collection
https://read.qxmd.com/read/38418099/the-disease-loophole-index-terms-and-their-role-in-disease-misclassification
#1
JOURNAL ARTICLE
Alex N Roberts
The definitions of disease proffered by philosophers and medical actors typically require that a state of ill health be linked to some known bodily dysfunction before it is classified as a disease. I argue that such definitions of disease are not fully implementable in current medical discourse and practice. Adhering to the definitions would require that medical actors keep close track of the current state of knowledge on the causes and mechanisms of particular illnesses. Yet, unaddressed problems in medical terminology can make this difficult to do...
March 14, 2024: Journal of Medicine and Philosophy
https://read.qxmd.com/read/38424251/-masked-dissociation-the-many-faces-of-technology
#2
JOURNAL ARTICLE
Alessia Musicò
After briefly explaining the concepts of dissociation and repression and discussing the new interest that the concept of dissociation has acquired within the actual psychoanalytic panorama, the author explains the concept of a dissociative continuum and presents Peter Goldberg's theory on somatic dissociation. Starting from this model, she proposes an interpretation of the use of technology, and especially of the internet, as a dissociative modality that helps separate the mind from the body, one that allows the maintenance of personal security-a concept dear to Sullivan-through physical distance...
February 29, 2024: American Journal of Psychoanalysis
https://read.qxmd.com/read/38217619/covert-consciousness
#3
JOURNAL ARTICLE
Michael J Young, Brian L Edlow, Yelena G Bodien
Covert consciousness is a state of residual awareness following severe brain injury or neurological disorder that evades routine bedside behavioral detection. Patients with covert consciousness have preserved awareness but are incapable of self-expression through ordinary means of behavior or communication. Growing recognition of the limitations of bedside neurobehavioral examination in reliably detecting consciousness, along with advances in neurotechnologies capable of detecting brain states or subtle signs indicative of consciousness not discernible by routine examination, carry promise to transform approaches to classifying, diagnosing, prognosticating and treating disorders of consciousness...
2024: NeuroRehabilitation
https://read.qxmd.com/read/38243150/disclosing-results-of-tests-for-covert-consciousness-a-framework-for-ethical-translation
#4
JOURNAL ARTICLE
Michael J Young, Karnig Kazazian, David Fischer, India A Lissak, Yelena G Bodien, Brian L Edlow
The advent of neurotechnologies including advanced functional magnetic resonance imaging and electroencephalography to detect states of awareness not detectable by traditional bedside neurobehavioral techniques (i.e., covert consciousness) promises to transform neuroscience research and clinical practice for patients with brain injury. As these interventions progress from research tools into actionable, guideline-endorsed clinical tests, ethical guidance for clinicians on how to responsibly communicate the sensitive results they yield is crucial yet remains underdeveloped...
January 19, 2024: Neurocritical Care
https://read.qxmd.com/read/38327828/covert-cortical-processing-a-diagnosis-in-search-of-a-definition
#5
JOURNAL ARTICLE
Michael J Young, Matteo Fecchio, Yelena G Bodien, Brian L Edlow
Historically, clinical evaluation of unresponsive patients following brain injury has relied principally on serial behavioral examination to search for emerging signs of consciousness and track recovery. Advances in neuroimaging and electrophysiologic techniques now enable clinicians to peer into residual brain functions even in the absence of overt behavioral signs. These advances have expanded clinicians' ability to sub-stratify behaviorally unresponsive and seemingly unaware patients following brain injury by querying and classifying covert brain activity made evident through active or passive neuroimaging or electrophysiologic techniques, including functional MRI, electroencephalography (EEG), transcranial magnetic stimulation-EEG, and positron emission tomography...
