[Prediabetic state. Realities and illusions].
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Adolescent↗
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Results for “Reality Testing”
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Experience with V-STORE: considerations on presence in virtual environments for effective neuropsychological rehabilitation of executive functions.
The paper discusses the use of immersive virtual reality systems for the cognitive rehabilitation of dysexecutive syndrome, usually caused by prefrontal brain injuries. With respect to classical P&P and flat-screen computer rehabilitative tools, IVR systems might prove capable of evoking a more intense and compelling sense of presence, thanks to the highly naturalistic subject-environment interaction allowed. Within a constructivist framework applied to holistic rehabilitation, we suggest that this difference might enhance the ecological validity of cognitive training, partly overcoming the implicit limits of a lab setting, which seem to affect non-immersive procedures especially when applied to dysexecutive symptoms. We tested presence in a pilot study applied to a new VR-based rehabilitation tool for executive functions, V-Store; it allows patients to explore a virtual environment where they solve six series of tasks, ordered for complexity and designed to stimulate executive functions, programming, categorical abstraction, short-term memory and attention. We compared sense of presence experienced by unskilled normal subjects, randomly assigned to immersive or non-immersive (flat screen) sessions of V-Store, through four different indexes: self-report questionnaire, psychophysiological (GSR, skin conductance), neuropsychological (incidental recall memory test related to auditory information coming from the "real" environment) and count of breaks in presence (BIPs). Preliminary results show in the immersive group a significantly higher GSR response during tasks; neuropsychological data (fewer recalled elements from "reality") and less BIPs only show a congruent but yet non-significant advantage for the immersive condition; no differences were evident from the self-report questionnaire. A larger experimental group is currently under examination to evaluate significance of these data, which also might prove interesting with respect to the question of objective-subjective measures of presence.
Cognition Disorders↗
The mutagenic activity of ethylnitrosourea at low doses in spermatogonia of the mouse as assessed by the specific-locus test.
Ethylnitrosourea is the most efficient chemical mutagen in spermatogonial stem cells of the mouse and its mutagenic activity has been intensively studied. The pertinent specific-locus mutation test results for a discussion of low dose-effect studies have been summarized and indicate: (1) A threshold dose response best characterizes the relationship between dose and mutation rate. (2) The reduced effectiveness of ethylnitrosourea in the low dose range is likely due to a saturable repair process. (3) The recovery of the saturable repair process as assessed in fractionated dose experiments is long (ca. 168 h). The dynamics of stem cell spermatogonia suggests a long time interval before the cell population passes through at least one cell division and this may be relevant to an interpretation of the fractionation effects. (4) There is a slight but important discrepancy between the predicted and observed mutagenic activity of ethylnitrosourea in the low dose range. This is interpreted to be due to the differences between a mathematical abstraction and the biological realities of the system being studied.
Animals↗
Epidemiology, prevention, and early detection of breast cancer.
The evidence that alcohol consumption increases a woman's chances of getting breast cancer is now more persuasive. Higher blood concentrations of organochlorine compounds were not associated with increased risk of breast cancer in recent studies. The relationship of exogenous estrogen use to breast cancer risk is now clarified: current users of both oral contraceptives and hormone replacement therapy experience a slightly elevated risk that dissipates after cessation of use. Alcohol consumption and hormone replacement therapy are both associated with slightly increased breast cancer risk, but the overall health benefits of hormone replacement therapy and low levels of alcohol consumption appear to outweigh the risks in the general population. These circumstances underscore the complex decisions facing women and the need to consider individual risk factor profiles. For the genes BRCA1 and BRCA2, more data are needed to understand the risks associated with specific mutations, optimal implementation of genetic testing, and prevention and early detection strategies for women who have positive test results. Interesting leads in identifying women at increased risk for breast cancer have been generated via the study of genetic polymorphisms. The results of tamoxifen in the Breast Cancer Prevention Trial have made the possibility of chemoprevention for breast cancer a reality. Raloxifene, another antiestrogen, has emerged as a potential chemopreventive agent. Its efficacy in reducing breast cancer risk will be compared with that of tamoxifen in a randomized trial.
