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PubMed2002

Child labour a reality: results from a study of a squatter settlement of Karachi.

INTRODUCTION: Pakistan's exports have suffered heavy losses due to its denunciation for use of children in the industry on the premise that it destroys their childhood and desires for progress. The international community has not realized the root cause of child employment and imposed harsh economic sanctions that have harmed Pakistan's economy leading to further deterioration of health and well being of these unprivileged children. OBJECTIVES: To identify the reasons behind child labour and to asses the occupational, health and related problems faced by the working children. METHODS: This study was done in a section of a squatter settlement Bhutta village near the seaport called Accora with a population of 10000 (approx.). It was a cross-sectional study using a structured questionnaire with questions regarding occupation, eating habits, health, hopes and aspirations. Respondents were 150 male working children permanent residents of Bhutta Village (Accora) selected by systematic sampling. RESULTS: The children were between the ages of 12-14 years (mean = 13.91 yrs). The average family size of these children was 7.4 members and the average family income was Pak Rupees 2,884/month. Fifty seven percent said they get no time to rest whereas the remaining got half to one hour of rest during the day. The usual foods consumed included pulses (46%), vegetables (39%) and meat (15%). Eighty seven percent were not suffering from any disease at the time of interview. The children had an average income of Pak Rupees 615/month (range: 200-1200). Forty five percent were helpers in shops the rest were employed in other businesses. The reasons given for job included family support (89%), parent's pressure (5%), fond of work (4%), learning skills (1%) and self support (1%). The majority (56%) was working for more than 7 hours per-day and 79% said that they do not like to work. Majority of the children wanted to study, play, be born in another family and become doctors, engineers and officers. CONCLUSION: The children in this area were deprived and were trapped between work for family and the desire of living the life of a child with hopes dreams and aspiration for a better future. Making them jobless is only going to aggravate their health and financial problems and will not improve their social and economic status. A policy for supporting these children has to be worked out which caters to their need for financial support and at the same time provides them with learning opportunities.

Adolescent↗

PubMed1991

[Effects of tianeptine on learning and memory in mice. Improvement of impairments induced by chronic alcoholism and brain aging].

Tianeptine, a molecule with antidepressant properties, was found to affect certain learning and memory impairments induced by chronic alcoholism and aging in the mouse. Impairment in spontaneous alternation induced by chronic (12 months) alcohol intake and accelerated loss of spatial learning skills related to aging disappeared totally after administration of tianeptine (10 mg.kg-1). In certain situations (discrimination acquisitions), tianeptine was uneffective in older animals at this dosage, but had a facilitating effect in young animals. The effects of tianeptine on serotonin mediated transmission and the probable implication of hypofunctioning central cholinergic systems in the observed impairments are discussed. Tianeptine might reduce the inhibiting action of serotonin terminaisons on acetylcholine release and might thus permit normal cholinergic transmission.

Aging↗

PubMed1988

Organization of the zebra finch song control system: I. Representation of syringeal muscles in the hypoglossal nucleus.

Understanding the representation of learned skills in the brain requires that one know the neural substrate for those skills. The avian song control system uses auditory information to establish and modify motor programs, which provide patterns for the excitation of individual muscles. In the present study, a combination of neurophysiological and anatomical techniques was used to map the representation of syringeal muscles in the tracheosyringeal part of the hypoglossal nucleus of adult male zebra finches. Microstimulation revealed that control zones for individual muscles are arranged along the rostrocaudal axis of the nucleus. The ventralis and dorsalis muscles have the largest domains, located at the rostral and caudal ends of the nucleus, respectively. The retrograde tracer fluorogold was applied to the muscles and confirmed this pattern. The muscle map obtained will provide a useful tool for further study of the convergence of muscle representation and sound representation in the more central portions of the song control pathway. This knowledge is essential for understanding how learned sounds are perceived and produced.

Animals↗

PubMed2001

Praxis lateralization: errors in right and left hemisphere stroke.

