bluuebunny/crossref_metadata_2025 huggingface dataset:
Sources and the Enforcement of International Law
Authors: Tzanakopoulos Antonios , Methymaki Eleni
Published: January 2018

This chapter examines the role of domestic courts in the ideal continuum commencing from sources and ultimately ending in the enforcement of the law in a specific case. It asks whether domestic court decisions are a cause (source) or an effect (enforcement) of international law. The chapter argues that the enforcement of international law is reflexive, rather than reactive. There is thus no real continuum, with domestic courts occupying this or that position on it. Rather, domestic court decisions are both part of the cause and of the effect of international law. The enforcement of a rule of law in a specific case constitutes, in accordance with the sources doctrine, yet another brick in the wall of that same ever-changing rule. And given the increasingly important position that domestic courts are assuming in the enforcement of international law, they become ever more important agents of the development of that law.
Sources of International Human Rights Law
Authors: Besson Samantha
Published: January 2018

This chapter discusses the sources of international human rights law (IHRL) in the light of general international law scholarship. It addresses the question of the autonomy of IHRL as a self-contained regime of international law and, accordingly, that of the ‘generality’ of general international law in respect of sources. It argues that there are at least three features of IHRL that account for their specificities in terms of sources and are reflected thereby. These are: their dual moral and legal nature as rights, and the corresponding objectivity that characterize some of their sources; their dual domestic and international legality as legal rights, and the corresponding transnationality of some of their sources; and their universality as moral and legal rights, and the corresponding generality of some of their sources. Finally, the chapter tackles the distinctiveness of the sources of IHRL and draws some implications for the sources of international law in general.
Sources of International Organizations’ Law
Authors: Reinisch August
Published: January 2018

This chapter notes that for a considerable period, international organizations scholarship was preoccupied with establishing international organizations as actors enjoying their own international legal personality. With the increase and diversification of tasks fulfilled by such organizations, the question has come to the fore as to what extent these subjects of international law may become responsible for their actions. This debate has overshadowed the underlying and more fundamental question of what kinds of obligations can be identified as binding upon international organizations. According to this chapter, the latter central question requires one to turn to the sources of international organizations’ law. It places special emphasis on the practical implications of identifying the right sources for accountability issues, whether they concern UN embargoes, targeted sanctions, peacekeeping, or the administration of (criminal) justice by international organizations.
Sources of International Investment Law
Authors: Viñuales Jorge E.
Published: January 2018

This chapter addresses the challenges posed by the practice of international investment law to the conventional theory of the sources of international law. After a brief overview of the main ‘sources’ of ‘international investment law’, the chapter examines three challenges to this basic understanding, which arise from the need to account for the domestic laws governing different aspects of foreign investment transactions, the detailed jurisprudential norms generated by investment tribunals to specify broadly formulated norms, and the norms of general international law expressing the sovereignty of the State. For each category of norms, the chapter selects several problems that put the most widely accepted understanding of the sources of international law to test. It then explains why the problems examined have potentially important practical implications. The chapter concludes with some observations on the interactions between practice and the theory of the sources of international law.
Implication of Terms
Authors: McMeel Gerard
Published: January 2018

This chapter considers the implication of terms. It first looks to the general principles of the implication of terms, noting that courts have resorted to implied terms even in the context of very elaborate contracts in writing. The chapter then considers how implied terms are used in the context of law, showing that it is easier to state the law in terms of what terms have been implied in law, by reference to statutory codification or authoritative appellate judicial pronouncements, than to provide practical guidance on when the courts will identify a new implied term in law in the future. However, in order to illustrate the scope and flexibility of the technique, a few representative common law and statutory examples are introduced in this chapter. Next, the governing principles for implying new terms at law are considered.
Common Assumptions, Estoppel by Convention, and Estoppel by Deed
Authors: McMeel Gerard
Published: January 2018

This chapter mainly focuses on estoppel by convention, although it also briefly considers estoppel by deed. Where two parties arrive at a common understanding of their relationship the doctrine of estoppel by convention may preclude them from subsequently departing from the terms of that understanding where it would be unconscionable to do so. Such a result may substantially alter or contradict any prior agreement or arrangement between the parties, whether or not contained in a written instrument. It represents a major qualification of, or departure from, orthodox principles of the law of contract. The doctrine of estoppel by deed, meanwhile, precludes the maker of the deed from denying the truth of any matter which they have so asserted.
The Status of Instruments
Authors: McMeel Gerard
Published: January 2018

This chapter considers two special doctrines: first, the ancient rule which discharges a contract by operation of law if it is materially altered, commonly known as the rule in Pigot's Case; secondly, non est factum. It begins with a discussion of the impact of forgery on a document, as a forged document is a legal nullity. The chapter then turns to the above-mentioned doctrines in more detail, by first exploring the original formulation of the deliberate alternation of instruments in Pigot's Case before discussing the modern scope of the rule. Next, the plea of non est factum (‘this is not my deed’) is then examined. Finally, the chapter considers the principles which apply where a document is alleged to be a ‘sham’.
The International Sale of Goods
Authors: Bridge M G
Published: January 2018

