It has been documented that social determinants of health have a far greater impact on individuals than the actual provision of health care. Social determinants include the conditions in which people are born, live, work, and age, and the health systems they can access. These determinants of health are in turn shaped by a wider set of forces: economics, social dynamics, environmental policies, and politics.

There is accumulated evidence that measures of physical health such as the prevalence of infectious diseases, infant mortality rate, and life expectancy may be impacted by social determinants. Recently, scientists have found that mental health may also be impacted by such determinants.

Previously, genetic underpinnings of mental illnesses have been heavily focused on. In recent decades, however,  there has been a shift to a biopsychosocial model, which takes social factors into consideration during diagnosis. This illustrates that mental health professionals are increasingly cognisant of the fact that mental illnesses are strongly driven by social factors.

Mental health inequities may be understood as being at least partially determined by unequal distribution of opportunity and, more deeply, by social norms and public policies. Social norms are the cultural opinions and biases that set the stage for poorer health among disadvantaged groups – for example, racial biases against minority groups. Public policies refers to legislation that may not particularly concern health but has far-reaching effects on health. Examples of public policies that have diverse downstream effects on health include the tuition costs for higher education within university systems, minimum wage legislations, and a city’s zoning ordinances.Two of the social determinants that may greatly impact mental health are income inequality and education level.

Income inequality as a social determinant of mental health

There is evidence that people in low socioeconomic classes suffer from mental health issues and their adverse consequences at a disproportionate rate compared to people in higher socioeconomic classes. Income inequality produces psychosocial stress, which leads to deteriorating health and higher mortality over time. There is good evidence that common mental disorders, such as depression and anxiety, are distributed according to a gradient of economic disadvantage across social strata.

The Canadian Institute for Health Information published results from a nationwide study that showed that between 2003 and 2013, self-ratings of poor or fair mental health increased in the lowest income level but remained stable in the highest income level: the rate in the lowest income level is still more than five times higher than that in the highest income level (14.5 per cent versus 2.8 per cent).

In 2010, Lund and colleagues, researchers from the Department of Psychiatry and Mental Health at  University of Cape Town, published a systematic review of the epidemiological literature on common mental illness and poverty in low and middle-income countries. It was shown that 70 per cent of the 115 studies reviewed reported positive associations between a variety of poverty measures and common mental illness. In another systematic review, it was reported that depressed mood or anxiety was 2.5 times higher among young people aged 10 to 15 years with low socioeconomic status than among youths with high socioeconomic status.

It is important to keep in mind that inequalities occur along a continuum and affect everyone in the population, not only the poorest or most disadvantaged. Researchers contend that inequality reduces social cohesion, a dynamic that leads to more stress, fear, and insecurity for everyone. Consequently, high levels of inequality can negatively affect the health of even the most affluent.  Money does not guarantee immunity from mental illness, nor does a lack of money lead to mental illness; however, it is generally conceded that poverty can be both a determinant and a consequence of poor mental health.

Education as a social determinant of mental health

Poor education is associated with decreased physical and mental health. Higher quality education and higher education attainment have been associated with better social outcomes, such as stable employment and higher income. Additionally, employment is a major determinant for mental health status. Unemployment significantly increases the odds of diagnosis with psychiatric disorders: in a study published in 2004, it was noted that unemployment almost quadrupled the odds of drug dependence after controlling for other socio-demographic variables.

Ethical implications of inequalities in mental health

The effect of inequality on mental health has profound ethical implications. Public health organizations are beginning to recognize the detrimental effects of social inequalities, and are making efforts to fulfill key bioethics principles of medicine and public health: respect for individuals, justice, beneficence, and non-malfeasance.

Importance of intervention at the policy-making level

Intervention at the policy-making level appears to be just as important as intervention at the individual and familial level. More attention should be paid to government funded programs that focus on reducing poverty. There is often political debate about the allocation of resources to programs that could narrow the inequality gaps. Politicians should be aware of the fact that funding these programs may, in the long term, better society by indirectly decreasing the burden on the health care system.

The changing roles of health care professionals

Absolute social equality is difficult to achieve. Therefore, varying prevalence rates of mental illness between unequal groups in society, will be difficult to completely eradicate. Researchers, psychiatrists, and other public health professionals must reduce the magnitude of this inequality.

There is a sense that the role of psychiatrists and other public health care professionals might evolve to include advocating for policy change. Psychiatrists may be forced to have a more active non-clinical role by advocating for policies that address these social determinants of mental health at varying levels in society.

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We make thousands of decisions every day. We wake up, decide what to wear, choose what we eat, and decide which route we will take to get to school or work. It seems that we are consciously guiding our bodies in a purposeful way; we think that our thoughts and actions are freely chosen.

Psychologists Dan Wegner and Thalia Wheatley published a paper almost twenty years ago that altered popular conceptions  of free will. They proposed that the experience of intentionally willing an action is often nothing more than a post hoc causal inference that our thoughts caused some behavior.