BRCA2 Protein↗
Balancing human exposure, risk and reality: questions raised by the Canadian aboriginal methylmercury program.
Environmental contaminants such as methylmercury which bio-accumulate in aquatic ecosystems present an exposure risk to Aboriginal peoples living traditional lifestyles. The results of a 20 year testing program of methylmercury exposure levels of 38,571 Canadian Aboriginal people in 514 native communities across Canada are presented. 608 individuals had blood or blood equivalent levels over 100 micrograms/l. The highest individual level was 660 micrograms/l. The highest mean levels were found in the Inuit in N.W.T. In that same group, over 30% of women aged 15-45 years who were tested had levels over 10 micrograms/g methylmercury in hair with a mean of 16 micrograms/g, well into the 10-20 micrograms/g "risk" range defined by WHO for fetal exposure. A discussion of the management of risk from exposure to methylmercury in the Canadian Aboriginal population is presented, concentrating especially on the need to balance the theoretical basis of the risk assessment, for different population groups and for different exposure patterns, against the potential real impact on health caused by restrictive advice on consumption of traditional foods, especially fish.
Adolescent↗
The role of presence in virtual reality exposure therapy.
A growing body of literature suggests that virtual reality is a successful tool for exposure therapy in the treatment of anxiety disorders. Virtual reality (VR) researchers posit the construct of presence, defined as the interpretation of an artificial stimulus as if it were real, to be a presumed factor that enables anxiety to be felt during virtual reality exposure therapy (VRE). However, a handful of empirical studies on the relation between presence and anxiety in VRE have yielded mixed findings. The current study tested the following hypotheses about the relation between presence and anxiety in VRE with a clinical sample of fearful flyers: (1) presence is related to in-session anxiety; (2) presence mediates the extent that pre-existing (pre-treatment) anxiety is experienced during exposure with VR; (3) presence is positively related to the amount of phobic elements included within the virtual environment; (4) presence is related to treatment outcome. Results supported presence as a factor that contributes to the experience of anxiety in the virtual environment as well as a relation between presence and the phobic elements, but did not support a relation between presence and treatment outcome. The study suggests that presence may be a necessary but insufficient requirement for successful VRE.
Adaptation, Psychological↗
Homophobia: an evolutionary analysis of the concept as applied to nursing.
Homophobia is a socially accepted, culturally based belief, which is heavily influenced by an individual's or a community's inherent attitudes, beliefs and values. This conceptual analysis of homophobia has endeavoured to review existing literature on homophobia and subsequently identify and examine the phobic constituents of the concept. References to homophobia are mostly from the 1970-1980 period and there is much unacknowledged conceptual baggage that accompanies the term, which results in restrictive and inappropriate ideas about this concept. This is mainly the consequence of comparisons of homophobia to other phobias, which directly infers fear of homosexuals, while in reality homophobia is more of a biased disgust at homosexuals' lifestyles. This paper attempts to re-conceptualize homophobia so that empirical research can begin to test the critical attributes of the concept. This forms the basis for the development of a comprehensive social psychological theory of attitudes towards homosexuals. Such a theory would transcend the unilateral and unidimensional concept of homophobia as a fear and help the understanding of attitudes and feelings towards homosexuals.
Attitude of Health Personnel↗
[Value of the ERGOS work simulator as a component of functional capacity assessment in disability evaluation].
The use of assessment instruments in evaluating functional capacity is an important element in the process of social-medical judgement of whether a person will likely be able to reintegrate into working life. Standardized work processes are used in simulating occupational reality over several hours, with all the requirements involved, and the performance found is contrasted with the requirements to be expected at a workplace. Time-tested in the U.S. for more than 20 years and applied throughout Germany for some two years now, the ERGOS work simulation system is presented in the article, using a case example for more detailed description. Using five different work stations, performance data are collected for job tasks such as carrying, working in kneeling position or overhead, and subjected to computer-based comparison with the job requirements information contained in relevant databases. This enables computerized identification of excessive demands, and hence may point to a need for further rehabilitative action. An important feature is objective assessment, as subjective information on the basis of observation or reports of painfulness are raised separately, hence do not influence the findings of the work simulation performed.
