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At least 1,657 records · Page 92Linked to original sources
PubMed2005

Effects of group experiential cognitive therapy for the treatment of panic disorder with agoraphobia.

A treatment protocol, called experiential cognitive therapy (ExCT), was developed. It integrated traditional cognitive behavior therapy (CBT) with virtual reality exposure for the treatment of panic disorder with agoraphobia (PDA). The objective of this study was to test the efficacy of short-term (four sessions) ExCT compared with a traditional 12-session panic control program (PCP) for the treatment of PDA. Forty patients diagnosed as having PDA by the diagnostic criteria of DSM-IV were randomly assigned to ExCT and PCP groups of 20 patients each. The treatment effects were measured with self-report questionnaires, including the BDI, STAI, ASI, PBQ, ACQ, and BSQ. The authors also assessed high end-state functioning (HES), including the success rate of stopping or reducing medication at post-treatment and 6-month follow-up. In all ratings, both ExCT and PCP groups showed significant improvement post-treatment compared with pre-treatment scores. There were no significant differences between the two treatment groups in HES and medication discontinuation at post-treatment, but there was a significant difference in medication discontinuation at 6-month follow-up. These results suggested that although short-term effectiveness of ExCT might be comparable to the effectiveness of PCP, long-term effectiveness of ExCT might be relatively inferior to the effectiveness of PCP.

Adult↗
PubMed2004

Assessment of basic human performance resources predicts the performance of virtual ureterorenoscopy.

PURPOSE: Regardless of training, innate ability may influence the acquisition of endoscopic skills. Until recently objective methods to assess innate ability have not been available. We compared objective measures of human basic performance resources (BPRs) using nonlinear causal resource analysis (NCRA) and expert rated endoscopic performance of medical students on a virtual reality (VR) simulator. MATERIALS AND METHODS: BPRs were measured in 18 medical students (group 1) using 13 validated tests. BPR results were compared to the results of ureteroscopic skills assessment on the VR simulator. An NCRA model was devised to predict performance based on BPRs and the limiting performance resource (LPR). The same BPRs were measured in a second group of 14 medical students (group 2). Using the model created from group 1 performance of VR ureterorenoscopy was predicted based on LPR for each student in group 2. Predicted performance was compared to rated performance. RESULTS: The average difference in score between 2 expert raters was 7.2%. The average difference in predicted score based on the NCRA model and rated score was only 8.0%. In 9 of the 14 group 2 subjects (63%) the performance prediction by NCRA was in excellent agreement (+/-10%) with the expert rating on the VR simulation. NCRA over predicted performance in 2 subjects (14%) and under predicted performance in 3 (21%). CONCLUSIONS: Objective prediction of ureteroscopic performance in the VR environment using LPRs (measures of innate ability) for each subject is possible and practical using new measurement and modeling methods. The selection of surgical candidates, training and the educational curriculum could be impacted.

Clinical Competence↗
PubMedDate not supplied

Children's perseverative appearance-reality errors are related to emerging language skills.

Two experiments explored the communicative bases of preschoolers' object appearance-reality (AR) errors. In Experiment 1, 3-, 4-, and 5-year-olds (N = 36) completed the AR test (with high- and low-deceptive objects), a control test with the same discourse structure but nondeceptive stimuli, and stimulus naming and memory tests. AR performance correlated positively with control (discourse) and naming test performance. Object deceptiveness had little effect. In Experiment 2, 3- and 4-year-olds (N = 64) completed AR tests that experimentally varied question phrasing and use of exemplar objects. Children also completed memory, vocabulary, and control tests (of verbal perseveration). AR performance variance was predicted by a composite perseveration score from three non-AR tasks, vocabulary, and exemplars. The results indicate that the discourse structure of the AR test elicits a perseverative tendency that is mediated by children's verbal knowledge.

Child↗
PubMed2003

On the detection of dispersion in the head-related transfer function.

