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At least 1,225 records · Page 68Linked to original sources
PubMed2003

Copability, coping, and learning as focal concepts in the evaluation of computerised diabetes disease management.

INTRODUCTION: Within diabetes care, the majority of health decisions are in the hands of the patient. Therefore, the concepts of disease management and self-care represent inescapable challenges for both patient and healthcare professionals, entailing a considerable amount of learning. Thus, a computerised diabetes disease management systems (CDDM) is to be seen not merely as tools for the medical treatment, but also as pedagogical tools to enhance patient competence. HYPOTHESIS: The unfortunate lack of success for most knowledge-based systems might be related to the problem of finding an adequate way of evaluating the systems from their development through the implementation phase to the daily clinical practice. The following presents the initial methodological considerations for evaluating the usefulness of a CDDM system called DiasNet, which is being implemented as a learning tool for patients. The evaluation of usefulness of a CDDM, we claim, entails clinical assessment taking into account the challenges and pitfalls in diabetes disease management. RESULTS: Drawing on activity theory, we suggest the concept of copability as a supplement to 'usability' and 'utility' when determining 'usefulness'. We maintain that it is necessary to ask how well the user copes with the new situation using the system. As ways to measure copability of DiasNet the concepts of coping and learning are discussed, as well as ways this methodology might inform systems development, implementation, and daily clinical practice.

Adaptation, Psychological↗
PubMed2004

Interface methods for using intranet portal organizational memory information system.

In this paper, an intranet portal is considered as an information infrastructure (organizational memory information system, OMIS) supporting organizational learning. The properties and the hierarchical structure of information and knowledge in an intranet portal OMIS was identified as a problem for navigation tools of an intranet portal interface. The problem relates to navigation and retrieval functions of intranet portal OMIS and is expected to adversely affect user performance, satisfaction, and usefulness. To solve the problem, a conceptual model for navigation tools of an intranet portal interface was proposed and an experiment using a crossover design was conducted with 10 participants. In the experiment, a separate access method (tabbed tree tool) was compared to an unified access method (single tree tool). The results indicate that each information/knowledge repository for which a user has a different structural knowledge should be handled separately with a separate access to increase user satisfaction and the usefulness of the OMIS and to improve user performance in navigation.

Analysis of Variance↗
PubMed2000

Speak up: the manager's guide to oral presentations.

Public speaking is a skill that can prove to be of considerable value to health care managers, yet a great many managers have not been trained as speakers and thus tend to avoid speaking situations or approach them with fear and doubt. However, any working manager can become an effective speaker through conscious effort to do so. The keys to developing one's ability to deliver effective oral presentations are preparation and practice. Preparation includes knowing one's subject and one's audience, appropriately organizing the material, learning how to present information according to what one wishes to convey or accomplish, learning how to use visual aids, and working to improve one's manner of using language in a public setting. Beyond following the guidelines for appropriate preparation and delivery, success and a degree of comfort with public speaking comes with practice, practice, practice.

Guidelines as Topic↗
PubMedDate not supplied

The manager and oral presentations: from conference room to convention hall.

Public speaking is a skill that can prove to be of considerable value to health care managers, yet a great many managers have not been trained as speakers and thus tend to avoid speaking situations or approach them with fear and doubt. However, any working manager can become an effective speaker through conscious effort to do so. The keys to developing one's ability to deliver effective oral presentations are preparation and practice. Preparation includes knowing one's subject and one's audience, appropriately organizing the material, learning how to present information according to what one wishes to convey or accomplish, learning how to utilize visual aids, and working to improve one's manner of using language in a public setting. The same guidelines apply whether the manager is speaking to a small audience in a conference room or a large audience at a conference or convention. Beyond following the guidelines for appropriate preparation and delivery, regardless of scope of presentation and size of audience, success and a degree of comfort with public speaking come with practice, practice, practice.

Health Facility Administrators↗
PubMed1997

Long short-term memory.

