User:Pierre-Alain Gouanvic

I developped an interest for several scientific and biomedical fields of enquiry after spending my first years of university in philosophy and literature. Then, disease stroke. I ingested gigs of information in the following years.

I work as a translator. I'm also building a Web site designed to welcome and offer shelter to persons who want to become "expert patients". Citizens, when faced with the problem of their physical integrity, are able and willing to become responsible and knowledgeable citizens in matters related to their biology, taken in its widest sense.

I have worked as a terminologist (scientific and technical terminology). I am married and I am the father of two adorable children.

See below for some interesting things to read.

But first, what is strong collaboration?

Strong collaboration requires something akin to friendship. Knowledgeworkers should not be forced to work with each other. But they ought to. An online community of people sharing a deep commitment to knowledge should be closer to each other than neighbors or relatives.

The debate over authorship is misleading: authors of articles may get what they want, their names on or near an excellent article... with an elaborate list of "who did what"... but the real goal is to make authors proud to say: I belonged to this group in Citizendium which was able to come together (experts and ordinary citizens) and get along and create this whole set of articles.

... in progress ...

Questions on my mind

• How Does Our Brain Constitute Defense Mechanisms? First-Person Neuroscience and Psychoanalysis
• Empirical Studies Validate Prominence of Unconscious Processes "Consciousness is the tip of the psychic iceberg that Freud imagined it to be"
• How the Brain Translates Money into Force: A Neuroimaging Study of Subliminal Motivation, Science 11 May 2007. "Unconscious motivation in humans is often inferred but rarely demonstrated empirically. We imaged motivational processes, implemented in a paradigm that varied the amount and reportability of monetary rewards for which subjects exerted physical effort. We show that, even when subjects cannot report how much money is at stake, they nevertheless deploy more force for higher amounts."
• • Evidence-Based Medicine - watching out for its friends Excellent overview of the state of affairs with EBM

Ethics and evidence-based medicine

Ethics and evidence based medicine:

Deciding between competing claims The second philosophical criticism, that it may be impossible to decide between competing claims of different stakeholders, is emphasised by the manner in which patients continue to have little influence over the priorities of research. Evidence based medicine claims to reject the power of expert opinion but it is still mostly doctors who determine research objectives, who interpret research data, and who implement research findings. A number of commentators have called for greater involvement by consumer groups in setting research agendas, but how conflicts between the agendas of the different stakeholders are to be resolved remains unclear. Evidence based medicine is unable to address political concerns because the values of different stakeholders, and hence the way in which they interpret evidence, cannot always be made congruent with each other. Systematic bias Governments and health funds find the notion of allocating health resources on the basis of evidence attractive.26 Eddy has suggested that healthcare funds should be required to cover interventions only if there is sufficient evidence that they can be expected to produce their intended effects.27 The Australian health minister, Dr Michael Wooldridge, who is a strong supporter of evidence based medicine, has adopted a similar position, stating "[we will] pay only for those operations, drugs and treatments that according to available evidence are proved to work."26 Given the complexities of the issues surrounding resource allocation, the drive to seek certainty and simplicity at the policy level is understandable. However, the large quantities of trial data required to meet the standards of evidence based medicine are available for relatively few interventions. Evidence based medicine may therefore introduce a systematic bias, resulting in allocation of resources to those treatments for which there is rigorous evidence of effectiveness, or towards those for which there are funds available to show effectiveness (such as new pharmaceutical agents). This may be at the expense of other areas where rigorous evidence does not currently exist or is not attainable (such as palliative care services). Allocating resources on the basis of evidence may therefore involve implicit value judgments, and it may only be a short step from the notion that a therapy is "without substantial evidence" to it being thought to be "without substantial value."8 (...) Simplistic solutions

According to Williams, "there is great pressure for research into techniques to make larger ranges of social value commensurable. Some of the effort should rather be devoted to learning---or learning again---how to think intelligently about conflicts of values which are incommensurable."9 This is particularly the case where it comes to making decisions about allocation of health resources. Those charged with making these decisions are seeking simplistic solutions to inherently complex problems---the danger is that through evidence based medicine we will supply them.

