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PubMedDate not supplied

Ethical issues in Alzheimer disease research.

Research in Alzheimer disease (AD) is required to advance knowledge for the ultimate goal of finding a cure or prevention and to improve care for persons with AD and their caregivers. All research needs to be planned and conducted ethically, but research in AD has many ethical issues to consider due to the diminished cognitive capacity of potential subjects and genetic testing for AD. This paper describes the development of guidelines for ethical research, applying ethical principles to issues in human subjects research, and ethical issues in AD research. Important ethical questions must be addressed in AD research and basic moral and professional values will certainly be tested as the state of the science improves and research on AD, especially research involving genetic testing for the disease, becomes more acceptable and available.

Aged↗
PubMed2003

Hormone replacement therapy--is there a place for its use in neurology?

Stroke remains the third leading cause of mortality in developed countries despite declining tendency over the past decades. As the leading cause of disability and second cause of dementia, primary prevention should be the main way to fight the disease, since therapy is not efficient enough. Several observations pointed to estrogen as a protective agent that may reduce stroke risk, however, studies have shown conflicting data. There is no strong evidence that hormone replacement therapy (HRT) increases stroke risk. Several studies have shown that HRT may reduce the risk of fatal stroke. Conflicting results have been found for Alzheimer's disease and HRT as well. An association between higher serum concentration of estradiol and decreased risk of cognitive decline has been found in some studies, supporting the hypothesis that estrogen concentration may play a significant role in brain protection. Having in mind results of recent randomized trials, it is suggested that HRT should not be recommended on general basis for the primary or secondary prevention of cardiovascular/cerebrovascular diseases or for primary prevention of degenerative diseases such as Alzheimer's disease. Osteoporosis, cognitive decline and climacteric symptoms that are likely to impact on quality of life, speak in favor for recommendation of HRT use. On the other side, family history of breast carcinoma, mastopathy, thromboembolism, in certain cases gallbladder disease, will discourage the commencement of HRT. Respecting the patient's preferences and having benefits and risks in mind as well as science advisory statements, individual counseling regarding HRT should be the leading concept in the healthcare of postmenopausal women.

Aged↗
PubMed2002

Group-based parent-training programmes for improving emotional and behavioural adjustment in 0-3 year old children.

BACKGROUND: Mental health problems in children are common. Research suggests that parenting has an important role to play in helping children to become well adjusted adults, and that the first few months and years of a child's life are especially important in establishing patterns of emotional, cognitive and social functioning which will in turn influence the child's future development and in particular, their mental health. Parenting programmes may therefore have a role to play in improving the mental health of infants and toddlers. OBJECTIVES: The objectives of this review are as follows: a) To establish whether group-based parenting programmes are effective in improving the mental health of children less than three years of age b) To assess the role of parenting programmes in the primary prevention of mental health problems SEARCH STRATEGY: A range of biomedical and social science databases were searched including MEDLINE, EMBASE, CINAHL, PsychLIT, Sociofile, Social Science Citation Index, ASSIA, the Cochrane Library including SPECTR, CENTRAL, National Research Register (NRR) and ERIC. SELECTION CRITERIA: Only randomised controlled trials were included and studies had to include at least one standardised instrument measuring some aspect of infant mental health. DATA COLLECTION AND ANALYSIS: The treatment effect for each outcome in each study was standardised by dividing the mean difference in post-intervention scores for the intervention and treatment group, by the pooled standard deviation, to obtain an effect size. The results for each outcome in each study have been presented with 95% confidence intervals. Where appropriate the results have been combined in a meta-analysis using a random effect model. MAIN RESULTS: A total of five studies were included in the review. The 5 included studies provided a total of 36 assessments of infant and toddler mental health including emotional and behavioural adjustment, and sleep patterns. All of the results apart from 6 showed positive findings favouring the intervention group. While some of findings were non-significant, most of the effect sizes were large and the wide confidence intervals crossing the zero that were obtained in a number of the studies, were very probably due to small sample sizes. There was sufficient data from four studies to combine the results in a meta-analysis. The results of the meta-analysis show a significant difference in children's emotional and behavioural adjustment favouring the intervention group. Overall, the limited follow-up data provide equivocal evidence concerning the maintenance of these effects over time. REVIEWER'S CONCLUSIONS: The results of this review suggest that parenting programmes can be effective in improving the mental health of infants and toddlers. There is, however, insufficient evidence to reach any firm conclusions regarding the role that such programmes might play in the primary prevention of mental health problems. Furthermore, there is insufficient evidence to know whether the short-term benefit of these programmes is maintained over time, and further research is required.