The fourth edition of this text on all aspects of international trade law has been updated to incorporate and analyse the major recent developments, both in English law and contracts under the United Nations Convention on Contracts for the International Sale of Goods (CISG). As well as contract law, the book also covers property matters and addresses those issues which arise from the use of documents of title, such as marine bills of lading. There is extensive treatment of the rights and duties of both the buyer and the seller, and sale contracts are considered alongside other contracts such as charter parties and letter of credit contracts. The CISG material has been significantly developed in this fourth edition and there is more extensive treatment of such matters as remedies, passing of property, standard form contracts, and the international dealing of commodities. The major developments in the case law are examined, most notably further developments on interpretation and implied terms in the Supreme Court, bunkers litigation, and the implications for the compensatory principle following the Supreme Court decision in Bunge SA v Nidera NV (2015).
Bills of Lading and Documents of Title
Authors: Bridge M G
Published: January 2018

This chapter discusses the notion of the bill of lading as a document of title, before undergoing a legislative treatment of the subject as a whole. It had been decided in the eighteenth century, in recognition of mercantile custom to this effect, that the ocean bill of lading was a negotiable document of title. In consequence, the due negotiation of it by the seller to the buyer could transfer the property in the underlying goods. More importantly, it meant that constructive possession could be transferred and that the carrier had to deliver the cargo to the new holder (subject to any lien for unpaid freight) and could not plead that, without attorning directly to the new holder, they might not be made to do so. The new holder acquired the right to immediate possession and thus the necessary standing to maintain a tort action against the carrier.
Formation and Performance of the Contract
Authors: Bridge M G
Published: January 2018

This chapter discusses the differences in the formation and performance of the contract between the Sale of Goods Act and the CISG. The differences between English law and the CISG are various. They include, first, rules in the CISG that have no counterpart in English sales law. They also include rules that on the face of it differ from their English equivalents, rules that appear to accord with English law but on closer inspection may depart from it, and rules in English law that are not to be found in the CISG. The chapter pays attention to the form in which the contractual agreement may be expressed, to the incorporation of standard terms in the contract by reference to an external source, to the question whether and to what extent all communications passing between the parties constitute part of the contract, and to the interpretation of the contract itself.
Introduction
Authors: Hayk Kupelyants
Published: January 2018

The introduction sets the scene for the examination of sovereign defaults. It sets the structure of and the methodology employed in the book. It provides a summary overview of sovereign debt crises, ensuing restructurings, and litigation. It also introduces the reader to the debate about the legitimacy of litigation against impecunious sovereign debtors.
3 Jurisdiction and Cognate Matters
Authors: Hayk Kupelyants
Published: January 2018

Chapter 3 examines the international jurisdiction in sovereign debt disputes and particularly the following matters: service of proceedings; the jurisdiction under the Brussels Regulation, the jurisdiction under English national rules; individual standing of beneficial bondholders; class actions. The chapter also examines the issue of pre-emptive strikes in sovereign debt litigation, in other words whether private creditors may initiate legal actions before the conclusion of the sovereign debt restructuring and how courts may constrain such litigation. The chapter argues that the English courts may stay proceedings if they are brought in contravention of the powers of bondholders under majority action clauses. The chapter lastly addresses the issue of whether the majority may modify the bonds after the English court has issued a judgment.
Office of the United Nations High Commissioner for Refugees
Authors: Higgins Rosalyn , Webb Philippa , Akande Dapo , Sivakumaran Sandesh , Sloan James
Published: January 2018

The Office of the United Nations High Commissioner for Refugees (UNHCR) was established by the General Assembly in 1950. UNHCR was initially created for a provisional period of three years, its being provided in the Statute that the arrangements for the Office were to be revisited at the eighth regular session of the General Assembly ‘with a view to determining whether the Office should be continued beyond 31 December 1953’. Between 1953 and 2003, the mandate of the UNHCR was extended periodically, for a period of five years at a time, making it more difficult for it to engage in long-term planning of its work. Only in 2004 did the General Assembly remove the temporal limitation attached to the UNHCR, authorizing the continuation of the Office ‘until the refugee problem is solved’. This chapter discusses the UNHCR’s position within the UN system, its structure, location, mandate, and role.
Protecting the Environment
Authors: Higgins Rosalyn , Webb Philippa , Akande Dapo , Sivakumaran Sandesh , Sloan James
Published: January 2018

