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Neuroscience in psychiatry training: how much do residents need to know?

OBJECTIVE: With the explosion of research in psychiatric neuroscience, the extent and means by which neuroscientific progress will translate into clinical care remains largely uncertain. The authors sought to determine how this dilemma is currently being played out in residency training programs, in which training directors must decide how best to integrate neuroscience teaching in a rapidly changing clinical landscape. METHOD: The authors surveyed U.S. and Canadian psychiatry residency training directors to characterize current and future trends in neuroscience education and to examine training directors' views on the relevance of neuroscience to clinical practice. RESULTS: The amount of neuroscience in residency curricula has increased significantly over the past 5 years, and further increases are expected in each specific neuroscience content area examined. While most training directors agreed that training in neuroscience was important for all residents, even those becoming primarily psychotherapists, relevance to future (but not current) practice was consistently cited as a motivating factor. CONCLUSIONS: While psychiatric residency programs continue to increase the neuroscience content of their curricula, it remains unclear how this added training will influence clinical work. Reframing current practices, including psychotherapy, into a neuroscientific context may ultimately prove more useful to trainees.

Canada↗

Toward socially inspired social neuroscience.

Social neuroscience, often viewed as studying the neural foundations of social cognition, has roots in multiple disciplines. This paper argues that it needs a firmer base in social psychology. First, we outline some major opportunities from social psychology--the power of social context and social motives in shaping human behavior. Second, as the social cognition field moves away from studying only deliberate, explicit processes to studying also automatic, implicit processes, adopting a dual-process perspective, social neuroscience also lends itself to both automatic and controlled processes. Finally, social neuroscience is especially suited to study the efficiency and spontaneity of social judgments. All this brings social behavioral grounding to cognitive neuroscience. Among the implications for social neuroscience: Social cognition intrinsically evokes affect, so social cognitive affective neuroscience glues together a variety of fields in psychological and neurosciences.

Cognition↗

Neuroethics: a modern context for ethics in neuroscience.

Neuroethics, a recently modernized field at the intersection of bioethics and neuroscience, is founded on centuries of discussion of the ethical issues associated with mind and behavior. Broadly defined, neuroethics is concerned with ethical, legal and social policy implications of neuroscience, and with aspects of neuroscience research itself. Advances in neuroscience increasingly challenge long-held views of the self and the individual's relationship to society. Neuroscience also has led to innovations in clinical medicine that have not only therapeutic but also non-therapeutic dimensions that extend well beyond previously charted boundaries. The exponential increase in cross-disciplinary research, the commercialization of cognitive neuroscience, the impetus for training in ethics, and the increased attention being paid to public understanding of science all illuminate the important role of neuroethics in neuroscience.

Bioethical Issues↗

The neuroscience nursing 2005 role delineation study: implications for certification.

A task force appointed by the American Board of Neuroscience Nursing conducted a role delineation study to define current practice in neuroscience nursing. The results were used to validate the content matrix for future Certified Neuroscience Registered Nurse (CNRN) examinations. The study employed a survey design for which the Nursing Intervention Classification taxonomy was the guiding theoretical framework. The eligible sample included all current CNRNs and all members of the American Association of Neuroscience Nursing. An invitation to participate in an online survey was successfully emailed to 2,462 neuroscience nurses; the survey was completed by 477 respondents. They rated the performance and importance of 175 neuroscience nursing activities. On the basis of data analysis conducted by Schroeder Measurement Technologies, Inc., the task force recommended revisions to the CNRN examination matrix to reflect current practice in neuroscience nursing.

Certification↗

Neuroscience in middle schools: a professional development and resource program that models inquiry-based strategies and engages teachers in classroom implementation.

The Department of Neuroscience at the University of Minnesota and the Science Museum of Minnesota have developed and implemented a successful program for middle school (grades 5-8) science teachers and their students, called Brain Science on the Move. The overall goals have been to bring neuroscience education to underserved schools, excite students about science, improve their understanding of neuroscience, and foster partnerships between scientists and educators. The program includes BrainU, a teacher professional development institute; Explain Your Brain Assembly and Exhibit Stations, multimedia large-group presentation and hands-on activities designed to stimulate student thinking about the brain; Class Activities, in-depth inquiry-based investigations; and Brain Trunks, materials and resources related to class activities. Formal evaluation of the program indicated that teacher neuroscience knowledge, self-confidence, and use of inquiry-based strategies and neuroscience in their classrooms have increased. Participating teachers increased the time spent teaching neuroscience and devoted more time to "inquiry-based" teaching versus "lecture-based teaching." Teachers appreciated in-depth discussions of pedagogy and science and opportunities for collegial interactions with world-class researchers. Student interest in the brain and in science increased. Since attending BrainU, participating teachers have reported increased enthusiasm about teaching and have become local neuroscience experts within their school communities.