Computer Simulation↗
Disembodiment is a cyberspace myth: discourse and the self in real space.
Much social science writing about the Internet is disembodied. This paper will try show how this is rhetorically practiced by the cyberfeminist author Sadie Plant. From the work of Fred Newman, Michael Billig, and also from discourse work, comes the idea that it is not views that should be studied per se, but rather, the giving of views. To understand people, one needs to understand them when they are in dialogue with one another. Not to test them in isolation, but to study their interrelatedness as they perform social life. A social space was constructed through which embodiment could be revealed. This reality is "real space," the space that is on the other side of the screen, so to speak. To understand the psychology of the Internet is to enter into dialogue with people, and real space constitutes the embodied practice of social talk, specifically in the context of the interview. Two semistructured interviews were carried out with a student from the Ukraine. These interviews were transcribed closely. Just as real space constitutes interviews, cyberspace constitutes E-mailing. An international student born in New Zealand was questioned through E-mail. A discourse analysis was performed on selected extracts. The sequences were typified by diversity and multiplicity of theme, which included the drawing upon of embodied resources. The experience of being internationals in a U.K. academic institution were perpetually being negotiated, concomitantly to the giving of views about the Internet. The problematic issues of writing about social life are practically addressed in the discussion. I explore the realities created by real space and cyberspace by deconstructing them. Discourse work allowed for a critical self-reflection concerning the meanings that were given to the performance of the Internet.
Adult↗
[Pareidolia in Beato de Liébana's illuminated Visigothic codes].
The visual perception alterations constitute a characteristic etymological field in some neurological and psychiatric processes (such as hallucinations, hallucinosis, etc.) that can also appear in healthy people (metamorphosias, pareidolias). The pareidolia is a phenomenon characterized by the non auto-provoked visualization of a perception in which reality and daydream are combined. It constitutes a source of inspiration for different artistic manifestations, is the basis of some common psychological explorations (such as Rorcharch test) and it even can be the explication to some situations considered as paranormals, for example the vision of faces in the Moon or in Mars or the apparition of sacred figures either in spots or shades... Beato of Liébana was a cantabrian presbyter, author in the eight century of the Comments of the Apocalypse exegesis, copied and illuminated repeated times all through the following centuries. Given the marked revealing and eschatological component of the Apocalypse, starting from the Leon's School (known also as Mozarabic since the Ninth Century), the original was enriched adding another texts with their own illustrations. From them, the Comments to Daniel's Book, from Saint Jeronimus, stands out. The whole of the illuminated Hispanic manuscripts constitutes a "corpus" of amazing codices international known today as Beatos. We have demonstrated that the first History's graphic representation of a pareidolia phenomenon is found in the miniature Visigoth Hispanic manuscripts known as Beatos; we have arrived to this conclusion studying two facsimiles from the x Century (Beato of Valcavado and Beato of Gerona) specially the miniature called Baltasar's Feast; in both codices, is illustrated how this Babylon king perceives the way a phantasmagoric hand spurts up from a candlestick flame and writes in the adjacent wall three mysterious words: MANE, TECEL, FARES, which were only interpreted by Prophet Daniel, requested ad hoc. Baltasar mixed up unintentionally the perceived and the daydreamed starting from a visual field barely structured, we conclude that he suffered from a pareilolia phenomenon, graphically represented by the first time in History in the Beatos.
Fantasy↗
Clinical management where medicine meets management. Array of hope.
Routine use of genetic profiling for managing some cancers could soon be a reality. Its wider application in cancer care will require substantial public investment in research and development, IT and setting up a service infrastructure. The first commercial test kits for breast cancer prognosis have already been launched in Europe and the US.
