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Brun C, Penavayre M, Gonon F. The political leaning of the neuroscience discourse about school education in the French press from 2000 to 2020. PUBLIC UNDERSTANDING OF SCIENCE (BRISTOL, ENGLAND) 2024; 33:121-138. [PMID: 37542420 DOI: 10.1177/09636625231183650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/07/2023]
Abstract
Political actors pay attention to newspapers because they stimulate them to address a topic, reflect public opinion, provide feedback to their decisions, and help them to generate effective messages. Previous surveys showed that this is true for scientific issues. It follows that the newspaper coverage of scientific issues should appear as politically oriented, as observed regarding climate change. Here, we tested this prediction regarding educational neuroscience. This scientific issue is interesting because it implies no major economic interest and because the relevance of neuroscience regarding teaching in the classroom is still highly controversial. As hypothesized, we observed that the French press appeared strongly polarized: the right-leaning press was mostly favorable to educational neuroscience, whereas critical opinions were mainly found in the social-democrat press. Although the relevance of neuroscience toward teaching was rarely discussed in scientific arguments, political actors often invoked educational neuroscience in the press to legitimate their decision.
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Cherkasova MV, Fu JF, Jarrett M, Johnson P, Abel S, Tam R, Rauscher A, Sossi V, Kolind S, Li DKB, Sadovnick AD, Machan L, Girard JM, Emond F, Vosoughi R, Traboulsee A, Stoessl AJ. Cortical morphology predicts placebo response in multiple sclerosis. Sci Rep 2022; 12:732. [PMID: 35031632 PMCID: PMC8760243 DOI: 10.1038/s41598-021-04462-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Accepted: 12/22/2021] [Indexed: 11/27/2022] Open
Abstract
Despite significant insights into the neural mechanisms of acute placebo responses, less is known about longer-term placebo responses, such as those seen in clinical trials, or their interactions with brain disease. We examined brain correlates of placebo responses in a randomized trial of a then controversial and now disproved endovascular treatment for multiple sclerosis. Patients received either balloon or sham extracranial venoplasty and were followed for 48 weeks. Venoplasty had no therapeutic effect, but a subset of both venoplasty- and sham-treated patients reported a transient improvement in health-related quality of life, suggesting a placebo response. Placebo responders did not differ from non-responders in total MRI T2 lesion load, count or location, nor were there differences in normalized brain volume, regional grey or white matter volume or cortical thickness (CT). However, responders had higher lesion activity. Graph theoretical analysis of CT covariance showed that non-responders had a more small-world-like CT architecture. In non-responders, lesion load was inversely associated with CT in somatosensory, motor and association areas, precuneus, and insula, primarily in the right hemisphere. In responders, lesion load was unrelated to CT. The neuropathological process in MS may produce in some a cortical configuration less capable of generating sustained placebo responses.
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Affiliation(s)
- Mariya V Cherkasova
- Department of Psychology, University of British Columbia, Vancouver, Canada. .,Department of Psychology, West Virginia University, 2128 Life Science Building, Morgantown, WV, 26506, USA.
| | - Jessie F Fu
- Department of Physics and Astronomy, University of British Columbia, Vancouver, BC, Canada
| | - Michael Jarrett
- Population Data BC, University of British Columbia, Vancouver, BC, Canada
| | - Poljanka Johnson
- Department of Medicine (Division of Neurology), Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, BC, Canada
| | - Shawna Abel
- Department of Medicine (Division of Neurology), Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, BC, Canada
| | - Roger Tam
- Department of Radiology, University of British Columbia, Vancouver, BC, Canada.,School of Biomedical Engineering, University of British Columbia, Vancouver, BC, Canada
| | - Alexander Rauscher
- Depatment of Pediatrics (Division of Neurology), University of British Columbia, Vancouver, BC, Canada
| | - Vesna Sossi
- Department of Physics and Astronomy, University of British Columbia, Vancouver, BC, Canada
| | - Shannon Kolind
- Department of Medicine (Division of Neurology), Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, BC, Canada
| | - David K B Li
- Department of Medicine (Division of Neurology), Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, BC, Canada.,Department of Radiology, University of British Columbia, Vancouver, BC, Canada
| | - A Dessa Sadovnick
- Department of Medicine (Division of Neurology), Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, BC, Canada.,Department of Medical Genetics, University of British Columbia, Vancouver, BC, Canada
| | - Lindsay Machan
- Department of Radiology, University of British Columbia, Vancouver, BC, Canada
| | - J Marc Girard
- Centre Hospitalier de L'Université de Montréal, Montréal, QC, Canada
| | - Francois Emond
- CHU de Québec-Université Laval, Hôpital de L'Enfant-Jésus, Québec, Canada
| | - Reza Vosoughi
- Department of Internal Medicine (Neurology), University of Manitoba, Winnipeg, Canada
| | - Anthony Traboulsee
- Department of Medicine (Division of Neurology), Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, BC, Canada
| | - A Jon Stoessl
- Department of Medicine (Division of Neurology), Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, BC, Canada
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Abstract
PURPOSE OF REVIEW The purpose of this review is to describe ethical and legal issues that arise in the management of patients with disorders of consciousness ranging from the minimally conscious state to the coma state, as well as brain death. RECENT FINDINGS The recent literature highlights dilemmas created by diagnostic and prognostic uncertainties in patients with disorders of consciousness. The discussion also reveals the challenges experienced by the disability community, which includes individuals with severe brain injury who are classified as having a disorder of consciousness. We review current guidelines for management of patients with disorders of consciousness including discussions around diagnosis, prognosis, consideration of neuropalliation, and decisions around life sustaining medical treatment. SUMMARY In the setting of uncertainty, this review describes the utility of applying a disability rights perspective and shared decision-making process to approach medical decision-making for patients with disorders of consciousness. We outline approaches to identifying surrogate decision makers, standards for decision-making and decision-making processes, specifically addressing the concept of futility as a less useful framework for making decisions. We also highlight special considerations for research, innovative and controversial care, brain death, organ donation, and child abuse and neglect.
