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Neuroscience patients, even with vigorous preventive efforts, are often at risk for developing pressure ulcers. Recognition of risk factors and institution of preventive techniques are essential aspects of initial management. Neuroscience nurses familiar with current treatment principles and products will be better prepared to offer their patients comprehensive skin care.
There have been numerous advances in the neurosciences in the last decade. These include discoveries in the area of neurogenetics, as well as advances in the prevention, diagnosis and treatment of neurologic diseases such as stroke, epilepsy and Parkinson's disease. These advances raise issues which have dramatic implications for nursing. In our society there is an increasing focus on technology. This focus, coupled with the reductionism of cellular and biochemical advances in the neurosciences, tends to take the focus away from the patient. Nursing care is critical in bridging the gap created by technological and biochemical discoveries.
Nurse case managers are becoming more visible within the nursing profession. Practice settings range from acute care to independent companies developed for the purpose of case management. In each area, the development of a more autonomous nurse is emphasized. Neuroscience nurses are particularly suited for the role of case manager since their patients often require extensive rehabilitation and nursing care. As patients face earlier discharges, neuroscience case managers will be the link to vital resources in what is now an often fragmented system of care.
The case management model for patient care in the neuroscience area was recently implemented in the neurosciences area at a tertiary care hospital. Understanding of the concepts of case management and managed care were essential to the implementation process. Clustering of case types and appointment of group leaders made the development of individual care maps a manageable task. Case management of 2 case types, Parkinson's disease and Guillain Barré syndrome are described, including the rationale for selection, care map development and education. The process of continuing education focused on operational issues regarding utilization of the map and professional issues such as health teaching responsibilities.
The historical development and correlation of neuroscience nursing literature and nursing practice were traced through a review of selected texts commonly used in nursing education. The primary focus was nursing care of the adult patient with coma secondary to traumatic brain injury, although this patient population was not always identified in early texts. Literature and practice were divided into three periods: early, transitional and modern. The neuroscience literature from 1887-1992 revealed changes in authorship and literary style as well as changes in nursing roles from an almost totally dependent practice to one with an extremely high degree of independence. A correlation between authorship, literary style and nursing practice was evident.
The Human Genome Project has nearly completed the identification of the human genome. The medical, social, and legal implications are numerous. Neuroscience nurses have the unique opportunity to be an integral part of the genetics age because of the many genetic-based neuroscience diseases.
The evolution of the neuroscience education team has been a very positive development at our institution. In addition to their other daily responsibilities, the team members coordinated the orientation of 80 new staff members hired in a 2-year period. This diverse group presented challenges, but the overall outcome was increased staff retention. The team has seen new staff hires grow into competent neuroscience nurses.
Faster than ever, neuroscience is generating vast amounts of data that await cross-referencing, comparison, integration and interpretation in the endeavour to unravel the mechanisms of the brain. The complex, diverse and distributed nature of these data requires the development of advanced neuroinformatics methodologies for databases and associated tools that are now beginning to emerge. This paper presents an overview of current issues in the representation, integration and analysis of neuroscience data from molecular to brain systems levels, including issues of implementation, standardization, management, quality control, copyright, confidentiality and acceptance. Particular emphasis is given to integrative neuroinformatics approaches for exploring structure-function relationships in the brain.
Neuropsychological research on the neural basis of behaviour generally posits that brain mechanisms will ultimately suffice to explain all psychologically described phenomena. This assumption stems from the idea that the brain is made up entirely of material particles and fields, and that all causal mechanisms relevant to neuroscience can therefore be formulated solely in terms of properties of these elements. Thus, terms having intrinsic mentalistic and/or experiential content (e.g. 'feeling', 'knowing' and 'effort') are not included as primary causal factors. This theoretical restriction is motivated primarily by ideas about the natural world that have been known to be fundamentally incorrect for more than three-quarters of a century. Contemporary basic physical theory differs profoundly from classic physics on the important matter of how the consciousness of human agents enters into the structure of empirical phenomena. The new principles contradict the older idea that local mechanical processes alone can account for the structure of all observed empirical data. Contemporary physical theory brings directly and irreducibly into the overall causal structure certain psychologically described choices made by human agents about how they will act. This key development in basic physical theory is applicable to neuroscience, and it provides neuroscientists and psychologists with an alternative conceptual framework for describing neural processes. Indeed, owing to certain structural features of ion channels critical to synaptic function, contemporary physical theory must in principle be used when analysing human brain dynamics. The new framework, unlike its classic-physics-based predecessor, is erected directly upon, and is compatible with, the prevailing principles of physics. It is able to represent more adequately than classic concepts the neuroplastic mechanisms relevant to the growing number of empirical studies of the capacity of directed attention and mental effort to systematically alter brain function.
