the brain of the afflicted individual, psychiatry has failed to establish the bridge that, from the nineteenth century on, underpinned the epistemology of modern clinical medicine—the capacity to link the troubles of the troubled and troubling individuals who are its subjects with the vital anomalies that underpin them.
Mary Briody Mahowald
- Published in print:
- 2006
- Published Online:
- September 2006
- ISBN:
- 9780195176179
- eISBN:
- 9780199786558
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/0195176170.003.0004
- Subject:
- Philosophy, Feminist Philosophy
Cases illustrating variables relevant to women’s decisions about preconception counseling, preimplantation diagnosis, prenatal testing, misattributed paternity, and sex selection are presented. For ...
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Cases illustrating variables relevant to women’s decisions about preconception counseling, preimplantation diagnosis, prenatal testing, misattributed paternity, and sex selection are presented. For each topic, empirical and theoretical factors are discussed from an “egalitarian perspective” that imputes privileged status to the standpoint of those who are “nondominant”, i.e., those whose input tends to be neglected. Implications of different positions about moral status of fetuses are also considered.Less
Cases illustrating variables relevant to women’s decisions about preconception counseling, preimplantation diagnosis, prenatal testing, misattributed paternity, and sex selection are presented. For each topic, empirical and theoretical factors are discussed from an “egalitarian perspective” that imputes privileged status to the standpoint of those who are “nondominant”, i.e., those whose input tends to be neglected. Implications of different positions about moral status of fetuses are also considered.
Harry Chugani, MD (ed.)
- Published in print:
- 2010
- Published Online:
- January 2011
- ISBN:
- 9780195342765
- eISBN:
- 9780199863617
- Item type:
- book
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780195342765.001.0001
- Subject:
- Neuroscience, Disorders of the Nervous System
Perhaps the most important achievements in the field of epileptology in the past two decades have been in the neuroimaging and genetic breakthroughs as applied to patients with epilepsy. Indeed, ...
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Perhaps the most important achievements in the field of epileptology in the past two decades have been in the neuroimaging and genetic breakthroughs as applied to patients with epilepsy. Indeed, neuroimaging has become a vital part in the study of epilepsy, affecting broad aspects of the disorder ranging from diagnosis and classification to treatment and prognosis. Neuroimaging in epilepsy encompasses many different approaches that have reached various levels of expertise across epilepsy centers worldwide. This book discusses every imaging modality used to gather information on epilepsy. Each technique is described by world experts and epilespy centers worldwide.Less
Perhaps the most important achievements in the field of epileptology in the past two decades have been in the neuroimaging and genetic breakthroughs as applied to patients with epilepsy. Indeed, neuroimaging has become a vital part in the study of epilepsy, affecting broad aspects of the disorder ranging from diagnosis and classification to treatment and prognosis. Neuroimaging in epilepsy encompasses many different approaches that have reached various levels of expertise across epilepsy centers worldwide. This book discusses every imaging modality used to gather information on epilepsy. Each technique is described by world experts and epilespy centers worldwide.
Jacalyn Duffin
- Published in print:
- 2009
- Published Online:
- January 2009
- ISBN:
- 9780195336504
- eISBN:
- 9780199868612
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780195336504.003.0004
- Subject:
- Religion, History of Christianity
An exploration of the problems resolved miraculously. The vast majority are cures from illness. The diseases amendable to miracle cure change through time according to medical science. Some ...
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An exploration of the problems resolved miraculously. The vast majority are cures from illness. The diseases amendable to miracle cure change through time according to medical science. Some conditions, such as cancer, appear consistently through time. Gradually, the cures were of specific organic ailments, with tuberculosis increasing in frequency. Cures of psychic disorders always were rare; from the nineteenth century forward, a diagnosis of hysteria could stop the process. Diseases unknown in past centuries, such as leukemia or multiple sclerosis, appear soon after descriptions in the medical literature. The illness must also have defied up-to-date medical care including surgery. In other words, suffering must be a problem that is thought to be beyond the control of the best medical art of the time.This chapter also examines the nonmedical miracles, including the incorruptibility of the saint’s corpse, preservation from accidental death, and multiplication of food.Less
An exploration of the problems resolved miraculously. The vast majority are cures from illness. The diseases amendable to miracle cure change through time according to medical science. Some conditions, such as cancer, appear consistently through time. Gradually, the cures were of specific organic ailments, with tuberculosis increasing in frequency. Cures of psychic disorders always were rare; from the nineteenth century forward, a diagnosis of hysteria could stop the process. Diseases unknown in past centuries, such as leukemia or multiple sclerosis, appear soon after descriptions in the medical literature. The illness must also have defied up-to-date medical care including surgery. In other words, suffering must be a problem that is thought to be beyond the control of the best medical art of the time.
