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PubMed2002

Estrogen and Alzheimer's disease: the story so far.

The ovarian hormone estrogen has long been used to treat the physical symptoms of menopause and to aid in the prevention of osteoporosis in postmenopausal women. Cumulative evidence from basic science and clinical research suggests that estrogen also plays a significant neuromodulatory and neuroprotective role. The numerous estrogenic effects in the brain include the modulation of synaptogenesis, increased cerebral blood flow, mediation of important neurotransmitters and hormones, protection against apoptosis, anti-inflammatory actions, and antioxidant properties. These multiple actions in the central nervous system support estrogen as a potential treatment for the cognitive decline associated with Alzheimer's disease (AD), the most common form of dementia. Evidence from epidemiological studies supports enhanced cognitive function in women with AD taking estrogen replacement therapy (ERT) as well as a reduced risk for developing AD in healthy women receiving ERT. Additional clinical evidence suggests that estrogen may modulate specific cognitive functions such as working memory and verbal learning and memory. However, results from more recent controlled trials have not consistently shown a beneficial effect of estrogen on the cognitive function of women with AD. Future research should focus on examining the influence of multiple potential mediators of ERT including the route of estrogen administration, form of estrogen (conjugated estrogens vs estradiol), duration of treatment, opposed versus unopposed estrogen and the use of estrogen analogues. Further, sensitive neuropsychological measures may provide more detailed information concerning the specific effects of estrogen on cognitive function. These important issues must be addressed in order to establish the role of estrogen for the prevention and treatment of AD in women.

Alzheimer Disease↗
PubMed2005

Bachelor of science degree education programs: organization, structure, and curriculum.

Therapists with bachelor's degrees in respiratory therapy have become the new advanced clinicians of the twenty-first century. Although the opportunity has increased in recent years, earning a baccalaureate degree in respiratory therapy remains a limited option. The "2-year preprofessional plus 2-year respiratory therapy" is the most popular curriculum design, but several other notable designs also fulfill the definition of a bachelor's degree in respiratory therapy. Two landmark documents issued in 2003 make strong arguments for expanding opportunities for baccalaureate education in respiratory therapy. Recognizing the "need to increase the number of respiratory therapists with advanced levels of training and education to meet the demands of providing services requiring complex cognitive abilities and patient management skills," the American Association for Respiratory Therapy has strongly encouraged the continuing development of baccalaureate education. Strategies for expanding baccalaureate opportunities include increasing the number and capacities of traditional programs, creating more articulation and bridge agreements between community and junior colleges with 4-year colleges and universities, and offering baccalaureate respiratory therapy through distance education. For the profession of respiratory therapy to require a baccalaureate at entry level, expansion of baccalaureate education will be necessary, and educators, managers, practitioners, and professional leaders will need to pursue all viable strategies. As an interim phase in the evolution of the profession, Becker suggests a strategy of"reprofessionalism" aimed at assisting therapists currently in the workforce to complete their degrees. Through a combination of strategies, a bachelor's degree in respiratory therapy will inevitably become the standard for clinicians in the decades to come.

Allied Health Personnel↗
PubMed2026

The impact of artificial intelligence on critical thinking and clinical reasoning in health professions education: A systematic review and meta-analysis.

BACKGROUND: Critical thinking and clinical reasoning underpin healthcare professionals' ability to navigate uncertainties and deliver safe and effective care. With artificial intelligence (AI) advancement and growing adoption, AI-based educational tools are increasingly used to support these cognitive competencies' development. OBJECTIVE: To synthesize randomised and controlled clinical trials on AI-based educational tools in health professions education and examine their effects on critical thinking and clinical reasoning among health professions students. METHODS: Six electronic databases were searched from January 1, 2014 to July 28, 2025 was reviewed: PubMed, Cochrane Central Register of Controlled Trials, CINAHL, Scopus, Embase and Web of Science. Two independent reviewers performed data extraction and quality assessment using standardized JBI checklists. The GRADE approach was used to assess the certainty of evidence. Studies were pooled via random-effects meta-analyses or narrative syntheses. RESULTS: Fourteen randomised controlled trials and seven controlled clinical trials were included (n = 21). Meta-analyses revealed small to medium effect sizes for the surrogate clinical reasoning outcomes of performance-based assessment scores (SMD 0.68; 95% CI [0.38, 0.98], p-value = 0.00; I2 = 38%) and knowledge test scores (SMD 0.39; 95% CI [0.09, 0.69], p-value = 0.01; I2 = 79%). Critical thinking and clinical reasoning skills and dispositions were narratively synthesized, with majority of included studies favouring AI-based interventions but the evidence had low to very low certainty. CONCLUSION: AI-based educational interventions may improve critical thinking and clinical reasoning among health profession students, but the evidence is very uncertain. This review offers preliminary insights but does not allow identification of optimal interventions or discipline-specific recommendations due to small sample sizes and substantial intervention heterogeneity. Further research is required to draw definitive conclusions. PROTOCOL REGISTRATION: CRD42025634074.

