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PubMed1998

Role of vasopressin in learning and memory in the hippocampus.

The involvement of arginine8-vasopressin (VP) in learning and memory in the hippocampus is examined in mice using a discriminative learning task. Bilateral dorsal hippocampal lesion blocks the enhancing effect of intracerebroventricular (i.c.v.) injection of VP on retrieval and relearning processes. An additional study showed that immunoneutralization of dorsal hippocampal endogenous VP inhibited the facilitating effect of i.c.v. injection of VP, suggesting that hippocampus is essential for the expression of VP's behavioral effects. Using in situ microinjection, a greater sensitivity of the ventral part of the hippocampus to the memory enhancing effects of VP has been reported. This effect is mediated by vasopressin V1 type receptors and oxytocin receptors. Then, we examined the effects on behavior of VP applied to the ventral hippocampus, in relation to the time of treatment during learning. When the animals have no previous information about the task to learn, a deleterious effect of VP appears (pre-first session treatment). Regarding memory consolidation, the effects of VP may depend upon the previous level of performance acquired by the animals since, when injected after the first learning session, the peptide slightly delayed performance, whereas when the injection took place after the second learning session, it enhanced learning. Concerning memory retrieval, the effects of VP depend on the quality of the previously stored information. The fact that VP did not generate the same behavioral effects when the treatment was performed at the beginning or in the middle of the learning processes, suggests that mnemonic context is an important factor in understanding the effect of VP on memory in the ventral hippocampus. Finally, the role of hippocampal adrenergic receptors in the enhancing VP effects on memory retrieval has been examined. The facilitatory effects of VP seem to depend upon the functional state of both alpha- and beta-adrenergic receptors, but further studies will be necessary to clarify the role played by each receptor type in retrieval processes, and to determine the relationships that might exist between them.

Animals↗

PubMed1991

Nonprogramming relational database primer: a case study--pharmacist intervention audits.

Using a database product has never been easier. The above example may appear to be complicated, but the Alpha Four software program guides you at every step. You have to decide what you wish to accomplish, then set up the program to handle the task. Alpha Four (or any other nonprogrammable relational database) can also be used for formulary management, investigational drug accounting, personnel management, inventory, purchase order requisitions, etc. Some drug distribution systems provide access to the patient records and clinical information. If you learn how to operate a database manager, you can create reports that may not be available from the vendor. Computers have reduced the workload required for drug distribution. The future of pharmacy practice is headed toward a highly automated setting. New roles for the pharmacist may include the provision of information from the point of admission to discharge and possibly continued follow-up. This will all be an automated process with the pharmacist as a key resource person. If you do not learn how to control the computer systems you work with, they will eventually control you. You do not have to be an expert to learn how to use a database application. If computer applications are not already part of your professional responsibilities, they soon will be.

Clinical Pharmacy Information Systems↗

PubMed2001

The declarative/procedural model of lexicon and grammar.

Our use of language depends upon two capacities: a mental lexicon of memorized words and a mental grammar of rules that underlie the sequential and hierarchical composition of lexical forms into predictably structured larger words, phrases, and sentences. The declarative/procedural model posits that the lexicon/grammar distinction in language is tied to the distinction between two well-studied brain memory systems. On this view, the memorization and use of at least simple words (those with noncompositional, that is, arbitrary form-meaning pairings) depends upon an associative memory of distributed representations that is subserved by temporal-lobe circuits previously implicated in the learning and use of fact and event knowledge. This "declarative memory" system appears to be specialized for learning arbitrarily related information (i.e., for associative binding). In contrast, the acquisition and use of grammatical rules that underlie symbol manipulation is subserved by frontal/basal-ganglia circuits previously implicated in the implicit (nonconscious) learning and expression of motor and cognitive "skills" and "habits" (e.g., from simple motor acts to skilled game playing). This "procedural" system may be specialized for computing sequences. This novel view of lexicon and grammar offers an alternative to the two main competing theoretical frameworks. It shares the perspective of traditional dual-mechanism theories in positing that the mental lexicon and a symbol-manipulating mental grammar are subserved by distinct computational components that may be linked to distinct brain structures. However, it diverges from these theories where they assume components dedicated to each of the two language capacities (that is, domain-specific) and in their common assumption that lexical memory is a rote list of items. Conversely, while it shares with single-mechanism theories the perspective that the two capacities are subserved by domain-independent computational mechanisms, it diverges from them where they link both capacities to a single associative memory system with broad anatomic distribution. The declarative/procedural model, but neither traditional dual- nor single-mechanism models, predicts double dissociations between lexicon and grammar, with associations among associative memory properties, memorized words and facts, and temporal-lobe structures, and among symbol-manipulation properties, grammatical rule products, motor skills, and frontal/basal-ganglia structures. In order to contrast lexicon and grammar while holding other factors constant, we have focused our investigations of the declarative/procedural model on morphologically complex word forms. Morphological transformations that are (largely) unproductive (e.g., in go-went, solemn-solemnity) are hypothesized to depend upon declarative memory. These have been contrasted with morphological transformations that are fully productive (e.g., in walk-walked, happy-happiness), whose computation is posited to be solely dependent upon grammatical rules subserved by the procedural system. Here evidence is presented from studies that use a range of psycholinguistic and neurolinguistic approaches with children and adults. It is argued that converging evidence from these studies supports the declarative/procedural model of lexicon and grammar.

