Saturday, 27 December 2014

What is genetic screening? |


Newborn Screening

The most widespread use of genetic screening is the testing of newborn babies. The purpose of newborn screening is to provide immediate treatment after birth to affected infants so that the symptoms of a disease can be lessened or prevented.









Screening for phenylketonuria (PKU) began in the 1960s and is one of the oldest and best-known newborn screening programs. Blood samples are taken from the heels of newborn babies in the hospital nursery, placed on filter papers as dried spots, and sent off to appropriate laboratories for analysis. Newborns with elevated phenylalanine levels can be effectively treated with a diet low in phenylalanine (low-protein foods). If treatment is not initiated within the first two months of life, mental retardation will occur. Individuals with PKU lack the enzyme phenylalanine hydroxylase (PAH), which converts the essential amino acid phenylalanine into the amino acid tyrosine. The lack of the enzyme PAH leads to the accumulation of phenylalanine in the body, which causes irreversible brain damage.


In addition to PKU, the newborn screen can test for other metabolic disorders, endocrine disorders (such as congenital hypothyroidism),
blood conditions, deafness, and some acquired perinatal infections. In the United States, differences exist between states in terms of what conditions are screened for on the newborn panel. In 2005, the median number of tests on the newborn screen in each state was twenty-two. Only screening for PKU and congenital hypothyroidism is mandatory in all states.




Carrier Screening

Carrier screening is the voluntary testing of healthy individuals of reproductive age who may be carriers for an autosomal recessive disorder. Autosomal recessive disorders occur when an individual inherits a nonworking gene, or mutation, from both of their parents. The parents are called “carriers” because they have one working copy of the gene and one nonworking copy of the gene. Carriers do not exhibit any symptoms of the genetic condition. However, with each pregnancy, two carrier parents have a 25 percent chance for the offspring to inherit the genetic condition.


The risk of being a carrier for an autosomal recessive disorder is often dependent upon one’s ancestry. For example, individuals of African descent have an increased risk of being a carrier for sickle-cell anemia, which is a blood disorder associated with a change in the shape of the red blood cells that can lead to difficulty transporting oxygen around the body. Individuals of Ashkenazi Jewish heritage are at increased risk of being carriers of at least ten genetic conditions. Tay-Sachs disease, which is a progressive neurological condition associated with death in infancy, is one of the best-known conditions for which Ashkenazi Jewish individuals are offered screening.


Historically, people were not always given a choice to have carrier screening. In the early 1970s, mandatory, large-scale screening of African American couples and some schoolchildren was implemented in an effort to identify carriers of the gene for sickle-cell anemia. Screening results were not kept in strictest confidence; consequently, many healthy African Americans who were carriers for sickle-cell disease were stigmatized and discriminated against in terms of employment and insurance coverage. There were also charges of racial discrimination because carriers were advised against bearing children. The laws mandating screening were later repealed. Today, carrier screening programs are very different from newborn screening programs because individuals are able to choose whether they want testing.


The choice to have carrier screening is a personal one. If both parents are found to be carriers of the same genetic condition, during a pregnancy the family is offered prenatal diagnosis via amniocentesis or chorionic villus sampling (CVS). Both procedures carry a small risk of miscarriage. Some families elect to have prenatal diagnosis so that they can prepare for the birth of a child with a medical condition. Other families may consider adoption or termination of the pregnancy if the fetus is found to have a genetic condition. Some families prefer to find out about such conditions at birth. If a couple learns that they are both carriers of a genetic condition prior to pregnancy, then their options include conceiving a pregnancy and considering prenatal diagnosis, egg or sperm donation, adoption, no pregnancy, or a fairly new technique called preimplantation genetic diagnosis. Religion, socioeconomic status, and emotions all play a role in these decisions. Genetic counselors often meet with individuals to help them decide if they want testing.




Prenatal Screening

All pregnant women are routinely offered screening tests for chromosome abnormalities such as Down syndrome, the most common chromosome condition. Individuals with Down syndrome have an extra copy of chromosome number 21 that leads to a distinctive appearance, mild-to-moderate mental retardation, and sometimes other medical issues such as heart defects or digestive system problems. The risk of having a baby with Down syndrome increases with a woman’s age, but all women have some risk. Blood and ultrasound tests are routinely offered to all women to determine if the pregnancy is at increased risk for Down syndrome. Women in the high-risk category are offered diagnostic testing such as a CVS or amniocentesis.




Impact and Applications

With the completion of the Human Genome Project, the number of genetic screening options has grown exponentially. In 2003, the American College of Obstetricians and Gynecologists recommended that providers offer all couples who are pregnant or planning a pregnancy carrier screening for cystic fibrosis, an autosomal recessive multisystem disorder that can affect the lungs, digestive system, and urogenital tract. Most states now also offer newborn screening for cystic fibrosis. In 2008, the American College of Medical Genetics issued a practice guideline stating that providers should offer all couples carrier screening for spinal muscular atrophy, an autosomal recessive neurological disorder. Some experts are advocates for population-based carrier screening for fragile X syndrome, a relatively common genetic form of mental retardation in males that can be carried by females and inherited by their sons. The technology to detect fetal cells in the maternal bloodstream is rapidly evolving, and soon pregnant woman may be able to learn if their fetus has Down syndrome with a simple blood draw.


As new tests are added to routine screening protocols and further tests are considered for population screening, society is faced with the ethical dilemma of deciding what makes a disease a candidate for genetic screening. In order for a disease to be considered for a population screening program, certain factors must exist. Some are concrete entities, such as a reliable test, infrastructure to carry out a screening program, and a high frequency of the particular disorder. Other factors are more subjective, such as the definition of the disease as “serious.”


The source of contention is that the population differs on what makes a disease “serious.” For example, many individuals involved with the Down syndrome community are opposed to the idea of offering prenatal screening because they do not see individuals with Down syndrome as very different from the rest of the population. Individuals with Down syndrome can go to school, participate in hobbies, and have meaningful interactions with their families. Similarly, some individuals who have cystic fibrosis do not see the disease as an impediment to accomplishing their life goals.


As the technology for genetic testing improves, medical professionals and lay people will both be confronted with even more ethical dilemmas about genetic screening. Where does one draw the line on what defines a disease? Is a disease simply a variation thought to be undesirable by the majority of the population? These questions are quickly becoming real issues for society to reckon with rather than something characters deal with in the world of science fiction.




Key terms



amniocentesis

:

invasive procedure performed during the second trimester of pregnancy that involves the removal of a small amount of amniotic fluid with a needle to perform genetic testing on cells from the fetus




chorionic villus sampling

:

invasive procedure performed during the first trimester of pregnancy that involves the removal of a small amount of the tissue that will form the placenta for genetic testing




genetic counselor

:

professional trained in genetics and counseling who provides individuals with information about genetic testing and facilitates decision making




preimplantation genetic diagnosis

:

in this process, embryos are conceived via in vitro fertilization, and genetic testing for a particular condition is performed on the embryos prior to implantation in the uterus; only unaffected embryos are implanted





Bibliography


Chadwick, Ruth, et al., eds. The Ethics of Genetic Screening. Boston: Kluwer Academic, 1999. Print.



