Emerging therapeutics for Alzheimer's disease: an avenue of hope

Emerging therapies for Alzheimer's disease offer hope to patients and their caregivers. Future treatments will probably include combination approaches with agents that modify amyloid processing, deposition, and clearance. One example, the AD vaccine, reduced amyloid burden and changed behavior in animal models of AD, but the human trial was halted when several subjects developed brain inflammation. Anti-inflammatory agents have epidemiologic support, but clinical trials have been disappointing, possibly related to inadequate study with anti-inflammatory agents that modify amyloid processing. Agents that target known cardiovascular risk factors, such as hypercholesterolemia, hypertension, and insulin resistance, have epidemiologic, preclinical, and clinical evidence to warrant further investigation. Heavy metal chelators, antioxidants, neurotrophic factors, glutaminergic modulators, and agents that modify hyperphosphorylation of Tau are other approaches in research and development.     

Normativity unbound: Liminality in palliative care ethics

This article applies the anthropological concept of liminality to reconceptualize palliative care ethics. Liminality possesses both spatial and temporal dimensions. Both these aspects are analyzed to provide insight into the intersubjective relationship between patient and caregiver in the context of palliative care. Aristotelian practical wisdom, or phronesis, is considered to be the appropriate model for palliative care ethics, provided it is able to account for liminality. Moreover, this article argues for the importance of liminality for providing an ethical structure that grounds the doctrine of double effect and overcomes the impasse of phronesis in the treatment of the terminally ill.     

Learning from parents' stories about what works in early intervention

Using a multiple case study approach, this ethnography examined the experiences of parents of children deemed at risk for developmental delays or disabilities who had received early intervention (EI) services (birth to age 3 years) in a large urban location in Western Canada. Participants (11 adult parents and 7 children) were drawn from six families. Methods of data collection included focus groups (FG), face‐to‐face interviews and file reviews. Member check and expert reviews were conducted throughout data collection and data analyses as part of the validation process in this ethnography. Qualitative content analyses followed by thematic analyses highlighted the implementation of family‐centred practices (FCP) as a main theme. Parents identified how EI professionals using FCP embraced collaborative practices. FCP resulted in parents leading the EI process for their children. More specifically, EI professionals shared strategies and information to support parents in gaining a deeper understanding of their children's individual developmental characteristics. Parents expressed how empowering this level of understanding was for them as they learned to articulate what were their children's needs for developmental, health and educational services. Recommendations for future research include inquiring about parents' experiences for families of diverse constellations and/or residing in smaller urban or rural communities.     

The epistemic significance of consensus

Philosophers have often noted that science displays an uncommon degree of consensus on beliefs among its practitioners. Yet consensus in the sciences is not a goal in itself. I consider cases of consensus on beliefs as concrete events. Consensus on beliefs is neither a sufficient nor a necessary condition for presuming that these beliefs constitute knowledge. A concrete consensus on a set of beliefs by a group of people at a given historical period may be explained by different factors according to various hypotheses. A particularly interesting hypothesis from an epistemic perspective is the knowledge hypothesis: shared knowledge explains a consensus on beliefs. If all the alternative hypotheses to the knowledge hypotheses are false or are not as good in explaining a concrete consensus on beliefs, the knowledge hypothesis is the best explanation of the consensus. If the knowledge hypothesis is best, a consensus becomes a plausible, though fallible, indicator of knowledge. I argue that if a consensus on beliefs is uncoerced, uniquely heterogeneous and large, the gap between the likelihood of the consensus given the knowledge hypothesis and its likelihoods given competing hypotheses tends to increase significantly. Consensus is a better indicator of knowledge than “success” or “human flourishing”.     

Electronic records of undesirable driving events

The cause of the majority of road crashes can be attributed to drivers’ behavior. Recent in-vehicle monitoring technologies enable continuous and high resolution measurements of drivers’ behaviors. We analyzed the information received from a novel in-vehicle technology which identifies the occurrences of undesirable driving events such as extreme braking and accelerating, sharp cornering and sudden lane changing. We undertook an exploratory analysis to provide better understanding of events frequency (EF) statistical properties. Our findings show higher EF in trip edges (trip beginning and trip end) than in the middle of the trip, higher EF for males than for females and higher EF at nighttime than at daytime. Use of the in-vehicle technology’s continuous and high resolution measurements enabled interesting advanced statistical analyses. Future research can use our findings to build similar statistical models to predict the occurrence of undesirable driving events by other independent variables.     

The impact of cognitive interference on performance during prolonged sleep loss

Summary A study was conducted on the effects of off-task cognitions on performance during sleep deprivation. Subjects answered the Thought Occurrence Questionnaire, assessing their proneness to engage in off-task cognitions, and were deprived of sleep for 72 hours, during which they performed a variety of tasks including visual discrimination and three versions of a logical reasoning task in which cognitive load was varied systematically. In addition, every day subjects answered the Cognitive Interference Questionnaire, which taps off-task cognitions during the experiment. Results indicated that subjects who habitually engage in off-task cognitions performed worse during 72 hours of sleep loss than subjects who do not engage in such distracting activities. In addition, it was found that the engagement in off-task cognitions increased during the 72 hours of sleep loss and such an engagement was related to deficits in performance accuracy. The mechanisms of off-task cognitions and sleep loss underlying these effects are discussed.