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PubMed2006

A living will clause for supporters of animal experimentation.

Many people assume that invasive research on animals is justified because of its supposed benefits and because of the supposed mental inferiority of animals. However probably most people would be unwilling to sign a living will which consigns themselves to live biomedical experimentation if they ever, through misfortune, end up with a mental capacity equivalent to a laboratory animal. The benefits would be greater by far for medical science if living will signatories were to be used, and also the mental superiority boast would no longer apply. Ultimately, it is argued that invasive biomedical experiments would be unacceptable in a democratic society whose members are philosophically self-consistent.

Animal Experimentation↗
PubMed1990

[How to evaluate dental fear].

The measurement of complex behavioral phenomena like dental fear requires allegiance to two great domains that often seem to conflict with one another: natural scientific method and the seemingly unpredictable human psyche. The need to preserve strict objectivity in scientific observations and yet flexibility enough to appreciate the contextual facets of psychological and social variables are a difficult combination. There are differing scientific philosophies that are presented here not as incompatible opposites, but as a complementary team of approaches to aid human behavioral problem solving in dental clinical science. The "positivistic falsification" tradition requires "objective" double-blind type experimental hypothesis testing, while the "phenomenologic-hermaneutic" tradition requires the researcher to grasp the context of the phenomena to be studied in order to understand and thereafter test the most relevant variables. Thus, there is a need for both traditions, since the relevant variables should be systematically evaluated (qualitative phase) before they can be adequately tested (quantitative phase). Clinical evaluation of dental fear draws on information gathered about a patient's verbal (cognitive) descriptions, behavioral symptoms and physiologic reactions. Commonly used psychometric testing scales developed to differentiate fears specific to dentistry, as opposed to general anxiety syndromes, are the result of observations made in several qualitative studies that not all dental phobics have general anxiety symptoms. Examples of these and other tests are listed and described, noting that verbal and behavioral testing appear more reliable than physiologic indicators. The patient's subjective sense of improvement is deemed to be an important factor in their confidence and efficacy to deal with the threats that the dental environment can bring them.(ABSTRACT TRUNCATED AT 250 WORDS)

Dental Care↗
PubMed1978

Utilizing program requirements to your advantage.

A curriculum summary developed to assist program officials and faculty of this medical technology program in meeting the American Medical Association Committee on Allied Health Education and Accreditation requirements as enumerated in the Essentials of an Accredited Educational Program for the Medical Technologist is described. After developing this curriculum summary, the faculty and program officials reaped unanticipated benefits from this summary. The curriculum summary aided the faculty and program officials in assuring that there was agreement between cognitive, affective, and psychomotor terminal behavioral objectives with instructional activities and methods of student evaluation. The psychomotor terminal behavioral objectives were modified and utilized as the basis for criterion-referenced, pass/fail laboratory practicals. Finally, the curriculum summary provided a rapid means of review for the curriculum review committee.

Accreditation↗
PubMed2001

Evaluating informatics applications--some alternative approaches: theory, social interactionism, and call for methodological pluralism.

A review of evaluation literature concerning CDSSs indicates that randomized controlled clinical trials (RCTs) are the 'gold standard' for evaluation. While this approach is excellent for studying system or clinical performance, it is not well suited to answering questions concerning whether systems will be used or how they will be used. Because lack of use of CDSS has been of concern for some years, other evaluation research designs are needed to address those issues. This paper critiques RCT and experimental evaluation approaches and presents alternative approaches to evaluation that address questions outside the scope of the usual RCT and experimental designs. A wide range of literature is summarized to illustrate the value of evaluations that take into account social, organizational, professional, and other contextual considerations. Many of these studies go beyond the usual measures of systems performance or physicians' behavior by focusing on 'fit' of the system with other aspects of professional and organizational life. Because there is little explicit theory that informs many evaluations, the paper then reviews CDSS evaluations informed by social science theories. Lastly, it proposes a theoretical social science base of social interactionism. An example of such an approach is given. It involves a CDSS in psychiatry and is based on Kaplan's 4Cs, which focus on communication, control, care, and context. Although the example is a CDSS, the evaluation approach also is useful for clinical guideline implementation and other medical informatics applications. Similarly, although the discussion is about social interactionism, the more important point is the need to broaden evaluation through a variety of methods and approaches that investigate social, cultural, organizational, cognitive, and other contextual concerns. Methodological pluralism and a variety of research questions can increase understanding of many influences concerning informatics applications development and deployment.