Humans↗
PubMedDate not supplied

[Rational structures in health education models: basics and systematization].

The different Health Education (HE) models appeared in the scientific literature are analyzed, trying to eliminate the confusion produced by its great diversity, applying a general and systematic point of view. Due to the relevance of that topic in the activities of Health Promotion in Primary Health Care it is urgent a deep reappraisal due the heterogeneity of scientific papers dealing with that topic. The curriculum, as the confluence of thought and action in Health Education, is the basic concept thanks to which it is possible to integrate both scientific logic, the biological one and that pertaining to the social sciences. Of particular importance have been the different paradigms that have emerged in the field of HE from the beginning of the present century: a first generation with a "normative" point of view, a second one orientated from positivistic bases, and a third generation adopting an hermeneutic and critic nature. This third generation of paradigms in HE has taken distances from the behaviouristic and cognitive perspectives being more critical and participative. The principal scientific contributors in the field of HE, internationals as well as spaniards are studied and classified. The main conclusions obtained from this Health Education paradigm controversy are referred to both aspects: 1) planning, programming and evaluating activities, and 2) models, qualitative and quantitative methodologies. Emphasis is given to the need of including Community Participation in all phases of the process in critic methodologies of HE. It is postulated the critic paradigm as the only one able to integrate the rest of the scientific approaches in Health Education.

Community Health Centers↗
PubMed1993

[Nature study and happiness in life: Hugo de Vries, Eli Heimans and Jac. P. Thijsse].

This article analyses the backgrounds of Hugo de Vries' stance with regard to the Dutch nature study movement, which rapidly gained momentum in the 1890s. The movement has received little attention from historians until now. A short exposition of its aims and intentions, as envisioned by its main protagonists, Heimans and Thijsse, is provided. It is shown that De Vries' scientific ideas on the improvability of the human species and his liberal social views led him to conclude that both socialism and right-wing 'laisser-faire' ideologies were scientifically unsound. Hereditary theory implied that the human races were genetically stable entities which could not be improved by selection of any kind. The progress of society could only be furthered by placing the emphasis on the individual and its cognitive and social development. According to de Vries, the study of nature provided an excellent means to this end, since it contributed to the individual's personal development as well as to its happiness.

Environment↗
PubMed2006

The rise of the boy-genius: psychological neoteny, science and modern life.

The mid-20th century saw the rise of the boy-genius, probably because a personality type characterized by prolonged youthfulness is advantageous both in science and modern life generally. This is the evolution of 'psychological neoteny', in which ever-more people retain for ever-longer the characteristic behaviours and attitudes of earlier developmental stages. Whereas traditional societies are characterized by initiation ceremonies marking the advent of adulthood, these have now dwindled and disappeared. In a psychological sense, some contemporary individuals never actually become adults. A child-like flexibility of attitudes, behaviours and knowledge is probably adaptive in modern society because people need repeatedly to change jobs, learn new skills, move to new places and make new friends. It seems that this adaptation is achieved by the expedient of postponing cognitive maturation - a process that could be termed psychological neoteny. ('Neoteny' refers to the biological phenomenon whereby development is delayed such that juvenile characteristics are retained into maturity.) Psychological neoteny is probably caused by the prolonged average duration of formal education, since students' minds are in a significant sense 'unfinished'. Since modern cultures favour cognitive flexibility, 'immature' people tend to thrive and succeed, and have set the tone of contemporary life: the greatest praise of an elderly person is to state that they retain the characteristics of youth. But the faults of youth are retained with well as its virtues: short attention span, sensation- and novelty-seeking, short cycles of arbitrary fashion and a sense of cultural shallowness. Nonetheless, as health gets better and cosmetic technologies improve, future humans may become somewhat like an axolotl - the cave-dwelling salamander which retains its larval form until death.

