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At least 289 records · Page 16Linked to original sources
PubMed1988

Peculiarities of participation of the fronto-thalamo-caudate system in extrapolatory behavior.

After observing a chimpanzee constructing a step-ladder to reach a hanging fruit, on one of his "Wednesday-meetings" (on November 13th, 1935), I. P. Pavlov said that one could not call this complex behavior "a conditioned reflex," "...this is the beginning of knowledge accumulation, establishment of constant connections between objects--the basis, underlying the scientific activity, causality laws and so on" (Pavlovskije sredi, 1949, v. 3, p. 263). So, I.P. Pavlov thought that higher nervous activity had, besides the conditioned reflex, other forms of manifestation. These ideas were developed by the famous Soviet scientist Prof. L. V. Krushinsky (1911-1984) (Chief of the Laboratory of Physiology and Genetics of Behavior, Dept. of Physiology of Higher Nervous Activity, the Biofaculty of the Moscow State Univ.). The results of this work were first published in 1958 and opened a new trend in the behavioral research. L.V. Krushinsky was the first to distinguish an extrapolatory reflex (as he called it) from a great number of complex behavioral acts. This reflex is one of the types of association, underlying the animal ability to perceive objective reality. "The more laws, interrelating the environmental elements the animal perceives, the more developed rational activity it has" (Krushinsky, 1986, p. 11, 234). L. V. Krushinsky adopted the term "extrapolation" from mathematics. It means definition of the value of the function outside of the limits of the interval where the function is already defined. In the case with extrapolatory behavior one speaks about the animal's ability to perceive this regularity. Our interest in the role of association brain structures during this behavior is not occasional. Clinical and, mainly, neuropsychological researches of Luria and his coworkers, and the experimental analysis of conditioned-reflex behavior suggest a great role of the above structures in complex forms of higher nervous activity. Just the forebrain association structures--frontal, parietal, temporal cortical areas, as well as the caudate nucleus and the association thalamic nuclei--are undergoing a complex evolutionary development in mammals. We see the culmination of their development in man. This paper sums up our research concerning the role of the most important forebrain association structures in realization of extrapolatory reflex. Here we publish the results of our experiments on cats.

Animals↗
PubMed1988

Living with Asthma. I. Genesis and development of a self-management program for childhood asthma.

This paper traces the roots of Living with Asthma, a self-management program for childhood asthma, from the Children's Asthma Research Institute and Hospital (CARIH), a residential treatment center in Denver, Colorado. The basic components of the program were developed and tested over the 40-year history of CARIH; the findings of an educational unit were added to this accumulated knowledge and expertise to complete the system. The program rests heavily on social learning theory, particularly two major tenets: 1) the concept of reciprocal determinism and 2) the learning/performance dichotomy. The crucial role of these concepts is described here, especially with respect to the design of the program and the selection of dependent variables. The remainder of this article describes the essentials of Living with Asthma, particularly the skills taught and performed by patients in a formal evaluation of the system. The design of the study, characteristics of patients enrolled in the program, and results obtained with the system are discussed. The program proved highly effective in significantly improving the knowledge of asthma in parents and their children, and in developing positive attitudes in both groups. It also produced significant reductions in the number of attacks experienced by the youngsters and improved their peak flow values. Participation in the program resulted in changes in morbidity indices of asthma, including significant reductions in school absenteeism and health-care costs incurred because of the disorder. These changes, it was concluded, reflected the result of the performance by patients of the self-management skills taught in Living with Asthma, coupled with the exceptional medical treatment they received.

Absenteeism↗
PubMed1992

The role of neopterin as a monitor of cellular immune activation in transplantation, inflammatory, infectious, and malignant diseases.

The accumulated knowledge about the organization and function of the human immune system contributes to a better understanding of the pathogenesis of most diverse disorders and is opening new avenues for therapeutic regimens. To gain further insight into the complex interactions within the components of the immune system, it has become increasingly necessary to develop rapid and simple methods to monitor the status of the immune system in patients. The determination of neopterin concentrations in human body fluids allows to investigate sensitively the cell-mediated immune status to be investigated with considerable sensitivity. In recent years it was shown that production and release of neopterin is inducible in human monocytes/macrophages by interferon gamma. Increased neopterin levels indicate endogenous formation of gamma interferon, and monitoring of neopterin levels therefore permits the activation status of the cell-mediated immune system to be examined. Neopterin concentrations in serum and in urine increase in parallel to the clinical course of infections with viruses, intracellular bacteria, and parasites. In patients with human immunodeficiency virus infection neopterin concentration in serum and urine is a significant predictor of disease progression, the statistical power being similar to CD4+ T-cell numbers. In patients with autoimmune disorders, neopterin levels correlate with the extent and the activity of the disease. Neopterin concentrations are also sensitive indicators of immunological complications in allograft recipients. In certain malignant diseases neopterin concentrations correlate with the stage of the disease and bear prognostic information. Results of neopterin measurements agree with the important role that the cellular immune system plays in these disorders.