This chapter also examines the nonmedical miracles, including the incorruptibility of the saint’s corpse, preservation from accidental death, and multiplication of food.
Jacalyn Duffin
- Published in print:
- 2009
- Published Online:
- January 2009
- ISBN:
- 9780195336504
- eISBN:
- 9780199868612
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780195336504.003.0007
- Subject:
- Religion, History of Christianity
Until recently, modern physicians rarely were able to dignify the role of spirituality in health care by making it part of scientific study. Pastoral care may have always been welcome and respected, ...
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Until recently, modern physicians rarely were able to dignify the role of spirituality in health care by making it part of scientific study. Pastoral care may have always been welcome and respected, but it lay outside the realm of what was considered scientific. With the advent of randomized controlled trials, some investigators have brought the claims of spiritualists to the scrutiny of science. This rapprochement of medicine and religion reminds us that the two realms may depart from radically different premises, but they have many similarities in focus, conception, and practice. Both medicine and religion are ancient semiotic endeavors. They seek to detect (diagnose?) the “reality” of metaphysical entities behind individual suffering: disease, sin, health, redemption, miracle, and holiness. The objects of this medical and religious identification are not immutable, three-dimensional things, waiting to be unearthed like potsherds in an archeological dig. They are ideas formulated through science and/or theology to explain suffering and to console misery. As a result, diseases, sins, health, redemption, healing, and miracles are contingent on time and place. They change more than do human suffering and the responses to it. The illness experiences of individuals are co-opted by the epistemic frameworks of medicine and religion to bolster and advance their projects. But sickness, healing behaviors, and death are part of a longue durée of cultural pluralism. In our time, the greatest impetus for the continued work of the medical saints is the positivistic posture of medicine itself.Less
Until recently, modern physicians rarely were able to dignify the role of spirituality in health care by making it part of scientific study. Pastoral care may have always been welcome and respected, but it lay outside the realm of what was considered scientific. With the advent of randomized controlled trials, some investigators have brought the claims of spiritualists to the scrutiny of science. This rapprochement of medicine and religion reminds us that the two realms may depart from radically different premises, but they have many similarities in focus, conception, and practice. Both medicine and religion are ancient semiotic endeavors. They seek to detect (diagnose?) the “reality” of metaphysical entities behind individual suffering: disease, sin, health, redemption, miracle, and holiness. The objects of this medical and religious identification are not immutable, three-dimensional things, waiting to be unearthed like potsherds in an archeological dig. They are ideas formulated through science and/or theology to explain suffering and to console misery. As a result, diseases, sins, health, redemption, healing, and miracles are contingent on time and place. They change more than do human suffering and the responses to it. The illness experiences of individuals are co-opted by the epistemic frameworks of medicine and religion to bolster and advance their projects. But sickness, healing behaviors, and death are part of a longue durée of cultural pluralism. In our time, the greatest impetus for the continued work of the medical saints is the positivistic posture of medicine itself.
Jie W Weiss and David J Weiss
- Published in print:
- 2008
- Published Online:
- January 2009
- ISBN:
- 9780195322989
- eISBN:
- 9780199869206
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780195322989.003.0021
- Subject:
- Psychology, Cognitive Psychology
This chapter argues that computer-aided medical diagnosis can become an effective and economically feasible tool through the routine use of appropriately obtained physician estimates of likelihoods. ...
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This chapter argues that computer-aided medical diagnosis can become an effective and economically feasible tool through the routine use of appropriately obtained physician estimates of likelihoods. The first section introduces the concept of subjective probability, shows that humans can be effective probability estimators, describes methods for obtaining good subjective estimates, and demonstrates the use of subjective likelihood estimates in Bayes's theorem. The next section describes specific problems that have limited the application of frequentistic Bayesian diagnostic procedures and shows how these problems can be resolved by incorporating subjective likelihood estimates into Bayes's theorem. It is argued that the use of human judgment in assessing the conditional independence of symptoms is an economical and adequate procedure to a prohibitively complex statistical problem.Less
This chapter argues that computer-aided medical diagnosis can become an effective and economically feasible tool through the routine use of appropriately obtained physician estimates of likelihoods. The first section introduces the concept of subjective probability, shows that humans can be effective probability estimators, describes methods for obtaining good subjective estimates, and demonstrates the use of subjective likelihood estimates in Bayes's theorem. The next section describes specific problems that have limited the application of frequentistic Bayesian diagnostic procedures and shows how these problems can be resolved by incorporating subjective likelihood estimates into Bayes's theorem. It is argued that the use of human judgment in assessing the conditional independence of symptoms is an economical and adequate procedure to a prohibitively complex statistical problem.
