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The biopsychosocial model (BPSM) was proposed by George Engel in 1977 as an improvement to the biomedical model (BMM), to take account of psychological and social as well as biological factors relevant to health and disease. Since then the BPSM has had a mixed reputation, as the overarching framework for psychiatry, perhaps for medicine generally, while also being criticized for being theoretically and empirically vacuous. Over the past few decades, substantial evidence has accumulated supporting the BPSM but its theory remains less clear. The first part of this paper reviews recent well-known, general theories in the relevant sciences that can provide a theoretical framework of the model, constituting a revitalized BPSM capable of theorizing causal interactions within and between biological, psychological, and social domains. Fundamental concepts in this new framework include causation as regulation and dysfunction as dysregulation. Associated research paradigms are outlined in Part 2. Research in psychological therapies and social epidemiology are major examples of programs that have produced results anomalous for the BMM and consistent with the BPSM. Theorized models of causal mechanisms enrich empirical data and two biopsychosocial examples are models of chronic stress and pain perception. Clinical implications are reviewed in Part 3. The BPSM accommodates psychological and social as well as biological treatment effects evident in the clinical trials literature. Personal, interpersonal, and institutional aspects of clinical care are out of the scope of the BMM, assigned to the art of healthcare rather than the science, but can be accommodated and theorized in the BPSM.

Two models of attention deficit hyperactivity disorder (ADHD) coexist: the biomedical and the psychosocial. We identified in nine French newspapers 159 articles giving facts and opinions about ADHD from 1995 to 2015. We classified them according to the model they mainly supported and on the basis of what argument. Two thirds (104/159) mainly supported the biomedical model. The others either defended the psychodynamic understanding of ADHD or voiced both models. Neurological dysfunctions and genetic risk factors were mentioned in support of the biomedical model in only 26 and eight articles, respectively. These biological arguments were less frequent in the most recent years. There were fewer articles mentioning medication other than asserting that medication must be combined with psychosocial interventions (14 versus 57 articles). Only 11/159 articles claimed that medication protects from school failure. These results were compared to those of our two previous studies. Thus, both French newspapers and the specialized press read by social workers mainly defended either the psychodynamic understanding of ADHD or a nuanced version of the biomedical model. In contrast, most French TV programmes described ADHD as an inherited neurological disease whose consequences on school failure can be counteracted by a very effective medication.

The aim of this review article is to provide an overview of the role of pigs as a biomedical model for humans. The usefulness and limitations of porcine models have been discussed in terms of metabolic, cardiovascular, digestive and bone diseases in humans. Domestic pigs and minipigs are the main categories of pigs used as biomedical models. One drawback of minipigs is that they are in short supply and expensive compared with domestic pigs, which in contrast cost more to house, feed and medicate. Different porcine breeds show different responses to the induction of specific diseases. For example, ossabaw minipigs provide a better model than Yucatan for the metabolic syndrome as they exhibit obesity, insulin resistance and hypertension, all of which are absent in the Yucatan. Similar metabolic/physiological differences exist between domestic breeds (e.g. Meishan v. Pietrain). The modern commercial (e.g. Large White) domestic pig has been the preferred model for developmental programming due to the 2- to 3-fold variation in body weight among littermates providing a natural form of foetal growth retardation not observed in ancient (e.g. Meishan) domestic breeds. Pigs have been increasingly used to study chronic ischaemia, therapeutic angiogenesis, hypertrophic cardiomyopathy and abdominal aortic aneurysm as their coronary anatomy and physiology are similar to humans. Type 1 and II diabetes can be induced in swine using dietary regimes and/or administration of streptozotocin. Pigs are a good and extensively used model for specific nutritional studies as their protein and lipid metabolism is comparable with humans, although pigs are not as sensitive to protein restriction as rodents. Neonatal and weanling pigs have been used to examine the pathophysiology and prevention/treatment of microbial-associated diseases and immune system disorders. A porcine model mimicking various degrees of prematurity in infants receiving total parenteral nutrition has been established to investigate gut development, amino acid metabolism and non-alcoholic fatty liver disease. Endoscopic therapeutic methods for upper gastrointestinal tract bleeding are being developed. Bone remodelling cycle in pigs is histologically more similar to humans than that of rats or mice, and is used to examine the relationship between menopause and osteoporosis. Work has also been conducted on dental implants in pigs to consider loading; however with caution as porcine bone remodels slightly faster than human bone. We conclude that pigs are a valuable translational model to bridge the gap between classical rodent models and humans in developing new therapies to aid human health.

