Medicine and Health Sciences Commons^™

Balancing The Presentation Of Information And Options In Patient Decision Aids: An Updated Review, Purva Abhyankar, Robert J. Volk, Jennifer Blumenthal-Barby, Paulina Bravo, Angela Buchholz, Elissa Ozanne, Dale C. Vidal, Nananda Col, Peep Stalmeier

Dartmouth Scholarship

Standards for patient decision aids require that information and options be presented in a balanced manner; this requirement is based on the argument that balanced presentation is essential to foster informed decision making. If information is presented in an incomplete/non-neutral manner, it can stimulate cognitive biases that can unduly affect individuals’ knowledge, perceptions of risks and benefits, and, ultimately, preferences. However, there is little clarity about what constitutes balance, and how it can be determined and enhanced. We conducted a literature review to examine the theoretical and empirical evidence related to balancing the presentation of information and options.

Bdnf In The Dentate Gyrus Is Required For Consolidation Of "Pattern-Separated" Memories., Pedro Bekinschtein, Brianne A Kent, Charlotte A Oomen, Gregory D Clemenson, Fred H Gage, Lisa M Saksida, Timothy J Bussey

Brain and Mind Institute Researchers' Publications

Successful memory involves not only remembering information over time, but also keeping memories distinct and less confusable. The computational process for making representations for similar input patterns more distinct from each other has been referred to as "pattern separation." In this work, we developed a set of behavioral conditions that allowed us to manipulate the load for pattern separation at different stages of memory. Thus, we provide experimental evidence that a brain-derived neurotrophic factor (BDNF)-dependent pattern separation process occurs during the encoding/storage/consolidation, but not the retrieval stage of memory processing. We also found that a spontaneous increase in BDNF in …

Sexual Coercion And Sexual Violence At First Intercourse Associated With Sexually Transmitted Infections, Corrine M. Williams, Emily R. Clear, Ann L. Coker

CRVAW Faculty Journal Articles

BACKGROUND: Violence against women has been associated with subsequent risky sexual behaviors and sexually transmitted infections (STIs). We explored whether sexual coercion or violence at first intercourse was associated with self-reported STIs.

METHODS: Using nationally representative data from the 2006 to 2010 National Survey of Family Growth, we analyzed female respondents aged 18 to 44 (n = 9466) who answered questions on coercion at first intercourse (wantedness, voluntariness, and types of force used) and STIs using logistic regression analyses. We explored degrees of coercion, which we label as neither, sexual coercion (unwanted or nonphysical force), or sexual violence (involuntary or …

Diabetes And Prostate Cancer Screening In Black And White Men, Maureen Sanderson, Jay H. Fowke, Loren Lipworth, Xijing Han, Flora Ukoli, Ann L. Coker, William J. Blot, Margaret K. Hargreaves

CRVAW Faculty Journal Articles

PURPOSE: Prior studies conducted primarily among white men find a reduced risk of prostate cancer associated with time since developing diabetes. While biologic explanations are plausible, the association may in part arise from more frequent prostate cancer screening among those with a diabetes diagnosis. The purpose of the present study was to investigate the association between diabetes and prostate cancer screening.

METHODS: We examined differences in prostate cancer screening (prostate-specific antigen and/or digital rectal examination) testing practices after a diabetes diagnosis among lower-income persons living in the southeastern United States and enrolled in the Southern Community Cohort Study between 2002 …

Randomized Clinical Trial Examining Duration Of Voucher-Based Reinforcement Therapy For Cocaine Abstinence., Kimberly C Kirby, Carolyn M Carpenedo, Karen L Dugosh, Beth J Rosenwasser, Lois A Benishek, Alicia Janik, Rachel Keashen, Elena Bresani, Kenneth Silverman

Faculty Scholarship for the College of Science & Mathematics

BACKGROUND: This is the first study to systematically manipulate duration of voucher-based reinforcement therapy (VBRT) to see if extending the duration increases abstinence during and following VBRT.