Attitude↗
PubMed2006

The foundations of psychological understanding.

In this paper, I review some recent submissions to Developmental Science that advance our understanding of psychological development. More and more submissions to the journal explore the origins of knowledge and, for psychological knowledge, such origins are multiple. Here I consider the contribution of mechanisms such as contingency detection, gaze following and gaze monitoring, social referencing and joint attention to emergent psychological understanding. I also consider infant understanding of goal-directed action, and the intimate connection between language acquisition and psychological development. The centrality of intention-reading skills to both language and social cognition is highlighted.

Attention↗
PubMed2003

Abstraction and art.

In a given social context, artistic creation comprises a set of processes, which relate to the activity of the artist and the activity of the spectator. Through these processes we see and understand that the world is vaster than it is said to be. Artistic processes are mediated experiences that open up the world. A successful work of art expresses a reality beyond actual reality: it suggests an unknown world using the means and the signs of the known world. Artistic practices incorporate the means of creation developed by science and technology and change forms as they change. Artists and the public follow different processes of abstraction at different levels, in the definition of the means of creation, of representation and of perception of a work of art. This paper examines how the processes of abstraction are used within the framework of the visual arts and abstract painting, which appeared during a period of growing importance for the processes of abstraction in science and technology, at the beginning of the twentieth century. The development of digital platforms and new man-machine interfaces allow multimedia creations. This is performed under the constraint of phases of multidisciplinary conceptualization using generic representation languages, which tend to abolish traditional frontiers between the arts: visual arts, drama, dance and music.

Art↗
PubMed2000

Sleep and health: research and clinical perspectives.

Overall, the Workshop covered most of the principal areas which will be the focus of the Worldwide Project on Sleep and Health. Presentations ranged from the basic science of melatonin receptors to the epidemiology of untreated insomnia, and finally, to the education of primary care physicians. It was emphasized that there is a need for more data, and new experimental paradigms are necessary for successful public health initiatives dealing with sleep disorders.

Circadian Rhythm↗
PubMed1996

Environmental factors and nutritional status of rural children.

The nutritional status of school-aged children is a growing concern of health care professionals today. In collaboration with a Kellogg Project in the deep south, students from a large university school of nursing participated in a project to improve the nutritional status of rural school-aged children. The project goals focused on educating thd children about the U.S. Department of Agriculture (USDA) Food Guide Pyramid, reading nutritional labels and recognizing foods with high fat content, and the importance of exercise along with diet. The nursing students created a nutritional assessment tool to use with each child to determine their educational needs. The project involved lecture, interactive class discussion, and hands-on activities. Information from the assessment tool revealed that fast food and foods high in fat were the most popular with the children. After project completion, the posttest revealed an increase in cognitive knowledge of nutrition among all the children. In addition to this positive learning experience for the children, improving the health status of children in the community was an excellent educational opportunity for the nursing students.

Child↗
PubMed1992

The Language Research Center's Computerized Test System for environmental enrichment and psychological assessment.

In the spring of 1987, we undertook to provide environmental enrichment to nonhuman primate subjects in ways that would complement and even contribute to the bio-behaviorial science that justified the monkeys' captivity. Of course, the psychological well-being of captive primates--and indeed all research species-- has been an area of intense research activity since the 1985 amendment of the Animal Welfare Act. This mandate for researchers to ensure the psychological, as well as physical, fitness of experimental animals catalyzed the humane and scientific interests of the research community. The contemporary literature is replete with proposed means both of assaying and of providing enrichment and well-being. Notwithstanding, consensus on either assessment or intervention has yet to be reached. The paradigm we employed was modelled after successful efforts with chimpanzees. An automated test system was constructed in which subjects responded to computer tasks by manipulating a joystick. The tasks, interactive game-like versions of many of the classic testing paradigms of cognitive and comparative psychology, permitted the controlled presentation of stimuli and demands without the required presence of a human experimenter. Despite significant barriers to the success, rhesus monkeys (Macaca mulatta) and a variety of other primate species (including, of course, humans) have mastered the skills necessary for testing in this paradigm. Previous experiments have illustrated the utility of the test system for addressing questions of learning, memory, attention, perception, and motivation. Additional data have been reported to support the contention that the Language Research Center's Computerized Test System (LRC-CTS) serves its other raison d'etre--providing environmental enrichment and assessing psychological well-being. This paper is designed to augment previous descriptions of the technology and the paradigm for scientists and caretakers interested in environmental enrichment and performance assessment with primates.