Learning to store information over extended time intervals by recurrent backpropagation takes a very long time, mostly because of insufficient, decaying error backflow. We briefly review Hochreiter's (1991) analysis of this problem, then address it by introducing a novel, efficient, gradient-based method called long short-term memory (LSTM). Truncating the gradient where this does not do harm, LSTM can learn to bridge minimal time lags in excess of 1000 discrete-time steps by enforcing constant error flow through constant error carousels within special units. Multiplicative gate units learn to open and close access to the constant error flow. LSTM is local in space and time; its computational complexity per time step and weight is O(1). Our experiments with artificial data involve local, distributed, real-valued, and noisy pattern representations. In comparisons with real-time recurrent learning, back propagation through time, recurrent cascade correlation, Elman nets, and neural sequence chunking, LSTM leads to many more successful runs, and learns much faster. LSTM also solves complex, artificial long-time-lag tasks that have never been solved by previous recurrent network algorithms.

Algorithms↗
PubMed2003

Experience-dependent activation patterns in human brain during visual-motor associative learning.

Multiple brain regions, including parietal and frontal cortical areas, seem to participate in learning and rehearsing associations between spatially defined visual cues and appropriate motor responses. However, because most previous studies have related learning to changes in brain activation according to elapsed time or number of trials but not categories based on performance, it remains unclear how and when areas implicated in learning sensory-motor associations actually participate in the process. The current experiment used functional magnetic resonance imaging to examine changes in brain activation when participants learned to associate an arbitrarily located visual cue with a finger movement. Associative trials were categorized as incorrect, first correct, or subsequent correct. Participants also performed a spatially compatible visual-motor control task. A group analysis revealed four major findings addressing the behavioral processes occurring during forming and rehearsing visual-motor rules. First, brain networks related to processing associative information, through initial learning to rehearsal, yielded more activation in a myriad of neocortical structures than did a simple motor task. Second, we revealed frontal and parietal areas that differentially processed errors and correct responses. Third, we found frontal-parietal networks that seemed to mediate the transition of learning to rehearsing arbitrary visual-motor associations and that this activation exhibited dynamic characteristics. Last, we found a frontal-parietal network that appeared to have a key role in expressing the learned sensory-motor association. The current results provide a foundation for understanding how neocortical structures participate in the various behavioral processes that combine to form and consolidate novel and arbitrary sensory-motor associations.

Adult↗
PubMed1998

Changes in brain activity during motor learning measured with PET: effects of hand of performance and practice.

The aim of this study is to assess brain activity measured during continuous performance of design tracing tasks. Three issues were addressed: identification of brain areas involved in performing maze and square tracing tasks, investigation of differences and similarities in these areas related to dominant and nondominant hand performance, and most importantly, examination of the effects of practice in these areas. A total of 32 normal, right-handed subjects were instructed to move a pen with the dominant right hand (16 subjects) or nondominant left hand (16 subjects) continuously through cut-out maze and square patterns with their eyes closed during a 40-s positron emission tomography (PET) scan to measure regional blood flow. There were six conditions: 1) holding the pen on a writing tablet without moving it (rest condition); 2) tracing a maze without practice; 3) tracing the same maze after 10 min of practice; 4) tracing a novel maze; and tracing an easily learned square design at 5) high or 6) low speed. To identify brain areas generally related to continuous tracing, data analyses were performed on the combined data acquired during the five tracing scans minus rest conditions. Areas activated included: primary and secondary motor areas, somatosensory, parietal, and inferior frontal cortex, thalamus, and several cerebellar regions. Then comparisons were made between right- and left-hand performance. There were no significant differences in performance. As for brain activations, only primary motor cortex and anterior cerebellum showed activations that switched with hand of performance. All other areas, with the exception of the midbrain, showed activations that were common for both right- and left-hand performance. These areas were further analyzed for significant conditional effects. We found patterns of activation related to velocity in the contralateral primary motor cortex, related to unskilled performance in right premotor and parietal areas and left cerebellum, related to skilled performance in supplementary motor area (SMA), and related to the level of capacity at which subjects were performing in left premotor cortex, ipsilateral anterior cerebellum, right posterior cerebellum and right dentate nucleus. These findings demonstrate two important principles: 1) practice produces a shift in activity from one set of areas to a different area and 2) practice-related activations appeared in the same hemisphere regardless of the hand used, suggesting that some of the areas related to maze learning must code information at an abstract level that is distinct from the motor performance of the task itself.

