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How many pounds of oxygen do we "eat" each day?

As teachers we feel the need to do more than merely teach basic facts and concepts. We want to make the subject matter more relevant; we would like to help integrate the various threads of the students' education and life experiences; and, finally, we wish to increase the students' interest and involvement in the learning process. There is the temptation, however, when thinking along these lines, to consider the use of time-consuming, complex methods of approach. These might involve slide presentations, videos, special lectures, special assignments, student, reports, etc: The very complexity of these approaches often reduces their effectiveness. Moreover, the time and effort required often keeps us from attempting them more than once or twice. Are simpler and more effective approaches to enrichment possible? Reflecting on our own education, many of us may recall the disproportionate impact of some revealing aside thrown by a teacher unexpectedly into an otherwise mundane lecture or discussion: perhaps a short, penetrating observation providing an unexpected perspective on what was being discussed, a bolt of lightening that briefly illuminated the dim landscape of the classroom. This we may remember when much from the course has been totally forgotten. These jewels of thought--epiphanies--can be shared by teachers to enrich, enlighten, and refresh their students and each other. The jewels we speak of need not be precious or rare. Indeed, the metaphors "a bolt of lightening" and "jewels" may mislead by their intensity and drama. Is it not in the often unexamined, simple, and humble all around us that wisdom can be found? The following is an example.

Energy Metabolism↗

Acoustic characteristics [correction of characeristics] of adolescent actors' and non-actors' voices.

The aim of the present study was to investigate differences in the acoustic characteristics of the voice between adolescent actors and non-actors. The experimental sample consisted of 10 actresses and 10 actors while the control sample included 13 girls and 14 boys. Phonation of the vowel /a/, spontaneous speaking and oral reading provided a set of acoustic variables (fundamental frequency, jitter, shimmer, speaking and reading ranges); t test showed statistically significant differences between actresses and non-actresses in speaking range, reading F(0) maximum, and reading range, whereas between actors and non-actors the difference was found in reading range only. The results showed that drama in education without systematic voice training had no effects in terms of acoustic characteristics of the voice.

Acoustics↗

The bioinformatics of psychosocial genomics in alternative and complementary medicine.

The bioinformatics of alternative and complementary medicine is outlined in 3 hypotheses that extend the molecular-genomic revolution initiated by Watson and Crick 50 years ago to include psychology in the new discipline of psychosocial and cultural genomics. Stress-induced changes in the alternative splicing of genes demonstrate how psychosomatic stress in humans modulates activity-dependent gene expression, protein formation, physiological function, and psychological experience. The molecular messengers generated by stress, injury, and disease can activate immediate early genes within stem cells so that they then signal the target genes required to synthesize the proteins that will transform (differentiate) stem cells into mature well-functioning tissues. Such activity-dependent gene expression and its consequent activity-dependent neurogenesis and stem cell healing is proposed as the molecular-genomic-cellular basis of rehabilitative medicine, physical, and occupational therapy as well as the many alternative and complementary approaches to mind-body healing. The therapeutic replaying of enriching life experiences that evoke the novelty-numinosum-neurogenesis effect during creative moments of art, music, dance, drama, humor, literature, poetry, and spirituality, as well as cultural rituals of life transitions (birth, puberty, marriage, illness, healing, and death) can optimize consciousness, personal relationships, and healing in a manner that has much in common with the psychogenomic foundations of naturalistic and complementary medicine. The entire history of alternative and complementary approaches to healing is consistent with this new neuroscience world view about the role of psychological arousal and fascination in modulating gene expression, neurogenesis, and healing via the psychosocial and cultural rites of human societies.

Adaptation, Physiological↗

Training outcome in future professional voice users after 18 months of voice training.

The goal of this study is to define the long-term influence of vocal hygiene education and the effectiveness of voice training in 46 students. Half of the subjects, called the trained group (n = 23), received vocal hygiene education during 1 school year and voice training during 2 school years (18 months). The other half, also 23 subjects, received neither vocal hygiene education nor voice training as such (called the untrained group). The voice training is made up of technical workshops (30 h a year in groups of 5-8 subjects) and vocal coaching in the radio and drama projects (30 h whole class). In the lectures (30 h) a theoretical background on breathing, articulation, voicing and vocal hygiene was discussed. A multidimensional test battery containing the GRBAS scale, videolaryngostroboscopy, maximum phonation time, jitter, lowest intensity, highest frequency, Dysphonia Severity Index (DSI) and Voice Handicap Index (VHI) was applied before and after 18 months to evaluate the effect of voice training over time. A questionnaire on daily habits was presented before the lectures, and after 18 months to detect the long-term effect of the lectures. The objectively measured voice quality (DSI) of the trained group improved significantly over time (p < 0.001) due to training (p = 0.008), which was not the case in the untrained group. The self-assessed VHI, on the other hand, changed over time (p < 0.001) in both groups. For the trained group the VHI changed from 18.4 to 14.4 and in the untrained group from 20.1 to 15.3. It is important to note that the VHI scores of both groups remained high. The interpretation of the results of the daily habit questionnaire is disturbing: the initial high degree of smoking, vocal abuse, stress and late meals was not influenced by the lectures or training and remained high. This study proves the positive outcome and emphasizes the need for a well-organized voice training program in future professional voice users. However, the lectures and training on vocal hygiene failed to improve voice-conserving habits.

