Based on Lucy Grealy’s memoir, Autobiography of a Face, this article explores the relationship between gender and illness in our culture, as well as the paradox of “intimacy without intimacy” in the clinical encounter. Included is a brief review of how authenticity, vulnerability, and mutual recognition of suffering can foster the kind of empathic doctor-patient relationship that Lucy Grealy sorely needed, but never received. As she says at the end of her memoir, “All those years I’d handed my ugliness over (...) to people, and seen only the different ways it was reflected back to me.”. (shrink)

ObjectiveOverweight and obesity [body mass index ≥ 25 kg/m2] are associated with poorer prognosis among women with breast cancer, and weight gain is common during treatment. Symptoms of depression and anxiety are also highly prevalent in women with breast cancer and may be exacerbated by post-diagnosis weight gain. Altered brain function may underlie psychological distress. Thus, this secondary analysis examined the relationship between BMI, psychological health, and resting state functional connectivity among women with breast cancer.MethodsThe sample included 34 post-menopausal women (...) newly diagnosed with Stage 0-IIa breast cancer who were enrolled in a 6-month randomized controlled trial of aerobic exercise vs. usual care. At baseline prior to randomization, whole-brain analyses were conducted to evaluate the relationship between BMI and seed-to-voxel rsFC of the hippocampus and amygdala. Connectivity values from significant clusters were then extracted and examined as predictors of self-reported depression and anxiety.ResultsMean BMI was in the obese range. For both seeds examined, higher BMI was associated with lower rsFC with regions of prefrontal cortex, including ventrolateral PFC, dorsolateral PFC, and superior frontal gyrus. Hippocampal connectivity with the vlPFC was negatively correlated with self-reported anxiety.ConclusionHigher BMI was associated with lower hippocampal and amygdala connectivity to regions of PFC implicated in cognitive control and emotion regulation. BMI-related differences in hippocampal and amygdala connectivity following a recent breast cancer diagnosis may relate to future worsening of psychological functioning during treatment and remission. Additional longitudinal research exploring this hypothesis is warranted. (shrink)

© 2015, Springer-Verlag Berlin Heidelberg.Genetic studies have identified single nucleotide polymorphisms associated with the risk of prostate cancer. It remains unclear whether such genetic variants are associated with disease aggressiveness. The NCI-SPORE Genetics Working Group retrospectively collected clinicopathologic information and genotype data for 36 SNPs which at the time had been validated to be associated with PC risk from 25,674 cases with PC. Cases were grouped according to race, Gleason score and aggressiveness. Statistical analyses were used to compare the frequency (...) of the SNPs between different disease cohorts. After adjusting for multiple testing, only PC-risk SNP rs2735839 was significantly and inversely associated with aggressive and high-grade disease in European men. Similar associations with aggressive and high-grade disease were documented in African-American subjects. The G allele of rs2735839 was associated with disease aggressiveness even at low PSA levels in both European and African-American men. Our results provide further support that a PC-risk SNP rs2735839 near the KLK3 gene on chromosome 19q13 may be associated with aggressive and high-grade PC. Future prospectively designed, case-case GWAS are needed to identify additional SNPs associated with PC aggressiveness. (shrink)

Farrell, Marie T Review(s) of: The first thing to do is live: Essays sacred and secular, by Adrian Lyons SJ (Melbourne: David Lovell Publishing, 2013), pp. 136, pb $27.95.

Ever since its nascent days, psychoanalysis has enjoyed an uneasy coexistence with religion. However, in recent decades, many analysts have been more interested in the healing potential of both psychoanalytic and religious experience and have explored how their respective narrative underpinnings may be remarkably similar. In _Toward Mutual Recognition_, Marie T. Hoffman takes just such an approach. Coming from a Christian perspective, she suggests that the current relational turn in psychoanalysis has been influenced by numerous theorists - analysts and philosophers (...) alike - who were themselves shaped by an embedded Christian narrative. As a result, the redemptive concepts of incarnation, crucifixion, and resurrection - central to the tenets of Christianity - can be traced to relational theories, emerging analogously in the transformative process of mutual recognition in the concepts of identification, surrender, and gratitude, a trilogy which she develops as forming the "path of recognition." Each movement on this path of recognition is given thought-provoking, in-depth attention. Chapters dedicated to theoretical perspectives utilize the thinking of Benjamin, Hegel, and Ricoeur. In her historical perspectives, she explores the personal and professional histories of analysts such as Sullivan, Fairbairn, Winnicott, Erikson, Kohut, and Ferenczi, among others, who were influenced by the Christian narrative. Uniting it all together is the clinical perspective offered in the compelling extended case history of Mandy, a young lady whose treatment embodies and exemplifies each of the steps along the path of growth in both the psychoanalytic and Christian senses. Throughout, a relational sensibility is deployed as a cooperative counterpart to the Christian narrative, working both as a consilient dialogue and a vehicle for further integrative exploration. As a result, the specter of psychoanalysis and religion as mutually exclusive gives way to the hope and redemption offered by their mutual recognition. (shrink)

