22 research outputs found
Before it is too late: professional responsibilities in late-onset Alzheimer's research and pre-symptomatic prediction
The development of a wide array of molecular and neuroscientific biomarkers can provide the possibility to visualize the course of Alzheimerās disease (AD) at early stages. Many of these biomarkers are aimed at detecting not only a preclinical, but also a pre-symptomatic state. They are supposed to facilitate clinical trials aiming at treatments that attack the disease at its earliest stage or even prevent it. The increasing number of such biomarkers currently tested and now partly proposed for clinical implementation calls for critical reflection on their aims, social benefits, and risks. This position paper summarizes major challenges and responsibilities. Its focus is on the ethical and social problems involved in the organization and application of dementia research, as well as in healthcare provision from a cross-national point of view. The paper is based on a discussion of leading dementia experts from neuroscience, neurology, social sciences, and bioethics in the United States and Europe. It thus reflects a notable consensus across various disciplines and national backgrounds. We intend to initiate a debate on the need for actions within the researchersā national and international communities
Regulatory objectivity in action: Mild cognitive impairment and the collective production of uncertainty
In this paper, we investigate recent changes in the definition and approach to Alzheimerās disease brought about by growing clinical, therapeutic and regulatory interest in the prodromal or preclinical aspects of this condition. In the last decade, there has been an increased interest in the biomolecular and epidemiological characterization of pre-clinical dementia. It is argued that early diagnosis of dementia, and particularly of Alzheimerās disease, will facilitate the prevention of dementing processes and lower the prevalence of the condition in the general population. The search for a diagnostic category or biomarker that would serve this purpose is an ongoing but problematic endeavour for research and clinical communities in this area. In this paper, we explore how clinical and research actors, in collaboration with regulatory institutions and pharmaceutical companies, come to frame these domains as uncertainties and how they re-deploy uncertainty in the ācollective productionā of new diagnostic conventions and bioclinical standards. While drawing as background on ethnographic, documentary and interview data, the paper proposes an in-depth, contextual analysis of the proceedings of an international meeting organized by the Peripheral and Central Nervous System Drug Advisory Committee of the US Food and Drug Administration to discuss whether or not a particular diagnostic convention ā mild cognitive impairment ā exists and how best it ought to be studied. Based on this analysis we argue that the deployment of uncertainty is reflexively implicated in bioclinical collectivesā search for rules and conventions, and furthermore that the collective production of uncertainty is central to the āknowledge machineryā of regulatory objectivity
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Late Quaternary Paleoenvironments and Archaeology in the San Pedro Basin, Southeastern Arizona, U.S.A.
One of the most challenging questions surrounding the Clovis colonization of North America is the character and structure of terminal Pleistocene environments, including floral and faunal communities. A series of cores in the mouth of an arroyo revealed late Pleistocene - early Holocene wetland sediments buried 12 meters below surface, at the approximate elevation of the entrenched modern San Pedro River channel. A suite of Ā¹ā“C dates show that wetlands of the ancestral San Pedro River occupied portions of the inner valley coincident with the Younger Dryas (13,000 - 11,500 cal yr BP) and the early Holocene (10,000 - 9,500 cal yr BP). A lack of Sporormiella fungal spores indicates that mammoths were rare or absent when Clovis populations appeared in the valley around 12,800 cal yr BP. Palynological and stable carbon isotope analyses show that Cā grasses increased at 9,940 cal yr BP, just prior to frequent burning after 9,510 cal yr BP and rapid erosion at 9,470 cal yr BP. Ī“ Ā¹āøO values from soil carbonates vary but do not record a systematic shift in precipitation source or temperature during the late Pleistocene - early Holocene transition. The establishment of Cā grasslands in the inner valley correlates with widespread changes in the Chihuahuan Desert flora around 10,000 cal yr BP. A relatively dense accumulation of Clovis-mammoth associations in San Pedro Basin contrasts the lack of megaherbivores indicated at Palominas Arroyo. The upper San Pedro Basin of southeastern Arizona contains a minimum of four Clovis-mammoth associations, making it possibly one of the densest concentrations of human-proboscidean sites on earth in terms of time and space. I use the Younger Dryas-age stratum known as the "black mat" to compare the Clovis-age archaeofaunal record of the basin to its paleontological background in order to measure the level of human predation that created this remarkable record. This analysis indicates that Clovis people were affecting the last mammoth populations to a significant degree, a situation expected only in the presence of abundant mammoths. I argue that this condition was met in the San Pedro Basin, possibly in the form of a terminal Pleistocene refugium. If the refuge hypothesis indeed explains mammoth predation, then Clovis-mammoth associations should occur as clusters as they do in the San Pedro Basin rather than as isolates as they are known to occur elsewhere. The use of radiocarbon frequency distributions to reconstruct prehistoric human and animal populations must account for taphonomic loss and other factors that affect the archaeological and paleontological records. Surovell et al. (Journal of Archaeological Sciences, 36, 1715ā1724) have recently proposed a volcanic-based correction factor for removing "taphonomic bias" from temporal frequency distributions. Analysis of 718 radiocarbon dates sampled from the alluvium of the San Pedro and Santa Cruz Rivers and their tributaries in southeastern Arizona shows that discovery and scientific biases play an equally important role in the creation of radiocarbon frequency distributions, and that "taphonomic bias" has not been systematic through time. The latter principle is further demonstrated using a sample of 123 Pliocene to Clovis-age proboscideans from the San Pedro Valley. We propose an alternative model that is based on the nature of the stratigraphic record, with discovery bias, scientific bias, taphonomic loss, and the shape of the calibration curve all operating to influence the temporal frequency distribution of prehistoric phenomena
Jesse O. Ballenger correspondence
Typed transcripts of several letters written by Jesse O. Ballenger: one is dated 1855 and sent to relatives from the Green River country while traveling to Utah. The second is sent from Springville, Utah, in 1875. Both of these are accompanied by copies of the original letters. Tthe remaining four letters, from 1876 and 1877, are sent from Sunset, Arizona, where he was an early settler
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Before it is too late: professional responsibilities in late-onset Alzheimer's research and pre-symptomatic prediction.
The development of a wide array of molecular and neuroscientific biomarkers can provide the possibility to visualize the course of Alzheimer's disease (AD) at early stages. Many of these biomarkers are aimed at detecting not only a preclinical, but also a pre-symptomatic state. They are supposed to facilitate clinical trials aiming at treatments that attack the disease at its earliest stage or even prevent it. The increasing number of such biomarkers currently tested and now partly proposed for clinical implementation calls for critical reflection on their aims, social benefits, and risks. This position paper summarizes major challenges and responsibilities. Its focus is on the ethical and social problems involved in the organization and application of dementia research, as well as in healthcare provision from a cross-national point of view. The paper is based on a discussion of leading dementia experts from neuroscience, neurology, social sciences, and bioethics in the United States and Europe. It thus reflects a notable consensus across various disciplines and national backgrounds. We intend to initiate a debate on the need for actions within the researchers' national and international communities
Recommended from our members
Before it is too late: professional responsibilities in late-onset Alzheimer's research and pre-symptomatic prediction
First report the findings: genuine balance when reporting CTE
No abstract available