Evans, Mark I., ed. Metabolic and Genetic Screening. Philadelphia: Saunders, 2001. Print.



Heyman, Bob, and Mette Henriksen. Risk, Age, and Pregnancy: A Case Study of Prenatal Genetic Screening and Testing. New York: Palgrave, 2001. Print.



Juth, Niklas, and Christian Munthe. The Ethics of Screening in Health Care and Medicine: Serving Society or Serving the Patient? Dordrecht: Springer, 2012. Print.



Milunsky, Aubrey, and Jeff M. Milunsky. Genetic Disorders and the Fetus: Diagnosis, Prevention, and Treatment. 6th ed. Chichester: Wiley, 2010. Print.



Nussbaum, Robert, et al. Genetics in Medicine. 6th ed. Rev. reprint. Philadelphia: Thompson, 2004. Print.



Pierce, Benjamin A. The Family Genetic Sourcebook. New York: Wiley, 1990. Print.



Shannon, Joyce Brennfleck, ed. Medical Tests Sourcebook. Detroit: Omnigraphics, 1999. Print.



Teichler-Zallen, Doris. To Test or Not to Test: A Guide to Genetic Screening and Risk. Piscataway: Rutgers UP, 2008. Print.



Timmermans, Stefan, and Mara Buchbinder. Saving Babies?: The Consequences of Newborn Genetic Screening. Chicago: U of Chicago P, 2013. Print.

What is taste aversion? |


Introduction

When an animal eats a food, especially one with which it has had little experience, and then becomes ill, the food acquires a nauseating or aversive quality and will subsequently be avoided. This phenomenon is called bait shyness, food aversion, or, most commonly, taste aversion, although the odor and sometimes even the sight of the food also become aversive.





When confronted with a new food, rats will investigate it thoroughly by sniffing. If the odor is unfamiliar, and familiar food is available elsewhere, the rats may pass by the novel food without eating it. If sufficiently hungry, the rats may sample the new food by nibbling at it and then withdrawing to wait for adverse effects. If none occurs, the new food may be accepted, but if the rats become ill the food will be avoided; even the trails or runways where the new food is located may be abandoned. This cautiousness toward novel foods makes rats notoriously difficult to poison.




Stimulus and Response

Taste-aversion learning has been construed both as instrumental avoidance learning and as Pavlovian conditioning. Clearly, elements of both are involved. Development of the aversion itself, in which the food takes on a negative motivational quality, is seen by most learning theorists as Pavlovian conditioning. Subsequent avoidance of the food is learned by instrumental conditioning.


In development of the aversion, the smell or taste of the food clearly serves as the conditioned stimulus; however, there has been some confusion in the literature as to what constitutes the unconditioned stimulus
in taste-aversion conditioning. In a typical experiment, rats are presented with water that contains a distinctive flavor, such as saccharin or almond extract. After drinking the flavored water, the rats are treated in some way that makes them ill. Illness treatments have been as diverse as X-ray irradiation and spinning on a turntable, but the preferred method is injection of a toxic drug such as lithium chloride or apomorphine. As a result of the treatment-produced illness, the rats subsequently avoid the flavored water.


Most frequently, “illness” is cited as the unconditioned stimulus in these experiments, but one also sees references to “poisoning” or to the “illness treatment” in this regard. These latter references actually make more sense and are more consistent with other research in which a drug treatment (the unconditioned stimulus) is seen as producing an innate drug effect (the unconditioned response).


In 1927, Ivan Petrovich Pavlov described experiments with morphine and apomorphine in which the drug injection, the drug itself, or “changes in the internal environment due to alteration in the composition of the blood” were construed as the unconditioned stimulus. The drug effects, including salivation, nausea, vomiting, and sleep, were construed as unconditioned responses. Pavlov even described an experiment in which tying off the portal vein led to development of an aversion to meat in dogs because of buildup in the blood of toxic substances derived from the digestion of the meat. The implication was that the smell and taste of meat were conditioned stimuli and the toxins (or the alterations in blood chemistry) were unconditioned stimuli.


In taste-aversion conditioning, the smell or taste (and sometimes the sight) of food serves as the conditioned stimulus. This stimulus signals the presence of a toxin, which acts as the unconditioned stimulus by altering body chemistry, which in turn produces nausea, illness, or vomiting, the unconditioned response. Through conditioning, nausea or “aversion” develops as the conditioned response to presentation of the taste, smell, or sight of the food. This aversion then motivates an instrumental avoidance response; that is, because of the conditioned aversion, the animal does not eat the food.




Learning Aversions

Taste aversion plays an important adaptive role in the everyday life of animals, especially those that eat a diversity of foods. Food preferences are learned early in the lives of such animals—they eat what they see their mothers eating or, even earlier, they come to prefer foods with flavors encountered previously in mothers’ milk. To cope with a variable environment, however, animals must often adopt a new food. Animals with no mechanism for learning to accept safe foods while rejecting toxic ones would soon perish.


Nor is taste-aversion learning seen only in laboratory animals. Humans, too, learn food aversions quickly and convincingly. Martin E. P. Seligman, a prominent learning theorist, has supplied his own autobiographical account of taste aversion learning. Six hours after eating filet mignon flavored with béarnaise sauce, Seligman became violently ill with the stomach flu. “The next time I had sauce béarnaise, I couldn’t bear the taste of it,” he relates. He did not, however, develop an aversion to the steak, to the white plates from which it had been eaten, or to the opera that he attended during the six-hour interstimulus interval.


Seligman’s experience exemplifies several peculiarities of taste-aversion learning that have made it an important topic in the literature of learning theory: A strong conditioned response develops in a single learning trial, the conditioned response develops even when the conditioned and unconditioned stimuli are separated by long interstimulus intervals, the aversion develops selectively to some stimuli but not to others, and the conditioned response is irrational in the sense that it is not much affected by conscious knowledge that the food was not tainted or is not likely to be tainted in the future.




Natural Aversions

In nature, taste-aversion learning is a common event. Animals that do not specialize on one or a few foods must be able to reject toxic foods. Rats especially have a problem in this regard, since they do not vomit and therefore cannot expel poisons once they have ingested them. When rats have access to many foods, their behavior is marvelously adapted to detecting toxins. They eat only one or two different food types at a time and may eat these exclusively for days. Then they shift to concentration on another food type. If illness develops, the rats know immediately which type of food is probably to blame and subsequently avoid it. If the rats had eaten a variety of foods all the time, such discrimination would not be possible.


