Objective: Neurocognitive impairment is commonly reported at onset of psychotic disorders. However, the long-term neurocognitive course remains largely uninvestigated in first episode psychosis (FEP) and the relationship to clinically significant subgroups even more so. We report 10 year longitudinal neurocognitive development in a sample of FEP patients, and explore whether the trajectories of cognitive course are related to presence of relapse to psychosis, especially within the first year, with a focus on the course of verbal memory. Method: Forty-three FEP (...) subjects (51% male, 28±9 years) were followed-up neurocognitively over five assessments spanning 10 years. The test battery was divided into four neurocognitive indices; Executive Function, Verbal Learning, Motor Speed, and Verbal Fluency. The sample was grouped into those relapsing or not within the first, second and fifth year. Results: The four neurocognitive indices showed overall stability over the ten year period. Significant relapse by index interactions were found for all indices except Executive Function. Follow-up analyses identified a larger significant decrease over time for the encoding measure within Verbal Memory for patients with psychotic relapse in the first year (F (4,38)=5.8, p=0.001, η2=0.40) Conclusions: Main findings are long-term stability in neurocognitive functioning in first episode psychosis patients, with the exception of verbal memory in patients with psychotic relapse or non-remission early in the course of illness. We conclude that worsening of specific parts of cognitive function may be expected for patients with on-going psychosis, but that most patients should expect no change in cognitive performance during the first 10 years after being diagnosed. (shrink)
The aim of this study was to explore and reflect upon mental health nursing and first-episode psychosis. Seven multidisciplinary focus group interviews were conducted, and data analysis was influenced by a grounded theory approach. The core category was found to be a process named ‘working behind the scenes’. It is presented along with three subcategories: ‘keeping the patient in mind’, ‘invisible care’ and ‘invisible network contact’. Findings are illuminated with the ethical principles of respect for autonomy and paternalism. Nursing (...) care is dynamic, and clinical work moves along continuums between autonomy and paternalism and between ethical reflective and non-reflective practice. ‘Working behind the scenes’ is considered to be in a paternalistic area, containing an ethical reflection. Treating and caring for individuals experiencing first-episode psychosis demands an ethical awareness and great vigilance by nurses. The study is a contribution to reflection upon everyday nursing practice, and the conclusion concerns the importance of making invisible work visible. (shrink)
Aim of the lectures -- Early Brahmanical literature -- Panini's grammar -- A passage from the Chandogya Upanisad -- The structures of languages -- The Buddhist contribution -- Vaisesika and language -- Verbal knowledge -- The contradictions of Nagarjuna -- The reactions of other thinkers -- Sarvastivada Samkhya -- The Agamasastra of Gaudapada -- Sankara -- Kashmiri Saivism -- Jainism -- Early Vaisesika -- Critiques of the existence of a thing before its arising -- Nyaya -- Mimamsa -- The Abhidharmakosa (...) bhasya of Vasubandhu -- The Abhidharmasamuccaya of Asanga and its bhasya -- Bhartrhari -- The problem of negation -- Dignaga and verbal knowledge -- The Bodhisattvabhumi -- Prajnakaragupta -- Indian thinkers and the correspondence principle -- Appendix. The Mahaprajnaparamitasastra and the Samkhya tanmatras. (shrink)
After three proceedings in which neuroscience was a relevant factor for the final verdict in Italian courts, for the first time a recent case puts in question the legal relevance of neuroscientific evidence. This decision deserves international attention in its underlining that the uncertainty still affecting neuroscientific knowledge can have a significant impact on the law. It urges the consideration of such uncertainty and the development of a shared management of it.
Maine de Biran a toujours été considéré comme un représentant exemplaire de l'anti-matérialisme dans la philosophie française du début du XIXe siècle. N'a-t-il pas tenté, sur la base de l'expérience du fait primitif, de fonder une doctrine dualiste? Certes, mais des textes récemment publiés montrent que cela n'a pas toujours été le cas: vers 1800, sous l'influence des Idéologues, et particulièrement de Cabanis, il a, pour un temps, épousé les thèses du naturalisme matérialiste. Ce sont ces textes que nous examinons (...) ici, avant d'envisager certaines objections que l'on pourrait faire à notre interprétation. In the french philosophy of the XIXth century's beginning, Maine de Biran has always been regarded as a supporter of anti-materialism. Has he not tried to establish the foundations of a dualistic doctrine, on the basis of the « fait primitif »? Certainly, but some recently published texts show that it has not always been so: about 1800, under the influence of the Ideologists, Cabanis particularly, Biran has for a while endorsed materialistic-naturalistic theses. We examine here these texts and survey some objections against our interpretation. (shrink)