Respect for patients’ self-determination has long been considered central to efforts to improve end-of-life care, yet efforts to promote advance directives or engage patients in end-of-life discussions are often unsuccessful. In this article, I contend that this is because the shared decision-making approach typically used in healthcare assumes patients’ capacity to make rational choices, which is not always possible in end-of-life decisions. Drawing on decision theory, behavioral psychology, and related studies of endof-life care, I present a growing body of evidence (...) that suggests the novelty, complexity, and uncertainty of end-of-life circumstances make rational and stable preferences difficult to establish. I argue that an effective decision-making approach for the terminally ill must recognize and respond to the unique characteristics of endof-life choices, including their nonrational dimensions. I conclude with a description of an initiative that appears to do so, resulting in increased patients’ satisfaction. (shrink)

Farrell, Marie T Review(s) of: How to read a graveyard: Journeys in the company of the dead, by Peter Stanford (London: Bloomsbury, 2013), pp.263, $32.95.

Farrell, Marie T Review of: Jesus and the dreaming: Discovering an Australian spirituality through Aboriginal-Christian dialogue, by Frank Fletcher, MSC, ed. Fabian Byers, pp. 344, paperback $24.95.

This paper examines contemporary Catholic higher education and its unique role in preparing graduates, who have been grounded in natural moral law, to respond to the bioethical questions of the day. The importance of the commitment by both administration and faculty to articulating and embracing the mission of Catholic higher education as they prepare graduates for a culture of relativism is presented. Curricular objectives, content, and teaching strategies are provided which address the most relevant bioethical dilemmas of the day. The (...) importance of an integrated approach to examining these dilemmas, as well as a grounding in core content in philosophy and theology for all graduates, regardless of discipline of concentration, are presented. The interjection of government mandates into the void of bioethical resolutions is examined in relationship to the rights of conscience. The paper concludes with examples of best practices, showing the role of Catholic higher education as uniquely suited to advance the common good. National Catholic Bioethics Quarterly 11.4 (Winter 2011): 705–734. (shrink)

The protein Po has long been proposed to be responsible for the compact nature of peripheral myelin through interactions of both its extracellular and cytoplasmic domains. Recent studies support such a role for Po's extracellular region while more precise mapping of its adhesive domains are ongoing. As Po is a member of the immunoglobulin gene superfamily and perhaps bears the closest similarity to the ancestral molecule of this whole family, these studies may also have more general implications for adhesive interactions. (...) In addition, although long believed to be purely an inert, structural molecule, Po has been reported to promote neurite outgrowth, which suggests a more dynamic role for this interesting molecule. (shrink)

Eddington, A. The decline of determinism.--Heisenberg, W. and others. Dialogue concerning science and philosophical positions.--Sinnott, E. Biology and freedom.--Nuttin, J. The unconscious and freedom.--Nagel, E. Determinism in history.--Ayer, A. J. Freedom and necessity.--Campbell, C. A. Philosophical defence of freedom.--Hare, R. M. Freedom and reason.--Dewey, J. Freedom as a problem.--Sartre, J.-P. Freedom and total responsibility.--Camus, A. Freedom and rebellion.--Rand, A. Freedom and individualism.--Thévenaz, P. Freedom and action.--Luijpen, W. A. Phenomenology of freedom.--Teilhard de Chardin, P. Cosmic freedom.--Jaspers, K. Freedom and society.--Macmurray, J. (...) Freedom in the personal nexus.--Brunner, A. Incarnation of freedom.--Ricoeur, P. Freedom as human creativity.--Finance, J. de. Freedom and existence.--Bibliography (p. 243-251). (shrink)

Augustine of Hippo is a giant in the history of Christian thought, commended by St Jerome for having virtually 're-founded the old faith'.

Today the connection between "person" and the "I" is acknowledged in many respects but not always analyzed. The need to relate it to the reality of the human being has sparked the present investigation of the philosophical anthropology of four thinkers from the late ancient, medieval, and contemporary periods. Although it may seem that the question of the role of the "I" with respect to the human being hinges on the larger problem of objectivity v. subjectivity, this does not seem (...) to be the case. Many topics, however, are necessarily entailed in this investigation such as individuality and universality, soul and body, consciousness and action, substance and history, the self and the other, the metaphysical and the phenomenological, and experience and the ethical. At the end of this study we arrive at more than a grammatical use of the "I." From reflection on the contributions of Plotinus, Augustine, Aquinas, and Wojtyla, the ontological role of the "I" is identified. In doing so, one realizes that the ontological does not forsake the concrete, but penetrates it more deeply. Indeed, that was what Plotinian philosophy claimed to be doing: recognizing the richness of human reality. (shrink)