Animals↗
PubMedDate not supplied

When do older patients change primary care physicians?

BACKGROUND: Concerns have been raised about changes in the health care system that may disrupt continuity of care and thereby reduce the quality of that care. The purpose of this study was to look at the reasons that older patients give for changing primary care physicians (PCPs) and to look at relationships between the duration of the PCP-patient relationship and the perceived quality of primary care received. METHODS: We analyzed data collected during the first 2 years of a longitudinal study of primary care patients 65 years of age and older. Variables included sociodemographic characteristics, duration of relationship with current PCP, reasons for leaving last PCP, estimated numbers of visits to PCP, other clinics, and emergency departments, and admissions to hospitals and nursing homes in the last year, self-rated health, 2 measures of health-related quality of life, and the Components of Primary Care Index (CPCI). RESULTS: 799 patients of 23 PCPs were enrolled in year 1 of the longitudinal study, and 579 were re-evaluated in year 2. The mean and median PCP-patient relationship durations were 10.27 and 8 years, respectively. Duration of the PCP-patient relationship was associated with greater patient age, income, level of education, and frequency of visits to the PCP. Longer relationship duration was also associated with higher scores on all 8 CPCI subscales. The distribution of reasons for changing PCP was associated with duration of relationship; those with a longer relationship were more likely to change involuntarily. Insurance-related reasons for changing PCP were more common in those who had changed more recently. One hundred and fourteen (14%) changed PCP during the first year of the study. Three CPCI subscale scores predicted PCP change, accumulated knowledge, communication, and family orientation. Eighty-seven percent changed involuntarily, 44% for insurance-related reasons and 40% because their doctors had moved, retired, or died. CONCLUSIONS: Older patients, particularly those who are older and have more education and income, tend to stay with their PCPs until they are forced to change. The longer they stay in the relationship, the better they feel about the quality of the primary services they receive. Changes in the health care system may have increased the number of patients forced to change PCP.

Aged↗
PubMed2001

Intraaneurysmal flow dynamics study featuring an acrylic aneurysm model manufactured using a computerized tomography angiogram as a mold.

OBJECT: To obtain precise flow profiles in patients' aneurysms, the authors developed a new in vitro study method featuring an aneurysm model manufactured using three-dimensional computerized tomography (3D CT) angiography. METHODS: A clear acrylic basilar artery (BA) tip aneurysm model manufactured from a patient's 3D CT angiogram was used to analyze flow modifications during one cardiac cycle. Stereolithography was utilized to create the aneurysm model. Three-dimensional flow profiles within the aneurysm model were obtained from velocity measurements by using laser Doppler velocimetry. The aneurysm inflow/outflow zones changed dynamically in their location, size of their cross-sectional area, and also in their shapes over one cardiac cycle. The flow velocity at the inflow zone was 16.8 to 81.9% of the highest axial velocity in the BA with a pulsatility index (PI) of 1.1. The flow velocity at the outflow zone was 16.8 to 34.3% of the highest axial velocity of the BA, with a PI of 0.68. The shear stress along the walls of the aneurysm was calculated from the fluid velocity measured at a distance of 0.5 mm from the wall. The highest value of shear stress was observed at the bleb of the aneurysm. CONCLUSIONS: This clear acrylic model of a BA tip aneurysm manufactured using a CT angiogram allowed qualitative and quantitative analysis of its flow during a cardiac cycle. Accumulated knowledge from this type of study may reveal pertinent information about aneurysmal flow dynamics that will help practitioners understand the relationship among anatomy, flow dynamics, and the natural history of aneurysms.

Acrylic Resins↗
PubMed2002

[The role of natural killer T cells in host defense to cryptococcal infection--a bridge from innate to acquired immunity].

