Hormones and Cognition: Current Concepts and Issues in Neuropsychology

This article provides an extensive and comprehensive review of the effects of hormones on cognition. Studies detailing specific neurocognitive functions affected by variation in hormone levels across the life span are presented. Dysregulation of hormone levels is considered from models of both normal and diseased functioning. Patterns of cognitive dysfunction are described for a range of syndromes involving the neuroendocrine system, and evidence of specific neurophysiological mechanisms that can account for these findings is outlined. This review includes discussion of treatment outcomes and the permanency of endocrine-related cognitive dysfunction. The authors present a set of guidelines for clinical neuropsychologists to use for assessment of patients with neuroendocrine system dysfunction. Clinical and methodological issues in research and treatment settings are discussed.     

Health-Related Decision-Making in HIV Disease

Individuals living with HIV show moderate decision-making deficits, though no prior studies have evaluated the ability to make optimal health-related decisions across the HIV healthcare continuum. Forty-three HIV+ individuals with HIV-associated neurocognitive disorders (HAND+), 50 HIV+ individuals without HAND (HAND?), and 42 HIV? participants were administered two measures of health-related decision-making as part of a comprehensive neuropsychological battery: (1) The Decisional Conflict Scale (DCS), and (2) The Modified UCSD Brief Assessment for Capacity to Consent (UBACC-T). Multiple regression analyses revealed that HAND was an independent predictor of both the DCS and the UBACC-T, such that the HAND+ sample evidenced significantly poorer scores relative to comparison groups. Within the HIV+ sample, poorer health-related decision-making was associated with worse performance on tests of episodic memory, risky decision-making, and health literacy. Findings indicate that individuals with HAND evidence moderate deficits in effectively comprehending and evaluating various health-related choices.     

Neurocognitive Complications of HIV Disease

Neurocognitive complications are the most common sequelae of HIV infection if the full spectrum of HIV disease—from initial seroconversion to death from advanced AIDS—is considered. Though resembling subcortical neurological disorders from a neuropsychological standpoint, the presentation is variable, and almost any pattern can be seen. Although neuropsychological impairment is often subtle, it can affect day-to-day life and is associated with earlier mortality. It is not clear if milder forms of neurocognitive disturbance necessarily presage advanced dementia, and current data suggest a two-factor model: a subacute relapsing-remitting condition that can occur at any stage of HIV disease and a progressive, more fulminant dementia. The pathological substrates of these conditions are not well characterized, although recent data support the notion that synaptodendritic damage underlies the neuropsychological impairment, and may precede the neuronal loss and other pathological features more characteristic of HIV encephalitis. Some reversibility of neurocognitive disturbance has been reported with zidovudine therapy, though the data are not consistent. New regimens involving protease inhibitors need to be evaluated in terms of benefit to the central nervous system because many drugs of this class do not penetrate the blood-brain barrier efficiently. Finally, studies utilizing experimental treatments that may affect the putative mechanisms of neural injury are in progress.     

The Basic HIV Disease Knowledge Questionnaire: a Rasch-scaled instrument to measure essential HIV knowledge.

The need for improvement in HIV disease-related psychometric questionnaires is noted. In response to this need a Rasch-scaled measure to ascertain basic HIV disease knowledge was developed and calibrated on 1092 subjects. Four studies conducted with the measure suggest adequate test-retest reliability. Three validity studies also conducted with this questionnaire suggest that the measure is sensitive to knowledge obtained from HIV-related training and education. Potential uses and limitations of this new questionnaire are discussed.     

Tensions and Opportunities in Convergence: Shifting Concepts of Disease in Emerging Molecular Medicine

The convergence of biomedical sciences with nanotechnology as well as ICT has created a new wave of biomedical technologies, resulting in visions of a ‘molecular medicine’. Since novel technologies tend to shift concepts of disease and health, this paper investigates how the emerging field of molecular medicine may shift the meaning of ‘disease’ as well as the boundary between health and disease. It gives a brief overview of the development towards and the often very speculative visions of molecular medicine. Subsequently three views of disease often used in the philosophy of medicine are briefly discussed: the ontological or neo-ontological, the physiological and the normative/holistic concepts of disease. Against this background two tendencies in the field of molecular medicine are highlighted: (1) the use of a cascade model of disease and (2) the notion of disease as a deviation from an individual pattern of functioning. It becomes clear that molecular medicine pulls conceptualizations of disease and health in several, partly opposed directions. However, the resulting tensions may also offer opportunities to steer the future of medicine in more desirable directions.     

循证理念在当代传染病防控领域的应用

循证医学引发医学领域的创新和革命,其理念应用于公共卫生领域形成了循证公共卫生。21世纪多种新发和复发传染病的全球性暴发为循证理念的应用带来挑战。高风险的研究环境、复杂的干预手段、证据稀缺、研究设计困难,以及在高度不确定和紧迫时间下建立程序和生成建议的需求,使循证方法学必须通过拓展和调适以解决传染病问题。六步骤快速风险评估机制、AGREE Ⅱ指南评估工具、全球传染病循证资源数据库,成为满足传染病防治的特殊要求而创新的循证实践工具。

     

Discussion of Symposium on Current Research Applications of Rorschach Derived Concepts

In this investigation, we examined the validity of Levenson's Self-Report Psychopathy Scale (LSRP; Levenson, Kiehl, &; Fitzpatrick, 1995) in a sample of undergraduate students (n = 403). Utilizing a step-down hierarchical multiple regression procedure (e.g., Arbisi, Ben-Porath, &; McNulty, 2002), we used LSRP scores to predict psychopathic personality traits to determine the presence of gender-moderated test bias. Results indicate similar correlational magnitudes for men and women. However, systematic over- and underprediction of scores (i.e., differential intercepts) was found for external criteria measuring key affective (i.e., low empathy) and behavioral (i.e., aggression, antisocial behavior) components of the psychopathic personality, although these effects were generally small.     