Beginning of Human Life↗
PubMed2005

Neuroethics: the practical and the philosophical.

In comparison with the ethical issues surrounding molecular genetics, there has been little public awareness of the ethical implications of neuroscience. Yet recent progress in cognitive neuroscience raises a host of ethical issues of at least comparable importance. Some are of a practical nature, concerning the applications of neurotechnology and their likely implications for individuals and society. Others are more philosophical, concerning the way we think about ourselves as persons, moral agents and spiritual beings. This article reviews key examples of each type of issue, including the relevant advances in science and technology and their accompanying social and philosophical problems.

Brain↗
PubMed2004

"He sees the development of children's concepts upon a background of sociology": Jean Piaget's honorary degree at Harvard University in 1936.

In the recent memory, Jean Piaget has been known as a cognitive developmental psychologist. But in 1936 when Harvard gave him his first honorary degree, he was recognized mainly as a sociologist. Why did Harvard honor him in 1936? Who knew his work well enough to nominate him? This article will address these questions by exploring archival documents from different sources. Evidence draws our attention to a broad social and intellectual endeavor in philanthropy, other social sciences, and especially industrial research that brought Piaget across the water. This article also attempts to interpret the circumstances of the nomination process inside and outside of Harvard University by using a theory of institutional design. It suggests that embodied in Harvard's honor of Piaget in 1936 was an idealistic act in social designing for a future society.

Awards and Prizes↗
PubMed1999

[Brain science in the 21st century].

Neuroscience has advanced markedly through the 20th century; material processes of brains have been analyzed in detail, and information processes approached as well. Clarification of the material processes has brought about three major strategies to cure and prevent neurological and psychiatric diseases: creation of new drugs, regeneration and transplantation therapy, and gene therapy. An epoch-making progress in medicine is expected to arise from the combination of these three strategies. A trend expected in the 21st century is developmental neuroscience on the growth and differentiation of brains. Cognitive and computational neuroscience will also aim at the clarification of information processes of brains. Neuroscience will exert great influence on pediatrics, in particular on the studies of mental development in childhood.

Brain↗
PubMed1989

The Duke University program for integrating ethics and human values into medical education.

In its second year of development, this program blends cognitive and affective approaches to integrating ethics and human values into medical education. The core of this effort is the establishment of direct and continuing relationships between the four advisory deans and their medical student advisees through small groups that continue throughout the four years of medical school. Clinical correlation seminars, lecture/discussions, the humanities, clinical clerkships, and electives are components of this integration process. Both basic science and clinical faculty members have observed positive changes in the degree and depth of participation, discussion, and interest, as well as in the general attitudes of the students.

Administrative Personnel↗
PubMed2003

Quality of life philosophy III. Towards a new biology: understanding the biological connection between quality of life, disease, and healing.

