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The recent advances of Molecular Biology and Computer Sciences in Neurosciences open unprecedented perspectives for biomedical investigation. Neuroheuristics offers as a new paradigm where these disciplines are no longer restricted to their technical expertise, but rather subserve a dynamical approach to the clinical and fundamental research for the neurological sciences.
The responses from Europe, Asia, Australia, and America illustrate the diversity in the development of the nursing profession and in the possibilities of career advancement for nurses in different countries. Whereas advanced nursing practice is a natural component of the healthcare system in North America, and gradually becoming so in Australia and the United Kingdom, it is far from reality in many other countries. Although the presence or absence of such opportunities necessarily does not reflect the quality of nursing or skills of practicing nurses, their absence clearly prevents professional development, acceptance, and recognition for nurses as a group. In several countries, training programs and courses are available from individual hospitals and other sources. However, as long as such programs and, in particular, the qualifications they lead up to, are not recognized by health authorities at an official level, their contribution beyond that of improving personal knowledge of the trainee is very limited. Undertaking such training may be beneficial for nurses in their present positions but is of little use if they want to change to a new job. Unless the new employer chooses to acknowledge such qualifications, he does not have to. A nurse is a nurse, is a nurse. Needless to say, this also has important implications for nurses' salaries. This was illustrated in a recent survey that identified the average annual salary for nurses in the United States as $37,980 (U.S.). In comparison, official statistics from the Swedish Association of Health Professionals state that the average annual nurse salary in Sweden in 1999 approximated $25,146 (U.S.), with mean salaries ranging from $23,871 (U.S.) (hospital ward nurses) to $33,724 (U.S.) (nurse managers and executives). Although I have not been able to find old comparative data from other countries, informal sources have indicated that the pattern is similar. The need for increased and improved career opportunities for nurses is apparent. How these should be designed and the exact roles of different categories of nurses in various countries will have to be dictated by local needs and other circumstances. However, the scheduled inclusion of this topic at the forthcoming WFNN Congress in Sydney will provide an excellent opportunity for nurses from across the globe to discuss these issues and perhaps initiate work towards setting common international goals for neuroscience nurses. In parallel, it is of outstanding importance that contributions by advanced practice nurses are evaluated in a broad and scientifically sound manner in countries in which they are established and being introduced. Further comments on the topic are highly appreciated!
Cerebral localization, including hierarchical organization of the nervous system, was the critical conceptual advance that made possible the development of modern neuroscience in the nineteenth century. Some of our most basic ideas about neural organization were contributed by Hughlings Jackson. In the early twentieth century, Charles Sherrington combined localization with the neurone theory to create the paradigm of neurophysiological integration. Because Sherrington was educated in the Jacksonian tradition of British neurology, Sherringtonian integration contains ideas that are derived from Jackson and from Herbert Spencer.
INTRODUCTION: About five thousand years ago, one of the most ancient, important and enduring civilisations in the history of Mankind flourished on the banks of the Nile. In Egypt, all the branches of human knowledge attained a high degree of development and today it is considered the mother of medicine. Despite the marked religious component that affected all its activities, the medicine of the Pharaohs was practised in a rational and deductive manner, and the Egyptians were the inventors of clinical observation. METHOD: The desert climate of the Nile Valley has preserved monuments, mummies and papyruses which have enabled us to get a certain idea of the degree of development reached in medical matters. The aim of this work is to analyse them from a neuroscientific point of view. The anatomical discoveries of the Egyptians originated in the inspection of wounds and the practice of embalming. They came to know a large number of diagnoses and were able to prescribe many different forms of treatment. They also attained a certain proficiency in dealing with neurotraumatological patients. They practised anamnesis, prognostics and a regulated surgery that infrequently included trephination. Their conservatism meant that, after the Macedonian domination, the traditional Egyptian medicine was replaced the Greek medicinal arts, which reached their maximum period of splendour in the School of Alexandria, where Herophilus and Erasistratus, pioneers in the study of anatomy and brain circulation, were especially renowned. CONCLUSIONS: From the point of view of the neurosciences, the Egyptians were the first to describe the brain, migraine, epilepsy, strokes, tetanus, Bell s palsy and the sequelae of head injuries and of spinal transection. Their artwork sometimes shows neurological patients and, according to Herodotus, there were doctors who were specialised in head diseases and could therefore be considered the precursors of our present day neurologists.
Neuroscience is generating vast amounts of highly diverse data which is of potential interest to researchers beyond the laboratories in which it is collected. In particular, quantitative neuroanatomical data is relevant to a wide variety of areas, including studies of development, aging, pathology and in biophysically oriented computational modelling. Moreover, the relatively discrete and well-defined nature of the data make it an ideal application for developing systems designed to facilitate data archiving, sharing and reuse. At present, the only widely used forms of dissemination are figures and tables in published papers which suffer from inaccessibility and the loss of machine readability. They may also present only an averaged or otherwise selected subset of the available data. Numerous database projects are in progress to address these shortcomings. They employ a variety of architectures and philosophies, each with its own merits and disadvantages. One axis on which they may be distinguished is the degree of top-down control, or curation, involved in data entry. Here we consider one extreme of this scale in which there is no curation, minimal standardization and a wide degree of freedom in the form of records used to document data. Such a scheme has advantages in the ease of database creation and in the equitable assignment of perceived intellectual property by keeping the control of data in the hands of the experts who collected it. It does, however, require a more sophisticated infrastructure than conventional databases since the software must be capable of organizing diverse and differently documented data sets in an effective way. Several components of a software system to provide this infrastructure are now in place. Examples are presented, showing how these tools can be used to archive and publish neuronal morphology data, and how they can give an integrated view of data stored at many different sites.
