Medição funcional no domínio da ética empírica

This paper presents the proposal of an empirical approach to ethics derived from a psychological theory of human judgment proposed by Norman Anderson. It shows how the methodology specific to this theory —functional measurement— makes it possible to characterize the various personal positions that exist in all societies regarding public health problems. The main results of three studies carried out in three different countries (Guinea, France, and Colombia) on various problems are presented as an illustration of what this approach can offer. These analyses focused on three deliberately very different problems: (a) the duty to care for infected patients in the event of a pandemic that puts at risk the lives of the health professionals, (b) the acceptability of postmortem reproduction in the specific context of fallen soldiers, and (c) the acceptability of physicianassisted suicide.El presente artículo propone un enfoque empírico de la ética derivado de la teoría psicológica del juicio humano propuesta por Norman Anderson. Muestra cómo la metodología de esta teoría —denominada medición funcional— puede utilizarse para caracterizar las diversas posiciones personales que existen en todas las sociedades respecto a los problemas de salud pública. Los principales resultados de tres estudios realizados en tres países diferentes (Guinea, Francia y Colombia) se presentan como ilustración de lo que puede aportar este enfoque. Dichos análisis se centraron en tres problemas deliberadamente muy diferentes: (a) el deber de atender a los pacientes infectados, en caso de una epidemia que ponga en peligro la vida de los cuidadores; (b) la aceptabilidad de la reproducción postmortem, en el caso de los soldados que mueren en combate, y (c) la aceptabilidad del suicidio asistido por un médico.Este artigo propõe uma abordagem empírica da ética derivada da teoria psicológica do julgamento humano proposta por Norman Anderson. Mostra como a metodología dessa teoria —denominada medição funcional— pode ser utilizada para caracterizar as diversas posições pessoais que existem em todas as sociedades em relação aos problemas de saúde pública. Os principais resultados de três estudos, realizados em três países diferentes (Guiné, França e Colômbia), são apresentados como uma ilustração do que esta abordagem pode contribuir.Esses estudos se concentraram em três problemas deliberadamente muito diferentes: (a) o deber de cuidar de pacientes infectados no caso de uma epidemia que ponha em risco a vida dos cuidadores, (b) a aceitabilidade da reprodução postmortem no caso de soldados que morrem em combate, e (c) a aceitabilidade do suicidio assistido por médicos

Autoantibodies against type I IFNs in patients with critical influenza pneumonia

In an international cohort of 279 patients with hypoxemic influenza pneumonia, we identified 13 patients (4.6%) with autoantibodies neutralizing IFN-alpha and/or -omega, which were previously reported to underlie 15% cases of life-threatening COVID-19 pneumonia and one third of severe adverse reactions to live-attenuated yellow fever vaccine. Autoantibodies neutralizing type I interferons (IFNs) can underlie critical COVID-19 pneumonia and yellow fever vaccine disease. We report here on 13 patients harboring autoantibodies neutralizing IFN-alpha 2 alone (five patients) or with IFN-omega (eight patients) from a cohort of 279 patients (4.7%) aged 6-73 yr with critical influenza pneumonia. Nine and four patients had antibodies neutralizing high and low concentrations, respectively, of IFN-alpha 2, and six and two patients had antibodies neutralizing high and low concentrations, respectively, of IFN-omega. The patients' autoantibodies increased influenza A virus replication in both A549 cells and reconstituted human airway epithelia. The prevalence of these antibodies was significantly higher than that in the general population for patients 70 yr of age (3.1 vs. 4.4%, P = 0.68). The risk of critical influenza was highest in patients with antibodies neutralizing high concentrations of both IFN-alpha 2 and IFN-omega (OR = 11.7, P = 1.3 x 10(-5)), especially those <70 yr old (OR = 139.9, P = 3.1 x 10(-10)). We also identified 10 patients in additional influenza patient cohorts. Autoantibodies neutralizing type I IFNs account for similar to 5% of cases of life-threatening influenza pneumonia in patients <70 yr old

CIBERER : Spanish national network for research on rare diseases: A highly productive collaborative initiative

Altres ajuts: Instituto de Salud Carlos III (ISCIII); Ministerio de Ciencia e Innovación.CIBER (Center for Biomedical Network Research; Centro de Investigación Biomédica En Red) is a public national consortium created in 2006 under the umbrella of the Spanish National Institute of Health Carlos III (ISCIII). This innovative research structure comprises 11 different specific areas dedicated to the main public health priorities in the National Health System. CIBERER, the thematic area of CIBER focused on rare diseases (RDs) currently consists of 75 research groups belonging to universities, research centers, and hospitals of the entire country. CIBERER's mission is to be a center prioritizing and favoring collaboration and cooperation between biomedical and clinical research groups, with special emphasis on the aspects of genetic, molecular, biochemical, and cellular research of RDs. This research is the basis for providing new tools for the diagnosis and therapy of low-prevalence diseases, in line with the International Rare Diseases Research Consortium (IRDiRC) objectives, thus favoring translational research between the scientific environment of the laboratory and the clinical setting of health centers. In this article, we intend to review CIBERER's 15-year journey and summarize the main results obtained in terms of internationalization, scientific production, contributions toward the discovery of new therapies and novel genes associated to diseases, cooperation with patients' associations and many other topics related to RD research

Multiancestry analysis of the HLA locus in Alzheimer’s and Parkinson’s diseases uncovers a shared adaptive immune response mediated by HLA-DRB1*04 subtypes

