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A model for diagnostics in neurological rehabilitation: an answer to 'the biopsychosocial disease consequence model in rehabilitation' of Talo et al.
In 1996, Talo et al. published their comprehensive version of a bio-psycho-social disease consequence model in rehabilitation, which deals with 'model development in the Finnish "Work hardening" programme for chronic pain'. The explanations given here serve to check the theoretical background of this model for certain basic assumptions as well as for the possibility to transfer it to other fields of rehabilitation. This is done from the viewpoint of neurological rehabilitation. The starting point is the consideration that the conceptions underlying the ICIDH are not suitable to serve as a mainstay of a model for diagnostics in rehabilitation because they do not reflect essential characteristics of the diagnostic process which is the basis for intervention. A model for diagnostics in neurological rehabilitation is contrasted to that of Talo et al. Regarding the theoretical background this model has different characteristics compared to that developed by the Finnish authors. It is guided by the process of gaining cognition in two different ways: (1) On the assumption that the diagnostic process reflects the same principles basically valid for theory-development in science, the basis of the model are conceptions for description and explanation of a patient's current condition. (2) Due to a holistic idea of disablement these conceptions are related to the individual's bio-psychosocial existence. As it relates to the model developed by Talo et al. this one represents a type of 'meta-level'. With regard to the long-term objective the main interest associated with the alternative model refers to its implications concerning the conception of the rehabilitation process as a prerequisite for internal quality management.
Research on attention networks as a model for the integration of psychological science.
As Titchener pointed out more than one hundred years ago, attention is at the center of the psychological enterprise. Attention research investigates how voluntary control and subjective experience arise from and regulate our behavior. In recent years, attention has been one of the fastest growing of all fields within cognitive psychology and cognitive neuroscience. This review examines attention as characterized by linking common neural networks with individual differences in their efficient utilization. The development of attentional networks is partly specified by genes, but is also open to specific experiences through the actions of caregivers and the culture. We believe that the connection between neural networks, genes, and socialization provides a common approach to all aspects of human cognition and emotion. Pursuit of this approach can provide a basis for psychology that unifies social, cultural, differential, experimental, and physiological areas, and allows normal development to serve as a baseline for understanding various forms of pathology. D.O. Hebb proposed this approach 50 years ago in his volume Organization of Behavior and continued with introductory textbooks that dealt with all of the topics of psychology in a common framework. Use of a common network approach to psychological science may allow a foundation for predicting and understanding human behavior in its varied forms.
Behavioral and Brain Functions. A new journal.
Behavioral and Brain Functions (BBF) is an Open Access, peer-reviewed, online journal considering original research, review, and modeling articles in all aspects of neurobiology or behavior, favoring research that relates to both domains. Behavioral and Brain Functions is published by BioMed Central. The greatest challenge for empirical science is to understand human behavior; how human behavior arises from the myriad functions such as attention, language, memory and emotion; how these functions are reflected in brain structures and functions; and how the brain and behavior are altered in disease. Behavioral and Brain Functions covers the entire area of behavioral and cognitive neuroscience - an area where animal studies traditionally play a prominent role. Behavioral and Brain Functions is published online, allowing unlimited space for figures, extensive datasets to allow readers to study the data for themselves, and moving pictures, which are important qualities assisting communication in modern science.
A personal encounter with psychology (1937-2002).
An undergraduate assistantship with Abraham Maslow, research with Solomon Asch, and an indirect exposure to Ernest Nagel's philosophy of science encouraged Howard H. Kendler to become involved with methodological issues in psychology. Graduate training with Kenneth Spence led to an active research career that was initially immersed in the latent learning controversy and later, with the collaboration of his wife Tracy Kendler, in the extension of the Hull-Spence model of cognitive development. Methodological concerns from a variety of sources encouraged Kendler to express his ideas on the methodology and history of psychology as well as its role in ethical and social policy issues. A productive symbiotic relationship is created from the interaction of democracy, natural-science psychology, and moral pluralism.
