Determinants of subjective quality of life in post acute patients with schizophrenia

Although Quality of Life (QoL) is of growing interest in schizophrenia research, little is known about putative causal determinants of this multidimensional construct. The present study explored the utility of objective indicators, psychopathological symptoms and psychosocial concepts drawn from empirical findings in community samples and the vulnerability-stress-coping model of schizophrenia for predicting general subjective QoL in post acute patients with schizophrenia. The analyses were based on cross-sectional data from 66 post acute patients with schizophrenia. The relationships between QoL and possible determinants were investigated using correlational analysis, regression analysis and structural equation techniques. As a result no significant relationships between objective indicators and general QoL were found. The strongest significant determinants were depressive symptoms and the psychosocial concepts of negative coping, perceived social support and self-efficacy. The empirical causal modelling results indicated that depression led to a direct negative impact upon QoL, whereas the other determinants had direct negative or positive effects on depression and affected QoL indirectly. One could conclude that to enhance patients' QoL, improvements in depressive symptoms, negative coping style, social support and self-efficacy seem to be most effective.     

What are the roles that children’s drawings play in inquiry of science concepts?

This study was designed to identify the roles that drawing played in the process of children’s acquisition of science concepts. Seventy pre-service teachers through four semesters from a Midwest University in the USA developed lesson plans on science concepts and then taught them to 70 young children ages 4–7, respectively. This experience was completely new to all the participants. Their first-hand experiences were transcribed and children’s drawings were collected. The participants were also asked to report on perceptions, before and after the project, of the roles that drawings play in children’s inquiry in science. The researcher coded and categorised the reflections to identify the roles. It was found that drawings played roles in assessment, teaching, learning, communication, boosting confidence for adults and children, integrating curriculum, building a relaxed learning atmosphere, and facilitating the learning of children with special needs. This paper ends with educational implications and future research suggestions.     

A Data-Driven Functional Mapping of the Anterior Temporal Lobes

Although the anterior temporal lobe (ATL) comprises several anatomic and functional subdivisions, it is often reduced to a homogeneous theoretical entity, such as a domain-general convergence zone, or “hub,” for semantic information. Methodological limitations are largely to blame for the imprecise mapping of function to structure in the ATL. There are two major obstacles to using fMRI to identify the precise functional organization of the ATL: the difficult choice of stimuli and tasks to activate, and dissociate, specific regions within the ATL; and poor signal quality because of magnetic field distortions near the sinuses. To circumvent these difficulties, we developed a data-driven parcellation routine using resting-state fMRI data (24 females, 64 males) acquired using a sequence that was optimized to enhance signal in the ATL. Focusing on patterns of functional connectivity between each ATL voxel and the rest of the brain, we found that the ATL comprises at least 34 distinct functional parcels that are arranged into bands along the lateral and ventral cortical surfaces, extending from the posterior temporal lobes into the temporal poles. In addition, the anterior region of the fusiform gyrus, most often cited as the location of the semantic hub, was found to be part of a domain-specific network associated with face and social processing, rather than a domain-general semantic hub. These findings offer a fine-grained functional map of the ATL and offer an initial step toward using more precise language to describe the locations of functional responses in this heterogeneous region of human cortex.SIGNIFICANCE STATEMENT The functional role of the anterior aspects of the temporal lobes (ATL) is a contentious issue. While it is likely that different regions within the ATL subserve unique cognitive functions, most studies revert to vaguely referring to particular functional regions as “the ATL,” and, thus, the mapping of function to anatomy remains unclear. We used resting-state fMRI connectivity patterns between the ATL and the rest of the brain to reveal that the ATL comprises at least 34 distinct functional parcels that are organized into a three-level functional hierarchy. These results provide a detailed functional map of the anterior temporal lobes that can guide future research on how distinct regions within the ATL support diverse cognitive functions.     

