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The impact of learning of a genetic predisposition to nicotine dependence: an analogue study.

OBJECTIVES: To examine the consequences of informing smokers of a genetic predisposition to nicotine dependence and of providing treatment efficacy information tailored to genetic status. DESIGN: Analogue study using four vignettes; 2 (genetic status) x 2 (whether treatment efficacy information provided) between subjects design. PARTICIPANTS: 269 British adult smokers. OUTCOME MEASURES: Preferred cessation methods and perceived control over quitting. RESULTS: Gene positive participants were significantly more likely to choose the cessation method described as effective for their genetic status, but significantly less likely to choose to use their own willpower. Providing tailored treatment information did not alter these effects. Perceived control was not significantly affected by either genetic status or information provision. CONCLUSIONS: Learning of a genetic predisposition to nicotine dependence may increase desire for effective cessation methods, but may undermine the perceived importance of willpower in stopping smoking.

Adult↗

Word learning is 'smart': evidence that conceptual information affects preschoolers' extension of novel words.

We examined electrophysiological correlates of conscious change detection versus change blindness for equivalent displays. Observers had to detect any changes, across a visual interruption, between a pair of successive displays. Each display comprised grey circles on a background of alternate black and white stripes. Foreground changes arose when light-grey circles turned dark-grey and vice-versa. Physically stronger background changes arose when all black stripes turned white and vice-versa. Despite their physical strength, background changes were undetected unless attention was directed to them, whereas foreground changes were invariably seen. Event-related potentials revealed that the P300 component was suppressed for unseen background changes, as compared with the same changes when seen. This effect arose first over frontal sites, and then spread to parietal sites. These results extend recent fMRI findings that fronto-parietal activation is associated with conscious visual change detection, to reveal the timing of these neural correlates.

Analysis of Variance↗

Spatial learning in transgenic mice expressing human presenilin 1 (PS1) transgenes.

Dominant mutations in the Presenilin 1 gene are linked to an aggressive, early-onset form of familial Alzheimer's Disease (FAD). Spatial memory of transgenic (Tg) mice expressing either mutant (lines Tg(M146L)1, Tg(M146L)76, Tg(L286V)198) or wild type (line Tg(PS1wt)195) human PS1 transgenes was investigated in the Morris water maze (WM) test at 6 and 9 months of age. The results showed that the mutated Tg mice had increased swim speed when compared to non-Tg littermates or Tg PS1 wild type mice. The swim speed difference did not, however, significantly affect the spatial learning in the WM test and all groups showed comparable search paths during training and similar spatial bias during probe trials. When re-tested at 9 months, all mice showed significantly improved learning acquisition of spatial information. The lack of progressive spatial learning impairment in mice expressing the mutated human PS1 transgene in the WM does not preclude impairments in other cognitive tasks but suggests that full phenotypic expression of mutant PS1 alleles may require co-expression of human versions of other AD-associated genes.

Alzheimer Disease↗

Functional brain networks in Parkinson's disease.

With the advent of new methods of network analysis, we have utilized metabolic data acquired through positron emission tomography (PET) to identify disease-related patterns of functional pathology in the movement disorders. In Parkinson's disease (PD), we have used [(18)F]-fluorodeoxyglucose (FDG)/PET to identify a disease-related regional metabolic covariance pattern characterized by lentiform and thalamic hypermetabolism associated with regional metabolic decrements in the lateral premotor cortex, the supplementary motor area, the dorsolateral prefrontal cortex, and the parieto-occipital association regions. The expression of this network is modulated in a predictable fashion by levodopa therapy and by stereotaxic interventions for PD.We have extended this network analytical approach from studies of glucose metabolism in the resting state to dynamic studies of brain activation during motor performance. These PET studies utilized [(15)O]-water (H(2) (15)O) to measure cerebral blood flow activation responses during the execution of simple and complex motor tasks. In addition to the modulation of abnormal resting metabolic networks, effective PD therapy can enhance brain activation responses during motor execution, with specific regional associations with improvements in timing and spatial accuracy.This approach is also useful in identifying specific brain networks mediating the learning of sequential information. We have found that the normal relationship between brain networks and learning performance are altered in the earliest stages of PD with a functional shift from striatal to cortical processing. Brain activation PET studies during therapeutic interventions for PD demonstrate how normal brain-behavior relationships can be restored with successful therapy. Thus, functional brain imaging with network analysis can provide insights into the mechanistic basis of basal ganglia disorders and their treatment.

Antiparkinson Agents↗

Executive control of learning and memory in children with bilateral spastic cerebral palsy.

Executive control of learning and memory was examined in children with bilateral spastic cerebral palsy (SCP). We hypothesized that SCP-related brain damage would disrupt executive but not associative aspects of learning and memory. To test this hypothesis, the California Verbal Learning Test-Children's Version was administered to 16 children with bilateral SCP and 19 control children ranging from 6 to 18 years of age. Controlling for general verbal ability, the groups did not differ in initial learning and retention of information over time, suggesting that associative learning and memory processes subserved by medial temporal brain regions were relatively intact in children with SCP. In contrast, impairments in learning over repeated trials, strategic processing, and inhibition in the SCP group pointed to disruptions in prefrontally-mediated executive aspects of learning and memory. The inhibitory deficit was more pronounced in younger children with SCP, suggesting a developmental delay in this ability.

Adolescent↗

Adding new information to semantic memory: how much learning is enough to produce automatic priming?