Adolescent↗

Neuroscience in Yugoslavia.

This survey is a personal account of the present status of neuroscience in Yugoslavia within the context of recent upheavals in Eastern Europe. The current situation in Yugoslavia, characterized by the absence of a Federal Ministry of Science and a poor scientific communication between federal states (republics), does not allow a comprehensive overview of neuroscience at the federal level. Even more difficult is to envisage the prospects of Yugoslav neuroscience in the light of European integration. Several problems serve to illustrate the present situation concerning Yugoslav neuroscience. First, the weakness of the self-organization of science in Yugoslavia during the past 20 years is still the most important denominator in the current trend of neuroscience. Second, different Yugoslav republics have significantly different systems of science funding and evaluation, which reflect very plainly different levels of democratic (and socioeconomic) changes that were attained during 1990. Third, due to the different numbers of trained scientists, facilities and equipment, funds and levels of international scientific cooperation there are major differences between republics in the tempo of progress towards real achievements in science. Finally, the present explosive development of neuroscience and the proclamation of the 'Decade of the Brain' will hopefully stimulate Yugoslav neuroscientists to seek better programmes of neuroscience research and to improve the extent and quality of international cooperation.

Animals↗

For the law, neuroscience changes nothing and everything.

The rapidly growing field of cognitive neuroscience holds the promise of explaining the operations of the mind in terms of the physical operations of the brain. Some suggest that our emerging understanding of the physical causes of human (mis)behaviour will have a transformative effect on the law. Others argue that new neuroscience will provide only new details and that existing legal doctrine can accommodate whatever new information neuroscience will provide. We argue that neuroscience will probably have a transformative effect on the law, despite the fact that existing legal doctrine can, in principle, accommodate whatever neuroscience will tell us. New neuroscience will change the law, not by undermining its current assumptions, but by transforming people's moral intuitions about free will and responsibility. This change in moral outlook will result not from the discovery of crucial new facts or clever new arguments, but from a new appreciation of old arguments, bolstered by vivid new illustrations provided by cognitive neuroscience. We foresee, and recommend, a shift away from punishment aimed at retribution in favour of a more progressive, consequentialist approach to the criminal law.

Brain↗

Neuroscience of decision making and informed consent: an investigation in neuroethics.

Progress in neuroscience will allow us to reveal the neuronal correlates of psychological processes involved in ethically relevant notions such as informed consent. Informed consent involves decision making, the psychological and neural processes of which have been investigated extensively in neuroscience. The neuroscience of decision making may be able to contribute to an ethics of informed consent by providing empirical and thus descriptive criteria. Since, however, descriptive criteria must be distinguished from normative criteria, the neuroscience of decision making cannot replace the ethics of informed consent. Instead, the neuroscience of decision making could complement the current ethics, resulting in what can be called neuroethics of informed consent. It is concluded that current progress in the neurosciences could complement and change the way in which we approach ethical problems in neuropsychiatry.

Bioethical Issues↗

Ethical considerations of neuroscience research: the perspectives on neuroethics in Japan.

Recent technologies and developments in neuroscience have contributed to remarkable scientific discoveries, and have also raised many new philosophical, ethical, legal, and social issues. Research in "neuroethics" has identified various ethical issues, which will be difficult for current biomedical ethics to resolve from both an experimental and a social perspective, such as criminal applications of brain scans, incidental findings during non-clinical brain imaging, and cognitive enhancement. Although American and European neuroscience societies have demonstrated immediate, concrete reactions to these ethical issues, including academic conferences, study programs, and publications, Japanese neuroscientists have so far produced little response. Ethics is tightly linked with one's religion, nationality, culture, and social background, whereas science is tightly linked with the demand, economics, and politics of the society to which individuals belong. Taken together, it is important and necessary for Japanese neuroscientists to consider the ethical problems in Japanese neuroscience. In this paper, we first review the history of neuroethics in the world, and then report the less-developed ethical issues in the Japanese neuroscience community, focusing on neuroimaging and manipulative neuroscience as a first step in discussing how to apply principles in neuroethics to this rapidly progressing field of research.