Toward applied behavior analysis of life aloft.
This article deals with systems at multiple levels, at least from cell to organization. It also deals with learning, decision making, and other behavior at multiple levels. Technological development of a human behavioral ecosystem appropriate to space environments requires an analytic and synthetic orientation, explicitly experimental in nature, dictated by scientific and pragmatic considerations, and closely approximating procedures of established effectiveness in other areas of natural science. The conceptual basis of such an approach has its roots in environmentalism which has two main features: (1) knowledge comes from experience rather than from innate ideas, divine revelation, or other obscure sources; and (2) action is governed by consequences rather than by instinct, reason, will, beliefs, attitudes or even the currently fashionable cognitions. Without an experimentally derived data base founded upon such a functional analysis of human behavior, the overgenerality of "ecological systems" approaches render them incapable of ensuring the successful establishment of enduring space habitats. Without an experimentally derived function account of individual behavioral variability, a natural science of behavior cannot exist. And without a natural science of behavior, the social sciences will necessarily remain in their current status as disciplines of less than optimal precision or utility. Such a functional analysis of human performance should provide an operational account of behavior change in a manner similar to the way in which Darwin's approach to natural selection accounted for the evolution of phylogenetic lines (i.e., in descriptive, nonteleological terms). Similarly, as Darwin's account has subsequently been shown to be consonant with information obtained at the cellular level, so too should behavior principles ultimately prove to be in accord with an account of ontogenetic adaptation at a biochemical level. It would thus seem obvious that the most productive conceptual and methodological approaches to long-term research investments focused upon human behavior in space environments will require multidisciplinary inputs from such wide-ranging fields as molecular biology, environmental physiology, behavioral biology, architecture, sociology, and political science, among others.
Left-right asymmetry in embryonic development: a comprehensive review.
Embryonic morphogenesis occurs along three orthogonal axes. While the patterning of the anterior-posterior and dorsal-ventral axes has been increasingly well characterized, the left-right (LR) axis has only recently begun to be understood at the molecular level. The mechanisms which ensure invariant LR asymmetry of the heart, viscera, and brain represent a thread connecting biomolecular chirality to human cognition, along the way involving fundamental aspects of cell biology, biophysics, and evolutionary biology. An understanding of LR asymmetry is important not only for basic science, but also for the biomedicine of a wide range of birth defects and human genetic syndromes. This review summarizes the current knowledge regarding LR patterning in a number of vertebrate and invertebrate species, discusses several poorly understood but important phenomena, and highlights some important open questions about the evolutionary origin and conservation of mechanisms underlying embryonic asymmetry.
The role of proprioception in the management and rehabilitation of athletic injuries.
Rehabilitation continues to evolve with the increased emphasis on patient management and proprioceptive training. Proprioception can be defined as a specialized variation of the sensory modality of touch that encompasses the sensation of joint movement (kinesthesia) and joint position (joint position sense). Numerous investigators have observed that afferent feedback to the brain and spinal pathways is mediated by skin, articular, and muscle mechanoreceptors. Examining the effects of ligamentous injury, surgical intervention, and proprioceptively mediated activities in the rehabilitation program provides an understanding of the complexity of this system responsible for motor control. It appears that this neuromuscular feedback mechanism becomes interrupted with injury and abnormalities, and approaches restoration after surgical intervention and rehabilitation. Rehabilitation programs should be designed to include a proprioceptive component that addresses the following three levels of motor control: spinal reflexes, cognitive programming, and brainstem activity. Such a program is highly recommended to promote dynamic joint and functional stability. Thus far, current knowledge regarding the basic science and clinical application of proprioception has led the profession of sports medicine one step closer to its ultimate goal of restoring function.
[On spatio-temporality. A psychiatric and interdisciplinary study].
