The image of people with intellectual disability in Taiwan newspapers

Legislation has been introduced in states of Australia to claify who may give consent to medical and dental treatments on behalf of adults who are unable to make effective decisions because of a mental disability. In South Australia, a Guardianship Board has been given the responsibilities both to assess ability to consent, and to identify delegates who are authorised to consent on behalf of people unable to make valid decisions. This study aimed to clarify relations between various estimates of ability to give valid consent. The study examined relations between assessments of ability to consent made by the Guardianship Board and assessments made using six other measures of ability to consent. The best single predictor of assessments by the Guardianship Board was a Consent Questionnaire, which was based on a legal definition of ability to give informed consent and used the concepts of alternative actions and their likely consequences.     

Dichotic listening in commissurotomized and hemispherectomized subjects

Three commissurotomized and two left-hemispherectomized subjects were tested on spoken report of sequences of three dichotic pairs of digits. With instruction to report only one digit from each pair, there was an overall advantage to the ear contralateral to the hemisphere mediating speech, but report of ipsilateral-ear digits ranged from 40 to 100%. In commissurotomized subjects, the more extreme ipsilateral suppression under instructions to report all digits may be due to failure to gain access to unattended information stored in the right hemisphere, rather than to suppression of the ipsilateral pathway. However one commissurotmized patient did appear to have access to right-hemisphere items, the result either of subcortical transfer or of external cross-cueing. The hemispherectomized subjects seemed able to store both attended and unattended information in the same hemisphere.     

Representation of information about skin temperature in the discharge of single cortical neurons

A single-unit study was undertaken in the squirrel monkey to characterize the response of units in the cerebral cortex to temperature stimulation of the skin. Thermal stimulation was applied to the hand with a Peltier module. Thirty-one thermally responsive units were found in both the precentral and postcentral gyri. Individual units were found to respond to either steady-state temperature levels or to phasic temperature changes but never to both. Responses to steady-state thermal stimuli were characterized by monotonic increasing thermometer functions or decreasing thermometer functions. Responses appearing to signal deviation from steady-state neutral temperature without changes in mean frequency of firing were also observed. Responses to phasic temperature changes were increases or decreases in frequency of discharge to both warming and cooling, or were similar to the phasic behavior of ‘cold’ units. All but 3 of the 15 units tested for a tactile receptive field responded to mechanical as well as thermal stimulation.     

The auditory P50 component to onset and offset of sound.

OBJECTIVE: The auditory Event-Related Potentials (ERP) of component P50 to sound onset and offset have been reported to be similar, but their magnetic homologue has been reported absent to sound offset. We compared the spatio-temporal distribution of cortical activity during P50 to sound onset and offset, without confounds of spectral change. METHODS: ERPs were recorded in response to onsets and offsets of silent intervals of 0.5 s (gaps) appearing randomly in otherwise continuous white noise and compared to ERPs to randomly distributed click pairs with half second separation presented in silence. Subjects were awake and distracted from the stimuli by reading a complicated text. Measures of P50 included peak latency and amplitude, as well as source current density estimates to the clicks and sound onsets and offsets. RESULTS: P50 occurred in response to noise onsets and to clicks, while to noise offset it was absent. Latency of P50 was similar to noise onset (56 ms) and to clicks (53 ms). Sources of P50 to noise onsets and clicks included bilateral superior parietal areas. In contrast, noise offsets activated left inferior temporal and occipital areas at the time of P50. Source current density was significantly higher to noise onset than offset in the vicinity of the temporo-parietal junction. CONCLUSIONS: P50 to sound offset is absent compared to the distinct P50 to sound onset and to clicks, at different intracranial sources. P50 to stimulus onset and to clicks appears to reflect preattentive arousal by a new sound in the scene. Sound offset does not involve a new sound and hence the absent P50. SIGNIFICANCE: Stimulus onset activates distinct early cortical processes that are absent to offset.     