Aphasia↗

PubMed1995

What is the learning curve for laparoscopic colectomy?

Learning curves have been described for a variety of laparoscopic procedures including cholecystectomy, tubal ligation, and diagnostic laparoscopy. Although multiple series of laparoscopic colectomies have appeared, there is little information regarding the learning curve associated with this advanced procedure. The purpose of this study is to present a single team's experience with laparoscopic colon resection to allow the description of our learning curve. The data collected included age, sex, operating room time, recovery of bowel function, days to clear liquid, hospital stay, conversion, complications, indication for operation, and site of resection. Sixty consecutive patients were analyzed and divided into three groups: First 20, Second 20, and Third 20. There were no significant differences between the three groups with respect to age, male versus female ratio, indications for surgery, or site of resection. However, the complexity of surgical procedures and the incidence of previous major abdominal surgery increased steadily with experience. The incidence of pulmonary complications was 30 per cent in the First 20 group and decreased to 5 per cent for the next two groups. The conversion rate was 20 per cent for the First 20 group, 45 per cent for the Second 20 group, and decreased to 10 per cent for the Third 20 group.(ABSTRACT TRUNCATED AT 250 WORDS)

Abdomen↗

PubMed1989

Category learning and change: differences in sensitivity to information that enhances or reduces intercategory distinctions.

We examined the amenability of abstractions of categories to new and relevant information. In Experiment 1, Ss formed impressions of 2 sets of numbers by periodically estimating the cumulative means of each set. During the 1st half of the procedure, the 2 means were mathematically stable. During the 2nd half of the procedure, the mean of 1 set was modified and the mean of the other set remained unchanged. We predicted and found that the resultant estimates for the modified category changed more when the mean difference between the 2 categories was enhanced than when it was reduced. Experiment 2 suggested that the accentuation effect results from a 2-stage process of category learning (Stage 1) and category change (Stage 2). Experiment 3 replicated the effect with person categories. The relevance of category accentuation is discussed with respect to the modifiability of social beliefs.

Adult↗

PubMed2006

Afferentation of the lateral nidopallium: A tracing study of a brain area involved in sexual imprinting in the zebra finch (Taeniopygia guttata).

The lateral forebrain of zebra finches that comprises parts of the lateral nidopallium and parts of the lateral mesopallium is supposed to be involved in the storage and processing of visual information acquired by an early learning process called sexual imprinting. This information is later used to select an appropriate sexual partner for courtship behavior. Being involved in such a complicated behavioral task, the lateral nidopallium should be an integrative area receiving input from many other regions of the brain. Our experiments indeed show that the lateral nidopallium receives input from a variety of telencephalic regions including the primary and secondary areas of both visual pathways, the globus pallidus, the caudolateral nidopallium functionally comparable to the prefrontal cortex, the caudomedial nidopallium involved in song perception and storage of song-related memories, and some parts of the arcopallium. There are also a number of thalamic, mesencephalic, and brainstem efferents including the catecholaminergic locus coeruleus and the unspecific activating reticular formation. The spatial distribution of afferents suggests a compartmentalization of the lateral nidopallium into several subdivisions. Based on its connections, the lateral nidopallium should be considered as an area of higher order processing of visual information coming from the tectofugal and the thalamofugal visual pathways. Other sensory modalities and also motivational factors from a variety of brain areas are also integrated here. These findings support the idea of an involvement of the lateral nidopallium in imprinting and the control of courtship behavior.

Afferent Pathways↗

PubMed2005

What learning to see arbitrary motion tells us about biological motion perception.

