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This paper introduces Mahāyāna Buddhist medicine into the contemporary international relations (IR) literature. In this paper, we will elucidate the perception towards subjectivity and relationality based upon the non-binary relationality of Mahāyāna Buddhist medicine, and strive to provide a refreshing understanding of the world. In order to achieve this goal, we start this article by focussing upon the way in which the essentialised subjectivity became the norm of contemporary IR even in non-Western regions. Second, we will provide a general introduction to Mahāyāna Buddhism. Here, we will explain the fluid subjectivity of this particular philosophical tradition, particularly its assumptions of subjectivity, relationality and temporality. Third, we will shift our focus to a practical application of this line of thought, Mahāyāna Buddhist medicine. We argue that Mahāyāna Buddhist medicine is extremely suggestive to contemporary colonial/postcolonial relations in the sense that it provides a practical way to cure those who are suffering from fear and anxiety generated by the assumptions of autonomy and independence. Last, we will return to the discourses of IR, in particular a recent discussion on temporality, relationality and ethics, to consider the possible contributions of Mahāyāna Buddhist medicine to IR. [ABSTRACT FROM AUTHOR]

In this paper, I will argue how Paracelsus's concept of the universal ensoulment of nature may relate to his understanding of the self-healing capacity of the body, as shown in his Grosse Wundartzney (1536). Here, his new approach to medicine is visible, focusing not on retaining or restoring the balance of bodily humours but on strengthening the inner "essence" of life (the so-called "balsam," "mummy," "astral spirit," etc.). This is possible by means of life-endowed essences of healing substances which can affect the body's vital principle by means of inner sympathies. Here, a link is established to medical alchemy as a way to produce more subtle medicines, the "essences" of things. Such an undertaking is possible only in the framework of the natural magic concept with its underlying microcosm-macrocosm analogy. It is my aim to show not only the principles of Paracelsus's new medicine, alchemy, and his worldview in general, but also how his theories may relate to his predecessors, including Marsilio Ficino, one of the few authors who escaped Paracelsus's harsh critique. [ABSTRACT FROM AUTHOR]

This paper focuses on a specific aspect of the emergence of psychology and psychiatry as scientific disciplines in the late eighteenth and early nineteenth centuries. It examines how psychological knowledge, which was scattered across different fields of knowledge such as philosophy and anthropology, as well as medical subfields such as physiology, pathology and state medicine, was filtered into medical education in three medical faculties of the Habsburg Monarchy: Vienna, Prague and Pest. As education was the primary arena of producing authoritative medical knowledge, the three institutions played a key role in the transfers of knowledge within the Monarchy and in shaping 'official' medical practices acknowledged by the state. These in turn could be used to validate different measures to normalize or optimize its population. Through the lens of education and the underlying tension between the different approaches to psychological knowledge that constituted a type of 'arcane knowledge' in the period, with fluid and often dubious boundaries and questionable applicability, the article points at the epistemological uncertainty and transitory nature of the psychological field. The paper also looks at how it was nevertheless integrated into medical education with varying success by the 1840s as part of the professionalization of psychiatry and with the pronounced aim of training specialists who could cooperate in creating functioning spaces for the mad where they could not only be kept, but also normalized and (re)integrated into society. [ABSTRACT FROM AUTHOR]

The practice of osteopathy differs around the world. However, the dominant practice is that of manual therapy interventions guided by assessment of the neuromusculoskeletal system. Patient populations treated by osteopaths vary across the lifespan and include groups with more-nuanced care requirements such as those who are pregnant. The volume of evidence for osteopathy care is increasing. This umbrella review seeks to identify systematic reviews of osteopathic care with the purpose of highlighting current knowledge about the high-level evidence underpinning the profession. The umbrella review will be conducted consistent with the Joanna Briggs Institute umbrella review methodology. Articles will be limited to those describing osteopathic care. An initial search did not identify a similar study and nor is one registered. A search of MEDLINE and CINAHL informed the search syntax. A full search will be performed across MEDLINE (PubMed), CINAHL (EBSCO), Scopus, Web of Science, PEDro, Osteopathic Research Web, AMED, Index to Chiropractic Literature, Cochrane Database of Systematic Reviews, and the Osteopathic Medicine Digital Repository (OSTMED.DR). The reference lists of included articles will be reviewed to identify potentially relevant systematic reviews. Data will be extracted from each systematic review and presented in tabular format. The umbrella review will synthesise what is known about osteopathic care as described in systematic reviews. The review will inform stakeholders about the role of osteopathic care in the health system and provide recommendations for future research. The findings will be submitted for peer-review publication. [ABSTRACT FROM AUTHOR]

