Medicine - Mathematics & History

'We now come to the input of mathematics into medical history, and to the related questions of arithmetic and quantification, ratio and proportion, geometrical argument and diagrams, and probability. Mathematics (consisting in arithmetic, geometry, astrology and music) had an established place in the quadrivium of the medieval arts course; its application to medicine is demonstrated in such textbooks as the Articella, which include treatises on weights and measures, and in studies of proportion and ratio such as those of the medieval Oxford calculators which Italian doctors among others caused to be revived at the beginning of our period. In the sixteenth century, it was a vigorously debated subject; there is a well-documented discussion of the certainty of mathematics, concerning its status in respect to the logical adequacy of its proofs, in which some natural philosophers and doctors (notably Cardano) take part. It will come therefore as no surprise that it was prescribed for doctors by most Renaissance pedagogical writers;  this prescription is often specifically linked to Galen's geometrical (axiomatic) method whose operations are the constitution of objects from elements, the comparison of existing objects and their reduction into their constitutive elements.

Associated with mathematics are diagrams, that is, abstract quantified spatial representations. There is a modern debate about the contribution of technical innovations in illustration in the Renaissance (most notably perspective) to the scientific revolution: this is only relevant here insofar as some participants in this debate argue for the importance of diagrammatic symbolisation of mental abstractions above those, like perspective, which are still representations of the real world, and see the former as a step on the path to full algebraic notation of geometry. Not all Renaissance thinkers were persuaded of their usefulness: Argenterio describes the diagrams of Manardo and Akakia reproduced below as 'vain and false tables and figures'; but I shall argue here that they were related to the uptake of doctors from the arts course insofar as well-known logical diagrams reproduced above (4.3:3) were adapted by them for their own purposes.' pp.171-172.

Maclean, Ian. 2002. Chapter 5, Beyond logic: geometry, proportion, quantity. In Logic, Signs, and Nature in the Renaissance: The Case of Learned Medicine. Cambridge/New York: Cambridge University Press.

Related to ongoing reading, Maclean provides two (among several) historical illustrations (with apologies for the quality) on pp.174-175, the first is from the Wellcome Collection:

Dubois, Jacques, 1478-1555 (Boe͏̈, Jacques, Bois, J. d., Boë, J., del, Boë, J., Del Boë, J., DelBoe͏̈, J., . . . Sylvius/de Bois). (1548). Methodus sex librorum galeni in differentiis et causis morborum et symptomatum in tabellas sex ordine suo conjecta paulo fusius ne brevitas obscura lectorem remoretur & fallat. de signis omnibus medicis, hoc est salubribus, insalubribus, & neutris, commentarius / ... per jacobum sylvium ..Paris: Retrieved from https://www.proquest.com/books/methodus-sex-librorum-galeni-differentiis-et/docview/2090356749/se-2

Jacobus Sylvius, 1539

Which Maclean then translates / interprets (p.174):

Maclean. Figure 5.1, p.174.

'Manardo goes further, and causes and symptoms adapts the square of contraries to represent not only all the possible combinations of temperaments (combinations of cold and hot and wet and dry are cleverly excluded) but also inserts a mediate point to represent the absolutely temperate body: see fig. 5.2.
This adaptation of the square of contraries (which has precedents in the medieval period) shows the appropriation for their own use by doctors of the logical instruments at their disposal.

As we have seen, it is a feature of medical thinking to take into account many circumstantiae or variables, and, over time, the numbers of variables taken into consideration increases.' p.174-175.

Figure 5.2 Giovanni Manardo, p.175.

individual

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INTERPERSONAL : SCIENCES             

humanistic ------------------------------- mechanistic

SOCIOLOGY : POLITICAL   

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group

quality logic	quantity past - present - future diagrams symptoms - signs
subjective	objective

Previously: 'medicine' : 'history' : 'diagram'

WPA/IACAPAP Global Curriculum Survey

Dear Neil et al.,

Would it be possible to recirculate this invitation to complete this ~5minute survey.

We recevied a good response (~200 with 72% expressing interest to join future steps) from the last round but we could have had more representation from Oceana, the Carribean, the Mediteranean, Central Asia, Russia, and perhaps more from any areas as emphasized in line 3 below.

Thank you in advance for your consideration, David
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Dear Colleagues, Families, Relatives, Young Adults, Adults, and Friends!

Anyone affected or who knows someone who is affect by a mental health problem.

We need your help, especially from those living in remote urban or rural areas, or otherwise underserved regions anywhere in this wide world!

