doi: 10.3389/fnbeh.2014.00358 An fMRI study on the influence of sommeliers ’ expertise on the int... more doi: 10.3389/fnbeh.2014.00358 An fMRI study on the influence of sommeliers ’ expertise on the integration of flavor
Group emotional dynamics are a central concern in the study of human interaction and communicatio... more Group emotional dynamics are a central concern in the study of human interaction and communication. To study group emotions, the social context of a musical event in natural conditions may overcome several limits of laboratory experiments and could provide a suitable framework. This study aimed to evaluate if cultural events such as a conductor competition could welcome scientific research for the study of group emotional sharing. We led an observational study, which suggests that in this particular context, public, musicians and jury would agree to participate and to wear neurophysiological and physiological devices to monitor their emotional state during the competition. Self-administrated scales showed that, in the context of a musical competition, members of the public felt strong musical emotions such as music chills. Our results suggest that such a specific competition design is a suitable experimental model to lead an experiment under ecological conditions to effectively investigate collective emotional synchronization. In the future, with the implementation of an acquisition system recording synchronous neurophysiological data for a large group of participants, we may be able to highlight mechanisms involved in emotional synchronization in a natural musical setting.
Introduction Assessment of decision-making capacity (DMC) is essential in daily life as well as f... more Introduction Assessment of decision-making capacity (DMC) is essential in daily life as well as for defining a person-centred care plan. Nevertheless, in ageing, especially if signs of dementia appear, it becomes difficult to assess decision-making ability and raises ethical questions. Currently, the assessment of DMC is based on the clinician's evaluation, completed by neuropsychological tests. Functional MRI (fMRI) could bring added value to the diagnosis of DMC in difficult situations. Methods and analysis IMAGISION is a prospective, monocentric, single-arm study evaluating fMRI compared with clinical assessment of DMC. The study will begin during Fall 2021 and should be completed by Spring 2023. Participants will be recruited from a memory clinic where they will come for an assessment of their cognitive abilities due to decision-making needs to support ageing in place. They will be older people over 70 years of age, living at home, presenting with a diagnosis of mild dementia, and no exclusion criteria of MRI. They will be clinically assessed by a geriatrician on their DMC, based on the neuropsychological tests usually performed. Participants will then perform a behavioural task in fMRI (Balloon Analogue Risk Task) to analyse the activation areas. Additional semistructured interviews will be conducted to explore real life implications. The main analysis will study concordance/discordance between the clinical classification and the activation of fMRI regions of interest. Reclassification as 'capable', based on fMRI, of patients for whom clinical diagnosis is 'questionable' will be considered as a diagnostic gain. Ethics and dissemination IMAGISION has been authorised by a research ethics board (Comité de Protection des Personnes, Bordeaux, II) in France, in accordance with French legislation on interventional biomedical research, under the reference IDRCB number 2019-A00863-54, since 30 September 2020. Participants will sign an informed consent form. The results of the study will be presented in international peer-reviewed scientific journals, international scientific conferences and public lectures.