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Affiliation(s)
- Lauren Rissman
- Ann & Robert H. Lurie Children’s Hospital of Chicago, Chicago, IL
- Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Erin Talati Paquette
- Ann & Robert H. Lurie Children’s Hospital of Chicago, Chicago, IL
- Northwestern University Feinberg School of Medicine, Chicago, IL
- Northwestern University Pritzker School of Law (by courtesy), Chicago, IL
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Abstract
Despite significant progress in the study of the epidemiology and genetics of autism, the etiology and patho-physiology of this condition is far from being elucidated and no curative treatment currently exists. Although solid scientific research continues, in an attempt to find explanations and solutions, a number of nonscientific and pure myths about autism have emerged. Myths that vaccines or mercury are associated with autism have been amplified by misguided scientists; frustrated, but effective parent groups; and politicians. Preventing the protection provided by vaccination or administration of mercury-chelating agents may cause real damage to autistic individuals and to innocent bystanders who as a result may be exposed to resurgent diseases that had already been “extinguished. ” That such myths flourish is a consequence of the authority of scientific evidence obtained by scientific methodology losing ground to alternative truths and alternative science. This article presents a narrative of the origin of the myths around autism.
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Fins JJ, Bernat JL. Ethical, Palliative, and Policy Considerations in Disorders of Consciousness. Arch Phys Med Rehabil 2018; 99:1927-1931. [PMID: 30098790 DOI: 10.1016/j.apmr.2018.07.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
This essay complements the scientific and practice scope of the American Academy of Neurology Guideline on Disorders of Consciousness by providing a discussion of the ethical, palliative, and policy aspects of the management of this group of patients. We endorse the renaming of "permanent" vegetative state to "chronic" vegetative state given the increased frequency of reports of late improvements but suggest that further refinement of this class of patients is necessary to distinguish late recoveries from patients who were misdiagnosed or in cognitive-motor dissociation. Additional nosologic clarity and prognostic refinement is necessary to preclude overestimation of low probability events. We argue that the new descriptor "unaware wakefulness syndrome" is no clearer than "vegetative state" in expressing the mismatch between apparent behavioral unawareness when patients have covert consciousness or cognitive motor dissociation. We advocate routine universal pain precautions as an important element of neuropalliative care for these patients given the risk of covert consciousness. In medical decision-making, we endorse the use of advance directives and the importance of clear and understandable communication with surrogates. We show the value of incorporating a learning health care system so as to promote therapeutic innovation. We support the Guideline's high standard for rehabilitation for these patients but note that those systems of care are neither widely available nor affordable. Finally, we applaud the Guideline authors for this outstanding exemplar of engaged scholarship in the service of a frequently neglected group of brain-injured patients.
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Affiliation(s)
- Joseph J Fins
- Division of Medical Ethics and Consortium for the Advanced Study of Brain Injury, Weill Cornell Medical College, New York, NY; Solomon Center for Health Law & Policy, Yale Law School, New Haven, CT
| | - James L Bernat
- Departments of Neurology and Medicine, Geisel School of Medicine at Dartmouth, Hanover, NH.
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Fins JJ, Bernat JL. Ethical, palliative, and policy considerations in disorders of consciousness. Neurology 2018; 91:471-475. [PMID: 30089621 DOI: 10.1212/wnl.0000000000005927] [Citation(s) in RCA: 55] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2017] [Accepted: 03/07/2018] [Indexed: 11/15/2022] Open
Abstract
This essay complements the scientific and practice scope of the American Academy of Neurology Guideline on Disorders of Consciousness by providing a discussion of the ethical, palliative, and policy aspects of the management of this group of patients. We endorse the renaming of "permanent" vegetative state to "chronic" vegetative state given the increased frequency of reports of late improvements but suggest that further refinement of this class of patients is necessary to distinguish late recoveries from patients who were misdiagnosed or in cognitive-motor dissociation. Additional nosologic clarity and prognostic refinement is necessary to preclude overestimation of low probability events. We argue that the new descriptor "unaware wakefulness syndrome" is no clearer than "vegetative state" in expressing the mismatch between apparent behavioral unawareness when patients have covert consciousness or cognitive motor dissociation. We advocate routine universal pain precautions as an important element of neuropalliative care for these patients given the risk of covert consciousness. In medical decision-making, we endorse the use of advance directives and the importance of clear and understandable communication with surrogates. We show the value of incorporating a learning health care system so as to promote therapeutic innovation. We support the Guideline's high standard for rehabilitation for these patients but note that those systems of care are neither widely available nor affordable. Finally, we applaud the Guideline authors for this outstanding exemplar of engaged scholarship in the service of a frequently neglected group of brain-injured patients.
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Affiliation(s)
- Joseph J Fins
- From the Division of Medical Ethics and Consortium for the Advanced Study of Brain Injury (J.J.F.), Weill Cornell Medical College, New York, NY; Solomon Center for Health Law & Policy (J.J.F.),Yale Law School, New Haven, CT; and Departments of Neurology and Medicine (J.L.B.), Geisel School of Medicine at Dartmouth, Hanover, NH
| | - James L Bernat
- From the Division of Medical Ethics and Consortium for the Advanced Study of Brain Injury (J.J.F.), Weill Cornell Medical College, New York, NY; Solomon Center for Health Law & Policy (J.J.F.),Yale Law School, New Haven, CT; and Departments of Neurology and Medicine (J.L.B.), Geisel School of Medicine at Dartmouth, Hanover, NH.
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