Human infants may adopt a similar strategy when allowed to eat without supervision. In the 1920s, Clara Davis gave infants the opportunity to eat any of a variety of nutritious foods, none of which alone supplied a balanced diet. The infants specialized on one or two foods for days at a time before shifting to another food. Although daily diets were certainly not nutritionally balanced, the infants did, over the long run, eat a balanced, healthful diet. The behavior of one infant was particularly interesting. This child voluntarily consumed cod-liver oil, a vile-tasting fluid usually rejected by children. This child, however, had a vitamin D deficiency, and the cod-liver oil supplied the necessary vitamin. After the deficiency was eliminated, the infant stopped eating cod-liver oil and never went back to it.


The idea that the infant’s behavior may be related to taste learning was shown by Paul Rozin, who found that rats fed a thiamine-deficient diet subsequently chose a food laced with thiamine supplements even though thiamine itself is tasteless. The rats apparently were able to use the taste of the food as a discriminative stimulus for its nutritive properties. Thus, the phenomenon is the opposite of taste-aversion learning—the development of specific hungers for foods with nutritive qualities, foods that promote health or recovery from illness. Anecdotal reports suggest that humans sometimes also suddenly develop tastes for foods that contain needed nutrients.


Taste aversion is apparently only one side of the story of food selection and rejection in nature. Both appetitive and avoidance behaviors can be predicated on taste cues. In some cases, these behaviors are innate responses to the taste. Bitter tastes usually indicate the presence of toxic alkaloids and are often rejected by young animals that have had no prior experience with them. Human infants do the same. In other cases, the response to taste cues must be learned. Thus, specific hungers and taste aversions both represent examples of appropriate behaviors that are cued by discriminative taste stimuli.


Lincoln Brower has described a classic example of taste-aversion learning in nature. Blue jays, he noted, typically avoid preying on monarch butterflies. If hungry enough, however, jays will take and eat monarchs. The caterpillars of these butterflies eat milkweed, which contains a poison to which the butterflies are immune but birds are not. Enough of the poison remains concentrated in the tissues of adult monarchs to make a bird that eats one quite sick. The jays subsequently reject monarchs after a brief taste, and eventually the distinctive orange and black insects are rejected on sight.




Induced Aversions

In more applied settings, Carl Gustavson and John Garcia have described the use of taste-aversion conditioning in wildlife management. On the western ranges where large flocks of sheep are left relatively unprotected, ranchers often face the threat of predation by coyotes, wolves, and mountain lions. One response has been wholesale shooting and poisoning of these wild predators, but this is a less-than-ideal solution. Gustavson and Garcia found that predators, such as coyotes, that scavenge a lamb carcass laced with a sublethal dose of lithium chloride will subsequently develop a strong aversion to lamb and may even avoid areas where lamb and sheep are grazing. The authors proposed a scheme for reducing predation on sheep using taste-aversion conditioning that would drastically reduce the need for shooting and the use of indiscriminate lethal poisons.


In humans, many medical conditions are accompanied by loss of appetite and weight loss. Although this is often attributable to chemical changes within the body, it can also be caused by taste-aversion learning. Ilene Bernstein investigated the loss of appetite, or anorexia, that frequently accompanies cancer chemotherapy and found that, in all likelihood, it was attributable to aversive conditioning caused by the cancer medications, which often induce nausea and vomiting. Bernstein and her colleague, Soo Borson, investigated other anorectic syndromes and found the same possibility. In an important review article published in 1999, Bernstein proposed that taste-aversion learning may play a significant role in such conditions as cancer anorexia, tumor anorexia, anorexia nervosa, and the anorexias that accompany clinical depression and intestinal surgery.


On the other hand, taste-aversion learning is intentionally induced in some types of aversion therapy for maladaptive behaviors. Alcoholics are sometimes given a drug called disulfiram (Antabuse) that interferes with alcohol metabolism in the liver. Drinking alcohol after taking this drug results in a very unpleasant illness that conditions an aversion to alcohol. Subsequently, the taste, smell, or even the thought of alcohol can induce nausea. Cigarette smoking has been treated similarly.




Experimental Aversions

Before 1966, psychologists believed that learning obeyed the law of equipotentiality. In Pavlovian conditioning, the nature of conditioned and unconditioned stimuli was seen as unimportant—if they were paired appropriately, learning would occur with equal facility for any stimulus pair. In instrumental conditioning, psychologists believed that any reinforcer would reinforce any behavior.


Equipotentiality had been challenged. Ethologists insisted that each species of animal is unique in what it learns, that learning is an evolutionary adaptation, and that species are not interchangeable in learning studies. Nikolaas Tinbergen, in The Study of Instinct (1951), wrote of the innate disposition to learn. Keller and Marian Breland, who trained animals for commercial purposes, discovered that animals drifted toward species-specific food-related behaviors when their arbitrary instrumental responses were reinforced with food.


In 1966, Garcia, Robert Koelling, and Frank Ervin published their research on taste-aversion learning. In an article called “Relation of Cue to Consequence in Avoidance Learning,” they described an experiment in which rats received aversive consequences for licking water from a drinking spout. In the “tasty water” condition of the experiment, the water was flavored with saccharin, while in the “bright-noisy water” condition, licking the spout activated a flashing lamp and a clicking relay. Half the animals from each condition were made sick after drinking. The other half received a mild but disruptive electric shock after licking the spout. In the tasty water condition, animals that were made sick, but not those that were shocked, avoided drinking. In the bright-noisy water condition, animals that were shocked, but not those that were made sick, avoided drinking. Thus, light and noise were easily associated with shock, and taste was easily associated with illness, but the contrary associations were much more difficult to establish.


In a second article, called “Learning with Prolonged Delay of Reinforcement,” Garcia, Ervin, and Koelling demonstrated that taste aversion developed even when the taste and illness treatment were separated by seventy-five minutes. Learning with such prolonged delays had been regarded as impossible, and it could not be reproduced in shock-avoidance experiments. These results were quickly replicated in other laboratories. Similar effects were demonstrated in other types of learning experiments, including traditional avoidance paradigms and even in mazes and Skinner boxes. The fact that something was wrong with traditional learning theory and equipotentiality was soon evident.


The doctrine of prepared learning replaced equipotentiality. Preparedness is the idea that evolution equips animals to learn things that are important to their survival. Examples of prepared learning already existed in the literature, but until 1966 their significance was not widely recognized among psychologists. Ethologists, however, pointed to studies of imprinting, food recognition, song learning, and place learning in a variety of animals, all illustrating prepared learning. Psychologists quickly included language learning and the learning of some phobias under the umbrella of preparedness. It was even proposed that human cognition evolved to cope with widely divergent situations that require unprepared learning. Taste-aversion learning, however, which is strongly prepared apparently even in humans, seems relatively immune to such ratiocination.