Child Development↗
PubMed2006

Directed postgraduate study result in quantitative improvement in American Board of Surgery In-Training Exam scores.

BACKGROUND: The collective study habits of 1 group of residents involved in educationally distinct periods of time in a community-based general surgery residency program were evaluated. METHODS: American Board of Surgery In-Training Exam (ABSITE) score results of 31 residents were calculated during 3 distinctive educational time periods: resident independent, self-directed study; resident-directed study with weekly systematic textbook reviews; and faculty-directed study with additional formal basic science and clinical lectures. RESULTS: Aggregate higher scores were observed when ABSITE results for the directed study period were compared with those observed during the independent study period in mid-level resident years (postgraduate year [PGY] 2 to 4). CONCLUSIONS: With limited faculty resources, community-based surgery residency programs have more challenges in opportunities for resident acquisition of cognitive knowledge and subsequent quantitative improvement in ABSITE scores. This study demonstrated a successful methodology particularly in the face of mandated limitation of weekly resident work hours and diminishing allocated education resources.

Accreditation↗
PubMed2005

A user's guide to animal welfare science.

Here, I provide a guide for those new to the burgeoning field of animal welfare science as to what this comprehensive, relatively young discipline is all about. Drawing on all branches of biology, including behavioural ecology and neuroscience, the science of animal welfare asks three big questions: Are animals conscious? How can we assess good and bad welfare in animals? How can we use science to improve animal welfare in practice? I also provide guidelines for an evidence-based approach to welfare issues for policy makers and other users of animal welfare research.

Animal Husbandry↗
PubMed2001

Oxcarbapezine: anticonvulsant profile and safety.

Oxcarbazepine is a molecule chemically related to carbamazepine that shares most of the pharmacological and therapeutic effects of carbamazepine while displaying a more favorable profile regarding tolerability and drug-drug interactions. In contrast to carbamazepine, oxcarbazepine is metabolized through cytochrome P450-independent reductases, and is thus devoid of inductive effects on hepatic oxidative metabolism. Oxcarbazepine has been shown to be useful both as monotherapy and adjunctive therapy in patients with partial seizures with or without secondary generalization. The drug has been documented as safe and effective in adults as well as children aged 4-16 years. Additional data suggests that oxcarbazepine might improve cognition and psychomotor performance and might increase alertness, in contrast to the cognition/psychomotor impairment observed with some other antiepileptic drugs. Both the pharmacokinetic advantages over other anticonvulsant drugs and the lack of pharmacological interactions with oxcarbazepine may point to this drug as a first-line treatment for the management of partial and tonic-clonic epilepsy.(c) 2001 Prous Science. All rights reserved.

Journal Article↗
PubMed2004

Job loss, human capital job feature, and work condition job feature as distinct job insecurity constructs.

The projected growth of new technologies, increasing use of automation, and continued consolidation of health-related services suggest that continued study of job insecurity is needed for health care professionals. Using a sample of 178 medical technologists over a 5-year period, this study's findings extend earlier work by Blau and Sharp (2000) and suggest that job loss insecurity, human capital job feature insecurity, and work condition job feature insecurity are related but distinct types of job insecurity. A seven-item measure of job loss insecurity, a four-item measure of human capital job feature insecurity, and a four-item measure of work condition job feature insecurity were analyzed. Confirmatory factor analysis using a more heterogeneous sample of 447 working adults supported this three-factor structure. Using correlation and path analysis, different significant relationships of antecedent variables and subsequent organizational withdrawal cognitions to these three types of job insecurity were found.

Adult↗
PubMed1998

Conditioning, awareness, and the hippocampus.

For the past 50 years, psychologists have wrestled with questions regarding the relationship between conscious awareness and human conditioned behavior. A recent proposal that the hippocampus mediates awareness during trace conditioning (Clark, Squire, Science 1998;280:77-81) has extended the awareness-conditioning debate to the neuroscience arena. In the following commentary, we raise specific theoretical and methodological issues regarding the Clark and Squire study and place their finding into a broader context. Throughout our discussion, we consider the difficulties in assessing subjective awareness, the importance of establishing necessary and sufficient conditions for cognitive mediation effects, the influence of conditioned response modality, and the nature of hippocampal requirements across conditioning protocols. It is clear that trace eyeblink conditioning is a hippocampal-dependent task, but whether awareness is a necessary component of trace conditioning is not definitively proven. We propose that future functional neuroimaging studies and behavioral experiments using on-line measures of awareness may help clarify the relationship among classical conditioning, awareness, and the hippocampus.