Symptoms of PTSD according to individual and work environment characteristics of Korean railroad drivers with experience of person-under-train accidents

OBJECTIVE: The purpose of this study is to collect basic data on the prevalence pattern of posttraumatic stress disorder (PTSD) in Korean railroad drivers exposed to person-under-train accidents according to the individual and working environmental characteristics. METHODS: Questionnaires were sent to all the railroad drivers accompanying active service now by company post. A total of 639 of the 800 questionnaires sent out were returned, showing a response rate of 79.9%. The Impact of Event Scale was utilized to address psychological status of railroad drivers after exposure to person-under-train accident. RESULTS: Score of PTSD, intrusion, and avoidance ranged from 9.6 to 13.2, from 4.2 to 6.1, and from 5.4 to 7.2 according to individual characteristics and ranged from 11.44 to 12.70, from 5.03 to 5.67, and from 6.41 to 7.04 according to working environmental characteristics, respectively. CONCLUSION: This study demonstrated that Korean railroad drivers who experienced person-under-train accident expressed adverse symptoms physically and psychologically more than those who did not experience it. Apart from effect of train driver's age, a wide range of individual and working environmental factors appear to have no association with the level of posttraumatic distress following a person-under-train accident.     

Choosing Wisely? Let’s Start with Working Wisely: Choisir avec soin? Commen?ons par travailler avec soin

There is an increasing emphasis on quality and, relatedly, cost-effectiveness as it relates to the delivery of health care. Choosing Wisely is an initiative adopted by numerous specialties with the goal of starting a dialogue about efficient use of health care resources. People need to be able to access care to have an opportunity to choose wisely. There is a considerable amount of evidence that access to care is poor for specialty mental health care, particularly access to psychiatrists. Consequently, we suggest that psychiatrists and the broader mental health system need to consider working wisely, and in our paper outline key issues (for example, implementation of wait times and objective measures of need in a centralized referral management system; incorporation of performance indicators with longitudinal monitoring for continuous quality improvement) that need to be addressed to develop a mental health system that would allow people to access care to choose wisely.     

Effects of repetitive daily acute stress on pituitary LH and prolactin release during exposure to the same stressor or a second novel stress

The present study was carried out to examine the effect of repetitive acute stress on pituitary secretion of prolactin (PRL) and luteinizing hormone (LH) during subsequent exposure to the same stimulus or to a second, novel stress. Intact adult male rats were subjected to either a single or 10 daily acute episodes of a psychological stress, transfer to a novel environment, or a physical stressor, restraint. A single acute exposure to either stress caused a temporary but significant increase in circulating concentrations of LH and PRL, and repetitive daily exposure to these stressors resulted in the habituation of stress-stimulated release of both hormones by the 10th consecutive day. When rats previously exposed to daily novel environment stress were subjected to a single episode of restraint stress, they showed an attenuation of both the LH and PRL secretory responses to this type of stress, compared to rats exposed to only one episode of restraint. These results indicate that repeated daily exposure to specific acute stress stimuli can result in the eventual habituation of both the LH and PRL hormonal responses to stress. At least with regard to the paired stressors examined in this study, adaptation to one type of acute stress stimulation may result in altered hormonal responsiveness to a second, unfamiliar stressor.     

Commentary: so the pendulum swings--making sense of the duty to protect

Psychiatry has been struggling for nearly 40 years to make sense of the duty to protect. The great jurisdictional disparity as to what constitutes the duty has been a significant contributing factor. The American Psychiatric Association (APA) released the Model Statute in 1987 to establish a framework to guide legislators and courts toward consensus, to some effect. In response to case law and statutory requirements in most states, psychiatric practice has incorporated the assessment of risk to third parties by patients as an essential element of psychiatric assessment and care. Although court cases shortly after the Tarasoff decision expanded the scope and breadth of the duty to protect, in recent years there appears to have been a shift toward a more narrow interpretation as to what conditions must exist to find a defendant psychiatrist guilty of failing to exercise the duty properly. The threshold for the duty to warn or protect often rests precariously beside the criteria permitting an exception to confidentiality, placing the psychiatrist in a tenuous position. If appellate verdicts continue to find for the defendant psychiatrist in cases claiming a breach of the duty to protect, it could have an impact on how psychiatrists assess and manage threats made by patients toward third parties.     