2024: Neuroscience of Consciousness
https://read.qxmd.com/read/37076304/covert-tracking-to-visual-stimuli-in-comatose-patients-with-traumatic-brain-injury
#6
JOURNAL ARTICLE
Ayham Alkhachroum, Gabriela Aklepi, Amin Sarafraz, Linda E Robayo, Brian M Manolovitz, Carlos F Blandino, Brian Arwari, Evie Sobczak, Danielle H Bass, Pardis Ghamasaee, Daniel Samano, Nina Massad, Mohan Kottapally, Amedeo Merenda, Salim Dib, Jonathan R Jagid, W Dalton Dietrich, Tatjana Rundek, Kristine O'Phelan, Jan Claassen, Mark F Walker
OBJECTIVES: This study investigated video eye tracking (VET) in comatose patients with traumatic brain injury (TBI). METHODS: We recruited healthy participants and unresponsive patients with TBI. We surveyed the patients' clinicians on whether the patient was tracking and performed the Coma Recovery Scale-Revised (CRS-R). We recorded eye movements in response to motion of a finger, a face, a mirror, and an optokinetic stimulus using VET glasses. Patients were classified as covert tracking (tracking on VET alone) and overt tracking (VET and clinical examination)...
September 12, 2023: Neurology
https://read.qxmd.com/read/37421413/disability-transition-costs-and-the-things-that-really-matter
#7
JOURNAL ARTICLE
Tommy Ness, Linda Barclay
This article develops a detailed, empirically driven analysis of the nature of the transition costs incurred in becoming disabled. Our analysis of the complex nature of these costs supports the claim that it can be wrong to cause disability, even if disability is just one way of being different. We also argue that close attention to the nature of transition costs gives us reason to doubt that well-being, including transitory impacts on well-being, is the only thing that should determine the wrongness of causing or removing disability...
July 8, 2023: Journal of Medicine and Philosophy
https://read.qxmd.com/read/35505222/ethics-priorities-of-the-curing-coma-campaign-an-empirical-survey
#8
JOURNAL ARTICLE
Ariane Lewis, Jan Claassen, Judy Illes, Ralf J Jox, Matthew Kirschen, Benjamin Rohaut, Stephen Trevick, Michael J Young, Joseph J Fins
BACKGROUND: The Curing Coma Campaign (CCC) is a multidisciplinary global initiative focused on evaluation, diagnosis, treatment, research, and prognostication for patients who are comatose due to any etiology. To support this mission, the CCC Ethics Working Group conducted a survey of CCC collaborators to identify the ethics priorities of the CCC and the variability in priorities based on country of practice. METHODS: An electronic survey on the ethics priorities for the CCC was developed using rank-choice questions and distributed between May and July 2021 to a listserv of the 164 collaborators of the CCC...
August 2022: Neurocritical Care
https://read.qxmd.com/read/35472071/reframing-postconcussional-syndrome-as-an-interface-disorder-of-neurology-psychiatry-and-psychology
#9
JOURNAL ARTICLE
Camilla N Clark, Mark J Edwards, Bee Eng Ong, Luke Goodliffe, Hena Ahmad, Michael D Dilley, Shai Betteridge, Colette Griffin, Peter O Jenkins
Persistent symptoms following a minor head injury can cause significant morbidity, yet the underlying mechanisms for this are poorly understood. The shortcomings of the current terminology that refer to non-specific symptom clusters is discussed. This update considers the need for a multi-dimensional approach for the heterogenous mechanisms driving persistent symptoms after mild traumatic brain injury. Relevant pathophysiology is discussed to make the case for mild traumatic brain injury to be conceptualized as an interface disorder spanning neurology, psychiatry and psychology...
June 30, 2022: Brain
https://read.qxmd.com/read/35419140/return-to-work-within-four-months-of-grade-3-diffuse-axonal-injury
#10
JOURNAL ARTICLE
Michael J Young, William R Sanders, Rose Marujo, Yelena G Bodien, Brian L Edlow
Neuroprognostication following diffuse axonal injury (DAI) has historically relied on neuroimaging techniques with lower spatial resolution and contrast than techniques currently available in clinical practice. Since the initial studies of DAI classification and prognosis in the 1980s and 1990s, advances in neuroimaging have improved detection of brainstem microbleeds, a hallmark feature of Grade 3 DAI that has traditionally been associated with poor neurologic outcome. Here, we report clinical and radiologic data from two patients with severe traumatic brain injury and grade 3 DAI who recovered functional independence and returned to work within 4 months of injury...