Bibliography


Bernstein, Ilene L., and Soo Borson. “Learning Food Aversion: A Component of Anorexia Syndromes.” Psychological Review 93, no. 4 (1986): 462–72. Print.



Bernstein, Ilene L. "Taste Aversion Learning: A Contemporary Perspective." Nutrition 15.3 (1999): 229–34. Print.



Bolles, Robert C. Learning Theory. 2d ed. New York: Holt, Rinehart and Winston, 1979. Print.



Braveman, Norman S., and Paul Bronstein, eds. Experimental Assessments and Clinical Applications of Conditioned Food Aversions. New York: New York Academy of Sciences, 1985. Print.



Brower, Lincoln Pierson. “Ecological Chemistry.” Scientific American 220 (February, 1969): 22–29. Print.



Bures, Jan, Federico Bermudez-Rattoni, and Takashi Yamamoto. Conditioned Taste Aversion: Learning of a Special Kind. New York: Oxford University Press, 1998. Print.



Gustavson, Carl R., and John Garcia. “Pulling a Gag on the Wily Coyote.” Psychology Today 8 (August, 1974): 68–72. Print.



Holstein, Sarah E., et al. "Adolescent C57BL/6J Mice Show Elevated Alcohol Intake but Reduced Taste Aversion as Compared to Adult Mice: A Potential Behavioral Mechanism for Binge Drinking." Alcoholism: Clinical and Experimental Research 35.10 (2011): 1842–51. Print.



Pierce, W. David, and Carl D. Cheney. Behavior Analysis and Learning. 5th ed. New York: Taylor & Francis, 2013. Print.



Reilly, Steve, and Todd R. Schachtman, eds. Conditioned Taste Aversion: Neural and Behavioral Processes. New York: Oxford University Press, 2009. Print.



Seligman, Martin E. P., and Joanne L. Hager, eds. Biological Boundaries of Learning. New York: Appleton-Century-Crofts, 1973. Print.



Verendeev, Andrey. "Conditioned Taste Aversion and Drugs of Abuse: History and Interpretation." Neuroscience & Biobehavioral Reviews 36.10 (2012): 2193–205. Print.

Friday, 26 December 2014

What is the history of psychology?


Introduction

Psychology can be assessed from points of view that regard it as a folk, cultural, or religious process; as a philosophical approach; as a scientific method; as an academic discipline; or as a set of postmodern assumptions.




From the folk process point of view, peoples have formed their own cultures and religions from the beginning of human history. These different cultures and religions have unique values and norms within which the person is considered and evaluated. Out of these norms come the everyday beliefs and expectations that members of the group will hold about themselves, other people, and the world. Thus, in every culture there is an implicit theory of psychology. Since this process is always operative, it has always been a factor in how specific thinkers such as philosophers, scientists, and psychologists, as well as laypeople, have been able to think about the human person. The folk process remains an especially important factor in some areas of psychology, such as humanistic psychology
and clinical psychology.


Philosophy began to emerge about the year 600 BCE. At that time, Thales, a Greek thinker, began to consider systematically the nature of the world. His view that the world’s basic element is water demanded that the philosopher give up the folk process, or “common sense,” and argue for a conclusion based on rational premises. This new way of thinking led to a much broader set of possibilities in the understanding of the world and the human being. In terms of psychology, philosophers would concentrate on topics such as the relationship between the mind and the body and the process of acquiring knowledge, especially about what is outside the body. In the last decade of the twentieth century, cognitive psychology
was strongly influenced by philosophic thinking.


By the end of the Middle Ages and the beginning of the Renaissance, another way of thinking and solving problems began to emerge. As a result of dissatisfaction with both religious and philosophic answers to understanding the world and its place in the cosmos, as well as knowledge about the nature of the human being, a process of systematic and repeated observation and rigorous thinking began to emerge. This new process, which has been labeled a part of modern thinking, has become the scientific method, requiring another separation from the folk process. For instance, when the Polish astronomer Nicolaus Copernicus and the Italian mathematician and astronomer Galileo Galilei argued from their observations that the earth revolved around the sun rather than the opposite, “common-sense” view, they offended both religious authorities and philosophers, but they opened the door to a new way of solving problems and understanding the world and human beings. This new way was named science.


Thanks to both philosophy and science, by the middle to end of the nineteenth century various scholarly areas had emerged, each with a unique use of methodology and subject matter. One of these disciplines was psychology. In 1879, Wilhelm Wundt, a German philosopher and physiologist, set up what is generally considered the first laboratory in experimental psychology. From that point, psychology began to be recognized as a discipline by scholars in the Western world.


Through an interaction with disciplines such as anthropology and linguistics, which were thriving on relativistic assumptions, and a philosophy of language that limited meaning to the particular and situational case, a psychological point of view developed in the mid- to late twentieth century called social constructionism. Although promoted by those who identify with the discipline of psychology, social constructionism is at odds with the assumptions of the modern period, including many of those that go with science, and is, therefore, labeled postmodern. Such an approach seeks only to describe and interpret rather than to explain, as is the aim in science. Parallel developments such as deconstruction in the field of literary criticism were taking place at the same time.




The Philosophers

Over the years, philosophers asked questions about the world and how humans come to have knowledge of it, provided assumptions that would limit or promote certain kinds of explanations, and attempted to summarize the knowledge that was available to an educated person.


Those thinkers who considered the nature of reality and the world between the years ca. 624 to 370 BCE were called pre-Socratics. One of them, Heraclitus, opposed Thales’s idea of water as the basic element with his idea that fire was the basic element, and therefore the world and everything in it was in a state of flux and constant change. Empedocles went a step further to propose that there were four basic elements: earth, air, fire, and water. This scheme, when applied by physicians such as the Greek Hippocrates and the Greco-Roman Galen led to the notion of the four humors and a prototheory of personality that has been influential for almost two thousand years.


From his understanding of the thinking of Socrates and Pythagoras, Plato constructed a systematic view of the human as a dualistic creature having a body that is material and a soul that is spiritual. This doctrine had significant consequences for religion, for philosophy, and for psychology. Plato also saw knowledge as acquired by the soul through the process of recollection of the form, which exists in an ideal and abstract state. Plato’s student Aristotle systematized the study of logic, promoted the use of observation as a means of acquiring knowledge, and presented a different view of the human as one whose senses were reliable sources of information and whose soul, while capable of reasoning, was the form that kept the body (and the person) in existence.


The philosophers who came during the medieval period generally split into two camps: those who followed Plato and those who followed Aristotle. Just prior to the medieval period, Saint Augustine, bishop of Hippo (now part of Algeria), had combined Neoplatonism, Christianity, and Stoicism (to the extent of believing that following the natural law was virtuous). The Neoaristotelian tradition was typified by Thomas Aquinas, an Italian Dominican priest, who integrated Aristotelian thought with Christianity and who promoted the use of reason in the obtaining of knowledge. Although not anticipated by Thomas, this Aquinas point of view would ease the way for what would become scientific thinking.