A dominant view of the relationship between free will and moral responsibility is that if an agent does not have free will, then that agent is not morally responsible for their actions. Free will, as the name suggests, means that an agent has the capacity to choose their course of action. Our action entails responsibility — how we choose to act is our fault — because our actions are self-determined. We must be responsible, because we are in control. Therefore, some insist that free will is necessary for a person to be morally responsible for their actions.

Joshua D. Greene, an assistant professor of psychology at Harvard, says that “to a neuroscientist, you are your brain; nothing causes your behavior other than the operations of your brain.” He continues, “If that’s right, it radically changes the way we think about the law. Often those who do not support free will are said to be determinists. A determinist says that the causal mechanisms in a person’s brain, for example, a genetic predisposition to violence, makes someone less culpable for their actions.” The rationale is: if there are rules that govern the universe which exist outside of ourselves, and if before we are born, these rules anticipate our actions, how can we be responsible for those actions? If our behaviours are governed by chemical interactions in the brain, then they are a result of predictable interactions governed by laws of classical physics.

How far can we take determinism?

There have been several legal cases in which neuroscientific evidence has had an impact on the outcome of the trial. Lie detector tests, and other neuroimaging results, have been used to indicate abnormalities in the brain which caused the aberrant behavior of the defendant. In the early 1990s, 68 year-old Herbert Weinstein was charged with murder of his wife. Weinstein’s lack of emotion while discussing the crime, and his apparent lack of remorse for his actions, led his legal team to question whether he might be suffering from a neurological impairment which might have caused such an uncharacteristic act of aggression. Physicians who consulted with Mr. Weinstein’s defense attorneys suggested that Mr. Weinstein undergo neuropsychological testing and brain scanning that could reveal potential structural and/or functional deficits in his brain. And those tests showed Weinstein’s brain had an abnormal cyst. Weinstein’s lawyers argues that his actions were because of this abnormality in his arachnoid membrane, which surrounds the brain like a spider web. Can we excuse Weinstein’s behaviour with the discovery of a cyst?

Stephen J. Morse, professor of law and psychiatry at the University of Pennsylvania, maintains that “brains do not commit crimes; people commit crimes” — a conclusion, he suggests, that has been ignored by advocates of determinism. He believes that often, those who support determinism are “infected and inflamed by stunning advances in our understanding of the brain . . . [and] all too often make moral and legal claims that the new neuroscience . . . cannot sustain.” He calls this “brain overclaim syndrome.” Morse is referring to the use of neuroscientific evidence to distinguish between “normal” and “abnormal” brains. “There’s nothing new about the neuroscience ideas of responsibility; it’s just another material, causal explanation of human behavior,” says Morse, “How is this different than the Chicago school of sociology?”

Morse does not believe that using scientific evidence to identify an “abnormal brain” should mitigate responsibility. Neuroscience could hypothetically reveal that reason actually plays no role in determining human behavior: without our conscious participation, all actions are simply determined. If determinism is taken at face value, humans are automatons in this respect. But if all behavior is caused by our brains, this mean all behavior could potentially be excused. This may mean we have to abandon current ideas about responsibility and seek other ways of protecting society.

Neither free will nor determinism are proven, but remain controversially debated. Determinism is inconsistent with societal views of responsibility, self-control, and moral obligation. When neuroscientific evidence is introduced in trials, questions about moral responsibility waver and are strongly debated on a case-by-case basis.

Perhaps it is not necessary to equate free will with non-determinism at all. Just because our choices are predictable it does not mean that we do not consciously make those choices. Regardless of whether you believe in free will or determinism, it seems that the two oppositional philosophical explanations for human behaviour cannot individually determine moral responsibility. Even if neuroscience is able to disprove any trace of free will in human behaviour, determinism alone fails to justify the absolution of moral responsibility for actions.

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Today, the field of brain-computer interface (BCI) technology has allowed people to functionally merge with electrical devices. BCI tech can assist individuals unable to speak in communicating, and those unable to use their limbs regain mobility. At the University of Pittsburgh, researchers used signals recorded inside the brain to control a robotic arm. At Stanford, researchers extracted the movement intentions of paralyzed patients from their brain signals, allowing them wireless control of a tablet. The most common BCI tech gadgets are Cochlear implants, devices that assist with hearing.

What is brain-computer interface technology?

Matthew Sample, a researcher at the Institut de Recherches Clinique de Montreal (IRCM) noted that the definition of BCI is contested: “Even the name is in flux, with some researchers writing about ‘brain-machine interfaces’ and ‘neural interfaces.’” Some researchers only apply the label BCI to devices that require the users “will” something, regulating their thoughts to consciously achieve some task with the help of a computer. Other BCI developers are more flexible in their definition and also include devices that only passively collect information from the user’s brain. Sample concludes that “definitional disagreement aside, we could safely say that BCI describes a variety of emerging technologies that connect brain tissue to computer hardware.”

