Somesthetic Functions in Patients with Brain Disease and Normal Subjects

This paper summarizes the results of a series of studies of somatosensory function in normal and brain-diseased subjects that were designed to investigate: (1) neural mechanisms in tactile resolution and masking, and; (2) cerebral dominance and somesthesis. Our results are consistent with the possibility that lateral inhibition effects influence tactile resolution and masking. Additional findings suggest that the physiologic mechanisms involved in tactile masking and obscuration in healthy subjects also mediate the pathologic expressions of these phenomena shown by patients with cerebral disease. Studies of hemispheric dominance and somesthesis have indicated that patients with right hemisphere disease often demonstrate bilateral impairment in tactile perception of direction while this deficit is confined to the right hand of patients with left hemisphere disease. Consistent with the implications of these clinical findings, right-handed normal subjects show a left-hand superiority for tactile perception of direction. Bilateral impairment on a proprioception task was found for patients with unilateral cerebral disease of either hemisphere. However, only patients with right hemisphere lesions were unable to utilize increments in proprioceptive feedback to improve their performance. The results on tactile perception of direction and proprioceptive feedback are interpreted as consistent with findings for other sensory modalities that point to the crucial role of the right hemisphere in spatial aspects of perception

Right-Left Discrimination and Finger-Localization in Normal and Brain Injured Subjects

Right-left discrimination and finger-localization are perceptual skills of considerable clinical interest because impairment in these abilities is sometimes encountered in patients with cerebral disease (2). With the rather gross methods employed in the typical clinical neurological examination, isolated impairment in right-left discrimination or finger-localization does not appear to be a frequent finding in adult patients with cerebral injury or disease. This is not altogether surprising when it is realized that the responsible cerebral lesion is almost invariably to be found in the dominant cerebral hemisphere. A frequent consequence of such a lesion is, of course, an aphasic disorder which is likely to interfere with the assessment of these skills, since the tasks by their very nature involve some degree of symbol-understanding or symbolic response. Moreover, if a patient with gross sensory disturbances or profound impairment of the body-image is unable to identify the right and left sides of his body or to localize his fingers, the deficits are not usually designated as right-left disorientation or finger-agnosia because of the presence of the more general disability. Nevertheless, even when these factors are discounted, defective right-left discrimination and finger-localization seem to be rather infrequently observed in brain-injured adults

Surface Feature-Guided Mapping of Cerebral Metabolic Changes in Cognitively Normal and Mildly Impaired Elderly

Purpose: The aim of this study was to investigate the longitudinal positron emission tomography (PET) metabolic changes in the elderly. Procedures: Nineteen nondemented subjects (mean Mini-Mental Status Examination 29.4±0.7 SD) underwent two detailed neuropsychological evaluations and resting 2-deoxy-2-[F-18]fluoro-D-glucose (FDG)-PET scan (interval 21.7±3.7 months), baseline structural 3T magnetic resonance (MR) imaging, and apolipoprotein E4 genotyping. Cortical PET metabolic changes were analyzed in 3-D using the cortical pattern matching technique. Results: Baseline vs. follow-up whole-group comparison revealed significant metabolic decline bilaterally in the posterior temporal, parietal, and occipital lobes and the left lateral frontal cortex. The declining group demonstrated 10–15 % decline in bilateral posterior cingulate/precuneus, posterior temporal, parietal, and occipital cortices. The cognitively stable group showed 2.5–5% similarly distributed decline. ApoE4-positive individuals underwent 5–15 % metabolic decline in the posterior association cortices. Conclusions: Using 3-D surface-based MR-guided FDG-PET mapping, significant metaboli

Towards an ethical ecology of international service learning

International Service-Learning (ISL) is a pedagogical activity that seeks to blend student learning with community engagement overseas and the development of a more just society. ISL programmes have grown as educational institutions and non-governmental organisations have sought to achieve the goal of developing ‘global citizens’. However, Service Learning (SL) in general and International Service-Learning (ISL) in particular remain deeply under theorised. These educational initiatives provide policy makers with a practical response to their quest for a ‘Big Society’and present alluring pedagogical approaches for Universities as they react to reforms in Higher Education and seek to enhance both the student learning experience and graduate employability. After outlining the development of ISL in policy and practice, this paper draws on the rich tradition of ISL at one British university to argue that ISL is a form of engagement that has the potential to be ethical in character although we identify a number of factors that militate against this. Our contention is that ISL which promotes rationaland instrumental learning represents a deficit model and we therefore conceptualise ISL here as a transformative learning experience that evinces distinctly aesthetic and even spiritual dimensions. Upon this theoretical groundwork we lay the foundations for conceptualizing ISL in ways that ensure its ethical integrity