René Descartes, a French Renaissance philosopher, created a dualistic system called interactionism, where the soul, which was spiritual, interacted with the body, which was material. Both the notion of interaction and its site, the pineal gland, were so open to debate that the theory led to two different traditions: a rationalist tradition and an empiricist tradition. The rationalist tradition was led by German thinkers such as Gottfried Wilhelm Leibniz, who was also an inventor of the calculus; Immanuel Kant, who taught that the mind had an innate categorizing ability; and Johann Friedrich Herbart, who held that, if expressed in mathematical terms, psychology could become a science. All the rationalists opted for the notion of “an active mind,” and Herbart’s thinking was very influential for those, such as Wundt, who would view psychology as a scientific discipline. The empiricist tradition was stronger in France and England. Several decisive representatives of empiricism were Englishmen John Locke, David Hume, and John Stuart Mill. Empiricism postulated that all knowledge came through the senses and that the ideas that made up the mind were structured on the percepts of the senses. Eventually, in Mill’s thinking, the ideas of the mind were held together through the laws of association.


Another tradition developed past the midpoint of this period was positivism. Positivism, as developed by Frenchman August Compte, argued that the only knowledge that one can be sure of is information that is publicly observable. This would strongly influence both the subject matter and the methodology of science in general and psychology in particular.


In the beginning of the twentieth century, Englishman Bertrand Russell introduced symbolic logic, and his student Ludwig Wittgenstein created a philosophy of language. Both of these developments were necessary precursors of the late twentieth century interest in the nature of mind, in which many disciplines came together to form cognitive science. Wittgenstein’s work would open the door for social constructionism.




The Scientists

The development of the scientific method was only one of the factors that was associated with the change from the Middle Ages to the Renaissance. Developments in anatomy, physiology, astronomy, and other fields from the middle of the sixteenth century to the beginning of the twentieth century have had a major impact on the understanding of science and have paved the way for psychology as a science. The work of Copernicus and Galileo, in freeing astronomy from folk and religious belief, was a start. In the field of anatomy Flemish scientist Andreas Vesalius published in 1543 the first accurate woodcuts showing the anatomy of the human body. This was a decisive break with the tradition of Galen. By 1628, Englishman William Harvey had described accurately the circulation of blood.


In the meantime, Englishman Francis Bacon, a contemporary of Galileo, offered a view of science that favored inductive reasoning on the basis of a series of observations. This was another break with the tradition of relying on the classical authorities. In 1687, the
Principia
was published by Englishman Isaac Newton, who laid the foundation for the calculus, enhanced the understanding of color and light, grasped the notion of universal gravitation, and produced laws (natural law) of planetary motion.


Soon Swiss mathematicians, members of the Bernoulli family and Leonhard Euler, were refining the differential and integral calculus that was invented independently of Newton by the philosopher Leibniz.


In 1751, a Scot, Robert Whytt, working on frogs, noted the importance of the spinal cord for reflex action. Localization of function in the nervous system was beginning.


By 1754, Swedish botanist Carolus Linnaeus had produced a system of classification for plants, animals, and minerals that made observation and discussion in science simpler.


German anatomist Franz Gall maintained that “faculties” of the brain were discernible by observing the contours of the skull: Phrenology was another step in localization but a false one that violated scientific axioms. It spread rapidly, especially in the United States, as a form of folk psychology and diagnosis.


In 1795, an assistant at the Royal Observatory in Greenwich, England, was found to be recording times of stellar transit consistently later than his supervisor. German astronomer Friedrich Wilhelm Bessel recognized that this was involuntary and might be calibrated as a personal equation. This recognition of reaction time foreshadowed many studies in the laboratories of psychology.


Italian physician and physicist Luigi Galvani in 1791 stimulated movement in a frog’s leg with electricity, demonstrating that electrical stimulation had a role in neural research. Englishman Charles Bell, in 1811, and Frenchman François Magendi, in 1822, demonstrated differential functions of the dorsal (sensory) and ventral (motor) roots of the spinal cord. Again, localization of function was promoted. In 1824–1825, Pierre Flourens introduced the technique of ablation studies for brain tissue.


The field of physiology came together in the Handbuch der Physiologie des Menschen für Vorlesungen(1833–1840; manual of physiology), published by German Johannes Müller. Müller’s law of specific nerve energies, which claimed that there was a specific pathway and type of signal for each kind of sensation, was a significant contribution.


German Ernst Weber expanded the study of touch and kinesthesis and created the Weber fraction and the two-point threshold. Gustav Theodor Fechner expanded Weber’s work into Weber’s Law and provided a rationale and methodology for early psychology with his development of psychophysical methods.


Frenchman Paul Broca made use of the clinical method of studying brain lesions. With this methodology, the language area was localized in the third frontal convolution of the cortex.


German Hermann von Helmholtz, a student of Müller who argued against his teacher’s support for vitalism, applied the law of conservation of energy to living creatures, measured rate of nerve conduction, and wrote esteemed handbooks on the physics and physiology of vision and audition. An opposing theorist, German Ewald Hering, a nativist, created the opponent process theory of color vision.


In 1870, Germans Gustav Fritsch and Eduard Hitzig introduced electrical stimulation of the brain, which demonstrated the motor areas of the brain.


From the middle to the latter part of the nineteenth century, Englishman Francis Galton, a cousin of Charles Darwin who was also interested in evolution, promoted mental testing and the study of individual differences. He also stimulated the work of Englishman mathematician Karl Pearson, who invented the statistics to support such studies and much of psychology.


By 1902, an American, Shepard Ivory Franz, combined the ablation technique with training procedures to investigate the function of the frontal lobes in cats. His work led to the work of the great American neuropsychologist Karl Lashley, who led the quest to find the neural basis for memory in his 1950 work In Search of the Engram. Two of Lashley’s students, Canadian Donald O. Hebb, with his work on cell assemblies and phase sequences, and American Roger Sperry, with his work on split-brain preparations in the 1960s, would do much to promote neuropsychology and prepare for cognitive science.




Beginning of Psychology as a Discipline

In 1879, Wilhelm Wundt, a student of Helmholtz, brought together his two disciplines of physiology and philosophy by creating a laboratory for experimental psychology at the University of Leipzig in Germany. His laboratory attracted many of the individuals who would become leaders in the new science of psychology. Among these were German Oswald Külpe, Englishman Edward Titchener, and American James McKeen Cattell.


Meanwhile, in the United States, William James, a scientist and philosopher who was familiar with European scholarly trends, published the defining American work on psychology,
The Principles of Psychology
(1890). This became the dominant text in the English-speaking world and attracted many more Americans to the study of psychology. Both Wundt and James were instrumental in separating psychology from other disciplines both in methodology and in subject matter. Both saw psychology as an introspective science that was to study adult human consciousness. Introspection required that the investigator focus on her or his own experience or awareness, that is, what the individual is thinking and feeling at any one moment.