Cryptococcosis is an opportunistic fungal infectious pathogen in immunocompromised patients with acquired immunodeficiency syndrome and hematological malignancies. The host defense to this pathogen is mediated mostly by cellular immunity. Th1-type cytokines including IFN-gamma, IL-12 and IL-18 play a pivotal role in this process. Recently, innate immunity mediated by NK, NKT and gammma-delta-T cells has garnered much attention from investigators. NKT cell has been identified as a particular cell population which recognizes glycolipids and participates in the development of tumor immunity and autoimmune diseases. In the present review, the accumulating knowledge on the roles of NKT cells in host defense to infectious pathogens are summarized with our own data on cryptococcal infection.

AIDS-Related Opportunistic Infections↗
PubMed2006

[Cooperative regulation of the host defense to cryptococcal infection by innate immune lymphocytes].

Cryptococcus neoformans is an opportunistic fungal infectious pathogen in immunocompromised patients with acquired immunodeficiency syndrome and hematological malignancies. Recently, innate immune cells, such as NK, NKT and ganmma delta T cells, have been found critical for determining the quality of acquired immunity by affecting the direction of Th1-Th2 balance. Th1-type immune response is important for the host defense against C. neoformans, and innate immunity may involve this process. In the present review, the accumulated knowledge including our own data on the role of innate immune lymphocytes in the host defense to this fungal pathogen are summarized, focusing on NKT and ganmma delta T cells.

Animals↗
PubMed2005

Modeling resistance to pathway-targeted therapy in ovarian cancer.

A detailed understanding of the biochemical pathways that are responsible for cancer initiation and maintenance is critical to designing targeted cancer therapy. Although we have accumulated knowledge about individual molecular changes that underlie cancer development, we are still learning how multiple biochemical pathways cooperate in cancer. This cooperation and cross-talk between redundant biochemical pathways appear to be the main reasons for the failure of therapeutic agents that are designed to interfere with a specific molecular target. In order to simulate the cooperation of several biochemical pathways in cancer development, we have engineered mouse ovarian cancer cell lines and tumors with different combinations of defined genetic alterations. We have used this system to determine the functional contributions of individual pathways that are necessary for cell proliferation and tumor maintenance, as well as to test the molecular mechanisms of tumor resistance to pathway-targeted therapy.

Adaptor Proteins, Signal Transducing↗
PubMed1995

[A descriptive analysis of cognitive activities involved in locating fishing points: In the case of fishermen of Toyoshima Island, Hiroshima Prefecture].

This study aimed at descriptive understanding of traditional methods involved in locating fishing points and navigating to them in the sea, and investigate associated cognitive activities. Participant observations and interviews were conducted for more than 30 fishermen who employed hand-line or long-line fishing methods near Toyoshima Island, Hiroshima Prefecture. The main findings were: (1) Fishermen readily perceived environmental cues when locating fishing points, which enabled them to navigate to a correct point on the sea. (2) Their memory of fishing points was not verbal, but visual, directly tied to the cue perception, and was constantly renewed during fishing activities. (3) They grasped configurations of various natural conditions (e.g., swiftness of the tide, surface structure of the sea bottom) through tactile information from the fishing line, and comprehended their surroundings with accumulated knowledge and inductive inferences. And (4) their cognitive processes of perception, memory, and understanding were functionally coordinated in the series of fishing work.

Adult↗
PubMed1998

Transitional portfolios: orchestrating our professional competence.

Reflective professional development results from thoughtful planning of goals and meeting learning objectives. With rapid changes in health care resulting in major reevaluation and even modification of the role and functions of an occupational therapy practitioner, producing a historical record of competencies in order to learn from one's own experience and to plan for change is essential. A new use of the portfolio is presented to show that a portfolio can be more than the typical repository of completed projects. The transitional portfolio is introduced as a tool for one to self-direct professional development through thoughtful engagement with artifacts created during one's career in relationship to professional goals and desired roles. The transitional portfolio process is holistic, flexible, and reflective. It can serve as a way to document accumulated knowledge and skill acquisition as well as facilitate thoughtful, planned reflection on one's career development in occupational therapy. This article describes the use of transitional portfolios to connect professional development learning experiences, accomplishments, and future opportunities for occupational therapy practitioners.

Career Mobility↗
PubMed2005

Systematic review: the relationship between clinical experience and quality of health care.