There is no scientific knowledge without a method, no method without a minimum of theory and no theory without a general frame of reference. The concepts of space and time constitute undoubtedly the most comprehensive frame of reference; it is relevant both to the interior, experienced world of man and to the universe in which he lives. The concepts of space and time, which have emerged from various disciplines such as philosophy, cosmology, physics, biology, neurophysiology, ethology and psychiatry show a certain number of mutual relations and even connections. Characteristically, these concepts fit in with the levels, integrations, communications and self-regulations, all the structural properties, which are emphasized by the model of mental disturbances, created by application of a special systems approach, the "systemal method", to the psychiatric clinic. This structural isomorphism between the mental disturbances and the cognitive concepts of space-time reinforce by feed-back the validity of the systemal method. It also indicates the relevance of the basic sciences to the further development of psychiatry.
Effect of perceived stress on student performance in dental school.
A commonly held view is that chronic stress has an adverse affect on academic performance. Because dental students typically report high levels of stress, they may be at particular risk. This research examined the relationship between perceived stress and academic performance in 202 dental students enrolled in an Australian dental school. In this study, four key stress factors labelled "self-efficacy beliefs," "faculty and administration," "workload," and "performance pressure" previously identified by our group from principal components analysis of the Dental Environment Stress (DES) questionnaire, together with gender, ethnicity, and stage of course, were entered as independent variables into multiple regression analyses. Three measures of academic performance (basic and applied science knowledge, clinical competency, and contextual understanding) were entered as dependent variables. Regression analysis revealed little support for the assumption that chronic stress predicted academic performance. The only finding of note was that students reporting higher levels of stress on the DES factor "faculty and administration" tended to show lower grades for clinical competency and contextual understanding. In summary, although the DES factor solution used in the present study remains to be validated, we found little support for an association between increased DES factor stress scores and reduced academic performance in dental students.
Intelligence: genetics, genes, and genomics.
More is known about the genetics of intelligence than about any other trait, behavioral or biological, which is selectively reviewed in this article. Two of the most interesting genetic findings are that heritability of intelligence increases throughout the life span and that the same genes affect diverse cognitive abilities. The most exciting direction for genetic research on intelligence is to harness the power of the Human Genome Project to identify some of the specific genes responsible for the heritability of intelligence. The next research direction will be functional genomics--for example, understanding the brain pathways between genes and intelligence. Deoxyribonucleic acid (DNA) will integrate life sciences research on intelligence; bottom-up molecular biological research will meet top-down psychological research in the brain.
Computer and the thought process.
Modelling of brain is an eternal problem and was revitalized by arrogant claims of some computer scientists. Several basic results of mathematics, especially in problems of uncertainty, computational complexity and logic prove limits of computation and indications that the brain works otherwise. The complexity of brain is not accessible by current electronic technology. However, brain research and computer science can learn a lot from each other by revealing relevant analogies.
Roots of the Pavlovian Society's missions of the past and present: the Pavlov dimension.
This paper offers an interpretation of the relation between Pavlov's life and work and the missions of the Pavlovian Society, both past ("observation and observation") and present ("interdisciplinary research on the integrated organism"). I begin with an account of Pavlov's life and his influence on contemporary thought. I then indicate the relation of some of Pavlov's attitudes (e.g., his motto, his epistemological stance) to the Society's past mission. In the concluding and most controversial section, I argue for six guiding principles derived from Pavlov, to be applied to the Society's mission. These are: (a) a confident methodological behaviorism; (b) a significant role assigned to both physiological and psychological factors in the prediction and control of the integrated organism; (c) approximately equal taxonomic precision of physiological and psychological explanatory concepts; (d) distrust of teleological explanatory concepts; (e) rejection of psychology's instrumentalist "cognitive paradigm shift"; and (f) rejection of the representational theory of knowledge.
Anaesthesia: the patient's point of view.