This paper addresses (in a philosophical way) the complex and enigmatic interface between matter, life, and consciousness in modern medical science. The problem today in understanding living matter is not at the molecular level, but at the macro level where all molecular activities in the individual cell are coordinated, and especially at a higher level, where the activities of all the organism"s cells are coordinated. Although we understand very much of the body"s chemistry, we have only just started to get the gist of the tremendous organization of living matter. We are just beginning to acknowledge the enormous flow of information that is needed to make everything function in a healthy organism, including consciousness, where every cell does exactly what it has to do to make the organs function. A concept that seems to be able to bridge the scientifically very different domains of matter, life, and consciousness seems to be "biological information". If a cell is seen as a liquid crystal in which the cell"s molecules constantly connect in firm mutual relationships only to dissolve again and become fluid and free, whenever the cell needs it, the backbone of the cell seems to be the information that organizes the cell. For example, in cell motion a cell is able to crawl with the help of a skeleton of fibers that can be created guided by biological information, whenever the cell needs the solidity provided by the fibers. The moment it has finished crawling or intends to crawl in another direction, these fibers will dissolve again. The fibers are made of millions of molecules that connect in an arranged pattern, and they dissolve when these molecules again let go of each other. How the cell precisely regulates such processes is today a complete mystery. How cells cocreate consciousness is also an enigma. All we can do is describe the cell and the organisms arising from its cells as filled with energy and information as well as an unbeatable ability to organize itself way down to the molecular level, where apparently the cell is in control of almost every single molecule. Our understanding today of how the information is stored and how it flows through living matter is still very limited. The source of the qualities (the qualia) characterizing the human being as a whole--like joy, love, motivation, consciousness, free will, wisdom, intuitive competence--is still practically unknown and scientifically unexplained, more than 50 years after science has turned itself towards these fundamental problems. We believe that we need a radically new biology and medicine to give the scientific explanations of the structure, dynamics, and quality of life, and of its consciousness.

Animals↗
PubMed1991

Obsessive-compulsive disorder. The effect of research on nursing care.

The purpose of research is the expansion of knowledge. Research with greatest impact on the discipline is that which expands knowledge to enable the provision of effective care. Nursing, as an applied science, responds to changes in the knowledge base with concomitant changes in the application of the nursing process. OCD is an example of an expansion in knowledge after a history of care based on a limited understanding of the etiology of the disorder. The impact on the nursing care of the client with OCD includes the importance of careful assessment with attention to behaviors, feelings, and cognitions. The implementation of nursing actions is guided by a focus on the present and includes physical and emotional support provided for needs created by both the symptoms of OCD and the accompanying symptoms of anxiety and depression, as well as client education regarding OCD and the safe use of clomipramine when it is prescribed.

Adult↗
PubMedDate not supplied

Information searching in health care: a pilot study.

Although many academic institutions have attempted to incorporate formal instruction in library skills into their curricula, the question as to the best method of conveying the necessary information has been a continual challenge to health care educators. A library skills workshop, which included the distribution of a workbook, was offered to physical therapy and occupational therapy students in a Bachelor of Health Science program with the aim of assisting students to develop skills in library searches and to perform critical appraisals of the literature. Thirty-three students agreed to participate in a study designed to determine its effectiveness: 24 who had volunteered to attend the workshop formed the experimental group, and 9 who did not attend acted as controls. A Library Skills Questionnaire that attempted to measure cognitive and psychomotor skills in retrieving and appraising health care literature was given to all participants prior to, and at the completion of, the two-session workshop. Nine students in the experimental group did not attend the second session and were then termed "drop-outs" for the purpose of the study. The results show that the drop-outs had statistically significant higher knowledge scores (p = less than 0.05) in their post-test scores in comparison with both the students who attended the two sessions and the students in the control group. One explanation for this finding is that the drop-outs may be better self-directed learners who used the workbook to teach themselves.(ABSTRACT TRUNCATED AT 250 WORDS)

Canada↗
PubMedDate not supplied

Recognizing through feeling. A physical and computer simulation based on educational theory.

This article focuses on the educational theory underpinning computer-based simulation in professional education. An innovative computer-based physical simulation to facilitate student learning of assessment and palpation skills in midwifery has been developed to prototype stage and preliminary evaluations conducted. The learning experience explicitly builds on the learning and teaching theory--a "conversational framework"--developed by Laurillard. A template incorporating all the dimensions of the Laurillard framework in the learning experience is presented and discussed. It is argued that this template could have wider application especially in clinically based health science courses. The case-based learning environment allows the students to solve problems and make valid clinical judgments. Throughout the learning experiences, students effectively examine a pregnant woman while interrelating their experiences with the academic knowledge of the teacher (a world of "descriptions"). The structure for learning relies on a mechanism for identifying and addressing the misunderstandings students initially hold. The creation of situations of cognitive conflict in the student's world of action (Laurillard's concept of intrinsic feedback) is seen as central to the learning experience. Finally, the article will canvass the issues faced by a project team designing and developing a technology-based educational package around an educational theory.