BACKGROUND: Physicians with more experience are generally believed to have accumulated knowledge and skills during years in practice and therefore to deliver high-quality care. However, evidence suggests that there is an inverse relationship between the number of years that a physician has been in practice and the quality of care that the physician provides. PURPOSE: To systematically review studies relating medical knowledge and health care quality to years in practice and physician age. DATA SOURCES: English-language articles in MEDLINE from 1966 to June 2004 and reference lists of retrieved articles. STUDY SELECTION: Studies that provided empirical results about knowledge or a quality-of-care outcome and included years since graduation or physician age as explanatory variables. DATA EXTRACTION: We categorized studies on the basis of the nature of the association between years in practice or age and performance. DATA SYNTHESIS: Overall, 32 of the 62 (52%) evaluations reported decreasing performance with increasing years in practice for all outcomes assessed; 13 (21%) reported decreasing performance with increasing experience for some outcomes but no association for others; 2 (3%) reported that performance initially increased with increasing experience, peaked, and then decreased (concave relationship); 13 (21%) reported no association; 1 (2%) reported increasing performance with increasing years in practice for some outcomes but no association for others; and 1 (2%) reported increasing performance with increasing years in practice for all outcomes. Results did not change substantially when the analysis was restricted to studies that used the most objective outcome measures. LIMITATIONS: Because of the lack of reliable search terms for physician experience, reports that provided relevant data may have been missed. CONCLUSIONS: Physicians who have been in practice longer may be at risk for providing lower-quality care. Therefore, this subgroup of physicians may need quality improvement interventions.

Age Factors↗
PubMed1999

[Children of letters--ghosts from the past with a new name. A small group if stringent criteria are used].

Hyperkinetic disorders, MBD (minimal brain dysfunction), DAMP [deficits in attention, motor function (or muscular control) and perception], ADD (attention deficit disorder), and ADHD (attention deficit hyperactivity disorder), are currently the focus of interest among parents, clinicians and researchers in Sweden; and guidelines for the assessment and treatment of such disorders were published in the USA in 1997, and in Europe in 1998. However, despite the accumulated knowledge, and new hypotheses which have been proposed, e.g., that ADHD is "a disorder of adaptation," there is no consensus as to the understanding, treatment and prevention of these disorders. In a consensus statement published by an NIH (National Institutes of Health) panel in the USA it was concluded that, after years of clinical research and experience, our knowledge of the aetiology of ADHD remains speculative, and no documented strategies for its prevention are available. A review of Swedish views and concepts of these disorders since 1950 showed discussion to have been characterised by more similarities than differences, and that nothing really new had emerged. However, differences have existed in the sphere of general education. Since WWI, changes in the organisation of the statutory school system have been designed to improve both education and health among schoolchildren. Such changes seem to have had both beneficial and adverse effects on the overall health of the children. The prevalence of ADHD-like problems declined during the period, 1949-70, when all Swedish six-year-olds were screened for school-readiness with a standardised national test, and the class in which a child started school was dependent on intellectual capacity, overall mental age, and the presence or absence of reading, spelling and learning difficulties, and of behavioural problems. Since this was discontinued after reorganisation of the school system in 1970, the prevalence of problematic behaviour has once again increased. Thus, in the search for new approaches to the support of children with hyperactivity and attention deficit problems, analysis of the organisation of the school system should not be forgotten.

Attention Deficit Disorder with Hyperactivity↗
PubMedDate not supplied

Leadership is the key to chief medical officer success.

Senior physician executives were surveyed in 1998/99 to ascertain that they see as their greatest value to their organizations. They believe that their most significant contribution is their accumulated knowledge and experience--both in medicine and management. This medical management perspective is considered the key advantage of serving on the senior management team and helping to shape the organization's decisions and direction. Additionally, they rated their relationships with physicians as a critical aspect of their position. They were also asked what activities they most enjoyed. The number one response was working with the physicians on the medical staff and in the community. This includes the day-to-day involvement as a leader, as a mentor and educator, and overall as a liasion to the organization's practitioners. The activities that they found most rewarding were also those they perceived to be of greatest value. If these physicians are correct about what is valued in their organizations, they are the right people in the right jobs--and they enjoy what they do.

Attitude of Health Personnel↗
PubMed1976

Trial State Boards as a teaching technique.

