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Biomedical subjects

C M Brooks

Publications and source records attributed to C M Brooks.

116 records · Page 7Linked to original sources
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Patterns of reflex action, their autonomic components, and their behavioral significance.

This is a discussion of the evidence that autonomic system reflexes are invariably triggered by stimuli that evoke both simple and complex somatic reflexes. Stimuli not only initiate reverberatory activity but sequences of reinforcements from higher centers. Reflexes come in chains, one reaction triggering another. Reflex actions are patterned, and these patterns are appropriate to the behavioral requirement indicated by stimuli. Reciprocal action produces a powerful braking or stimulatory action. Coactivation or synergic action of autonomic "antagonists" also occurs and can effect a greater cardiac output in certain vascular reflexes that can sympathetic action alone. Coactivation of vagus and sympathetic fibers occurring in reflex action or resulting from stimulation of specific areas in the hypothalamus has a physiologic importance to attainment of maximal cardiac function. Finally, two additional suggestions are made: (1) that the rhythmic reflex feedback discharge of the vagus from the baroreceptors aids in maintaining the regularity of cardiac rhythm as by interaction of oscillators and (2) that the autonomic system, due to its early and often conditioned response, can be determinative as well as modulatory and supportive of behavior.

Animals↗
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I. P. Pavlov and W. B. Cannon: founders of modern physiological thought relative to behavior and the autonomic nervous system.

It was almost a half century ago that I last attended an International Congress in Moscow and Leningrad--the IUPS Congress of 1935. My wife and I traveled far and saw the majesty of this land and its peoples. Here I met the great Pavlov and heard him present his thoughts concerning the conditioning of behavior. Cannon presented his concepts of transmitters and receptors. There were many other famous physiologists present, A. V. Hill and Lord Adrian; Kato of Japan demonstrated single nerve fiber studies. Someone talked of conditioned diuresis; I read a paper on hypothalamic control of the hypophysis. That was the dawn of neuroendocrinology, studies of hypothalamic function, sensory receptors, and the transmitter-receptor era. It was, like now, a time of great scientific endeavor, but there were clouds in the sky--Stalin and Hitler were coming to power, but the U.S.S.R. and America were friends, and in science it is still so. I wonder what some young man here will be able to report 50 years from now.

Autonomic Nervous System↗
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Newer concepts of the autonomic system's role derived from reductionist and behavioral studies of various animal species.

The evolution of newer concepts, many from old precursors, are elaborated. Among the bases for new thought has been the realization that all body tissues receive autonomic innervation and that this system affects all functions. It is involved in the minutia or reactions studied by their reductionists and in activity of the total organism studied by behaviorists. Newer knowledge suggests that the system's functions can be subdivided into 2 major categories: (1) a role in basic metabolic or vegetative functions. There are 3 realms of such involvement: in energy storage and release; in control of endocrine and neuroendocrine secretions; and in control of exocrine secretion and thus intake, conservation or loss and transformation of energy. The hypothalamus is most highly involved in these autonomic system functions; (2) a role in behavior. The hypothalamus is also highly involved, especially in alerting and defense reactions, concepts relating to Cannon's ideas of emergency function and Selye's concepts of stress. It can be said that the normal, phasic functions of the autonomic system and its involvement in organ and body reactivity are controlled in parallel with the regulation of somatic performances. The several newer interpretative ideas originating from studies of reflexes, reflex patterns and sequences, and of general behavior are the integrative role, the supportive role, the modulatory and finally the anticipatory or determinative role in behavior. The similarity of the role of the autonomic nervous system function in all species, from birds to man, has caught the attention of investigators. This rather than the specializations of the system that are appropriate to the peculiar characteristics of individual species has been emphasized; but species specializations do exist and these should be worthy of future investigation. New concepts of the system's role are evolving from old ideas and new discoveries. Newer concepts of transmitter genesis and tissue receptors are developing that add more detail to our major channels of thought concerning the autonomic system's function. There is a new realization of the system's involvement in pain. Its' directives affect and integrate organ and tissue activity; it determines behavior and expresses the sympathy and judgements of man.

Aging↗
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Subjective symptomatology of asthma in an outpatient population.

Characteristics of subjective symptomatology of asthma were examined within a group of 132 adult asthma patients receiving medical care in a university-based, ambulatory clinic setting. Patients responded to 36 symptom descriptions or adjectives associated with asthma which were included in a modified version of the Asthma Symptoms Checklist (ASC). A principal components exploratory factor analysis was conducted and five factors were identified. The five factors measured 1) panic-fear, 2) airways obstruction, 3) hyperventilation, 4) fatigue, and 5) irritability. Psychometric properties of the factor scores were satisfactory. The reliabilities were high, standard deviations were large, and differences in factor mean scores conformed to clinical experience. Correlational analyses support the construct validity of the ASC, especially the panic-fear factor. An important outcome of this study was to verify the ASC factor structure in an outpatient setting. The ASC was confirmed as a valuable instrument for use in self-management programs for adults with asthma. The five ASC factors represent highly stable components of subjective symptomatology of asthma among diverse adult patient populations and geographical settings.

Adaptation, Psychological↗
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Advance directives in cardiac and pulmonary rehabilitation patients.

PURPOSE: Advance directives have been available in parts of the United States for more than 20 years, but research shows that only a small percentage of adults (5-25%) have some form of written advance directive. The purose of this study was to examine the presence of advance directives among persons entering cardiac and pulmonary rehabilitation, and identify characteristics of persons most likely to have advance directives. METHODS: The sample consisted of 336 cardiac patients and 181 pulmonary patients who enrolled in the University of Alabama at Birmingham's Cardiopulmonary Rehabilitation Program between January 1996 and December 1999. As part of the initial program assessment, patients were asked two questions: (1) Do you have a living will? (2) Do you have any advance directives? For the purposes of this study, the two questions were combined to examine the presence of either a living will or other type of advance directive. RESULTS: Results indicate that 25% of both subgroups (cardiac and pulmonary patients) report having written advance directives. Logistic regression analysis indicates that among cardiac patients whites and older persons were more likely to have advance directives. Among pulmonary patients, females and whites were more likely to have advance directives. CONCLUSIONS: These results indicate that only a minority of cardiopulmonary rehabilitation patients have advance directives upon entry into the program, and that the prevalence differs among gender, racial, and age groups. Cardiac and pulmonary rehabilitation programs may be valuable sites for educating patients about advance directives and efforts by rehabilitation personnel may increase the prevalence of advance directives among patients.

Adult↗
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Nutrition education for medical students: evaluation of the relative contribution of freshman courses in biochemistry and nutrition to performance on a standardized examination in nutrition.

An examination previously developed and used for assessment of nutrition knowledge of medical students in the Southeastern Regional Medical-Nutrition Education Network was used to compare the effectiveness of a basic medical biochemistry course and a 58-hour required nutrition course. The examination was administered to a cohort of freshman students upon entry to medical school, after biochemistry, and then after nutrition. Two other student groups took the examination at the end of the sophomore and senior years, respectively. In the freshman cohort, mean nutrition knowledge scores increased slightly after biochemistry, (52% to 56%), which contained 37 nutrition-related lectures. The mean score of the cohort was 75% after the nutrition course. The sophomores scored 75% and the seniors 73%. These findings suggest 1) basic science courses such as biochemistry cannot be relied upon to add significantly to nutrition knowledge, and 2) a required freshman course can be an effective way to introduce basic and clinical nutrition with good retention of knowledge in subsequent years.

Biochemistry↗