April 2022: Neurohospitalist
https://read.qxmd.com/read/35142409/the-spectrum-of-data-sharing-policies-in-neuroimaging-data-repositories
#11
REVIEW
Anita S Jwa, Russell A Poldrack
Sharing data is a scientific imperative that accelerates scientific discoveries, reinforces open science inquiry, and allows for efficient use of public investment and research resources. Considering these benefits, data sharing has been widely promoted in diverse fields and neuroscience has been no exception to this movement. For all its promise, however, the sharing of human neuroimaging data raises critical ethical and legal issues, such as data privacy. Recently, the heightened risks to data privacy posed by the rapid advances in artificial intelligence and machine learning techniques have made data sharing more challenging; the regulatory landscape around data sharing has also been evolving rapidly...
June 1, 2022: Human Brain Mapping
https://read.qxmd.com/read/34763107/what-does-coma-mean-implications-for-shared-decision-making-in-acute-brain-injury
#12
JOURNAL ARTICLE
Christos Lazaridis, Fernando D Goldenberg, Ali Mansour, Christopher Kramer, Alexandra Tate
BACKGROUND: Insufficient attention has been devoted to shared decision-making (SDM) in the setting of acute brain injury (ABI). Communication occupies a central role that has been highlighted in recent research on SDM with brain injured patients, with respect to "the impact of specific clinician words and expressions". In this investigation, we seek to understand lay public understandings of the term "coma." METHODS: Qualitative analysis of lay interpretations of the term "cComa" using modified open coding of a free-text response question at the end of a survey exploring public attitudes in the context of hypothetical ABI...
February 2022: World Neurosurgery
https://read.qxmd.com/read/35277446/ethics-and-the-2018-practice-guideline-on-disorders-of-consciousness-a-framework-for-responsible-implementation
#13
JOURNAL ARTICLE
Andrew Peterson, Michael J Young, Joseph J Fins
The 2018 practice guideline on disorders of consciousness marks an important turning point in the care of patients with severe brain injury. As clinicians and health systems implement the guideline in practice, several ethical challenges will arise in assessing the benefits, harms, feasibility, and cost of recommended interventions. We provide guidance for clinicians when interpreting these recommendations and call on professional societies to develop an ethical framework to complement the guideline as it is implemented in clinical practice...
April 26, 2022: Neurology
https://read.qxmd.com/read/35101909/emerging-subspecialties-in-neurology-neuroethics-an-emerging-career-path-in-neurology
#14
JOURNAL ARTICLE
Michael J Young, James L Bernat
Essential to responsible practice and progress in neurology and neuroscience research is robust engagement with associated ethical dimensions and challenges. By virtue of the privileged relationship between personhood and the brain, and the importance of properties of the nervous system to what for most makes life worth living, conditions that affect neurologic function introduce a growing host of novel ethical and philosophical issues. Rather than serving a reactionary role, it is important for neurologists to anticipate such issues and develop familiarity with ethical analysis to inform quality medical practice and to safeguard neuroscience research...
March 22, 2022: Neurology
https://read.qxmd.com/read/35016251/neuroethics-in-the-era-of-teleneurology
#15
JOURNAL ARTICLE
Michael J Young
The accelerating integration of telehealth technologies in neurology practice has transformed traditional interactions between neurologists and patients, allied clinicians and society. Despite the immense promise of these technologies to improve systems of neurological care, the infusion of telehealth technologies into neurology practice introduces a host of unique ethical challenges. Proactive consideration of the ethical dimensions of teleneurology and of the impact of these innovations on the field of neurology more generally can help to ensure responsible development and deployment across stages of implementation...
