Acute Effects of Cannabis Smoking on Skills Related to Driving : an fMRI Study

Introduction : Driving is a complex everyday task requiring mechanisms of perception, attention, learning, memory, decision making and action control, thus indicating that involves numerous and varied brain networks. If many data have been accumulated over time about the effects of alcohol consumption on driving capability, much less is known about the role of other psychoactive substances, such as cannabis (Chang et al.2007, Ramaekers et al, 2006). Indeed, the solicited brain areas during safe driving which could be affected by cannabis exposure have not yet been clearly identified. Our aim is to study these brain regions during a tracking task related to driving skills and to evaluate the modulation due to the tolerance of cannabis effects. Methods : Eight non-smoker control subjects participated to an fMRI experiment based on a visuo-motor tracking task, alternating active tracking blocks with passive tracking viewing and rest condition. Half of the active tracking conditions included randomly presented traffic lights as distractors. Subjects were asked to track with a joystick with their right hand and to press a button with their left index at each appearance of a distractor. Four smoking subjects participated to the same fMRI sessions once before and once after smoking cannabis and a placebo in two independent cross-over experiments. We quantified the performance of the subjects by measuring the precision of the behavioural responses (i.e. percentage of time of correct tracking and reaction times to distractors). Functional MRI data were acquired using on a 3.0T Siemens Trio system equipped with a 32-channel head coil. BOLD signals will be obtained with a gradient-echo EPI sequence (TR=2s, TE=30ms, FoV=216mm, FA=90°, matrix size 72×72, 32 slices, thickness 3mm). Preprocessing, single subject analysis and group statistics were conducted on SPM8b. Results were thresholded at p<0.05 (FWE corrected) and at k>30 for spatial extent. Results : Behavioural results showed a significant impairment in task and cognitive test performance of the subjects after cannabis inhalation when comparing their tracking accuracy either to the controls subjects or to their performances before the inhalation or after the placebo inhalation (p<0.001 corrected). In controls, fMRI BOLD analysis of the active tracking condition compared to the passive one revealed networks of polymodal areas in superior frontal and parietal cortex dealing with attention and visuo-spatial coordination. In accordance to what is known of the visual and sensory motor networks we found activations in V4, frontal eye-field, right middle frontal gyrus, intra-parietal sulcus, temporo-parietal junction, premotor and sensory-motor cortex. The presence of distractors added a significant activation in the precuneus. Preliminary results on cannabis smokers in the acute phase, compared either to themselves before the cannabis inhalation or to control subjects, showed a decreased activation in large portions of the frontal and parietal attention network during the simple tracking task, but greater involvement of precuneus, of the superior part of intraparietal sulcus and middle frontal gyrus bilaterally when distractors were present in the task. Conclusions : Our preliminary results suggest that acute cannabis smoking alters performances and brain activity during active tracking tasks, partly reorganizing the recruitment of brain areas of the attention network.

Critical thinking and accuracy of nurses' diagnoses. Part II: application of cognitive skills and guidelines for self-development

Part I of this article, the author explained the difficulties of achieving accuracy of nurses' diagnoses, the relevance of critical thinking to the achievement of accuracy, and newer views of critical thinking. In Part II, the critical thinking dimensions identified as important for nursing practice are applied in the diagnostic process using a case study of a 16 year old girl with type 1 diabetes. Application of seven cognitive skills and ten habits of mind illustrate the importance of using critical thinking for accuracy of nurses' diagnoses. Ten strategies are proposed for self-development of critical thinking abilities.

Communication skills training in oncology: a position paper based on a consensus meeting among European experts in 2009.

BACKGROUND: Communication in cancer care has become a major topic of interest. Since there is evidence that ineffective communication affects both patients and oncology clinicians (physicians and nurses), so-called communication skills trainings (CSTs) have been developed over the last decade. While these trainings have been demonstrated to be effective, there is an important heterogeneity with regard to implementation and with regard to evidence of different aspects of CST. METHODS: In order to review and discuss the scientific literature on CST in oncology and to formulate recommendations, the Swiss Cancer League has organised a consensus meeting with European opinion leaders and experts in the field of CST, as well as oncology clinicians, representatives of oncology societies and patient organisations. On the basis of a systematic review and a meta-analysis, recommendations have been developed and agreed upon. RESULTS: Recommendations address (i) the setting, objectives and participants of CST, (ii) its content and pedagogic tools, (iii) organisational aspects, (iv) outcome and (v) future directions and research. CONCLUSION: This consensus meeting, on the basis of European expert opinions and a systematic review and meta-analysis, defines key elements for the current provision and future development and evaluation of CST in oncology.