The Schools of Psychology

There were very quickly a number of individuals who either agreed partly or disagreed wholly with Wundt and James. Some of these individuals argued their points persuasively and a number of schools or points of view coalesced around them during the last decade of the nineteenth century and the first several decades of the twentieth century.


Coming from the German rationalist tradition of philosophy, Wundt took as his goal the understanding of consciousness using the method of introspection. Wundt’s point of view has become known as voluntarism. Wundt stressed the role of will, choice, and purpose, all of which he saw present in attention and volition.


Wundt’s student Titchener created a somewhat similar school of thought when, in 1892, he came to Cornell University in Ithaca, New York. Titchener also wanted to study consciousness using the introspective method. He differed from Wundt in that his preferred philosophy was English empiricism, and this led him to a different understanding of consciousness. His approach was to discover the elements of consciousness, and this approach was called structuralism. His successful program led to a strong interest in experimentation, especially on sensation and perception, in American psychology. He trained a large number of Americans in the almost four decades that he taught at Cornell.


American psychologists were not wholly devoted to either Wundt’s or Titchener’s approach to psychology even if they had received their PhDs with them. Instead, they often were motivated by their appreciation for the work of Charles Darwin, who had published his theory of evolution in his famous
On the Origin of Species by Means of Natural Selection
(1859). Darwin’s writing had been popularized in the English-speaking world by the English writer and speaker Herbert Spencer, who promoted the idea of social Darwinism, that is, that processes of competition among groups of humans would weed out the unfit and thus help to perfect the human race. Following Spencer, many psychologists in the United States saw adaptation as a fundamental concern for their academic field. Among these was philosopher and psychologist John Dewey, whose 1896 article, “The Reflex Arc Concept in Psychology,” was seen as the formal beginning of the school of functionalism.


One student of both Wundt and James who was very influential in early functionalism was American G. Stanley Hall, who founded the American Journal of Psychology in 1887 and who founded Clark University and its psychology department in 1888. He was a leading proponent for developmental psychology, the founder of the American Psychological Association (in 1892), and an untiring organizer.


Very influential in the promotion of applied psychology was a Prussian student of Wundt who had followed James in the laboratories of Harvard University, Hugo Münsterberg, who arrived at Harvard University in 1892.


Two major branches of the school of functionalism were associated with the University of Chicago and Columbia University. There were three leaders at the University of Chicago. Dewey served from 1894 to 1904, when he moved to Teacher’s College at Columbia University. He was succeeded by James Rowland Angell, who served for twenty-five years and who was followed by his student, Harvey Carr, who specialized in the adaptive acts of learning and perception.


At Columbia University, the first significant leader was James McKeen Cattell, who accepted a professorship in 1891 and who stayed for twenty-six years. In addition, very influential was a student of Cattell, Robert S. Woodworth. Woodworth wrote extensively on many topics in psychology, including physiological psychology, the history of psychology, motivation, and experimental psychology. He wrote the significant Experimental Psychology in 1938. The third major influence at Columbia was the very productive Edward L. Thorndike. Thorndike was active at Columbia from 1899 until 1940. He wrote on animal learning, developing a theory called connectionism that accounted for learning in an animal or human on the basis of a strengthening of a connection between a stimulus and a response. Besides learning theory, Thorndike also wrote on verbal behavior, educational practices, intelligence testing, and the measurement of other types of psychological and sociological phenomena. As a school of thought, functionalism came to represent the interests of a great number of American psychologists who were involved in areas that called for practical intervention such as testing, clinical, social, and developmental psychology.


The reaction to Wundtian psychology took a different direction in Europe. Influenced by a group of teachers who adopted a more holistic view of human functioning, a system known as Gestalt psychology started in Germany in 1910. Among the teachers was Franz Clemens Brentano. Brentano, trained in Aristotelian philosophy, promoted an “act psychology,” which stated that the study of the mind had to do with mental acts (such as willing or perceiving), not the study of consciousness divisible into elements. One of Brentano’s students at the University of Vienna was Austrian Christian von Ehrenfels, who was himself licensed to teach at Vienna in 1888. Ehrenfels wrote a paper, “Über Gestaltqualitäten” (1890; on Gestalt qualities), that would be the formative document in the thinking of all future Gestalt psychologists. This paper asserted that the significant aspect in any perception was the pattern created by the individual elements and not the individual elements themselves, as with the melody rather than the individual notes of the melody. Foremost among the Gestalt psychologists was Czech-born Max Wertheimer, who received his PhD in 1904 from the University of Würzbürg. In 1910, Wertheimer involved the two other founders of Gestalt psychology in a study of apparent movement that became known as the phi phenomenon. These two were German Kurt Koffka and Estonian Wolfgang Köhler. Both had just received their PhDs at the University of Berlin under the direction of German Carl Stumpf, who was himself a student of Brentano and whose lifework was devoted to the study of music, space perception, and audition. His work would lead to the phenomenological approach that was common to Gestalt psychology. In the 1930s, with the coming to power of National Socialism in Germany, the three main Gestalt psychologists—Wertheimer, Koffka, and Köhler—emigrated to the United States, where they found behaviorism’s associationism and elementism as unacceptable as it was in both Wundtian psychology and psychoanalysis.


William McDougall was born in England, educated in England and at the University of Göttingen in Germany, and began his teaching at Oxford University in England. In 1920, he came to the United States, where he developed his brand of psychology called hormic psychology, from the Greek word horme, which means “urge.” He called himself a behaviorist, but one who viewed behavior as instinctually directed and at the same time as purposeful. McDougall was widely admired but seemed out of step with the dominant behaviorism of his time. His views are much more congenial with the cognitive psychology of the late twentieth century.


Basing part of his rationale on the work of Russian reflexologist Ivan Petrovich Pavlov, who discovered the principles of conditioning while doing work on the digestive system of dogs, American John Broadus Watson promoted a radical behaviorism that rejected introspection as a method and suggested that the study of animal behavior was the equivalent of the study of human behavior. His lectures at Columbia University, which were published in the Psychological Review in 1913 under the title “Psychology as the Behaviorist Views It,” are seen as the beginning of behaviorism. They certainly separated behaviorism from both structuralism and functionalism.


In 1900, Mary W. Calkins, an American student of James, began her defense of a self psychology. Despite the functionalist interest in adaptation and the behaviorist rejection of introspection, Calkins would continue to assert that the self was an existential reality; that is, it was knowable in one’s own awareness. After her death in 1930, the self came to be considered a conceptualization. Gordon Allport, an American who studied extensively in Europe, became the leading self psychologist for another thirty years. In Allport’s later years, clinicians such as Carl R. Rogers, who developed client-centered therapy (later known as person-centered therapy), would keep the idea of self and its centrality alive in psychology until the cognitive revolution of the 1960s and 1970s allowed the self to become a popular integrating construct again.