bioRxiv (Cold Spring Harbor Laboratory), Mar 26, 2021
Over the years, several publications have proposed that musical sound could be an ancestral emoti... more Over the years, several publications have proposed that musical sound could be an ancestral emotional way of communication, thus positing an ancestral biological function for music. Understanding how musical emotions, and the pleasure derived from music regardless of the musical valence, can be shared between individuals is a fascinating question, and investigating it can shed light on the function of musical reward. Is the pleasure felt at the individual level transmitted on a collective level? And if so, how? We investigated these questions in a natural setting during an international competition for orchestra conductors. Participants (n=15) used a dedicated smartphone app to report their subjective emotional experiences in 1
Dans Jusqu'à la mort accompagner la vie Jusqu'à la mort accompagner la vie 2012/4 (n° 111) 2012/4... more Dans Jusqu'à la mort accompagner la vie Jusqu'à la mort accompagner la vie 2012/4 (n° 111) 2012/4 (n° 111), pages 93 à 110 Éditions Presses universitaires de Grenoble Presses universitaires de Grenoble
e19623 Background: ASCO highlighted the need to improve communication with and decision making fo... more e19623 Background: ASCO highlighted the need to improve communication with and decision making for pts with advanced cancer. This study explores the decision-making process for pts with advanced cancer when the question to WH/WD ACT is raised, with a cross-analysis of physicians and pts points of view. Methods: Multi-center qualitative study in 5 oncology and hematology units, based on semi-structured single interviews with referent oncologists and their pts. An epidemiological survey was performed to identify the prevalence of such decisions. Results: Of the 839 pts hospitalized during a given week, the question to WH/WD ACT was raised in 3.4% of cases (n=29) and in 12,8% when excluding ambulatory pts (n=26 of 202). All 29 referent physicians and 21 pts were interviewed. Futility and poor general condition were the most frequently cited reasons to WH/WD ACT. Subjective determinants related to the physician/patient relationship and their respective experiences were also predominant in all interviews. Although most physicians reported attempting to fully inform pts about their poor prognosis and treatment options, only a minority were able to anticipate the option to WH/WD ACT in these discussions. The fear to remove pts’ hope and to increase anxiety, and a feeling of capitulation and abandonment were the main obstacles they pointed out. For pts, hope and struggle attitudes were predominant, as well as anxiety about their situation and confidence in the physicians’ decisions. More than 80% of pts declared leaving the physician to decide alone. Most of them expected to be involved in the decisions, but only 1/3 reported being actually aware of this questioning. Conclusions: In this study, oncologists faced the difficult decision whether to continue, WH/WD ACT for 1/7 hospitalized patient. The uncertainty of the benefit/risk assessment seemed to strengthen the subjective determinants of the questioning. Pts and physicians mutual willingness to maintain hope reinforced an attitude of “not giving up”. Communication training of health professionals and integrative palliative care could favor the ethical questioning and improve care through the respect of pts’ preferences.
Abstract 2076 Context: The decision to limit or withdraw specific therapies (DLWT) in patients wi... more Abstract 2076 Context: The decision to limit or withdraw specific therapies (DLWT) in patients with advanced cancer is a complex process that is always painful for patients, relatives and professionals. For more than 10 years, shared decision making has been more and more emphasized. However, few data in the literature rely on clinical research. In order to understand their difficulties and issues, this study explores the determinants and modalities of DLWT and analyses the feasibility of different methods for investigating this decision making process. Method: We conducted a multi-center pilot study in oncology and hematology units of 5 institutions: 2 university hospitals, 1 general hospital, 1 cancer center and 1 private hospital. The study included two different approaches: an epidemiological section to identify the prevalence of these situations in different institutions and a qualitative study section exploring factors influencing the decision process. The epidemiological analysis included all hospitalized patients identified with advanced cancer for whom the question of DLWT was raised in a given week or during the two weeks preceding the investigation. The qualitative analysis was based on interviews with the referent oncologist (or hematologist) and his patient (conducted by a physician and a psychologist respectively) as well as interviews with other partners involved in the situation (care staff and relatives) depending