OBJECTIVE: Generalizing the data models underlying two prototype neurophysiology databases, the authors describe and propose the Common Data Model (CDM) as a framework for federating a broad spectrum of disparate neuroscience information resources. DESIGN: Each component of the CDM derives from one of five superclasses-data, site, method, model, and reference-or from relations defined between them. A hierarchic attribute-value scheme for metadata enables interoperability with variable tree depth to serve specific intra- or broad inter-domain queries. To mediate data exchange between disparate systems, the authors propose a set of XML-derived schema for describing not only data sets but data models. These include biophysical description markup language (BDML), which mediates interoperability between data resources by providing a meta-description for the CDM. RESULTS: The set of superclasses potentially spans data needs of contemporary neuroscience. Data elements abstracted from neurophysiology time series and histogram data represent data sets that differ in dimension and concordance. Site elements transcend neurons to describe subcellular compartments, circuits, regions, or slices; non-neuroanatomic sites include sequences to patients. Methods and models are highly domain-dependent. CONCLUSIONS: True federation of data resources requires explicit public description, in a metalanguage, of the contents, query methods, data formats, and data models of each data resource. Any data model that can be derived from the defined superclasses is potentially conformant and interoperability can be enabled by recognition of BDML-described compatibilities. Such metadescriptions can buffer technologic changes.
One of the most significant developments in biology in the past half century was the emergence, in the late 1950s and early 1960s, of neuroscience as a distinct discipline. We review here factors that led to the convergence into a common discipline of the traditional fields of neurophysiology, neuroanatomy, neurochemistry, and behavior, and we emphasize the seminal roles played by David McKenzie Rioch, Francis O Schmitt, and especially Stephen W Kuffler in creating neuroscience as we now know it. The application of the techniques of molecular and cellular biology to the study of the nervous system has greatly accelerated our understanding of the mechanisms involved in neuronal signaling, neural development, and the function of the major sensory and motor systems of the brain. The elucidation of the underlying causes of most neurological and psychiatric disorders has proved to be more difficult; but striking progress is now being made in determining the genetic basis of such disorders as Alzheimer's disease, amyotrophic lateral sclerosis, Parkinson's disease, and a number of ion channel and mitochondrial disorders, and a significant start has been made in identifying genetic factors in the etiology of such disorders as manic depressive illness and schizophrenia. These developments presage the emergence in the coming decades of a new nosology, certainly in neurology and perhaps also in psychiatry, based not on symptomatology but on the dysfunction of specific genes, molecules, neuronal organelles and particular neural systems.
We describe the development of a computer-assisted instructional tool for the neurosciences. Designed to run on readily available MS-DOS computers, the Graphic Brain utilizes computer-generated static and animated images and accompanying text to assist in instruction of neuroanatomy and neurophysiology. We have used the Graphic Brain in our medical neuroscience course and report that, as measured anecdotally and by test scores, it facilitates student comprehension of the space- and time-varying aspects of anatomy and physiology. When the Graphic Brain is used as an adjunct to lecture, we find that we can cover the same material in 75% of the time required using traditional methods.
Current progress in the cognitive neurosciences is highly relevant to the development of psychoanalytic theory and practice. Neuroscience is today becoming mature enough to provide empirical biological approaches for the investigation of psychoanalytic models and observations. The current state of functional neuroimaging techniques is reviewed, selected paradigms and findings relevant to psychotherapy research are presented, and ways to pursue the dialogue between psychoanalysts and neuroscientists are discussed, as are some related obstacles and pitfalls. The emerging dialogue between psychoanalysts and neuroscientists may help not only to reestablish a solid position of psychodynamic theory and treatment in contemporary medicine, but also to bridge the division between "psychological" and "somatic" treatments, and gain important insights into the mind-brain relationship.