The United Nations (UN) has taken action to protect the environment despite the absence of any explicit mention of the environment or its protection in the UN Charter. The UN has ‘played a pivotal role as a framework for developing environmental decision-making’. It has also ‘contributed to many of the principles of environmental law’, including the polluter-pays principle, the notion of common differentiated responsibilities, and the precautionary principle. This chapter discusses the work of the principal organs, including the General Assembly, Security Council, Economic and Social Council, and International Court of Justice; the work of the specialized agencies; institutional arrangements of multilateral environmental agreements; and the United Nations Environment Programme.
Osteoporosis
Authors: Shepherd Angela J. , Mckee Juliet M.
Published: January 2018

Osteoporotic fractures are major causes of suffering and death. Dual-energy x-ray absorptiometry (DEXA) is the standard of care for diagnosis (T-score ≤ –2.5) of osteoporosis. Prevention of fractures requires addressing bone and muscle strength and balance. Physical exercise, good nutrition (fruits, vegetables, adequate calcium), adequate vitamin intake (C, D, and K), tobacco cessation, and no more than moderate alcohol intake enhance bone health and decrease fracture risk. Long-term treatment with glucocorticoids, certain drugs used in breast or prostate cancer treatment, and proton pump inhibitors used for gastroesophageal reflux disease may increase the risk for osteoporosis. Pharmacologically, bisphosphonates are the mainstay of osteoporosis treatment.
Integrative Geriatric Psychiatry
Authors: Glick Ronald , Gebara Marie Anne , Lenze Eric
Published: January 2018

Psychiatric disorders, most prominently anxiety disorders and depression, are common among older adults and are associated with significant morbidity and impact on quality of life. Standard approaches, including pharmacotherapy and psychotherapy, are helpful for many patients, but treatment resistance and incomplete response are common. Complementary and integrative approaches have the potential to augment the response to traditional treatments. This chapter provides a background on the evaluation and management of these disorders. Treatment considerations focus on mind–body and biological approaches, with the latter including the informed use of nutritional supplements and two whole-systems approaches.
Common Rheumatic Diseases in the Elderly
Authors: Manek Nisha J. , Muñoz George
Published: January 2018

With increasing longevity, the prevalence and impact of rheumatic diseases are projected to rise dramatically in the coming decades. Common rheumatic diseases such as osteoarthritis typically arise among the elderly. For diseases such as rheumatoid arthritis and gout, patients diagnosed at earlier ages carry the burden into their later years. Gout is associated both with comorbid conditions whose prevalence rises with age as well as with medications commonly prescribed in older people. These factors, along with the unique challenges associated with optimal diagnosis and treatment of arthritides in the elderly, suggest we can expect a “perfect storm” of health challenges for older patients and their health care providers. The chapter reviews the most common rheumatic diseases in geriatric patients and the evidence base for complementary and integrative therapies. In most cases, a multidisciplinary approach is beneficial.
Interprofessional Team-Based Care
Authors: Lunsford Beverly , Mikovich Terry A.
Published: January 2018

As older adults live longer, they experience a concomitant increase in chronic illness, which may be associated with a more frequent need for health care and intermittent or progressive functional decline. There is an increased need for regular health care monitoring as well as treatment and coordination of care among multiple providers and across settings to prevent, delay, or minimize decline in health and quality of life. Interprofessional collaboration is critical for safe coordination of care, reduction of duplication in services, and cost containment. Health care professionals who serve older adults are developing new models of collaboration to provide more integrated and person-centered approaches to maintaining the quality of life for older adults, especially those with multiple chronic illnesses. These models include health-oriented teams, home and community-based services, Acute Care for Elders (ACE), home-based primary care, Program of All-Inclusive Care for the Elderly (PACE), comprehensive geriatric assessment, and palliative care teams.
Hepatitis C Virus
Authors: Honegger Jonathan R.
Published: January 2018

An estimated 185 million individuals have been infected with hepatitis C virus (HCV) worldwide. Although often clinically silent for decades, chronic HCV infection predisposes to late-onset complications, including liver cirrhosis and hepatocellular carcinoma. Mother-to-child transmission (MTCT) of HCV affects approximately 5% of children born to viremic mothers and is the primary route of HCV infection in young children. While some vertically acquired HCV infections are resolved during the first years of life, many persist indefinitely. Chronically infected children tend to be asymptomatic and have mild liver disease, but they face a risk of progression to advanced liver disease in adulthood. Current diagnostic and management strategies leave most infected children undiagnosed and untreated. Widespread use of newly-available direct-acting antiviral therapies has the potential to substantially reduce the global burden of HCV, including vertically acquired HCV, but an effective vaccine likely will be required to achieve this ultimate goal.
Hepatitis E Virus
Authors: Krain Lisa J. , Nelson Kenrad E.
Published: January 2018