on the center. Researchers also participated in multidisciplinary meetings and monitored changes in the decision over a three month period. Results: Of the 839 patients hospitalized in the inclusion week, the question of DLWT was raised in 3.5% of cases (no=30) and in 14.3% (no=27 of 188 patients) when excluding outpatients. All primary care physicians and 70% (no=21) of patients were questioned in interviews. Subjective determinants related to the physician/patient relationship, and their respective experiences seemed predominant in DLWT. Futility and poor general condition were the most frequently cited reasons to limit or withdraw specific therapies. The complexity of the DLWT was linked primarily to the uncertainty of benefit-risk balance, emotional aspects, communication issues and possible discrepancies between physician and…
Since the beginning of the 20 th century, electroencephalography (EEG) has been used in a wide va... more Since the beginning of the 20 th century, electroencephalography (EEG) has been used in a wide variety of applications, both for medical needs and for the study of various cerebral processes. With the rapid development of the technique, more and more precise and advanced tools have emerged for research purposes. However, the main constraints of these devices have often been the high price and, for some devices the low transportability and the long setup time. Nevertheless, a broad range of wireless EEG devices have emerged on the market without these constraints, but with a lower signal quality. The development of EEG recording on multiple participants simultaneously, and new technological solutions provides further possibilities to understand the cerebral emotional dynamics of a group. A great number of studies have compared and tested many mobile devices, but have provided contradictory results. It is therefore important to test the reliability of specific wireless devices in a specific research context before developing a large-scale study. The aim of this study was to assess the reliability of two wireless devices (g.tech Nautilus SAHARA electrodes and Emotiv™ Epoc +) for the detection of musical emotions, in comparison with a gold standard EEG device. Sixteen participants reported feeling emotional pleasure (from low pleasure up to musical chills) when listening to their favorite chill-inducing musical excerpts. In terms of emotion detection, our results show statistically significant concordance between Epoc + and the gold standard device in the left prefrontal and left temporal areas in the alpha frequency band. We validated the use of the Emotiv™ Epoc + for research into musical emotion. We did not find any significant concordance between g.tech and the gold standard. This suggests that Emotiv Epoc is more appropriate for musical emotion investigations in natural settings.
In May 2022, the European Regulation 2017/746 (IVDR) came into force. It changes the approach of ... more In May 2022, the European Regulation 2017/746 (IVDR) came into force. It changes the approach of in vitro medical devices (IVD-MDs) for industry and institutions. It reinforces the clinical evidence requirements to improve performance, safety and transparency. Despite extended transition periods and existing guides, IVDR remains difficult to interpret and bringing devices into compliance requires efforts. The generation of clinical evidence is essential to demonstrate compliance with IVDR, and encompasses scientific validity, analytical performance and clinical performance. It is required to demonstrate, per intended use in the target population and clinical care pathway, IVD-MDs clinical performance (compared to a predefined clinical performance). Thus, there is a need for IVD-manufacturers and end-users in health care institutions, to obtain guidance on how to generate this clinical evidence. This article aims industrials and clinicians to identify key steps imposed by the IVDR fo...
Objectives To quantify and model normal foetal lung and liver elasticities between 24 and 39 week... more Objectives To quantify and model normal foetal lung and liver elasticities between 24 and 39 weeks of gestation (WG) using two-dimensional shear wave elastography (2D-SWE). To assess the impact of the distance between the probe and the target organ on the estimation of elasticity values. Methods Measurements of normal foetal lungs and liver elasticity were prospectively repeated monthly between 24 and 39 WG in 72 foetuses using 2D-SWE. Elasticity was quantified in the proximal lung and in the region inside the hepatic portal sinus. The distance between the probe and the target organ was recorded. Trajectories representing foetal lung and liver maturation from at least 3 measurements over time were modelled. Results The average elasticity for the lung and liver was significantly different from 24 WG to 36 WG (p < 0.01). Liver elasticity increased during gestation (3.86 kPa at 24 WG versus 4.45 kPa at 39 WG). From 24 WG to 32 WG, lung elasticity gradually increased (4.12kPa at 24 W...