Adult↗

Substituting a judgment of best interests: dignity and the application of objective principles to PVS cases in the U.K.

The mêlée that surrounded the last days of Terri Schiavo's life was reminiscent of a classical Greek tragedy. Much like Antigone, Ms. Schiavo became enmeshed in irresistible and opposite forces, resolved to use her situation as an arena for the determination of political and legal issues as diverse as the exercise of states' rights, the extent of individual rights, the role of the judiciary, the re-opening of the abortion debate, and the regulation of stem cell research. As Europeans watched the drama unfold, the forces at play in the United States clashed head-on, in a rhetorically inflammatory spectacle which, on this side of the Atlantic, left many aghast. Most unsettling was the prospect of individuals wielding the power of state and national legislatures in what was, ultimately, an intensely personal affair. In the United Kingdom, the struggle was a stark reminder of the differences, not only between British and American political culture, but between our approaches to legal issues which present themselves at the end of life. The existence of well-established procedures and principles, and the extensive involvement of neutral third parties and the courts in pursuit of an objective determination of an individual patient's 'best interests', are key to the conclusion that Terri Schiavo's case would have been handled at least as effectively and efficiently as it was by the courts in Florida and the United States. That issues of consent and capacity can be determined by British courts on the basis of generally applicable principles leads to the subsequent conclusion that a 'best interests' determination leaves significantly less scope for conflict than the individualistic, much more personal and determinative construct of the 'substituted judgment' test in the United States.

Euthanasia, Passive↗

A multifaceted approach to psychodrama in a day treatment center.

Staff at the day treatment center at Norristown (Pa.) State Hospital have found several ways of using psychodrama to facilitate information gathering, diagnostic decision-making, and treatment planning and implementation. They use behavioral techniques such as role rehearsal and modeling. In addition they use techniques such as the mirror image, in vivo dramas, and slight deception to facilitate catharsis. These approaches, which broaden the applicability of psychodrama, are illustrated by case examples.

Day Care, Medical↗

The play of transference: some reflections on enactment in the psychoanalytic situation.

The incessant play of nonverbal activity between patient and analyst actualizes and amplifies the primary verbal data of the psychoanalytic dialogue. Both parties must inevitably register this kinesic level of communication, and react with capacities acquired in and elaborated from earliest childhood. The analyst's apperceptive (unfocused) looking, as part of his freely hovering attentiveness, utilizes these capabilities gradually to perceive and organize patterns combining the verbal and nonverbal data. It is through the recognizing and eventual understanding of these gestalts that the analyst builds up his knowledge of his patients. In these patterns can be identified: (a) conspicuous behaviors, idiosyncratic for the individual, which often yield to psychoanalytic inquiry to reveal their dynamic-historical antecedents; and (b) inconspicuous background kinesics, habitual to the individual, which ordinarily are opaque to analytic exploration, yet hold rich meaning. Observing these small behaviors in relation to verbal content provides evidence of their linkage to, and enactment of, pregenital- and genital-level conflicts over diadic and triadic object relations, even in highly structured personalities. These enactments combine elements of play, miming, and drama to constitute an experiential dimension that actualizes and externalizes the patients' inner life of conflict and relation to objects.

Adult↗

A variation on Freud's theme in "A child is being beaten"--mother's role: some implications for superego development in women.

Clinical material is presented leading to a discussion of beating fantasies which varies from Freud's model. Analysis shows that the fantasied role girls assign to mother as the punisher in the oedipal drama is equivalent to the fantasied role boys ascribe to father as castrator. For both sexes, castration anxiety spurs the internalization of parental prohibitions, the repression of oedipal wishes, and the subsequent structuralization of the superego. Mother establishes the "oedipal law" for the girl analogously to father's doing the same for the boy. The role that such fantasies play in the formation of the female superego is examined.

Adolescent↗

Macbeth in the resource room: students with learning disabilities study Shakespeare.

