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PubMed2003

Early stage Parkinson's disease patients and normal volunteers: comparative mechanisms of sequence learning.

Early-stage nondemented Parkinson's disease (PD(es)) patients can learn short but not long sequences as well as controls. We have previously shown that to achieve normal performance, PD(es) patients activated the same right-sided cortical regions as controls plus the homologous left sided cortex and bilateral cerebellum. In this study, we evaluated two related hypotheses to explain the behavioral abnormalities and the increased bilateral brain activation observed in the PD(es) group. Hypothesis 1 proposed that PD(es) patients recruit regions from a normal bilateral network specialized for sequence learning that healthy controls would activate if performing difficult tasks. Thus, PD(es) patients can learn short sequences as well as controls. Hypothesis 2 proposed that information processing within the network in the PD(es) group is impaired. Thus, PD(es) patients cannot learn as difficult a sequence as controls. To test hypothesis 1, we increased task difficulty and statistical power in the control group and showed that the control and the PD(es) groups activated the same regions. To test hypothesis 2, we analyzed the equal performance data using two partial least squares (PLS) multivariate analyses. The task-PLS analysis showed that to perform equally with controls, the PD(es) group expressed the normal bilateral network more than the control group. The behavior-PLS analysis showed that the correlation between learning performance and regional activation was significantly different between the groups. We conclude that PD(es) patients have near normal learning if task difficulty is moderate because they can recruit additional regions from a normal bilateral network specialized for sequence learning. However, when a difficult task would normally require bilateral activation, PD(es) patients fail to learn because information processing within the network is impaired. Hum. Brain Mapp. 20:246-258, 2003.

Aged↗
PubMed2002

MEDICOL: online learning in medicine and dentistry.

OBJECTIVE: MEDICOL (Medicine and Dentistry Integrated Curriculum Online) provides a variety of Web-based resources that act as important adjuncts to all the teaching components of the medical and dental undergraduate curriculum. It uses WebCT, a course-management system, to provide the following educational functions: (1) track students' progress and present course information such as time-tables, learning objectives, handout materials, images, references, course assignments, and evaluations; (2) promote student-to-student and student-to-instructor interactions (through e-mail and bulletin boards); and (3) deliver self-directed learning components, including weekly self-assessment quizzes that provide immediate feedback and multimedia learning modules (clinical skills, radiology, evidence-based medicine, etc.). DESCRIPTION: The University of British Columbia Faculties of Medicine and Dentistry feature a problem-based learning (PBL) curriculum in which students access many of the same tools they will utilize in their professional practice. In the PBL curriculum, students must access the relevant clinical data and educational resources. A MEDICOL site has also been developed for medical students to use during their rural family practice, a four- to six-week experience in the summer after their second year. This site has been designed to be a supplemental learning environment for not only these students, but also for their physician preceptors. It is intended to foster communication among participants, bring new resources to the rural setting, and allow preceptors to develop their Internet skills with the help of students who are already familiar with the electronic environment. The MEDICOL sites enable the exchange of information about the learning issues between, as well as within, tutorial groups. MEDICOL also provides students with faculty-reviewed resources that are listed online; multimedia presentations; and access to histology, radiology, and pathology images through an online image database. Each week, students have access to a new interactive and automatically graded self-assessment quiz for individual study. These quizzes test learning objectives from tutorial, lecture, and lab material for each week of the curriculum and are modeled after summative examinations held twice each year. Question authors provide immediately accessible quality feedback to students. A comprehensive quiz databank of approximately 1,500 questions has been attained. WebCT enables MEDICOL to deliver anonymous, online program-evaluation questionnaires during clinical clerkships (resulting in a 99% response rate after a few e-mail reminders), with easy and timely data collection and reporting methods. Summative assessments have also been delivered through MEDICOL. DISCUSSION: Use statistics indicate that over 90% of students regularly use the MEDICOL sites and have found them helpful. University of British Columbia medical school enrollment will increase because of collaborations with campuses and medical centers across the province. MEDICOL will likely play an increased role in distance learning by continuing to deliver the resources already described, as well as facilitating synchronous communications (e.g., PBL chat rooms) and teaching (e.g., video-streamed lectures) to students located across the province.

Education, Dental↗
PubMed2001

Implicit learning revealed by the method of opposition.

Complex information, such as that required for motor skills, can be learned implicitly, without awareness. Much debate has centered on the appropriate methods for proving that implicit learning is not influenced by explicit awareness. A recent study by Destrebecqz and Cleeremans has provided compelling evidence for implicit sequence learning without awareness by using the 'method of opposition'.

Journal Article↗
PubMed2003

Problem-based learning in online vs. face-to-face environments.