Proceedings of the 15th International Joint Conference on Biomedical Engineering Systems and Technologies, 2022
The evolution of technological innovations and medical devices requires particular reflections in... more The evolution of technological innovations and medical devices requires particular reflections in terms of regulation. In order to harmonise practices between European countries and to reinforce clinical investigations, the European Regulation on medical devices 2017/745 has come to give a regulatory framework to the world of devices. A summary of the regulatory approaches for a clinical investigation of a new class III device conducted in France, Ireland and England is proposed in this article to illustrate the complexity of the processes, ending with an example. This illustrates the impact of the EU regulation and Brexit on the conduct of clinical investigations. a
Proceedings of the 15th International Joint Conference on Biomedical Engineering Systems and Technologies, 2022
Retrospective studies are studies that easily provide data on a population. As the data are alrea... more Retrospective studies are studies that easily provide data on a population. As the data are already available in the medical records, the collection and analysis of the results is faster. These studies are particularly valuable in the post-marketing clinical follow-up of medical devices. They allow manufacturers to easily and proactively obtain safety and performance data. The regulatory procedures associated with this type of study also appear to be much less burdensome than a prospective study. We propose to illustrate the procedures through a multinational retrospective study conducted in France, England and Ireland. a
The question of withdrawing artificial nutrition and hydration from people in a permanent vegetat... more The question of withdrawing artificial nutrition and hydration from people in a permanent vegetative state sparks considerable ethical and legal debate. Therefore, understanding the elements that influence such a decision is crucial. However, exploring perceptions of artificial nutrition and hydration is methodologically challenging for several reasons. First, because of the emotional state of the professionals and family members, who are facing an extremely distressing situation; second, because this question mirrors representations linked to a deep-rooted fear of dying of hunger and thirst; and third, because of taboos surrounding death. We sought to determine the best method to explore such complex situations in depth. This article aims to assess the relevance of the photo-elicitation interview method to analyze the perceptions and attitudes of health professionals and families of people in a permanent vegetative state regarding artificial nutrition and hydration. The photo-elicitation interview method consists in inserting one or more photographs into a research interview. An original set of 60 photos was built using Google Images and participants were asked to choose photos (10 maximum) and talk about them. The situations of 32 patients were explored in 23 dedicated centers for people in permanent vegetative state across France. In total, 138 interviews were conducted with health professionals and family members. We found that the photo-elicitation interview method 1) was well accepted by the participants and allowed them to express their emotions constructively, 2) fostered narration, reflexivity and introspection, 3) offered a sufficient "unusual angle" to allow participants to go beyond stereotypes and habits of thinking, and 4) can be replicated in other research areas. The use of visual methods currently constitutes an expanding area of research and this study stressed that this is of special interest to enhance research among populations facing end-of-life and ethical issues
doi: 10.3389/fnbeh.2014.00358 An fMRI study on the influence of sommeliers ’ expertise on the int... more doi: 10.3389/fnbeh.2014.00358 An fMRI study on the influence of sommeliers ’ expertise on the integration of flavor
Group emotional dynamics are a central concern in the study of human interaction and communicatio... more Group emotional dynamics are a central concern in the study of human interaction and communication. To study group emotions, the social context of a musical event in natural conditions may overcome several limits of laboratory experiments and could provide a suitable framework. This study aimed to evaluate if cultural events such as a conductor competition could welcome scientific research for the study of group emotional sharing. We led an observational study, which suggests that in this particular context, public, musicians and jury would agree to participate and to wear neurophysiological and physiological devices to monitor their emotional state during the competition. Self-administrated scales showed that, in the context of a musical competition, members of the public felt strong musical emotions such as music chills. Our results suggest that such a specific competition design is a suitable experimental model to lead an experiment under ecological conditions to effectively investigate collective emotional synchronization. In the future, with the implementation of an acquisition system recording synchronous neurophysiological data for a large group of participants, we may be able to highlight mechanisms involved in emotional synchronization in a natural musical setting.
