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PubMed2005

The descent of words: evolutionary thinking 1780-1880.

Histories of evolutionary thought are dominated by organic evolution. The colossus in our midst that is evolutionary biology casts its shadow over history, making it appear that what is so widespread and important today was always the primary subject of evolutionary speculation. Thus many histories assume that the core meaning of evolution is the change of organic life and that other forms of evolutionary thinking, such as linguistic, social or cultural evolution, are only analogies or offshoots of the main biological evolutionary trunk. Ironically this is an ahistorical understanding. Long before the work of Charles Darwin, scholars were independently developing evolutionary concepts such as descent with modification and divergence from a common stock in order to understand cultural change.

Biological Evolution↗

PubMed2005

The Drosophila type II receptor, Wishful thinking, binds BMP and myoglianin to activate multiple TGFbeta family signaling pathways.

Wishful thinking (Wit) is a Drosophila transforming growth factor-beta (TGFbeta) superfamily type II receptor most related to the mammalian bone morphogenetic protein (BMP) type II receptor, BMPRII. To better understand its function, we undertook a biochemical approach to establish the ligand binding repertoire and downstream signaling pathway. We observed that BMP4 and BMP7, bound to receptor complexes comprised of Wit and the type I receptor thickveins and saxophone to activate a BMP-like signaling pathway. Further we demonstrated that both myoglianin and its most closely related mammalian ligand, myostatin, interacted with a Wit and Baboon (Babo) type II-type I receptor complex to activate TGFbeta/activin-like signaling pathways. These results thereby demonstrate that Wit binds multiple ligands to activate both BMP and TGFbeta-like signaling pathways. Given that myoglianin is expressed in muscle and glial-derived cells, these results also suggest that Wit may mediate myoglianin-dependent signals in the nervous system.

Activin Receptors↗

PubMed2004

China's evolving health care market: how doctors feel and what they think.

This paper reports on a questionnaire survey and 12 focus groups conducted among doctors in three provinces of China, namely Guangdong, Shanxi, and Sichuan. The survey (N = 720) and focus group participants were drawn from both rural and urban areas, as well as public and private sectors, in equal numbers The aim was to gauge how Chinese doctors feel about themselves and what they think of the Chinese health care system. We found low satisfaction levels with own income (8%), job (27%), skill (30%), and other important aspects of their professional life. The health care system received only 32% approval rating. Quality of care and patient safety issues were major concerns, especially in the growing but poorly regulated private sector. The public sector came under criticism for its high fees and bad service quality. The feedback point to the need for an appropriate regulatory framework to guide the development of China's evolving health care market. A revitalized medical profession that is fully engaged in the reform process could also significantly impact the success of ongoing health care reform efforts.

Attitude of Health Personnel↗

PubMed2003

Identification of factors affecting purchasing and preparation of fruit and vegetables by stage of change for low-income African American mothers using the think-aloud method.

The objective of this study was to identify factors affecting the purchase and preparation of fruits and vegetables according to stage of change for low-income African American women with young children. The think-aloud method was used to collect verbalization data in grocery stores as women shopped (N=70) and in their homes during meal preparation (N=68). Audiotaped verbalizations were transcribed verbatim before encoding. Content analysis procedures were used to identify common themes by stage of change. Factors affecting decision making that varied by stage of change were preferences and specific needs (eg, for meals, for family members). Preferences regarding variety, quantity, color, and liking were more often expressed by women in later stages. Women in the later stages also often used meal-planning skills to include fruits and vegetables in meals. Interventions could be tailored according to selected factors regarding purchase and preparation of fruits and vegetables by stage of change to contribute to greater changes in intake.

Adult↗

PubMed2004

Application of value-focused thinking on the environmental selection of wall structures.

The decision of selecting building structures with respect to the environmental demand is an issue commonly addressed in environmental management. In this paper, the importance of considering the decision analysis technique value-focused thinking in the environmental selection of wall structures is investigated. In this context, a qualitative value model is developed in which the external and internal environmental factors are considered. The model is applied on a case study in which a decision should be made on three categories of exterior wall structures: wood, masonry and concrete. It is found that the wall structure made of wood is the most compatible option with respect to the external and internal environmental requirements of building structures.

Conservation of Natural Resources↗

PubMed2005

Clinical multiple sclerosis occurs at one end of a spectrum of CNS pathology: a modified threshold liability model leads to new ways of thinking about the cause of clinical multiple sclerosis.