Whereas the representations of skilled movements in most right handers are stored in the left hemisphere, the right hemisphere's contribution to action planning remains unclear. We investigated error patterns in left (LHD) and right hemisphere damaged (RHD) subjects as well as normal control subjects (C) to determine if specific components of action programs may be processed by the right hemisphere or bilaterally represented. We had these subjects perform gestures to verbal command with the ipsilesional limb. Although the LHD group made significantly more qualitative errors than the C and RHD groups, the RHD subjects produced a number of apraxic errors. Specifically, the LHD group produced a wide range of spatiotemporal and conceptual errors for both transitive and intransitive gestures, while the RHD group made specific spatial and temporal errors primarily when performing transitive gestures. These findings support the postulate that the left hemisphere stores the spatiotemporal and conceptual representations of learned skilled movements, while several specific components of action programs, such as external configuration (limb orientation) and timing, may have bihemispheric representations.

Aged↗

PubMed1981

A method for selecting which procedural skills should be learned by internal medicine residents.

Despite a need for better documentation of training in procedural skills in internal medicine, there is no general agreement regarding which skills should be required. This paper describes a method for selecting which procedural skills should be mastered by medicine residents. Seventy-two skills were collected from faculty suggestions, review of the literature, and hospital privilege request forms. Residents and faculty at the University of Nebraska College of Medicine were asked to select from the list those skills which should be mastered by all residents completing the three-year general internal medicine residency. At least 80 percent of the 107 respondents agreed on 30 skills that should be learned by all residents, but there was significant disagreement regarding the need for some of the skills. In a second survey, at least one-fourth of the 16 senior residents did not feel competent to perform 13 of the 30 skills, indicating areas which require scrutiny.

Clinical Competence↗

PubMed2003

Self-organizing continuous attractor networks and motor function.

Motor skill learning may involve training a neural system to automatically perform sequences of movements, with the training signals provided by a different system, used mainly during training to perform the movements, that operates under visual sensory guidance. We use a dynamical systems perspective to show how complex motor sequences could be learned by the automatic system. The network uses a continuous attractor network architecture to perform path integration on an efference copy of the motor signal to keep track of the current state, and selection of which motor cells to activate by a movement selector input where the selection depends on the current state being represented in the continuous attractor network. After training, the correct motor sequence may be selected automatically by a single movement selection signal. A feature of the model presented is the use of 'trace' learning rules which incorporate a form of temporal average of recent cell activity. This form of temporal learning underlies the ability of the networks to learn temporal sequences of behaviour. We show that the continuous attractor network models developed here are able to demonstrate the key features of motor function. That is, (i) the movement can occur at arbitrary speeds; (ii) the movement can occur with arbitrary force; (iii) the agent spends the same relative proportions of its time in each part of the motor sequence; (iv) the agent applies the same relative force in each part of the motor sequence; and (v) the actions always occur in the same sequence.

Excitatory Postsynaptic Potentials↗

PubMed1998

1997 C. H. McCloy Research Lecture: Knowledge is more than we can talk about: implicit learning in motor skill acquisition.

This article discusses the acquisition of knowledge about environmental regulatory features that guide the selection and execution of movements involved in performing open motor skills. First, empirical evidence related to the visual search characteristics of skilled and novice performers is considered to demonstrate that learning environmental regulatory features is an important part of performing an open motor skill. Then, the hypothesis is proposed and discussed that environmental regulatory features can, and probably should, be learned implicitly, which means the features can be learned and used, even though the learner is not consciously aware of the specific characteristics of those features. This article also discusses laboratory-based experiments that provide evidence supporting this hypothesis and presents implications for developing instructional strategies and practice conditions.

Humans↗

PubMed1988

Evaluation of a self-instructional method for improving doctor-patient communication.

The purpose of the project reported here was to develop and evaluate an educational intervention to improve the interviewing skills learned in medical school. Sixty fourth-year medical students in a required ambulatory care rotation were randomly selected and randomly assigned to one of four conditions. All students interviewed a simulated patient who presented with one of five main complaints, and the interview was videotaped. Students were assigned to a control group or to one of three intervention groups: viewing a self-instruction videotape, viewing and critiquing a videotape of their interview, or both of these activities. The students assigned to the control group did not participate in any educational interventions. At the end of the intervention period, the students again interviewed a simulated patient and were videotaped. The 120 videotaped interviews were reliably rated by a scoring system developed by the project team. The postintervention interviews conducted by students in the two groups that used the self-instruction videotape received significantly higher ratings than those in the control group. These results suggest that this self-instruction intervention can improve the interviewing skills of senior medical students.