Bioethical Issues↗

Women in neuroscience (WIN): the first twenty years.

Women in Neuroscience (WIN) is an international organization whose major goal is to promote the professional advancement of women neuroscientists. To this end, WIN facilitates contacts and communication among women working in neuroscience, and organizes appropriate activities at the annual Society for Neuroscience (SfN) meeting. WIN was created in 1980, when despite major changes and advances in 'equal opportunities', women were still not achieving a proportionate level of success in the subdiscipline of neurosciences. In 1980, women made up 40 to 50% of entering classes in medical schools or graduate programs, but often comprised only 5 to 15% of leadership in respective organizations. Although there had been women elected to serve as SfN presidents, council, and committee members, women were under-represented in other positions of the Society, such as symposium and session chairs. There was an even lesser degree of representation in leadership positions at universities and medical schools in terms of full professorships, chairs, and program directors, as well as on editorial boards, advisory boards, and councils. Over the years, WIN has worked with success toward increasing the participation of women in neuroscience.

Female↗

Women and the history of the neurosciences.

Since the closing decades of the nineteenth century, women have been contributing in a significant way to the neurosciences. This article looks at the contributions of some of the leading women pioneers in this field. It also deals with women who have written on the history of the neurosciences and the representation of women in the International Society for the History of the Neurosciences, the largest neuroscience history organization. Trends suggest that books and articles from and about women in the history of the neurosciences will increase markedly in the future.

Female↗

Inclusiveness and coherency in the history of the neurosciences.

The International Society for the History of the Neurosciences (ISHN) defines "neurosciences" broadly, and we want to encourage the widest possible range of scholarly approaches to our subject. However, this deliberate inclusiveness could potentially cause problems with internal coherency in our organization and in the scholarship that we are trying to create. In other words, we need to avoid the pitfalls of the internalist-externalist tension without losing the benefits of both perspectives. In fact, I think that there is a large and interesting "gray zone," where the boundary between these supposedly separate approaches is both artificial and porous. This should be one of the most rewarding intellectual domains for the study of neuroscience history, because our subject is always culturally loaded by the mind/body problem and by the assumptions that it entails. Of course, neuroscience history is also influenced by all of the other cultural and scientific aspects of the milieus in which it is conducted. Understanding neuroscience history in all of its multiple historical contexts will require the participation of a wide range of scholarly viewpoints. To keep ourselves coherent in the process, we will have to educate each other.

Historiography↗

An analysis of trends in neuroscience nursing research: 1960-1988.

This study examined trends in neuroscience nursing research from 1960 to 1988. The review was an extension of a study analyzing trends in cardiovascular nursing from 1960 to 1985. Four questions (similar to those developed by Yarcheski regarding elements essential to development of a scientific base) framed the present analysis of neuroscience nursing research studies. The sampling frame for the study consisted of four journals: Nursing Research, 1960-1988; Western Journal of Nursing Research, 1979-1988; Research in Nursing and Health, 1978-1988; Journal of Neurosurgical Nursing, 1969-1985; and Journal of Neuroscience Nursing, 1986-1988. These journals were canvassed for studies meeting specified criteria as neuroscience nursing research studies. A total of 71 studies meeting the stated criteria were included in the final sample and reviewed in a systematic manner to identify such characteristics as variables measured, type of approach to theory development, type of research design, number and type of subjects, data analysis procedures, interpretation and conclusions of the study. Findings of the study indicate there has been a substantial increase in the number of neuroscience studies conducted and reported by nurses and an increase in the number of principal authors with advanced degrees. The orientation of studies has shifted from chronic care or rehabilitation to acute care research. An absence of studies about prevention of head and spinal cord injury was noted. Although a trend toward the theory-then-research approach was detected, the research-then-theory approach has been and continues to be the primary strategy for the development of a body of scientific knowledge. It is possible that clinical nurses are using research more frequently to solve problems. Finally, the scientific methods employed in this group of studies have become more complex and varied over time.

Data Collection↗

Are you ready (to be a neuroscience nurse)?