Hepatitis E virus (HEV) poses serious risks to pregnant women and their developing fetuses, including increased risk of pregnancy loss, stillbirth, preterm delivery, and early infant death. Supportive care is currently the standard treatment for pregnant women with HEV infection, but in some cases, ribavirin treatment or early delivery may be indicated. Infants born with acute HEV infection face increased risk of complications and death. Intensive monitoring and support may be required in the neonatal period, particularly for preterm infants. Infants who survive the early neonatal period are likely to recover fully and clear the virus. Immunoassays and molecular methods for diagnosis of HEV have improved markedly over the past decade. New HEV vaccines may provide an opportunity to prevent both maternal illness and mother-to-child transmission (vertical transmission) (MTCT).
Varicella-Zoster Virus
Authors: Picone Olivier , Vauloup-Fellous Christelle , Mandelbrot Laurent
Published: January 2018

Chickenpox in a pregnant woman is uncommon, but it is a major concern for patients and their families, as well as for clinicians caring for pregnant women. Varicella infection during pregnancy is usually benign, but there can be serious consequences for both mother and child. Notably, fetal varicella syndrome (FVS) can happen when infection occurs before 21 weeks of gestation. It can present with serious neurological anomalies and unusual cicatricial skin lesions. Later in pregnancy, primary neonatal varicella may occur when the mother is infected in the peripartum period, and it can be life-threatening. The complications of varicella during pregnancy are reviewed, with an emphasis on early recognition, accurate timing of infection, and risk to the developing fetus and newborn infant. The impact of varicella vaccine on the epidemiology of these infections is reviewed, as well as indications for varicella-zoster virus (VZV)–specific immune globulin and antiviral therapy with acyclovir.
Values and Pluralism in Psychiatry
Authors: Peteet John R.
Published: January 2018

Psychiatry belongs to both science and the humanities, but it has often been more concerned with being evidence based than value based. One consequence has been the unacknowledged acceptance of values prevailing in the culture. Another, despite growing attention to ethical concerns, has been the lack of a clearly articulated set of values with which to approach the complexities of clinical work. Four core values—prevention and treatment of disease, patient centeredness, relief of suffering, and enhancement of functioning—can be seen to emerge from psychiatry’s roots in humanistic medicine. Each of these values needs to be counterbalanced by the others and interpreted from the perspective of the clinician’s and the patient’s spiritual or religious worldview. Together, they offer a rationale for assessing the patient’s disorder, chief concern, and prerequisites for flourishing. In this chapter, three vignettes illustrate the utility of these core values in approaching challenging clinical cases.
Theological Ethics Relevant to Mental Health and Psychiatry
Authors: Grossoehme Daniel H. , Dell Mary Lynn
Published: January 2018

This chapter defines several commonly used terms in discussions of world religions, spirituality, and the contributions to and overlapping concerns of theological ethics and bioethics. Brief summaries of six major world faith traditions are offered, including historical origins, demographic information, basic theological tenets, and key themes in the religions’ ethics. Attitudes and beliefs about life, illness, suffering, medical care, end of life, and mental health care are discussed. Points at which theological ethics inform use of the Jonsen Four Topics Model are reviewed. Readers are provided a list of resources for additional reading and study at the intersection of theological and medical ethics. Although this chapter is not intended to be an exhaustive review of major world faith traditions, readers are reminded that understanding aspects of the religious and spiritual traditions and their imperatives for living may be of great importance to patients and their ethical decision making.
Child and Adolescent Psychiatry
Authors: Kessler Carol L. , Dell Mary Lynn
Published: January 2018

The clinical issues at the interface of ethics, religion/spirituality, and child and adolescent psychiatry are limitless. This chapter seeks to help fill the void in the literature concerning ethics, religion/spirituality, and child mental health in a way that is most helpful to practicing clinicians struggling with these issues in their daily clinical contacts. Three specific areas are addressed that commonly present challenges: (1) religious/spiritual objections to psychiatric care; (2) ethical issues surrounding the clinician’s relationship with children and families; and (3) ethical issues that may arise when mental health clinicians work with religious/spiritual professionals and institutions. Implications of religious and cultural diversity for both patients and clinicians are also discussed throughout the chapter.
Spirituality, Ethics, and People with Intellectual Disabilities
Authors: Gaventa William , Dell Mary Lynn
Published: January 2018

This chapter addresses the spirituality of people with intellectual disabilities with particular focus on those factors that are often critical to understanding their situations and perspectives when ethical topics or dilemmas arise in their mental health care. Basic information on disability and spirituality is provided. Principlism and ethics of care are discussed because these ethical theories are especially suited to enlighten ethical thinking and decision making regarding those with disabilities. Common ways in which spirituality plays out in the lives of people with disabilities are considered. Throughout the chapter, the importance of family and other caregivers is highlighted. Suggestions for mental health providers are offered, and references for additional reading and study are provided.
International Perspectives on Ethical Issues in Religion and Psychiatry
Authors: Sarhan Walid , Fung Wai Lun Alan
Published: January 2018