METHODS: We randomized cocaine-dependent methadone-maintained adults to Standard (12 weeks; n=62) or Extended (36 weeks; n=68) VBRT and provided escalating voucher amounts contingent upon urinalysis verification of cocaine abstinence. Urinalysis was scheduled at least every 2 weeks during the 48-week study and more frequently during VBRT (3/week) and 12 weeks of Aftercare (2/week).

RESULTS: Extended VBRT produced longer durations of continuous cocaine abstinence during weeks 1-24 (5.7 vs 2.7 weeks; p=0.003) and proportionally …

Mapping Disease At An Approximated Individual Level Using Aggregate Data: A Case Study Of Mapping New Hampshire Birth Defects, Xun Shi, Stephanie Miller, Kevin Mwenda, Akikazu Onda

Dartmouth Scholarship

Limited by data availability, most disease maps in the literature are for relatively large and subjectively-defined areal units, which are subject to problems associated with polygon maps. High resolution maps based on objective spatial units are needed to more precisely detect associations between disease and environmental factors. Method: We propose to use a Restricted and Controlled Monte Carlo (RCMC) process to disaggregate polygon-level location data to achieve mapping aggregate data at an approximated individual level. RCMC assigns a random point location to a polygon-level location, in which the randomization is restricted by the polygon and controlled by the background (e.g., …

The Drug Facts Box: Improving The Communication Of Prescription Drug Information, Lisa M. Schwartz, Steven Woloshin

Dartmouth Scholarship

Communication about prescription drugs ought to be a paragon of public science communication. Unfortunately, it is not. Consumers see $4 billion of direct-to-consumer advertising annually, which typically fails to present data about how well drugs work. The professional label—the Food and Drug Administration's (FDA) mechanism to get physicians information needed for appropriate prescribing—may also fail to present benefit data. FDA labeling guidance, in fact, suggests that industry omit bene

A Multivariate Method To Determine The Dimensionality Of Neural Representation From Population Activity., Jörn Diedrichsen, Tobias Wiestler, Naveed Ejaz

Brain and Mind Institute Researchers' Publications

How do populations of neurons represent a variable of interest? The notion of feature spaces is a useful concept to approach this question: According to this model, the activation patterns across a neuronal population are composed of different pattern components. The strength of each of these components varies with one latent feature, which together are the dimensions along which the population represents the variable. Here we propose a new method to determine the number of feature dimensions that best describes the activation patterns. The method is based on Gaussian linear classifiers that use only the first d most important pattern …

Skill Learning Strengthens Cortical Representations Of Motor Sequences., Tobias Wiestler, Jörn Diedrichsen

Brain and Mind Institute Researchers' Publications

Motor-skill learning can be accompanied by both increases and decreases in brain activity. Increases may indicate neural recruitment, while decreases may imply that a region became unimportant or developed a more efficient representation of the skill. These overlapping mechanisms make interpreting learning-related changes of spatially averaged activity difficult. Here we show that motor-skill acquisition is associated with the emergence of highly distinguishable activity patterns for trained movement sequences, in the absence of average activity increases. During functional magnetic resonance imaging, participants produced either four trained or four untrained finger sequences. Using multivariate pattern analysis, both untrained and trained sequences could …

Erps Reveal The Temporal Dynamics Of Auditory Word Recognition In Specific Language Impairment., Jeffrey G Malins, Amy S Desroches, Erin K Robertson, Randy Lynn Newman, Lisa M D Archibald, Marc F Joanisse

Brain and Mind Institute Researchers' Publications

We used event-related potentials (ERPs) to compare auditory word recognition in children with specific language impairment (SLI group; N=14) to a group of typically developing children (TD group; N=14). Subjects were presented with pictures of items and heard auditory words that either matched or mismatched the pictures. Mismatches overlapped expected words in word-onset (cohort mismatches; see: DOLL, hear: dog), rhyme (CONE -bone), or were unrelated (SHELL -mug). In match trials, the SLI group showed a different pattern of N100 responses to auditory stimuli compared to the TD group, indicative of early auditory processing differences in SLI. However, the phonological mapping …

