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Graduate Study; Interdisciplinary Approach; Anatomy; Pathology; Physiology; Molecular Biology; Doctoral Programs; Medical Schools; Laboratory Experiments; Research; Medicine; Clinical Experience; Core Curriculum; Theory Practice Relationship; Human Capital

Abstract:
The need for interdisciplinary graduate training programs which prepare students to conceptualize the application of their research in clinical settings continues to grow. Though several programs have been cultivated to address this need, demand still outweighs supply. The following describes a curriculum developed with the intent of incorporating medical knowledge into a PhD graduate training program. Development of this Molecular Medicine program by the Cleveland Clinic Lerner College of Medicine in collaboration with Case Western Reserve University was funded by the Howard Hughes Medical Institute "Med into Grad" initiative. The core curriculum of this program begins with a foundation in Human Physiology and Disease course in which anatomy faculty introduce students to a basic overview of gross anatomy structure and function. This course is followed by five fundamental basic science courses, a composite course focusing on principles of clinical and translation research, a course on laboratory techniques and three, 12-week research rotations. In the second year of the program, students begin their dissertation research, complete their qualifying examination, and partake in an individually tailored Clinical Experience course. Interdisciplinary graduate programs like this provide another venue for faculty in anatomical sciences to help aspiring translational scientists relate basic science knowledge to human pathophysiology and health. (Contains 1 table.) Note:The following two links are not-applicable for text-based browsers or screen-reading software. Show Hide Full Abstract

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Anxiety Disorders; Brain Hemisphere Functions; Spectroscopy; Control Groups; Metabolism; Patients; Etiology; Children; Role; Physiology; Pathology; Color; Task Analysis; Word Recognition

Abstract:
Recent developments in near-infrared spectroscopy (NIRS) have enabled non-invasive clarification of brain functions in psychiatric disorders. Functional neuroimaging studies of patients with obsessive-compulsive disorder (OCD) have suggested that the frontal cortex and subcortical structures may play a role in the pathophysiology of the disorder. Twelve treatment-naive children with OCD and 12 age- and sex-matched healthy control subjects participated in the present study after giving consent. The relative concentrations of oxyhemoglobin (oxy-Hb) were measured with prefrontal probes every 0.1 s during the Stroop color-word task, using 24-channel NIRS machines. During the Stroop color-word task, the oxy-Hb changes in the OCD group were significantly smaller than those in the control group in the prefrontal cortex, especially in the frontopolar cortex. The present study suggests that children with OCD have reduced prefrontal hemodynamic response as measured by NIRS. Note:The following two links are not-applicable for text-based browsers or screen-reading software. Show Hide Full Abstract

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Communicable Diseases; Substance Abuse; Comorbidity; Mental Disorders; Medical Services; Screening Tests; Counseling Techniques; Chronic Illness; Patient Education; Genetics; Clinical Diagnosis; Diagnostic Tests; Barriers; Counselor Role; Outcomes of Treatment; Recidivism; Behavior Disorders; Drug Therapy; Patients; Needs; Physician Patient Relationship; Family Role; Program Evaluation; Prevention; Immunization Programs; Legal Problems; Ethics; Outreach Programs; Readiness; Acquired Immunodeficiency Syndrome (AIDS); Decision Making; Therapy; Social Influences; Counselor Client Relationship