Ambulatory Care↗

PubMed1985

Individual differences in the mental practice and imagery of motor skill performance.

The role of mental practice in motor skill learning is briefly reviewed, and the relationship between mental practice and imagery discussed. A case is made for the importance of considering individual differences for imagery in motor studies investigating mental practice. Studies that have examined imagery ability in the motor domain are outlined, and the reasons are addressed why a consistent relationship between imagery ability and motor performance has failed to emerge. Finally, an approach for investigating imagery ability is suggested. This approach concentrates on the inclusion and interaction of three imagery related variables: the measurement of imagery ability, the task to be performed, and the imagery instructions that are given to the subjects.

Humans↗

PubMed2006

Paretic hand in stroke: from motor cortical plasticity research to rehabilitation.

Research in neural plasticity of adult cortical representations brought hope of significant potential for further improvement in therapy after cerebrovascular stroke, but the same processes involved in plasticity also allow for maladaptive changes whether spontaneous or caused by inappropriate therapeutic manipulations. Within the extensive network of multiple and bilateral motor cortical and subcortical areas, this paper focuses on the primary motor cortex. We review selected data from humans and primates regarding its functional anatomy and the mechanisms of adaptive neuroplasticity in the presence of brain insults, and the impact of motor skill learning in normals and rehabilitation therapy in patients. The discussion centers on the potential impact of the mechanisms of motor cortex neuroplasticity, especially of the phenomenon of competition among primary motor cortical representations, on the rehabilitation of paretic hand and shoulder after stroke. Application of results from neurophysiology and functional brain imaging research into the clinical practice is in the initial stages and remains a challenge for the future. Nevertheless, even the available research provides an important message for clinical rehabilitation of stroke patients: the need to widen multimodal and interdisciplinary approaches to rehabilitation of the paretic hand.

Brain Damage, Chronic↗

PubMed1988

Peak performance and age among superathletes: track and field, swimming, baseball, tennis, and golf.

The purpose of this study is to identify the age of peak performance in a broad range of athletic events incorporating multiple, diverse biological systems, learned skills, and motivation. Although many researchers have noted that the absolute levels of peak performance among superathletes have improved dramatically in the last 100 years, to date no one has answered the question of stability of peak performance age over this time period. Analyses of Olympic track and field and swimming data show that the age at which peak performance is achieved has remained remarkably consistent. For both men and women, the age of peak performance increases with the length of the foot race, and women generally achieve peak performance at younger ages. The pattern of increased age with increasing distance is reversed for female swimmers, where younger ages are associated with increasing distance. For most categories of performance in baseball, the peak age of performance is equivalent to that of a long distance runner, about 28 years of age, while top tennis players reach their highest levels of performance at age 24. Golfers, in comparison, peak at about 31 years of age, although recent data suggest movement toward younger ages. A task analysis of each event is carried out, and the relative roles of biology and learning are discussed as determinants of peak performance.

Adolescent↗

PubMed1993

Mnestic performance profile of a bilateral diencephalic infarct patient with preserved intelligence and severe amnesic disturbances.

The case of a patient with above-average intelligence and educational background, high motivation, and an approximate IQ-MQ difference of 40 points is documented. The patient has been examined repeatedly for nearly a decade. Extensive neuroradiological material of his focal bilateral brain damage in the dorsal diencephalon is available. A widespread range of cognitive tests was used to investigate his actual performance on all relevant aspects of intelligence, attention, subjective memory, immediate retention, learning, skill and problem solving abilities, concept formation, cognitive flexibility, priming, constructional ability, retrograde memory, and long-term retention. The total of more than 50 tests included German-language forms of the revised Wechsler Memory Scale and of the Rivermead Behavioural Memory Test. The patient's short-term memory and attention were, in spite of his advanced years, average or well above average. He gave a number of examples of still intact skills and implicit memory abilities, though there was no uniformity in his performance on implicit memory tests (e.g., with respect to stored vs. new implicit information). He had no awareness of his severe anterograde and retrograde amnesia, documented over a large range of verbal and figural tests. Taken together, the results from our patient confirm the principal dichotomy between declarative and nondeclarative mnestic functions, but give evidence for some restrictions as well. They furthermore demonstrate that focal diencephalic damage may result in profound anterograde and selective retrograde amnesia, especially with respect to data-based material, and that disconnecting portions of the medial and basolateral limbic circuits has devastating consequences on memory.