MännerSzenen

It is a multifarious challenge to develop functioning male gender roles. The concept of scenic diagnosis serves as a pattern to identify themes which are important for men and to generate future prospects. One axiological aim is to breach the knee-jerk degradation of males. Under sociodramatic perspective the point is to make work a place of contribution to the shaping of identity not a place of alienation. A sociometric perspective is not to instrumentalize male networks but develop real friendship. In psychodramatic terms male gender roles are in need of playful strategies to get rid of their historical congealment. A physiodramatic aim could be to leave the reduction of the male body to its functionality.     

Neuroimaging characteristics of intracerebral haematoma

The objective of brain imaging is to identify the hematoma according to its different stages and to find a potential underlying cause because of the risk of recurrence and the possibilities of treatment. In emergency, the diagnosis of hematoma is often obtained by CT scan, however today MRI has proved to be more accurate than CT to detect hemorrhage and to identify an underlying etiology. In some cases, according to the patient age, the medical history and the location of the hematoma, it may be necessary to perform a conventional angiography in order to exclude an intracranial vascular malformation. The aim of this review is to detail the different aspects of intracerebral hemorrhages according to the sequences and the temporal evolution, and to describe special findings which can help to identify an underlying etiology.     

The importance of treatment acceptability to patients

Antipsychotic drug treatment plays a central role in the care of patients with schizophrenia. The chronic nature of the illness means that most patients are likely to require long-term antipsychotic medication to alleviate symptoms and to prevent recurrence of an acute psychotic episode. Unfortunately, a high proportion of patients with schizophrenia do not comply with medication and this has profound consequences in terms of the number and severity of relapse episodes, rehospitalization rates, worsening of residual symptoms and social costs, including substance misuse, homelessness and the burden on carers. Ensuring that antipsychotic treatment is acceptable to the patient is fundamental to managing adherence. Side-effects, particularly mental and extrapyramidal symptoms (EPS), are the cause of much distress to patients and dissatisfaction with treatment, so a treatment regimen with a low side effect profile will help to improve adherence to the treatment. Such regimens have unmasked many of the other side-effects of treatment that were previously viewed as subsidiary to EPS; but the physical and psychological consequences of side-effects such as antipsychotic-induced sexual dysfunction or weight gain are highly distressing to the patient, and as likely as EPS to trigger non-adherence to medication. Consequently, careful selection of antipsychotic agent and dose regimens is essential to maximize the efficacy of the antipsychotic and to minimize the overall burden of side-effects. Satisfaction also depends very much on the extent to which the patient understands the treatment and its side-effects. Therefore, a close therapeutic alliance between the patient and the psychiatrist must underpin all attempts to increase the acceptability of treatment. This will allow the clinician to determine how the illness and its treatment are affecting all aspects of the life of the patient, and then to tailor the treatment continuously to obtain the best possible outcome for the patient.     

卒中病房医患互动中的心理分析与应对

本文分别从主客体关系、人格、防御机制、移情和反移情以及马斯洛的需要理论方面对 医患关系的现状进行论述,并提出了积极的建议,如：在患者中可以进行小组集体心理治疗解决类 似的心理问题,并将叙事医学的理念渗透其中;在医护人员中进行巴特林小组的训练,提升医师的医 患沟通技巧,了解自身能力和责任的局限性,明确自身的职业定位,提高职业认同感,更好地服务患 者,有益于建立良好的医患关系。     

Topographic organization of subcortical projections to the anterior thalamic nuclei in the rat.