The organization of the conceptual system: The case of the “object versus action” dimension

There are very numerous reports in the neuropsychological literature of patients showing, in naming and/or comprehension tasks, a disproportionate deficit for nouns in comparison with verbs or a disproportionate deficit for verbs in comparison with nouns. A number of authors advanced that, in at least some or even in every of these reported cases, the noun/verb dissociation in fact reflected an underlying conceptual deficit disproportionately affecting either object or action concepts. These patterns thus would put an additional constraint on theories of conceptual knowledge organization, which should be able to explain how brain damage could selectively disrupt the concepts of objects or the concepts of actions. We have reviewed 69 papers (published from 1984 to 2009) that reported a pattern of a noun or a verb disproportionate deficit in a single-case, multiple-case, or group study of brain-damaged patients with various aetiologies. From this review, we concluded that none of these studies provided compelling evidence in favour of the interpretation that the observed noun or verb disproportionate deficit arose at the conceptual processing level and, accordingly, that this level may be organized according to the “object/action” dimension. Furthermore, we argue that investigating conceptual impairments in brain-damaged patients according to the “object/action” dichotomy is not empirically fruitful if the purpose is to inform theories of conceptual knowledge organization. In order to provide evidence relevant to these theories, one needs to consider finer grained distinctions within both the object and the action category when investigating the scope of the patients' conceptual impairment.     

上海市杨浦区中青年居民健康需求的调查研究

目的对中青年居民的健康观念与健康需求进行调查,为卫生行政部门进行决策和医疗机构改善服务提供参考。方法选杨浦区殷行街道年龄在18~60岁的中青年居民2 000位,应用自行设计的调查问卷进行调查。结果共回收有效问卷1372份。调查发现,68.0%的调查对象月收入在3 000元以下,59.8%的调查对象文化程度在大学以下;51.86%的人健康投入意愿为小于100元/月;调查接受度随年龄降低而降低;87.9%的调查对象不满意就诊等候时间太长,95.2%抱怨实际就诊时间太短;总体的健康关注度为38%,且低收入者关注度明显偏低（26.1%,P〈0.05）、不关注度明显偏高（22.6%,P〈0.05）;获取健康知识的主要途径是电视（37.8%,P〈0.001）;58.7%的调查对象（P〈0.01）希望于双休日开展讲座/义诊,其中45.5%的调查对象（P〈0.01）愿意在居民小区进行;对中西药并无特别偏好;55.61%的调查对象愿意接受自费项目,且以医疗咨询为主42.33%。结论中青年居民对健康的关注度与健康投入意愿相对不足,但其健康需求相对强烈且多元。而卫生行政部门与医疗机构及其从业人员并未全面了解其健康观念与健康需求,这提示需要设计出更多、更加科学、更加全面的大样本调查,从而为改善医疗卫生服务提供指导。     

Postgraduate training in Oral- and Maxillofacial Surgery: Results of a survey among 74 German interns

The aim of this study was to asses a survey of residents to obtain relevant information about their current situation in training in Oral and Maxillofacial Surgery in Germany. Special focus was given to the personal and clinical preferences of the residents, their main subjects of interest and plans after residency. Furthermore, the different principles of education at German teaching hospitals were evaluated.Overall, 74 questionnaires were completed on a voluntary and anonymous basis by German residents for Oral and Maxillofacial Surgery. Participants’ mean age was 32.74 years (68% male, 27% female). Most participants were in the fifth year of training (32%) and members of the German Association of Oral and Maxillofacial Surgery (70%). This rate increased with progress in residency (p = 0.006). Most residents (70%) were employed at university hospitals, followed by non-university hospitals (26%) and private practices (4%). Residents from university hospitals (3.06 ± 0.39 years) were less advanced in training compared to residents from non-university hospitals and private practices (4.10 ± 0.54 years; p = 0.005). Part-time employed residents were significantly younger (30.64 ± 2.37 years) than full-time employed residents (33.25 ± 0.64 years, p = 0.002).Structured concepts of training existed in 64% of the hospitals, while training depending on the current year of residency (42%) was most common. Most of the residents would prefer a systematic rotation system (59%). Main subjects of clinical interest were aesthetic (50%) and orthognathic surgery (46%). The interest in dento-alveolar surgery (34%) significantly increased with participants’ age (p = 0.008). Clefts and malformations were favoured by few residents (16%). Most participants planned to specialize in facial plastic surgery after residency (76%).The data collected might give evidence for an increasing importance of structured training concepts in Oral and Maxillofacial Surgery. It might be relevant to enhance the interest and the excitement of residents for oncology, traumatology, cleft and malformation surgery.     