Major findings from the past 55 years of psychological treatment research indicate that 3 questions are now pivotal to continued practice-relevant progress: What is the nature of the problem(s) to be treated? What are the causal change mechanisms of efficacious psychological treatments? Can more efficient and broadly effective psychological treatments be developed? Contemporary cognitive, affective, and behavioural neurosciences offer particularly promising resources for psychological treatment research that can help accelerate progress regarding these questions. This article explains why the questions are pivotal and presents neuroscience findings to illustrate how progress can be made on each one and for diverse problems and disorders such as major depression, posttraumatic stress disorder, obsessive-compulsive disorder, drug addiction, and regulation of negative affect.
The design of database models and schemas for storing, cross-referencing, and retrieving neuroscience information faces issues that are similar but more complex than most of the other biomedical disciplines, such as genomics and proteonomics. Specifically, the visualization and manipulation of very large and diverse image data, such as digital brain atlases and functional magnetic resonance images, play a unique role in neuroscience while much of the associated information is textually recorded. Nongraphical information can include the annotation of large brain structures ranging from anatomical regions to intracellular structures, the description of cellular functional properties, and their various interrelationships, such as fiber connections. It is necessary that the heterogeneous and distributed types of data be cross-referenced to each other so that this diverse information can be efficiently retrieved, shared, and exchanged among the different neuroscientific disciplines. Continued advances in computers and Internet technologies appear to indicate that increasingly large data sets will be maintained on local or regional file servers and that informational interoperability will be achieved using a networked information system infrastructure. The authors and others have proposed and implemented models of semantically organized information systems that utilize centrally stored and highly structured archival information to index, cross-reference, and retrieve diverse, Web-based data sets.
New technological and cultural developments surrounding adolescents' use of the World Wide Web offer an opportunity for turning aspects of the Internet gaming phenomenon to the advantage of neuroscience education. Specifically, an experimental project to transmit aspects of problem-based learning and the National Science Standards through an interactive Web adventure is reported here. The Reconstructors is an episodic Web-based adventure series entitled Medicinal Mysteries from History. It is funded by the National Institute on Drug Abuse, and the first series focuses on opioids. It was created with the input of middle school students and teachers. Through the use of multimedia technologies, middle school students enter a futuristic world in which they become "reconstructors," members of an elite scientific unit charged with recovering lost medical knowledge about analgesic drugs. Two of the four episodes have been evaluated through a comprehensive review process involving middle school students, teachers, neuroscience researchers, and clinicians. Analysis of the pretest and posttest scores demonstrated significant knowledge gain that validly can be attributed to use of the game. These data provide evidence that science content can be transmitted through innovative online techniques without sacrificing compelling content or effective pedagogical strategies.
Decision making, the process of choosing between options, is a fundamental human behavior that has been studied intensively by disciplines ranging from cognitive psychology to economics. Despite the importance of this behavior, the neural substrates of decision making are only beginning to be understood. Impaired decision making is recognized in neuropsychiatric conditions such as dementia and drug addiction, and the inconsistencies and biases of healthy decision makers have been intensively studied. However, the tools of cognitive neuroscience have only recently been applied to understanding the brain basis of this complex behavior. This article reviews the literature on the cognitive neuroscience of human decision making, focusing on the roles of the frontal lobes, and provides a conceptual framework for organizing this disparate body of work.
Understanding basic neuronal mechanisms hold the hope for future treatment of brain disease. The 1st international conference on synapse, memory, drug addiction and pain was held in beautiful downtown Toronto, Canada on August 21-23, 2006. Unlike other traditional conferences, this new meeting focused on three major aims: (1) to promote new and cutting edge research in neuroscience; (2) to encourage international information exchange and scientific collaborations; and (3) to provide a platform for active scientists to discuss new findings. Up to 64 investigators presented their recent discoveries, from basic synaptic mechanisms to genes related to human brain disease. This meeting was in part sponsored by Molecular Pain, together with University of Toronto (Faculty of Medicine, Department of Physiology as well as Center for the Study of Pain). Our goal for this meeting is to promote future active scientific collaborations and improve human health through fundamental basic neuroscience researches. The second international meeting on Neurons and Brain Disease will be held in Toronto (August 29-31, 2007).