Animals↗
PubMed1997

Vertical biases in scene memory.

In a recent theoretical paper (Behavioral and Brain Sciences, 1990, 13, 519-542), Previc argued that vertical asymmetries in perception may largely result from the biases of the lower and upper visual fields toward proximal and distal space, respectively. The present study examined whether this same relationship may exist for visual scene memory, by re-analyzing data from Intraub and Richardson (Journal of Experimental Psychology: Learning, Memory, and Cognition, 1989, 15, 179-187). In that study, subjects remembered photographs of scenes as being farther away than was actually the case and extended the boundaries of the scenes accordingly; in some cases, the remembered scenes were also shifted vertically. This study formally examined whether prominent landmarks in Intraub and Richardson's close-up and wide-angle photographs were displaced vertically in subjects' reproductions of them from memory. A total of 475 measurements in 210 drawings by 41 subjects were made. The results were that 64% of the original landmark points were shifted downward in the drawings made from memory, whereas only 36% were shifted upward. Although most of the original points were located in the upper-field and would have been expected to be shifted downward as the original image contracted in memory, a chi-square analysis showed that more upper-field points were shifted downward than were lower-field points shifted upward in the remembered scenes. The downward shift could reflect an expansion of the upper-field in memory, consistent with the scene being placed farther away, or it could reflect an elevation of the assumed viewing (head) position in memory.

Adult↗
PubMed2005

A portable cardiopulmonary bypass/extracorporeal membrane oxygenation system for the induction and reversal of profound hypothermia: feasibility study in a Swine model of lethal injuries.

The Cleveland Clinic Foundation's (CCF) cardiopulmonary bypass/extracorporeal membrane oxygenation (CPB/ECMO) system capabilities were tested in a hypothermia trauma management feasibility study in a porcine animal model at the Uniformed Services University of the Health Sciences (USUHS, Bethesda, MD, U.S.A.). In this survival series, the CCF system was used in a simulated forward lines combat casualty application where lethal uncontrolled hemorrhage from major vascular injuries was repaired under a state of profound hypothermic arrest (suspended animation), followed by recovery and monitoring in an intensive care unit (ICU) setting. The animals were monitored for survival, neurological impact, cognitive functions, organ damage, and delayed complications over 3 weeks. A survival rate of 83% matched rates previously found using conventional equipment. Neurological findings, organ dysfunction, and complication rates also were no different from previous studies using standard equipment. Successful survival results demonstrated that the CCF CPB/ECMO system could be used to induce a period of profound hypothermic arrest for the repair of lethal traumatic injuries. The logistical advantages of this system make it an attractive choice for use in austere settings and during transport.

Animals↗
PubMed2006

Towards a virtual laboratory for FMRI data management and analysis.

Functional Magnetic Resonance Imaging (fMRI) is a popular tool used in neuroscience research to study brain activation due to motor or cognitive stimulation. In fMRI studies, large amounts of data are acquired, processed, compared, annotated, shared by many users and archived for future reference. As such, fMRI studies have characteristics of applications that can benefit from grid computation approaches, in which users associated with virtual organizations can share high performance and large capacity computational resources. In the Virtual Laboratory for e-Science (VL-e) Project, initial steps have been taken to build a grid-enabled infrastructure to facilitate data management and analysis for fMRI. This article presents our current efforts for the construction of this infrastructure. We start with a brief overview of fMRI, and proceed with an analysis of the existing problems from a data management perspective. A description of the proposed infrastructure is presented, and the current status of the implementation is described with a few preliminary conclusions.

Databases as Topic↗
PubMed1977

Meditation, esoteric traditions--contributions to psychotherapy.

This article is a brief introduction to several different Eastern systems of philosophy and therapy. It surveys the Buddhist contributions and several contemporary applications of traditional meditation techniques within the framework of modern psychologic science. It is suggested that meditative exercises produce three therapeutic gains: insight into repetitive, self-defeating patterns of behavior, desensitization of painful thoughts, and the conditioning of the central nervous system.

Attitude↗
PubMed1998

Language learning impairments: integrating basic science, technology, and remediation.