Emerging research points to the increasingly expansive ontologies of gender that young people engage with in contemporary society. This paper examines the representations of gender that emerged in one urban site: a science gallery exhibition in London that sought to de-centre fixed binary gender categories – a site where gender is explicitly being 'redone' (West & Zimmerman, 2009). Drawing on research work on curation (Acord, 2010) we examine data (drawings and text) produced by 516 young people who attended the exhibition, exploring the ways gender is narrativised and re-curated within the physical and discursive space(s) of the gallery. Our findings show the ways that gender was felt and represented in these recurations, as fixed and unfixed, and productive and unproductive. The participants reassembled the ideas of gender presented within the gallery through representations imbued with affect. This included representations that conflated sex and gender and privileged bio-essentialist narratives, as well as representations that drew on binary models and logics. These re-curations, we argue, point to the ways that young people are making sense of gender (im)possibilities. We argue that these narratives highlight the ways young people are grappling with discourses of gender as they transition into adulthood in contemporary society. [ABSTRACT FROM AUTHOR]

Physicians generally recommend that patients resuscitated with naloxone after opioid overdose stay in the emergency department for a period of observation in order to prevent harm from delayed sequelae of opioid toxicity. Patients frequently refuse this period of observation despiteenefit to risk. Healthcare providers are thus confronted with the challenge of how best to protect the patient's interests while also respecting autonomy, including assessing whether the patient is making an autonomous choice to refuse care. Previous studies have shown that physicians have widely divergent approaches to navigating these conflicts. This paper reviews what is known about the effects of opioid use disorder on decision-making, and argues that some subset of these refusals are non-autonomous choices, even when patients appear to have decision making capacity. This conclusion has several implications for how physicians assess and respond to patients refusing medical recommendations after naloxone resuscitation. [ABSTRACT FROM AUTHOR]

The objective of the ASPIRE award programme of the International Association for Health Professions Education is to go beyond traditional accreditation processes. Working in partnership with the ASPIRE Academy, the programme aims to encourage and support excellence in health professions education, in part by showcasing and exemplifying best practices. Each year ASPIRE award applications received from institutions across the globe describe their greatest achievements in a variety of areas, one of which is curriculum development, where evaluation of applications is carried out using a framework of six domains. These are described in this paper as key elements of excellence, specifically, Organisational Structure and Curriculum Management; Underlying Educational Strategy; Content Specification and Pedagogy; Teaching and Learning Methods and Environment; Assessment, Monitoring and Evaluation; Scholarship. Using examples from the content of submissions of three medical schools from very different settings that have been successful in the past few years, achievements in education processes and outcomes of institutions around the world are highlighted in ways that are relevant to their local and societal contexts. [ABSTRACT FROM AUTHOR]

Current attempts to understand unusually high rates of psychiatric illness in complex, chronic illnesses can be guilty of operating within an explanatory framework whereby there are two options. Either (a) that the psychiatric predicaments are secondary to the bodily condition, and (b) that they are primary. In this paper, I draw upon philosophical work on affect, contemporary empirical work, and qualitative first-person patient data to illustrate a much messier reality. I argue that affective experience is generally more complex in such conditions, and that a variety of pre- and post-morbid causal factors dynamically interact such that the resultant psychiatric predicaments do not permit to classification as strictly primary or secondary to the bodily condition. Affective scaffolding, in my view, provides an apt theoretical framework for capturing this nuance. [ABSTRACT FROM AUTHOR]

AbstractA novel advantage of the use of machine learning (ML) systems in medicine is their potential to continue learning from new data after implementation in clinical practice. To date, considerations of the ethical questions raised by the design and use of adaptive machine learning systems in medicine have, for the most part, been confined to discussion of the so-called “update problem,” which concerns how regulators should approach systems whose performance and parameters continue to change even after they have received regulatory approval. In this paper, we draw attention to a prior ethical question: whether the continuous learning that will occur in such systems after their initial deployment should be classified, and regulated, as medical research? We argue that there is a strong prima facie case that the use of continuous learning in medical ML systems should be categorized, and regulated, as research and that individuals whose treatment involves such systems should be treated as research subjects. [ABSTRACT FROM AUTHOR]