Jie W Weiss and David J Weiss
- Published in print:
- 2008
- Published Online:
- January 2009
- ISBN:
- 9780195322989
- eISBN:
- 9780199869206
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780195322989.003.0022
- Subject:
- Psychology, Cognitive Psychology
This chapter argues that there are actually two intellectual steps in diagnosis after data collection is complete. One is the judgment of the meaning of each individual symptom; the other is the ...
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This chapter argues that there are actually two intellectual steps in diagnosis after data collection is complete. One is the judgment of the meaning of each individual symptom; the other is the aggregation of the symptoms in order to reach a diagnosis. The first is often inevitably a task for human expertise, either because this particular symptom or set of symptoms is essentially unique (N = 1) or because, though it is not unique, information about its association with diseases is unavailable. The second step—aggregation—is readily mechanized by means of Bayes's Theorem, and such mechanization has great advantages over more intuitive, less formal methods of doing the same intellectual work.Less
This chapter argues that there are actually two intellectual steps in diagnosis after data collection is complete. One is the judgment of the meaning of each individual symptom; the other is the aggregation of the symptoms in order to reach a diagnosis. The first is often inevitably a task for human expertise, either because this particular symptom or set of symptoms is essentially unique (N = 1) or because, though it is not unique, information about its association with diseases is unavailable. The second step—aggregation—is readily mechanized by means of Bayes's Theorem, and such mechanization has great advantages over more intuitive, less formal methods of doing the same intellectual work.
Jie W Weiss and David J Weiss
- Published in print:
- 2008
- Published Online:
- January 2009
- ISBN:
- 9780195322989
- eISBN:
- 9780199869206
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780195322989.003.0025
- Subject:
- Psychology, Cognitive Psychology
This chapter describes how both humans and machines carry out the task of diagnosis, classically defined as the purposeful process of classifying cases. The chapter is organized into four sections: ...
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This chapter describes how both humans and machines carry out the task of diagnosis, classically defined as the purposeful process of classifying cases. The chapter is organized into four sections: the first presents a conceptual model of the diagnostic process; the second investigates the purpose of diagnosis; the third explores the question of evaluating diagnostic proficiency; the fourth provides conclusions and recommendations.Less
This chapter describes how both humans and machines carry out the task of diagnosis, classically defined as the purposeful process of classifying cases. The chapter is organized into four sections: the first presents a conceptual model of the diagnostic process; the second investigates the purpose of diagnosis; the third explores the question of evaluating diagnostic proficiency; the fourth provides conclusions and recommendations.
Chloe Silverman
- Published in print:
- 2011
- Published Online:
- October 2017
- ISBN:
- 9780691150468
- eISBN:
- 9781400840397
- Item type:
- chapter
- Publisher:
- Princeton University Press
- DOI:
- 10.23943/princeton/9780691150468.003.0001
- Subject:
- Anthropology, Social and Cultural Anthropology
This book examines the evolution of the diagnostic category of autism as people have understood it in different places and times, with a particular focus on the importance of affect in biomedical ...
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This book examines the evolution of the diagnostic category of autism as people have understood it in different places and times, with a particular focus on the importance of affect in biomedical research during the second half of the twentieth century and the first few years of the twenty-first. It considers the degree to which representation of autism depends on particular institutional and epistemological arrangements; shifts the focus from psychiatrists, epidemiologists, and geneticists to parents, counselors, diagnosticians, and lawyers, as they try to make sense of and apply systematic, authoritative knowledge in their daily lives and work; and highlights the centrality of love as a way of knowing about bodies, persons, and relationships in biomedicine. This introduction provides an overview of theories of love in biomedicine, the ethics of treating autism and how it relates to the question of moral personhood, the history of diagnosis of autism, biosociality and contested illnesses, and the book's methodology.Less
This book examines the evolution of the diagnostic category of autism as people have understood it in different places and times, with a particular focus on the importance of affect in biomedical research during the second half of the twentieth century and the first few years of the twenty-first. It considers the degree to which representation of autism depends on particular institutional and epistemological arrangements; shifts the focus from psychiatrists, epidemiologists, and geneticists to parents, counselors, diagnosticians, and lawyers, as they try to make sense of and apply systematic, authoritative knowledge in their daily lives and work; and highlights the centrality of love as a way of knowing about bodies, persons, and relationships in biomedicine. This introduction provides an overview of theories of love in biomedicine, the ethics of treating autism and how it relates to the question of moral personhood, the history of diagnosis of autism, biosociality and contested illnesses, and the book's methodology.