Multiple sclerosis (MS) is a complex trait, the causes of which are elusive. A threshold liability model influences thinking about the causes of this disorder. According to this model, a population has a normal distribution of genetic liability to MS. In addition, a threshold exists, so that MS begins when an individual's liability exceeds the MS threshold; environmental and other causative factors may increase or decrease an individual's MS liability. It is argued here, however, that this model is misleading, as it is based on the incorrect assumption that MS is a disorder that one either has or does not have. This paper hypothesizes, instead, that patients with a diagnosis of MS share identical CNS pathology, termed MS pathology, with some individuals who have a diagnosis of possible MS and with some apparently healthy individuals, who may never have a diagnosis of MS. In order to accommodate this hypothesis, the current threshold liability model is modified as follows. (1) In addition to a normal distribution of MS liability within a population, a spectrum of MS pathology occurs in some who have a high MS liability. (2) A clinical MS threshold exists at a point on this liability distribution, where the burden and distribution of MS pathology permits a diagnosis of clinical MS. (3) Additional thresholds exist that correspond to a lower MS liability and a lesser burden of MS pathology than occur at the clinical MS threshold. This modified threshold model leads to the postulate that causes act at various time points to increase MS liability and induce MS pathology. The accumulation of MS pathology sometimes leads to a diagnosis of clinical MS. One implication of this model is that the MS pathology in clinical MS and in some with possible MS differs only in the extent but not in the type of CNS injury. Thus, it may be possible to obtain insight into the causative environmental factors that increase MS liability and induce MS pathology by focusing on patients who have clinical MS; some environmental factors that induce new lesions in patients with clinical MS may be identical to those that induce MS pathology in genetically susceptible individuals who do not have clinical MS. Identification of these causative factors has importance, as specific treatment may prevent the accumulation of MS pathology that leads to the significant CNS damage associated with clinical MS.

Central Nervous System Diseases↗

PubMed2005

What stroke patients want to know and what medical professionals think they should know about stroke: Korean perspectives.

BACKGROUND AND PURPOSE: Patients and medical professionals are likely to have different perspectives of stroke, making what patients want to know about stroke different from what medical professionals think they should know. We wished to determine these differences for patients and medical professionals in South Korea, as well as to identify patients' characteristics associated with perceptions of stroke education. METHODS: Fifty consecutive patients with acute stroke admitted to Asan Medical Center, Seoul, Korea, and 88 medical professionals (31 doctors and 57 nurses) working in the Departments of Neurology or Neurosurgery were administered a structured questionnaire regarding various aspects of patient education concerning stroke. RESULTS: The average ranking of total items for stroke education was higher in nurses than in doctors or patients (P < 0.01 for each). Patients gave higher rankings than doctors for 'possibility to cure with drug treatment' (P < 0.01), 'stress management' (P < 0.01), and most items concerning 'general medical knowledge' and 'post-stroke diet management,' whereas doctors gave higher rankings than patients for most items concerning risk factor management and treatment with surgery. Items concerning 'post-stroke diet management' were ranked lower by male patients than females patients (P < 0.005), and were ranked lower by doctors than by patients or nurses (P < 0.001). Younger patients gave higher rankings than older patients for items concerning 'medical knowledge regarding stroke,' 'exercise,' and 'post-stroke sexual activities' (P < 0.001 for each). CONCLUSIONS: Perspectives on stroke education differ among doctors, nurses and patients. They also differ according to the situation of the patient. Education of stroke patients should be based on an understanding of these differences.

Activities of Daily Living↗

PubMed2004

Genetic red flags: clues to thinking genetically in primary care practice.

This article presents an approach to "thinking genetically" in primary care. Busy practitioners often lack the time to consider thoroughly whether their patients have an underlying genetic diagnosis. To assist the primary care clinician, a working group of the Genetics in Primary Care Faculty Development Initiative developed a simple mnemonic, Family GENES, that alerts the clinician to consider genetic causes in the differential diagnosis. In addition to family history, the red flags include Groups of anomalies, Early or Extreme presentations of common diseases, Neurodevelopmental or Neurodegenerative conditions, Exceptional or unusual pathology, and Surprising laboratory values. This article discusses the components of the mnemonic, provides examples, and gives guidelines to appropriate actions once the possibility of a genetic diagnosis has been raised.