It's a clinical line that usually takes a back seat to higher-profile services like cardiology, oncology and orthopedics. But hospitals are starting to pay more attention to neuroscience for a number of reasons, including its tertiary nature and the high volume of imaging studies involved. More importantly, it usually generates a profit.
OBJECTIVE: In this review we trace some of the mayor developments in the use of transcranial magnetic stimulation (TMS) as a technique for the investigation of cognitive neuroscience. Technical aspects of the magnetic stimulation are also reviewed. DEVELOPMENT: Among the many methods now available for studying activity of the human brain, magnetic stimulation is the only technique that allows us to interfere actively with human brain function. At the same time it provides a high degree of spatial and temporal resolution. Standard TMS applications (central motor conduction time, threshold and amplitude of motor evoked potentials) allow the evaluation of the motor conduction in the central nervous system and more complex TMS applications (paired pulse stimulation, silent period) permit study the mechanisms of diseases causing changes in the excitability of cortical areas. These techniques also allow investigation into motor disorder, epilepsy, cognitive function and psychiatric disorders. CONCLUSIONS: Transcranial magnetic stimulation applications have an important place among the investigative tools to study cognitive functions and neurological and psychiatric disorders. Even so, despite the many published research and clinical studies, a systematic study about the possible diagnostic value and role in neurocognitive rehabilitation of TMS testing need to be realized to offer new possibilities of future applications.
In 1939 Alan Turing, a major scholar in the field of mechanical computation, described a system whose computational power was beyond that of a discrete, finite state machine (Turing Machine). The composition of this system was likely the first example of what is now called an hybrid computational system. Since then, development of neural networks and brain automata has made aware that forms of computation might exist that are likely to go beyond Turing's limits. Natural systems, like the central nervous system in Mammals and man, are likely to use such a type of computation, especially to perform highly integrating activities, like feedback controls and mental creative processes. The latter are usually understood as processes that involve infinitary procedures, ending up in a complex information network, the computational maps, in which both digital, Turing-like computation and continuous, analog forms of calculus are expected to occur. Pictorial representation may be a fruitful example, mostly metaphorical, to analyze the use of this hybrid forms of computation by higher order computational maps, and the possible role of these types of computational processes in painting creativity is briefly analyzed in comparing 15th vs 16th century Renaissance Art. An open challenge for neuroscience in the 21st century is to clarify whether a hybrid neural learning network might represent a reasonable clue to scientifically interpret the theme of "creativity".
Modern cognitive neuroscience provides a powerful framework in which biological models of recovery and neurorehabilitation can be constructed and tested. The widespread availability, relatively low cost and informativeness of functional magnetic resonance imaging (fMRI) has made it the most popular of the techniques available to help with this task. Here, on the basis of functional imaging studies of stroke, diffuse microvascular disease and multiple sclerosis, we argue that processes of motor control and learning in the healthy brain share common mechanisms with those for adaptive functional reorganisation during spontaneous recovery after brain injury or with neurorehabilitation. Relatively stringent criteria can be met to confirm that adaptive functional reorganisation limits disability even in the adult brain: functional brain changes are related to disease burden, can be found in patients with demonstrable pathology but no clinical deficits and can be defined (in motor cortex) even in the absence of volitional recruitment. Initial studies of neurorehabilitation responses using fMRI and transcranial magnetic stimulation demonstrate that adaptive reorganisation can be manipulated directly with both pharmacological and behavioural interventions. The combination of strategies based on a strong biological rational with monitoring their effects using highly informative functional brain imaging methods heralds a new era of scientifically-founded neurorehabilitation.
New directions in educational assessment and instruction are supported by recent advances in the neurosciences. Among these are early identification of potential learning problems through brief, efficient assessments of specific language skills that predict later reading outcomes; early intervention that systematically targets critical linguistic processing skills; and the necessity of stimulating all functions of a reading, writing, or computing brain.
Dramatic advances in neuroscience have created fast-rising expectations for improvements in the health and well-being of people around the world. But fulfilling this promise is proving to be neither quick nor easy, and not for scientific reasons alone. Alan Leshner urges that neuroscientists not only address the significant challenges of their own investigations but also be willing to participate in ethical and legal dialogues with colleagues and non-colleagues alike.
Despite a large and growing interest in applying brain science to the ends of justice, the implications of neuroscience for the law are still unclear. But Stephen Morse argues that, unless discoveries about the brain radically change our conception of ourselves, they are unlikely to fundamentally alter legal doctrine. For most challenges the findings might raise to justice, equality, and liberty, he writes, the law has rich theoretical resources with which to address them. On the other hand, the author acknowledges, one can easily imagine substantial changes in particular doctrines.