Adult↗
PubMed1999

Hippocampus as a memory map: synaptic plasticity and memory encoding by hippocampal neurons.

Hippocampal cells contribute to memory by rapidly encoding information about the perceptual and behavioral structure of experience. This paper describes two complementary experimental approaches that illustrate two important mechanisms that confer these properties to hippocampal cells: (1) Enduring spatial memory and stable place fields each depend upon synaptic plasticity mechanisms that normally rely on the same NMDA-receptor mediated metabolic events as long-term potentiation (LTP). Thus, hippocampal cells "learn" to encode information about the perceptual and behavioral structure of experiences. (2) Hippocampal cells encode the structure of experience and respond in a manner inconsistent with a spatial representation. Place fields are distributed heterogeneously in space, their locations are determined by non-geometric information, the population of active cells can indicate more than one location in space, and hippocampal cells encode discriminative stimuli independent of their spatial location. To the extent that the hippocampus encodes a map, it is more simply described as a memory map than a spatial map. Rather than computing spatial locations, the space it encodes is better described as a life or a problem space that encodes the history of experience into the relational structure of episodes.

Animals↗
PubMed2005

Neural dynamics of error processing in medial frontal cortex.

Adaptive behavior requires an organism to evaluate the outcome of its actions, such that future behavior can be adjusted accordingly and the appropriate response selected. During associative learning, the time at which such evaluative information is available changes as learning progresses, from the delivery of performance feedback early in learning to the execution of the response itself during learned performance. Here, we report a learning-dependent shift in the timing of activation in the rostral cingulate zone of the anterior cingulate cortex from external error feedback to internal error detection. This pattern of activity is seen only in the anterior cingulate, not in the pre-supplementary motor area. The dynamics of these reciprocal changes are consistent with the claim that the rostral cingulate zone is involved in response selection on the basis of the expected outcome of an action. Specifically, these data illustrate how the anterior cingulate receives evaluative information, indicating that an action has not produced the desired result.

Adaptation, Psychological↗
PubMed1994

Cytoskeletal involvement in neuronal learning: a review.

This paper introduces the ideas of neural networks in the context of currently recognized cellular structures within neurons. Neural network models and paradigms require adaptation of synapses for learning to occur in the network. Some models of learning paradigms require information to move from axon to dendrite. This motivated us to examine the possibility of intracellular signaling to mediate such signals. The cytoskeleton forms a substrate for intracellular signaling via material transport and other putative mechanisms. Furthermore, many experimental results suggest a link between the cytoskeleton and cognitive processing. In this paper we review research on intracellular signaling in the context of neural network learning.

Animals↗
PubMed2004

Long-term impairment of acquisition of a spatial memory task following isoflurane-nitrous oxide anesthesia in rats.