Introduction Assessment of decision-making capacity (DMC) is essential in daily life as well as f... more Introduction Assessment of decision-making capacity (DMC) is essential in daily life as well as for defining a person-centred care plan. Nevertheless, in ageing, especially if signs of dementia appear, it becomes difficult to assess decision-making ability and raises ethical questions. Currently, the assessment of DMC is based on the clinician's evaluation, completed by neuropsychological tests. Functional MRI (fMRI) could bring added value to the diagnosis of DMC in difficult situations. Methods and analysis IMAGISION is a prospective, monocentric, single-arm study evaluating fMRI compared with clinical assessment of DMC. The study will begin during Fall 2021 and should be completed by Spring 2023. Participants will be recruited from a memory clinic where they will come for an assessment of their cognitive abilities due to decision-making needs to support ageing in place. They will be older people over 70 years of age, living at home, presenting with a diagnosis of mild dementia, and no exclusion criteria of MRI. They will be clinically assessed by a geriatrician on their DMC, based on the neuropsychological tests usually performed. Participants will then perform a behavioural task in fMRI (Balloon Analogue Risk Task) to analyse the activation areas. Additional semistructured interviews will be conducted to explore real life implications. The main analysis will study concordance/discordance between the clinical classification and the activation of fMRI regions of interest. Reclassification as 'capable', based on fMRI, of patients for whom clinical diagnosis is 'questionable' will be considered as a diagnostic gain. Ethics and dissemination IMAGISION has been authorised by a research ethics board (Comité de Protection des Personnes, Bordeaux, II) in France, in accordance with French legislation on interventional biomedical research, under the reference IDRCB number 2019-A00863-54, since 30 September 2020. Participants will sign an informed consent form. The results of the study will be presented in international peer-reviewed scientific journals, international scientific conferences and public lectures.
bioRxiv (Cold Spring Harbor Laboratory), Mar 26, 2021
Over the years, several publications have proposed that musical sound could be an ancestral emoti... more Over the years, several publications have proposed that musical sound could be an ancestral emotional way of communication, thus positing an ancestral biological function for music. Understanding how musical emotions, and the pleasure derived from music regardless of the musical valence, can be shared between individuals is a fascinating question, and investigating it can shed light on the function of musical reward. Is the pleasure felt at the individual level transmitted on a collective level? And if so, how? We investigated these questions in a natural setting during an international competition for orchestra conductors. Participants (n=15) used a dedicated smartphone app to report their subjective emotional experiences in 1
Dans Jusqu'à la mort accompagner la vie Jusqu'à la mort accompagner la vie 2012/4 (n° 111) 2012/4... more Dans Jusqu'à la mort accompagner la vie Jusqu'à la mort accompagner la vie 2012/4 (n° 111) 2012/4 (n° 111), pages 93 à 110 Éditions Presses universitaires de Grenoble Presses universitaires de Grenoble
e19623 Background: ASCO highlighted the need to improve communication with and decision making fo... more e19623 Background: ASCO highlighted the need to improve communication with and decision making for pts with advanced cancer. This study explores the decision-making process for pts with advanced cancer when the question to WH/WD ACT is raised, with a cross-analysis of physicians and pts points of view. Methods: Multi-center qualitative study in 5 oncology and hematology units, based on semi-structured single interviews with referent oncologists and their pts. An epidemiological survey was performed to identify the prevalence of such decisions. Results: Of the 839 pts hospitalized during a given week, the question to WH/WD ACT was raised in 3.4% of cases (n=29) and in 12,8% when excluding ambulatory pts (n=26 of 202). All 29 referent physicians and 21 pts were interviewed. Futility and poor general condition were the most frequently cited reasons to WH/WD ACT. Subjective determinants related to the physician/patient relationship and their respective experiences were also predominant in all interviews. Although most physicians reported attempting to fully inform pts about their poor prognosis and treatment options, only a minority were able to anticipate the option to WH/WD ACT in these discussions. The fear to remove pts’ hope and to increase anxiety, and a feeling of capitulation and abandonment were the main obstacles they pointed out. For pts, hope and struggle attitudes were predominant, as well as anxiety about their situation and confidence in the physicians’ decisions. More than 80% of pts declared leaving the physician to decide alone. Most of them expected to be involved in the decisions, but only 1/3 reported being actually aware of this questioning. Conclusions: In this study, oncologists faced the difficult decision whether to continue, WH/WD ACT for 1/7 hospitalized patient. The uncertainty of the benefit/risk assessment seemed to strengthen the subjective determinants of the questioning. Pts and physicians mutual willingness to maintain hope reinforced an attitude of “not giving up”. Communication training of health professionals and integrative palliative care could favor the ethical questioning and improve care through the respect of pts’ preferences.
