Relieving pain using dose-extending placebos

Placebos are often used by clinicians, usually deceptively and with little rationale or evidence of benefit, making their use ethically problematic. In contrast with their typical current use, a provocative line of research suggests that placebos can be intentionally exploited to extend analgesic therapeutic effects. Is it possible to extend the effects of drug treatments by interspersing placebos? We reviewed a database of placebo studies, searching for studies that indicate that placebos given after repeated administration of active treatments acquire medication-like effects. We found a total of 22studies in both animals and humans hinting of evidence that placebos may work as a sort of dose extender of active painkillers. Wherever effective in relieving clinical pain, such placebo use would offer several advantages. First, extending the effects of a painkiller through the use of placebos may reduce total drug intake and side effects. Second, dose-extending placebos may decrease patient dependence. Third, using placebos along with active medication, for part of the course of treatment, should limit dose escalation and lower costs. Importantly, provided that nondisclosure is pre-authorized in the informed consent process and that robust evidence indicates therapeutic benefit comparable to that of standard full-dose therapeutic regimens, introducing dose-extending placebos into the clinical arsenal should be considered. This novel prospect of placebo use has the potential to change our general thinking about painkiller treatments, the typical regimens of painkiller applications, and the ways in which treatments are evaluated

Political participation of unemployed youth: the moderator effect of associational membership

<span class="abs_content">This article discusses how associational membership can compensate for that lack of opportunities and motivation necessary for political participation that unemployment usually provokes. We investigate such a moderator effect of associational membership by means of a CATI survey of young people realized in two different cities: Turin in Italy and Kielce in Poland. The survey was part of a larger research on youth unemployment funded by the EU FP7 program (Younex). We propose an exploratory analysis allowing us to assess at a low level of abstraction and through a local level comparison, how far associational membership performs even across different contexts as a promoter of political engagement of a specific group of young, deprived, individuals.</span><br /

Actions for the environment

As an International Organization, one the most important issues that CERN has to respect and guarantee is the protection of the environment. Several of ST activities and operations have a direct impact on the environment: civil engineering works, electrical (transformers) and air-cooling operation, chemical products storage, various waste disposal etc.... Important measures, taken in the past, have to be kept and new ones should be applied in order to insure the conformity of the infrastructure with existing legislation, the correct operation of equipment and systems, the constant monitoring of the different situations and the traceability of the events. Moreover good management of the environment would bring large savings to CERN

Recent Trends and Impacts of Fisheries Exploitation on Mediterranean Stocks and Ecosystems

This review focuses on the recent data on Mediterranean fishing fleets and landings, results from stock assessments and ecosystem models to provide an overview of the multiple impacts of fishing exploitation in the different Mediterranean geographical sub-areas (GSAs). A fleet of about 73,000 vessels is widespread along the Mediterranean coasts. Artisanal activities are predominant in South Mediterranean and in the eastern basin, while trawling features GSAs in the western basin and the Adriatic Sea. The overall landings of fish, crustaceans and cephalopods, after peaking during mid 90s at about one million tons, declined at about 700,000 tons in 2013. However, while landings are declining in EU countries since the 90s, in non-EU countries a decreasing trend was observed only in the last 5–10 years. The current levels of fishing effort determine a general overexploitation status of commercial stocks with more than 90% of the stock assessed out of safe biological limits. Indicators obtained from available ecosystem models were used to assess the sustainability of the fisheries. They included primary production required to sustain fisheries (PPR), mean trophic level of the catch (mTLc), the loss in secondary production index (L index), and the probability of the ecosystem to be sustainably exploited (psust). In areas exploited more sustainably (e.g., Gulf of Gabes, Eastern Ionian, and Aegean Sea) fishing pressure was characterized by either low number of vessels per unit of shelf area or the large prevalence of artisanal/small scale fisheries. Conversely, GSAs in Western Mediterranean and Adriatic showed very low ecosystem sustainability of fisheries that can be easily related with the high fishing pressure and the large proportion of overfished stocks obtained from single species assessments. We showed that the current knowledge on Mediterranean fisheries and ecosystems describes a worrisome picture where the effect of poorly regulated fisheries, in combination with the ongoing climate forcing and the rapid expansion of non-indigenous species, are rapidly changing the structure and functioning of the ecosystem with unpredictable effects on the goods and services provided. Although this would call for urgent conservation actions, the management system implemented in the region appears too slow and probably inadequate to protect biodiversity and secure fisheries resources for the future generations

Bioetica e scienza nell'informazione giornalistica. Un'analisi deontologica

Il saggio intende individuare doveri etico-deontologici specifici al trattamento giornalistico della bioetica, disciplina caratterizzata dalla compresenza di una dimensione fattuale e di una dimensione axiologica. La dimensione fattuale richiede che il giornalista sappia riconoscere le teorie conformi al metodo scientifico. La dimensione axiologica richiede che il giornalista renda riconoscibile lo statuto della propria comunicazione