Mary Coleman (ed.)
- Published in print:
- 2005
- Published Online:
- September 2007
- ISBN:
- 9780195182224
- eISBN:
- 9780199786701
- Item type:
- book
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780195182224.001.0001
- Subject:
- Psychology, Cognitive Neuroscience
This book uses the tools of neurological analysis to address a number of major questions that have arisen in the study of autism. The answers it presents have important implications for the ...
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This book uses the tools of neurological analysis to address a number of major questions that have arisen in the study of autism. The answers it presents have important implications for the direction of future autism research, diagnosis, and treatment. What are the neurological signs and symptoms of autism? The latest information is presented in an in-depth discussion of epilepsy, cranial circumference, changes in muscle tone, stereotypies, and mutism found in children with autism. In addition, a template is provided for practitioners to follow when conducting neurological examinations of a child with autism. What are the best options for the treatment of autism? The current medical, educational, and alternative therapies are thoroughly reviewed and evaluated. Is autism reversible? The question is explored for syndromic autism, where diseases may have a transient autistic phase, and reviewed in detail for nonsyndromic autism. Is autism primarily a single disease, as originally described by Leo Kanner? Research presented here suggests that autism is, instead, a syndrome involving many disease entities. Has the incidence of autism been increasing in recent years? An historical review of autisms prevalence rates suggests that it has never been rare. What is the relationship between autism and Asperger syndrome? The latest evidence presented here sheds light on the degree to which both syndromes share more than clinical characteristics; this evidence also show some similar findings in imaging, neuropathological, and genetic studies. Which components of the brain's neural networks need to be impaired to cause the appearance of autistic symptoms? Although there are many candidate regions, dysfunction of the cerebellum and its circuits is noted to be of great interest.Less
This book uses the tools of neurological analysis to address a number of major questions that have arisen in the study of autism. The answers it presents have important implications for the direction of future autism research, diagnosis, and treatment. What are the neurological signs and symptoms of autism? The latest information is presented in an in-depth discussion of epilepsy, cranial circumference, changes in muscle tone, stereotypies, and mutism found in children with autism. In addition, a template is provided for practitioners to follow when conducting neurological examinations of a child with autism. What are the best options for the treatment of autism? The current medical, educational, and alternative therapies are thoroughly reviewed and evaluated. Is autism reversible? The question is explored for syndromic autism, where diseases may have a transient autistic phase, and reviewed in detail for nonsyndromic autism. Is autism primarily a single disease, as originally described by Leo Kanner? Research presented here suggests that autism is, instead, a syndrome involving many disease entities. Has the incidence of autism been increasing in recent years? An historical review of autisms prevalence rates suggests that it has never been rare. What is the relationship between autism and Asperger syndrome? The latest evidence presented here sheds light on the degree to which both syndromes share more than clinical characteristics; this evidence also show some similar findings in imaging, neuropathological, and genetic studies. Which components of the brain's neural networks need to be impaired to cause the appearance of autistic symptoms? Although there are many candidate regions, dysfunction of the cerebellum and its circuits is noted to be of great interest.
Margaret Lock
- Published in print:
- 2013
- Published Online:
- October 2017
- ISBN:
- 9780691149783
- eISBN:
- 9781400848461
- Item type:
- chapter
- Publisher:
- Princeton University Press
- DOI:
- 10.23943/princeton/9780691149783.003.0003
- Subject:
- Anthropology, Social and Cultural Anthropology
This chapter considers repeated attempts at diagnostic refinement and standardization of Alzheimer disease (AD). It explores the difficulties of reconciling repeated mismatches between a clinical and ...