Green Chemistry: Some important forerunners and current issues

In this essay some important forerunners of green chemistry will be discussed and compared with the present state. The relationship to ethics will be considered. Starting from the new movement of green chemistry by Anastas, some important highlights will be presented. The new activities of IUPAC and other institutions on the concepts of metrics for green syntheses will be discussed. The prime importance of the inclusion of developing African countries into the concepts will also be covered. Green chemistry philosophy has become part of sustainable chemistry which emphasizes the implementation of the concept of sustainability in the production and use of chemicals and chemical products for sustainable development and, some sustainable development concepts are included under the section on Africa.     

An exploration of understanding of quantity in children who are blind

The paper reports an exploratory investigation of blind children's concepts of number, substance, length, area, weight, and volume conservation. Children totally without sight or with light perception at most who were in a special unit in a mainstream first school were pretested, taught and posttested twice. Tasks used in a series of studies were specifically adapted for tactual presentation of materials with appropriate questioning, and children's responses closely examined. Teaching introducing key explanations and experiences explored and developed their understanding of quantity conservation. On posttesting children taught showed increased understanding. Individual differences in development were marked.     

Remodelling of the retinal arterioles in descending optic atrophy follows the principle of minimum work

Mathematical modelling indicates that the minimum energy cost for blood flow is achieved when the arteries are arranged in a branching hierarchy such that the radii of the vessels are adjusted to the cube root of the volumetric flow (principle of minimum work). This is known to apply over several magnitudes of vessel calibres, and in many different organs, including the brain, in humans and in animals. This paper addresses the issue of remodelling of one and the same arterial network to long-term changes in blood flow. This has not been studied previously in humans. We measured the radius of parent (r₀) and branch segments (r_l and r₂) of the retinal arteriolar network in fundus photographs of six patients with blinding, non-vascular retrobulbar optic nerve lesions, mostly traumatic in origin, before and after the development of descending optic atrophy. Attenuation of retinal arterioles is a well-known phenomenon in descending optic atrophy, and is attributable to decreased metabolic demand secondary to loss of the retinal ganglion cells and their axons. On average, arteriolar diameters decreased by 15.2±17.7% (SD), with 95% confidence intervals of 18.7% and 11.7%; the radii decreased significantly (P= 0.0001) (n= 99). The area ratio of the bifurcations, defined as (r²₁+r²₂)r^-₀², was 1.23±0.2 before, and 1.18±0.2 after optic atrophy (n= 36); the change of area ratio was not significant. The branching geometry of the retinal arteriolar network obeyed strictly the optimum branching rule of the principle of minimum work, or r³₀=r³₁+r³₂. Bifurcation exponents corrected for the Fåhræus-Lindquist effect were ?? 3 before optic atrophy and remained unchanged after remodelling of the arterioles. It is concluded that the branching of the retinal arterioles and their adaptation to long-term changes in blood flow in descending optic atrophy obey the principle of minimum work.     

Prescribing endodontic retreatment: towards a theory of dentist behaviour

The large variations observed in dentists' management of periapical lesions in endodontically treated teeth suggest that disease concepts used in clinical practice should be investigated. In the present study it was hypothesized that dentists regard various periapical conditions as different stages on a health continuum. Variations could then be regarded as the result of the individuals selection of differing cut-off points for prescribing retreatment. The hypothesized decision-making model was tested using dental students in Amsterdam (Holland), Gothenburg (Sweden) and Pavia (Italy). The students were shown six simulated cases among which the quality of root filling seal and presence of post and crown were systematically varied. For each case, management of five periapical conditions was assessed. Five options were offered: no therapy, wait-and-see, nonsurgical retreatment, surgical retreatment, and extraction. For each examiner and case a ‘retreatment preference score (RPS)’ was established. The investigation showed large interindividual variations in RPS. A statistically significant higher mean RPS was seen among students in Pavia compared with students in Amsterdam and Gothenburg. Among all observers and cases it was found that if retreatment was proposed for a certain size of lesion, retreatment was subsequently selected for all larger lesions. The experiment gave evidence in support of the proposed hypothesis. The data also suggest that the choice of retreatment criterion is affected by values, costs of retreatment and technical quality of the original treatment.