Austrian physician Sigmund Freud published Studien über Hysterie (1895; Studies in Hysteria, 1950) and began the school of therapy known as psychoanalysis. Psychoanalysis soon became a general theory of personality. Freud’s possessiveness about the theory led to the ouster from his inner circle of two theorists who would go on to create their own approaches to psychoanalysis. The first was Austrian Alfred Adler in 1911. Adler’s point of view would become known as individual psychology. The second, in 1913, was Swiss Carl Jung, who questioned the sexual basis of the motivating energy proposed by Freud. Jung’s point of view has become known as analytical psychology. By the 1930s, Freud’s classic psychology of the unconscious had shifted to a greater appreciation of the conscious. Thus, Freud’s daughter, Anna Freud, following the interests of her father, published Das Ich und die Abwehrmechanismen (1936; The Ego and the Mechanisms of Defense, 1937). Classic psychoanalysis had changed into ego psychology. The best-known representative of the new ego psychology was the child analyst and writer Erik H. Erikson
. Erikson, who was born in Germany and who had been analyzed by Anna, came to the United States in 1933. His Childhood and Society (1950) made connections to and enriched developmental psychology, especially in terms of his reworking of Freud’s five developmental stages into the “eight ages of man.”




Applied Psychology

Frenchman Alfred Binet published the first individual test of intelligence in 1905. Lewis Madison Terman, an American student of G. Stanley Hall, published his revision of Binet’s test, called the Stanford Binet, in the United States in 1912. An industry was born. The test was reissued in 1916, 1937, 1960, 1986, and 2003. Group tests of intelligence were developed for the military during both World War I and World War II. The needs of the military also promoted another applied psychology: clinical psychology. In World War II, short-term psychotherapy was found to be useful in returning combatants to active service. Many academic psychologists were pressed into training programs to become psychotherapists. By the time the war ended, a number of psychologists viewed themselves as clinicians and returned to redirect graduate programs in psychology toward clinical psychology. By the late 1940s testing, diagnosis, and clinical practice were well established.




Neobehaviorism

In 1924, a group of philosophers in Vienna, Austria, known as the Vienna Circle, revised and refined positivism into logical positivism, and in 1927, Percy Williams Bridgman, an American physicist, proposed operationism, in which every theoretical construct would be defined by the operations that were used to measure it. These developments allowed experimenters to deal positivistically with abstract variables and led to a more sophisticated behaviorism labeled neobehaviorism. Americans Edward C. Tolman, Clark L. Hull, and B. F. Skinner were notable representatives of neobehaviorism, which specialized in the study of learning and motivation, mostly with nonhuman species. Skinner differed from the others in that he favored induction and description as the basis for his studies. Neobehaviorism was superseded by changes that brought about the cognitive revolution in the 1960s and 1970s. Its heritage remains in psychology in the area of methodology.


In addition, by the 1950s, a rift that had begun in the days of Titchener between those who saw themselves as pure scientific psychologists as opposed to those who practiced an applied psychology was reconceptualized as a conflict between the academic psychologists who maintained a behavioristic approach and the clinicians who were heavily influenced by psychoanalysis and were beginning to appreciate Rogers’s person-centered approach. This struggle was exacerbated by the growing number of practitioners, who began to outnumber the academic psychologists. One result of this disciplinary conflict was the foundation of a separate organization for the academics, the American Psychological Society, formed in 1988.




The 1960s and 1970s

The emergence of the computer both as a tool and as a model of the human mind had a major effect on psychology. Neuroscience, philosophy, anthropology, linguistics, artificial intelligence, and psychology came together in the 1960s to form the basis for a new discipline: cognitive science. The new technology and the opportunity to work with people and ideas from other disciplines freed psychology to reinvestigate questions of mental functioning and consciousness.


In 1954, American Abraham Maslow published the influential Motivation and Personality, which began humanistic psychology, a movement seen by Maslow as an antidote to the dehumanizing assumptions of both behaviorism and psychoanalysis. By 1961, there was the Journal of Humanistic Psychology and, by 1962, the American Association of Humanistic Psychologists. Rogers, with his person-centered therapy, added to the attractiveness of the movement for American psychologists. Its emphasis on admitting the whole person to psychology gained more general acceptance and, together with the cognitive revolution, promoted a more humanistic and cognitively oriented general psychology.




The 1980s and 1990s

Developmental psychology, building on the work of Swiss Jean Piaget from the 1920s through the 1960s, and cognitive psychology, stimulated by the early 1960s work of Americans George A. Miller and Jerome Bruner, began once again to study consciousness and its development, but this time from infancy through adulthood. A student of Miller, German-born Ulric Neisser built on this and his earlier work, Cognitive Psychology (1967), to bring to the 1980s and 1990s an integrative approach to consciousness, concept formation, perception, and selfhood. In general, the period was one of eclecticism and was labeled neofunctionalism by one historian.




Social Constructionism

Another trend that impacted psychology was postmodern thought. Although present in philosophy and anthropology through the twentieth century, it became obvious in psychology only in the 1970s, where it was known as social constructionism. Since the 1970s, it has made its presence obvious in the subfield called cultural psychology and in social psychology. When applied to personality development, the concept of narrative as an inborn mechanism has become a focus for those who wish to describe the process of self-development.




The 2000s and 2010s

Notable milestones in genetics and neuroscience during the 2000s and 2010s provided the basis for ongoing research into human development and pathology. In April 2003, the Human Genome Project reported that it had produced a finished version of the human genome sequence, with 99 percent of genome sequenced, an accuracy rate of less than one error per ten thousand nucleotide base pairs, and less than four hundred sequence gaps. In 2013, the Obama administration announced the formation of Brain Research through Advancing Innovative Neurotechnologies, also called the BRAIN Initiative or Brain Activity Map Project. The initiative's goal is to map every neuron in the human brain over a ten-year period. In April 2014, the first installment of the National Institute of Mental Health–funded BrainSpan Atlas of the Developing Human Brain project, produced by Seattle's Allen Institute for Brain Science, was reported online by Nature. The project intends to profile gene activity over the course of the brain's development and thereby help researchers understand the genesis of brain-based disorders such as schizophrenia and autism.




Bibliography


Allen Institute for Brain Science. BrainSpan Atlas of the Developing Human Brain. Allen Inst. for Brain Science, 2004–2014. Web. 27 June 2014.



Brett, George Sidney. A History of Psychology. London: Routledge, 2014. Digital file.



Gardner, Howard. The Mind’s New Science: A History of the Cognitive Revolution. New York: Basic, 1998. Print.



Hergenhahn, B. R. An Introduction to the History of Psychology. 6th ed. Belmont: Wadsworth, 2009. Print.



Hilgard, Ernest Ropiequet. Psychology in America: A Historical Survey. New York: Harcourt, 1987. Print.