In separate studies, observers viewed upright biological motion, inverted biological motion, or arbitrary motion created from systematically randomizing the positions of point-light dots. Results showed that observers (a) could learn to detect the presence of arbitrary motion, (b) could not learn to discriminate the coherence of arbitrary motion, although they could do so for upright biological motion, (c) could apply a detection strategy to learn to detect the presence of inverted biological motion nearly as well as they detected upright biological motion, and (d) performed better discriminating the coherence of upright biological motion compared with inverted biological motion. These results suggest that learning and form information play an important role in perceiving biological motion, although this role may only be apparent in tasks that require processing information from multiple parts of the motion display.

Attention↗

PubMed1982

A survey to evaluate parental consent as public policy for neonatal screening.

Most states currently have laws which result in compulsory neonatal screening practices, despite a widespread consensus that participation in genetic services and programs should be voluntary. In 1976, Maryland adopted a regulation designed to respect parents' rights to refuse neonatal screening by imposing a parental consent requirement. The results of a study designed to evaluate the effects of this regulation are reviewed here. Many health care providers were unaware of the parental consent regulation. However, hospitals were generally in compliance with the technical stipulations of the regulations. There was little evidence that the regulation resulted in additional costs to the health care system, either in terms of hospital staff time or in terms of loss of efficiency in the number of infants screened. Mothers affected by the regulation were largely in favor of being informed about neonatal screening and learned a significant amount of new information from the disclosure process. They were almost evenly divided on whether they favored parental consent.

Adult↗

PubMed2004

A multimedia interactive education system for prostate cancer patients: development and preliminary evaluation.

BACKGROUND: A cancer diagnosis is highly distressing. Yet, to make informed treatment choices patients have to learn complicated disease and treatment information that is often fraught with medical and statistical terminology. Thus, patients need accurate and easy-to-understand information. OBJECTIVE: To introduce the development and preliminary evaluation through focus groups of a novel highly-interactive multimedia-education software program for patients diagnosed with localized prostate cancer. METHODS: The prostate interactive education system uses the metaphor of rooms in a virtual health center (ie, reception area, a library, physician offices, group meeting room) to organize information. Text information contained in the library is tailored to a person's information-seeking preference (ie, high versus low information seeker). We conducted a preliminary evaluation through 5 separate focus groups with prostate cancer survivors (N = 18) and their spouses (N = 15). RESULTS: Focus group results point to the timeliness and high acceptability of the software among the target audience. Results also underscore the importance of a guide or tutor who assists in navigating the program and who responds to queries to facilitate information retrieval. CONCLUSIONS: Focus groups have established the validity of our approach and point to new directions to further enhance the user interface.

Adult↗

PubMed2005

Tunable retina encoders for retina implants: why and how.

Current research towards retina implants for partial restoration of vision in blind humans with retinal degenerative dysfunctions focuses on implant and stimulation experiments and technologies. In contrast, our approach takes the availability of an epiretinal multi-electrode neural interface for granted and studies the conditions for successful joint information processing of both retinal prosthesis and brain. Our proposed learning retina encoder (RE) includes information processing modules to simulate the complex mapping operation of parts of the 5-layered neural retina and to provide an iterative, perception-based dialog between RE and human subject. Alternative information processing technologies in the learning RE are being described, which allow an individual optimization of the RE mapping operation by means of iterative tuning with learning algorithms in a dialog between implant wearing subject and RE. The primate visual system is modeled by a retina module (RM) composed of spatio-temporal (ST) filters and a central visual system module (VM). RM performs a mapping 1 of an optical pattern P1 in the physical domain onto a retinal output vector R1(t) in a neural domain, whereas VM performs a mapping 2 of R1(t) in a neural domain onto a visual percept P2 in the perceptual domain. Retinal ganglion cell properties represent non-invertible ST filters in RE, which generate ambiguous output signals. VM generates visual percepts only if the corresponding R1(t) is properly encoded, contains sufficient information, and can be disambiguated. Based on the learning RE and the proposed visual system model, a novel retina encoder (RE*) is proposed, which considers both ambiguity removal and miniature eye movements during fixation. Our simulation results suggest that VM requires miniature eye movements under control of the visual system to retrieve unambiguous patterns P2 corresponding to P1. For retina implant applications, RE* can be tuned to generate optimal ganglion cell codes for epiretinal stimulation.

Action Potentials↗

PubMed2005

Access to learning resources for students on placement in the UK: what are the issues and how can we resolve them?