So by current definitions, BCIs include all devices that convert neural signals into purposeful movements, for both medical and non-medical purposes. Restorative devices like neuroprosthetics help paralyzed patients move robotic limbs. In gaming, BCIs can allow players to move around and manipulate objects within virtual game environments using thought alone. What’s more, BCIs also include devices that enhance sensorimotor functioning past the typical range of human capacity (i.e. enhancement or augmentation).

How does brain-computer interface technology work?

Unidirectional and multidirectional transfers of information between the computer and the brain take place in Brain-Computer Interfaces (BCI). BCIs can use a wired or wireless system to allow transmission of signals from the brain to a machine. Non-invasive BCIs like electroencephalogram or functional magnetic resonance imaging do not involve intracranial surgery nor any implantation in the brain. On the other hand, invasive procedures like electrocorticography usually involve the implantation of electrodes epidurally (under the skin), subdurally (under the scalp), or intracortically (recording within the cerebral cortex).

With the invention and usage of such technology comes the discussion of its moral and ethical implications. There are challenges in translating this BCI technology to practical clinical applications. Two of the major challenges in widespread BCI use are individual user risks and widespread societal risks and concerns.

User Risks

Invasive procedures like electrocorticography carry risks of infections or hemorrhage. As a result, there may be scarring and immune reactions, and this can cause implants to lose effectiveness over time. Another major issue is the biocompatibility between the implanted objects and the surrounding neural tissue. The implanted object may cause changes in the tissues, which in turn leads to neurological and psychological sequelae (a pathological condition resulting from a disease, injury, therapy, or other trauma).

There is also the risk of altering cognitive processes such as decision-making. Sample explains that how a BCI affects behavior, decision-making, and cognition is still largely unknown. But “the biomedical literature has some very striking examples of strange effects, like personality changes caused by particular uses of deep brain stimulation.” The uncertainty surrounding potential effects of BCI on the brain is a major concern because long-term effects to the user have not been thoroughly researched.

There is a long standing debate about whether or not structural or genetic abnormalities in the brain can mitigate responsibility of actions, leading to “my brain made me do it” arguments. The use of BCI technology can create nuanced claims: “my BCI technology made my brain make me do it.” BCI works to decode signals from the brain and translate them into commands to an output device that accomplishes the user’s intention. If the BCI malfunctions, it becomes difficult to determine if the user’s intentions were accurately translated into an action. BCIs may cause accidents. For example, if a BCI incorrectly interprets a wheelchair or prosthesis command and causes harm to another individual, it is difficult to pinpoint the true intent of the individual that caused harm. This would have an influence in legal disputes. There would have to be implementation of new laws and regulations to clarify policies regarding BCI technology and legal culpability. Legal cases would have to analyze the initial ailment (in cases of medical use), as well as the influence that a particular BCI technology has on cognition regardless of, or in combination with a medical condition.

Societal risks

Invasive BCIs pose the most obvious risks to the users, but we should also ask whether the technology could be a threat to the body politic. Sample demonstrates that “just as we have asked whether the internet and social media have made us better, collectively, we can explore these questions for BCIs.” It is worth exploring the feasibility of integrating BCI seamlessly into medical treatment and healthcare systems.

A specific example of a social concern of BCI implementation is the healthcare rationing of BCI technology. There may be risks to health care justice about the fair distribution of these very expensive technologies. Justice not only permits but in principle requires a national health scheme to deny some people of effective medical treatment they need. Rationing is unavoidable because need is limitless and resources are not. If there is widespread BCI use, questions about who to treat and what BCI technological services to offer will have to be addressed. How rationing of BCI technology occurs is important because it not only affects individual lives but also expresses what values are most important to society; for instance medical treatment of different disorders listed in order of precedence.

Many of these risks are future-oriented and thus largely speculative, but Sample notes that “so is the act of imagining new neural technology; the question is whether we have speculated carefully and in cooperation with the people most likely to be affected.” There is no doubt that BCI technology can provide useful medical treatments, but it will require a lot of regulations. The concern lies with deciding if the risks of the of BCI are worth the risks of possible detrimental changes to the brain. There also needs to be better evaluation of potential societal concerns. In this evaluation there needs to be inclusion of expert opinions as well as the opinion of the diverse public that will be affected. There is still a lot of research that needs to be conducted, but the hope is that before new BCI becomes routinely used, there would be proper analysis of both individual user risks as well are the broad spectra of societal risks.  

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Members of the scientific community have proposed the use of memory-altering drugs to treat disorders like PTSD (posttraumatic stress disorder). PTSD is a mental illness that some people develop after experiencing or witnessing a stressful event, like military combat, a natural disaster, a car accident, or sexual assault. Patients often suffer from sleeplessness, nightmares, comorbidities, and interpersonal problems. Scientists have hypothesized that memory-altering drugs can eliminate fearful responses to traumatic memories in PTSD patients, and hence alleviate symptoms.