This chapter provides international perspectives on ethical issues at the intersection between religion/spirituality and psychiatry. It begins by describing international patterns of spirituality and religion, then discusses the role of professional ethics in psychiatry from an international perspective and the stances of various professional psychiatric associations on the topic. These are illustrated by the case example of terrorism, including suicide and religious terrorism. The chapter also discusses ethical considerations regarding the intersection between religion/spirituality and traditional beliefs & cultures, which are illustrated by the case example of ethics and healing in ancient China and India. The importance of a global ethic and various international attempts at its development are discussed. Several clinical vignettes illustrate these ethical challenges in an international context. The chapter concludes with a discussion of the challenges in developing a global ethic in relation to psychiatry and spirituality/religion.
Ethical Considerations for Mental Health Providers Responding to Disasters and Emergencies
Authors: Thielman Samuel B. , Goss Glenn
Published: January 2018

Ethical considerations in psychiatry may have spiritual dimensions that are not always apparent to mental health providers. The ethical issues faced by responders to disasters and emergencies can be particularly thorny because ethical guidelines from professional bodies frequently do not address particular situations that arise in disaster settings. This chapter discusses the issue of dual agency in disaster situations. It also addresses concerns about psychiatric competencies in disaster response, especially where no guidelines exist. It addresses concerns raised by the need for documentation and confidentiality and discusses the limits of psychiatric explanatory models during times of disaster. Additionally, the chapter reviews ethical and spiritual dimensions of specific psychosocial interventions when used with the general public affected by disasters in non-Western cultural settings.
Pain in Europe
Authors: Eccleston Christopher , Morlion Bart , Wells Christopher
Published: January 2018

There are over 740 million people living in the 37 countries who are members of the European Pain Federation of chapters of the International Association for the Study of Pain. The editors introduce the field of pain management, in particular the work of over 20,000 people in acute (largely injury related) pain, chronic pain including cancer pain management, and palliative care. We then describe how the book European Pain Management is structured. There are three sections: an introduction to the world of pain and the epidemiology of pain. The main section, which is 37 chapters long, reports describing the practice of pain management in each country, the challenges and innovations. And a final section looks at specific issues that cut across all nations, and ends with a concluding analysis of the statue of European Pain Management.
Epidemiology of pain: Its importance for clinical management and research
Authors: Breivik Harald
Published: January 2018

Chronic pain affects at least 20% of the adult population in Europe. Musculoskeletal, abdominal pain, abdominal pain, and headache dominate. About 10% have widespread pain. Women suffer more chronic pain than men. Chronic pain is more common in older persons, in 50% of home-dwelling women, and 60% of women living in nursing homes. Chronic pain increases, with increasing age, and with increasing obesity, and with more patients surviving after treatment for cancer. After injuries and surgical operations new pain develops and persists longer than healing of the surgical wound in about 10%; with 1% developing disabling pain. Apart from sex and age, risk factors that can be reduced by preventive measures are disturbed sleep, psychological stress, depression, and anxiety. Chronic pain costs 2–10% of gross national products of European countries. Epidemiological studies can enable policymakers to provide preventive and therapeutic measures, and research investment to address this suffering.
Albania
Authors: Vaso Apostol
Published: January 2018

Albania is a member of the European Pain Federation (EFIC). The national pain society works to support the needs of patients with pain, including those with acute pain, chronic pain, cancer pain, pain in later life, and at the end of life. In this chapter of European Pain Management we describe first the geography and history of the country as it relates to the recent demographics of the population, the prevalence of pain and needs for pain management, the pain workforce and its organization, the system pain specialists work within, and specific issues that have been tackled to improve the delivery of pain care. An example of recent innovation is also described.
Hungary
Authors: Tajti János , Szok Délia , Szolcsányi János
Published: January 2018

Hungary is a member of the European Pain Federation (EFIC). The national pain society works to support the needs of patients with pain, including those with acute pain, chronic pain, cancer pain, pain in later life, and at the end of life. In this chapter of European Pain Management we describe first the geography and history of the country as it relates to the recent demographics of the population, the prevalence of pain and needs for pain management, the pain workforce and its organization, the system pain specialists work within, and specific issues that have been tackled to improve the delivery of pain care. An example of recent innovation is also described.
Serbia
Authors: Pjevic Miroslava
Published: January 2018

Serbia is a member of the European Pain Federation (EFIC). The national pain society works to support the needs of patients with pain, including those with acute pain, chronic pain, cancer pain, pain in later life, and at the end of life. In this chapter of European Pain Management we describe first the geography and history of the country as it relates to the recent demographics of the population, the prevalence of pain and needs for pain management, the pain workforce and its organization, the system pain specialists work within, and specific issues that have been tackled to improve the delivery of pain care. An example of recent innovation is also described.
Slovenia
Authors: Komar Marija Cesar , Krcˇevski-Škvarcˇ Nevenka , Požlep Gorazd
Published: January 2018