Animal Welfare↗
PubMedDate not supplied

Ondansetron for reduction of drinking among biologically predisposed alcoholic patients: A randomized controlled trial.

CONTEXT: Early-onset alcoholism differs from late-onset alcoholism by its association with greater serotonergic abnormality and antisocial behaviors. Thus, individuals with early-onset alcoholism may be responsive to treatment with a selective serotonergic agent. OBJECTIVE: To test the hypothesis that drinking outcomes associated with early vs late-onset alcoholism are differentially improved by the selective 5-HT(3) (serotonin) antagonist ondansetron. DESIGN: Double-blind, randomized, placebo-controlled clinical trial. SETTINGS: University of Texas Health Science Center in Houston (April 1995-June 1998) and University of Texas Health Science Center in San Antonio (July 1998-December 1999). PARTICIPANTS: A total of 321 patients with diagnosed alcoholism (mean age, 40.6 years; 70.5% male; 78.6% white) were enrolled, 271 of whom proceeded to randomization. INTERVENTIONS: After 1 lead-in week of single-blind placebo, patients were randomly assigned to receive 11 weeks of treatment with ondansetron, 1 microg/kg (n = 67), 4 microg/kg (n = 77), or 16 microg/kg (n = 71) twice per day; or identical placebo (n = 56). All patients also participated in weekly standardized group cognitive behavioral therapy. MAIN OUTCOME MEASURES: Self-reported alcohol consumption (drinks per day, drinks per drinking day, percentage of days abstinent, and total days abstinent per study week); and plasma carbohydrate deficient transferrin (CDT) level, an objective and sensitive marker of transient alcohol consumption. RESULTS: Patients with early-onset alcoholism who received ondansetron (1, 4, and 16 microg/kg twice per day) compared with those who were administered placebo, had fewer drinks per day (1.89, 1.56, and 1.87 vs 3.30; P =.03, P =.01, and P =.02, respectively) and drinks per drinking day (4.75, 4.28, and 5.18 vs 6.90; P =.03, P =.004, and P =.03, respectively). Ondansetron, 4 microg/kg twice per day, was superior to placebo in increasing percentage of days abstinent (70.10 vs 50.20; P =.02) and total days abstinent per study week (6.74 vs 5.92; P =.03). Among patients with early-onset alcoholism, there was a significant difference in the mean log CDT ratio between those who received ondansetron (1 and 4 microg/kg twice per day) compared with those who received the placebo (-0.17 and -0.19 vs 0.12; P =.03 and P =.01, respectively). CONCLUSION: Our results suggest that ondansetron (particularly the 4 microg/kg twice per day dosage) is an effective treatment for patients with early-onset alcoholism, presumably by ameliorating an underlying serotonergic abnormality. JAMA. 2000;284:963-971

Adult↗
PubMed1991

Cholinergic mechanisms in learning, memory and dementia: a review of recent evidence.

The discovery in the late 1970s that cholinergic neurons in the basal forebrain degenerate in Alzheimer's disease (AD) greatly accelerated research on the role of cholinergic mechanisms in learning and memory. As is often the case in science, the early enthusiasm for the cholinergic hypothesis has been tempered by the results of subsequent research. Although there is substantial pharmacological evidence that unspecified cholinergic systems in the brain play important roles in some forms of learning and memory, recent findings in humans indicate that antimuscarinic drugs do not model the deficits seen in AD. In addition, the goal of elucidating the functions of these basal forebrain neurons in animals has proved to be difficult and is yet to be achieved. Despite substantial effort, therefore, the cognitive and behavioral consequences of cholinergic pathology in AD remain unknown. Under these circumstances, attempts to develop cholinergic pharmacotherapies for these deficits in AD are based on questionable assumptions.

Animals↗
PubMed2005

Lesbian families and family functioning: an overview.