Advancements in neuroscience technology offer unique opportunities to treat resilient illnesses. Yet many people are alarmed by this prospect. As far back as 2003, the US President’s Council on Bioethics issued a report that largely decried the use of such drugs. The council argued that memories are associated with our sense of self, so any form of memory manipulation can affect a person’s individuality. In this case, to treat severe memory-related disorders like PTSD by using memory-altering drugs is claimed to fundamentally change who we are.

Memories form a mental schema which helps us avoid making mistakes of the past. When the emotional valence of a memory is altered to treat PTSD, it can be argued that a person rebuilds his or her life on a facade. But the dampening of emotional salience of memory does not undermine our sense of self or personal identity. Using combination therapy, drug administration in conjunction with counselling, may actually speed up the healing process. Disorders like PTSD which often accompany severely traumatic experiences can alter everyday functioning of individuals. Consequently, pharmacology could transform living conditions for those with PTSD into healthier ones, in which individuals are no longer consumed by overwhelming emotions from recalling traumatizing memory.

Media reports on memory alteration and memory-altering drugs

The media often mischaracterizes neuroscience technology, making it partly responsible for the misconceptions about the effectiveness of memory-altering pharmacology and its treatment of PTSD. The media overexaggerates the effectiveness of the memory-altering drug, propranolol. These inaccuracies in reporting could lead readers to believe that one of the highest priorities of medical professionals is to implement treatment options for PTSD that involve complete erasure of consolidated traumatic memories-the introduction of a “memory-wiping pill.” Propranolol does not allow neuroscientists to erase the contextual content of memories that have been consolidated. Yet several media articles claimed that scientists can already pinpoint and erase any specific memory by using propranolol, and if not for ethical restrictions, this technique would be implemented to treat PTSD. In fact, as opposed to popular media reports, most scientific publications conclude that there is “promise to reducing subsequent memory for new or recalled emotional material,” but that extensive clinical research is needed before emotional-memory-altering pharmacology is available for widespread use.

This misinformation needs to be challenged to curb the growing public perception that neuroscientists seek to completely erase painful memories. Media titles often include phrases like “Scientists erasing memory with light,” or “Would you erase your ex? Bad memories could soon be DELETED from our minds for good.” Headlines claimed there was a  “drug helps erase fearful memories”, the Daily Mail talked about a “pill to erase bad memories”. These are sure to grab readers’ attention but these titles, like many others, are dishonest. These media outlets are using catchy headlines to gain readership, making it difficult for those who might benefit from this pharmacology to make informed decisions about using drugs to treat symptoms of psychological trauma. There are some articles that have worked to advance the public’s understanding of neuroscientific technology but others facilitate misunderstanding and violate public trust. These media headlines obscure the interpretation of scientific data about memory consolidation, reconsolidation, and pharmacological alteration of the emotional valence of memories.

Charles R. Marmar of the San Francisco Veterans Affairs Medical Center confirmed that there is an unfortunate misconception that technology can blot out memories. He believes that drugs such as propranolol simply adjust memories so that they can become tolerable to people with PTSD. In clinical trials, propranolol made it easier for individuals to cope with the traumatic stress of an incident; patients had fewer physiological symptoms of PTSD when measured at a later date. Joseph E. LeDoux,, a memory researcher at New York University, said that the use of drugs like propranolol is not a radical surgery on memory: “all [scientists] like to do is help people have better control of the memories they want, or prevent intrusive memories from resurfacing coming into their minds when they don’t want them.”

Kolber, a professor of law at Brooklyn Law School and editor of the Neuroethics & Law blog, writes that “drugs are viewed as special, like magic potions that can be used for good or evil. In reality, though, our memories are constantly being erased and modified over time. . . For some reason, though, we are more accepting of memory modification when it happens without pharmaceutical intervention,” such as in talk therapy.

Fake news is not a new phenomenon. There is false celebrity gossip, fabricated stories of political figures, and in this case, miscommunication about scientific research. At times it is not that the published information is apparently wrong, there can be subtle deceptions in the descriptions of the significance of scientific findings. It is up to readers to check the most suspect stories and subtleties in wording. The International Fact Checking Network (IFCN), a branch of the Florida-based journalism think tank Poynter, was recently enlisted for this purpose. This has allowed Facebook users to flag articles they believe to be deliberately false, and to use thirdparty fact checkers with the IFCN to confirm or deny claims. As a reader  of news articles, take everything that you read with a grain of salt. Follow the linked sites in articles to confirm information from primary sources. We need to be critical of what we read and develop informed opinions about important issues that are being covered in popular media.

The media has wrongfully influenced public perception about the goals of neuroscientists, the biological mechanisms of propranolol, and its medical applications. For memory-altering drugs, there need to be more standardized clinical trials so that we have a better understanding of the effects, and their ability to treat severe cases  of PTSD. Erroneous claims of intent and ability to use this medication to completely wipe memory of human patients should not be promoted.