Across multiancestry groups, we analyzed Human Leukocyte Antigen (HLA) associations in over 176,000 individuals with Parkinson’s disease (PD) and Alzheimer’s disease (AD) versus controls. We demonstrate that the two diseases share the same protective association at the HLA locus. HLA-specific fine-mapping showed that hierarchical protective effects of HLA-DRB1*04 subtypes best accounted for the association, strongest with HLA-DRB1*04:04 and HLA-DRB1*04:07, and intermediary with HLA-DRB1*04:01 and HLA-DRB1*04:03. The same signal was associated with decreased neurofibrillary tangles in postmortem brains and was associated with reduced tau levels in cerebrospinal fluid and to a lower extent with increased Aβ42. Protective HLA-DRB1*04 subtypes strongly bound the aggregation-prone tau PHF6 sequence, however only when acetylated at a lysine (K311), a common posttranslational modification central to tau aggregation. An HLA-DRB1*04-mediated adaptive immune response decreases PD and AD risks, potentially by acting against tau, offering the possibility of therapeutic avenues

Etats d'esprit et motifs d'action - volume I

International audienceLa Théorie du Renversement Psychologique postule l’existence de quatre oppositions majeures qui structurent le flux de nos expériences quotidiennes. Selon cette théorie, l’on peut se trouver dans un état d’esprit sérieux ou enjoué, conformiste ou transgressif, centré sur soi-même ou centré sur autrui, et chercher à dominer son environnement ou bien à entrer en sympathie avec lui. Les motifs de nos actions sont, en permanence, associés à ces états d’esprit. Le présent ouvrage se veut une contribution empirique à cette théorie. Il offre une synthèse de toute une série de travaux ayant cherché à inventorier les motifs de nos conduites de santé : motifs à consulter un praticien, motifs à adhérer (ou non) à un traitement, motifs à recourir à la chirurgie (y compris esthétique), motifs à adopter (ou non) des comportements de protection, motifs à donner (ou non) ses organes, ou encore motifs à se porter volontaire comme soignant (en cas d’épidémie). La démarche qui est adoptée associe toujours approche qualitative et approche de vérification

Evaluando los procesos de integración de la información utilizando diseños entre- o intra- sujetos: más evidencia

Within-subject designs (WSDs) remain unappreciated in psychology although many experimental tactics can reduce or eliminate the demand and order effects that WSDs tend to create. Comparative studies conducted in the Information Integration Theory (IIT) framework have shown that patterns of results observed using WSDs can largely be replicated using between-subject designs (BSDs). In order to add evidence to these findings, three additional studies were conducted in order to complement data obtained in previous studies. One of these studies was about health risk perception and tested the possibility to find evidence for a disjunctive rule of information integration using a BSD. The other two studies focused on the valuation process of IIT. The new findings regarding the disjunctive rule added support to the view that equivalent results can be obtained either with a highly economical repeated-measures design or with a much costlier independent factorial group arrangement. However, when the focus was on the valuation process and not on the integration process, ratings obtained in the BSD condition seemed to be restricted to a limited range of values by comparison with ratings obtained in the WSD condition. An explanation in terms of context effect is offered.Los diseños intra sujetos (WSD) no se aprecian en la psicología, aunque existen muchas tácticas experimentales que pueden reducir o eliminar la demanda y los efectos de orden que tienden a crear los WSD. Los estudios comparativos realizados en el marco de la Teoría de Integración de la Información (IIT) han demostrado que los patrones de resultados observados con WSD se pueden replicar en gran medida utilizando diseños entre sujetos (BSD). Para agregar evidencia a estos hallazgos, se realizaron tres estudios adicionales para complementar los datos obtenidos en estudios anteriores. Uno de estos estudios fue sobre la percepción de riesgo en salud y evaluó la posibilidad de encontrar evidencia de regla disyuntiva de integración de la información utilizando un BSD. Los otros dos estudios se centraron en el proceso de valoración de IIT. Los nuevos hallazgos con respecto a la regla disyuntiva sustentaron la opinión de que se pueden obtener resultados equivalentes tanto con un diseño altamente económico de medidas repetidas o con un acuerdo de grupo factorial independiente mucho más costoso. Sin embargo, cuando la atención se centró en el proceso de valoración y no en el proceso de integración, las calificaciones obtenidas en la condición BSD parecían estar restringidas a un rango limitado de valores en comparación con las calificaciones obtenidas en la condición WSD. Se ofrece una explicación en términos del efecto de contexto

Why patients want to take or refuse to take antibiotics: an inventory of motives

Abstract Background Inappropriate use of antibiotics is a worldwide issue. In order to help public health institutions and each particular physician to change patterns of consumption among patients, it is important to understand better the reasons why people accept to take or refuse to take the antibiotic drugs. This study explored the motives people give for taking or refusing to take antibiotics. Methods Four hundred eighteen adults filled out a 60-item questionnaire that consisted of assertions referring to reasons for which the person had taken antibiotics in the past and a 70-item questionnaire that listed reasons for which the person had sometimes refused to take antibiotics. Results A six-factor structure of motives to take antibiotics was found: Appropriate Prescription, Protective Device, Enjoyment (antibiotics as a quick fix allowing someone to go out), Others’ Pressure, Work Imperative, and Personal Autonomy. A four-factor structure of motives not to take antibiotics was found: Secondary Gain (through prolonged illness), Bacterial Resistance, Self-defense (the body is able to defend itself) and Lack of trust. Scores on these factors were related to participants’ demographics and previous experience with antibiotics. Conclusion Although people are generally willing to follow their physician’s prescription of antibiotics, a notable proportion of them report adopting behaviors that are beneficial to micro-organisms and, as a result, potentially detrimental to humans

Attitudes of French populations towards the disclosure of unsolicited findings in medical genetics

International audienc