BACKGROUND: The authors demonstrated previously that isoflurane-nitrous oxide anesthesia attenuates performance improvement on an already-learned spatial memory task and that the effect persists for weeks. This experiment was designed to test the hypothesis that learning of new information is particularly susceptible to prolonged disruption after general anesthesia. METHODS: Six- (n = 5) and 20- (n = 5) month-old male Fischer 344 rats were anesthetized for 2 h with 1.2% isoflurane, 70% nitrous oxide, and 30% oxygen. Age-matched control rats received 30% oxygen and 70% nitrogen (n = 5 per group). Rats breathed spontaneously, and anesthetic and oxygen concentrations were measured. Spatial learning was assessed daily for 21 days on a 12-arm radial maze (RAM) beginning 48 h after anesthesia. In a post hoc experiment to examine locomotion, swim speed was assessed in a separate group of identically treated rats (n = 3 per group) for 4 days beginning 48 h after anesthesia. RESULTS: Aged rats were slower to complete the maze, made fewer correct choices before first error, and made more errors at baseline than young rats (P < 0.05). Anesthesia worsened maze performance in both age groups, as evidenced by increased time to complete the maze and a decreased number of correct choices before first error (P < 0.05), but there were no statistically significant differences in total number of errors. Interestingly, there were no age-by-anesthesia interactions. Aged rats swam slower than adult rats (P < 0.001), but there were no differences between the control and anesthesia groups. CONCLUSIONS: Isoflurane-nitrous oxide anesthesia is associated with a persistent deficit in RAM performance that is not explained by impaired locomotion. This impairment occurs in adult and aged rats, indicating that it is not an age-specific phenomenon. Thus, RAM performance is altered after general anesthesia for longer than predicted by the pharmacology of the drugs used, which, by inference, suggests a long-term deficit in learning/memory.

Aging↗
PubMed1998

Enhanced long-term potentiation and impaired learning in mice with mutant postsynaptic density-95 protein.

Specific patterns of neuronal firing induce changes in synaptic strength that may contribute to learning and memory. If the postsynaptic NMDA (N-methyl-D-aspartate) receptors are blocked, long-term potentiation (LTP) and long-term depression (LTD) of synaptic transmission and the learning of spatial information are prevented. The NMDA receptor can bind a protein known as postsynaptic density-95 (PSD-95), which may regulate the localization of and/or signalling by the receptor. In mutant mice lacking PSD-95, the frequency function of NMDA-dependent LTP and LTD is shifted to produce strikingly enhanced LTP at different frequencies of synaptic stimulation. In keeping with neural-network models that incorporate bidirectional learning rules, this frequency shift is accompanied by severely impaired spatial learning. Synaptic NMDA-receptor currents, subunit expression, localization and synaptic morphology are all unaffected in the mutant mice. PSD-95 thus appears to be important in coupling the NMDA receptor to pathways that control bidirectional synaptic plasticity and learning.

Animals↗
PubMedDate not supplied

Survey of continuing professional education within nursing homes.

This article reports a survey of qualified nurses employed in nursing homes in a large city in the north of England. The aim of the study was to describe nurses' experiences and perceptions of continuing professional education (CPE), and their views on the development of their knowledge and skills through formal and informal education. Findings revealed that nurses in nursing homes perceived the value of educational programmes but had limited opportunities to attend formal education programmes. They faced a number of barriers and challenges in accessing formal education. Various informal ways of learning were used, including reading professional journals, watching videotapes and television programmes and accessing the Internet. However, respondents appeared not to use fully opportunities for sharing knowledge with colleagues. Although this study is based on a small sample, the findings support those of other studies in this field. Collectively, these studies suggest an urgent need to develop a range of approaches to CPE within care homes, both formal and informal, if the standards outlined within recent policy initiatives are to be achieved.

Attitude of Health Personnel↗
PubMed1975

Cataloging audiovisual materials: a new dimension.

A new more comprehensive system for cataloging audiovisual materials is described. Existing audiovisual cataloging systems contain mostly descriptive information, publishers' or producers' summaries, and order information. This paper discusses the addition of measurable learning objectives to this standard information, thereby enabling the potential user to determine what can be learned from a particular audiovisual unit. The project included media in nursing only. A committee of faculty and students from the University of Alabama in Birmingham School of Nursing reviewed the materials. The system was field-tested at nursing schools throughout Alabama; the schools offered four different types of programs. The system and its sample product, the AVLOC catalog, were also evaluated by medical librarians, media specialists, and other nursing instructors throughout the United States.

Audiovisual Aids↗
PubMed1998

Neural learning rules for the vestibulo-ocular reflex.