Dynamic And Opposing Adjustment Of Movement Cancellation And Generation In An Oculomotor Countermanding Task., Brian D Corneil, Joshua C Cheng, Samanthi C Goonetilleke

Brain and Mind Institute Researchers' Publications

Adaptive adjustments of strategies help optimize behavior in a dynamic and uncertain world. Previous studies in the countermanding (or stop-signal) paradigm have detailed how reaction times (RTs) change with trial sequence, demonstrating adaptive control of movement generation. Comparatively little is known about the adaptive control of movement cancellation in the countermanding task, mainly because movement cancellation implies the absence of an outcome and estimates of movement cancellation require hundreds of trials. Here, we exploit a within-trial proxy of movement cancellation based on recordings of neck muscle activity while human subjects attempted to cancel large eye-head gaze shifts. On a subset …

Intracranial Injection Of Gammagard, A Human Ivig, Modulates The Inflammatory Response Of The Brain And Lowers AΒ In App/Ps1 Mice Along A Different Time Course Than Anti-AΒ Antibodies, Tiffany L. Sudduth, Abigail Greenstein, Donna M. Wilcock

Sanders-Brown Center on Aging Faculty Publications

Gammagard IVIg is a therapeutic approach to treat Alzheimer's disease currently in phase 3 clinical trials. Despite the reported efficacy of the approach the mechanism of action is poorly understood. We have previously shown that intracranial injection of anti-Aβ antibodies into the frontal cortex and hippocampus reveals important information regarding the time course of events once the agent is in the brain. In the current study we compared IVIg, mouse-pooled IgG, and the anti-Aβ antibody 6E10 injected intracranially into the frontal cortex and hippocampus of 7-month-old APP/PS1 mice. We established a time course of events ranging from 1 …

Two Distinct Ipsilateral Cortical Representations For Individuated Finger Movements., Jörn Diedrichsen, Tobias Wiestler, John W Krakauer

Brain and Mind Institute Researchers' Publications

Movements of the upper limb are controlled mostly through the contralateral hemisphere. Although overall activity changes in the ipsilateral motor cortex have been reported, their functional significance remains unclear. Using human functional imaging, we analyzed neural finger representations by studying differences in fine-grained activation patterns for single isometric finger presses. We demonstrate that cortical motor areas encode ipsilateral movements in 2 fundamentally different ways. During unimanual ipsilateral finger presses, primary sensory and motor cortices show, underneath global suppression, finger-specific activity patterns that are nearly identical to those elicited by contralateral mirror-symmetric action. This component vanishes when both motor cortices are …

Prevalence And Patterns Of Sexting Among Ethnic Minority Urban High School Students, Melissa Fleschler Peskin, Christine M Markham, Robert C Addy, Ross Shegog, Melanie Thiel, Susan R Tortolero

Journal Articles

Although sexting among U.S. youth has received much popular media attention, there are only limited data on its prevalence among ethnic minority youth. This study, therefore, specifically examined the prevalence and patterns of sexting (sending and/or receiving a nude or semi-nude picture/video or a sexual text-only message) among a sample of black and Hispanic youth. Data from 1,034 tenth graders from a large, urban school district in southeast Texas were used to calculate the prevalence of sexting by gender-race/ethnicity. Overlap among sexting behaviors was also examined. Electronic surveys were administered via an audio-computer-assisted self-interview on laptop computers. Prevalence estimates were …

Decoding The Neural Mechanisms Of Human Tool Use., Jason P Gallivan, D Adam Mclean, Kenneth F Valyear, Jody C Culham

Brain and Mind Institute Researchers' Publications

Sophisticated tool use is a defining characteristic of the primate species but how is it supported by the brain, particularly the human brain? Here we show, using functional MRI and pattern classification methods, that tool use is subserved by multiple distributed action-centred neural representations that are both shared with and distinct from those of the hand. In areas of frontoparietal cortex we found a common representation for planned hand- and tool-related actions. In contrast, in parietal and occipitotemporal regions implicated in hand actions and body perception we found that coding remained selectively linked to upcoming actions of the hand whereas …