Congenital Abnormalities↗

PubMed2004

"Social thinking" and cultural images: teenagers' notions of tobacco use.

The health hazards of tobacco use are well-known, and it is considered particularly important to prevent tobacco use among teenagers. New generations of teenagers still start using tobacco. To develop a more profound understanding of tobacco use among teenagers, the purpose of this study is to explore representations of tobacco use, smoking as well as snuffing, at the age when young people often start using tobacco. Focus-group interviews were carried out with 14-15 year olds in two schools in the Stockholm area. The analysis reveals that teenagers are well informed about the health-hazards of tobacco use. At the same time they hold complex and conflicting ideas concerning the relationship between tobacco use, risk, the body and "human nature". At the most general level of "social thinking" there is a dynamic relation between the three main representations of tobacco use related to: (1) notions of risk, (2) "human nature" and; (3) society's efforts to discipline its citizens, which together can be seen as the social representation of tobacco use. These representations of tobacco use are discussed as related to the teenagers' identity-work and gender identities.

Adolescent↗

PubMed2004

The World Health Organization International Classification of Functioning, Disability, and Health: a model to guide clinical thinking, practice and research in the field of cerebral palsy.

The way we think about health and disease determines to a considerable extent what we do and say in our clinical encounters with patients. The recent publication and promotion of the World Health Organization's International Classification of Function, Health, and Disability (known as the ICF) represents an exciting new way to consider health and disease. In the context of children and youth with cerebral palsy, this model offers many heretofore ignored "point of entry" for counselling and intervention with these conditions. This model also provides many possibilities to explore research questions with a fresh approach. This article outlines the ICF model and discusses these opportunities.

Activities of Daily Living↗

PubMed2005

The reactions of parents who think that a child is dying in a seizure--in their own words.

PURPOSE: The goal of this work was to report the words parents use to describe a seizure in which they thought their child was dying, so as to increase the awareness of professionals with respect to the impact seizures may have on family life. METHODS: An audit was carried out on 234 cases from a specialist epilepsy center and 35 cases from a tertiary referral outpatient clinic. RESULTS: Of the 54 parents who thought their child was dying in a seizure, in 45 cases the parents' exact words were recorded in the first person, and in 9 cases, their words were reported in the third person. Many parents took actions that illustrated their high degree of concern: 32 children were taken to hospital, 18 by ambulance, and 3 parents gave mouth-to-mouth resuscitation. CONCLUSIONS: Seizures often cause major concern in parents and many think that their child is dying. Prolonged seizures and limpness and/or cyanosis appear to be associated with this fear. Professionals can gain valuable insight into the impact of seizures on parents by asking them about their reactions to seeing their child having a seizure.

Adolescent↗

PubMed2004

The presence of magical thinking in obsessive compulsive disorder.

Two research groups have raised the possibility that magical ideation may be a fundamental feature of obsessive-compulsive disorder. It has been proposed to underlie thought action fusion and superstitious beliefs. In this study, the Magical Ideation scale, the Lucky Behaviours and Lucky Beliefs scales, the Thought Action Fusion-Revised scale, the Padua Inventory, and the Obsessive Compulsive Inventory-Short Version were completed by 60 obsessive compulsive patients at a hospital clinic. Of all the measures, the Magical Ideation (MI) scale was found to be the most strongly related to obsessive compulsive symptoms. Large and significant relationships between MI scores and the measures of OCD were obtained even when alternative constructs (Lucky Behaviours, Lucky Beliefs, Thought Action Fusion-Revised scales) were held constant. No other variable remained significantly related to the Obsessive Compulsive Inventory-Short Version when magical ideation scores were held constant. The findings suggest that a general magical thinking tendency may underpin previous observed links between superstitiousness, thought action fusion and OCD severity.

Adolescent↗

PubMed2000

Thinking ahead: the case for motor imagery in prospective judgements of prehension.