AIM: To compile a list of the issues regarding access to learning resources which affect students on placement in the UK and suggest some ways in which these can be resolved. RESULTS: Issues relating to PC access, network access, software, firewalls, disciplinary procedures, electronic information resources, virtual learning environments, service level agreements, physical access to libraries, book loans, reading lists and course committees are identified and discussed in relation to NHS libraries. CONCLUSIONS: Successful resolution of the IT and library issues, which are increasingly inter-linked, can help to ensure that students have a positive placement experience. Resolution will depend on close, regular liaison and can be assisted by negotiation of a clear Service Level Agreement.

Access to Information↗

PubMed2000

Bridging cultural differences in medical practice. The case of discussing negative information with Navajo patients.

BACKGROUND: Cultural differences between doctors and their patients are common and may have important implications for the clinical encounter. For example, some Navajo patients may regard advance care planning discussions to be a violation of their traditional values. OBJECTIVE: To learn from Navajo informants a culturally competent approach for discussing negative information. DESIGN: Focused ethnography. SETTING: Navajo Indian reservation, northeast Arizona. PARTICIPANTS: Thirty-four Navajo informants, including patients, traditional healers, and biomedical health care providers. MEASUREMENT: In-depth interviews. MAIN RESULTS: Strategies for discussing negative information were identified and organized into four stages. Assessment of patients is important because some Navajo patients may be troubled by discussing negative information, and others may be unwilling to have such discussions at all. Preparation entails cultivating a trusting relationship with patients, involving family members, warning patients about the nature of the discussion as well as communicating that no harm is intended, and facilitating the involvement of traditional healers. Communication should proceed in a caring, kind, and respectful manner, consistent with the Navajo concept k'é. Reference to a third party is suggested when discussing negative information, as is respecting the power of language in Navajo culture by framing discussions in a positive way. Follow-through involves continuing to care for patients and fostering hope. CONCLUSIONS: In-depth interviews identified many strategies for discussing negative information with Navajo patients. Future research could evaluate these recommendations. The approach described could be used to facilitate the bridging of cultural differences in other settings.

Arizona↗

PubMed2000

Accurate route demonstration by experienced homing pigeons does not improve subsequent homing performance in naive conspecifics.

We describe an experiment that uses the grouping tendencies and navigational abilities of the homing pigeon (Columba livia) to investigate the possibility of socially mediated information transfer in a field setting. By varying the composition of paired-release types, we allowed some naive birds to receive an accurate demonstration of the home route whilst others were paired with similarly naive conspecifics. After this 'paired phase', we predicted that if any learning of spatial information occurred then naive members of the former pairs would outperform their untutored conspecifics when re-released individually during the subsequent 'single phase' of the experiment. This prediction was not confirmed. Neither homing speed nor initial orientation was superior in individually released tutored versus untutored birds, despite the fact that both performance measures were better in the earlier 'paired phase' with experienced demonstrators. Our results suggest that although naive homing pigeons clearly interact with their experienced partners, they are unable to transfer any individually useful spatial information to subsequent homing flights.

Animals↗

PubMed2004

Impaired higher order implicit sequence learning on the verbal version of the serial reaction time task in patients with Parkinson's disease.

Although neuroimaging studies have strongly implicated basal ganglia involvement in implicit sequence learning, serial reaction time (SRT) studies with Parkinson's disease (PD) patients have yielded mixed results. The present research sought to examine the ability of people with PD to implicitly learn sequences with different sequential structures and to objectively assess explicit knowledge. A version of the SRT task that reduces motor demands was used to compare 19 patients with PD but not dementia and 37 matched controls. PD patients showed less implicit sequence-specific learning for both sequences and reduced response time improvement over sequential trials for the more complex sequence. A closer examination revealed that the deficit involved higher order sequential associations as well as the learning of pairwise information.

Aged↗

PubMed1992

Learning induces changes in the central cholinergic system of the rat in a sexually dimorphic pattern.

The involvement of the central cholinergic system in learning and the possible sexual dimorphism in related brain responses were investigated. Rats were exposed to different environmental conditions and to active avoidance learning. The resulting changes were studied using the following approaches: muscarinic receptor binding (MRB), acetylcholinesterase (AChE) and choline acetyltransferase (CAT) activities. The statistical evaluation of the data reveal that learning induces changes, especially in the postsynaptic component of the central cholinergic system, which shows some sexual dimorphism, and that males and females respond with different levels of increased cholinergic activity to informal and associative learning.

