Conciousness Expanded

Many kinds of human states of consciousness have been distinguished, including colourful or anomalous experiences that are felt to have spiritual significance by most people who have them. The neurosciences have isolated brain-state correlates for some of these colourful states of consciousness, thereby strengthening the hypothesis that these experiences are mediated by the brain. This result both challenges metaphysically dualist accounts of human nature and suggests that any adequate causal explanation of colourful experiences would have to make detailed reference to the evolutionary and genetic conditions that give rise to brains capable of such conscious phenomena. This paper quickly surveys types of conscious states and neurological interpretations of them. In order to deal with the question of the significance of such experiences, the paper then attempts to identify evolutionary and genetic constraints on proposals for causal explanations of such experiences. The conclusion is that a properly sensitive evolutionary account of human consciousness supports a rebuttal of the argument that the cognitive content of colourful experiences is pure delusion, but that this evolutionary account also heavily constrains what might be inferred theologically from such experiences. They are not necessarily delusory, therefore, but they are often highly misleading. Their significance must be construed consistently with this conclusion.

Paediatric malaria case-management with artemether-lumefantrine in Zambia: a repeat cross-sectional study

BACKGROUND:Zambia was the first African country to change national antimalarial treatment policy to artemisinin-based combination therapy - artemether-lumefantrine. An evaluation during the early implementation phase revealed low readiness of health facilities and health workers to deliver artemether-lumefantrine, and worryingly suboptimal treatment practices. Improvements in the case-management of uncomplicated malaria two years after the initial evaluation and three years after the change of policy in Zambia are reported.METHODS:Data collected during the health facility surveys undertaken in 2004 and 2006 at all outpatient departments of government and mission facilities in four Zambian districts were analysed. The surveys were cross-sectional, using a range of quality of care assessment methods. The main outcome measures were changes in health facility and health worker readiness to deliver artemether-lumefantrine, and changes in case-management practices for children below five years of age presenting with uncomplicated malaria as defined by national guidelines.RESULTS:In 2004, 94 health facilities, 103 health workers and 944 consultations for children with uncomplicated malaria were evaluated. In 2006, 104 facilities, 135 health workers and 1125 consultations were evaluated using the same criteria of selection. Health facility and health worker readiness improved from 2004 to 2006: availability of artemether-lumefantrine from 51% (48/94) to 60% (62/104), presence of artemether-lumefantrine dosage wall charts from 20% (19/94) to 75% (78/104), possession of guidelines from 58% (60/103) to 92% (124/135), and provision of in-service training from 25% (26/103) to 41% (55/135). The proportions of children with uncomplicated malaria treated with artemether-lumefantrine also increased from 2004 to 2006: from 1% (6/527) to 27% (149/552) in children weighing 5 to 9 kg, and from 11% (42/394) to 42% (231/547) in children weighing 10 kg or more. In both weight groups and both years, 22% (441/2020) of children with uncomplicated malaria were not prescribed any antimalarial drug.CONCLUSION:Although significant improvements in malaria case-management have occurred over two years in Zambia, the quality of treatment provided at the point of care is not yet optimal. Strengthening weak health systems and improving the delivery of effective interventions should remain high priority in all countries implementing new treatment policies for malaria.

A Quantitative Evaluation of the AVITEWRITE Model of Handwriting Learning

Much sensory-motor behavior develops through imitation, as during the learning of handwriting by children. Such complex sequential acts are broken down into distinct motor control synergies, or muscle groups, whose activities overlap in time to generate continuous, curved movements that obey an intense relation between curvature and speed. The Adaptive Vector Integration to Endpoint (AVITEWRITE) model of Grossberg and Paine (2000) proposed how such complex movements may be learned through attentive imitation. The model suggest how frontal, parietal, and motor cortical mechanisms, such as difference vector encoding, under volitional control from the basal ganglia, interact with adaptively-timed, predictive cerebellar learning during movement imitation and predictive performance. Key psycophysical and neural data about learning to make curved movements were simulated, including a decrease in writing time as learning progresses; generation of unimodal, bell-shaped velocity profiles for each movement synergy; size scaling with isochrony, and speed scaling with preservation of the letter shape and the shapes of the velocity profiles; an inverse relation between curvature and tangential velocity; and a Two-Thirds Power Law relation between angular velocity and curvature. However, the model learned from letter trajectories of only one subject, and only qualitative kinematic comparisons were made with previously published human data. The present work describes a quantitative test of AVITEWRITE through direct comparison of a corpus of human handwriting data with the model's performance when it learns by tracing human trajectories. The results show that model performance was variable across subjects, with an average correlation between the model and human data of 89+/-10%. The present data from simulations using the AVITEWRITE model highlight some of its strengths while focusing attention on areas, such as novel shape learning in children, where all models of handwriting and learning of other complex sensory-motor skills would benefit from further research.

Normal and Amnesis Learning, Recognition, and Memory by a Neural Model of Cortico-Hippocampal Interactions

The processes by which humans and other primates learn to recognize objects have been the subject of many models. Processes such as learning, categorization, attention, memory search, expectation, and novelty detection work together at different stages to realize object recognition. In this article, Gail Carpenter and Stephen Grossberg describe one such model class (Adaptive Resonance Theory, ART) and discuss how its structure and function might relate to known neurological learning and memory processes, such as how inferotemporal cortex can recognize both specialized and abstract information, and how medial temporal amnesia may be caused by lesions in the hippocampal formation. The model also suggests how hippocampal and inferotemporal processing may be linked during recognition learning.