One of the fundamental goals of the modern field of neuroscience is to understand how neuronal activity gives rise to higher cortical function. However, to bridge the gap between neurobiology and behavior, we must understand higher cortical functions at the behavioral level at least as well as we have come to understand neurobiological processes at the cellular and molecular levels. This is certainly the case in the study of speech processing, where critical studies of behavioral dysfunction have provided key insights into the basic neurobiological mechanisms relevant to speech perception and production. Much of this progress derives from a detailed analysis of the sensory, perceptual, cognitive, and motor abilities of children who fail to acquire speech, language, and reading skills normally within the context of otherwise normal development. Current research now shows that a dysfunction in normal phonological processing, which is critical to the development of oral and written language, may derive, at least in part, from difficulties in perceiving and producing basic sensory-motor information in rapid succession--within tens of ms (see Tallal et al. 1993a for a review). There is now substantial evidence supporting the hypothesis that basic temporal integration processes play a fundamental role in establishing neural representations for the units of speech (phonemes), which must be segmented from the (continuous) speech stream and combined to form words, in order for the normal development of oral and written language to proceed. Results from magnetic resonance imaging (MRI) and positron emission tomography (PET) studies, as well as studies of behavioral performance in normal and language impaired children and adults, will be reviewed to support the view that the integration of rapidly changing successive acoustic events plays a primary role in phonological development and disorders. Finally, remediation studies based on this research, coupled with neuroplasticity research, will be presented.

Dominance, Cerebral↗
PubMed1998

Distance learning, problem based learning and dynamic knowledge networks.

This paper is an attempt to develop a distance learning model grounded upon a strict integration of problem based learning (PBL), dynamic knowledge networks (DKN) and web tools, such as hypermedia documents, synchronous and asynchronous communication facilities, etc. The main objective is to develop a theory of distance learning based upon the idea that learning is a highly dynamic cognitive process aimed at connecting different concepts in a network of mutually supporting concepts. Moreover, this process is supposed to be the result of a social interaction that has to be facilitated by the web. The model was tested by creating a virtual classroom of medical and nursing students and activating a learning session on the concept of knowledge representation in health sciences.

Computer Communication Networks↗
PubMed2005

Relearning how to learn: enrolled nurse transition to degree at a New Zealand rural satellite campus.

The demise of enrolled nurse (EN) training in New Zealand hastened the development of transition to registration/degree programmes for enrolled nurses. A North Island tertiary institution developed a flexible course to enabled ten enrolled nurses working in rural settings, the majority of whom were Māori, to continue working while studying at a small satellite campus. An exploratory, descriptive, qualitative research study utilizing focus group interviews was undertaken to examine the factors that assisted or hindered their transition. Two major categories emerged from comparative analysis of the data. One category entitled 'relearning how to learn', demonstrated the cognitive and behavioural adaptations made and is the focus of this paper. The other category 'barriers and catapults', demonstrated the physical and environmental factors that influenced the students' transition but is outside the scope of this paper. Recent changes in New Zealand nursing education have witnessed the clarification of scopes of nursing practice and the controversial development of a new Certificate in Health Science (Nurse Assistant). Currently enrolled nurses are again facing threats to employment and it is envisaged that many will be seeking to undertake transition to registered nurse in the near future.

Attitude of Health Personnel↗
PubMed2005

The psychologic context of pediatric diabetes.

During the past few decades, there has been an explosion of behavioral science research on family management of pediatric diabetes. This article distills the major conclusions from that literature, emphasizing how primary care providers can apply these findings in clinical practice.

Adolescent↗
PubMed1989

Toward a model of positive health.

This article proposes a model of positive health based on a human-system framework. Such a framework is comprehensive in that (a) it encompasses all of the human system's behavioral subsystems (biochemical, physiological, perceptual, cognitive, and interpersonal), and (b) it permits a higher asymptote of health conceptualization and measurement than that afforded by Western biomedical theory. The article sets forth the conceptual basis of the model and reviews empirical studies that support the model. Finally, the article explores implications of the model for health research, for programs of health enhancement, and for the role of the behavioral sciences in health theory.

Adaptation, Psychological↗
PubMed2005

Exercise and its effects on the central nervous system.

Exercise can have profound effects on numerous biologic systems within the human body, including the central nervous system (CNS). The inherent complexity of the CNS, and the methodologic difficulties in evaluating its in vivo neurochemistry in humans, provide challenges to investigators studying the impact of exercise on the CNS. As a result, our knowledge in this area of exercise science remains relatively limited. However, advances in research technology are allowing investigators to gain valuable insight into the neurobiologic mechanisms that contribute to the bidirectional communication that occurs between the periphery and the CNS during exercise. This article examines how exercise-induced alterations in the CNS contribute to central fatigue and the overtraining syndrome, and how exercise can influence psychologic wellbeing and cognitive function.

Affect↗