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This chapter considers repeated attempts at diagnostic refinement and standardization of Alzheimer disease (AD). It explores the difficulties of reconciling repeated mismatches between a clinical and a neuropathological diagnosis of AD, as are the discrepancies in diagnoses between specialized memory clinics and general and family practice settings. A diagnosis of AD involves the demonstration at autopsy of neuritic amyloid plaques, neurofibrillary tangles, and also cell loss or shrinkage of brain tissue. For two decades the preeminent model to account for plaque buildup has been the “amyloid cascade hypothesis” that, it is argued, initiates the eventual formation of tangles and other neuropathological changes. The model is currently being questioned by an increasing number of key researchers and continues to be a driving force, even as the entire Alzheimer enterprise moves to include prevention as a major goal.Less
This chapter considers repeated attempts at diagnostic refinement and standardization of Alzheimer disease (AD). It explores the difficulties of reconciling repeated mismatches between a clinical and a neuropathological diagnosis of AD, as are the discrepancies in diagnoses between specialized memory clinics and general and family practice settings. A diagnosis of AD involves the demonstration at autopsy of neuritic amyloid plaques, neurofibrillary tangles, and also cell loss or shrinkage of brain tissue. For two decades the preeminent model to account for plaque buildup has been the “amyloid cascade hypothesis” that, it is argued, initiates the eventual formation of tangles and other neuropathological changes. The model is currently being questioned by an increasing number of key researchers and continues to be a driving force, even as the entire Alzheimer enterprise moves to include prevention as a major goal.
Margaret Lock
- Published in print:
- 2013
- Published Online:
- October 2017
- ISBN:
- 9780691149783
- eISBN:
- 9781400848461
- Item type:
- chapter
- Publisher:
- Princeton University Press
- DOI:
- 10.23943/princeton/9780691149783.003.0004
- Subject:
- Anthropology, Social and Cultural Anthropology
This chapter looks at the adoption in the 1980s of the clinical diagnosis known as “mild cognitive impairment” (MCI). Formal recognition of MCI, the value of which continues to be debated in some ...
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This chapter looks at the adoption in the 1980s of the clinical diagnosis known as “mild cognitive impairment” (MCI). Formal recognition of MCI, the value of which continues to be debated in some circles, is the result of an exerted effort to systematically identify incipient Alzheimer disease (AD) in the clinic and is closely associated with the founding of specialist memory clinics. The chapter presents ethnographic findings of interviews with individuals who have been diagnosed with MCI. The move toward the prevention of AD represents a shift in which it is assumed that embodied risk can be made manifest in the form of biomarkers. This shift is to be accomplished by researching, standardizing, and gradually routinizing the use of several biomarkers believed to put individuals at increased risk for AD.Less
This chapter looks at the adoption in the 1980s of the clinical diagnosis known as “mild cognitive impairment” (MCI). Formal recognition of MCI, the value of which continues to be debated in some circles, is the result of an exerted effort to systematically identify incipient Alzheimer disease (AD) in the clinic and is closely associated with the founding of specialist memory clinics. The chapter presents ethnographic findings of interviews with individuals who have been diagnosed with MCI. The move toward the prevention of AD represents a shift in which it is assumed that embodied risk can be made manifest in the form of biomarkers. This shift is to be accomplished by researching, standardizing, and gradually routinizing the use of several biomarkers believed to put individuals at increased risk for AD.
William Jagust and Mark D'Esposito (eds)
- Published in print:
- 2009
- Published Online:
- February 2010
- ISBN:
- 9780195328875
- eISBN:
- 9780199864836
- Item type:
- book
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780195328875.001.0001
- Subject:
- Neuroscience, Techniques, Development
The study of brain aging has been revolutionized through advances in molecular neuroscience, cognitive neuroscience, and brain imaging. The application of new concepts and techniques has permitted ...
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The study of brain aging has been revolutionized through advances in molecular neuroscience, cognitive neuroscience, and brain imaging. The application of new concepts and techniques has permitted investigators to explore the changes in structure, function, and biochemistry in living humans in order to unravel mechanisms that underlie both age-related cognitive decline and preservation of cognition into old age. This book reviews both the basic science and clinical applications of brain imaging in the study of brain aging. Topics reviewed include technical issues associated with imaging studies in older brains, pathology of brain aging, structural changes in the aging brain, changes in dopamine function, and mechanisms of brain reserve and plasticity. The use of genetics in combination with brain imaging and the use of animal models are also explored. Clinical applications include the diagnosis and prediction of cognitive decline using a variety of different imaging approaches as well as a detailed description of amyloid imaging using PET scanning. Other topics include functional MRI studies in aging, the use of imaging in therapeutic monitoring and drug development, and the role of large-scale databases. The volume contains information both for those involved in brain imaging research and for those new to the field who are in need of a systematic overview.Less
The study of brain aging has been revolutionized through advances in molecular neuroscience, cognitive neuroscience, and brain imaging. The application of new concepts and techniques has permitted investigators to explore the changes in structure, function, and biochemistry in living humans in order to unravel mechanisms that underlie both age-related cognitive decline and preservation of cognition into old age. This book reviews both the basic science and clinical applications of brain imaging in the study of brain aging. Topics reviewed include technical issues associated with imaging studies in older brains, pathology of brain aging, structural changes in the aging brain, changes in dopamine function, and mechanisms of brain reserve and plasticity. The use of genetics in combination with brain imaging and the use of animal models are also explored. Clinical applications include the diagnosis and prediction of cognitive decline using a variety of different imaging approaches as well as a detailed description of amyloid imaging using PET scanning. Other topics include functional MRI studies in aging, the use of imaging in therapeutic monitoring and drug development, and the role of large-scale databases. The volume contains information both for those involved in brain imaging research and for those new to the field who are in need of a systematic overview.