Because of dispersion in head-related transfer functions (HRTFs), the interaural time difference (ITD) varies with frequency. This physical effect ought to have consequences for the size or shape of the auditory image of broadband noise because different frequency regions of the noise have different ITDs. However, virtual reality experiments suggest that human listeners are insensitive to head-related dispersion. The experiments of this article test that suggestion by experiments that isolate dispersion from amplitude effects in the HRTF and attempt to optimize the opportunity for detecting it. Nevertheless, the experiments find that the only effect of dispersion is to shift the lateralization of the auditory image. This negative result is explained in terms of the cross-correlation function for head-dispersed noise. Although the broad-band cross-correlation function differs considerably from 1.0, the cross-correlation functions within bands characteristic of auditory filters do not. A detailed study of the lateralization shifts show that the experimental shifts can be successfully calculated as an average of stimulus ITDs as weighted by Raatgever's frequency-weighting function (Thesis, Delft, The Netherlands, 1980).

Adult↗
PubMed1992

The utility of lipid-associated sialic acid (LASA or LSA) as a serum marker for malignancy. A review of the literature.

The utility of the lipid-associated sialic acid (LASA or LSA) test as a serum marker for malignancy is reviewed. The name LASA or LSA test is confusing because it suggests that only or mainly lipid-bound sialic acid is measured. In reality, glycoprotein-bound sialic acid is determined predominantly. The assay appears to have a particularly high positivity rate in leukemia, Hodgkin's disease, melanoma, sarcoma, advanced ovarian carcinoma and oropharyngeal tumors, suggesting that LASA may serve as a valuable marker in these malignancies. As a consequence of the rise of sialic acid-rich acute-phase proteins, such as alpha 1-acid glycoprotein, in inflammatory diseases the specificity of LASA and therefore its diagnostic accuracy is low. LASA can be useful for monitoring cancer patients during treatment, especially in combination with other tumor markers.

Antigens, Neoplasm↗
PubMed2005

How eyewitnesses resist misinformation: social postwarnings and the monitoring of memory characteristics.

Previous findings have been equivocal as to whether the postevent misinformation effect on eyewitness memory is reduced by warnings presented after the misinformation (postwarnings). In the present research, social postwarnings, which characterize the postevent source as a low-credibility individual, diminished the misinformation effect in both cued recall and recognition tests. Discrediting the source as being either untrustworthy or incompetent was effective (Experiment 1). Also, postwarned participants rated reality characteristics of their memories more accurately than did participants receiving no or high-credibility information about the postevent source (Experiment 2). A social postwarning yielded the same results as an explicit source-monitoring appeal and led to longer response times for postevent items, relative to a no-warning condition (Experiments 3 and 4). The findings suggest that the reduced misinformation effect was due to more thorough monitoring of memory characteristics by postwarned participants, rather than to a stricter response criterion or to enhanced event memory.

Adult↗
PubMed2000

[Molecular biology and medicine at the end of the 20th Century].

This paper reviews basic concepts of modern molecular biology with the premise that its influence in today's medicine is so important that its knowledge cannot remain limited to a few experts. I first analyze the overall structure and organization of human genes, their split nature and the flow of genetic information from DNA to protein. The role of transcriptional control in the regulation of gene expression and cell differentiation is described by introducing experimental examples that define the importance of "master" genes. Basic concepts of genetic engineering, the generation of transgenic and knock out animals and the uses of molecular biology in clinical diagnosis, paternity tests and forensic medicine are presented. Finally, I discuss the possibilities of gene therapy and the fantasies and realities of transgenesis and cloning by nuclear transplant in humans.

Animals↗
PubMed1992

[Can type-1 diabetes in children be prevented?].