Aged↗

PubMed2001

Assessment in problem-based learning: the role of the tutor.

INTRODUCTION: Problem-based learning (PBL) in medicine emphasises the tutor's role in facilitating collaborative and integrated learning. While it is widely recognised that tutors come to know their students, they traditionally play little part in the formal assessment process. We introduced tutor assessment into a problem-based medical curriculum and examined the patterns of tutor marks in four subjects, in terms of within semester consistency and their relation to other forms of assessment in the course. MATERIALS AND METHOD: Seventy-four tutors assessed 187 students twice (formative assessment in mid-semester, summative assessment at the end of semester) in each semester, using an assessment tool that focussed on communication and learning skills. Tutor marks were examined using correlations, cluster analysis and chi-square coefficients. RESULTS: There were consistent trends in the patterns of cluster membership for pairs of marks in high, average and low clusters from mid-semester formative to end-of-semester summative assessment. Cluster membership for pairs of marks was predominantly consistent. Most movement was from lower to higher clusters over the two assessments, reflecting student improvement after tutors' feedback and tutor responsiveness to feedback to them. There was little variance in the marks of different tutors. Tutor marks correlated moderately and significantly with other forms of assessment in each subject. CONCLUSION: Tutor marks contribute useful, distinctive dimensions to assessment in a problem-based medical curriculum.

Education, Medical↗

PubMed1998

Problem-based learning in a health sciences librarianship course.

Problem-based learning (PBL) has been adopted by many medical schools in North America. Because problem solving, information seeking, and lifelong learning skills are central to the PBL curriculum, health sciences librarians have been actively involved in the PBL process at these medical schools. The introduction of PBL in a library and information science curriculum may be appropriate to consider at this time. PBL techniques have been incorporated into a health sciences librarianship course at the School of Library and Information Science (LIS) at the University of Wisconsin-Milwaukee to explore the use of this method in an advanced Library and Information Science course. After completion of the course, the use of PBL has been evaluated by the students and the instructor. The modified PBL course design is presented and the perceptions of the students and the instructor are discussed.

Curriculum↗

PubMed1998

Therapeutic effects of complex motor training on motor performance deficits induced by neonatal binge-like alcohol exposure in rats . I. Behavioral results.

The effects of complex motor task learning on subsequent motor performance of adult rats exposed to alcohol on postnatal days 4 through 9 were studied. Male and female Long-Evans rats were assigned to one of three treatments: (1) alcohol exposure (AE) via artificial rearing to 4.5.g kg-1 day-1 of ethanol in a binge-like manner (two consecutive feedings), (2) gastrostomy control (GC) fed isocaloric milk formula via artificial rearing, and (3) suckling control (SC), where pups remained with lactating dams. After completion of the treatments, the pups were fostered back to lactating dams, and after weaning they were raised in standard cages (two-three animals per cage) until they were 6 months old. Rats from each of the postnatal treatments then spent 20 days in one of three conditions: (1) inactive condition (IC), (2) motor control condition (MC) (running on a flat oval track), or (3) rehabilitation condition (RC) (learning to traverse a set of 10 elevated obstacles). After that all the animals were tested on three tasks, sensitive to balance and coordination deficits (parallel bars, rope climbing and traversing a rotating rod). On parallel bars, both male and female rats demonstrated the same pattern of outcomes: AE-IC rats made significantly more mistakes (slips and falls) than IC rats from both control groups. After 20 days of training in the RC condition, there were no differences between AE and both SC and GC animals in their ability to perform on the parallel bars test. On rope climbing, female animals showed a similar pattern of abilities: AE-IC rats were the worst group; exercising did not significantly improve the AE rats' ability to climb, whereas the RC groups (SC, GC and AE) all performed near asymptote and there were no significant differences among three neonatal treatment groups. There was a substantial effect of the male rats' heavier body weight on climbing ability, and this may have prevented the deficits in AE rats behavior from being detected. Nevertheless, male animals from all three postnatal treatments (SC, GC and AE) were significantly better on this task after RC. Female and male rats from all three postnatal groups demonstrated significantly better performance on the rotarod task after 20 days of 'rehabilitation'. These results suggest that complex motor skill learning improves some of the motor performance deficits produced by postnatal exposure to alcohol and can potentially serve as a model for rehabilitative intervention.

