1,721,024 research outputs found
The autonomic nervous system and the brainstem: A fundamental role or the background actors for consciousness generation? Hypothesis, evidence, and future directions for rehabilitation and theoretical approaches
Full text linkIntroduction: One of the hardest challenges of the third century is to develop theories that could joint different results for a global explanation of human consciousness. Some important theories have been proposed, trying to explain the emergence of consciousness as the result of different progressive changes in the elaboration of information during brain processing, giving particular attention to the thalamocortical system. Methods: In this article, a summary review of results that highlighted as cerebral cortex could not be so fundamental for consciousness generation is proposed. In detail, three topics were analyzed: (a) studies using experimental approach (manipulating stimuli or brain areas), such as decorticated animals or subliminal presentation of stimuli; (b) studies using anatomo-clinical method (conscious inferenced from observed behaviors); and (c) data from neurostimulation of subcortical areas or of the autonomic nervous system. Results: We sketch two speculative hypothesis relative, firstly, to the possible independence from cortical areas of the on/off mechanism for consciousness generation and, secondly, to the possible role of information variability generated by the bottom-up exchange of information among neural systems as a switch for consciousness. Conclusions: A broad range of evidence regarding the functional role of the brainstem and autonomic nervous system is reviewed for its bearing on a future hypothesis regarding the generation of consciousness experience
Stati vegetativo e di minima coscienza: risultati del progetto nazionale di ricerca.
No full textL’articolo riporta i risultati della ricerca che ha condotto alla raccolta di dati relativi a 602 persone (566 adulti e 36 bambini), con diagnosi di stato vegetativo o stato di minima coscienza. Vengono riportati i valori rispetto alle caratteristiche del campione indagato (dati sociodemografici, tempo trascorso dall’evento acuto, condizione clinica, alimentazione e idratazione, respirazione , terapie eccetera) sulla base di una definizione di funzionamento e disabilità nell’ottica del modello biopsicosociale della classificazione ICF
Analyzing the paradigmatic cases of two persons with a disorder of consciousness: reflections on the legal and ethical perspectives
Full text linkBackground: Media have increasingly reported on the difficulties associated with end-of-life decision-making in patients with Disorders of Consciousness (DOC), contextualizing such dilemma in detailed accounts of the patient’s life. Two of the first stories debated in the scientific community were those related to the cases of two women, one American, the other Italian, who captured attention of millions of people in the first years of this third millennium.
Methods: Much has been written about the challenges of surrogate decision-making for patients in DOC, but less has been written comparing these challenges across legal systems and cultures. In our paper, we propose a systematic analysis of the final legal documents written by the American and Italian Courts in relation to the two cases, developing our discussion around three areas: the level of certainty/reliability of diagnosis and prognosis, the reconstruction of self-expression, time of illness and time of care. They are examples of the typical issues discussed by legal authors and allow us to understand the link and the difference between the legal and ethical perspectives.
Results: The legal approach to the two cases has some common elements: the need to be certain about the diagnosis and prognosis and the fact that the clinical criteria are necessary in determining the most appropriate treatments, although these criteria are not sufficient unless they are supplemented by the patient’s will. The issue of relations takes on importance both from a legal and an ethical point of view, but from two different perspectives. While ethics safeguards relationships by guaranteeing their differences and makes them reconcilable, law safeguards relationships by guaranteeing the cold forms of respect, equality, impartiality, symmetry, reciprocity, and irreversibility. In this perspective, the link between the time of care and the decision of the family members assumes importance.
Conclusions: The most interesting point that emerges from our analysis is the issue of relationships and how they affect decisions, both from a legal and ethical point of view. For this reason, during the patients’ hospitalization, it is necessary to identify ways in which they might give their opinion about the moral issues underlying their choices
Problems of Connectionism
Full text linkThe relationship between philosophy and science has always been complementary. Today, while science moves increasingly fast and philosophy shows some problems in catching up with it, it is not always possible to ignore such relationships, especially in some disciplines such as philosophy of mind, cognitive science, and neuroscience. However, the methodological procedures used to analyze these data are based on principles and assumptions that require a profound dialogue between philosophy and science. Following these ideas, this work aims to raise the problems that a classical connectionist theory can cause and problematize them in a cognitive framework, considering both philosophy and cognitive sciences but also the disciplines that are near to them, such as AI, computer sciences, and linguistics. For this reason, we embarked on an analysis of both the computational and theoretical problems that connectionism currently has. The second aim of this work is to advocate for collaboration between neuroscience and philosophy of mind because the promotion of deeper multidisciplinarity seems necessary in order to solve connectionism's problems. In fact, we believe that the problems that we detected can be solved by a thorough investigation at both a theoretical and an empirical level, and they do not represent an impasse but rather a starting point from which connectionism should learn and be updated while keeping its original and profoundly convincing core
Risk factors for mortality in 600 patients in vegetative and minimally conscious states.
No full textA significant proportion of patients who survive traumatic or nontraumatic severe acquired brain injuries experiences disorders of consciousness. The vegetative state and the minimally conscious state may have different prognoses, and while some patients regain awareness, others have negative outcomes and die. The aim of this work is to identify age-related, medical and behavioural risk factors for mortality in those patients. Participants were enrolled from June 2009 to March 2012 in 107 Italian health care institutions. Univariate and multivariate Cox proportional hazard models were adopted to screen and test candidate risk factors. The study enrolled 600 subjects in vegetative and minimally conscious states for an overall mortality rate of 180.1 per 1,000 person-years. The following traits were associated with a significantly lower chance of survival: age at the acute event higher than 51 years, disease duration less than 1 year, post-anoxic aetiology, absence of visual fixation, and the presence of endocrine, nutritional, and metabolic diseases, and immunity disorders. Clinical history, behavioural assessment, and age-related factors provide important prognostic information on negative outcomes that helps clinicians and researchers to predict patients who are at higher risk of mortality. This knowledge has important clinical, managerial, and ethical implications
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Variations on the Author
Full text link“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
Appropriate Similarity Measures for Author Cocitation Analysis
Full text linkWe provide a number of new insights into the methodological discussion about author cocitation analysis. We first argue that the use of the Pearson correlation for measuring the similarity between authors’ cocitation profiles is not very satisfactory. We then discuss what kind of similarity measures may be used as an alternative to the Pearson correlation. We consider three similarity measures in particular. One is the well-known cosine. The other two similarity measures have not been used before in the bibliometric literature. Finally, we show by means of an example that our findings have a high practical relevance.information science;Pearson correlation;cosine;similarity measure;author cocitation analysis
Physical and mental health, anxiety and depressive symptoms in caregivers of patients in vegetative state and minimally conscious state.
No full textCaregivers of patients in vegetative state and minimally conscious state play a crucial role in the process of taking care and, as previous studies reported, they can suffer of high burden and negative health outcomes. The aim of this national cross-sectional study was to assess whether physical and mental health of caregivers, considering gender differences, is related to the presence of depressive symptoms, anxiety, age and patient’s disease duration. Four-hundred and eighteen caregivers, 294 women and 124 men, completed the State Trait Anxiety Inventory-Y, Beck Depression Inventory, second version and Short Form-12. Hierarchical multiple regression analyses were performed to evaluate to which extent depressive and anxiety symptoms predict physical and mental health. Men reported higher levels of mental health state, whereas physical health was not different across gender. High levels of anxiety symptoms were associated to negative mental health outcomes in both genders, whereas depressive symptoms were found to impact on female’s mental and physical health only. A comprehensive and cost-effective screening of anxiety and depressive symptoms may help to identify determinants of health worsening in order to plan, when necessary, caregivers’ support
- …