Increased knowledge of the etiopathogenesis of Type 1 diabetes has focused great interest on the possibilities of preventing the disease. Type 1 diabetes is considered to be a chronic autoimmune disease characterized by gradual beta-cell destruction mediated by autoreactive T-lymphocytes during an asymptomatic prediabetic phase of varying duration. Both experimental and epidemiologic data indicate that nutritional cow milk exposure early in life may play a critical role in the initiation of beta-cell destruction. Accordingly a primary prevention study has been planned to test the hypothesis that dietary elimination of cow milk proteins over the first 9 months of life will decrease the subsequent risk of childhood type 1 diabetes in high risk infants. The possibility of identifying prediabetic individuals before decisive loss of beta-cell function by various islet cell-specific autoantibodies enables measures of secondary prevention in the prediabetic phase. There are indications from experimental and human studies that nicotinamide, a water-soluble group B vitamin, may be effective in preventing or delaying the presentation of diabetes. A European multicentre study will be initiated in the near future to explore whether oral nicotinamide can prevent or delay the clinical manifestation of Type 1 diabetes in high risk first degree relatives of diabetic children. We have to wait for the results of these intervention studies for years, and similarly other prevention strategies have to be tested in large-scale long-lasting clinical trials. Nevertheless, prevention of childhood diabetes may become a reality in the next century.

Child↗
PubMed1989

General principles of DNA repair in microorganisms and implications for future research.

The analysis of DNA repair and mutagenesis in organisms that have high resolution genetic and molecular biological systems has led, and will continue to lead, to major advances in our understanding of these processes. It is striking that almost all of the major insights highlighted in this chapter have been gained within the last 10 years and, in fact, several of the discoveries described here occurred during the actual writing of this report. It is worth reflecting that in the mid 1970s there was a widely held view that the essential elements of DNA repair in E. coli were well understood and, at that time, a considerable number of investigators shifted their focus to systems that did not offer the high resolution genetic and molecular biologic tools of E. coli and S. cerevisiae. The remarkable progress achieved over the past ten years underscores the limitations of that viewpoint. It is difficult, and probably unwise, to pinpoint specific issues in DNA repair in E. coli and S. cerevisiae as special targets for future research since so much remains to be learned. Most of the striking discoveries outlined in this chapter have come from skilled investigators using the full range of high resolution genetic, molecular biologic, and biochemical tools to address fundamental problems in DNA repair and mutagenesis. In most cases, it would have been impossible to have predicted the critical discoveries that have been made. For example, UV and chemical mutagenesis require the induction of a pair of genes, mediated by DNA-damage-stimulated proteolytic cleavage of a repressor and then the subsequent activation of one of these gene products by a mechanistically related proteolytic cleavage. In 1975 an hypothesis proposing such a mechanism for UV and chemical mutagenesis would have been dismissed as being utterly fanciful. Yet this is the current reality. As in the cases of the other findings detailed here, the key insights came not from the testing of fanciful hypotheses but rather from systematic scientific studies of fundamental problems. Funding in this area should then support inquiries of fundamental issues in DNA repair and mutagenesis by investigators who are skilled at using the full range of sophisticated experimental tools available for these organisms. It is worth noting that supporting this type of research will shed light not only on mechanisms of DNA repair and mutagenesis but also on more fundamental issues in the biology of living organisms.(ABSTRACT TRUNCATED AT 400 WORDS)

Adaptation, Physiological↗
PubMed2005

Consequences of different diagnostic "gold standards" in test accuracy research: Carpal Tunnel Syndrome as an example.

Test accuracy studies assume the existence of a well-defined illness definition and clear-cut diagnostic gold standards or reference standards. However, in clinical reality illness definitions may be vague or a mere description of a set of manifestations, mostly clinical signs and symptoms. This can lead to disagreements among experts about the correct classification of an illness and the adequate reference standard. Using data from a diagnostic accuracy study in carpal tunnel syndrome, we explored the impact of different definitions on the estimated test accuracy and found that estimated test performance characteristics varied considerably depending on the chosen reference standard. In situations without a clear-cut illness definition, randomized controlled trials may be preferable to test accuracy studies for the evaluation of a novel test. These studies do not determine the diagnostic accuracy, but the clinical impact of a novel test on patient management and outcome.

Carpal Tunnel Syndrome↗
PubMedDate not supplied

[Psychic reality of hemiplegic patients during rehabilitation].

The authors face psychological problems of the hemiplegic patient through a free re-elaboration of Sacks' and coll.'s Test of Sentences to be Completed with the purpose of pointing out psychosocial and depressive dynamics which can interfere with rehabilitation processes as well as with the re-learning of adaptation motorial successions. Attained results appear to confirm a strict relation among hemiplegia, withdrawal from parenthetical social relation and development of depressive dynamics; they also suggest the opportunity of a systematic deepening of the research.