Purpose This paper aims to systematically review the current literature on compassion in mental health from a historical, service user and carer (SUAC)/academic researcher perspective with respect to the current paradigm/biomedical model. Design/methodology/approach Searches were conducted in CIANHL Complete, Academic Search Complete, British Education Index, ERIC, MEDLINE, PsycArticles, Scorpus, Proquest Central using a simplified PRISM approach. Findings In the UK, the SUAC-movement facilitated the adoption of more compassionate mental health in statutory services. Across the world, compassion-based approaches may be viewed as beneficial, especially to those experiencing a biomedical model “treatment”. Health-care workers, suffering burnout and fatigue during neoliberal economics, benefit from compassion training, both in their practice and personally. Randomised control trials (RCTs) demonstrate compassion-type interventions are effective, given sufficient intervention timing, duration and design methodology. Psychology creates outcome measures of adequacies and deficiencies in compassion, demonstrating their importance statistically, with reservations. The effective protection of mental health by self-compassion in both SUACs and health care professionals is evident. It is clear from qualitative research that SUACs prefer compassionate mental health. It also makes a large difference to mental health in general populations. Implications for practice and suggestions for future research are given, including a necessity to fund RCTs comparing compassionate mental health interventions with the biomedical model. Unless statutory mental health services adopt this emerging evidence base, medics and their SUACs will continue to rely on pharmaceuticals. Originality/value This is the first integrated literature review of compassion in mental health from a historical, SUAC/academic researcher viewpoint using all research methodologies.

The 12 narratives included in this symposium on living with mental health challenges reflect the broad spectrum of experiences and interpretations of individuals who have mental health conditions. They also reflect the range of views within global mental health discourse about effective ways to improve the mental health of individuals and populations. Some important issues are common in these narratives, notably how experiencing trauma, particularly in childhood, can impact mental health. The narratives present a broad spectrum of views regarding the interpretation of mental health conditions and the ways mental healthcare systems have addressed them. These narratives demonstrate an urgent need globally to liberate the field of mental health from the overuse of the biomedical model and allow other models to compete and receive support.

This study provides a brief historical background of scientific, medical and psychological approaches to transsexualities. It also makes considerations on how such approaches based the concept of pathology that is associated with trans people and how it has been responsible for maintaining the pathologization in the collective imaginary. More specifically, we will establish a chronology of events that, throughout history, have affected the study on and the intervention with trans people, based on the biomedical model. We will also refer to some Western figures responsible for creating this biomedical vision of trans people. Finally, the discussion about the (de)pathologization of transsexualities is presented, based on the emergence of the paradigm centered on the human rights of trans people and proposals for self-determination of their bodies and identities.

Numerical Modeling in Biomedical Engineering brings together the integrative set of computational problem solving tools important to biomedical engineers.Through the use of comprehensive homework exercises, relevant examples and extensive case studies, this book integrates principles and techniques of numerical analysis.

The mission ofthe National Institutes of Health (NIH) is to seek fundamental knowledge about the nature and behavior of living systems and to apply that knowledge to enhance health and reduce illness and disability. As new tools such as big data analytics, computational biology, and high throughput processes have emerged, the NIH has integrated these tools to fuel scientific advances. One tool that has become more commonly used is the theoretical framework of intersectionality, defined as how multiple marginalized or disadvantaged social statuses interact at the micro level of individuals' lived experience to reflect interlocking systems of privilege and oppression at the macro social structural level (e.g., racism, classism, colonialism, sexism, heterosexism, ableism).1,2 Intersectionality theory, long used in other disciplines, is a relative newcomer to health research. This theory can foster a greater understanding of human health by moving beyond the biomedical model and individual-level determinants to examine the health effects resulting from the intersection of structural power dynamics, such as systemic sexism and racism. In our roles in extramural research administration at NIH, we have seen a growth in research addressing intersectionality, as well as a lack of consensus about best practices for studying this complex construct. In this editorial, we share our views on important areas for research development that we believe will help to advance the science of intersectionality. These views were shaped in part by the numerous grant applications we have seen submitted to the NIH, where we have a first-hand opportunity to view the latest innovations and cutting-edge science, as well as gaps and limitations.

Background In 2020, the long‐lasting effects of the Covid‐19 virus were not included in public messages of risks to public health. Long Covid emerged as a novel and enigmatic illness with a serious and life‐changing impact. Long Covid is poorly explained by objective medical tests, leading to widespread disbelief and stigma associated with the condition. The aim of this organic research is to explore the physical and epistemic challenges of living with Long Covid. Methods Unlike any previous pandemic in history, online Covid communities and ‘citizen science’ have played a leading role in advancing our understanding of Long Covid. As patient‐led research of this grassroots Covid community, a team approach to thematic analysis was undertaken of 66 patient stories submitted online to covid19‐recovery.org at the beginning of the Covid‐19 pandemic between April and September 2020. Results The overriding theme of the analysis highlights the complexities and challenges of living with Long Covid. Our distinct themes were identified: the life‐changing impact of the condition, the importance of validation and how, for many, seeking alternatives was felt to be their only option. Conclusions Long Covid does not easily fit into the dominant evidence‐based practice and the biomedical model of health, which rely on objective indicators of the disease process. Patient testimonies are vital to understanding and treating Long Covid, yet patients are frequently disbelieved, and their testimonies are not taken seriously leading to stigma and epistemic injustice, which introduces a lack of trust into the therapeutic relationship. Patient Contribution The research was undertaken in partnership with our consumer representative(s) and all findings and subsequent recommendations have been coproduced.