The impact of economic crisis on civic attitudes: the moderating role of expected social mobility. Evidence from some European countries

In times of crisis, the deterioration of living standards may also have direct consequences on civic culture of people and become dangerous for the health of democracy. The purpose of this paper is to investigate the extent to which the recent economic crisis directly influences the civic attitudes in some European democracies focusing on two questions: how much does crisis exposure affect democratic legitimacy attitudes? And what is the role played by expected social mobility on this effect? Hypotheses are tested using data collected in the Western European countries included in the Life in Transition Survey II (France, Germany, Italy, Sweden and UK). The findings show that economic crisis exposure significantly affects civic attitudes. The results confirm that higher crisis exposure is associated with lower civic attitudes. Additionally, the present research rules out the possibility that crisis exposure affects attitudes in a specific way, depending on the expected mobility valence. This paper sheds light on the importance of analysing the negative civic effect of economic crisis and on the critical role that the fear of social downgrading plays in determining this effect

Identification and characterization of nursery areas of red mullet Mullus barbatus in the Central Tyrrhenian Sea

Red Mullet Mullus barbatus is an important target of fishing activities in the central Tyrrhenian Sea, so it is essential to identify its critical habitats in order to manage this resource efficiently. Our research specifically focused on the identification and characterization of nursery areas. The use of spatial interpolation techniques enabled us to identify five nurseries that were highly persistent through time. Moreover, the estimate of juvenile density confirmed the strong aggregation effect of these nursery grounds, as a great portion of young individuals were concentrated in a relatively small surface of the study area. The environmental characterization of these areas showed that juveniles were mainly distributed on bottoms with a relatively high percentage of sand (>70%; P <0.05). Shannon biodiversity index analysis indicated that the southern nurseries reached the highest values of habitat quality (P < 0.0001). Multivariate analysis showed that nursery grounds were divided into three main groups, and analysis of spatial dynamics showed that two different strategies characterized Red Mullet juveniles when density changes over time. In particular, in some areas young individuals selected habitats in a density-dependent way following the basin model scheme, while in other zones they selected habitats in a density-independent way according to the proportional density model. Results also showed that juveniles followed the proportional density model strategy into nursery areas with the highest Shannon biodiversity index values

Planning et coordination de l'installation du LHC

La division ST joue un rôle clé dans le projet LHC puisque fournissant une grande partie de l'infrastructure (génie civil, électricité, traitements de l'air, systèmes hydrauliques, transport, détection, contrôle d'accès…) tant pour la machine que pour les zones expérimentales. Un planning de coordination unique et consensuel entre les différents intervenants pour le design et l'installation des différents équipements est primordial pour la réussite du projet. Ce papier décrit les procédures pour obtenir ce planning unique, les modes d'information et de validation des différents changements, ainsi que les liens entre les différents acteurs de la planification du projet : à savoir les groupes ou divisions installateurs, le nouveau groupe de «Coordination de l'Installation » et la direction du projet LHC

Placebo and Nocebo Effects: The Advantage of Measuring Expectations and Psychological Factors

Several studies have explored the predictability of placebo and nocebo individual responses by investigating personality factors and expectations of pain decreases and increases. Psychological factors such as optimism, suggestibility, empathy and neuroticism have been linked to placebo effects, while pessimism, anxiety and catastrophizing have been associated to nocebo effects. We aimed to investigate the interplay between psychological factors, expectations of low and high pain and placebo hypoalgesia and nocebo hyperalgesia. We studied 46 healthy participants using a well-validated conditioning paradigm with contact heat thermal stimulations. Visual cues were presented to alert participants about the level of intensity of an upcoming thermal pain. We delivered high, medium and low levels of pain associated with red, yellow and green cues, respectively, during the conditioning phase. During the testing phase, the level of painful stimulations was surreptitiously set at the medium control level with all the three cues to measure placebo and nocebo effects. We found both robust placebo hypolagesic and nocebo hyperalgesic responses that were highly correlated with expectancy of low and high pain. Simple linear regression analyses showed that placebo responses were negatively correlated with anxiety severity and different aspects of fear of pain (e.g., medical pain, severe pain). Nocebo responses were positively correlated with anxiety sensitivity and physiological suggestibility with a trend toward catastrophizing. Step-wise regression analyses indicated that an aggregate score of motivation (value/utility and pressure/tense subscales) and suggestibility (physiological reactivity and persuadability subscales), accounted for the 51% of the variance in the placebo responsiveness. When considered together, anxiety severity, NEO openness-extraversion and depression accounted for the 49.1% of the variance of the nocebo responses. Psychological factors per se did not influence expectations. In fact, mediation analyses including expectations, personality factors and placebo and nocebo responses, revealed that expectations were not influenced by personality factors. These findings highlight the potential advantage of considering batteries of personality factors and measurements of expectation in predicting placebo and nocebo effects related to experimental acute pain