Purpose: The present article summarises the characteristics of Rasch's theory, providing an original metrological model for persons' measurements. Properties describing the person "as a whole" are key outcome variables in Medicine. This is particularly true in Physical and Rehabilitation Medicine, targeting the person's interaction with the outer world. Such variables include independence, pain, fatigue, balance, and the like. These variables can only be observed through behaviours of various complexity, deemed representative of a given "latent" person's property. So how to infer its "quantity"? Usually, behaviours (items) are scored ordinally, and their "raw" scores are summed across item lists (questionnaires). The limits and flaws of scores (i.e., multidimensionality, non-linearity) are well known, yet they still dominate the measurement in Medicine. Conclusions: Through Rasch's theory and statistical analysis, scores are transformed and tested for their capacity to respect fundamental measurement axioms. Rasch analysis returns the linear measure of the person's property ("ability") and the item's calibrations ("difficulty"), concealed by the raw scores. The difference between a person's ability and item difficulty determines the probability that a "pass" response is observed. The discrepancy between observed scores and the ideal measures (i.e., the residual) invites diagnostic reasoning. In a companion article, advanced applications of Rasch modelling are illustrated. Questionnaires' ordinal scores are poor approximations of measures. The Rasch analysis turns questionnaires' scores into interval measures, provided that its assumptions are respected. Thanks to the Rasch analysis, accurate measures of independence, pain, fatigue, cognitive capacities and other whole person's variables of paramount importance in rehabilitation are available. The current work is addressed to rehabilitation professionals looking for an introduction to interpreting published results based on Rasch analysis. The first of a series of two, the present article illustrates the most common graphic and numeric outputs found in published papers presenting the Rasch analysis of questionnaires. [ABSTRACT FROM AUTHOR]

In the health professions, altruism is a foundational value upon which professional privilege is built. This imperative towards self-sacrifice for the benefit of others is a key component of what it means to be professional. This paper explores how altruism operates as a coded mechanism of exclusion and oppression for disabled health professionals. Analysis is based on interviews with fifteen Canadian disabled healthcare professionals in medicine, nursing, occupational therapy, and social work about their experiences of inclusion and exclusion. Themes including the disproportionate sacrifice of time, resources, and income emerged, as did the need to manage political disclosure, often embodying the role of the 'super-crip' with patients/clients and colleagues so as to maintain others' faith in their professional competence and their professional privilege. Further discussion includes questions of how to 'crip' altruism as a professional value and the role of altruism as an ableist force within the health professions. Altruism, the idea of helping others even at cost to oneself, is an important value for health professionals. Disabled health professionals sacrifice more than non-disabled healthcare professionals to meet this obligation. Disabled healthcare professionals may work without accommodations, putting in extra time and effort to prove their altruism. Disabled healthcare professionals experience that disclosing disability may mean their colleagues will treat them as patients. [ABSTRACT FROM AUTHOR]

Reformist doctors in Thailand have combined to create a primary health care system in rural areas in which village health volunteers play a major role. Consistent with the WHO whole-of-society approach, these doctors have envisaged a decentralised system that emphasises volunteers as community oriented, self-reliant agents of change. Our ethnographic research in Chiang Mai, Thailand, reveals that these ideals of village health volunteer empowerment have not been realised. Rather, village health volunteers have become entrapped in a hierarchical, top-down health bureaucracy that affords them limited deliberative agency. We argue that this predicament reveals a conflict of paradigms between, on the one hand, an idealised holistic, spiritual dimension of health with village health volunteers as dedicated, self-sacrificing agents of local communities and, on the other hand, the imperatives of state authoritarian interventions in the avian influenza and COVID-19 pandemics, including rigorous public health protocols and epidemiological methods. [ABSTRACT FROM AUTHOR]

This essay reveals the intersection of medicine and proselytization as "salvific" activities and "tools of empire" in the missionary account of the Scottish physician, missionary, judge, and emissary of the Jewish Committee of the English Presbyterian Church, Robert Kerr. In the latter's account, Pioneering in Morocco: A Record of Seven Years' Medical Mission Work in the Palace and the Hut (1894), Kerr positions himself as a philanthropist who saves Moroccans from diseases and barbarity through medicine and the Gospel – two efficient colonial instruments. Kerr treated a significant number of patients, particularly in the region of Rabat and Salé, diagnosing their illnesses and checking their bodies for the sources of their ailments. As a practice, this colonial medicine is a form of epistemological colonization of the body, through the assertion of "western" medicine's superiority over indigenous healing. By checking Moroccan bodies, a peculiar, colonial vision, which is hinged on hegemonic surveillance, is transposed onto them. Kerr's emphasis on knowledge as the sole key to improvement and transformation as well as on his colonially informed ideas posit a shift from primitivism, decadence, and superstition to modernity, progress, and rationality through his western medical practice. The essay therefore tackles the relational thread and interplay between medicine, religion, and imperialism in precolonial Morocco. [ABSTRACT FROM AUTHOR]