Slovenia is a member of the European Pain Federation (EFIC). The national pain society works to support the needs of patients with pain, including those with acute pain, chronic pain, cancer pain, pain in later life, and at the end of life. In this chapter of European Pain Management we describe first the geography and history of the country as it relates to the recent demographics of the population, the prevalence of pain and needs for pain management, the pain workforce and its organization, the system pain specialists work within, and specific issues that have been tackled to improve the delivery of pain care. An example of recent innovation is also described.
Spain
Authors: Mateos Rafael Galvez , Cajaraville Juan Perez
Published: January 2018

Spain is a member of the European Pain Federation (EFIC). The national pain society works to support the needs of patients with pain, including those with acute pain, chronic pain, cancer pain, pain in later life, and at the end of life. In this chapter of European Pain Management we describe first the geography and history of the country as it relates to the recent demographics of the population, the prevalence of pain and needs for pain management, the pain workforce and its organization, the system pain specialists work within, and specific issues that have been tackled to improve the delivery of pain care. An example of recent innovation is also described.
European pain policy: Challenges and opportunities
Authors: van Rooij Norbert , van Griensven Joop , Votta Mariano , Morlion Bart
Published: January 2018

Pain is not just a personal problem, but a societal problem. In this chapter of European Pain Management we focus on the policy agenda within the European Union and in supporting individual countries within Europe. We review the emergence of national pain strategies which have culminated in the initiative of the Societal Impact on Pain (SIP). The SIP roadmap lays out seven steps to improve the quality of life of people in pain, with a focus on removing barriers to pain treatment, on the need to raise awareness of need, and the provision of training, education, and system reform.
Cosmos in the head?
Authors: Fuchs Thomas
Published: January 2018

‘Cosmos in the head’ contains a criticism of the neuroconstructivist epistemology, according to which phenomenal reality is to be understood as an internal modelling of the outer world in the brain. As it turns out, the idealistic theory of representation is still the basis of this conception. The criticism emphasizes, in contrast, the enactive character of perception which is always connected with the engagement of the body in the world. In order to show that the subjective space of the lived body is not only virtual, its coextension with the space of the objective body or the entire organism is demonstrated. On this basis, the objectifying achievement of perception, which brings us into direct connection with the world by means of circular interactions, can be recognized. Finally, taking the example of colours, the claim of a mere virtuality of perceived qualities is rejected.
Foundations: Subjectivity and life
Authors: Fuchs Thomas
Published: January 2018

‘Foundations: subjectivity and life’ develops the concept of embodied subjectivity, initially grounded in the phenomenology of bodily existence. A central concept for the investigation is the dual aspect of the living person as a dialectical unity of the subjective body and the physical body. The mind–brain problem is therefore reformulated as the ‘subject body–object body problem’ (Leib–Körper problem). Subsequently, an ecological conception of the living organism is developed. This focuses, on the one hand, on a living being’s self-organization and subjectivity and, on the other hand, on its relationship to the environment with reference to metabolism and the sensorimotor cycle. The chapter concludes with an analysis of the specific, circular causality of living systems. This incorporates the concept of capacity as a living being’s holistic, dispositional property, by means of which it becomes the cause of its own enactments of life.
The concept of dual aspectivity
Authors: Fuchs Thomas
Published: January 2018

‘The concept of dual aspectivity’ presents a renewed philosophical examination of the fundamental concept presented in Chapter 3. The unity of the living organism and its enactments of life provides an alternative to the separation of the mental and physical in philosophy of mind. A critical consideration of identity theory further develops this conceptual approach. The concept of integral causality is differentiated in the light of emergence theories, emphasizing the primacy of holistic functions over their components, and the reciprocity of downward and upward causation. The role and function of consciousness as the integral of the organism–environment interaction is discussed in detail. This gives rise to several conclusions regarding the intentional determination of neuronal processes, particular an embodied notion of free will, as well as an explanation of psychophysical interrelations.
Implications for psychiatry and psychological medicine
Authors: Fuchs Thomas
Published: January 2018

‘Implications for psychiatry and psychological medicine’ examines the ecological conception with regard to its consequences for mental disorders and their treatment. After an introduction on current neuroreductionist trends in psychiatry, the chapter develops a concept of mental illness as a fundamentally circular process with a pivotal impact on a person’s self-experience and interpersonal relationships. This dimension is traced as far as aetiology. Psychotherapy and somatic therapy and are then contrasted from the standpoint of dual aspectivity. In summary, an orientation towards embodied subjectivity is shown to be indispensable for psychopathology and psychological medicine.
Conclusion
Authors: Fuchs Thomas
Published: January 2018