Subcortical projections to the anterior thalamic nuclei were studied in the rat, with special reference to projections from the mammillary nuclei, by retrograde and anterograde transport of wheat germ agglutinin conjugated to horseradish peroxidase. The medial mammillary nucleus (MM) projects predominantly ipsilaterally to the entire anterior thalamic nuclei, whereas the lateral mammillary nucleus projects bilaterally to the anterodorsal nucleus (AD) of the anterior thalamic nuclei. A topographic relationship was recognized between the MM and the anterior thalamic nuclei. The dorsal region of the pars mediana of the MM projects to the interanteromedial nucleus (IAM), whereas the ventral region projects to the rostral part of the anteromedial nucleus (AM). The dorsal and the ventral regions of the pars medialis project to the dorsomedial part of the AM at its caudal and rostral levels, respectively. The dorsomedial region of the pars lateralis projects to the ventral AM. The ventrolateral region of the pars lateralis projects to the ventral part of the anteroventral nucleus (AV) in such a manner that rostral cells project rostrally and caudal cells project caudally. The pars basalis projects predominantly ipsilaterally to the dorsolateral AV and bilaterally to the AD. The rostrolateral region of the pars posterior projects to the lateral AV, whereas the medial and the caudal regions of the pars posterior project to the dorsomedial AV. The rostrodorsal part of the nucleus reticularis thalami was found to project to the anterior thalamic nuclei; cells located rostrally in this part project to the IAM and AM, whereas cells located caudodorsally project to the AV and AD. The laterodorsal tegmental nucleus projects predominantly ipsilaterally to the AV, especially to its dorsolateral part. The present study demonstrates that subdivisions of the subcortical structures are connected to the subnuclei of the anterior thalamic nuclei, with a clear-cut topography arranged in the dorsoventral and the rostrocaudal dimensions.     

Individual variation in the propensity to attribute incentive salience to an appetitive cue predicts the propensity to attribute motivational salience to an aversive cue

It has been proposed that animals that attribute high levels of incentive salience to reward-related cues may be especially vulnerable to addiction. Individual variation has also been observed in the motivational value attributed to aversive cues, which may confer vulnerability to anxiety disorders such as post-traumatic stress disorder (PTSD). There may be a core behavioral trait that contributes to individual variation in the motivational value assigned to predictive cues regardless of emotional valence. To test this hypothesis, we used a Pavlovian conditioned approach procedure to classify rats based on whether they learned to approach and interact with a cue predicting food reward (sign-trackers) or learned upon cue presentation to go to the location of impending food delivery (goal-trackers), and then examined Pavlovian fear conditioning in the same animals. It has recently been proposed that sign-trackers are more vulnerable to substance abuse because they attribute greater incentive motivational value to drug cues. Here we show that sign-trackers also have a tendency to be more fearful of discrete cues that predict footshock. In addition, we found that goal-trackers exhibited greater contextual fear when placed back into the original fear-conditioning context in the absence of temporally discrete cues. These results suggest that there may be a subset of individuals who tend to attribute high levels of motivational salience to predictive cues regardless of emotional valence, which may predispose them to a number of psychiatric comorbidities including PTSD and substance abuse. Other individuals use contexts to appropriately modify their reactions to such salient stimuli.     

Descending projections to the mammillary nuclei in the rat, as studied by retrograde and anterograde transport of wheat germ agglutinin-horseradish peroxidase

The cells of origin and projection fields of the descending afferents to the mammillary nuclei were studied in the rat with retrograde and anterograde transport of wheat germ agglutinin conjugated to horseradish peroxidase. The subiculum projects bilaterally to the entire medial mammillary nucleus (MM) in a topographic fashion along the two axes: 1) the proximal part of the subiculum along the presubiculo-CA1 axis projects to the caudal and lateral regions of the MM whereas the more distal part of the subiculum projects to the medial region; 2) the septal part of the subiculum projects to the caudodorsal region of the MM whereas the more temporal part projects progressively to the more rostroventral regions. The ventral subiculum also projects ipsilaterally to the ventral and lateral margin of the lateral mammillary nucleus (LM). The presubiculum projects bilaterally to the dorsolateral region of the pars posterior of the MM and ipsilaterally to the LM. The infra-limbic cortex projects bilaterally to the rostrodorsal region of the MM, whereas the retrosplenial cortex (areas 29a and 29b) projects bilaterally to the medial region at the midrostrocaudal and middorsoventral levels of the MM. The nucleus of the diagonal band projects bilaterally to the caudomedial region of the MM, whereas the lateral septal nucleus projects bilaterally to the pars mediana and the mammillary fiber capsule. A part of the anterior hypothalamic area ventromedial to the fornix projects predominantly ipsilaterally to the rostroventral part of the MM, whereas other basal forebrain regions such as the bed nucleus of the stria terminalis, the medial preoptic and anterior hypothalamic areas, and the area of the tuber cinereum send fibers predominantly ipsilaterally to the mammillary fiber capsule. The results reveal a complex organization of the descending projections to the mammillary nuclei, which may reflect the complex functions of these nuclei within the limbic circuitry.     