Abstract:
Treatment Improvement Protocols (TIPs) are developed by the Center for Substance Abuse Treatment (CSAT), part of the Substance Abuse and Mental Health Services Administration (SAMHSA) within the U.S. Department of Health and Human Services (HHS). Each TIP involves the development of topic-specific best-practice guidelines for the prevention and treatment of substance use and mental disorders. TIPs draw on the experience and knowledge of clinical, research, and administrative experts of various forms of treatment and prevention. TIPs are distributed to facilities and individuals across the country. Published TIPs can be accessed via the Internet at http://www.kap.samhsa.gov. Although each consensus-based TIP strives to include an evidence base for the practices it recommends, SAMHSA recognizes that behavioral health is continually evolving, and research frequently lags behind the innovations pioneered in the field. A major goal of each TIP is to convey "front-line" information quickly but responsibly. If research supports a particular approach, citations are provided. This TIP is organized into two parts: Part 1 is for counselors and administrators of behavioral health programs providing substance abuse treatment. It comprises seven chapters and emphasizes steps substance abuse treatment counselors and administrators can take to educate clients, prevent new hepatitis infections, and help clients who have viral hepatitis recover from their substance use disorders (SUDs). Information is provided at a basic level so that it can be understood by readers without medical training. Chapter 1 presents an overview of the most common types of viral hepatitis. Chapters 2 and 3 provide detailed information on screening for hepatitis and evaluation, respectively. Factors to consider when helping a client decide whether to undergo hepatitis treatment are addressed in Chapter 4; the treatment process is explained in Chapter 5. Chapter 6 describes counseling approaches for treating clients who have SUDs and viral hepatitis. Chapter 7 offers recommendations for administrators on how to add or improve hepatitis services, showcasing programs with proven track records. Note: Many people in treatment for SUDs are affected by mental disorders prior to the start of hepatitis treatment; mental disorders also may arise through the course of hepatitis treatment. Guidance for addressing co-occurring mental disorders is included throughout the TIP. Hepatitis-related issues specific to the treatment of mental disorders, not in the context of co-occurring SUDs, are covered in Appendix F. Part 2 is an online literature review for clinical supervisors, program administrators, and counselors interested in reviewing the medical literature on which this TIP is based. The literature review, available at http://www.kap.samhsa.gov, will be updated every 6 months for 5 years following publication of this TIP. Appended are: (1) Bibliography; (2) Glossary; (3) Hepatitis Resources; (4) Managing Side Effects of Hepatitis C Antiviral Treatment; (5) Medicinal Plants/Alternative Treatments Potentially Harmful to People Who Have Hepatitis; (6) Mental Health Treatment Considerations for People Who Have Chronic Viral Hepatitis C; (7) Motivational Interviewing and Counseling Resources; (8) Sources for Financial Assistance; (9) Hepatitis C Training Programs for Substance Abuse Treatment Program Staff; (10) Stakeholders Meeting Participants; (11) Field Reviewers; and (12) Acknowledgments. An index is included. (Contains 21 exhibits.) Note:The following two links are not-applicable for text-based browsers or screen-reading software. Show Hide Full Abstract

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Allied Health Occupations; College Freshmen; Physiology; Anatomy; Academic Achievement; Allied Health Occupations Education; Pilot Projects; At Risk Students; Instructional Effectiveness; Instructional Design; College Instruction; Science Instruction; Program Effectiveness; Program Implementation

Abstract:
Many first-year students interested in healthcare careers do not succeed in Anatomy and Physiology I (A&PI), which they take in their first semester. These first-year students withdraw from the course or the institution, or their final grade may be below the identified threshold for progressing in their programs. A&PI has become a gatekeeper course, preventing students from entering careers where they are sorely needed. Southern Vermont College (SVC) launched a pilot A&PI course designed for vulnerable first-year students. SVC identified first-year students deemed academically at risk, and they were offered an opportunity to enroll in a re-envisioned A&PI course that was stretched over two semesters. There have been positive trend indicators on all the major items being measured and, importantly, some positive, unintended benefits. (Contains 6 notes.) Note:The following two links are not-applicable for text-based browsers or screen-reading software. Show Hide Full Abstract

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 ERIC Full Text (89K)

Descriptors:
Workstations; Pathology; Neurology; Physiology; Anatomy; Institutional Mission; Photography; Allied Health Occupations Education; College Instruction; Medical School Faculty; Medical Schools; Medical Education; Teaching Methods; Science Curriculum; Science Education; Science Instruction; Science Laboratories; Laboratory Equipment; Laboratory Procedures; Science Equipment; Program Descriptions; Educational Technology; Computer Software; Electronic Learning; Information Technology; Foreign Countries; Educational Facilities Design; Educational Facilities Planning; Educational Facilities; Databases; Computer System Design; Computer Uses in Education