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Dr. Janusz Rak is a senior scientist at the Research Institute of the McGill University Health Centre (RI-MUHC) in the Child Health and Human Development Program, and a Professor in the Department of Pediatrics, Division of Experimental Medicine at McGill University. Rak describes the two types of drug resistance as the following:

The first type has “acquired resistance,” which means that a drug that once worked for a given patient no longer works after a period of time. He explains that this is “a problem that essentially defines the incurability of certain cancers.” There are several chemotherapeutic drugs that are used to treat specific cancers, but are prone to becoming ineffective over time. Vemurafenib is an example of a very effective drug used to treat certain types of malignant melanoma (skin cancer). It operates by inhibiting a mutant BRAF oncogene (a type of gene that has the potential to cause cancer, usually expressed at high levels in cancer patients). Initially, these drugs are effective in shrinking tumours or even causing their complete eradication, but the effects are short- lived. Tumour resistance to these drugs usually starts with  rapid tumour shrinkage, which leaves patients feeling hopeful, but it is then followed by the regrowth of these tumours weeks or months later.

The second type of drug resistance is called “de novo,” or “intrinsic resistance,” and involves drugs that are expected to work but don’t affect a given patient at all. This type of drug resistance exists from the very start of treatment. The increasing prevalence of these drug resistant cancers necessitates further research and treatment development.

How cancers evade chemotherapy drugs
The problem with drug resistance is more related to cancer cells and their biological surroundings than to the drugs themselves. Some of these evasion tactics include DNA mutations and metabolic changes which promote drug inhibition and degradation. There are a few major categories of mechanisms that can enable or promote direct or indirect drug resistance in human cancer cells. They include drug activation, drug target alteration, drug efflux, DNA damage repair, cell death inhibition, and the epithelial-mesenchymal transition (EMT), according to a review published in the journal Cancers in 2014. They can act independently or as a combination of  various signal transduction pathways.

The mechanisms in which cancers evade treatments are numerous and highly complex. For example, DNA damage repair is a way cancer cells evolve an ability to “repair” the damage that chemotherapeutics have on cellular DNA. Rak explains that “for a fraction of glioma (brain tumours), patients’ cancer cells express an enzyme which removes certain damaged elements in DNA, and therefore prevents cancer cell from being killed by the drug called temozolomide.”

How doctors are combating drug resistance of cancers
Doctors are trying to overcome drug resistance by using combination therapy. This involves treating cancer with many drugs at once, or in specific sequences. It is a treatment modality that combines two or more therapeutic agents, and it is a cornerstone of cancer therapy. Rak explains that, “combining drugs could also exploit different weaknesses of cancer cells and become synergistic, that is, more effective than a sum of effects associated with individual drugs.” Combination therapy reduces drug resistance, while simultaneously providing therapeutic anti-cancer benefits, such as reducing tumour growth and metastatic potential, arresting mitotically (dividing) active cells, reducing cancer stem cell populations, and inducing apoptosis (self-programmed cell death).

Combination therapy includes treatments of patients with immunotherapeutic agents. Doctors combat drug resistance by changing drugs, combining them, and using new therapeutic modalities, such as immunotherapy, to try to eradicate cancer cells.

Immunotherapy, also called biologic therapy, is a type of cancer treatment that boosts the body’s natural defenses against cancers. It is a way of mobilizing the immune system to kill cancer cells. It uses substances made either by the body or in a laboratory to improve or restore immune system functions. This could be achieved either by vaccines, or by removal of immunosuppressive effects of cancer on the immune system, or by engineering T cells, a subtype of white blood cells that play a central role in cell-mediated immunity, to kill specific cancers.

“The big question is whether it’s the tumour cells that are becoming resistant, or whether the immune system is becoming dysfunctional, or a combination of both,” says Dr. Jesse Zaretsky University of California, Los Ange­les.

Dr. Rak believes “it is probably a bit of both.” Tumours are exercising their ability to become resistant but patients may simultaneously be experiencing a dysfunctional immune system.

Immunotherapy treatments work in different ways. Some boost the body’s immune system, while  others help train the immune system to attack cancer cells specifically. Immunotherapy works for some cancers better than others and can be used by itself or in combination with other treatments.  

Some of the latest advances in research on immunotherapies involve checkpoint inhibitors to treat cancer. The immune system has checkpoint proteins (such as PD-1 and CTLA-4) which prevent it from attacking the healthy cells. One way cancers develop resistance is by taking advantage of these checkpoints to avoid being attacked by the immune system. Checkpoint inhibitors have shown impressive success in recent years; patients with metastatic melanoma or non-small cell lung cancer are showing promise in clinical trials.

Combination treatments and research on immunotherapies have shown a lot of potential. There is a wealth of human creativity involved, and the progress made has been tremendous. But despite advances in immunotherapies and molecular-targeted therapies, chemotherapy is still a frontline treatment for many cancers. Researchers have been hampered by the lack of biomarkers to predict whether a patient is resistant to these treatments, in which case the exposure to chemotherapy and its toxicity would be unwarranted.

