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HIV risk reduction strategies for low-income African American women.

Intervention strategies from the Health Education Reaching Out into the Community project that can be used in the clinical setting to assist low-income African American women adopt sexual behavior that is low risk for human immunodeficiency virus are discussed. These strategies include allocation of adequate time, the nurse practitioner's acceptance of the client, the use of adult learning principles, and active client participation through discussion, return demonstration, role play, and promotion of the client's ownership of the information learned.

Adult↗

The effects of peripheral endocrine hormone deficiencies on the processes of behavior, learning, and memory.

The effects of thyroid and adrenal cortex hormone and sex hormone deficiencies on the ability to learn, store memory traces, and behave were compared in male rats. These studies showed that removal of peripheral endocrine glands led to disruption of the learning process and the ability to reproduce learned information and also produced alterations in behavior. Analysis of the results showed that corticosteroid hormones are directly involved in the processes of learning and behavior. Sex and thyroid hormones appear to have modulatory effects on higher nervous activity.

Adrenal Cortex Hormones↗

Effects of subanesthetic concentrations of isoflurane and their interactions with epinephrine on acquisition and retention of the rabbit nictitating membrane response.

BACKGROUND: Evidence concerning the concentrations of volatile anesthetics that prevent learning and recall is limited. Epinephrine is believed to enable learning during anesthesia. We investigated the effects of isoflurane and its interaction with epinephrine on learning and subsequent retention of the rabbit's classically conditioned nictitating membrane response. METHODS: In experiment 1, a tone (conditioned stimulus, CS) preceded paraorbital shock (unconditioned stimulus, US) during 60-min daily sessions of 60 presentations of these paired stimuli for 6 days of acquisition training under 0, 0.4%, or 0.8% isoflurane (n = 8, 13, and 9, respectively). Responses were recorded as conditioned responses (CRs) if they occurred during the CS and before the onset of the US. After 1 day of rest, the animals were given 3 days of extinction consisting of 60 presentations of CS-alone and without isoflurane to assess the retention of CRs from acquisition training. In experiment 2, epinephrine in a dose of 0, 0.01, or 0.1 mg/kg was injected subcutaneously in rabbits receiving 0.4% isoflurane. Two types of epinephrine were used, a sustained release form and epinephrine hydrochloride. Acquisition and retention were tested in the same way as in experiment 1. No isoflurane or epinephrine was used during retention testing. RESULTS: Learning was significantly suppressed during 0.4% isoflurane (approximately equal to 0.2 MAC) treatment and eliminated during 0.8% (approximately equal to 0.4 MAC). Information learned during administration of 0.4% isoflurane was not retained (P < 0.05). Although the low doses of epinephrine improved learning during the last day of the acquisition phase (P < 0.05), there were no differences between the treatment groups on any of the remaining acquisition or extinction days. CONCLUSIONS: There was no learning during treatment with 0.8% concentration. Even a 0.4% concentration, which allowed some learning, abolished CRs in extinction, perhaps because of state-dependent retrieval. Epinephrine did not alter substantially the rates of CR acquisition or resistance to extinction.

Animals↗

Theoretical models and computer simulations of neural learning systems.

It has been generally assumed for a long time that learning is accomplished in the central nervous system (CNS) by modifying strengths of ties between neurons. Various mechanisms may contribute to this process, but it is not known which are the specific mechanisms, and what are the rules by which they operate. Theoretical models, which are based on that general assumption are introduced. The purpose of the models is to suggest plausible ways by which learned information may be stored in the neural network, and be retrieved when it is needed. The networks in the models consist of four basic subunits, in accordance with identified units in the CNS: sensing, response, feeling, and control, plus association areas. The suggested operation rules are based on established operation rules of individual neurons, and assumed rules when neurons in groups are considered. Computer simulations are done, to check the consistency of the models, and to illustrate how they work. They simulate how an hypothetical kitten learns part of its environment, and show how relevant information may be stored and retrieved in its neuronal network. The suggested mechanisms could be examined in experiments, albeit not easy ones to conduct.

Animals↗

Use of the Internet as a resource of health information by patients: a clinic-based study in the Indian population.