The ‘Conclusion’ summarizes fundamental concepts and insights of the book. The brain is presented as an organ of mediation, transformation, and resonance. Its functions are integrated by the living organism as a whole, or by the embodied person, respectively: persons have brains, they are not brains. The deadlocks of the mind–body problem result from a short circuit between mind and brain which follows as a consequence from the systematic exclusion of life. A combination of phenomenological, embodied, and enactive approaches seems best suited to overcome this deficit. In contrast to naturalistic reductionism, this leads to a personalistic concept of the human being which has its basis in intercorporeality: it is in the concrete bodily encounter that we primarily recognize each other as embodied subjects or persons.
Swept-Source Optical Coherence Tomography–Supervised Biopsy
Authors: Xu Qiuyun , Adabi Saba , Clayton Anne , Daveluy Steven , Mehregan Darius , Nasiriavanaki Mohammadreza
Published: January 2018

BACKGROUND

Currently, only skin biopsy can provide definitive histological confirmation for the diagnosis of skin diseases. To improve the diagnostic accuracy and to assist the dermatologist, various imaging techniques have been added to the examination of skin. Among all these techniques, the recent advances in optical coherence tomography (OCT) have made it possible to image the skin up to 2 millimeters in depth.

OBJECTIVE

To testify the feasibility of OCT imaging in skin biopsy, the authors investigated the OCT imaging for real-time visualization of needle insertion and punch biopsy techniques in both a tissue phantom and biological tissue.

MATERIALS AND METHODS

A swept-source OCT with 1,305-nm central wavelength was used in this study. The euthanized mouse was used for real-time visualization of needle insertion. A gelatin phantom with India ink was used to demonstrate the punch biopsy using OCT.

RESULTS

Optical coherence tomography can provide guidance for skin injections as well as real-time imaging to assist in the performance of punch biopsy.

CONCLUSION

Optical coherence tomography holds potential not only as a diagnostic tool in dermatology. It can also allow for visualization for more accurate drug delivery, and noninvasively assess the response to treatment.
Constipation and diarrhea during the menopause transition and early postmenopause: observations from the Seattle Midlife Women's Health Study
Authors: Callan Nini G.L. , Mitchell Ellen S. , Heitkemper Margaret M. , Woods Nancy F.
Published: January 2018

Objective:

To assess the relationship of constipation and diarrhea severity during the menopause transition (MT) with age, MT stage, reproductive biomarkers, stress-related biomarkers, and stress-related perceptions.

Methods:

From 1990 to 1992, women aged 35 to 55 years were recruited from the greater Seattle area; 291 of them consented to ongoing (1990-2013) annual data collection by daily menstrual calendar, health diary, and annual health questionnaire. A subset (n = 131) provided a first morning voided urine specimen (1997-2013). These were assayed for levels of E1G, follicle-stimulating hormone, testosterone, cortisol, norepinephrine, and epinephrine. Mixed-effects modeling was used to identify how changes in constipation and diarrhea severity over time related to age, MT stage, reproductive biomarkers, stress-related biomarkers, and stress-related perceptions.

Results:

In a univariate model, age, late reproductive (LR) stage, tension, and anxiety were all significantly and positively related to constipation severity, whereas cortisol was significantly and negatively associated. In a multivariate model, only tension and cortisol remained significant predictors of constipation severity (P < 0.05). In a univariate model, age, LR stage, and estrone glucuronide were significantly and negatively associated with diarrhea severity, whereas tension, anxiety, and perceived stress were significantly and positively related. In a multivariate model, only tension and age remained significant predictors of diarrhea severity.

Conclusions:

Key reproductive hormones do not play a significant role in constipation or diarrhea severity in the MT. In contrast, stress perception, tension, anxiety, and cortisol do. These factors should be evaluated in further research involving constipation and diarrhea.
Perspectives and decision-making about menopausal therapies in women who had bilateral oophorectomy
Authors: Siyam Tasneem , Ross Sue , Shandro Tami , Hagen Shelly , Battochio Lori , Yuksel Nesé
Published: January 2018

Objective:

The aim of the study was to explore the process of decision-making about menopausal treatments in women who have had surgical menopause as a result of bilateral oophorectomy (≤50 y).

Methods:

We used a descriptive qualitative research design. Women who had a surgical menopause were purposefully selected from the Edmonton Menopause Clinics. Focus groups were held, each with six to nine participants. All sessions were audio-recorded and transcribed verbatim. Data were analyzed using qualitative content analysis.

Results:

We conducted five focus groups from June 30 to July 21, 2016 (N = 37). One-third of the women had the surgery within the last 5 years. Almost all women had a concurrent hysterectomy (97%) and were current users of hormone therapy (70%). Four main themes identified were “perceptions of surgical menopause,” “perceptions of received support,” “being my own advocate,” and “concept of adequate support.” Women shared that the experience was worse than their expectations and did not believe they were given adequate support to prepare them to make therapy decisions. Women had to “be their own advocates” and seek support from within the healthcare system and outside to cope with their health issues. To make an informed decision about treatments postsurgery, women expressed a need to learn more about the symptoms of surgical menopause, treatment options, resources, avenues for support, and stories of similar experiences, preferably before the surgery.