Government and the distribution of skills

Individuals' life chances in the future will very much depend on how we invest in our children now. An optimal human capital model would combine a high mean with minimal variance of skills. It is well-established that early childhood learning is key to adult success. The impact of social origins on child outcomes remains strong, and the new role of women poses additional challenges to our conventional nurturing approach to child development. This paper focuses on skill development in the early years, examining how we might best combine family inputs and public policy to invest optimally in our future human capital. I emphasize three issues: one, the uneven capacity of parents to invest in children; two, the impact of mothers' employment on child outcomes; and three, the potential benefits of early pre-school programmes. I conclude that mothers' intra-family bargaining power is decisive for family investments and that universal child care is key if our goal is to arrive at a strong mean with minimal variance.

Barriers to Employment, March 2001

During the last five years, Iowa has experienced a shortage of workers and will continue to feel the impact of a short labor supply. As the state prepares to reverse this trend of a declining population, attracting immigrants and refugees has great potential. In addition, released preliminary reports from the 2000 Census are reporting growth of the Latino population in several Iowa counties. This survey was conducted as a way to supplement the information collected about the Latino population by the State Public Policy Group in 1999, Snapshot in Time: A clear view of the importance, value and impacts of the Latino population in central Iowa. (Una Foto Actual de la Comunicad Latina: Un panoramaclaro de la importancia, del valor, y de los impactos de la población Latina en el área central de Iowa.) Although this survey was enlightening, it was broad in scope. It was the goal of the agency to collect more specific data regarding workforce needs and barriers that the Latino population encounter in the State of Iowa. Although it was the desire to broaden the scope of the previous survey, it should be noted that the survey samples were not identical. But it is recognized that because the Latino population within the state is small, some of the respondents could have participated in both surveys. We were also hoping to benefit from the extensive work conducted by SPPG within the community as a way to increase the response rate for this survey. This executive summary highlights some of the most significant findings from the survey of Latinos residing in Central Iowa. This analysis centers on the impact the Latino population can have in filling the labor shortages and how Iowa can best embrace the new Iowan. In addition, some of the key findings could offer insight into removing unnecessary barriers that prevent immigrants from utilizing valuable work skills as they integrate into the workforce. This information may be insightful to community leaders and employers who want to welcome new immigrants into their community. The following diagram collected from the 2000 Census illustrates the percentage of Latinos residing in the state.

Condom use with steady partners among heterosexual people living with HIV in Europe: testing the information-motivation-behavioral skills model.

Guided by a modified information-motivation-behavioral skills model, this study identified predictors of condom use among heterosexual people living with HIV with their steady partners. Consecutive patients at 14 European HIV outpatient clinics received an anonymous, standardized, self-administered questionnaire between March and December 2007. Data were analyzed using descriptive statistics and two-step backward elimination regression analyses stratified by gender. The survey included 651 participants (n = 364, 56% women; n = 287, 44%). Mean age was 39 years for women and 43 years for men. Most had acquired HIV sexually and more than half were in a serodiscordant relationship. Sixty-three percent (n = 229) of women and 59% of men (n = 169) reported at least one sexual encounter with a steady partner 6 months prior to the survey. Fifty-one percent (n = 116) of women and 59% of men (n = 99) used condoms consistently with that partner. In both genders, condom use was positively associated with subjective norm conducive to condom use, and self-efficacy to use condoms. Having a partner whose HIV status was positive or unknown reduced condom use. In men, higher education and knowledge about condom use additionally increased condom use, while the use of erectile-enhancing medication decreased it. For women, HIV disclosure to partners additionally reduced the likelihood of condom use. Positive attitudes to condom use and subjective norm increased self-efficacy in both genders, however, a number of gender-related differences appeared to influence self-efficacy. Service providers should pay attention to the identified predictors of condom use and adopt comprehensive and gender-related approaches for preventive interventions with people living with HIV.

Iowa's Community College Basic Literacy Skills Credential Program Annual Report, 2002

The purpose of this report is to document the results of Iowa’s community college based basic literacy skills credential program for Program Year 2002 (July 1, 2001-June 30, 2002). The credentialing program is administered through Iowa’s community colleges and consists of four (4) components: (1) basic literacy skills certification, (2) Iowa High School Equivalency Diploma, (3) community college based adult high school diploma, and (4) traditional high school diploma. A brief description of each component is presented in the following sections.