The Human Brain Processes Syntax In The Absence Of Conscious Awareness., Laura Batterink, Helen J Neville

Brain and Mind Institute Researchers' Publications

Syntax is the core computational component of language. A longstanding idea about syntactic processing is that it is generally not available to conscious access, operating autonomously and automatically. However, there is little direct neurocognitive evidence on this issue. By measuring event-related potentials while human observers performed a novel cross-modal distraction task, we demonstrated that syntactic violations that were not consciously detected nonetheless produced a characteristic early neural response pattern, and also significantly delayed reaction times to a concurrent task. This early neural response was distinct from later neural activity that was observed only to syntactic violations that were consciously detected. …

An Ehealth System Supporting Palliative Care For Patients With Non-Small Cell Lung Cancer: A Randomized Trial, David H. Gustafson, Lori L. Dubenske, Kang Namkoong, Robert Hawkins, Ming-Yuan Chih, Amy K. Atwood, Roberta Johnson, Abhik Bhattacharya, Cindy L. Carmack, Anne M. Traynor, Toby C. Campbell, Mary K. Buss, Ramaswamy Govindan, Joan H. Schiller, James F. Cleary

Community & Leadership Development Faculty Publications

BACKGROUND: In this study, the authors examined the effectiveness of an online support system (Comprehensive Health Enhancement Support System [CHESS]) versus the Internet in relieving physical symptom distress in patients with non-small cell lung cancer (NSCLC).

METHODS: In total, 285 informal caregiver-patient dyads were assigned randomly to receive, for up to 25 months, standard care plus training on and access to either use of the Internet and a list of Internet sites about lung cancer (the Internet arm) or CHESS (the CHESS arm). Caregivers agreed to use CHESS or the Internet and to complete bimonthly surveys; for patients, these tasks …

Intracranial Injection Of Aav Expressing Nep But Not Ide Reduces Amyloid Pathology In App+Ps1 Transgenic Mice, Nikisha Carty, Kevin R. Nash, Milene Brownlow, Dana Cruite, Donna M. Wilcock, Maj-Linda B. Selenica, Daniel C. Lee, Marcia N. Gordon, Dave Morgan

Sanders-Brown Center on Aging Faculty Publications

The accumulation of β-amyloid peptides in the brain has been recognized as an essential factor in Alzheimer's disease pathology. Several proteases, including Neprilysin (NEP), endothelin converting enzyme (ECE), and insulin degrading enzyme (IDE), have been shown to cleave β-amyloid peptides (Aβ). We have previously reported reductions in amyloid in APP+PS1 mice with increased expression of ECE. In this study we compared the vector-induced increased expression of NEP and IDE. We used recombinant adeno-associated viral vectors expressing either native forms of NEP (NEP-n) or IDE (IDE-n), or engineered secreted forms of NEP (NEP-s) or IDE (IDE-s). In a six-week study, immunohistochemistry …

The Doctor-Patient Relationship Revisited. An Analysis Of The Placebo Effect., Herbert M. Adler, Md, Van B. Hammett. Md

Herbert M. Adler

An overview of prescientific medicine, evolution, and individual human development is presented in an attempt to discover the generic factors operating in all interpersonal therapies. We hypothesize that the placebo effect rests on the universal human need for a group and, by symbolic extension, a system.

Awareness And Beliefs Regarding Intimate Partner Violence Among First-Year Dental Students, Rhonda J. Everett, Karl Kingsley, Christina A. Demopoulos, Edward E. Herschaft, Christine Lamun, Sheniz Moonie, Timothy J. Bungum, Michelle Chino

Environmental & Occupational Health Faculty Publications

Intimate partner violence (IPV) may affect one to four million individuals per year in the United States, with women accounting for the majority of both reported and unreported cases. Dental professionals are in a unique position to identify many types of IPV because injuries to the head and neck may be indicators or predictors of IPV abuse. Fewer than half of dental programs surveyed have reported having IPV-specific curricula, and most dental students surveyed have reported having little experience or training to recognize IPV. Based on this information, this pilot study sought to assess the awareness and beliefs regarding IPV …