BACKGROUND: There is abundant literature documenting that the Internet is fast changing the way patients access health-related information, learn about their illnesses, and make healthcare-related decisions. However, there is hardly any data regarding Indian patients accessing health-related information available on the Internet. AIMS: To determine patients' use of the Internet as a medical information resource and to determine their experience, their perceptions of the quality and reliability of the information available. SETTING: The study was carried out in the outpatient clinic of an urban, tertiary care private sector hospital in November 2004. MATERIAL AND METHODS: Our survey instrument consisted of an anonymous single-page questionnaire. Eight hundred and eighty consecutive adults aged 18-70 years, attending the general outpatient clinic of a tertiary care private hospital completed the questionnaire. RESULTS: Two hundred and eighty-one (32%) patients acknowledged surfing the Internet, while 75% (212/281) of them acknowledged that they accessed health-related information. Amongst those who accessed the Internet, 130 (61%) found the information on the net to be of average quality. Almost all patients (211/212) felt that the information served the purpose and 95% (201/212) also found also found it to be reliable. Only 7% (21/281) patients were aware of the presence of any quality standards pertaining to health information sites and none could name any accreditation standard. CONCLUSIONS: One in four patients attending the private set-up is using the Internet for health information. A majority of patients find the information on the net reliable and of good quality. Awareness about health information quality standards is a rarity.

Adolescent↗

Using provisional restorations to improve results in complex aesthetic restorative cases.

UNLABELLED: Provisional restorations provide more than an intermediate functional and protective covering of teeth that have been prepared for indirect restorations. They provide the opportunity to build a relationship with the patient, to more clearly achieve the patient's aesthetic expectations, to build patient hygiene skills and habits, and to learn what is ideal for patients occlusally, phonetically, and aesthetically. This presentation examines the benefits of provisionalization and how to effectively communicate the information learned in this stage to the laboratory for replication in the definitive restorations. LEARNING OBJECTIVES: This article demonstrates how provisional restorations can be used to build a collaborative relationship between the prosthodontist, patient, dental specialists, and laboratory technician. Upon reading this article, the reader should: Understand how to use provisional restorations to develop patient expectations and to build a clear understanding of treatment goals. Understand how provisional restorations can be used to limit occlusal and phonetic difficulties that can occur in these restorations.

Communication↗

The Information Commons: a model for (physical) digital resource centers.

Since its planning, construction, and opening in 1996, the Information Commons, located in The University of Iowa's Hardin Library for the Health Sciences, has served as a common ground for self-directed learning, information research, hands-on class sessions, and multimedia development. Initiatives launched from the Information Commons not only have helped increase the visibility of Hardin Library as an environment well equipped to support traditional research and education needs, but have promoted the library as a campus leader and viable partner in planning and delivering digital technologies effectively. Ongoing initiatives have focused on better integrating the library's services and resources with the curricula and research needs of the university's health sciences units. This paper describes the facility, its programmatic elements, and its impact on education, communication, and technology trends in an academic health sciences setting. Particular attention is paid to initiatives launched during the first two years of operation. This paper also discusses plans for expansion of the facility.

Budgets↗

Information processes in movement learning: capacity and structural interference effects.

A series of experiments examined motor learning as an information processing activity occurring within a working short-term memory system and where response-produced feedback and knowledge of results (KR) are used to modify the action plan developed from previous attempts at the movement task. Use of interpolated activities in the KR delay interval allowed inferences to be made regarding the capacity and structural characteristics of these information processes. Results indicated no capacity limitations on the learning process but important structural effects were found. The results supported the idea that response-produced feedback is relatively unimportant as a feedback variable early in learning. Rather, the use of KR at a relatively high level of movement planning appears to be the important information processing activity underlying learning. Finally, the results supported the view that these information processes are related to cognitive problem solving activities.

Journal Article↗

Single versus multiple probe blocks of P300-based concealed information tests for self-referring versus incidentally obtained information.

UNLABELLED: The aim of the present study was to compare two protocols and two information types on detection of concealed knowledge. Four independent groups of subjects were run. Two were tested on probe stimuli of a self-referring (AUTO) nature and two were tested on incidentally acquired details of a mock crime (MOCK). Each pair of groups was run either in a one-probe (1PB) or multiple probe (6PB) block. In the single probe block, which was repeated three times with a different probe on each block, one probe item was randomly repeated multiple times in a Bernoulli series with frequently presented, meaningless or irrelevant items. There was also a rare target item designed to force attention to the stimulus screen. All stimulus types were of the same category within each block. In contrast, in the multiple probe (and category) block, rare probes, rare targets and frequent irrelevant items were repeatedly presented in a Bernoulli series within one block. MAJOR RESULTS: There was a difference in task demand as measured by reaction time between the two protocols (the multiple probe protocol was more demanding), and a difference trend in P300 detection sensitivity between protocols for both information types combined in favor of the 1PB (p<.07). With both protocols combined, there was a trend (p<.07) favoring detection of familiar versus incidentally learned information. In terms of P300 amplitudes, both protocols showed the usual result that P300 to probes was greater than that to irrelevants. Also, as with detection rates, self-referring information was better detected in terms of Probe-Irrelevant P300 amplitude differences than mock crime information, regardless of protocol. There was no effect of time passage across the repeated blocks of the one-probe protocol. Methodological problems with the multiple probe protocol as utilized in most recent publications are discussed.