Computer Simulation↗
PubMed1999

A JAVA implementation of a medical knowledge base for decision support.

Distributed decision support is a challenging issue requiring the implementation of advanced computer science techniques together with tools of development which offer ease of communication and efficiency of searching and control performance. This paper presents a JAVA implementation of a knowledge base model called ARISTOTELES which may be used in order to support the development of the medical knowledge base by clinicians in diverse specialised areas of interest. The advantages that are evident by the application of such a cognitive model are ease of knowledge acquisition, modular construction of the knowledge base and greater acceptance from clinicians.

Artificial Intelligence↗
PubMed1992

A European head injury evaluation chart.

In 1988, 40 experts (physicians, psychologists, social workers, lawyers, family association representatives...) coming from the E.E.C., the United States, Canada and Sweden met in Brussels to derive the guidelines for a minimal assessment of head injured people. This workshop led to a research contract between E.B.I.S. (European Brain Injury Society) and the E.E.C. Directorate for Science regarding a European evaluation document. The aims of the document are both clinical and scientific. Hence the document has to be simple, specific and feasible. The document has two parts: initial state and repeated follow-up. It ends with final comments and action plan. The first statistical data of the validation study concern mainly the link between initial severity of injury and final handicap, cognitive and behavioural troubles, familial and professional aspects of handicap.

Activities of Daily Living↗
PubMed2006

What is conceptual research in psychoanalysis?

The development of psychoanalysis as a science and clinical practice has always relied heavily on various forms of conceptual research. Thus, conceptual research has clarified, formulated and reformulated psychoanalytic concepts permitting to better shape the findings emerging in the clinical setting. By enhancing clarity and explicitness in concept usage it has facilitated the integration of existing psychoanalytic thinking as well as the development of new ways of looking at clinical and extraclinical data. Moreover, it has offered conceptual bridges to neighbouring disciplines particularly interested in psychoanalysis, e.g. philosophy, sociology, aesthetics, history of art and literature, and more recently cognitive science/neuroscience. In the present phase of psychoanalytic pluralism, of worldwide scientific communication among psychoanalysts irrespective of language differences and furthermore of an intensifying dialogue with other disciplines, the relevance of conceptual research is steadily increasing. Yet, it still often seems insufficiently clear how conceptual research can be differentiated from clinical and empirical research in psychoanalysis. Therefore, the Subcommittee for Conceptual Research of the IPA presents some of its considerations on the similarities and the differences between various forms of clinical and extraclinical research, their specific aims, quality criteria and thus their specific chances as well as their specific limitations in this paper. Examples taken from six issues of the International Journal of Psychoanalysis in 2002-3 serve as illustrations for seven different subtypes of conceptual research.

Empiricism↗
PubMed2002

The identification and description of critical thinking behaviors in the practice of clinical laboratory science, Part 1: Design, implementation, evaluation, and results of a national survey.

The ability to think critically has been identified as a pivotal attribute of health care professionals. The purpose of this study was to identify and describe critical thinking (CT) behaviors and observable events resulting from CT, important in the practice of clinical laboratory science. Medical, educational, and psychological literature related to the many behaviors characterized under the CT rubric has been focused by an operationalized definition positing CT to be a metaprocess that facilitates learning by interlinking the more basic processes associated with different learning orientations: behaviorist, cognitivist, humanist, and situated/contextual learning. A total of 65 CT behaviors were identified through a process including discovery (expert interviews, a focus group with practitioners) and refinement (literature comparisons, expert rankings/reviews, pilot survey). CT behaviors were characterized further through a national survey of practitioners (n = 1,571, > 50% of time in bench work). Using a 6-point scale, practitioners ranked the importance of the CT behaviors. Important CT behaviors were characterized as being not only cognitive in nature, but also behavioral, affective, and situated/contextual. These findings suggest a stronger relationship between CT behaviors and all aspects of practice than previously reported. Given that these behaviors span all learning domains, findings support the metaprocess view of CT. Implications are that CT behaviors cannot be learned or taught, apart from a discipline-related practice setting. This study contributes to learning theory related to transfer and how learning occurs and to literature describing survey methodology. It also provides a basis for measurement of CT in practice settings.

Data Collection↗