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At least 1,261 records · Page 70Linked to original sources
PubMed1995

Landmark positioning on maxilla of cleft lip and palate infant--a reality?

In this study, we tested the precision of landmark positioning for a set of landmarks that can be used for the edentulous cleft lip and palate maxilla of the infant, by analyzing intraobserver and interobserver repositioning and measuring on a series of 121 (unilateral and bilateral) study casts. To date, no data on interobserver and only minimal data on intraobserver reproducibility are available. We found intraobserver reproducibility acceptable with total measurement errors ranging from 0.51 to 1.54 mm. Interobserver reproducibility was only slightly less with total measurement errors ranging from 0.63 to 1.57 mm. Total measurement errors were found to be relatively high for some variables. Both the intra- and interobserver analyses show insight into expected precision of landmark positioning during placement of these points on casts. A learning effect for precise positioning has been demonstrated in both analyses. The points with the highest precision overall are Q and Q', followed by the linear measurements PL and P'L'. Quality of regular study casts (impressions) is an important factor, with room for improvement. Reproducible landmark positioning on the cleft lip and palate infant's maxilla, can only be a reality if the quality of the cast is optimal and the investigator is experienced. Intraobserver and interobserver reproducibility are in the same range, which justifies the comparison of results from different studies and relieves future investigators of the need to have all measurements within a study conducted by the same investigator. Aspects of the biologic meaning of landmarks are also discussed.

Cephalometry↗
PubMed2005

Virtual reality cue reactivity assessment: a case study in a teen smoker.

Cigarette smoking in adolescents is a major public health problem. To address the increasing need for efficacious assessment and treatment methods, we developed and tested a novel virtual reality cue reactivity assessment system. A case study of a controlled virtual reality cue reactivity trial with a 17-year-old adolescent cigarette smoker is presented. During the trial, the participant was exposed to virtual reality (VR) smoking cues and VR neutral cues and assessments of subjective craving and skin conductance response (SCR) were recorded. Upon exposure to VR smoking cues, craving increased. A novel methodology for collecting and analyzing SCR in VR was developed and explored to expand the role of physiological variables in VR research. SCR data indicated specific reactions to smoking cue stimuli, with the subject experiencing increased reactivity to smoking cues (i.e., cigarettes) compared to food or drinks. Based on this case study, further research using VR cue reactivity assessment in adolescent smokers is warranted. The impact of VR in drug research and future applications in research are also discussed.

Adolescent↗
PubMed2005

Ergonomic testing of two different types of handles via virtual reality simulation.

BACKGROUND: Ergonomics in laparoscopic surgery is an unsolved problem. Deficiencies of the instrument handles are well-known and described in several reports and studies. Today, virtual training modules for laparoscopic surgery are available. The aim of this study was to evaluate the ability of a virtual reality (VR) simulator to determine the ergonomic properties of two different laparoscopic instrument handles. METHODS: Two different types of handles, a ring and an axial handle from Richard Wolf, were used to perform the short clip and cut task of the Xitact 500 LS simulator. The task was repeated every 2 days for a period of 5 weeks. After every trial the volunteers were asked structured questions about their preferences while using the two handles. RESULTS: The axial handle was superior or equal to the ring handle in all criteria. Learning curves over the entire time and day by day were similar. No differences were found for travel distances and error rates, but task times were different for both handles. The subjects preferred the axial handle at the end of the study. CONCLUSION: It is possible to determine differences in ergonomics of handle design with a VR trainer. In this study, the Richard Wolf axial handle was superior to the ring handle.

Computer Simulation↗
PubMed2001

Bilateral hippocampal pathology impairs topographical and episodic memory but not visual pattern matching.

A virtual reality environment was used to test memory performance for simulated "real-world" spatial and episodic information in a 22-year-old male, Jon, who has selective bilateral hippocampal pathology caused by perinatal anoxia. He was allowed to explore a large-scale virtual reality town and was then tested on his memory for spatial layout and for episodes experienced. Topographical memory was tested by assessing his ability to navigate, recognize previously visited locations, and draw maps of the town. Episodic memory was assessed by testing the retrieval of simulated events which consisted of collecting objects from characters while following a route through the virtual town. Memory for the identity of objects, as well as for where they were collected, from whom, and in what order, was also tested. While the first task tapped simple recognition memory, the latter three tested memory for context. Jon was impaired on all topographical tasks and on his recall of the context-dependent questions. However, his recognition of objects from the virtual town, and of "topographical" scenes (as evaluated by standard neuropsychological tests), was not impaired. These findings are consistent with the view that the hippocampus is involved in navigation, recall of long term allocentric spatial information and context-dependent episodic memory, but not visual pattern matching.