Reflex Changes Associated With Anticipatory Postural Adjustments Preceding Voluntary Arm Movements In Standing Humans, Siddharth Vedula, Paul J. Stapley, Robert E. Kearney

Dr Paul J Stapley

Dynamic changes in human stability, such as those induced by upper body movements, are preceded by anticipatory postural adjustments (APAs) in the rest of the body. We measured the excitability of the stretch reflex of the triceps-surae muscle group during APAs associated with unilateral right arm raises in standing humans. Our results demonstrate that reflex excitability and underlying muscle activity are linked during the APA period, but that they differ in their relative timing. This supports the idea that reflexes are controlled independently of muscle activation.

Hd-Cnv: Hotspot Detector For Copy Number Variants., Jenna L Butler, Marjorie Elizabeth Osborne Locke, Kathleen A Hill, Mark Daley

Brain and Mind Institute Researchers' Publications

SUMMARY: Copy number variants (CNVs) are a major source of genetic variation. Comparing CNVs between samples is important in elucidating their potential effects in a wide variety of biological contexts. HD-CNV (hotspot detector for copy number variants) is a tool for downstream analysis of previously identified CNV regions from multiple samples, and it detects recurrent regions by finding cliques in an interval graph generated from the input. It creates a unique graphical representation of the data, as well as summary spreadsheets and UCSC (University of California, Santa Cruz) Genome Browser track files. The interval graph, when viewed with other software …

Differential Effects Of Parkinson's Disease And Dopamine Replacement On Memory Encoding And Retrieval., Alex A Macdonald, Ken N Seergobin, Adrian M Owen, Ruzbeh Tamjeedi, Oury Monchi, Hooman Ganjavi, Penny A Macdonald

Brain and Mind Institute Researchers' Publications

Increasingly memory deficits are recognized in Parkinson's disease (PD). In PD, the dopamine-producing cells of the substantia nigra (SN) are significantly degenerated whereas those in the ventral tegmental area (VTA) are relatively spared. Dopamine-replacement medication improves cognitive processes that implicate the SN-innervated dorsal striatum but is thought to impair those that depend upon the VTA-supplied ventral striatum, limbic and prefrontal cortices. Our aim was to examine memory encoding and retrieval in PD and how they are affected by dopamine replacement. Twenty-nine PD patients performed the Rey Auditory Verbal Learning Test (RAVLT) and a non-verbal analogue, the Aggie Figures Learning Test …

Sediment Disturbance Associated With Trampling By Humans Alters Species Assemblages On A Rocky Intertidal Seashore, Todd E. Minchinton, Katie J. Fels

Faculty of Science, Medicine and Health - Papers: part A

Our observations reveal that species living on rocky intertidal reefs can be positively and negatively associated with increasing sediment load. We therefore tested the hypothesis that sediment disturbance, including increased sediment loads associated with trampling by humans, alters the abundance of macroinvertebrates on a sheltered rocky intertidal platform in southern Australia. First we trampled the reef in shallow water at several disturbance intensities, simulating different numbers of people walking on the platform on a rising tide, and determined that sediment load was directly related to trampling intensity. Trampling displaced sediment, and up to an order of magnitude more sediment accumulated …

Humans, Megafauna And Environmental Change In Tropical Australia, Michael I. Bird, Lindsay B. Hutley, Michael J. Lawes, Jon Lloyd, Jon G. Luly, Peter V. Ridd, Richard G. Roberts, Sean Ulm, Christoper M. Wurster

Faculty of Science, Medicine and Health - Papers: part A

Debate concerning the environmental impact of human arrival in Australia has continued for more than a century. Here we review the evidence for human impact and the mechanisms by which humans may have affected the environment of tropical Australia. We limit our review to tropical Australia because, over three decades ago, it was proposed that the imposition of an anthropogenic fire regime upon human occupation of the Australian continent may have resulted in profound changes in regional vegetation and climate across this region. We conclude that ecological processes and vegetation-fire-climate-human feedbacks do exist that could have driven a significant shift …

