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Behavior is considered the response to internal and external stimuli. Both the basal ganglia as well as the cerebellum process internal (homeostatic) and external (environmental) cortical information in order to orchestrate adequately adapted behavior and send this processed information via the thalamus back to the cortex for final execution through motor neurons and neuromuscular structures. The basal ganglia arrange for the appropriate selection of behavioral fragments (response selection) out of the available pool of learned standard behaviors, and define their magnitude, while the cerebellum together with the sensory, visual, and vestibular organs deal with their coordination, that is, the exact timing of muscle actions so that the body can move smoothly. The final execution of these movements is enabled by upper/lower motor neurons and neuromuscular structures.
A comprehensive and multidisciplinary guide to understanding and treating a wide range of movement disorders, including parkinsonisms, tremor, tics, dystonia, chorea, ballism and myoclonus. Split into five sections, the first is a basic introduction to the subject, covering the principles of human motor behavior and functional anatomy. The next three sections discuss movement disorders in depth, grouped into hypokinetic, hyperkinetic, and dyscoordinative and otherwise inappropriate motor behaviours, covering clinical manifestations, diagnostic features and therapeutic strategies. The last section explores the different ways of objectifying selected behavioral movement disorders. 90 videos, hosted online, and over 200 figures illustrate the concepts covered in the book, offering a visual reference for the disorders discussed. This compendium offers an essential tool to recognize, interpret and understand the clinical manifestations and underlying disorders of neurological movement disorders, and to select the best therapeutic strategies.
In schizophrenia the life expectancy is significantly lower compared to the general population. To monitor their functioning over the course of the illness, a protocol for routine outcome monitoring (ROM) has been developed in the Netherlands.
Objective
This study investigated the effectiveness of Routine Outcome Monitoring (ROM) in clinical practice. More specifically, we investigated whether ROM outcomes resulted in treatment in accordance with guidelines for schizophrenia.
Methods
Out of the ROM database of 2010 (n=1040), a random sample of 100 patients diagnosed with a psychotic disorder was taken. Data from blood tests, a physical examination, interviews, and standardized questionnaires were used. The prevalence of cardiovascular risk factors, psychosocial problems and sexual dysfunctions was calculated. Offered treatment was investigated with the treatment plans of patients.
Results
The sample consisted of 63 males and 37 females. The average age was 44 and the average duration of illness was 17.7 years. High prevalences of cardiovascular risk factors, psychosocial problems and sexual dysfunctions were found. Cardiovascular risk factors remained untreated in 61% of cases, psychosocial problems remained untreated in 85% of cases and sexual dysfunctions were not treated at all in our sample.
Conclusions
High rates of non-treatment were found for cardiovascular risk factors, psychosocial problems and sexual dysfunctions, despite high prevalences as identified with ROM. Thus, ROM outcomes do not result in treatment in accordance with guidelines for the majority of patients. Steps are necessary to bridge the gap between ROM and treatment to ensure this group of severely mentally ill patients receives the best possible treatment.
The distinction made by Page between localist and distributed representations seems confounded by the distinction between competitive and associative learning. His manifesto can also be read as a plea for competitive learning. The power of competitive models can even be extended further, by simulating similarity effects in forced-choice perceptual identification (Ratcliff & McKoon 1997) that have defied explanation by most memory models.
We report about an ongoing study of the evolution of 24 S0s with UV-bright ring/arm-like structures observed with SWIFT-UVOT and interpreted via SPH simulations with chemo-photometric implementation.
The control of Johne's disease requires the identification of Mycobacterium avium ssp. paratuberculosis (MAP)-positive herds. Boot swabs and liquid manure samples have been suggested as an easy-to-use alternative to sampling individual animals in order to diagnose subclinical Johne's disease at the herd level, but there is a need to evaluate performance of this approach in the field. Using a logistic regression model, this study aimed to calculate the threshold level of the apparent within-herd prevalence as determined by individual faecal culture, thus allowing the detection of whether a herd is MAP positive. A total of 77 boot swabs and 75 liquid manure samples were taken from 19 certified negative and 58 positive dairy herds. Faecal culture, three different polymerase chain reaction (PCR) methods and the combination of faecal culture with PCR were applied in order to detect MAP. For 50% probability of detection, a within-herd prevalence threshold of 1·5% was calculated for testing both matrices simultaneously by faecal culture and PCR, with the threshold increased to 4·0% for 90% probability of detection. The results encourage the use of boot swabs or liquid manure samples, or a combination both, for identifying MAP-positive herds and, to a certain extent, for monitoring certified Johne's disease-negative cattle herds.
Effective infection control measures during norovirus outbreaks are urgently needed in places where vulnerable individuals gather. In the present study, the effect of a number of measures was investigated in daily practice. Forty-nine Dutch nursing homes were monitored prospectively for norovirus outbreaks during two winter seasons. A total of 37 norovirus outbreaks were registered. Control measures were most effective when implemented within 3 days after onset of disease of the first patient. Measures targeted at reduced transmission between persons, via aerosols, and via contaminated surfaces reduced illness in staff and in residents. Reducing illness in staff results in fewer costs for sick leave and substitution of staff and less disruption in the care of residents. The effect of control measures on outbreak duration was limited. This is the first intervention study examining the effect of control measures. Further research is needed to extend and refine the conclusions.