Abstract:
This article discusses factors in the design, commissioning, project management, and intellectual property protection of developments within a new clinical anatomy facility in the United Kingdom. The project was aimed at creating cost-effective facilities that would address widespread concerns over anatomy teaching, and support other activities central to the university mission-namely research and community interaction. The new facilities comprise an engaging learning environment and were designed to support a range of pedagogies appropriate to the needs of healthcare professionals at different stages of their careers. Specific innovations include integrated workstations each comprising of a dissection table, with removable top sections, an overhead operating light, and ceiling-mounted camera. The tables incorporate waterproof touch-screen monitors to display images from the camera, an endoscope or a database of images, videos, and tutorials. The screens work independently so that instructors can run different teaching sessions simultaneously and students can progress at different speeds to suit themselves. Further, database access is provided from within an integrated anatomy and pathology museum and display units dedicated to the correlation of cross-sectional anatomy with medical imaging. A new functional neuroanatomy modeling system, called the BrainTower[R], has been developed to aid integration of anatomy with physiology and clinical neurology. Many aspects of the new facility are reproduced within a Mobile Teaching Unit, which can be driven to hospitals, colleges, and schools to provide appropriate work-based education and community interaction. (Contains 2 figures.) Note:The following two links are not-applicable for text-based browsers or screen-reading software. Show Hide Full Abstract

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Descriptors:
Teaching Methods; Physiology; Anatomy; Biology; Concept Mapping; Undergraduate Students; Course Content; Models; Lecture Method; Pretests Posttests; Foreign Countries; Comparative Analysis; Control Groups; Experimental Groups; Higher Education; Computers; Evaluation; College Students; Computer Uses in Education; Computer Assisted Instruction; Feedback (Response)

Abstract:
The aim of this study is to compare the effectiveness of models of programmed instruction and conventional (informative-illustrative) expository teaching in terms of fulfilling the aims of the course "Human anatomy and physiology" which is included in the physiology programme and designed for undergraduate students majoring in biology education at the Faculty of Biology, University of Belgrade. For this purpose, a model of a pedagogical experiment with parallel groups of students was applied. One group was presented the course content through programmed instruction, with the help of computers and programmed materials, which included the elaboration of concept maps. The second group was presented the same content through expository (informative-illustrative) instruction, the traditional lecturing model. In terms of quantity and quality of knowledge acquired by students in the tested teaching field, the experimental model of programmed instruction was more effective. (Contains 2 tables and 5 figures.) Note:The following two links are not-applicable for text-based browsers or screen-reading software. Show Hide Full Abstract

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Descriptors:
Personality Problems; Pathology; Depression (Psychology); Psychotherapy; Personality; Patients; Outcomes of Treatment; Drug Therapy; Comorbidity; Correlation; Symptoms (Individual Disorders); Scores; Clinical Diagnosis; Predictor Variables; Role

Abstract:
Background: Depressed patients with comorbid personality pathology may fare worse in treatment for depression than those without this additional pathology, and comorbid personality pathology may be associated with superior response in one form of treatment relative to another, though recent findings have been mixed. We aimed to evaluate the effect of personality pathology on time to remission of patients randomly assigned to 1 of 2 treatment strategies for depression and to determine whether personality pathology moderated the effect of treatment assignment on outcome. Method: Individuals undergoing an episode of unipolar major depression (n = 275) received interpersonal psychotherapy (Klerman, Weissman, Rounsaville, & Chevron, 1984) or selective serotonin reuptake inhibitor (SSRI) pharmacotherapy for depression. Depressive symptoms were measured with the HRSD-17. Remission was a mean HRSD-17 score of 7 or below over a period of 3 weeks. Personality disorders were measured according to SCID-II diagnoses, and personality pathology was measured dimensionally by summing the positive probes on the SCID-II. Results: The presence of at least 1 personality disorder was not a significant predictor of time to remission, but a higher level of dimensionally measured personality pathology and the presence of borderline personality disorder were associated with a longer time to remission. Personality pathology did not moderate the effect of treatment assignment on time to remission. Conclusions: The findings suggest that depressed individuals with comorbid personality pathology generally fare worse in treatment for depression, although in this report, the effect of personality pathology did not differ by the type of treatment received. (Contains 5 tables and 3 footnotes.) Note:The following two links are not-applicable for text-based browsers or screen-reading software. Show Hide Full Abstract

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Autism; Pathology; Rating Scales; Patients; Foreign Countries; Children; Control Groups; Evaluation Methods; Drug Therapy; Outcomes of Treatment; Individual Differences; Observation; Psychiatry