Abstract 2076 Context: The decision to limit or withdraw specific therapies (DLWT) in patients wi... more Abstract 2076 Context: The decision to limit or withdraw specific therapies (DLWT) in patients with advanced cancer is a complex process that is always painful for patients, relatives and professionals. For more than 10 years, shared decision making has been more and more emphasized. However, few data in the literature rely on clinical research. In order to understand their difficulties and issues, this study explores the determinants and modalities of DLWT and analyses the feasibility of different methods for investigating this decision making process. Method: We conducted a multi-center pilot study in oncology and hematology units of 5 institutions: 2 university hospitals, 1 general hospital, 1 cancer center and 1 private hospital. The study included two different approaches: an epidemiological section to identify the prevalence of these situations in different institutions and a qualitative study section exploring factors influencing the decision process. The epidemiological analysis included all hospitalized patients identified with advanced cancer for whom the question of DLWT was raised in a given week or during the two weeks preceding the investigation. The qualitative analysis was based on interviews with the referent oncologist (or hematologist) and his patient (conducted by a physician and a psychologist respectively) as well as interviews with other partners involved in the situation (care staff and relatives) depending on the center. Researchers also participated in multidisciplinary meetings and monitored changes in the decision over a three month period. Results: Of the 839 patients hospitalized in the inclusion week, the question of DLWT was raised in 3.5% of cases (no=30) and in 14.3% (no=27 of 188 patients) when excluding outpatients. All primary care physicians and 70% (no=21) of patients were questioned in interviews. Subjective determinants related to the physician/patient relationship, and their respective experiences seemed predominant in DLWT. Futility and poor general condition were the most frequently cited reasons to limit or withdraw specific therapies. The complexity of the DLWT was linked primarily to the uncertainty of benefit-risk balance, emotional aspects, communication issues and possible discrepancies between physician and…
Since the beginning of the 20 th century, electroencephalography (EEG) has been used in a wide va... more Since the beginning of the 20 th century, electroencephalography (EEG) has been used in a wide variety of applications, both for medical needs and for the study of various cerebral processes. With the rapid development of the technique, more and more precise and advanced tools have emerged for research purposes. However, the main constraints of these devices have often been the high price and, for some devices the low transportability and the long setup time. Nevertheless, a broad range of wireless EEG devices have emerged on the market without these constraints, but with a lower signal quality. The development of EEG recording on multiple participants simultaneously, and new technological solutions provides further possibilities to understand the cerebral emotional dynamics of a group. A great number of studies have compared and tested many mobile devices, but have provided contradictory results. It is therefore important to test the reliability of specific wireless devices in a specific research context before developing a large-scale study. The aim of this study was to assess the reliability of two wireless devices (g.tech Nautilus SAHARA electrodes and Emotiv™ Epoc +) for the detection of musical emotions, in comparison with a gold standard EEG device. Sixteen participants reported feeling emotional pleasure (from low pleasure up to musical chills) when listening to their favorite chill-inducing musical excerpts. In terms of emotion detection, our results show statistically significant concordance between Epoc + and the gold standard device in the left prefrontal and left temporal areas in the alpha frequency band. We validated the use of the Emotiv™ Epoc + for research into musical emotion. We did not find any significant concordance between g.tech and the gold standard. This suggests that Emotiv Epoc is more appropriate for musical emotion investigations in natural settings.
In May 2022, the European Regulation 2017/746 (IVDR) came into force. It changes the approach of ... more In May 2022, the European Regulation 2017/746 (IVDR) came into force. It changes the approach of in vitro medical devices (IVD-MDs) for industry and institutions. It reinforces the clinical evidence requirements to improve performance, safety and transparency. Despite extended transition periods and existing guides, IVDR remains difficult to interpret and bringing devices into compliance requires efforts. The generation of clinical evidence is essential to demonstrate compliance with IVDR, and encompasses scientific validity, analytical performance and clinical performance. It is required to demonstrate, per intended use in the target population and clinical care pathway, IVD-MDs clinical performance (compared to a predefined clinical performance). Thus, there is a need for IVD-manufacturers and end-users in health care institutions, to obtain guidance on how to generate this clinical evidence. This article aims industrials and clinicians to identify key steps imposed by the IVDR fo...