Adult↗
PubMed2005

Participants' opinions of laparoscopic training devices after a basic laparoscopic training course.

BACKGROUND: Basic laparoscopic skills are initially best taught and practiced in an inanimate setting. Various devices are used to aid in this education of laparoscopic skills. These devices range from simple box trainers to sophisticated virtual reality trainers. This investigation tested the hypothesis that participants would prefer one trainer to another trainer. METHODS: Preclinical medical students volunteered for this study. All underwent a porcine laboratory. The students were then divided into 3 groups by method of training: group A--a virtual reality trainer (MIST-VR), group B--an inanimate box trainer (LTS 2000), and group C--both trainers. Each group participated in 10 laboratories with the assigned trainer(s). After completion of the laboratories, all students underwent a similar porcine laboratory. During this laboratory, opinions of each trainer and specific tasks were ascertained from each student. RESULTS: No statistical difference was seen between groups A and B when asked if their specific trainer helped their skills, was realistic, helped in the animal laboratory, and was interesting. When group C was asked the same questions about each trainer, no statistical difference was seen except that 47% thought the MIST-VR was not realistic as opposed to 0% who thought the LTS 2000 was not realistic (P <.003). The level of difficulty of each task correlated with how much the specific task helped in development of skills for both trainers (P <.0001). In group C, 89% of the participants thought the LTS 2000 helped more that the MIST-VR and 56% thought the LTS 2000 was more interesting than the MIST-VR. In addition, 83% of students in group C chose LTS 2000 when asked to pick only one trainer. CONCLUSIONS: While virtual reality trainers may have some advantages, most participants feel that inanimate box trainers help more, are more interesting, and should be chosen over virtual reality trainers if only one trainer is allowed. Further studies need to investigate if the opinions affect participants' utilization of these trainers.

Clinical Competence↗
PubMed2006

A standardized test battery for the study of synesthesia.

Synesthesia is an unusual condition in which stimulation of one modality evokes sensation or experience in another modality. Although discussed in the literature well over a century ago, synesthesia slipped out of the scientific spotlight for decades because of the difficulty in verifying and quantifying private perceptual experiences. In recent years, the study of synesthesia has enjoyed a renaissance due to the introduction of tests that demonstrate the reality of the condition, its automatic and involuntary nature, and its measurable perceptual consequences. However, while several research groups now study synesthesia, there is no single protocol for comparing, contrasting and pooling synesthetic subjects across these groups. There is no standard battery of tests, no quantifiable scoring system, and no standard phrasing of questions. Additionally, the tests that exist offer no means for data comparison. To remedy this deficit we have devised the Synesthesia Battery. This unified collection of tests is freely accessible online (http://www.synesthete.org). It consists of a questionnaire and several online software programs, and test results are immediately available for use by synesthetes and invited researchers. Performance on the tests is quantified with a standard scoring system. We introduce several novel tests here, and offer the software for running the tests. By presenting standardized procedures for testing and comparing subjects, this endeavor hopes to speed scientific progress in synesthesia research.

Algorithms↗
PubMed2005

[Application of interactive virtual reality technique in biomechanical analysis of knee joint stability].

OBJECTIVE: To test the feasibility of using interactive virtual reality technique for three-dimensional reconstruction and image segmentation for biomechanical analysis of the knee joint structures. METHODS: The muscular and fat tissues along with the connective tissues were removed from the knee joint, and the femur and tibia were embedded in polymethacrylate gel. The knee joint was reconstructed with three-dimensional analysis system after calibration of the sequence of the three-dimensional markers attached to the femur and tibia. RESULTS: The knee joint model was reconstructed and verified by three-dimensional analysis. This model provided information of the motions of the internal and external knee joint structures. CONCLUSION: This method is useful for reconstructing human joints and provides a new and highly efficient experimental method for biomechanical simulation of human joints.

Adolescent↗
PubMed2002

Risk assessment and management of high risk familial breast cancer.

The demand for genetic services by women with a family history of breast cancer has increased exponentially over the last few years. It is important that risks to women are accurately assessed and that processes are in place for appropriate counselling and management. The classification of risk into average, moderate, and high, depending upon the assessed lifetime risk of breast cancer, allows for the management of moderate risk women within cancer units and high risk women within the regional genetic centres. Management of high risk women includes discussion of options including screening, chemoprevention, and preventive surgery. The majority of these options are still unproven in the long term and continuing research is needed for their evaluation. Mutation screening and predictive testing are now a reality for a minority of families, allowing for a more informed basis for decisions regarding management options.