A teacher describes a secondary English unit on Shakespeare implemented in a manner designed to take advantage of the learning differences of resource room students. After developing and investigating questions relating to Macbeth, students then read and enjoyed the drama. As a result of acquiring an understanding of Shakespeare exceeding that of students in general classes, self-esteem and academic motivation increased. Finally, connections to practice and behavioral, constructivist, feminist, and critical theories are discussed. Appendices describe specific schedules and routines.

Adolescent↗

An autopsy case of a stunt man who jumped into seawater riding a motorcycle: a case report.

We report a rare case of the death of a stunt man who jumped into the sea driving a motorcycle on location for a TV drama. A special ramp had been constructed for the jump. The stunt man and a passenger drove up the ramp at a speed of 60-70 km/h and jumped into the sea from a height of about five metres. Both men swam up, but the driver fell unconscious at the surface. He was sent to hospital, but did not recover. The autopsy revealed a deep laceration of the right axilla with complete rupture of the axillary artery, bone fractures of the right ribs and the right pelvis, and a small laceration of the upper lobe of the right lung. Other visceral organs were not injured. We finally judged that his cause of death was exsanguination due to rupture of the right axillary artery on the basis of the presence of a small amount of blood inside the heart and ischemic organs. All injuries were probably inflicted by a collision with the motorcycle upon reaching the water surface; the axillary injury might be due to the left handlebar piercing into the part.

Accidents, Traffic↗

Temporal lobes signs and Jungian dimensions of personality.

Phenomenological experiences that suggest temporal lobe lability were correlated with Jungian personality (Myers-Briggs) indicators. People with frequent temporal lobe indicators were more intuitive than sensing and more perceiving than judging; in the more general population temporal lobe indicators were also weakly associated with feeling rather than thinking. Students who were actively engaged in a drama class also displayed more frequent temporal lobe signs than psychology students. The data are commensurate with the hypothesis that the relationship between belief in psi phenomena, psi experiences, and specific cognitive styles is derived from a temporal lobe lability factor.

Adolescent↗

Diagnosing migraine: are the criteria valid or invalid?

Making a clinical diagnosis is a thought process but we do not know how we remember, let alone think. Migraine attacks are dynamic, with symptoms evolving, progressing and regressing during 4-72 h. Some of us attempt to abstract criteria from this "drama", others try to see the whole "play" as a stage performance. However, we are dependent on patients' descriptions and must carefully evaluate the responses to our questions. Describing pain quality--translating feelings into words--is especially difficult. Patients can be led or misled by questions, particularly if posed by insensitive questionnaires applying rigid criteria. Nevertheless, criteria are essential for the inclusion or exclusion of patients in drug trials or a series when special investigations are being conducted, but not in a difficult diagnostic case when there are two concomitant headaches or when trying to help someone cope with migraine.

Adult↗

Depression's forgotten genealogy: notes towards a history of depression.

The history of depression remains unwritten, yet historians harbor plentiful assumptions about its pre-1800 past. These views are necessarily colored, even shaped, by modern views of depression formed after its nineteenth-century medicalization. A history of depression from ancient to modern times is an impossible task to complete successfully and would require, as a minimum, the historian's utmost vigilance to nuance, difference, and the inclusion of non-medical literature, especially poetry, drama and non-didactic prose. Nevertheless, five points about depression's pre-1800 European profile can confidently be made: (1) it developed along lines of female rather than male gender; (2) was transformed in the long eighteenth century when it blended with male madness under the sway of the cults of a pan-European sensibility movement; (3) always embedded a problematic pseudo-depressive state, or feigned version, which acted to permit female escape from dire socio-economic situation; (4) included sustained chronic duration as a requirement in its theory from the Renaissance forward; (5) is richly documented in its pre-1800 versions in imaginative literature, its often overlooked genealogy.

Depression↗

Archetypal healing.

With emphasis on healing versus curing, the authors draw from a wide assortment of treatment methods for psychospiritual relief of pain in the terminally ill. These archetypal methods include: life-review therapy; ministry of presence; clinical hypnosis; myths, symbols, rituals, and community; creative therapies. In life-review therapy, the ill person shares his/her life story with the provider much like the healing rituals of the ancient storyteller did in his community. In the ministry of presence, the caregiver focuses on sharing his vulnerability, not his professional skills. Clinical hypnosis emphasizes the naturalness and simplicity of accessing the unconscious along with problem areas of the hypnoclinician. Myths, symbols, rituals, and community serve as nurturing agents in the intervention of pain, while creative therapies such as music, drama, crafts, and art continue to be powerful healing instruments. Archetypal healing produces relief of pain in the caregiver, as well as the ill, with emphasis on healing versus curing.

Adult↗

The relationship between college students' schema regarding alcohol use, their television viewing patterns, and their previous experience with alcohol.