Trial State Boards call upon the dental hygiene student to pull together all the skills and knowledge accumulated during the course of studies before facing the actual Board of Dental Examiners. It has been the experience of many in the field of dental hygiene education that the anxiety created in a testing situation is largely a result of unknowns. At the Ohio State University, the Trial State Board is viewed as an effective means of eliminating some of the anxiety (by eliminating some of the unknowns) and thereby of helping the student to be more relaxed and to emerge with a more accurate evaluation of his or her abilities in terms of taking the licensing examination. Although this process is time consuming, the results seem well worth the time. For the clinical faculty the review by dentists, who do not normally see the students in the clinic, is of great value. Once the testing is over and the dentists have completed their evaluations and comments, these are reviewed by the members of the clinical faculty. A specialized program can be worked out for each student needing additional help to correct any deficiency before graduation. For some the idea of holding a Trial State Board will be a new concept in the traiing of dental hygiene students. For others it may already be part of the training program. For all involved in the education of members of the health professions it is worth considering as both a teaching tool and a learning experience.

Certification↗
PubMed2000

Angiotensin II AT2 subtype receptors: an emerging target for cardiovascular therapy.

This article reviews the impressive amount of knowledge accumulated in the last few years on the angiotensin II AT2 subtype receptor. Although still elusive, a large body of experimental evidence strongly suggests that it may play an important role in the adaptive changes of the cardiovascular structures in response to pathological conditions such as myocardial infarction, congestive heart failure or hypertension. The most intriguing aspects of the biology of this receptor, however, appear to be: 1) the regulation of its transcription, which plays an important role in the expression of the protein in adults or in injured tissues; 2) its interaction or "cross-talk" with the predominant angiotensin II receptor, the AT1 subtype, or with the receptors of other growth factors or cytokines; and 3) its connections with the bradykinin/nitric oxide pathways. These aspects may be relevant for the therapeutical use of drugs which antagonize the renin-angiotensin system, such as angiotensin-converting enzyme inhibitors or angiotensin receptor antagonists, as well as for new therapeutic approaches to the treatment of cardiovascular diseases.

Angiotensin II↗
PubMed2000

Rights and responsibilities of the psychiatric profession.

Psychiatry as a medical discipline relies on the authority of medicine that is associated with the help to a suffering and deserving individual. If this source of authority is obscured, the discipline will be blamed for serving as a social tool for controlling undesirable phenomena and practices. Psychiatry as a medical science accumulates knowledge on the relationship of biology and psychopathology. It can provide an explanation of the extent to which mental illness participates in socially undesirable behaviour and phenomena. But it cannot explain undesirable social phenomena as a mental illness of sorts, let alone offer an effective treatment for them. We should carefully guard the boundaries of psychiatry to prevent its abuse in the future.

Health Knowledge, Attitudes, Practice↗
PubMed2000

[Prediction of physiological response from mathematical models].

The ability to predict the physiological responses of workers exposed to extreme environmental conditions, has been a challenge to environmental physiologists for more than 3 decades. Therefore, mathematical models have been developed to predict metabolic rate under various levels of work intensity and dynamic changes in body temperature and heart rate. Based on the effect of exercise on the cardiovascular system, a model was developed to predict mean arterial blood pressure as a function of heart rate. Physiological strain could also be estimated on the basis of thermoregulatory and cardiovascular strains. This paper summarizes knowledge accumulated during 25 years of studies in the field of mathematical modeling of physiological parameters. Besides analyzing the logic underlying each model, it explains the scientific approach in developing a model from its early concept to the model's application in the field.

Blood Pressure↗
PubMed2000

[Genomic investigations in genetic cardiology: status and prospects].

The paper discusses relations of new disciplines in medical science, such as genetic cardiology and genomic medicine. It outlines today's achievements and prospects of genomic studies for some groups of cardiovascular diseases: congenital developmental defects of the heart and great vessels, cardiac arrhythmias and cardiomyopathies, and common diseases with complex inheritance, such as atherosclerosis and arterial hypertension. Accumulated knowledge on new candidate genes of these forms of pathology specifies their pathogenesis, makes it possible to outline new gene-specific therapeutical approaches, and serves as a basis for classifying risk groups by specific diseases. On the other hand, studies of the "sphere of influence" (fields of action) of genes that make up a molecular genetic basis of diseases are of fundamental value in defining the physiological role of sequenced human genomic fragments (functional genomics).

Cardiology↗