OBJECTIVES: In the last 30 years a growing body of studies on lesbian parents and the development of children has been published. METHODS: Four computerized databases were identified studies for inclusion in this review of research on lesbian families, namely PsychInfo, Educational Resources Information Centre (ERIC), Medline, and the Social Sciences Citation Index. RESULTS: Forty-four empirical studies on lesbian families published between 1978 and 2003 were reviewed. In the research on lesbian families two phases were identified. To begin with, systematic studies on lesbian families focused on lesbian families with children who were born in a previous heterosexual relationship. More recently, studies included lesbian families whose children were born to the lesbian couple (planned lesbian families). In both phases, articles reporting results on children's development (such as sexual identity, emotional/behavioral development, social relationships and cognitive functioning), and parental functioning (such as mental psychological health and parenting skills). This paper presents and discusses major finding of the reviewed articles. CONCLUSION: Studies in both phases have emphasized that lesbian and heterosexual families are very much alike. However, it is the stigma of lesbianism that makes the family situation of lesbian families different. PRACTICE IMPLICATIONS: Healthcare workers should be informed about the similarities and differences between lesbian families and heterosexual families, and about the non-traditional family situation of planned lesbian families.

Adaptation, Psychological↗
PubMed2001

The role of perceptual load in neglect: rejection of ipsilesional distractors is facilitated with higher central load.

Neglect is known to produce a bias towards the ipsilesional side. Here we examined whether this bias is automatic or can be modulated by manipulating perceptual load in a relevant task [e.g., Lavie, N. (1995). Perceptual load as a necessary condition for selective attention. Journal of Experimental Psychology: Human Perception and Performance, 21, 451-468]. Three patients with left neglect and three healthy controls made speeded choice responses to a target letter in the center of the display while attempting to ignore an irrelevant distractor presented on left or right. Perceptual load was manipulated by inducing a search for the target that appeared with another central stimulus, which was either a blob (low load) or a nontarget letter (higher load). Response competition effects from ipsilesional distractors were significantly reduced by higher load. The same increase of load, however, did not decrease distractor effects in the control group, as expected [e.g., Lavie, N., & Cox, S. (1997). On the efficiency of attentional selection: Efficient visual search results in inefficient rejection of distraction. Psychological Science, 8, 395-398]. These results demonstrate that ipsilesional bias in neglect is not fully automated and emphasize an additional restriction of perceptual capacity. Moreover, they supported our prediction that reduced perceptual capacity in neglect can lead to improved distractor rejection with just small increases in perceptual load.

Aged↗
PubMed2004

Research implications of science-informed, value-based decision making.

In 'Hard' science, scientists correctly operate as the 'guardians of certainty', using hypothesis testing formulations and value judgements about error rates and time discounting that make classical inferential methods appropriate. But these methods can neither generate most of the inputs needed by decision makers in their time frame, nor generate them in a form that allows them to be integrated into the decision in an analytically coherent and transparent way. The need for transparent accountability in public decision making under uncertainty and value conflict means the analytical coherence provided by the stochastic Bayesian decision analytic approach, drawing on the outputs of Bayesian science, is needed. If scientific researchers are to play the role they should be playing in informing value-based decision making, they need to see themselves also as 'guardians of uncertainty', ensuring that the best possible current posterior distributions on relevant parameters are made available for decision making, irrespective of the state of the certainty-seeking research. The paper distinguishes the actors employing different technologies in terms of the focus of the technology (knowledge, values, choice); the 'home base' mode of their activity on the cognitive continuum of varying analysis-to-intuition ratios; and the underlying value judgements of the activity (especially error loss functions and time discount rates). Those who propose any principle of decision making other than the banal 'Best Principle', including the 'Precautionary Principle', are properly interpreted as advocates seeking to have their own value judgements and preferences regarding mode location apply. The task for accountable decision makers, and their supporting technologists, is to determine the best course of action under the universal conditions of uncertainty and value difference/conflict.

Bayes Theorem↗
PubMed2005

Behavioral and social interventions for individuals with traumatic brain injury: a summary of the research with clinical implications.