The issue of cancer drug resistance is a daunting one, and it is pertinent that more research is conducted about ways cancers evade chemotherapeutic treatments. Rak expresses the need to come up with effective and efficient drugs: “As many others, I personally believe that formation of cancer cells with their enormous growth advantage and ability to spread comes at a cost of certain vulnerabilities. Finding these cancer vulnerabilities is a great way to combat or circumvent drug resistance.”

Immunotherapy, specifically immune checkpoint therapy, is one example of an area of cancer research that shows promise in combating cancer drug resistance. There needs to be further research to overcome the daunting prevalence rate of cancer drug resistance.

There are several labs at McGill which conduct studies on cancer drug resistance and immunotherapies. For more information on McGill labs that conduct this research, check out the funded projects at Goodman Cancer Research Centre, Lady Davis Institute, RI-MUHC, and other sites.

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An alarming 66 per cent of undergraduate students at McGill report feeling “academic distress” over the course of the school year. Currently, we are being hit with waves of midterms and papers, and soon we’ll be struck with the tsunami known as finals season. Paired with a lack of sleep and excessive amounts of caffeine intake, this academic pressure can create a stressful environment, and is just one of many factors that can trigger emotional turmoil for students at McGill. 90 per cent of students at McGill reported feeling overwhelmed at some point over the course of the year, 56 per cent reported feeling overwhelming anxiety, and 40 per cent reported feeling so depressed it was difficult to function. Repetitive bouts of stress can have different underlying causes for each student. The competitive academic environment can exacerbate emotional stress. Mental illness manifests in different ways, but those who do not have stereotypical and traditional embodiments of mental illness, or those who are deemed not ‘sick enough,’ are not taken seriously and are often overlooked.

The overwhelming sense of competition among students that exists at institutions like McGill contribute to high levels of academic stress. Among students, a hierarchy forms: those who continue to excel as they previously had and those who find themselves adjusting to their new environment at a slower pace. Undergraduate students are at a stage in their lives where they are attempting to create a platform for themselves. The general idea is that success now will lead to successful endeavors after graduation. McGill students find themselves associating poor academic performance today with a pessimistic outlook for the future. The anticipation and perfectionism that manifests in McGill students are traits that have been linked to the development of anxiety and depressive disorders.

Students often need external assistance from mental health resources to readjust or learn self-regulation strategies to help cope with emotional distress. It is imperative that students who feel they require mental health services are not denied so because they don’t qualify as ‘mentally ill enough.’ It is imperative that those who are not considered ‘ill enough’ receive care before they are in crisis. Some people go through stressful periods with little difficulty and arrive at the finish line unscathed and there are a few who suffer minor stumbles along the way. But some of us suffer from too many falls, cuts and bruises during the marathon that is an undergraduate degree. Some run through the pain without giving any obvious indication of distress. Others outwardly grimace in pain indicating to others that there is cause for concern. Some find themselves falling behind in the race and create such a gap between themselves and their peers that it becomes hard to ever catch up without external assistance. There is a sort of mental health care rationing that exist at McGill’s Mental Health clinic. Although they try to provide for as many students as they can, they place priority on only those student who need ‘urgent care,’ while also dismissing many of these students as ‘too ill,’ citing that McGill is “not a hospital.” When McGill students decide to reach out to external resources available on campus, often those who are deemed too high functioning — the marathoners who may not outwardly grimace in pain — are not given the appropriate attention they deserve because the don’t fall into the ‘sweet spot’ McGill sees as fit for treatment.

So what does poor mental health or mental illness look like? Researchers have highlighted genetic and neuronal variation between individuals based on race, gender, socioeconomic background to name a few. There is no definite answer to the question of what mental illness should look like. Scientists acknowledge that the variation in the human brain means that mental illness will naturally manifest in a variety of ways, but this understanding doesn’t translate similarly in our communities. Several studies have come up with reliable evidence for the deleterious effect of racism on mental health. Similarly, there is evidence of poor mental health in LGBTQ communities, in comparison to heterosexuals.There is a correlation between lower socioeconomics and the quality of your mental health. We need to acknowledge that mental illness does not have the same causes or look the same among different communities at McGill.

We have all found ourselves guilty of having preconceived notions of what poor mental health looks like. We find it difficult to believe that seemingly happy, ‘high functioning’ individuals may actually be suffering from a mental illness. There are stereotypes that those suffering from mental illness are violent, or must behave in what is often described using pejorative terms like ‘crazy’ or ‘nuts.’ People often wait until these extreme symptoms of mental illness become evident before taking an individual seriously. People believe those with mental illness have bizarre disruptive behaviour or are unable to communicate with others. People with mental illness can be valuable members of society. We expect all mentally ill people to embody their experiences in the same ways, ways that are palatable.

