Using action understanding to understand the left inferior parietal cortex in the human brain

Published in final edited form as: Brain Res. 2014 September 25; 1582: 64–76. doi:10.1016/j.brainres.2014.07.035.Humans have a sophisticated knowledge of the actions that can be performed with objects. In an fMRI study we tried to establish whether this depends on areas that are homologous with the inferior parietal cortex (area PFG) in macaque monkeys. Cells have been described in area PFG that discharge differentially depending upon whether the observer sees an object being brought to the mouth or put in a container. In our study the observers saw videos in which the use of different objects was demonstrated in pantomime; and after viewing the videos, the subject had to pick the object that was appropriate to the pantomime. We found a cluster of activated voxels in parietal areas PFop and PFt and this cluster was greater in the left hemisphere than in the right. We suggest a mechanism that could account for this asymmetry, relate our results to handedness and suggest that they shed light on the human syndrome of apraxia. Finally, we suggest that during the evolution of the hominids, this same pantomime mechanism could have been used to ‘name’ or request objects.We thank Steve Wise for very detailed comments on a draft of this paper. We thank Rogier Mars for help with identifying the areas that were activated in parietal cortex and for comments on a draft of this paper. Finally, we thank Michael Nahhas for help with the imaging figures. This work was supported in part by the NIH grant RO1NS064100 to LMV. (RO1NS064100 - NIH)Accepted manuscrip

Experience-core curriculum work in secondary modern schools

The provision of education for adolescents of average and less than average academic ability is a problem of long standing. However, in the last 50 years or so, authorities in the world of education have recognised this problem as one of urgency. In particular - the Hadow Report (1926) and, more recently, the Newsom Report (1963) in England have highlighted the need for a pattern of education which adequately caters for these pupils. The background of the thesis is thus an appreciation of thought about this problem in the first half of the 20th Century. The substance of the thesis is the development of experience-core curriculum, as appropriate to the educational needs of these pupils. The principles upon which experience-core curriculum can be based are discussed and the stages of development of curriculum are recognised. A description is given of experimental work with pupils, carried out over a period of years, in order to develop a curriculum based upon such principles. Finally, experience-core curriculum has been evaluated with special reference to the work in which the writer has been implicated

Reorganization of retinotopic maps after occipital lobe infarction

Published in final edited form as: J Cogn Neurosci. 2014 June ; 26(6): 1266–1282. doi:10.1162/jocn_a_00538.We studied patient JS, who had a right occipital infarct that encroached on visual areas V1, V2v, and VP. When tested psychophysically, he was very impaired at detecting the direction of motion in random dot displays where a variable proportion of dots moving in one direction (signal) were embedded in masking motion noise (noise dots). The impairment on this motion coherence task was especially marked when the display was presented to the upper left (affected) visual quadrant, contralateral to his lesion. However, with extensive training, by 11 months his threshold fell to the level of healthy participants. Training on the motion coherence task generalized to another motion task, the motion discontinuity task, on which he had to detect the presence of an edge that was defined by the difference in the direction of the coherently moving dots (signal) within the display. He was much better at this task at 8 than 3 months, and this improvement was associated with an increase in the activation of the human MT complex (hMT^+) and in the kinetic occipital region as shown by repeated fMRI scans. We also used fMRI to perform retinotopic mapping at 3, 8, and 11 months after the infarct. We quantified the retinotopy and areal shifts by measuring the distances between the center of mass of functionally defined areas, computed in spherical surface-based coordinates. The functionally defined retinotopic areas V1, V2v, V2d, and VP were initially smaller in the lesioned right hemisphere, but they increased in size between 3 and 11 months. This change was not found in the normal, left hemisphere of the patient or in either hemispheres of the healthy control participants. We were interested in whether practice on the motion coherence task promoted the changes in the retinotopic maps. We compared the results for patient JS with those from another patient (PF) who had a comparable lesion but had not been given such practice. We found similar changes in the maps in the lesioned hemisphere of PF. However, PF was only scanned at 3 and 7 months, and the biggest shifts in patient JS were found between 8 and 11 months. Thus, it is important to carry out a prospective study with a trained and untrained group so as to determine whether the patterns of reorganization that we have observed can be further promoted by training.This work was supported by NIH grant R01NS064100 to L. M. V. Lucia M. Vaina dedicates this article to Charlie Gross, who has been a long-time collaborator and friend. I met him at the INS meeting in Beaune (France), and since then we often discussed the relationship between several aspects of high-level visual processing described in his work in monkeys physiology and my work in neuropsychology. In particular, his pioneering study of biological motion in monkeys' superior temporal lobe has influenced my own work on biological motion and has led us to coauthor a paper on this topic. Working with Charlie was a uniquely enjoyable experience. Alan Cowey and I often spoke fondly about Charlie, a dear friend and close colleague to us both, whose work, exquisite sense of humor, and unbound zest of living we both deeply admired and loved. (R01NS064100 - NIH)Accepted manuscrip

Factors contributing to the patient safety culture in Saudi Arabia: a systematic review

Background: Patient safety, concerned with the prevention of harm to patients, has become a fundamental component of the global healthcare system. The evidence regarding the status of the patient safety culture in Arab countries in general shows that it is at a suboptimal level due to a punitive approach to errors and deficits in the openness of communications. Objectives: To identify factors contributing to the patient safety culture in Saudi Arabia. Design: Systematic review. Methods: A systematic search was carried out in May 2018 in five electronic databases and updated in July 2020—MEDLINE, CINAHL, Embase, PsycINFO and the Cochrane Database of Systematic Reviews. Relevant journals and reference lists of included studies were also hand-searched. Two independent reviewers verified that the studies met the inclusion criteria, assessed the quality of studies and extracted their relevant characteristics. The Yorkshire Contributory Factors Framework (YCFF) was used to categorise factors affecting safety culture in the included papers. Results: 14 papers were included and the majority of studies were appraised as being of good quality. Strength and weakness factors that contribute to patient safety culture were identified. Ineffective leadership, a blame culture, workload/inadequate staffing and poor communication are reported as the main factors hindering a positive patient safety culture in Saudi Arabia. Conversely, ‘strength’ factors contributing to a positive patient safety culture included supportive organisational attitudes to learning/continuous improvement, good teamwork within units and support from hospital management for patient safety. There is an absence of patient perspectives regarding patient safety culture in Saudi Arabia. Conclusion: Policymakers in the Saudi healthcare system should pay attention to the factors that may contribute to a positive patient safety culture, especially establishing a blame-free culture, improving communications and leadership capacity, learning from errors and involving patient perspectives in safety initiatives. Further research is required to understand in depth the barriers and facilitators to the implementation of a positive patient safety culture in Saudi Arabia

New advancements and developments in treatment of renal cell carcinoma: focus on pazopanib

With the recent approval of pazopanib, an oral multitargeted tyrosine kinase inhibitor which potently targets vascular endothelial growth factor receptors 1–3, platelet-derived growth factor, and c-kit, six agents are now available for use in the management of metastatic renal cell carcinoma (RCC). Pazopanib has shown improved progression-free survival compared with placebo in treatment-naïve or cytokine-treated patients with metastatic RCC in large Phase II and Phase III clinical trials. Pazopanib has demonstrated a tolerable side effect profile and is currently being compared with sunitinib in a Phase III noninferiority trial. In this review, the outcomes of the clinical testing of pazopanib are discussed, as well as a perspective on the placement of pazopanib among other approved agents