Conclusions:

We identified several modifiable deterrents to decision-making in early surgical menopause which can help inform the development of a patient decision aid for this context.
Comparison of Vaginal Axis in Women Who Have Undergone Hysterectomy Versus Women With an Intact Uterus
Authors: Lee Daniel D. , Siegelman Evan S. , Chua Wynne Y. , Arya Lily A. , Harvie Heidi S.
Published: January 2018

Objectives

To compare vaginal axis and posterior cul-de-sac measurements in women who have undergone hysterectomy and women with an intact uterus.

Methods

This was a retrospective cohort study comparing magnetic resonance imaging findings in women who had undergone hysterectomy with women with an intact uterus. The primary outcome was change in the upper, middle, and lower vaginal axes relative to the pelvic inclination correction system line. Secondary outcomes included angles between the upper-middle and middle-lower vagina, depth of the posterior cul-de-sac, and total vaginal length.

Results

In the hysterectomy group, the middle vaginal axis was significantly more anterior as compared with the intact uterus group (61.3 degrees ± 12.7 vs 49.4 degrees ± 23.6, P = 0.01). The upper-middle and the middle-lower vaginal angles were significantly more obtuse in the hysterectomy group than the intact uterus group (112.3 degrees ± 28.7 vs 69.3 degrees ± 56.6, P = 0.01 and 145.4 degrees ± 13.2 vs 130.9 degrees ± 29.7, P = 0.02, respectively). The mean depth of the posterior cul-de-sac and the total vaginal length were significantly shorter in the hysterectomy group than the intact uterus group (5.5 mm ± 7.6 vs 21.8 mm ± 11.9, P < 0.0001 and 78.7 mm ± 3.9 vs 100 mm ± 15.9, P < 0.001, respectively).

Conclusions

The vaginal anatomy of women who have undergone hysterectomy differs significantly from that of women with an intact uterus.
Fluidigm2PURC: automated processing and haplotype inference for double-barcoded PCR amplicons
Authors: Blischak Paul D. , Latvis Maribeth , Morales-Briones Diego F. , Johnson Jens C. , Di Stilio Verónica S. , Wolfe Andrea D. , Tank David C.
Published: January 2018

Premise of the study

Targeted enrichment strategies for phylogenomic inference are a time- and cost-efficient way to collect DNA sequence data for large numbers of individuals at multiple, independent loci. Automated and reproducible processing of these data is a crucial step for researchers conducting phylogenetic studies.

Methods and Results

We present Fluidigm2PURC, an open source Python utility for processing paired-end Illumina data from double-barcoded PCR amplicons. In combination with the program PURC (Pipeline for Untangling Reticulate Complexes), our scripts process raw FASTQ files for analysis with PURC and use its output to infer haplotypes for diploids, polyploids, and samples with unknown ploidy. We demonstrate the use of the pipeline with an example data set from the genus Thalictrum L. (Ranunculaceae).

Conclusions

Fluidigm2PURC is freely available for Unix-like operating systems on GitHub [https://github.com/pblischak/fluidigm2purc] and for all operating systems through Docker [https://hub.docker.com/r/pblischak/fluidigm2purc].
Partial correlation analysis of transcriptomes helps detangle the growth and defense network in spruce
Authors: Porth Ilga , White Richard , Jaquish Barry , Ritland Kermit
Published: January 2018

In plants, there can be a trade-off between resource allocations to growth versus defense. Here, we use partial correlation analysis of gene expression to make inferences about the nature of this interaction.

We studied segregating progenies of Interior spruce subject to weevil attack. In a controlled experiment, we measured pre-attack plant growth and post-attack damage with several morphological measures, and profiled transcriptomes of 188 progeny.

We used partial correlations of individual transcripts (ESTs) with pairs of growth/defense traits to identify important nodes and edges in the inferred underlying gene network, e.g., those pairs of growth/defense traits with high mutual correlation with a single EST transcript. We give a method to identify such ESTs.

A terpenoid ABC transporter gene showed strongest correlations (P=0.019); its transcript represented a hub within the compact 166-member gene-gene interaction network (P=0.004) of the negative genetic correlations between growth and subsequent pest attack. A small 21-member interaction network (P=0.004) represented the uncovered positive correlations.

Our study demonstrates partial correlation analysis identifies important gene networks underlying growth and susceptibility to the weevil in spruce. In particular, we found transcripts that strongly modify the trade-off between growth and defense, and allow identification of networks more central to the trade-off.