Breast Neoplasms↗
PubMed2003

A virtual reality dental simulator predicts performance in an operative dentistry manikin course.

This study was designed to test the ability of a virtual reality dental simulator to predict the performance of students in a traditional operative dentistry manikin course. Twenty-six dental students were pre-tested on the simulator, prior to the course. They were briefly instructed and asked to prepare 12 class I cavities which were automatically graded by the simulator. The instructors in the manikin course that followed were unaware of the students' performances in the simulator pre-test. The scores achieved by each student in the last six simulator cavities were compared to their final comprehensive grades in the manikin course. Class standing of the students in the simulator pre-test positively correlated with their achievements in the manikin course with a correlation coefficient of 0.49 (P = 0.012). Eighty-nine percent of the students in the lower third of the class in the pre-test remained in the low performing half of the class in the manikin course. These results indicate that testing students in a dental simulator, prior to a manikin course, may be an efficient way to allow early identification of those who are likely to perform poorly. This in turn could enable early allocation of personal tutors to these students in order to improve their chances of success.

Achievement↗
PubMed2000

Perception, mental imagery and reality discrimination in hallucinating and non-hallucinating schizophrenic patients.

OBJECTIVES: In this study the hypothesis was tested that hallucinations result from confusing external and internal stimulus sources, i.e., perception and imagery, respectively. DESIGN AND METHODS: Thirteen hallucinating and 19 non-hallucinating schizophrenic patients, as well as 14 control participants performed multiple tests of perception, vividness of mental imagery and the ability to discriminate between them (reality discrimination). These functions were tested in both the auditory and the visual modalities. RESULTS: There were no group differences on perceptual acuity. The results on one imagery task indicated that for the hallucinating patients, the relative, but not the absolute, level of vividness of mental images might be higher in the auditory modality, which was the modality in which 12 of the patients also experienced hallucinations, than in the visual modality. Finally, there was a positive relationship between severity of (auditory) hallucinations and reality discrimination problems. CONCLUSIONS: Hallucinations may result from increased vividness of mental imagery, and their severity increases with larger impairments in reality discrimination. It is recommended that research into, and cognitive behavioural therapy for, hallucinations should also focus on their sensory qualities.

Adult↗
PubMed2005

Reality confusion in spontaneous confabulation.

A woman produced spontaneous confabulations after rupture of an anterior communicating artery aneurysm. She confused currently irrelevant with currently relevant information in implicit memory; confabulations about people concerned only new acquaintances; false reality could be induced by an intensive 5-minute discussion; and in a recognition task, she confused false repetitions in another modality with real item repetitions. The findings support the theory that the defect causing spontaneous confabulation precedes conscious memory processing.

Basal Nucleus of Meynert↗
PubMed2006

Testing the domain-specificity of a theory of mind deficit in brain-injured patients: evidence for consistent performance on non-verbal, "reality-unknown" false belief and false photograph tasks.

To test the domain-specificity of "theory of mind" abilities we compared the performance of a case-series of 11 brain-lesioned patients on a recently developed test of false belief reasoning () and on a matched false photograph task, which did not require belief reasoning and which addressed problems with existing false photograph methods. A strikingly similar pattern of performance was shown across the false belief and false photograph tests. Patients who were selectively impaired on false belief tasks were also impaired on false photograph tasks; patients spared on false belief tasks also showed preserved performance with false photographs. In some cases the impairment on false belief and false photograph tasks coincided with good performance on control tasks matched for executive demands. We discuss whether the patients have a domain-specific deficit in reasoning about representations common to both false belief and false photograph tasks.

Adult↗
PubMed1999

An economic perspective on Alzheimer's disease.