How similar are judgements concerning how we expect to perform an action, to how we actually behave? The veracity of such prospective action judgements, and the mechanisms by which they are computed, was explored in a series of tasks that involved either grasping (MC conditions) or thinking about grasping (PJ conditions) a dowel presented in various orientations. PJs concerning limits of comfortable hand supination and pronation when turning a dowel in the picture plane were highly consistent with values obtained during actual hand rotation (Exp. 1). The same was true for judgements regarding the level of awkwardness involved in adopting a prescribed grip (e.g. overhand with right hand) for dowels in various picture plane orientations (Exp. 2). When allowed to select the most natural grip (overhand versus underhand) or hand (left versus right) for engaging dowels in these orientations, subjects preferred virtually identical responses in both PJ and MC conditions. In both instances, they consistently chose the least awkward response options. As would be expected for actual movements, PJs involving awkward hand postures had longer response times (RTs), and were less accurate. Likewise, latencies for both grip and hand judgements tended to increase as a function of the angular distance between the current positions of subjects' hands, and the orientation of the chosen posture. Together, these findings are consistent with a the hypothesis that PJs involve mentally simulated actions, or motor imagery. These results suggest that motor imagery does not depend on the existence of a completed premotor plan (Jeannerod, 1994), but may instead be involved in the planning process itself. A provisional model for the involvement of imagery in motor planning is outlined, as are a set of criteria for evaluating claims of the involvement of motor imagery in problem solving.

Adult↗

PubMed2004

Free radical biology - terminology and critical thinking.

What is an antioxidant? Can one, at a cellular level, speak of direct and indirect antioxidants? Can oxidative stress be quantified and characterized? What are the oxidant species that may have regulatory functions in a cell? Since the above concepts have become of frequent use in all Journals, it may be appropriate if some critical thinking outlined in this review could become available to a broad public.

Animals↗

PubMedDate not supplied

Creative thinking in nursing education: preparing for tomorrow's challenges.

The present health care environment requires creative change, a thought that evokes both excitement and apprehension and offers a clear challenge for the contemporary nurse. In this era of capitation, re-engineering, and redesign in the health care system, nursing programs must prepare nurses who can successfully perform in an environment that demands innovative problem solving. Integrating creative problem solving into this BSN program has (1) provided students with information and experience in the creative process, (2) fostered the personal creative development of nurses, (3) challenged students to use creative thinking in solving nursing problems, and most important, (4) further established and reinforced a new, higher level of nursing practice--a level that appropriately sees the nurse as a creative and innovative member of the health care team.

Creativity↗

PubMed2000

Watch, Discover, Think, and Act: a model for patient education program development.

In this report we describe the development of the Watch, Discover, Think and Act asthma self-management computer program for inner-city children with asthma. The intervention focused on teaching two categories of behaviors--asthma specific behaviors such as taking preventive medication and self-regulatory processes such as monitoring symptoms and solving asthma problems. These asthma self-management behaviors were then linked with empirical and theoretical determinants such as skills and self-efficacy. We then further used behavioral science theory to develop methods such as role modeling and skill training linked to the determinants. We matched these theoretical methods to practical strategies within the computer simulation and created a culturally competent program for inner-city minority youth. Finally, we planned a program evaluation that linked program impact and outcomes to the theoretical assumptions on which the intervention was based.

Asthma↗

PubMed2002

Strategic thinking in eye trauma management.

Treating patients with serious eye injuries is not only a difficult, but also occasionally frustrating process. Mastering the details of the management of individual tissue lesions allows one to "see the tree" but does not provide vision of the entire forest. To develop a comprehensive understanding that leads to strategic thinking before making actual reconstruction efforts, the surgeon should follow a fairly rigorous thought process to find the best possible management option for the particular injury (Fig. 1). His or her suggestion, as well as detailed information on other options, should be discussed with the patient, and the decision regarding how to proceed is best if it meets the approval of, and is supported by, the patient. Such an approach has the highest chance of rewarding the patient and the treating physician.

Decision Making↗

PubMed2002

wishful thinking encodes a BMP type II receptor that regulates synaptic growth in Drosophila.

We conducted a large-scale screen for Drosophila mutants that have structural abnormalities of the larval neuromuscular junction (NMJ). We recovered mutations in wishful thinking (wit), a gene that positively regulates synaptic growth. wit encodes a BMP type II receptor. In wit mutant larvae, the size of the NMJs is greatly reduced relative to the size of the muscles. wit NMJs have reduced evoked excitatory junctional potentials, decreased levels of the synaptic cell adhesion molecule Fasciclin II, and synaptic membrane detachment at active zones. Wit is expressed by a subset of neurons, including motoneurons. The NMJ phenotype is specifically rescued by transgenic expression of Wit only in motoneurons. Thus, Wit appears to function as a presynaptic receptor that regulates synaptic size at the Drosophila NMJ.

Animals↗