A series of experiments investigated the integration of new vocabulary words into semantic memory and the creation of new associations between preexisting, but previously unrelated, words. The ability of the newly learned vocabulary words and associations to facilitate lexical decisions when serving as primes under conditions associated with automatic processing was used to index integration. The results indicate that very extensive study is necessary for such integration to occur and that it is easier to add a new word to semantic memory than to establish a link between two formerly unconnected words already in semantic memory. The implications of these results for models of semantic memory and the episodic/semantic distinction are considered.

Adult↗

Using numerosity judgments to determine what is learned during automatization.

An important question in learning is the nature of the information required to support skilled, or automatic, performance. In 2 experiments, participants counted patterns of 8-10 objects displayed on a computer screen for 4 sessions of 240 trials each before being transferred to a different set of patterns for a final session of 240 trials. The patterns in the final session differed from those seen in the 4 training sessions in either overall configuration (Experiment 1) or identity of constituents (Experiment 2). Results indicated that both types of information are important in learning and automatization of a counting task and support the idea that what is attended to during training will be necessary to support subsequent automatic performance.

Automatism↗

[Three years of vertical networking in the German Network of Competence on Viral Hepatitis: what can we learn from the usage of different information tools?].

Treatment of patients with viral hepatitis is time-consuming and sometimes complicated. Several sources of information have been established as internet sites, however systematic analyses of the need and use of these information platforms are lacking. The Competence Network on Viral Hepatitis (Hep-Net) was established in 2002 and offers a telephone hotline, an e-mail service and a home page with frequently asked questions (FAQs). On the internet pages "FAQs" 38 125 hits have been registered on single "question-answer-units" within three years. In a half of the cases the question are associated with modes of transmission. In contrast, patient's questions in e-mail and the telephone hotline are mainly dealing with the treatment of hepatitis C. More than 46 % of the physician's questions referred to unclearness in indications for treatment. Questions on specific medical problems of individual patients and, in e-mail, also on legal issues played a major part. Many of these questions have not been addressed in the actual guidelines in Germany. In summary, the Hep-Net vertical networking tools represent a fast, quality-assured endorsement to the daily management of patients with viral hepatitis. The combination of internet, e-mail service and telephone hotline gives consideration to individual necessities of patients and physicians. However, the detailed analysis of usage also shows limitations of current guidelines which should be considered during updating.

Community Networks↗

A dynamic model of poliomyelitis outbreaks: learning from the past to help inform the future.

Policy-makers now face important questions regarding the tradeoffs among different strategies for managing poliomyelitis risks after they succeed with polio eradication. To estimate the potential consequences of reintroductions of polioviruses and the resulting outbreaks, the authors developed a dynamic disease transmission model that can simulate many aspects of outbreaks for different posteradication conditions. In this paper, the authors identify the issues related to prospective modeling of future outbreaks using such a model, including the reality that accurate prediction of conditions and associated model inputs prior to future outbreaks remains challenging. The authors explored the model's behavior in the context of three recent outbreaks resulting from importation of poliovirus into previously polio-free countries and found that the model reproduced reported data on the incidence of cases. The authors expect that this model can provide important insights into the dynamics of future potential poliomyelitis outbreaks and in this way serve as a useful tool for risk assessment.

Adolescent↗

Cognitive and learning styles in medical education.

In this paper, the author describes the three types of styles (affective, learning, and cognitive) that play roles in education and outlines the history of cognitive- and learning-style research. She then explores the range of ways learning styles can be applied in medical education, including ways to use information about students' learning styles to help them cope with the challenges of content mastery and professional socialization; to offer assistance to students coping poorly with the demands of medical education; and to shape efforts to recruit students from underrepresented racial and cultural groups.

Cognition↗

Cognitive function in adult cardiothoracic transplant candidates and recipients.

Innovative surgical and medical techniques have prolonged the life span of cardiothoracic (CT) transplant recipients and made transplantation an option for many older patients. Cognitive function is a key determinant of the CT transplant recipient's ability to manage the complex treatment regimen and experience optimum benefit of the procedure. As the CT population ages, risk of cognitive dysfunction due to normal aging is compounded by the physical and mental changes associated with end-stage organ disease, comorbid conditions, and transplant-related complications. Cognitive abilities consist of (a) receptive functions (ability to select, acquire, classify, and integrate information); (b) memory and learning (ability to store and retrieve information); (c) thinking (ability to mentally organize and reorganize information; and (d) expressive functions (ability to communicate or act upon information). Although each of these functions represents a distinct type of behavior, they are interdependent. The purpose of this article is to (a) discuss the literature regarding cognitive function before and after adult heart, lung, and heart-lung transplantation; (b) identify methodological problems associated with the studies done to date; and (c) make recommendations for future research in this area.

Adaptation, Psychological↗

Content areas for cardiac teaching: patients' perceptions of the importance of teaching content after myocardial infarction.

This descriptive study was undertaken to investigate patients' perceptions of the seven content areas commonly included in cardiac teaching in terms of how important and how realistic they were for being learned following the experience of an acute myocardial infarction (MI). Lazarus's stress-coping theory was used as a framework for the study. A sample of 30 MI subjects were interviewed before discharge and during early convalescence. Before discharge, subjects rated six out of the seven content areas as "important" for learning. Although the information was considered important, it was not rated as equally realistic to learn. During early convalescence, mean scores under 'important to learn' were slightly lower, but all seven content areas were rated as significantly more realistic to be learned (P less than 0.05). Little variation in patients' perceptions of the importance of teaching content was noted over time. However, there was major variation between their perceptions of how important and how realistic it was to learn the material before discharge. Both dimensions, how important and how realistic, are therefore crucial to consider in cardiac teaching.

Adult↗