Adolescent↗

Unifying cost and information in information-theoretic competitive learning.

In this paper, we introduce costs into the framework of information maximization and try to maximize the ratio of information to its associated cost. We have shown that competitive learning is realized by maximizing mutual information between input patterns and competitive units. One shortcoming of the method is that maximizing information does not necessarily produce representations faithful to input patterns. Information maximizing primarily focuses on some parts of input patterns that are used to distinguish between patterns. Therefore, we introduce the cost, which represents average distance between input patterns and connection weights. By minimizing the cost, final connection weights reflect input patterns well. We applied the method to a political data analysis, a voting attitude problem and a Wisconsin cancer problem. Experimental results confirmed that, when the cost was introduced, representations faithful to input patterns were obtained. In addition, improved generalization performance was obtained within a relatively short learning time.

Algorithms↗

Children's use of information in word learning.

Whenever children hear a novel word, the context supplies information about its meaning. One way children may cope with so much information is to use whatever seems to make sense, given their prior knowledge and beliefs, while ignoring or quickly forgetting the rest. This work examined if and how children's beliefs about word meanings may affect their use of contrastive linguistic information in the input in word learning. In Study 1, some 3- and 4-year-olds were introduced to a novel material or shape name and heard it contrasted with familiar words. Others merely heard the novel word used for referring to an object. These children were then tested to determine what they had learned about their new word meaning. In Study 2, another group of 3- and 4-year-olds were asked to name the materials and shapes used for introducing these novel terms. Children made use of linguistic contrast only in some situations. They benefited more when the novel term did not overlap much in denotation with any terms commonly known by 3- and 4-year-olds. These results suggest that children can use information in the input very efficiently in learning a term for an as-yet-unnamed category, but not in learning a term similar in denotation to a word they already know. Thus, the results are consistent with the claim that children believe every word has a unique denotation.

Child Language↗

Comparison of constant time delay and the system of least prompts in teaching preschoolers with developmental delays.

This investigation compared the effectiveness and efficiency (sessions, errors, percent of errors, and minutes of instructional time through criterion) of constant time delay and the system of least prompts in teaching sight words to developmentally delayed preschoolers. Maintenance of sight words and generalization across instructors and materials were assessed. Also, students' acquisition of relationships between the target behavior and previously learned information were assessed. Two sessions were conducted each day in their classroom, one with each procedure. Two of the children were taught 16 words and one child learned 12 words. The parallel treatments design was used to assess the effectiveness of the two instructional strategies. The results indicated that (a) both strategies produced criterion level responding in the instructional setting, (b) constant time delay resulted in fewer total trials, errors, percent of errors, and minutes of direct instructional time through criterion than the system of least prompts, (c) both strategies produced criterion-level responding that maintained in 1-, 3- and 5-week follow-up probes, (d) both strategies resulted in generalization across instructors and materials, and (e) both strategies resulted in cross-modal generalization from expressive to receptive, receptive and expressive identification of the words' function or action, and matching the written word to a photograph of its referent.

Attention↗

Factors perceived to facilitate and impede learning in the workplace.

A study was conducted to determine factors that facilitate and impede learning in a hospital nursing staff development department. Data were collected through interviews, observations, critical incidents, and document reviews. Findings show that factors perceived to facilitate learning are (1) support for education by nursing administration, (2) availability of education, (3) the inviting atmosphere of the staff development department, (4) small class size, (5) informal learning, (6) the expert instructor, and (7) support of education by first-line managers. Factors perceived to impede learning are fewer: (1) written tests, (2) short staffing, and (3) first-line managers.

Education, Nursing, Continuing↗

Education review: applied medical informatics--informatics in medical education.

The importance of informatics training within a health sciences program is well recognized and is being implemented on an increasing scale. At Chicago Medical School (CMS), the Informatics program incorporates information technology at every stage of medical education. First-year students are offered an elective in computer topics that concentrate on basic computer literacy. Second-year students learn information management such as entry and information retrieval skills. For example, during the Introduction to Clinical Medicine course, the student is exposed to the Intelligent Medical Record-Entry (IMR-E), allowing the student to enter and organize information gathered from patient encounters. In the third year, students in the Internal Medicine rotation at Norwalk Hospital use Macintosh power books to enter and manage their patients. Patient data gathered by the student are stored in a local server in Norwalk Hospital. In the final year, we teach students the role of informatics in clinical decision making. The present senior class at CMS has been exposed to the power of medical informatics tools for several years. The use of these informatics tools at the point of care is stressed.

