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Animal models of the ketogenic diet: what have we learned, what can we learn?

Despite its clinical use as a therapy for refractory epilepsy for more than 75 years, the ketogenic diet (KD) remains a therapy in search of an explanation. The mechanism of action of the KD is unclear and the optimal indications for its clinical use are incompletely defined. Animal models could help to elucidate these questions. Surprisingly, there have been very few animal studies of the KD, and those that have been performed are difficult to compare because of wide discrepancies in experimental methods. Earlier models concentrated on the effect of the KD on acute seizure threshold in normal (i.e. nonepileptic) animals. Recent studies are beginning to examine the longer term effects of the KD and its role in epileptogenesis. Some features of clinical experience have been replicated in animal models, including the role of ketosis, elevation of seizure threshold by both classic ketogenic and medium chain triglyceride diets, better effectiveness at younger ages, and rapid reversal of the seizure protective effect when the diet is discontinued. These parallels raise hope that pertinent clinical questions can be addressed in the more controlled setting of the research laboratory. As in the clinical arena, there has been a recent resurgence of interest in pursuing basic questions related to the ketogenic diet, using techniques of modern neuroscience. Experimental approaches such as brain slice neurophysiology, genetic models, dissection of metabolic pathways, and neurohistological techniques hold much promise in the effort to understand this intriguing alternative to standard anticonvulsants.

Age Factors↗

Preserved learning and memory in amnesia: intact adaptation-level effects and learning of stereoscopic depth.

Amnesic patients and control Ss performed similarly on 2 memory tests. In Experiments 1A and 1B, amnesic patients exhibited intact adaptation-level effects: An experience lifting and judging a group of weights influenced their judgments of a 2nd group of weights 20-25 min later. The effect did not depend on peripheral accommodation, because Ss used 1 hand during their 1st encounter with the weights and the opposite hand during their 2nd encounter. In Experiment 2, amnesic patients acquired at a normal rate the ability to perceive binocular depth using random-dot stereograms. In both experiments, amnesic patients benefited from recent experience, despite the fact that they could not remember their prior experience accurately. The preserved memory abilities demonstrated here appear to be examples of implicit, or nondeclarative, memory.

Adaptation, Psychological↗

A look back at lessons learned and not learned.

Many of the issues and problems of concern to Atwater are still being studied and debated. However, the major nutrition issue today is balancing food preferences against the risk of disease. This affects the relationship between agriculture and nutrition interests. Successful modification of eating habits will rest primarily upon the food industries. Foods with desirable nutritional profiles will sell if they are tasty, competitively priced, and convenient. In developing dietary recommendations, the changes necessary in the food supply must be considered. Unreasonable recommendations should be avoided. In addition, serious consideration should be given to how food consumption data are obtained, what standards are used to evaluate the data, and what legitimate conclusions can be drawn from these data.

Agriculture↗

Look, learn, and be satisfied: video playback as a learning strategy to improve clinical skills performance.

The study investigated the viability of video playback as a means to maintain and enhance nursing skills in today's healthcare environment. The purpose was to determine if video playback would improve performance of psychomotor clinical skills and increase participant satisfaction with the leaning process. A two-group sample of registered and student nurses participated in the study. Each participant performed a nursing procedure. Two nursing procedures were used, one for each group. Each nursing procedure was recorded on videotape and played back to the participant who then repeated the procedure and completed a satisfaction assessment questionnaire. Results showed improved performance and learner satisfaction.

Adult↗

Gene expression profiling in pediatric rheumatic disease: what have we learned? What can we learn?

PURPOSE OF THIS REVIEW: Gene expression profiling is emerging as a promising methodology in pediatric rheumatology research. There is considerable interest in using this technology as the basis for diagnostic assays. This review will summarize the new knowledge. RECENT FINDINGS: Most gene expression studies of children have been exploratory in nature. However, preliminary gene expression studies in juvenile dermatomyositis, systemic lupus erythematosus, and chronic forms of arthritis demonstrate both the promise and limits of this technology. It seems likely that gene expression profiling will significantly enhance our understanding of the immunopathology of childhood-onset rheumatic diseases; however, considerable impediments must be overcome before these assays move into the clinical arena. SUMMARY: Gene expression profiling carries considerable potential to provide novel insights into the rheumatic diseases of childhood. Future developments will determine whether these technologies provide new clinical diagnostic or prognostic tools.

Child↗

Assessment of learning in the cross-cultural domain: reflection leads to learning for the teacher.

The imposition of one set of cultural values on students from another culture is an ethical and practical concern for nurse educators. Theories of developmental psychology have been worked out mainly in the Western culture. Other cultures are studied, but measured against the Western framework, which is often uncritically accepted as 'usual'. This paper explores the ways in which the use of reflective practice allowed a group of nurse educators to perceive a cultural bias to their evaluation and to develop a strategy which they believe is more just and culturally fair for the student. Their experience is presented as a paradigm case to illustrate both reflection-in-action and the reframing of a cultural perspective which had limited educational development for both the student and the teachers.

Cultural Characteristics↗