Regional Variations In Transepidermal Water Loss, Eccrine Sweat Gland Density, Sweat Secretion Rates And Electrolyte Composition In Resting And Exercising Humans, Nigel As Taylor, Christiano A. Machado-Moreira

Faculty of Science, Medicine and Health - Papers: part A

Literature from the past 168 years has been filtered to provide a unified summary of the regional distribution of cutaneous water and electrolyte losses. The former occurs via transepidermal water vapour diffusion and secretion from the eccrine sweat glands. Daily insensible water losses for a standardised individual (surface area 1.8 m2) will be 0.6–2.3 L, with the hands (80–160 g.h−1) and feet (50–150 g.h−1) losing the most, the head and neck losing intermediate amounts (40–75 g.h−1) and all remaining sites losing 15–60 g.h−1. Whilst sweat gland densities vary widely across the skin surface, this same individual would possess some 2.03 …

Language, Reading, And Math Learning Profiles In An Epidemiological Sample Of School Age Children., Lisa M D Archibald, Janis Oram Cardy, Marc F Joanisse, Daniel Ansari

Brain and Mind Institute Researchers' Publications

Dyscalculia, dyslexia, and specific language impairment (SLI) are relatively specific developmental learning disabilities in math, reading, and oral language, respectively, that occur in the context of average intellectual capacity and adequate environmental opportunities. Past research has been dominated by studies focused on single impairments despite the widespread recognition that overlapping and comorbid deficits are common. The present study took an epidemiological approach to study the learning profiles of a large school age sample in language, reading, and math. Both general learning profiles reflecting good or poor performance across measures and specific learning profiles involving either weak language, weak reading, weak …

Acute Alcohol Consumption Impairs Controlled But Not Automatic Processes In A Psychophysical Pointing Paradigm., Kevin Johnston, Brian Timney, Melvyn A Goodale

Brain and Mind Institute Researchers' Publications

Numerous studies have investigated the effects of alcohol consumption on controlled and automatic cognitive processes. Such studies have shown that alcohol impairs performance on tasks requiring conscious, intentional control, while leaving automatic performance relatively intact. Here, we sought to extend these findings to aspects of visuomotor control by investigating the effects of alcohol in a visuomotor pointing paradigm that allowed us to separate the influence of controlled and automatic processes. Six male participants were assigned to an experimental "correction" condition in which they were instructed to point at a visual target as quickly and accurately as possible. On a small …

A Penile Spine/Vibrissa Enhancer Sequence Is Missing In Modern And Extinct Humans But Is Retained In Multiple Primates With Penile Spines And Sensory Vibrissae, Philip L. Reno, Cory Y Mclean, Jasmine E Hines, Terence D Capellini, Gill Bejerano, David M Kingsley

PCOM Scholarly Papers

Previous studies show that humans have a large genomic deletion downstream of the Androgen Receptor gene that eliminates an ancestral mammalian regulatory enhancer that drives expression in developing penile spines and sensory vibrissae. Here we use a combination of large-scale sequence analysis and PCR amplification to demonstrate that the penile spine/vibrissa enhancer is missing in all humans surveyed and in the Neandertal and Denisovan genomes, but is present in DNA samples of chimpanzees and bonobos, as well as in multiple other great apes and primates that maintain some form of penile integumentary appendage and facial vibrissae. These results further strengthen …

Internet-Based Photoaging Within Australian Pharmacies To Promote Smoking Cessation: Randomized Controlled Trial, Oksana Burford, Moyez Jiwa, Owen B. Carter, Richard Parsons, Delia Hendrie

Research outputs 2013

Background: Tobacco smoking leads to death or disability and a drain on national resources. The literature suggests that cigarette smoking continues to be a major modifiable risk factor for a variety of diseases and that smokers aged 18-30 years are relatively resistant to antismoking messages due to their widely held belief that they will not be lifelong smokers. Objective: To conduct a randomized controlled trial (RCT) of a computer-generated photoaging intervention to promote smoking cessation among young adult smokers within a community pharmacy setting. Methods: A trial was designed with 80% power based on the effect size observed in a …