The rapid growth of the world's Alzheimer's disease (AD) population has resulted in a tremendous financial burden on society, a situation exacerbated by the fact that the funding of health and social services faces increasing restrictions in the coming years. As a consequence, several cost-of-illness studies, aimed at assessing the total costs associated with the care of an AD patient or with individual components thereof, have been conducted, with a view to identifying areas in which costs might be reduced. For example, the Costs of Dementia (CoDem) study, described here, aims to give a profile of the total economic costs of AD in Italy. While this study found the number of Instrumental Activities of Daily Living lost to be the principal predictor of the weekly costs for home care, other studies have reported a correlation between total cost and Mini-Mental State Examination (MMSE) score. The basis for a correlation between cost and disease severity is discussed. Pharmacoeconomics aims to assess the cost effectiveness of interventions that may form part of an overall management strategy in AD. As institutionalization is the largest cost element in the care of any AD patient, efforts at cost containment have focused on maintaining patients at home for as long as possible. The results of studies on a number of interventions, namely, screening, reality orientation therapy, special care units, family interventions, and drug treatment, are discussed, although the costs and, indeed, the long-term benefits associated with many of these remain unknown. Although information concerning costs is essential in health resource allocation, it is also vital that meaningful ways in which to assess quality-of-life issues be developed as the basis for genuine cost-benefit judgments.

Activities of Daily Living↗
PubMedDate not supplied

North Star Project: reality orientation in an acute care setting for patients with traumatic brain injuries.

OBJECTIVE: The North Star Project is an acute care rehabilitation approach for patients with moderate and severe traumatic brain injuries. This patient-centered project uses the concepts of Reality Orientation Therapy to develop a unique approach that focuses "environment," "consistency" and "standardization" to promote a total team effort. Patients, treatment staff and members of the patient's family collaborate in a unified bedside protocol that stimulates orientation, encourages patients' appropriate interactions and aims to decrease the length of post-traumatic amnesia. Development of materials, protocols, training and outcome measurement initiatives are described.

Brain Injuries↗
PubMed1990

The impact of universal screening for gestational glucose intolerance on outcome of pregnancy.

Universal screening for gestational glucose intolerance has strong support, despite the lack of scientific evidence documenting its benefit. In the early 1980s, practicing obstetricians were split concerning the clinical importance of gestational glucose intolerance, so that some practitioners tested virtually all the patients they treated while others tested none. This historical reality provided concurrent screened and unscreened populations in whom to assess the impact of screening. We studied all 1,307 singleton pregnancies cared for and delivered at the New York Hospital-Cornell University Medical Center during a five month period. Large infants (birth weight greater than or equal to 4,000 grams) were born to 10.5 per cent of the women who were not screened (533) and to 11.2 per cent of the women who were screened (774). The process of screening not only failed to decrease the rate of large infants, but also failed to improve otherwise pregnancy outcomes and was associated with more intensive surveillance during pregnancy and a significantly higher rate of primary cesarean delivery. Given the unexpected concomitants of the screening process, we conclude that recommendations for universal screening for gestational glucose intolerance should be reconsidered.

Adult↗
PubMed2004

Projection, introjection, and projective identification: a reformulation.

In this essay, the author recommends a reformulation of the psychoanalytic concept of projection. The author proposes that projective processes are not merely defensive maneuvers that interfere with perception, but rather an essential means by which human perception is rendered possible. It is the manner in which human beings test and-evaluate reality in terms of their experiential structure, and their needs for survival and nourishment. Projection is the early phase of introjection.

Fantasy↗
PubMed2006

Effects of dopamine receptor type 1 and Gs protein alpha subunit gene polymorphisms on blood pressure at rest and in response to stress.

BACKGROUND: Exaggerated blood pressure (BP) response to behavioral stress has been recognized as an independent predictor of increased BP levels in human subjects. The coupling of dopamine receptor type 1 (DRD1) with stimulatory G-proteins plays an important role in BP regulation. Therefore, we investigated whether the A-48G polymorphism of the DRD1 gene and the T393C polymorphism of the Gs protein alpha subunit (GNAS) gene influenced BP levels at rest and in response to stress. METHODS: A total of 912 white and African American (44.5%) twin subjects (17.4 +/- 3.4 years) were genotyped. Systolic and diastolic BP were measured at rest and during two 10-min stress tasks (a social competence interview and a virtual reality car driving simulation test). Regular association analyses and sibpair transmission disequilibrium tests were performed. The two polymorphisms, A-48G (DRD1) and T393C (GNAS), were genotyped by polymerase chain reaction with restriction digestion enzymes. RESULTS: A dominant BP-lowering effect of the -48G allele was observed on diastolic BP at rest (P = .032) and in response to the car driving simulation test (P = .046). The 393C allele was associated with higher systolic BP levels during the social competence interview (P = .024) and the car driving simulation test (P = .016). There were no statistical significances between the two loci for systolic and diastolic BP at rest and during stress. CONCLUSIONS: Our findings suggest that DRD1 and GNAS loci contribute to BP regulation at rest, and in particular, in response to behavioral stress. The BP measurement during behavioral stress may have added value for gene association studies.

Adolescent↗