Iowa's Community College Basic Literacy Skills Credential Program Annual Report, 2003

The purpose of this report is to document the results of Iowa’s community college based basic literacy skills credential program for Program Year 2003 (July 1, 2002-June 30, 2003). The credentialing program is administered through Iowa’s community colleges and consists of four (4) components: (1) basic literacy skills certification, (2) Iowa High School Equivalency Diploma, (3) community college based adult high school diploma, and (4) traditional high school diploma. A brief description of each component is presented in the following sections.

Iowa's Community College Basic Literacy Skills Credential Program Annual Report, 2004

The purpose of this report is to document the results of Iowa’s community college based basic literacy skills credential program for Program Year 2004 (July 1, 2003-June 30, 2004). The credentialing program is administered through Iowa’s community colleges and consists of four (4) components: (1) basic literacy skills certification, (2) Iowa High School Equivalency Diploma, (3) community college based adult high school diploma, and (4) traditional high school diploma. A brief description of each component is presented in the following sections.

Iowa's Community College Basic Literacy Skills Credential Program Annual Report, 2006

The purpose of this report is to document the results of Iowa’s community college based basic literacy skills credential program for Program Year 2006 (July 1, 2005-June 30, 2006). The credentialing program is administered through Iowa’s community colleges and consists of four (4) components: (1) basic literacy skills certification, (2) Iowa High School Equivalency Diploma, (3) community college based adult high school diploma, and (4) traditional high school diploma. A brief description of each component is presented in the following sections.

Iowa's Community college Basic Literacy Skills Credential Program Annual Report, 2005

The purpose of this report is to document the results of Iowa’s community college based basic literacy skills credential program for Program Year 2005 (July 1, 2004-June 30, 2005). The credentialing program is administered through Iowa’s community colleges and consists of four (4) components: (1) basic literacy skills certification, (2) Iowa High School Equivalency Diploma, (3) community college based adult high school diploma, and (4) traditional high school diploma. A brief description of each component is presented in the following sections.

Modes of acquisition of health literacy skills in informal learning contexts

In this article we try to analyze the learning processes of health literacy skills in informal contexts. We intend to broaden the understanding of the learning process beyond the formal contexts, thus contributing to the elucidation of health professionals on how individuals acquire and manage their knowledge in health matters. Given our goal, we use an analytic corpus constituted by one hundred autobiographical narratives written between 2006 and 2011, in educational contexts but with recognized potential for use in different scientific fields, including health. The results reveal the existence of three different types of modes of learning health literacy skills in informal context: : i) learning that takes place in action, in achieving daily tasks; ii) learning processes that result from problem solving; iii) learning that occurs in an unplanned manner, resulting from accidental circumstances and, in some cases, devoid of intentionality.

Approaches and Strategies to Improve Writing Skills

I believe and, I hope others believe that writing well is not only a personal accomplishment but also a valuable form of social participation and leadership. After reviewing the literature, this work tries to identify the problem and to identify the key issues to EFL writing so as to suggest a remedial procedure that may help the learners to express themselves better in English. It aims at finding areas of difficulty in the writing skill among the students and to work out remedial procedures to help them overcome their weakness. A survey carried out on 12th grade students, regarding their comprehension, shows that organizing idea on paper is one of the factors which influences their ability to write. It also shows that students feel the need to be instructed on strategies of writing success and consequently improving their writing. There are a lot systematic approaches and methods for discerning which skills and type of writing teacher should focus on and meaningful classroom activities and strategies that teacher can use to help students improving their writing.

Relationship between the users' contact time in educational programs on diabetes mellitus and self-care skills and knowledge

Abstract OBJECTIVE Check the relationship between the users' contact time in educational programs and self-care and knowledge variables in diabetes mellitus. METHOD A longitudinal study with a quantitative approach with the participation, in the initial phase, of 263 users linked to Basic Health Units in Belo Horizonte, Brazil during the years 2012 and 2013. The data were collected with respect to the total contact time of the users' participation in the educational program as regards knowledge and self-care in acquired diabetes mellitus. The data were analyzed using the Student t-test for comparison of means, considering a 0.05 significance level. RESULTS The final sample included 151 users. The analysis showed that the improvement in self-care scores was statistically higher during an educational intervention of eight hours or more (p-value <0.05). In relation to the scores for knowledge, there was a statistically significant improvement at the end of the educational program. It was not possible to identify a value for the contact time from which there was an increase in mean scores for the ability of knowledge. CONCLUSION To improve the effectiveness of the promotion of skills related to knowledge and self-care in diabetes mellitus, it is necessary to consider the contact time as a relevant factor of the educational program.