Acetylcholine↗

PubMed2006

Not the same everywhere. Patient-centered learning environments at nine medical schools.

BACKGROUND: Learning environments overtly or implicitly address patient-centered values and have been the focus of research for more than 40 years, often in studies about the "hidden curriculum." However, many of these studies occurred at single medical schools and used time-intensive ethnographic methods. This field of inquiry lacks survey methods and information about how learning environments differ across medical schools. OBJECTIVE: To examine patient-centered characteristics of learning environments at 9 U.S. medical schools. DESIGN: Cross-sectional internet-based survey. PARTICIPANTS: Eight-hundred and twenty-three third- and fourth-year medical students in the classes of 2002 and 2003. MEASUREMENTS: We measured the patient-centeredness of learning environments with the Communication, Curriculum, and Culture (C3) Instrument, a 29-item validated measure that characterizes the degree to which a medical school's environment fosters patient-centered care. The C3 Instrument contains 3 content areas (role modeling, students' experiences, and support for students' patient-centered behaviors), and is designed to measure these areas independent of respondents' attitudes about patient-centered care. We also collected demographic and attitudinal information from respondents. RESULTS: The variability of C3 scores across schools in each of the 3 content areas of the instrument was striking and statistically significant (P values ranged from .001 to .004). In addition, the patterns of scores on the 3 content areas differed from school to school. CONCLUSIONS: The 9 schools demonstrated unique and different learning environments both in terms of magnitude and patterns of characteristics. Further multiinstitutional study of hidden curricula is needed to further establish the degree of variability that exists, and to assist educators in making informed choices about how to intervene at their own schools.

Adult↗

PubMed1992

The psychological basis of problem-based learning: a review of the evidence.

Several potential advantages for students' learning are claimed for problem-based learning (PBL). Students in PBL curricula may be more highly motivated; they may be better problem solvers and self-directed learners; they may be better able to learn and recall information; and they may be better able to integrate basic science knowledge into the solutions of clinical problems. Although some of these claims find theoretical support from the literature on the psychology of learning, to date there has been no review of the experimental evidence supporting the possible differences in students' learning that can be attributed to PBL. In this review article, the authors examine each claim critically in light of that evidence. They conclude that (1) there is no evidence that PBL curricula result in any improvement in general, content-free problem-solving skills; (2) learning in a PBL format may initially reduce levels of learning but may foster, over periods up to several years, increased retention of knowledge; (3) some preliminary evidence suggests that PBL curricula may enhance both transfer of concepts to new problems and integration of basic science concepts into clinical problems; (4) PBL enhances intrinsic interest in the subject matter; and (5) PBL appears to enhance self-directed learning skills, and this enhancement may be maintained.

Curriculum↗

PubMed2002

Psychostimulant-induced behavioral sensitization depends on nicotinic receptor activation.

Animal studies have shown that nicotine and psychostimulant drugs (amphetamine and cocaine) share the property of inducing long-lasting behavioral and neurochemical sensitization, which is thought to contribute to their addictive properties. Neuroplasticity subserving learning and memory mechanisms is considered to be involved in psychostimulant-induced sensitization and addiction behavior. Because nicotinic receptors in the brain play a role in the storage of drug-related information underlying reinforcement learning, we evaluated the possibility that activation of central nicotinic receptors may underlie psychostimulant-induced sensitization. Repeated exposure of rats to nicotine profoundly enhanced the psychomotor effects of nicotine and amphetamine 3 weeks after nicotine pretreatment. Moreover, the nicotinic receptor antagonist mecamylamine completely blocked the induction, but not the long-term expression, of behavioral sensitization to amphetamine in amphetamine-pretreated rats. Mecamylamine also prevented the development of cocaine-induced behavioral sensitization. Behavioral sensitization induced by nicotine, amphetamine, or cocaine was associated with an increase in the electrically evoked release of [(3)H]dopamine from nucleus accumbens slices. Coadministration of mecamylamine during pretreatment with nicotine, amphetamine, or cocaine prevented the development of this long-term hyperreactivity of nucleus accumbens dopamine neurons. Similarly, the high-affinity non-alpha7 subtype nicotinic receptor antagonist dihydro-beta-erythroidine prevented the development of amphetamine-induced behavioral and neurochemical sensitization. These data indicate that nicotinic receptor activation (by endogenously released acetylcholine) is a common denominator initiating neuroplasticity involved in the development of amphetamine, as well as cocaine-induced sensitization.

Amphetamine↗