Ralph Colp Jr. M.D.
- Published in print:
- 2008
- Published Online:
- September 2011
- ISBN:
- 9780813032313
- eISBN:
- 9780813039237
- Item type:
- chapter
- Publisher:
- University Press of Florida
- DOI:
- 10.5744/florida/9780813032313.003.0029
- Subject:
- History, History of Science, Technology, and Medicine
In the year 2000, Dr. Gordon Sauer, an American dermatologist, published an article, “Charles Darwin Consults a Dermatologist”, in which he diagnosed Darwin's skin disease as being atopic eczema. ...
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In the year 2000, Dr. Gordon Sauer, an American dermatologist, published an article, “Charles Darwin Consults a Dermatologist”, in which he diagnosed Darwin's skin disease as being atopic eczema. This was the first time in nearly 120 years of comments on Darwin's illness that anyone had proposed a diagnosis for his dermatological symptoms. While Dr. Sauer believes that this allergic state is a cause for Darwin's skin symptoms, he does not believe that allergy can account for the other symptoms of Darwin's illness, as has been proposed by Fabienne Smith. The evidence for his dermatological diagnosis is presented. Whether or not Darwin had atopic dermatitis can only be confirmed by allergen tests that have been developed since his death, and he may occasionally have had other kinds of skin disorders. But the diagnosis of atopic dermatitis fits what is known about the nature and history of his dermatitis better than any other diagnosis.Less
In the year 2000, Dr. Gordon Sauer, an American dermatologist, published an article, “Charles Darwin Consults a Dermatologist”, in which he diagnosed Darwin's skin disease as being atopic eczema. This was the first time in nearly 120 years of comments on Darwin's illness that anyone had proposed a diagnosis for his dermatological symptoms. While Dr. Sauer believes that this allergic state is a cause for Darwin's skin symptoms, he does not believe that allergy can account for the other symptoms of Darwin's illness, as has been proposed by Fabienne Smith. The evidence for his dermatological diagnosis is presented. Whether or not Darwin had atopic dermatitis can only be confirmed by allergen tests that have been developed since his death, and he may occasionally have had other kinds of skin disorders. But the diagnosis of atopic dermatitis fits what is known about the nature and history of his dermatitis better than any other diagnosis.
Rachel Mistur, Lisa Mosconi, Remigiusz Switalski, Susan De Santi, Yi Li, Lidia Glodzik, Miroslaw Brys, Wai Tsui, Henry Rusinek, and Mony J. de Leon
- Published in print:
- 2009
- Published Online:
- February 2010
- ISBN:
- 9780195328875
- eISBN:
- 9780199864836
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780195328875.003.0011
- Subject:
- Neuroscience, Techniques, Development
Reductions in the cerebral metabolic rate of glucose (CMRglc), a measure of neuronal function, have proven to be a promising tool in the early diagnosis of Alzheimer's disease (AD). FDG-PET imaging ...
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Reductions in the cerebral metabolic rate of glucose (CMRglc), a measure of neuronal function, have proven to be a promising tool in the early diagnosis of Alzheimer's disease (AD). FDG-PET imaging demonstrates progressive CMRglc reductions in AD patients, the extent and topography of which correlate with symptom severity. There is increasing evidence that hypometabolism appears during the preclinical stages of AD and can predict decline years before the onset of symptoms. This chapter provides an overview of FDG-PET results in individuals at risk for developing dementia, including presymptomatic individuals carrying mutations responsible for early-onset familial AD, patients with mild cognitive impairment (MCI), nondemented carriers of the Apolipoprotein E (ApoE) e4 allele, cognitively normal subjects with a family history of AD, subjects with subjective memory complaints, and the normal elderly followed longitudinally until they expressed the clinical symptoms of AD. Finally, this chapter discusses the potential to combine different PET tracers and cerebrospinal fluid (CSF) markers of pathology to improve the early detection of AD.Less
Reductions in the cerebral metabolic rate of glucose (CMRglc), a measure of neuronal function, have proven to be a promising tool in the early diagnosis of Alzheimer's disease (AD). FDG-PET imaging demonstrates progressive CMRglc reductions in AD patients, the extent and topography of which correlate with symptom severity. There is increasing evidence that hypometabolism appears during the preclinical stages of AD and can predict decline years before the onset of symptoms. This chapter provides an overview of FDG-PET results in individuals at risk for developing dementia, including presymptomatic individuals carrying mutations responsible for early-onset familial AD, patients with mild cognitive impairment (MCI), nondemented carriers of the Apolipoprotein E (ApoE) e4 allele, cognitively normal subjects with a family history of AD, subjects with subjective memory complaints, and the normal elderly followed longitudinally until they expressed the clinical symptoms of AD. Finally, this chapter discusses the potential to combine different PET tracers and cerebrospinal fluid (CSF) markers of pathology to improve the early detection of AD.