We have spent years battling the stigma of mental disorders. Over the last five years, there has been a 35 per cent increase in students seeking help from McGill Mental Health Services, which is indicative of more students willing to seek help. Yet there are still people who suffer in silence, and are not allowed access to the resources they require. Students have reported being turned away from receiving one-on-one mental health services because they were “too high functioning.” The strain on resources at McGill mental health and counselling services, along with budget alterations and structural changes, have left many students neglected and disillusioned. The school is currently operating with the belief that only certain manifestations of mental illness need immediate medical attention- this does not take into consideration students who are on the margins of the community, or whose mental illnesses exhibit themselves in unconventional ways. Those deemed high functioning are not prioritized until they exhibit extreme signs of urgency which mirror what mental illness stereotypically looks like.

Destigmatization of mental disorders through open discussions does not, by default, allow for their trivialization. Part of the ongoing stigma of mental illness is its constant invalidation. It can be dangerous to get caught in the stigma that homogenizes mental illness and defines it using stringent stereotyped ideas.

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Music does not provide any obvious evolutionary benefit like sex or food do, but most can say it is a necessity to life as we know it. Across all cultures, music –complex sound streams with hierarchical rules of temporal organization – is a universal source of entertainment.

In an interview with The Daily, David Sears ­– a PhD candidate studying Music Theory at McGill’s Music Perception and Cognition Lab – explained, “the experience of pleasure during music listening — or any other aesthetic experience for that matter — is dependent upon the listener reaching an optimum level of physiological arousal.” If a new musical context is too complex or surprising, we might feel fear, confusion, or disgust, and possibly conclude that we dislike the song. If the song is too simple or familiar, on the other hand, we might feel bored and dislike the song.

According to Sears, “to elicit pleasure, musical works we fall in love with tend to be somewhere in the middle” of this balance between familiarity and complexity. This might explain why we tend to dislike a tune when we hear it for the first time, but then grow to appreciate it after listening to it repeatedly. So one theory, as Sears puts it, might be that “humans seek out aesthetic experiences that optimally challenge us, where attaining a sense of understanding for a new song across repeated listenings is neither too easy nor too difficult.”

Robert Zatorre, James McGillProfessor of Neuroscience, and Alain Dagher professor of Neurology & Neurosurgery and Psychology at McGill, in collaboration with other researchers, used functional magnetic resonance imaging (fMRI) and positron emission tomography (PET) scans to investigate the neural processes involved when listening to music. Their research paper was published in Science Magazine in April 2013. The study showed that music triggers the release of dopamine, a neurotransmitter that is also released during sex and when eating food, to several areas of the brain, including the ventral striatum, which contains the nucleus accumbens.

The scientists used PET scans to determine how much dopamine was released and used the fMRI scans to track the areas that received the dopamine. In terms of pleasure, the study concluded that activity in the ventral striatum region of the brain, which is believed to be responsible for memory and movement, is the best predictor of how much pleasure is derived from a song. The study offers a biological explanation for the processes involved in gaining pleasure from listening to music.

However, why people are able to obtain pleasure from music, remains uncertain. A study published in 2011 in Nature Neuroscience by Zatorre and Dagher, and others suggests listening to music evokes certain emotions through “expectations, delay, tension, resolution, prediction, surprise, and anticipation.” The study concluded “that a sense of emotional expectation, prediction and anticipation in response to abstract pleasure can also result in dopamine release,” resulting in pleasure.

Neuroscientist Jeff Hawkins and New York Times science writer Sandra Blakeslee offer a similar explanation, in their book On Intelligence suggesting that the brain’s main function is in predicting the future. When the brain is able to successfully predict an event, it rewards itself via neural circuitry, and dopamine is released. If this is in fact true, it should be no surprise that music encourages listeners to make predictions, and this fulfillment leads to the kinds of pleasurable experiences that draw listeners back repeatedly.

Music is part of almost all facets of life and can evoke a wide range of emotions and memories. It can have profound effects on our behaviour and, at times, even physically move us. Yet, little is known about how it is able to do that, and even less on why we respond to it the way we do. Scientific inquiry into the neurochemical effects of music is slowly breaking out of its infancy as technology and non-invasive brain imaging techniques advance. Perhaps in the future, scientists will be able to offer more concrete insights into the complex relationship between music and the brain.

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The Professional Institute of the Public Service of Canada (PIPSC) recently published a report with shocking statistics about federal cuts to science. Between 2008 and 2013, $596 million was cut from science and technology at federal departments and agencies. This resulted in the elimination the equivalent of 2,141 full-time positions. These cuts have also had a drastic effect on departments like Environment Canada, which has seen cuts of $125 million, or 17.5 per cent; the National Research Council at $129 million, or 17.2 per cent; and Fisheries and Oceans at $28 million, or 10.2 per cent.

Canada runs the risk of coming to a standstill in scientific advancement, the drastic effects of which will be noticeable in the near future. According to Stephanne Taylor, a McGill PhD student in Atmospheric and Oceanic Sciences, cuts that affect research facilities have longterm consequences. Taylor told The Daily, “Research projects can’t just be shut down and then revitalized at the drop of a hat – closing a lab means halting years of ongoing research and work, and it takes considerable time [and funding] to restart all that background work that allows a lab to run effectively.”