Psychosocial Treatment of Children in Foster Care: A Review

A substantial number of children in foster care exhibit psychiatric difficulties. Recent epidemiologi-cal and historical trends in foster care, clinical findings about the adjustment of children in foster care, and adult outcomes are reviewed, followed by a description of current approaches to treatment and extant empirical support. Available interventions for these children can be categorized as either symptom-focused or systemic, with empirical support for specific methods ranging from scant to substantial. Even with treatment, behavioral and emotional problems often persist into adulthood, resulting in poor functional outcomes. We suggest that self-regulation may be an important mediat-ing factor in the appearance of emotional and behavioral disturbance in these children

Antiinflammatory Therapy with Canakinumab for Atherosclerotic Disease

Background: Experimental and clinical data suggest that reducing inflammation without affecting lipid levels may reduce the risk of cardiovascular disease. Yet, the inflammatory hypothesis of atherothrombosis has remained unproved. Methods: We conducted a randomized, double-blind trial of canakinumab, a therapeutic monoclonal antibody targeting interleukin-1β, involving 10,061 patients with previous myocardial infarction and a high-sensitivity C-reactive protein level of 2 mg or more per liter. The trial compared three doses of canakinumab (50 mg, 150 mg, and 300 mg, administered subcutaneously every 3 months) with placebo. The primary efficacy end point was nonfatal myocardial infarction, nonfatal stroke, or cardiovascular death. RESULTS: At 48 months, the median reduction from baseline in the high-sensitivity C-reactive protein level was 26 percentage points greater in the group that received the 50-mg dose of canakinumab, 37 percentage points greater in the 150-mg group, and 41 percentage points greater in the 300-mg group than in the placebo group. Canakinumab did not reduce lipid levels from baseline. At a median follow-up of 3.7 years, the incidence rate for the primary end point was 4.50 events per 100 person-years in the placebo group, 4.11 events per 100 person-years in the 50-mg group, 3.86 events per 100 person-years in the 150-mg group, and 3.90 events per 100 person-years in the 300-mg group. The hazard ratios as compared with placebo were as follows: in the 50-mg group, 0.93 (95% confidence interval [CI], 0.80 to 1.07; P = 0.30); in the 150-mg group, 0.85 (95% CI, 0.74 to 0.98; P = 0.021); and in the 300-mg group, 0.86 (95% CI, 0.75 to 0.99; P = 0.031). The 150-mg dose, but not the other doses, met the prespecified multiplicity-adjusted threshold for statistical significance for the primary end point and the secondary end point that additionally included hospitalization for unstable angina that led to urgent revascularization (hazard ratio vs. placebo, 0.83; 95% CI, 0.73 to 0.95; P = 0.005). Canakinumab was associated with a higher incidence of fatal infection than was placebo. There was no significant difference in all-cause mortality (hazard ratio for all canakinumab doses vs. placebo, 0.94; 95% CI, 0.83 to 1.06; P = 0.31). Conclusions: Antiinflammatory therapy targeting the interleukin-1β innate immunity pathway with canakinumab at a dose of 150 mg every 3 months led to a significantly lower rate of recurrent cardiovascular events than placebo, independent of lipid-level lowering. (Funded by Novartis; CANTOS ClinicalTrials.gov number, NCT01327846.

Competition and Combative Advertising: An Historical Analysis

Fred K. Beard (PhD, University of Oklahoma) is a professor of advertising in the Gaylord College of Journalism and Mass Communication, University of Oklahoma. His research interests include comparative advertising, advertising humor, and advertising history. His work has appeared in the Journal of Advertising, the Journal of Advertising Research, the Journal of Business Ethics, the Journal of Business Research, Journalism History, the Journal of Historical Research in Marketing, the Journal of Macromarketing, and the Journal of Marketing Communications, among others.Yeshttps://us.sagepub.com/en-us/nam/manuscript-submission-guideline