Harriet P. Lefley
- Published in print:
- 2009
- Published Online:
- September 2009
- ISBN:
- 9780195340495
- eISBN:
- 9780199863792
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780195340495.003.0012
- Subject:
- Social Work, Health and Mental Health, Children and Families
Although studies of family psychoeducation (FPE) have shown impressive effects, questions remain as to appropriate format and content, optimal duration, manualization, and cultural adaptation. Should ...
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Although studies of family psychoeducation (FPE) have shown impressive effects, questions remain as to appropriate format and content, optimal duration, manualization, and cultural adaptation. Should content be adapted to patients' age, different kin relationships, the family life cycle, or stages in the illness trajectory? With assisted living community residence, should FPE be targeted to case managers or staff of residential facilities rather than to family caregivers? This chapter discusses the continuing salience of high express emotion (EE) as a basic feature of FPE is discussed, in light of research that demonstrates diagnostic differences in response to emotional overinvolvement. Research suggests that families place greater emphasis on issues that cannot be fully dealt with in FPE. These include patients' denial and nonadherence to medications, disruptive and problem behaviors, negative symptoms and moods, family relationships, and handling issues of dependence and independence. FPE is arguably just one element in an integrated system of care. It should be accompanied by a forum for advocacy that can insure public and legislative support for a high-level system of care.Less
Although studies of family psychoeducation (FPE) have shown impressive effects, questions remain as to appropriate format and content, optimal duration, manualization, and cultural adaptation. Should content be adapted to patients' age, different kin relationships, the family life cycle, or stages in the illness trajectory? With assisted living community residence, should FPE be targeted to case managers or staff of residential facilities rather than to family caregivers? This chapter discusses the continuing salience of high express emotion (EE) as a basic feature of FPE is discussed, in light of research that demonstrates diagnostic differences in response to emotional overinvolvement. Research suggests that families place greater emphasis on issues that cannot be fully dealt with in FPE. These include patients' denial and nonadherence to medications, disruptive and problem behaviors, negative symptoms and moods, family relationships, and handling issues of dependence and independence. FPE is arguably just one element in an integrated system of care. It should be accompanied by a forum for advocacy that can insure public and legislative support for a high-level system of care.
Christopher Dye
- Published in print:
- 2015
- Published Online:
- October 2017
- ISBN:
- 9780691154626
- eISBN:
- 9781400866571
- Item type:
- chapter
- Publisher:
- Princeton University Press
- DOI:
- 10.23943/princeton/9780691154626.003.0004
- Subject:
- Biology, Disease Ecology / Epidemiology
This chapter considers a variety of tuberculosis control measures that can change the rates of transition between states of health. Without a better understanding of who is most at risk of infection ...
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This chapter considers a variety of tuberculosis control measures that can change the rates of transition between states of health. Without a better understanding of who is most at risk of infection and disease, the opportunities for targeted prevention and treatment are limited. This is why dominant TB control efforts today do not focus on hotspots but rather confront the disease in whole populations. The principal approach to TB control, drug treatment of active disease, has saved millions of lives but has been much less effective in stopping TB transmission. The chapter examines the effects of different approaches to TB control, current and future technologies, and the outcomes for infection, disease, and mortality. It shows that while the mitigation of risk factors such as diabetes, undernutrition, or tobacco smoking is helpful as an accessory to TB control, the greater opportunity for immediate impact lies with the early diagnosis and curative treatment of TB disease.Less
This chapter considers a variety of tuberculosis control measures that can change the rates of transition between states of health. Without a better understanding of who is most at risk of infection and disease, the opportunities for targeted prevention and treatment are limited. This is why dominant TB control efforts today do not focus on hotspots but rather confront the disease in whole populations. The principal approach to TB control, drug treatment of active disease, has saved millions of lives but has been much less effective in stopping TB transmission. The chapter examines the effects of different approaches to TB control, current and future technologies, and the outcomes for infection, disease, and mortality. It shows that while the mitigation of risk factors such as diabetes, undernutrition, or tobacco smoking is helpful as an accessory to TB control, the greater opportunity for immediate impact lies with the early diagnosis and curative treatment of TB disease.