Objectives To quantify and model normal foetal lung and liver elasticities between 24 and 39 week... more Objectives To quantify and model normal foetal lung and liver elasticities between 24 and 39 weeks of gestation (WG) using two-dimensional shear wave elastography (2D-SWE). To assess the impact of the distance between the probe and the target organ on the estimation of elasticity values. Methods Measurements of normal foetal lungs and liver elasticity were prospectively repeated monthly between 24 and 39 WG in 72 foetuses using 2D-SWE. Elasticity was quantified in the proximal lung and in the region inside the hepatic portal sinus. The distance between the probe and the target organ was recorded. Trajectories representing foetal lung and liver maturation from at least 3 measurements over time were modelled. Results The average elasticity for the lung and liver was significantly different from 24 WG to 36 WG (p < 0.01). Liver elasticity increased during gestation (3.86 kPa at 24 WG versus 4.45 kPa at 39 WG). From 24 WG to 32 WG, lung elasticity gradually increased (4.12kPa at 24 W...
Proceedings of the 15th International Joint Conference on Biomedical Engineering Systems and Technologies, 2022
The evolution of technological innovations and medical devices requires particular reflections in... more The evolution of technological innovations and medical devices requires particular reflections in terms of regulation. In order to harmonise practices between European countries and to reinforce clinical investigations, the European Regulation on medical devices 2017/745 has come to give a regulatory framework to the world of devices. A summary of the regulatory approaches for a clinical investigation of a new class III device conducted in France, Ireland and England is proposed in this article to illustrate the complexity of the processes, ending with an example. This illustrates the impact of the EU regulation and Brexit on the conduct of clinical investigations. a
Proceedings of the 15th International Joint Conference on Biomedical Engineering Systems and Technologies, 2022
Retrospective studies are studies that easily provide data on a population. As the data are alrea... more Retrospective studies are studies that easily provide data on a population. As the data are already available in the medical records, the collection and analysis of the results is faster. These studies are particularly valuable in the post-marketing clinical follow-up of medical devices. They allow manufacturers to easily and proactively obtain safety and performance data. The regulatory procedures associated with this type of study also appear to be much less burdensome than a prospective study. We propose to illustrate the procedures through a multinational retrospective study conducted in France, England and Ireland. a
The question of withdrawing artificial nutrition and hydration from people in a permanent vegetat... more The question of withdrawing artificial nutrition and hydration from people in a permanent vegetative state sparks considerable ethical and legal debate. Therefore, understanding the elements that influence such a decision is crucial. However, exploring perceptions of artificial nutrition and hydration is methodologically challenging for several reasons. First, because of the emotional state of the professionals and family members, who are facing an extremely distressing situation; second, because this question mirrors representations linked to a deep-rooted fear of dying of hunger and thirst; and third, because of taboos surrounding death. We sought to determine the best method to explore such complex situations in depth. This article aims to assess the relevance of the photo-elicitation interview method to analyze the perceptions and attitudes of health professionals and families of people in a permanent vegetative state regarding artificial nutrition and hydration. The photo-elicitation interview method consists in inserting one or more photographs into a research interview. An original set of 60 photos was built using Google Images and participants were asked to choose photos (10 maximum) and talk about them. The situations of 32 patients were explored in 23 dedicated centers for people in permanent vegetative state across France. In total, 138 interviews were conducted with health professionals and family members. We found that the photo-elicitation interview method 1) was well accepted by the participants and allowed them to express their emotions constructively, 2) fostered narration, reflexivity and introspection, 3) offered a sufficient "unusual angle" to allow participants to go beyond stereotypes and habits of thinking, and 4) can be replicated in other research areas. The use of visual methods currently constitutes an expanding area of research and this study stressed that this is of special interest to enhance research among populations facing end-of-life and ethical issues
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Papers by Lionel Pazart