HELP US DESIGN A GLOBAL CHILD AND ADOLESCENT MENTAL HEALTH, PSYCHIATRY AND ALLIED PROFESSIONS TRAINING CURRICULUM FRAMEWORK IN SUPPORT OF LOCALLY INTEGRATED COMMUNITY AND FAMILY-CENTERED EDUCATION AND ACTION.

The International Association for Child and Adolescent Psychiatry and Allied Professions (IACAPAP)

and

The World Psychiatric Association (WPA) Child and Adolescent Section are developing the Global Child and Adolescent Psychiatry and Mental Health Training curriculum FRAMEWORK.

To complete a short DESIGN feedback and ENGAGEMENT survey (~5 Minutes)

Click or Copy and Paste the following URL: https://forms.cloud.microsoft/r/x4MyX0MkYt

Here is A SHORT INFORMATIONAL VIDEO: https://www.youtube.com/shorts/NdMRqb1LVVM

 

HIFA profile: David Cawthorpe is Adjunct Professor, Cumming School of Medicine, Department of Community Health Sciences; Adjunct Professor, Cumming School of Medicine, Department of Psychiatry | Child and Adolescent Psychiatry; and Child Health & Wellness Researcher, Alberta Children's Hospital Research Institute, Canada. 
https://profiles.ucalgary.ca/david-cawthorpe cawthordATucalgary.ca

My source: HIFA.

Revisiting "patient career"

Almost a decade ago I posted:

Medical Sociology: The Importance of 1894....2015 patient career - health career

- which was prompted by:

McKinlay, J.B. (1971) The concept “patient career” as a heuristic device for making medical sociology relevant to medical students. Social Science and Medicine, 5(5), 441-460.

https://pubmed.ncbi.nlm.nih.gov/5160599/

McKinlay's abstract reads:

Abstract

Increasingly it is being suggested that the behavioural sciences can contribute to medical education and should be incorporated into the medical curriculum. Evidence for the development of this view in Great Britain can be found in the recommendations of the recent Royal Commission on Medical Education and the submissions of various bodies to it. Given that the behavioural sciences in general and medical sociology in particular, can contribute in a positive way to the medical curriculum this paper attempts to: (a) draw together and crystallize some of the major problems inherent in past attempts to organize and include the behavioural sciences in the medical curriculum; (b) devise some criteria for determining the behavioural science content of the medical curriculum; (c) outline and discuss one possible course in medical sociology utilizing, as an organizing framework, the concept “patient career”.

Brian Hodges created his eponymous model with curriculum planning, design and development as a key purpose. In the early-mid 1980s nursing was looking forward to becoming a degree, undergraduate course of study.

McKinlay's use of 'patient career' (and others) can obviously be associated with the impact of life chances upon a person's health career. 

Individual

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      INTERPERSONAL    :     SCIENCES               

HUMANISTIC  --------------------------------------  MECHANISTIC      

 SOCIOLOGY  :    POLITICAL 

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Group

'While discussing the relationship between the medical and social sciences, and the role of the social scientist in teaching and research in medicine, Butler groups the range of medical topics which have been studied sociologically into four main categories [l4]. These are, the sociology of illness, the sociology of health, the sociology of medical care and the sociology of healing.' p.443.^

McKinlay sees these categories as too comprehensive. Although within the SOCIOLOGICAL domain of Hodges' model this is a 'start'? McKinlay proceeds to identify specific difficulties presented to educators, which include (in summary and with my emphasis):

'(a) The failure to identify needs, specify objectives and devise criteria

(b) The failure to distinguish between perspectives

'Very generally, the behavioural sciences can be said to be conccrned with the description and explanation of the health and illness behaviour of groups and social categories, whilst medicine (especially clinical medicine) aims at the understanding and successful treatment of individual patient cases. By working exclusively on the basis of (or failing to take account of) these separate perspectives, meaningful dialogue between behavioural scientists and medical students has been made extremely difficult.'

(c) The failure to distinguish the audience

(d) The failure to take account of temporal location

(e) The failure to provide a conceptual framework

Most courses in the behavioural sciences either offered or proposed, to a greater or lesser extent, tend to ressemble a sort of shopping list. For example, the courses offered by Badgley, Martin et al., and those proposed by the Society for Social Medicine and the Royal Commission all reflect this "'shopping list" charactcristic. After working down the list it is assumed that students will have the technical goods required. It is, of course, difficult for students undertaking these "shopping list" courses to reflect on where they have been, appraise their current position, or consider where they may be going.

Two further general problems seem to be inherent in many of the attempts to systematize the field of medical sociology, and to some extent are associated with some of the problems already outlined. 

(f) The problem of trying to cover too much [Which lists 18 topics for 2nd year students.]
 (g) The problem of omitting important areas' pp.443-445.