Self-Healing Forces and Concepts of Health and Disease. A Historical Discourse

The phenomenon of self-healing forces has again and again challenged doctors in the different historical periods of medical science. They relied on effects of self-healing forces in diagnosis and therapy. They also tried to explain these effects based on the current model of organism. The understanding of this phenomenon has always influenced the understanding of therapy and played a role in defining the concept of health and disease. In the 17th and 18th century the idea of self-healing force was interpreted as a phenomenon related to the organic forces, whereas in the 19th century the explanation was reduced to a materialistic mechanism. Nowadays the knowledge of heath-shock-proteins open the way of a new understanding of the organic defense mechanisms. This revised version was published online in August 2006 with corrections to the Cover Date.     

Concepts: a potboiler

An informal, but revisionist, discussion of the role that the concept of a concept plays in recent theories of the cognitive mind. It is argued that the practically universal assumption that concepts are (at least partially) individuated by their roles in inferences is probably mistaken. A revival of conceptual atomism appears to be the indicated alternative.     

非酒精性脂肪性肝病的治疗进展

非酒精性脂肪性肝病的发病率逐渐上升,近年已成为危害全球公共健康的重要疾病之一。其治疗在于通过改变生活方式、增加胰岛素敏感性、抗炎保肝等措施纠正代谢紊乱、改善肝脏损害,以阻止疾病发生发展。本文就基础治疗、药物治疗及手术治疗三方面概述目前非酒精性脂肪性肝病的治疗进展。     

脑血管病治疗现状及评析

我国正处于人口老龄化、脑血管病患者迅速增加的时期,针对各地千差万别的医疗水平,系统梳理和总结国内外脑血管病有关指南及规范的基础上,强调了脑血管病的预防的重要性,并提出我国数种常见脑血管病的治疗策略选择的意见及建议。     

脑血管病治疗现状及评析

我国正处于人口老龄化、脑血管病患者迅速增加的时期,针对各地千差万别的医疗水平,系统梳理和总结国内外脑血管病有关指南及规范的基础上,强调了脑血管病的预防的重要性,并提出我国数种常见脑血管病的治疗策略选择的意见及建议.     

干细胞移植治疗冠心病的现状与未来

冠心病仍然是全球的主要死亡原因.其所造成的心肌梗死及慢性心力衰竭对生活质量的影响和由此造成的高额医疗费用促使我们不断寻求新的医疗措施.近几年有关干细胞用于心肌梗死后心肌再生、心肌内新生血管形成,可能还会改善梗死后的心功能的研究成为心脏病学研究的最热门领域.尽管干细胞治疗有可能使心力衰竭的治疗得到彻底的革命,但仍有部分问题需要澄清.已发表的各个研究结果设计不尽相同,致使对该项治疗的效果较难得出一致的结论.但这些研究都强调干细胞治疗在未来心血管疾病的治疗中可能会发挥较大的作用.干细胞治疗与药学、外科及介入治疗的结合会显著改善冠心病患者的预后.     

Positive Thought Induction for Arresting Disease Progression: A Hypnotherapeutic Application in HIV/AIDS

The present research aimed to investigate the effect of positive thought induction through hypnotherapeutic strategies, e.g., package of relaxation, guided imagery, positive suggestions, etc., on the coping strategies, clinical and immune parameters of disease progression in people living with HIV/AIDS(PLWHA). Data were collected from 20 adults HIV+ patients having CD4 count above 250 and plasma viral load less than 5000, screened from a large group of HIV+ patients who had volunteered for the study. A repeated measure design of research was used. Results of post and follow-up tests indicated that positive thought induction through hypnotherapy had yielded significant positive changes in several dimension of coping strategies (e.g., active coping, alcohol/drug abuse, denial, planning, reinterpretation and growth). Similarly, it led to significant increase in different Immunological parameters (e.g.,% of CD4 count, absolute CD4 count, absolute CD8 count, proportion of CD4 to CD8 count, and absolute CD3 count). These results suggest the effective use of hypnotherapy as an adjunct therapy to arrest disease progression and improve quality of life of PLWHA. In addition, the result highlights the effect of positive thoughts in strengthening positive coping strategies and improving immune competence in PLWHA.     

Heterosexual behaviors and risk of exposure to HIV: Current status and prospects for change

Prevalence of HIV among heterosexuals is relatively low as compared to that of gay and bisexual males and intravenous drug users (IDUs). However, many heterosexuals engage in behavior that places them at risk for exposure to HIV. Changes in sexual behavior in response to HIV are reviewed for both high-prevalence groups such as gay and bisexual men and IDUs and lower prevalence heterosexual groups. Psychosocial factors contributing to behavior change are evaluated. The implications for future changes by heterosexuals, especially the adoption of self-protective behaviors such as condom use, are discussed.