Diagnostic Tests, Routine↗
Practice standards: implications for the internist.
Pressure for national standards of medical practice is increasing from cost control initiatives, medical malpractice liability, and the desire to simplify complex practice problems. Good standards need to be academically sound, focused enough to be clinically useful, yet flexible enough to allow for the realities of practice. Standards have already been created by several professional societies, including anesthesiology and cardiology in internal medicine. Although physician education is primary, controlling the use of expensive new technologies is an unwritten but important secondary goal. While standards have reduced malpractice liability in some professional groups, some clinicians are concerned that standards will be too academic and unrealistic. Currently, third-party payers are watching the development of practice standards but are hesitant to use them as criteria for determination of reimbursement. The federal government has a major interest in practice standards as a means of both monitoring quality of care and controlling costs. A number of agencies are studying the development of standards and their implications for use. Recent articles questioning the usefulness of common diagnostic tests and even the routine physical examination have raised concern among internists that restriction of practice and reimbursement will follow. Some evolving standards, such as screening for breast cancer, seem to ignore the realities of clinical practice and may generate more cost than they save. Internists need to provide input as standards are developed to guarantee appropriateness and feasibility.
Costs and Cost Analysis↗
[Syndrome of reactive hypoglycemia. Myth or reality].
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Acarbose↗
Biological response modifiers: preclinical evaluation and clinical activity.
Biological response modifiers are agents capable of affecting the host immune response toward tumors and include those biological substances produced by the human mammalian cell genome. Interferons and other lymphokines, tumor antigens, antibodies and agents which can activate or stimulate host immune responses are all included in this general category of agents. With the advent of genetic engineering and with monoclonal antibody technology, highly pure preparations of these biological substances can now be produced for tests of activity in preclinical models and in man. As the initial results accrue with highly purified preparations of interferon and with monoclonal antibodies alone or conjugated to toxic substances, the possibility of tumor specific therapy is becoming a reality. The development of preclinical models to predict for clinical activity remains a most important task to attempt to bring to clinical trials the substances most likely to be efficacious as anticancer agents. Early clinical results indicate that many of these agents can give responses in patients with clinically perceptible disease and Phase II activity studies are just beginning to define the range of clinical activity for a variety of biological response modifying agents. The development of biological response modifiers through preclinical testing and into clinical trials will be discussed in detail.
Adjuvants, Immunologic↗
Economic analysis of alternative AD control programmes.
The threat imposed by its virulence brings a presumption that Aujeszky's disease (AD) must be controlled because potential losses are high. Viewed as an economic problem, the decision on whether and how to control AD hinges on comparing the costs of doing so with the benefits (in terms of reduced production losses) to be gained. Four strategies are considered: (a) doing nothing, (b) suppressing and maintaining the disease at low prevalence levels by vaccination, (c) suppressing to low levels and then eradicating by culling remaining positive animals and (d) eradicating in one step by means of a test-and-slaughter policy. The net economic merits of each strategy are examined using data derived from specific vaccination studies established in Germany and the Netherlands. A computer model is developed to estimate disease costs under different technical, epidemiological and economic assumptions, allowing the economically optimal strategies to be explored. In general no single strategy can be recommended as the 'best' for dealing with AD, since it depends on a host of factors relating to pig density, prevalence levels, production system, trade relations, etc. As usual, economic realities complicate the quest for operational simplicity in disease control. However, for the regions of high pig density studied the most economic AD control strategy is to lower herd prevalence by intensive vaccination before completing eradication by test-and-removal of remaining positive animals.
Animals↗
On the importance of considering porosity when simulating the fatigue of bone cement.