Adjustment Disorders↗
PubMed2001

Current status of doctoral-level training in psychological testing.

Training directors of 82 American Psychological Association (APA)-approved doctoral programs in clinical psychology responded to a survey on the current status and recent changes in doctoral training in psychological assessment. Although testing continues to be a major focus of training, a slight decline in emphasis on assessment was noted, most notably with projective techniques. With few exceptions (e.g., NEO-PI, Personality Assessment Inventory), traditional tests were emphasized in coursework and also were considered "essential" for the practicing psychologist. Interestingly, there seems to be increased emphasis on the interview and neuropsychological testing compared to prior surveys of academic settings. Only 29% of the training directors reported that their programs have been significantly affected by managed care, suggesting that most academic programs are somewhat insulated from marketplace pressures. It is recommended that training programs balance their focus on traditional academic values with the realities of the clinical practice arena.

Curriculum↗
PubMed2002

Temporal information for spatially constrained locomotion.

How is locomotion adapted to spatial environmental constraints? The control of this everyday behavior is claimed to be based on information that specifies either spatial or temporal properties of the actor-environment system. Although studies on open-loop locomotor pointing (i.e., the positioning of a foot on a target on the floor while walking) agree on the use of spatial information, studies on closed-loop locomotor pointing propose the use of temporal information. Here, we test the hypothesis of closed-loop locomotor pointing based on temporal information, by dissociating spatial and temporal information in a virtual reality setup (virtual environment connected to a treadmill). The results support this hypothesis and shed some light on the type of temporal information that is used. The performed dissociation between spatial and temporal information, however, does not rule out a control based on a continuous updating of spatial information. Therefore, our conclusion on the use of temporal information was moderated.

Adaptation, Physiological↗
PubMedDate not supplied

Benefits of a virtual play rehabilitation environment for children with cerebral palsy on perceptions of self-efficacy: a pilot study.

This paper presents the results of a clinical trial of a virtual reality play-based intervention. The results of three single case studies are presented. The virtual reality intervention used the Mandala Gesture Xtreme technology. It was applied to three school-aged children with cerebral palsy. A pre-test-post-test design was used. The relevant outcome of interest was self-efficacy as measured with the Canadian Occupational Performance Measure (COPM). Group scores on the COPM indicated clinically significant changes in self-efficacy for all children. Two of the participants demonstrated the greatest changes in both perceived performance abilities and satisfaction with performance with respect to task specific domain areas. Qualitative comments from the participants revealed a high degree of motivation, interest, pleasure, and opportunity for engagement in play, activities not previously engaged in. Overall, this pilot study suggests the viability of a virtual reality play-based intervention as part of the rehabilitation process for children with cerebral palsy. These results form the basis of a larger scale randomized clinical trial.

Cerebral Palsy↗
PubMed2003

Proteomic prediction of disease outcome in cancer : clinical framework and current status.

Better than gene sequencing or quantitative amplification, proteomics tools allow the study of tumor phenotype. Indeed, most current prognostic tests in cancer (carcinoembryonary antigen [CEA], prostate-specific antigen [PSA], CA 19-1, CA 125, alpha-fetoprotein [AFP], etc.) are based on the detection and quantification of single proteins in body fluids. However, a common characteristic of these tests is their relatively low predictive value, so that they are usually complemented with other procedures such as biopsy and/or endoscopy. Recently, improved analytical and bioinformatics tools have driven the attention on pattern recognition approaches rather then single-marker tests for prognostic forecasting. It is expected that predicting metastasization on the basis of tumoral protein patterns will soon be a reality. However, currently available technologies either limit the number of proteins that can be analyzed simultaneously or they are expensive, difficult, and time-consuming. Moreover, the tools adapted for expression proteomics might not be the same as those for prognostic studies that require investigation of protein function over time. We believe that clinical proteomics research designed within a precise clinical and pathology framework should be strongly supported, since many prognostic factors are determined not by the tumor itself, but by the patient, the treatment and the environment.

Animals↗