Abstract:
"Ginkgo biloba" has been reported to affect the neurotransmitter system and to have antioxidant properties that could impact the pathogenesis of Autism Spectrum Disorder. Based on these studies, we decided to assess the effectiveness of "Ginkgo biloba" extract (Ginko T.D., Tolidaru, Iran) as an adjunctive agent to risperidone in the treatment of autism. Forty-seven outpatients with a DSM-IV-TR diagnosis of autism ages between 4 and 12 years were assigned to this double blinded clinical trial and were randomly divided into two groups. One group received risperidone plus Ginko T.D and the other received risperidone plus placebo. The dose of risperidone was 1-3 mg/day and the dose of Ginko T.D. was 80 mg/day for patients under 30 kg and 120 mg/day for patients above 30 kg. Patients were assessed using Aberrant Behavior Checklist-Community (ABC-C) rating scale and the side effect check list every 2 weeks until the endpoint. None of the 5 subscales of ABC-C rating scale showed significant differences between the two groups. Incidents of side effects were not significantly different between the two groups. Adding "Ginkgo biloba" to risperidone did not affect the treatment outcome of ADs. Nevertheless, further observations are needed to confirm this result. Note:The following two links are not-applicable for text-based browsers or screen-reading software. Show Hide Full Abstract

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Descriptors:
Anxiety Disorders; Emotional Disturbances; Pathology; Behavioral Science Research; Depression (Psychology); Anxiety; Counseling Techniques; Severity (of Disability); Outcomes of Treatment; Mental Disorders; Emotional Response; Drug Therapy; Case Studies

Abstract:
Bipolar disorder (BD) is a chronic, debilitating disorder with recurrent manic and depressive episodes. More than 75% of bipolar patients have a current or lifetime diagnosis of a comorbid anxiety disorder. Comorbid anxiety in BD is associated with greater illness severity, greater functional impairment, and poorer illness-related outcomes. Effectively treating comorbid anxiety in individuals with BD has been recognized as one of the biggest unmet needs in the field of BD. Recently, the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders (UP) was developed to be applicable to the full range of anxiety and mood disorders, based on converging evidence from genetics, cognitive and affective neuroscience, and behavioral research suggesting common, core emotion-related pathology. Here, the authors present a preliminary evaluation of the efficacy of the UP for the treatment of BD with comorbid anxiety, in a clinical replication series consisting of three cases. (Contains 1 table.) Note:The following two links are not-applicable for text-based browsers or screen-reading software. Show Hide Full Abstract

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Attention Deficit Disorders; Intelligence Quotient; Genetics; Scientific Research; Brain Hemisphere Functions; Behavior Patterns; Correlation; Pathology; Physiology; Genetic Disorders; Diagnostic Tests; Control Groups

Abstract:
Background: Genetically Williams syndrome (WS) promises to provide essential insight into the pathophysiology of cortical development because its ~28 deleted genes are crucial for cortical neuronal migration and maturation. Phenotypically, WS is one of the most puzzling childhood neurodevelopmental disorders affecting most intellectual deficiencies (i.e. low-moderate intelligence quotient, visuospatial deficits) yet relatively preserving what is uniquely human (i.e. language and social-emotional cognition). Therefore, WS provides a privileged setting for investigating the relationship between genes, brain and the consequent complex human behaviour. Methods: We used "in vivo" anatomical magnetic resonance imaging analysing cortical surface-based morphometry, (i.e. surface area [Upsilon]SA/, cortical volume [Upsilon]CV/, cortical thickness [Upsilon]Cth/, gyrification index [Upsilon]GI/) and cortical complexity [Upsilon]CC/, which is of particular relevance to the WS genotype-phenotype relationship in 22 children (2.27-14.6 years) to compare whole hemisphere and lobar surface-based morphometry between WS (n = 10) and gender/age matched normal controls healthy controls (n = 12). Results: Compared to healthy controls, WS children had a (1) relatively preserved Cth; (2) significantly reduced SA and CV; (3) significantly increased GI mostly in the parietal lobe; and (4) decreased CC specifically in the frontal and parietal lobes. Conclusion: Our findings are then discussed with reference to the Rakic radial-unit hypothesis of cortical development, arguing that WS gene deletions may spare Cth yet affecting the number of founder cells/columns/radial units, hence decreasing the SA and CV. In essence, cortical brain structure in WS may be shaped by gene-dosage abnormalities. (Contains 3 tables and 3 figures.) Note:The following two links are not-applicable for text-based browsers or screen-reading software. Show Hide Full Abstract

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