Neuropsychological testing is a relatively new field in the area of clinical neuroscience. It has proven to be an effective and essential aid in the diagnostic process of brain-injured patients, especially in lesions of the cerebral cortex. More advanced countries have incorporated neuropsychological assessments in their standard neurological examinations of the brain damaged. Clinical neuropsychology is only beginning to be used in Singapore. Research using neuropsychological methods have also shown to be useful in providing a greater understanding of the brain-behaviour relationship in humans. Problems confronting the use of neuropsychological testing in Singapore are identified and the possible solutions discussed.
Parkinson's disease (PD) is a chronic, progressive neurological disease affecting 1.5 million Americans. The modern success of pharmacology and deep-brain stimulation surgery to treat the motor symptoms of tremor, rigidity, and bradykinesia provide PD patients with longer lives and increased motor functioning. However, in the moderate and advanced stages of disease, the therapeutic benefits of pharmacology diminish and motor symptoms are more complicated to treat. The nonmotor symptoms of PD receive little attention in clinical settings, although they can lead to disability and caregiver burden. The Center to Advance Palliative Care advocates applying the principles of palliative care to chronic disease. Likewise, the World Health Organization has redefined palliative care to include life-threatening illness. The Parkinson's Disease Model of Care (PDMC) takes the precepts of palliative care and presents a model for the neuroscience nurse to use in individual care planning across the trajectory of disease. The PDMC guides the nurse in providing relief from suffering for PD patients and their families, from diagnosis through bereavement, with an emphasis on advance care planning.
INTRODUCTION: Patients suffering clinical dementia caused by Alzheimer's disease have a high risk of developing malnutrition caused by all the physiological, socio-economic and psychological changes related to the disease, together with the ageing process. OBJECTIVE: To describe the nutritional condition of a group of patients with Alzheimer's dementia according to the degree of disease severity. Patients were selected from the University of Antioquia Neurosciences Group. MATERIALS AND METHODS: Descriptive cross sectional study. Patients were assessed and information was collected about their body composition, food consumption behaviour, clinical, and psychosocial variables. RESULTS: 77 patients were studied; their mean age was 65, 5 +/- 12.8 years. 48 had a family history of Alzheimer's disease; 39 were diagnosed more than 60 months before the study started; the most frequently found degree of severity was moderate, the most common type of dementia was the early family form. 26 began the disease process before they were 50 years old. Significant differences for Body Mass Index, brachial adipose area and brachial lean area were found (p = 0.001, p = 0.000, p = 0.000, respectively) between patients with the different degrees of disease severity. These parameters measures were lowest in patients with severe disease. The intake of calcium and folate was the lowest amongst the nutrients studied. CONCLUSION: The nutritional state is impaired in patients suffering Alzheimer's dementia from the early stages of the disease. The most important nutritional and clinical abnormalities found were depletion of the lean and fat stores, low intake of calcium and folate and clinical signs of the disease. Changes in these parameters worsen as the disease progresses.
The understanding of autism has improved with neurosciences, especially with genetics, molecular biology and cerebral neuroimaging. This trouble looks much more heterogenous than expected, from a clinical and an etiological point of view as well. No clear pathopsychological model about the syndromes of the autistic spectrum can so far be proposed but several scientific breakthroughs seem interesting.
The role played by Pavlov's principle of conditioned reflexes in neurosciences is discussed. The problem of interneuronal connections is shown to be key in the system of the sciences. The concept of formation of interneuronal connections underlying the conditioned reflex and long-term memory has been elaborated at the Department of Physiology of the Institute of Experimental Medicine named after Pavlov. Possible mechanisms of associations between the neural memory and cell genome are analysed and the problem of the engram localization and storage are discussed. Special attention is devoted to the role played by the subjective experience, mainly emotions, in the organization of the higher brain functions. The extensive experimental evidence gained by the authors during the recent 10-12 years is generalized.
Clinical neurology in veterinary medicine did receive its initial secure basis by Hermann DEXLER in Vienna during late fall of 19th century. He could demonstrate that knowledges in neuroanatomy and -pathology are basis requirements for a reliable interpretation of morbid entities of central and peripheral nervous system. During the following decades a varied development of neurosciences was to be observed in veterinary medicine, comparing different countries. In general, the most important influences--based upon comparative neuromorphology--came from pathologists. Thus, infectious morbid entities, hereditary diseases, malformations, neurodegenerative diseases, neurooncology, and traumatology had become central challenges for neuroscientists. In this context it is no surprise that BSE has brought a tremendous impact on research work in the whole field of human and animal spongiform encephalopathies. Regrettably, the integration of clinical neurology and neuropathology within the teaching programmes of the European veterinary colleges, especially in Germany, has still not reached a satisfactory level. Specific training procedures realized by several schools in USA and UK might serve as sound examples in view of the permanent growing importance of neurological diseases in large and small animal practice.