• IOW: Is there a lack of evidence-based medicine or an excess of lack-of-evidence-based medicine?
• Is objectivity a bias in a world where EBM creates clinical opinions?
• What will happen of the so-called anecdotal reports when everything will be assumed to be known from large-scale clinical trials?
  • Original research in pathology: judgment, or evidence-based medicine?
• Does the "invisible hand of market" take good care of science when deciding what trials will be funded?
  • Non-financial conflicts of interest are more serious than financial conflicts
  • Ethical problems arising in evidence based complementary and alternative medicine

RESEARCH FUNDS ARE SCARCE Funds are scarce for CAM research compared with most areas of medical research.21 Governments and other funding bodies usually allocate health resources on the basis of existing evidence.22 Because the evidence for CAM is fragmentary and evolving, research applications in CAM—other than to government agencies specifically created to fund CAM research, such as the (rather unique) National Center for Complementary and Alternative Medicine (NCCAM) at the NIH in the US—have a lower chance of receiving funding than those in conventional medicine. This situation creates a systemic bias, which results in allocation of resources to those areas of (conventional) medicine for which reasonably good evidence already exists. The resulting funding stream is at the expense of areas in which no or less evidence currently exists—for example, CAM.23 This impinges on the ethical principle of justice. In principle, it also perpetuates the under researched status of CAM.

ethics

• Desired Attributes of Evidence Assessments for Evidence-based Practices
• Why are stages of moral development not regularly assessed? (Kohlberg scale, others)
  • Generosity 'may be in the genes'

Userplan

What follows is a userplan. I found it hard to keep it up to date, but I leave it as it is because it is informative.

Pierre-Alain Gouanvic Status    last updated Jan. 23    [edit plan here] Get your own infobox! • Group Status ~ Plans ~ Short term plans 1. follow my intuitions Longer-term plans 1. etiology and pathophysiology for major diseases; findings, hypotheses 2. self-medication, self-prescription, patient autonomy, expert patient, right to health, deficiency diseases, hidden curriculum, medico-industrial complex, neutrality, etc. 3. bring new insights on all important controversies : mirror neurons, vitamin C, harm reduction, ethics, activism, etc. 4. promote the development of controversial articles to show CZ is THE place to consult 5. My 3 proposals to achieve CZ goals ~ Roles and notes ~ Roles in the system 1. author Notes to self Click edit above to start these notes Public notes : A number of commentators have called for greater involvement by consumer groups in setting research agendas, but how conflicts between the agendas of the different stakeholders are to be resolved remains unclear. Ethics and evidence based medicine Abridged watchlist CZ:Proposals > Internationalisation sandbox Tools To create references in Wiki format using PMIDs OAIster Open Access Index search Website Observatoire du droit à la santé English version (Right to Health Watch) coming soon. perhaps. TO DO LIST Not an inclusive list! J Altern Complement Med. 2007 Jul-Aug;13(6):659-68. The process of whole person healing: "unstuckness" and beyond. Koithan M, Verhoef M, Bell IR, White M, Mulkins A, Ritenbaugh C. Int J Neurosci. 2004 Sep;114(9):1195-220. EEG alpha sensitization in individualized homeopathic treatment of fibromyalgia. Bell IR, Lewis DA 2nd, Lewis SE, Schwartz GE, Brooks AJ, Scott A, Baldwin CM. J Altern Complement Med. 2004 Apr;10(2):285-99. Electroencephalographic cordance patterns distinguish exceptional clinical responders with fibromyalgia to individualized homeopathic medicines. Bell IR, Lewis DA 2nd, Schwartz GE, Lewis SE, Caspi O, Scott A, Brooks AJ, Baldwin CM. Doctors Kousmine Klenner Cathcart .... Conditions Stroke Stroke rehab (huge topic) CHD vs n-3 FAs (indicate the errors in the Cochrane review) MCS (description); cf recent research by Rae Molecules Vit C: see its talk page; transport; neurological role Mg Vit. D Carnitine .. Topics EBM : recent special edition in the JECP Notes