McKinlay then, is similarly preoccupied with the curriculum (for medical students):

'This section is concerned primarily with devising criteria which, given the finite amount of teaching time available, will offer some guidance in determining what aspects or areas of medical sociology should be given priority for teaching in the medical curriculum.' p.445.

This work from the 1970s surely invites reflection upon the meaning of 'progress'? 

^My formatting.

More to follow...?

Ethics and the 'big picture'

'It has been my experience that many of the most successful and creative heads of major research labs around the country came to their place from other disciplines. For example, one prominent geneticist that I know has his Ph.D. in chemistry. He told me that coming to genetics from outside the discipline gave him an awareness of structures and values that were invisible to those laboring inside the established system. Much as one has critical insights into the ambience of a city or culture when one comes from outside as a foreigner, so also is there critical understanding of academic disciplines. Thus, one response to the add-on question is to reply that the material you are providing can make your students better scientists by giving them a more global, contextual perspective. A global, contextual perspective allows one to consider divergent research designs that approach a problem in many directions. This is sometimes called "big picture" thinking. Part of the big picture includes other scientific contexts. For example, biology is seen in the context of chemistry, and chemistry is seen in the context of physics. But it is more than that. It also includes values. Should I, as a scientist, pursue all questions with the same vigor? Are there some questions that should be avoided because of the social consequences of their results? Is the scientist compelled to think in terms of helping humankind or helping himself to a Nobel Prize in any way he can? All of these involve values and ethics. They are critical components to global big picture thinking. Such a perspective is a valuable tool for anyone seeking excellence in scientific research.' p.28.

Boylan, M., & Donahue, J. (2003). Ethics across the curriculum : a practice-based approach. Lexington Books. 

INDIVIDUAL

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INTERPERSONAL : SCIENCES              

humanistic ------------------------------- mechanistic

SOCIOLOGY : POLITICAL   

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GROUP

PERSONAL ETHICS INDIVIDUAL INTEGRITY MY EXPERIENCE MY REFLECTIONS INTERSUBJECTIVITY PURPOSE BELIEFS CHARACTER EDUCATION PROFESSIONAL EDUCATION

PROCESS OBJECTIVITY FACTS  EMPIRICISM 'We define ethics as the process of reflection on the moral meaning of actions.' p.5. 'BIG PICTURE' PROFESSIONAL EDUCATION

PRACTICE COMMUNITY OF PRACTICE ETHOS^ (Chap. 6) 'Ethics is not a discrete body of knowledge that one simply acquires for application and use in particular situations. It entails the ongoing appropriation of ideas of the good as they relate to the changig situations, contexts, and developments in individuals and groups lives. ^ Ethics reflects on actions the actions of individuals and groups.' p.5.

PROFESSIONAL BODIES PROFESSIONAL STANDARDS PROFESSIONAL & COMMERCIAL - ACCOUNTABILITY PROFESSIONAL ETHICS DUTY OF CARE POLICY LAW JUSTICE autonomy; nonmaleficence; beneficence; justice*

^Stackhouse, M. (1972) Ethics and the Urban Ethos: An Essay in Social Theory and Theological Construction, Boston: Beacon Press. (Chap. 6, Boylan & Donahue)

*Beauchamp, T. L., & Childress, J. F. (2013). Principles of biomedical ethics (7th ed.). Oxford University Press. (Chap. 6, Boylan & Donahue)

Funded PhD in Empathic Healthcare (the only one in the world!)

 Artificial Empathy

Qualification: PhD



Department: School of Healthcare

Application deadline: 7 April 2024

Start date: 23 September 2024

Overview (referenced - see main)

Supervisors

Professor Jeremy Howick (jh815 AT leicester.ac.uk)
Dr Josie Solomon
Dr Amber Bennett-Weston

 
Project description

Empathic healthcare improves patient quality of life and satisfaction with their care while reducing their pain.1,2 Higher levels of practitioner empathy are also associated with lower mortality among diabetic patients.3 Empathy can also reduce practitioner burnout.4,5 Despite its importance, the extent to which patients report that their practitioners are empathic varies widely,6 and medical student empathy appears to decline throughout medical school.7 To address this problem, the Stoneygate Centre for Empathic Healthcare are developing and implementing a revolutionary evidence-based empathy curriculum to the Leicester Medical School, and also to healthcare professionals in the NHS and beyond.

Aims

To develop, deliver, and evaluate research-based educational empathy interventions to medical students and healthcare professionals. 

[NB: While hosted in a medical school, this is not a medical education project per se. The PhD candidates will focus on the research to underpin an evidence-based curriculum.]

continued ...

My source and image:

https://x.com/Empathy_Centre/status/1760690291726762402?s=20