January 11, 2022: Seminars in Neurology
https://read.qxmd.com/read/34746412/acquired-brain-injury-in-adults-a-review-of-pathophysiology-recovery-and-rehabilitation
#16
JOURNAL ARTICLE
Natalie Gilmore, Douglas I Katz, Swathi Kiran
PURPOSE: To summarize existing literature from a range of fields (i.e., neurology, neuropsychology, neuroscience, neuroimaging, rehabilitation, speech-language pathology) that is relevant to the development and/or revision of cognitive rehabilitation programs for individuals with acquired brain injury (ABI) and in particular, for young adults. METHOD: This paper reviews a range of ABI-associated topics including: 1) mechanisms of injury; 2) biological, individual-specific, and behavioral drivers of recovery; and 3) current methods of cognitive rehabilitation...
August 2021: Perspectives of the ASHA Special Interest Groups
https://read.qxmd.com/read/34710035/who-if-not-the-fda-should-regulate-implantable-brain-computer-interface-devices
#17
JOURNAL ARTICLE
Charles E Binkley, Michael S Politz, Brian P Green
Implantable brain-computer interface (BCI) and other devices with potential for both therapeutic purposes and human enhancement are being rapidly developed. The distinction between therapeutic and enhancement uses of these devices is not well defined. While the US Food and Drug Administration (FDA) rightly determines what is safe and effective, this article argues that the FDA should not make subjective, value-laden assessments about risks and benefits when it comes to approval of BCIs for therapy and enhancement...
September 1, 2021: AMA Journal of Ethics
https://read.qxmd.com/read/34474426/behavioral-assessment-of-patients-with-disorders-of-consciousness
#18
JOURNAL ARTICLE
Eileen Fitzpatrick-DeSalme, Angela Long, Ferzeen Patel, John Whyte
Brain injury resulting in coma may evolve into a prolonged disorder of consciousness, including the vegetative and minimally conscious states. Early detection of emerging consciousness has positive prognostic significance, and improvement in consciousness at any point may indicate the potential for meaningful communication and environmental control. Despite the importance of accurate assessment of consciousness, research indicates that as many as 40% of patients with a disorder of consciousness may be assessed incorrectly...
January 1, 2022: Journal of Clinical Neurophysiology: Official Publication of the American Electroencephalographic Society
https://read.qxmd.com/read/34474428/brain-computer-interfaces-in-acute-and-subacute-disorders-of-consciousness
#19
JOURNAL ARTICLE
Ren Xu, Rossella Spataro, Brendan Z Allison, Christoph Guger
Disorders of consciousness include coma, unresponsive wakefulness syndrome (also known as vegetative state), and minimally conscious state. Neurobehavioral scales such as coma recovery scale-revised are the gold standard for disorder of consciousness assessment. Brain-computer interfaces have been emerging as an alternative tool for these patients. The application of brain-computer interfaces in disorders of consciousness can be divided into four fields: assessment, communication, prediction, and rehabilitation...
January 1, 2022: Journal of Clinical Neurophysiology: Official Publication of the American Electroencephalographic Society
https://read.qxmd.com/read/34454687/brain-injury-after-cardiac-arrest
#20
REVIEW
Gavin D Perkins, Clifton W Callaway, Kirstie Haywood, Robert W Neumar, Gisela Lilja, Matthew J Rowland, Kelly N Sawyer, Markus B Skrifvars, Jerry P Nolan
As more people are surviving cardiac arrest, focus needs to shift towards improving neurological outcomes and quality of life in survivors. Brain injury after resuscitation, a common sequela following cardiac arrest, ranges in severity from mild impairment to devastating brain injury and brainstem death. Effective strategies to minimise brain injury after resuscitation include early intervention with cardiopulmonary resuscitation and defibrillation, restoration of normal physiology, and targeted temperature management...
October 2, 2021: Lancet
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