Mechanisms for the induction of motor learning in the vestibulo-ocular reflex (VOR) were evaluated by recording the patterns of neural activity elicited in the cerebellum by a range of stimuli that induce learning. Patterns of climbing-fiber, vestibular, and Purkinje cell simple-spike signals were examined during sinusoidal head movement paired with visual image movement at stimulus frequencies from 0.5 to 10 Hz. A comparison of simple-spike and vestibular signals contained the information required to guide learning only at low stimulus frequencies, and a comparison of climbing-fiber and simple-spike signals contained the information required to guide learning only at high stimulus frequencies. Learning could be guided by comparison of climbing-fiber and vestibular signals at all stimulus frequencies tested, but only if climbing fiber responses were compared with the vestibular signals present 100 msec earlier. Computational analysis demonstrated that this conclusion is valid even if there is a broad range of vestibular signals at the site of plasticity. Simulations also indicated that the comparison of vestibular and climbing-fiber signals across the 100 msec delay must be implemented by a subcellular "eligibility" trace rather than by neural circuits that delay the vestibular inputs to the site of plasticity. The results suggest two alternative accounts of learning in the VOR. Either there are multiple mechanisms of learning that use different combinations of neural signals to drive plasticity, or there is a single mechanism tuned to climbing-fiber activity that follows activity in vestibular pathways by approximately 100 msec.

Animals↗
PubMed1983

Behavioural strategies in the regulation of food choice.

The maintenance of nutrient and energy balance in the body depends on both metabolic and behavioural mechanisms, and is integrated by the brain. The regulatory system was developed by natural selection and not by mechanical engineers. Thus, rather than having unitary mechanisms regulating intake of each nutrient, evolution has incorporated and used a multitude of behavioural traits and metabolic adaptations. The criterion for inclusion was that each one conferred a persisting advantage in the prevailing environment. Behavioural strategies in food choice include: innate preference for sweetness and an aversion towards bitter tastes, a hesitancy towards unknown foods, preference for variety among familiar foods, and a special ability (long delay learning) to acquire information about both positive and negative metabolic consequences of eating different foods. In man, these more basic mechanisms interact with and are complemented by cognitive, social and cultural influences on food choice. In a very few cases, such as regulation of energy, sodium and (perhaps) protein intakes, feeding behaviour is also guided by signals from specific internal receptors. However, for most nutrients, appetites seem to be non-specific and learned. Using studies on the regulation of protein intake from our own and other laboratories as examples, this review illustrates how innate preferences, learning, social interactions, metabolic adaptation and diet-induced changes in brain neurotransmitter metabolism can all play a role in subjective decisions about what to eat.

Animals↗
PubMed2001

Crossmodal processing in the human brain: insights from functional neuroimaging studies.

Modern brain imaging techniques have now made it possible to study the neural sites and mechanisms underlying crossmodal processing in the human brain. This paper reviews positron emission tomography, functional magnetic resonance imaging (fMRI), event-related potential and magnetoencephalographic studies of crossmodal matching, the crossmodal integration of content and spatial information, and crossmodal learning. These investigations are beginning to produce some consistent findings regarding the neuronal networks involved in these distinct crossmodal operations. Increasingly, specific roles are being defined for the superior temporal sulcus, the inferior parietal sulcus, regions of frontal cortex, the insula cortex and claustrum. The precise network of brain areas implicated in any one study, however, seems to be heavily dependent on the experimental paradigms used, the nature of the information being combined and the particular combination of modalities under investigation. The different analytic strategies adopted by different groups may also be a significant factor contributing to the variability in findings. In this paper, we demonstrate the impact of computing intersections, conjunctions and interaction effects on the identification of audiovisual integration sites using existing fMRI data from our own laboratory. This exercise highlights the potential value of using statistical interaction effects to model electrophysiological responses to crossmodal stimuli in order to identify possible sites of multisensory integration in the human brain.

Brain↗