Specialists in communication disorders who work with individuals who have traumatic brain injury (TBI) often focus their rehabilitative efforts on the cognitive, social, and behavioral dimensions of disability. These domains of functioning are included in the scope of practice of the American Speech-Language and Hearing Association because of their close associations with communication effectiveness. This article summarizes relevant research findings and clinical perspectives in the areas of intervention for disorders of behavioral self-regulation and social-interactive competence after TBI. This clinical summary is associated with a systematic evidence review sponsored by the TBI Practice Guidelines Group of the Academy of Neurologic Communication Disorders and Sciences (ANCDS).

Behavior Therapy↗
PubMed2006

Practitioner review: Psychosocial interventions for children with selective mutism: a critical evaluation of the literature from 1990-2005.

BACKGROUND: There have been several reports of successful psychosocial interventions for children with selective mutism (SM), a disorder in which a child consistently fails to speak in one or more social settings (e.g., school) despite speaking normally in other settings (e.g., home). The present literature review was undertaken in order to provide an up-to-date summary and critique of the SM treatment literature published in the past fifteen years. METHODS: PubMed, PsycINFO, and Web of Science databases were searched to identify SM treatment studies published in peer-reviewed journals between 1990 and 2005. RESULTS: A total of 23 studies were included in the present review. Of these, ten used a behavioral/cognitive behavioral approach, one used a behavioral language training approach, one used a family systems approach, five used a psychodynamic approach, and six used multimodal approaches to SM treatment. CONCLUSIONS: Although much of this literature is limited by methodological weaknesses, the existing research provides support for the use of behavioral and cognitive-behavioral interventions. Multimodal treatments also appear promising, but the essential components of these interventions have yet to be established. An outline of a cognitive-behavioral treatment package for a typical SM child is provided and the review concludes with suggestions for future research.

Adolescent↗
PubMed2001

Desloratadine: A preclinical and clinical overview.

A new competitive histamine H(1)-receptor antagonist with superior binding affinity at this receptor as compared with other common antihistamines, desloratadine is the active metabolite of loratadine, the most extensively used agent of this class. Under development for the treatment of allergic rhinitis and urticaria and currently awaiting regulatory approval in the United States, desloratadine was recently approved and became commercially available in Europe for the treatment of allergic disease. Desloratadine is at least 50-fold more potent in vitro and appears to be 10-fold more potent in vivo than loratadine. The new antihistamine is metabolized to 3-hydroxydesloratadine, which retains biological activity. Absorption of orally administered desloratadine is dose proportional, and desloratadine achieves steady-state concentrations after approximately 5 doses with once-daily administration. This is consistent with mean half-life values of 24-27 h and a 24-h dosing interval. The absorption of desloratadine is not affected by food and there are no clinically relevant drug-drug interactions. In randomized, double-blind, placebo-controlled clinical trials, a single 5 mg dose of desloratadine conferred significant relief of seasonal allergic rhinitis (SAR) symptoms - including the complaint of nasal congestion - within hours of the first dose, and these effects were sustained both for the entire 24-h dosing interval and up to 2-4 weeks with once-daily treatment (5 mg/day). In addition, patients with seasonal exacerbations of mild to moderate asthma derived similar clinical benefits from desloratadine, with significant, first-dose relief of both SAR-related complaints such as nasal congestion as well as asthma symptoms. In addition, beta(2) agonist requirements for symptom management were significantly reduced from baseline in these asthma patients when treated with the 5 mg/day desloratadine regimen as compared with placebo. Also experiencing marked relief of symptoms upon treatment with desloratadine were patients with chronic idiopathic urticaria, who exhibited significant first-dose relief of pruritus and sustained reductions in this symptom, numbers of lesions (and size of largest hive) and sleep disturbances, with a marked improvement in their ability to carry out activities of daily living. The clinical benefits of desloratadine in the above clinical settings were accompanied by general improvements in quality of life. Desloratadine does not cross the blood-brain barrier, as demonstrated by both human studies using cognitive indices as well as work in animal models. Desloratadine is well tolerated, and no significant drug-related (or food-related) adverse effects were noted when the agent was administered together with cytochrome P450 inhibitors (e.g., ketoconazole, erythromycin). Administration of desloratadine has not been shown to cause any significant changes in cardiac activity at therapeutic doses, even at 9-fold higher doses, or in the presence of P450 inhibitors. Nor does administration of desloratadine lead to sedation, even in the presence of alcohol. (c) 2001 Prous Science. All rights reserved.

Journal Article↗