UNLABELLED: This study compared outcomes of problem-based learning between synchronous online groups and face-to-face tutorial groups. Specifically, the study compared learning outcomes, time-on-task and learning issue generation. METHODS AND PROCEDURES: A post-test only control group design was used to investigate the effects of learning conditions on learning outcomes and processes. The experimental learning condition was defined as computer-mediated problem-based learning (CMPBL) and the control condition was traditional problem based learning in face-to-face groups (TPBL). The learning process consisted of four elements: an initial tutorial, a period of self-directed learning, a second tutorial and a laboratory session. During the initial tutorial students generated learning issues that they submitted to the research assistant. In the self-directed learning phase, students researched their learning issues and returned for the second tutorial with their findings. Students in the CMPBL groups interacted with the resource person electronically via email, chat room or bulletin board. At the second tutorial, groups shared information related to their learning issues and completed their products for the problem. RESULTS: There was no difference in learning outcomes between groups. The CMPBL group spent significantly more time on learning than the TPBL group. There was no overall difference between groups on generation of learning issues; however, there was a significant relationship between number of learning issues generated and higher score on the examination regardless of tutorial medium.

Computer-Assisted Instruction↗
PubMed1998

Fimbria-fornix vs selective hippocampal lesions in rats: effects on locomotor activity and spatial learning and memory.

The behavioral effects of interrupting the axons that pass in the fimbria and dorsal fornix were compared with the effects of selective removal of the cells that comprise the hippocampus with ibotenic acid. Starting 4.5 months after surgery, lesioned and control rats were (i) trained in both the Morris water maze and the eight-arm radial maze using protocols that placed an emphasis on either working memory (WM) or reference memory (RM) and (ii) tested for locomotor activity in the home cage. In comparison to sham-operated rats, the rats from both lesion groups were impaired in most learning/memory tasks, but there were some interesting differences between the two lesioned groups. When compared to rats with fimbria-fornix lesions (FIFX rats), hippocampal rats (HIPP rats) were slower in learning to swim to a visible platform and showed a greater impairment than FIFX rats in the radial-maze task when the testing procedure required the utilization of RM and WM in a more demanding WM task. In the test of locomotor activity, FIFX and control rats did not differ, but HIPP rats were more active than the rats in both other groups. The pattern of results obtained after a 4.5-month recovery period support the following general conclusions. (1) While there are some similarities in the effects on behavior of interrupting the axons in the fimbria-fornix compared to removing the hippocampus, there are some important differences. (2) From the findings that are available, a possible explanation to account for the difference between FIFX and HIPP rats is that the 4.5-month survival time permitted some recovery in the group of rats with FIFX lesions. (3) While it is well known that the Morris water maze and the radial-arm maze tasks provide useful measures of spatial learning and memory processes, our results suggest that the information provided by the two spatial learning tasks may differ in important respects.

Analysis of Variance↗
PubMed1996

Deep assessment of machine learning techniques using patient treatment in acute abdominal pain in children.

Learning from patient records may aid knowledge acquisition and decision making. Existing inductive machine learning (ML) systems such us NewId, CN2, C4.5 and AQ15 learn from past case histories using symbolic and/or numeric values. These systems learn symbolic rules (IF... THEN like) which link an antecedent set of clinical factors to a consequent class or decision. This paper compares the learning performance of alternative ML systems with each other and with respect to a novel approach using logic minimization, called LML, to learn from data. Patient cases were taken from the archives of the Paediatric Surgery Clinic of the University Hospital of Crete, Heraklion, Greece. Comparison of ML system performance is based both on classification accuracy and on informal expert assessment of learned knowledge.

Abdomen, Acute↗
PubMed1997

Basic Sciences in an Integrated Medical Curriculum: The Case of Pharmacology.

Integrating basic medical sciences such as pharmacology, into the teaching of medical students is not easy. The material usually provided through lectures and laboratories seems irrelevant to the practice of clinical medicine. The essence of pharmacology can be gleaned from the aphorism: Drug MEETS Body; Body MEETS Drug. The central themes are better learned in the context of clinical problems. Problem-based learning provides one possible avenue. Teachers should realise that medical schools are not the sole repository of wisdom and knowledge nor does learning cease with graduation. Students who learn to seek, synthesise and integrate information will be better prepared for life-long learning.

Journal Article↗
PubMed1998

Computer-assisted learning and the general dental practitioner.

Computer-assisted learning is an acceptable form of education for general dental practitioners. Critical assessment of program structure and content is required if the maximum benefits of the medium are to be obtained. There is a need for information technology support for general dental practitioners to allow them to make best use of the programs.

Adult↗
PubMed2002

Fornix transection impairs conditional visuomotor learning in tasks involving nonspatially differentiated responses.

Rhesus monkeys learned a series of conditional visuomotor associations involving two-dimensional "objects" that instructed one of three responses: tapping a touch screen, steady contact with the screen for a brief period, or steady contact for a longer period. Relative to controls, fornix-transected monkeys were impaired in the acquisition of new associations and in the retention of preoperatively learned ones. These findings challenge the view that the hippocampal system participates in associative learning only when spatial information is relevant to either the stimulus or the response.

Animals↗
PubMed2003

Teaching Pharmacology in 2010--new knowledge, new tools, new attitudes.