Two hundred college students participated in an experiment investigating how individuals use television and real world experiences to construct alcohol use schema. Students were asked to write a story about a student who had a difficult day and, on arriving home, fixed himself a drink. In randomly assigned conditions, directions led the student to believe this was to be either a real world scenario or the setting for a television episode. Stories were coded for setting and social nature of use, quantity of use, consequences (both severity and valence), and overall tone. In general, stories characterized alcohol use as heavy, social, relaxing, and resulting in mostly minor consequences. Story characteristics did not differ based on direction type (real world vs. TV scenario). Students also completed a series of measures regarding television viewing habits, attitudes about alcohol use, and past experiences with use. Regarding television viewing patterns, those who watched more television overall created stories with more alcohol use. Viewing of dramas in particular was associated with less severe consequences as a result of use. In terms of personal experience with use, individuals who had driven under the influence of alcohol were more likely to construct a story with a positive tone and those who had passed out from drinking were less likely to conclude their stories with a moral tale discouraging drinking. The conclusion of this research is that both personal and observed experiences are important influencing factors in individuals' schema regarding alcohol use.

Adolescent↗

Television illness depictions, identity, and social experience: responses to multiple sclerosis on The West Wing among people with MS.

This project contributes to our understanding of how audiences interpret televised depictions of illness by investigating responses to the depiction of multiple sclerosis (MS) on the television drama The West Wing from 1999 to 2002. The study employs qualitative methods, including a focus group, individual interviews, and the collection of electronic message board posts to investigate how people with MS interpret the dramatization of the illness. Findings are analyzed in terms of respondents' perceptions of (a) the portrayal of the physical disease, (b) the portrayal of the social dimensions of MS, and (c) the impact of this portrayal for themselves and others with the disease. The study found that participants engaged in self-comparisons with the depiction of MS within the program. These comparisons resulted in a range of reactions from individuals varying in relation with their multiple physical and social experiences with the illness. Thus, illness experience adds complexity to judgments about accuracy, meaning, and outcomes related to health depictions. Participants expressed a desire to see more symptoms depicted, and they noted concern about the identities communicated to the public about people with MS and its influence on their daily, lived experience.

Attitude to Health↗

Medical-legal issues in Charcot's neurologic career.

OBJECTIVE: Trace the medical-legal involvement of the 19th century clinical neurologist Jean-Martin Charcot. BACKGROUND: The two major neurologic concerns of the 1800s that involved legal questions were topics of particular academic interest to Charcot: post-traumatic neurologic syndromes and the behavioral consequences of hysteria and hypnotism. Although Charcot's medical views influenced several nonmedical fields, including art, poetry, and drama, his impact on medical-legal issues has not been examined. METHODS: Original documents from the Bibliothèque Charcot at the Salpêtrière Hospital in Paris, legal documents, and publications from Charcot's era were examined. RESULTS: Although his involvement in medical-legal affairs was a modest element of Charcot's multifaceted career, he was involved in four different types of medical-legal activities: as a cited authority in the medical-legal literature, as an author of articles within medical-legal contexts, as a subpoenaed expert consultant, and as an expert examiner. CONCLUSIONS: Charcot's involvement demonstrates the long tradition of an interface between neurology and legal medicine and provides a model for highly limited but authoritative involvement by academic neurologists in medical-legal affairs.

Adult↗

Improving outcome after traumatic brain injury--progress and challenges.

This article describes the rapid advances in the head injury field which have taken place within the professional lifetime of many doctors in practice today. These have led to a better understanding of what happens in the injured brain and how these events might be manipulated to achieve better outcomes. Clinical tools we now take for granted, like the CT scanner and the Glasgow Coma Scale, were new developments 25 years ago. They provided a foundation on which clinicians and basic scientists could build what we now know: what to assess in the patient, how to respond to certain findings, what imaging to do, how to plan treatment rationally, how to minimise brain damage at different stages after injury, how to predict and measure outcome, what disabled survivors need, and how to organise the service to do the greatest good for the most people. Some of these topics raise as many questions as answers. The head injury field may be broad but it has essential unity. At one extreme, some patients have a life-threatening illness where the acts and omissions of the clinical team can powerfully influence not only survival but its quality. Later the drama of the acute phase gives way to the 'hidden disabilities' of the long-term deficits which so many survivors have. At the other end of the severity spectrum is the relatively vast number of people who suffer an apparently mild head injury, a few of whom deteriorate and need urgent treatment, and many of whom have unspectacular but, nevertheless, disabling problems. The article attempts to address this broad canvas. Clinicians, neuroscientists, policy makers, and service users must work together to address the major scientific, individual, and population challenges posed by head injury. Much has already been achieved, but much remains to be done, especially in translating 'what we know' into 'what we do'.

Brain Injuries↗