Response of anterior pituitary hormones to chronic stress. The specificity of adaptation

The effect of chronic noise stress on the response of anterior pituitary hormones to the same or to another stressor (forced swimming) was studied in adult male Wistar rats. Both acute stressors increased corticosterone, prolactin, LH and TSH secretion and inhibited GH secretion. Previous chronic exposure to noise reduced corticosterone response to the same stimulus without modifying corticosterone response to a novel acute stress. Neither prolactin nor TSH responses to acute noise were reduced by previous chronic exposure to noise. Since chronic noise increased basal levels of LH and decreased those of GH, the response of these hormones to acute stress was expressed as percent changes of their respective basal values. It was found that chronically stressed rats showed diminished LH response to noise but not to forced swimming. GH showed the same pattern without reaching statistical significance. These data indicate that the response of some anterior pituitary hormones can adapt after repeated exposure to the same stressor. When adaptation occurred, this was specific for the stressor which the animals were repeatedly exposed to. The pituitary-adrenal axis appears to be the most reliable index of adaptation to chronic stress among all the anterior pituitary endocrine axes.     

The NeuroDevNet vision

The NeuroDevNet Network of Centres of Excellence has created the first trans-Canada effort devoted to the study of brain development from basic to clinical to societal perspectives. NeuroDevNet's vision is to accelerate efforts to (i) understand normal brain development; (ii) enhance our ability to make diagnoses of when normal development goes awry; and (iii) develop interventions to improve or prevent neurodevelopmental disorders. An early diagnosis coupled with the right therapies, The NeuroDevNet Network of Centres of Excellence has created the first trans-Canada effort devoted to the study of brain development from basic to clinical to societal perspectives. NeuroDevNet's vision is to accelerate efforts to (i) understand normal brain development; (ii) enhance our ability to make diagnoses of when normal development goes awry; and (iii) develop interventions to improve or prevent neurodevelopmental disorders. An early diagnosis coupled with the right therapies, Demonstration Projects. Funds were also allocated for an Opportunities Initiative. There is a wide of expertise amongst NeuroDevNet members. Researchers are supported by the management centre, three Platforms (Imaging; Genetics/ Epigenetics; Animal Models) and three Cores (Neuroethics; Neuroinformatics; Knowledge Translation). We emphasize multidisciplinary training of young researchers to advance the understanding of brain disorders that affect children.     

For the Greater Good: Protection of Psychological Test Material

A key aspect of psychological work is formal psychological testing using standardised tests and procedures. In Australia formal psychological testing is unique to psychologists and psychologists' training and ethical obligations under their Code of Ethics requires that they seek to protect test material from scrutiny by non-psychologists. Legal requests for psychological test material leading to exposure of such material is not in the public interest as it can lead to misuse, misinterpretation, and damage to the integrity of the test for future use by the public through the loss of effective assessment tools. This effectively results in harm to the public. This article aims to increase understanding of the reasons that psychologists seek to restrict access to formal psychological test material, identifies legal precedents to support the protection of the material, and provides a process for relevant outcomes of psychological testing to be used for legal purposes.     

Deficits in visual motion processing following ibotenic acid lesions of the middle temporal visual area of the macaque monkey

Physiological experiments have produced evidence that the middle temporal visual area (MT) of the monkey is selectively involved in the analysis of visual motion. We tested this hypothesis by studying the effects of small chemical lesions of MT on eye movements made in response to moving as opposed to stationary visual targets. We observed two deficits for eye movements made to moving targets: a monkey's ability to match the speed of his smooth pursuit eye movements to the speed of the moving target was impaired, and a monkey's ability to adjust the amplitude of a saccadic eye movement to compensate for target motion was impaired. In contrast, saccades to stationary targets were unaffected by the MT lesions, suggesting that monkeys with MT lesions had more difficulty responding to moving than to stationary stimuli. These results provide the first behavioral evidence that neural processing in MT contributes to the cortical analysis of visual motion.