Changes in pharmacology teaching are being driven by various pressures. These originate: from changes in the discipline itself; from government; from professional bodies; from students; from changes in teaching styles and opportunities; from academic staff; from ethical/animal rights considerations; from employers and from higher education institutions. These changes will require an alteration in the knowledge, skills and attitudes of academic pharmacologists as much as they will require changes in the way teaching is delivered and learning is facilitated. Pharmacology courses will be provided in a changed environment and must prepare students to work in a changed discipline as well as being appropriate for students who will take employment in non-pharmacology areas. Change is likely to centre around the curriculum, problem based learning, simulated practicals, peer assessment, use of the internet, information technology and interactive computer based learning, virtual learning environments and integrated medical courses. The most effective strategy to achieve the necessary changes is likely to involve collaboration between pharmacology teachers on a global scale and a general consciousness among current academic pharmacologists that we need to ensure tomorrow's academics are well prepared for the changed environment in which they will have to work.

Attitude of Health Personnel↗
PubMed1995

Evaluation of a belief-network-based reminder system that learns from utility feedback.

PRETRIEVE is a belief-network-based, unsolicited information-retrieval system that performs machine learning based on user feedback. We report here on the document-ordering and document-retrieval performance of PRETRIEVE. We developed a test collection of 410 judgments of document utility in a simulated medical order-entry context. We characterized the validity of these judgments, which were elicited from domain experts, by measuring interrater and intrarater reproducibility. We developed a measure of the quality of document orderings similar to the ROC-curve analysis used to evaluate document-retrieval systems. We found that the ordering performance of the PRETRIEVE system was (1) substantially better than random, (2) somewhat less than ideal, and (3) superior to that of versions of the PRETRIEVE system that used relevance feedback instead of utility feedback. Under a set of assumptions, which we make explicit, we found that the documents retrieved by a version of PRETRIEVE that modeled time cost were of higher utility than those retrieved by a similar rule-based system.

Artificial Intelligence↗
PubMed2002

Alzheimer's disease through the eye of a mouse. Acceptance lecture for the 2001 Gayle A. Olson and Richard D. Olson prize.

There is now ample evidence that beta-amyloid proteins decrease memory. The SAMP8 mouse (P8) develops an early decline in the ability to learn and to retain new information. The studies reviewed here suggest that this is due to overproduction of beta-amyloid. Both antibodies to beta-amyloid and specific antisense to the amyloid precursor protein reverse these deficits in the P8 mouse. This antisense can cross the blood brain barrier. It is hypothesized that the overproduction of beta-amyloid leads to a decline in Delta(9) desaturase activity with an alteration in membrane fatty acids. This results in altered membrane mobility leading to a decline in neurotransmitter activity and a decreased release of acetylcholine. This decreased cholinergic activity results in a decreased ability of the P8 mouse to learn and retain new information.

Aging↗
PubMed1997

California Verbal Learning Test: normative data for the elderly.

Overlapping age tables were developed, separately for males and females, to provide additional normative information for the California Verbal Learning Test (CVLT) and extend the normative data to persons older than 80 years of age. Participants were 92 males and 120 females with means for age and education of 70.58 years (SD = 6.98) and 14.92 years (SD = 2.56), respectively. Normative information was also provided for additional measures of retention rate and proportion of perseverations and intrusions. The clinical utility of these norms strongly depends on how closely a person matches the demographic characteristics of the normative group.

Aged↗
PubMed1997

[Parents' coping with a diabetic child].

The purpose of this study is to describe and understand the process of parental coping with diabetic children in early childhood. The parental coping process was followed for a four-week period after the diagnosis of diabetes. The parents of two girls whose diabetes was diagnosed in early childhood served as study subjects. The data were collected by interviewing and observing the parents over four separate periods, first in hospital and later at home. The data were analyzed by the timeseries and content analysis methods. The main categories were formulated on the basis of coping theories. The subcategories were developed inductively from the data. Six phases of the parental coping were identified, which were named: 1). Disbelief, 2). Lack of information and Guilt, 3). Learning of Care, 4). Normalization, 5). Uncertainty and 6). Reorganization. In the different phases of parental coping the parents' experience of stress, coping strategies and sense of control varied. In the phase of Disbelief, parents tried to explain away the child's diabetes by questioning the diagnosis. The initial information given to the parents regarding their child's diabetes proved to be very important for parental coping. In the second phase of Lacking Information and Guilt, the parents sought for a reason for their child's diabetes and they felt guilty about it. As coping responses, the parents sought support from each other and from people who have undergone the same experience. In the Learning of Care phase, they recognized the demands caused by diabetes and took responsibility for the child's care. The parents responded that supervision based on their problems was the best. In the Normalization phase, the parents prepared to go home with the diabetic child. Getting back to normal life was one of the most effective parental coping responses. In the Uncertainty phase, the care to be given to the diabetic child changed the daily routines of the family. In the Reorganization phase, the parents adapted to the diagnosis of diabetes and the care of the diabetic child. The parents felt that the life of the family became normalized and controlled. The important parental coping responses consisted of concrete models of functioning, which they developed to control the demands caused by the child's diabetes.

Adaptation, Psychological↗