Federal scientists serve the public by providing the knowledge needed to make informed decisions. They are affected by the restrictions that federal science budget cuts impose; as such, they are unable to fulfill this duty to the public. As scientists employed by the federal government they are faced with an unavoidable identity crisis: in order to serve the public interest, they are forced to decide whether to thrust themselves into the political limelight and take action, or remain as neutral as much as they can.

In a statement to The Daily Edward Ruthazer, an associate professor in the Department of Neurology and Neurosurgery, said, “Science and politics are fundamentally different things.” According to Ruthazer, “the act of carrying out good science can be done in a political vacuum,” but the federal government is forcing scientists out of their traditional role. Scientists have been forced to engage in numerous political issues, such as objecting to current policies concerning scientific research and funding. CBC covered a protest held by scientists in Winnipeg on federal budget cuts to labs in Manitoba and across the country. A major concern of protesters was that “oppressive policies are being imposed on government scientists that restrict their ability to communicate their scientific findings.” CBC interviewed Pamela Godin, a science graduate student at the University of Manitoba who said, “As a scientist I’ve seen these cuts, and it’s made me more passionate. It’s made me more political.” If scientists do not advocate for policy change, no one else will.

“Research projects can’t just be shut down and then revitalized at the drop of a hat – closing a lab means halting years of ongoing research and work, and it takes considerable time [and funding] to restart all that background work that allows a lab to run effectively.”

— Stephanne Taylor, a McGill PhD student in Atmospheric and Oceanic Sciences

To be credible in the scientific community, one must be associated with either an academic or governmental institution. Canadian federal scientists’ association with the federal government has proven to be detrimental to their ability to pursue their work. Scientists, most notably federal environmental scientists, are being prevented from freely sharing and discussing their findings and data with the public. Moreover, in a survey of over 4,000 scientists conducted by PIPSC, 91 per cent of participants were worried that federal science cuts would impede their ability to serve the public, with environmental research and regulation cited as the area of highest concern among respondents.

The government can also deem research proposals from federal scientists as non-essential, often for reasons of economic disadvantage. Darin Barney, Canada Research Chair in Technology & Citizenship, told The Daily via email, “The government has retracted support for both disinterested scientific inquiry and scientific investigation connected to the regulation of industrial activity. At the same time, it has maintained substantial investment in scientific research connected to commercial and technological development.”

Ultimately, the government is deciding what science is to be done and is hindering the freedom and choice that scientists have. Scientists are forced to halt basic scientific research and pursue research that has been approved by those who are funding their projects, meaning that research is driven by economic concerns rather than social value. Barney highlighted that “the real conflict is not between abstract notions of environmental protection and economic gain,” but rather between “the class of capitalists who benefit disproportionately from resource depletion and the class that will suffer its consequences most heavily.”

Most environmental research falls under basic science, and the importance of this research should be self-evident. Additionally according to Taylor, “Basic science research is the foundation of the applied and industrial science research of the future […] without that exploratory knowledge, our applied research will stagnate.”

Prime Minister Stephen Harper’s government should be focused on public health, safety, and the environment; it should take the public’s best interest to heart. Ruthazer noted that large swaths of the Canadian economy are based in resource extraction, especially with the network of proposed pipelines and increased exporting of tar sand oil. According to Ruthazer, this creates a conflict between economic gain and environmental protection, especially at a time when carbon dioxide emissions need to be drastically reduced in order to combat climate change.

Canada’s global identity and reputation is slowly declining because of decisions made by our government. Foreign scientists have asked Harper to “restore science funding and freedom,” in an open letter drafted by the Union of Concerned Scientists, a group that represents U.S. scientists. The letter was signed by scientists from over 32 countries. “Canada’s leadership in basic research, environmental, health, and other public science is in jeopardy.” This is substantial evidence for the consequences of scientific budget cuts, and that restrictions have not been confined to Canadian borders.

The reputations of Canadian scientists on a global scale are on the line if they do not stand up and protest policies that are incongruent with their beliefs and the requirements of their jobs. Scientists do not solely hold the responsibility of bringing about change; ordinary citizens and the federal government share the load. It is up to the federal government to recognize that basic research funding is crucial for the progress of society and it is their responsibility to promote rather than neglect or prevent basic science research. Citizens should recognize the negative effect federal science budget cuts will have in the foreseeable future and must stand up for their right to be informed.

Canada’s identity is being put on the line, and if federal cuts to science continue, we can only imagine the detrimental impact on scientific development. Scientists are faced with the identity crisis: in order for them to pursue science for the benefit of the public, they are being forced into political confrontation. We need to stop only investing in research which promises industry and economic outcomes, and continue to fund basic science research that’s needed to discover future innovations. Who should set the goals for science – a government with misaligned priorities, or the scientists themselves?

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