On the pediatric neurosciences unit of British Columbia's Children's Hospital we are in the throes of a nursing staff crisis. In the last year alone we hired ten new graduates to work as casuals on our unit. With a two and a half day hospital orientation, five preceptor shifts, and a Competency Based Education Plan in hand, we send them off to the trenches. We know these nurses have little nursing experience and even less Neuroscience nursing experience. Yet, we expect them to care for patients and families whose problems they may not understand. For a preceptor, and senior colleague, this is a disturbing situation. We recognize that in their orientation shifts they have not even begun to experience the challenges of a Neuroscience unit. Have they cared for a child who has had a postoperative laminectomy? Do they recognize subtle seizures? Have they sat with a family who have just learned that their child has a brain tumor? No. We expect them to care for patients and families with minimal support. This is the reality of nursing today. Many of us pride ourselves on being committed pediatric Neuroscience nurses. Our physicians rely upon our assessment skills and they trust our intuition! We believe we have earned that trust. How can we convey our enthusiasm and excitement to our perceptees so they are motivated to stay and become experienced pediatric Neuroscience nurses? In this presentation we outline our paper to remedy this situation.

Career Choice↗

[Cajal and neuroscience in the eve of the third millenium].

This is a brief history of the birth of Neuroscience as an independent branch of knowledge. The importance of Cajal's contribution to the structuralization of modern Neuroscience is described. Outstanding contributions to Neuroscience of the last century, particularly the Decade of the Brain, are summarized. The reason for the huge increase and interest in neuroscientific studies are given. Finally, I emphasize the challenge that multidisciplinary study and interinstitutional collaboration pose to advancing our knowledge of the human brain. The second part of the talk demonstrated the validity of Cajal's work in modern Neuroscience insisting on three aspects: 1) the microscopic study of the Mammalian central nervous system, 2) the neurogenesis and development of the nervous system and 3) the degeneration, regeneration and plasticity of the central nervous system. I conclude that Cajal's timeliness is reflected by the fact that there are few problems in modern Neuroscience which Cajal did not address at one time or other.

History, 19th Century↗

A survey of neuroscience nurses.

This survey identified and described the characteristics and perceptions of neuroscience nurses as well as the basic and master's level curriculum relating to neuroscience theory and clinical components. The major sources of stress as perceived by neuroscience nurses were identified, categorized and prioritized in accordance with their present roles. The information in this survey can be used to guide future studies on neuroscience nurses. More must be learned about the neuroscience nurse so that nurse educators and administrators can provide the necessary resources to facilitate learning and coping. This is essential to insure the provision of high standards of patient care.

Adult↗

Nursing staff perspectives on oral care for neuroscience patients.

Neuroscience patients frequently experience poor oral health and related complications because of motor and cognitive dysfunction and the side effects of treatments. Inadequate oral care increases plaque deposits, which can lead to inflammation, pain, and infection. These patients often depend on nurses for oral hygiene. In practice, nurses frequently delegate the delivery of oral care to unlicensed personnel, including nursing assistants, technicians, and student nurses. Few studies have addressed oral care interventions for neuroscience patients. This article identifies oral care interventions practiced by nurses and unlicensed personnel caring for neuroscience patients with self-care deficits. An investigator-designed survey instrument was used to obtain data from nurses and unlicensed personnel working with neuroscience patients in a large hospital. Participants responded to questions about products and agents used in care, frequency of care, documentation of care, patient risk factors, and system support issues such as availability of supplies. Data were analyzed using frequency distributions. Findings demonstrated that selection of products and agents used for oral care is not always evidence based, that provider preference leads to variations in type and frequency of care, and that system issues affect care. These findings suggest the need for increased attention to oral care for neuroscience patients. Research is needed to further examine the relationship between oral care interventions and patient outcomes.

Attitude of Health Personnel↗

Social cognitive neuroscience: a review of core processes.

Social cognitive neuroscience examines social phenomena and processes using cognitive neuroscience research tools such as neuroimaging and neuropsychology. This review examines four broad areas of research within social cognitive neuroscience: (a) understanding others, (b) understanding oneself, (c) controlling oneself, and (d) the processes that occur at the interface of self and others. In addition, this review highlights two core-processing distinctions that can be neurocognitively identified across all of these domains. The distinction between automatic versus controlled processes has long been important to social psychological theory and can be dissociated in the neural regions contributing to social cognition. Alternatively, the differentiation between internally-focused processes that focus on one's own or another's mental interior and externally-focused processes that focus on one's own or another's visible features and actions is a new distinction. This latter distinction emerges from social cognitive neuroscience investigations rather than from existing psychological theories demonstrating that social cognitive neuroscience can both draw on and contribute to social psychological theory.

Awareness↗