Patients scheduled for surgical procedures continue to express concerns about their safety, outcome, and comfort. All medical interventions carry risks, but the patient often considers anaesthesia as the intervention with the greatest risk. Many still worry that they will not wake up after their surgery, or that they will be awake during the operation. Such events have received attention from the media, but are very rare. Challenges to improve the comfort of patients continue, especially with regard to the almost universal problems of nausea, vomiting, and pain after surgery. A newer concern is that patients will develop some degree of mental impairment that may delay return to a full work and social lifestyle for days and weeks. Developments in technology, education, and training have had a major effect on anaesthetic practice, so that anaesthesia is increasingly regarded as safe for the patient. This article explores patients' concerns, and considers whether science and technology help to provide solutions to these complex difficulties.
Nutrients, age and cognition.
UNLABELLED: Our knowledge about the influence of nutritional supplements on human cognition, especially in the elderly, rests largely on animal behavioural research and neurochemical experiments in vitro, while only a few epidemiological studies and even fewer controlled experiments in humans are reported. This is an inherent problem, due partly to the difficulty of conducting controlled nutritional experiments in humans, but may also partly be due to the gap between the research disciplines of nutritional and neurobehavioral experimental science. LEARNING OBJECTIVES: The aim of this paper is to discuss some new findings in this line of research, and to stress the importance of the need to start bridging the gap between disciplines by identifying possible human experimental models of altered cognitive function, which can elucidate the specific mechanisms of action through which nutritional supplements may enhance cognitive performance in humans in vivo. These experimental models are important because the research in this field is mostly based on epidemiological studies, which describe associations between nutrients and cognitive functions. Contrary to epidemiological studies, experimental models mimic associations between nutrients and cognition by manipulating their presumed mechanisms of action and can eventually explain the causal nature of found associations.
Stimulating consciousness and cognition following severe brain injury: a new potential clinical use for lamotrigine.
No medications clearly enhance consciousness or cognition following severe brain injury. This series (n = 13) suggests that lamotrigine may stimulate improvement of patients with impairment equivalent to level I-III on the Rancho Los Amigos Cognitive Scale. After a serendiptious clinical result, severely brain injured patients who were taking an anticonvulsant had an opportunity to start lamotrigine. This cohort had been transferred to this rehabilitation unit 14-304 (mean 73.9) days and started lamotrigine 20-310 (mean 87.5) days after acute brain injury. Compared to this unit's experience with patients with similar severe brain injuries, more patients (n = 10) were discharged to the conmmunity and fewer to skilled nursing facilities (n = 3) than were expected. This preliminary and provocative case series corresponds to basic science results, and further investigation of lamotrigine is warranted.
Non-contact eye-tracking on cats.
The objective of visual systems neuroscience has shifted over the past few years from determining the receptive fields of cells towards the understanding of higher level cognition in awake animals viewing natural stimuli. In experiments with awake animals it is important to control the relevant aspects of behavior. Most important for vision science is the control of the direction of gaze. Here we present Dual Purkinje eye-tracking on cats, which--as a non-contact method--brings a number of advantages. Along with the presented methods for calibration and for synchronization to off-the-shelf video presentation hardware, this method allows high precision experiments to be performed on cats freely viewing videos of natural scenes.
Development of scientific reasoning biases: cognitive versus ego-protective explanations.
Two conflicting perspectives have dominated the literature on self-serving reasoning biases. One maintains that individuals have difficulty objectively processing information relevant to their personal theories because they are reluctant to relinquish their cause-effect beliefs relevant to that domain. The ego-protective view claims that such biases arise because they enhance or protect individuals' self-views. These opposing positions were studied with 5th, 8th, and 11th graders. Scientific reasoning improved with age. Analyses of biases, indicated by ratings of evidence quality and written justifications, yielded mixed results regarding developmental trends in reasoning biases. Both theoretical beliefs and ego-protective motivations predicted reasoning biases. An accuracy motivation led to more complex justifications but failed to reduce reasoning biases. Adolescents appear to selectively apply their scientific reasoning skills.