Leanne M. Williams and Evian Gordon
- Published in print:
- 2010
- Published Online:
- January 2011
- ISBN:
- 9780195393804
- eISBN:
- 9780199863495
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780195393804.003.0003
- Subject:
- Neuroscience, Disorders of the Nervous System
In the emerging new paradigm of “Personalized Medicine,” the goal is to shift the treatment for brain-related illness from trial and error into a bull’s-eye. To date, much of the research in ...
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In the emerging new paradigm of “Personalized Medicine,” the goal is to shift the treatment for brain-related illness from trial and error into a bull’s-eye. To date, much of the research in Personalized Medicine has focused on genetic “markers” employed as predictors of individual treatment response. The complexity of the brain requires a shift in focus from genetic marker(s) to an integrated approach, in which a wider scope of molecular plus brain-related functional, structural and cognitive information is used in a complementary manner. This chapter provides a brief summary of the current evidence for markers that predict brain-related treatment response in depression, schizophrenia and ADHD. The chapter focuses on the current status of Personalized Medicine, including the principles of an integrative approach to personalized medicine for the brain, and building a new taxonomy for incorporating the most clinically effective markers, is also outlined.Less
In the emerging new paradigm of “Personalized Medicine,” the goal is to shift the treatment for brain-related illness from trial and error into a bull’s-eye. To date, much of the research in Personalized Medicine has focused on genetic “markers” employed as predictors of individual treatment response. The complexity of the brain requires a shift in focus from genetic marker(s) to an integrated approach, in which a wider scope of molecular plus brain-related functional, structural and cognitive information is used in a complementary manner. This chapter provides a brief summary of the current evidence for markers that predict brain-related treatment response in depression, schizophrenia and ADHD. The chapter focuses on the current status of Personalized Medicine, including the principles of an integrative approach to personalized medicine for the brain, and building a new taxonomy for incorporating the most clinically effective markers, is also outlined.
Alex Fornito and Edward T. Bullmore
- Published in print:
- 2010
- Published Online:
- January 2011
- ISBN:
- 9780195393804
- eISBN:
- 9780199863495
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780195393804.003.0004
- Subject:
- Neuroscience, Disorders of the Nervous System
Functional magnetic resonance imaging (fMRI) has rapidly emerged as an important tool for understanding the neural correlates of myriad cognitive and emotional processes. By offering a direct window ...
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Functional magnetic resonance imaging (fMRI) has rapidly emerged as an important tool for understanding the neural correlates of myriad cognitive and emotional processes. By offering a direct window into brain activity, fMRI promised to usher in a new era of psychiatry, in which clinical decisions would be based on objective neurobiological measures rather than often-contentious symptom classifications. However, research conducted over the past two decades has failed to realise this goal, and fMRI remains an unutilized tool in the psychiatric clinic. In this chapter, we consider reasons why fMRI has failed to fulfill its promise as a clinically useful tool for psychiatrists and consider recent progress towards this goal in three key clinical domains: diagnosis, prediction and treatment monitoring. In particular, we focus on moving away from using traditional case-control comparisons of mean differences in brain activation to more sophisticated statistical techniques using brain activity patterns to classify individual participants to key clinical outcome variables, such as diagnosis or treatment response.Less
Functional magnetic resonance imaging (fMRI) has rapidly emerged as an important tool for understanding the neural correlates of myriad cognitive and emotional processes. By offering a direct window into brain activity, fMRI promised to usher in a new era of psychiatry, in which clinical decisions would be based on objective neurobiological measures rather than often-contentious symptom classifications. However, research conducted over the past two decades has failed to realise this goal, and fMRI remains an unutilized tool in the psychiatric clinic. In this chapter, we consider reasons why fMRI has failed to fulfill its promise as a clinically useful tool for psychiatrists and consider recent progress towards this goal in three key clinical domains: diagnosis, prediction and treatment monitoring. In particular, we focus on moving away from using traditional case-control comparisons of mean differences in brain activation to more sophisticated statistical techniques using brain activity patterns to classify individual participants to key clinical outcome variables, such as diagnosis or treatment response.