Fatigue cracking in the cement mantle of total hip replacement has been identified as a possible cause of implant loosening. Retrieval studies and in vitro tests have found porosity in the cement may facilitate fatigue cracking of the mantle. The fatigue process has been simulated computationally using a finite element/continuum damage mechanics (FE/CDM) method and used as a preclinical testing tool, but has not considered the effects of porosity. In this study, experimental tensile and four-point bend fatigue tests were performed. The tensile fatigue S-N data were used to drive the computational simulation (FE/CDM) of fatigue in finite element models of the tensile and four-point bend specimens. Porosity was simulated in the finite element models according to the theory of elasticity and using Monte Carlo methods. The computational fatigue simulations generated variability in the fatigue life at any given stress level, due to each model having a unique porosity distribution. The fracture site also varied between specimens. Experimental validation was achieved for four-point bend loading, but only when porosity was included. This demonstrates that the computational simulation of fatigue, driven by uniaxial S-N data can be used to simulate nonuniaxial loadcases. Further simulations of bone cement fatigue should include porosity to better represent the realities of experimental models.
Biocompatible Materials↗
Laryngeal hyperfunction during whispering: reality or myth?
For years, otolaryngologists and voice therapists have warned voice patients that whispering causes more trauma to the larynx than normal speech. However, no large series of patients has ever been examined fiberoptically during whispering to test this hypothesis. As part of our routine examination, patients are asked to count from 1 to 10 in a normal voice and in a whispered voice. We reviewed recorded fiberoptic examinations of 100 patients who had voice complaints. We compared supraglottic hyperfunction and vocal fold closure during the normal and whispered phonation of each patient. Sixty-nine percent of the patients demonstrated increased supraglottic hyperfunction with whispered voice. Eighteen percent had no change, and 13% had less severe hyperfunction. The most common glottal configuration during whisper was an inverted Y, which resulted from compression of the anterior and middle thirds of the true vocal folds. However, 12 patients had no true vocal fold contact during whispered voice, despite having adequate glottic closure with normal voice. Although whispering involves more severe hyperfunction in most patients, it does not seem to do so in all patients. In some patients, it may be less traumatic than normal voice.
Adult↗
[Schizophrenic disorders--does cognitive dysfunction relate to characteristics of course and psychopathology of the illness?].
AIM: Because of their importance both for pathogenesis or clinical aspects of the disease and for patients' social functioning, cognitive dysfunctions are nowadays often considered as basic characteristics of schizophrenic disorders. This study was aimed at evaluation of the correlation between some indices of disordered cognitive functioning on the one hand and some variables describing course and psychopathology of schizophrenic disorders on the other. METHOD: The study group consisted of 69 inpatients suffering from schizophrenia diagnosed according to both DSM-IV and ICD-10 criteria. Their mental state was rated by two clinical tools (scales: PANSS, KOSS). Also social functioning of patients in the year preceding current hospitalisation was rated by two scales (GAF, scale W). Cognitive dysfunctions were assessed by computer-aided tests from Dr. Schufried's Vienna Test System including measures of reaction time (RT), visual line pursuit (LVT), perseveration (PERSEV), and span of visual-spatial short term memory (CORSI). In statistical analysis simple nonparametric tests and rank correlation measures were applied. RESULTS: Correlations were confirmed between cognitive dysfunctions and social functioning prior to hospitalisation, age, duration of illness and number of previous hospitalizations. Dysfunctions were less severe in first episode patients than in patients during relapses or the residuum stage of illness. Overall assessments of severity of illness do not correlate with cognitive dysfunctions, but detailed analysis of psychopathology revealed correlations of the latter with such psychopathological dimensions as deficit, disorganization and dysphoria. Reality distortion (positive) psychopathological dimension did not have any correlation with cognitive measures. All indices of cognitive dysfunction correlated with poorer outcome of treatment of the current episode. All correlations confirmed were only of weak or moderate level. CONCLUSIONS: Cognitive dysfunctions correlate rather with unfavourable characteristics of the course of the illness. Results of psychopathological assessment hardly correlate with neuropsychological measures--cognitive dysfunctions are related rather to deficit (negative), disorganisation or dysphoria dimensions of a schizophrenic syndrome than to productive (reality distortion, positive) dimension of the syndrome.
Adult↗
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