Attitude to Computers↗

Learning curves for mutual information maximization.

An unsupervised learning procedure based on maximizing the mutual information between the outputs of two networks receiving different but statistically dependent inputs is analyzed [S. Becker and G. Hinton, Nature (London) 355, 161 (1992)]. For a generic data model, I show that in the large sample limit the structure in the data is recognized by mutual information maximization. For a more restricted model, where the networks are similar to perceptrons, I calculate the learning curves for zero-temperature Gibbs learning. These show that convergence can be rather slow, and a way of regularizing the procedure is considered.

Journal Article↗

Spatial recognition memory deficits without notable CNS pathology in rats following herpes simplex encephalitis.

Survivors of herpes simplex encephalitis (HSE) experience intellectual impairment and an inability to store and recall information. Because the temporal lobes and associated limbic structures are central to storage and retrieval of memories, and are predominantly affected in adult HSE, injury to these areas is postulated to cause behavioral and learning disabilities. A previous study (Beers et al., 1993) demonstrated that intranasal inoculation of Lewis rats with herpes simplex virus type-1 (HSV-1) induced acute partial complex seizures, and hemorrhagic and inflammatory lesions of the hippocampus and entorhinal cortex. Consequently, it was of interest to determine whether rats that had recovered from HSE had limbic system-associated memory impairments. Therefore, rats were evaluated when signs and symptoms of encephalitis were no longer apparent using an eight arm radial maze to assess the acquisition and retention of learned information. An allocentric-spatial location paradigm revealed HSV-1 infected rats performed at chance levels on both acquisition and retention which were statistically different from sham-inoculated controls. However, using an egocentric-spatial left/right discrimination task, infected rats performed statistically similar to sham-inoculated controls. Furthermore, HSV-1 nucleic acids were detected in the nuclei of neurons within the hippocampus and entorhinal cortex using in situ hybridization techniques. Of interest was the observation that rats with learning and memory deficits had no apparent histopathological or immunocytochemical evidence of antecedent CNS infection. This is the first experimental demonstration that HSV-1 can cause behavioral impairments in the absence of obvious inflammatory injury to the temporal lobe memory system.

Animals↗

Role of imagery and verbal labeling in the performance of paired associates tasks by persons with closed head injury.

The facilitating effects of visual imagery and verbal labeling strategies on learning and retention were examined with 60 survivors of closed-head injury. Because individuals without known neurological deficits use cognitive strategies when learning new materials, we expected that head-injured subjects could also be taught to use these strategies. Subjects were asked to memorize the verbal and visual paired associates stimulus items from the revised Wechsler Memory Scale-Revised (WMS-R). One group of subjects received mental imagery instructions to help them learn the verbal paired associates. Another group received verbal labeling training to help them learn the visual paired associates. Subjects who received imagery but not verbal labeling instructions were able to recall more paired associations than those who did not receive imagery. Those subjects who received verbal labeling but not imagery instructions recalled more visual paired associations than those who did not. Subjects who received learning instructions also showed better retention of the learned information.

Adolescent↗

The mnemonic mechanisms of errorless learning.

Errorless learning enhances memory relative to errorful, trial-and-error learning, but the extent to which this advantage relies on implicit or explicit memory processes is not clear. Previous attempts to determine the mnemonic mechanisms of errorless learning have relied on contrasts between patient groups or between tasks, but both approaches are problematic. In this study, healthy younger and older adults were engaged in errorless or errorful learning using a process dissociation procedure that provides separate estimates of explicit recollection and implicit familiarity within-subjects and within-task (Hay & Jacoby, 1996). Consistent with much prior research, we found an age-related decrement in recollection, but age-invariance in familiarity. In the young adults, errorless learning reduced the misleading familiarity of prior errors, but this benefit was offset by the non-elaborative nature of the errorless learning condition that also reduced recollection. In the older adults, who are less able to oppose familiarity-based errors because of their lower recollection, errorless learning only reduced the misleading impact of previous errors. Our results support Baddeley and Wilson's (1994) position that the errorless learning effect is mediated by implicit memory processes: individuals with reduced explicit memory benefit from errorless learning because errorless learning bypasses the need to engage explicit error elimination processes. We do not recommend standard errorless learning for individuals with intact explicit memory, such as students trying to learn information in preparation for an examination.

Adolescent↗