Aging↗

PubMed1995

Psychosocial adaptation of 39 adolescents with sex chromosome abnormalities.

OBJECTIVES: Children with sex chromosome abnormalities (SCA) are known to be at increased risk for neuromotor, language, learning, and behavioral problems, but little is known of psychosocial adaptation of SCA adolescents. This study was conducted to evaluate psychologic characteristics of unselected SCA adolescents, including socialization, educational progress, separation from family, and incidence and severity of psychiatric disturbance. METHODS: Thirty-nine propositi identified through the screening of 40,000 consecutive Denver newborns, including boys with 47,XXY karyotypes and girls with 47,XXX, 45,X, and partial X monosomy, or SCA mosaic karyotypes, have been followed longitudinally into adolescence. Twenty-seven siblings served as controls. Between 12 and 19 years of age, all participated in blind psychiatric interviews and were administered standardized intelligence and achievement tests. RESULTS: SCA propositi demonstrated a mean IQ score 21 points lower than that of control subjects. In addition, lower mean scores were seen on achievement test results as well as lower overall psychosocial adaptation scores and increased incidence of psychiatric disturbance. Depression was the most frequent psychiatric diagnosis. Propositi were more likely to receive special education assistance in high school and were less likely to graduate from high school than were controls. Of the three nonmosaic propositi groups, the 47,XXX girls demonstrated the poorest overall psychosocial adaptation and highest degree of psychiatric disturbance. Mosaic girls were indistinguishable from control subjects. Marked variability was found among all three nonmosaic groups, with some individuals in each group demonstrating relatively strong psychosocial adaptation. CONCLUSIONS: The presence of nonmosaic sex chromosome abnormality increases the risk for impeded cognitive skills, learning abilities, and psychosocial adaptation in adolescence. The factors that allow for stronger adaptation in some of these adolescents include the presence of a stable and supportive family environment. The outlook for adaptation in unselected SCA adults remains uncertain.

Achievement↗

PubMed1997

Effects of aging and reduced relative frequency of knowledge of results on learning a motor skill.

Although there is evidence for age-related changes in both cognition and motor control, very little is known about the effect of age on learning of new motor skills. The present experiment addressed the interaction between aging and the role of knowledge of results (KR) on a motor learning task. Using a three-segment task on which each segment had specific timing goals, three different manipulations of relative frequency of information about performance were compared in younger and older adults. The three conditions were (a) 100% KR in which information about performance on each segment was provided after every trial, (b) 67% KR in which the performance information was faded over trials, and (c) 67% KR in which the performance information was faded over the segments within each trial. Following 90 acquisition trials, all subjects performed retention, transfer, and reacquisition tests. There were age-related differences for movement accuracy and consistency on acquisition and on the retention tests but not on the transfer test. However, none of these differences interacted with the frequency of KR manipulations. Surprisingly, there was no effect due to the fading schedules of KR. In general, these results indicated that younger and older adults use KR in a similar way to learn a motor skill.

Adult↗

PubMed2001

The patient-physician relationship. Teaching the human dimensions of care in clinical settings.

Despite repeated calls to emphasize the humanistic dimensions of care during medical education, these are few known techniques for effective teaching of humanism. We describe the barriers that inhibit humanistic teaching and suggest pragmatic teaching methods to overcome such barriers and teach humanistic care in clinical settings. We began by asking participants at a conference on patient-physician communications sponsored by the American Academy on Physician and Patient in June 1998, "What can we do in the patient's presence to improve and teach the human dimensions of care? Please provide one or more examples of approaches you found to be effective." We augmented this information with suggestions from a number of colleagues in other settings. In a series of iterations, we analyzed all their suggestions to identify key teaching methods. We found that barriers to teaching humanism largely consist of elements of the informal and hidden curricula in medical schools. We then defined methods to help teachers overcome these barriers. Specific methods fall into the 3 categories of taking advantage of seminal events, role modeling, and using active learning skills. We believe that formal courses and other well-motivated endeavors that take place away from patients fail to foster humanistic care. In contrast, we present pragmatic teaching methods that can be used in the fast-paced setting of the clinical environment.

Education, Medical↗