Hunt, Morton. The Story of Psychology. 2d ed. New York: Doubleday, 2007. Print.



Koch, Sigmund, and David Leary, eds. A Century of Psychology as Science. Washington, DC: American Psychological Association, 1992. Print.



Russell, Bertrand. A History of Western Philosophy. New York: Simon, 1945. Print.



Stevenson, Leslie, and David L. Haberman. Ten Theories of Human Nature. 5th ed. New York: Oxford UP, 2009. Print.



Stroebe, Wolfgang, and Arie W. Kruglanski. Handbook of the History of Social Psychology. New York: Psychology, 2012. Digital file.

Thursday, 25 December 2014

What is catheterization? |


Indications and Procedures

Many different types of catheters exist, and they can be used for many different purposes. What they all have in common is the placement of a tube (catheter) into a body cavity. The tube is used to draw a gas or liquid from the cavity or to inject a gas or liquid into the cavity. The most common uses of catheterization are the opening of an airway for breathing, the withdrawal of urine from the bladder, and the injection of dye or other substances such as an intravenous (IV) drip into blood vessels.



Catheterization can be used to assist in the breathing process. This procedure may be necessary when the patient’s airway is blocked, the patient is unconscious and unable to breathe, or the patient needs help to breathe. The tube or catheter is placed into the mouth, nose, throat, or lungs. Oxygen passes through the tube and into the lungs, where it can be absorbed by the blood. Catheters can also be used to remove secretions from these same areas to open the airway and improve breathing. They are also necessary in many emergency situations to open and maintain breathing. At times, a catheter must be introduced directly into the lungs through an incision in the neck, near the Adam’s apple; this procedure is known as a tracheostomy. A catheter may also be introduced into the patient’s nose to transport oxygen into the lungs. Catheterization is important for maintaining breathing during surgery under general anesthesia, when the body’s breathing mechanisms are shut down.


Another common catheterization procedure involves the introduction of a urethral catheter. This type of catheter is inserted into the urethra to drain urine from the bladder. Such a procedure may be necessary to empty the bladder when the urethra is blocked, or it may be used to collect urine when the person is unable to control his or her own bladder.


An area where catheters are being used more frequently is heart diagnosis and surgery. In cardiac catheterization
, a catheter is inserted into a large blood vessel (a vein or artery) in the upper arm or groin area. The physician then maneuvers the catheter into the heart and uses it to inject a dye directly into the organ. An X ray can show the distribution of the dye within the heart, allowing the physician to see if and where any coronary arteries are blocked. In addition, cardiac catheters can be used to determine blood pressures within the heart, the amount of oxygen in the blood in the heart, and how the valves are functioning. More recently, cardiac catheters have been developed to perform some types of surgery. A good example is balloon angioplasty
. Using similar procedures to insert the catheter, the cardiologist guides a specialized catheter into the coronary artery to the area of the blockage. A small balloon on the end of the catheter is inflated, pushing the fatty material blocking the artery
against the blood vessel wall and opening the artery to allow for the normal flow of blood.




Uses and Complications

Catheterization has been used safely and successfully for many years. When people are unable to breathe on their own, airway catheters have been instrumental in saving lives and making such patients more comfortable. Such procedures have been widely used on a daily basis, with few complications.


Likewise, urethral catheters are routinely employed to control the flow of urine from the bladder. This type of catheterization can be seen in many clinical settings. Although caution must be used to prevent the introduction of bacteria into the bladder and subsequent infection, this procedure is considered to be safe and effective.


The overall success rate of cardiac catheterization has been good, with few deaths resulting from the procedure. It is a valuable tool for the diagnosis of heart diseases and disorders because a major incision in the chest is avoided. This procedure is performed many times each day in all cardiac care units. Angioplasty has also been successful, but it is useful for only some types of blockages. A major risk of angioplasty is rupture of the artery if the balloon is inflated too much. When this happens, open heart surgery is necessary to prevent death. The death rate from angioplasty is less than 1 percent, however, and the success rate exceeds 90 percent. Another problem with balloon angioplasty is that in 33 percent of the cases, the blockages re-form within six months. Nevertheless, this procedure offers a good alternative to coronary artery bypass surgery.




Perspective and Prospects

The use of catheterization for airway management was first tried in 1871 by Friedrich Trendelenburg. Through the years, such procedures have been improved. Catheters will continue to be instrumental for airway management.


The cardiac catheterization of a living human being was done by Werner Forssmann in the 1920s: He performed the procedure on himself. His techniques were further developed by André Frédéric Cournand in the 1940s, for which he won the Nobel Prize in Physiology or Medicine in 1956. Continued advances in the procedure and improved technology have increased the applications of cardiac catheterization. New and better procedures, which will continue to replace some types of open heart surgery, are expected in the future.




Bibliography


Askari, Arman. T, and Medhi H. Shishehbor, eds. Introductory Guide to Cardiac Catheterization. Lippincott, Williams, & Wilkins, 2010.



Finucane, Brendan T., and Albert H. Santora. Principles of Airway Management. 3d ed. New York: Springer, 2003.



Karch, Amy Morrison. Cardiac Care: A Guide for Patient Education. New York: Appleton-Century-Crofts, 1981.



Kern, Morton J., ed. Cardiac Catheterization Handbook. 3d. Philadelphia: Saunders, 2012.



Nordlicht, Scott M., Alan N. Weiss, and Philip A. Ludbrook. Why Me? Approaching Coronary Heart Disease, Cardiac Catheterization, and Treatment Options from a Position of Strength. St. Louis, Mo.: Northern Lights, 1999.



"What Is Cardiac Catheterization?" nhlbi.nih.org, January 30, 2012.

What is fiber? |


Structure and Functions

Dietary fiber helps regulate the passage of food material through the gastrointestinal tract and influences the absorption of various nutrients. It represents the content of substances that cannot be broken down by human digestive enzymes or absorbed by the gastrointestinal tract. Nearly all dietary fiber content is contributed by the insoluble structural matter of plants. Cellulose is an insoluble unbranched glucose polymer that can absorb relatively large volumes of water. Hemicellulose is the name for a wide variety of polymers of five carbon sugars. Pectin is a water-soluble polymer that forms gels and binds water, cations, and bile acids. Gums and mucilages are highly branched polysaccharides that form gels and bind water and other organic material. Increased fiber intake may promote health by promoting the normal elimination of waste products of digestion, by promoting satiety, by helping control serum cholesterol, and by other mechanisms. Greatly increased fiber intake, however, may reduce the absorption of some nutrients.





Disorders and Diseases

The ingestion of too much fiber can result in the formation of an obstructing bolus in a narrowed intestinal or esophageal lumen. The purpose of a low-fiber or fiber-restricted diet is to help prevent this occurrence and to rest the gastrointestinal tract. In acute phases of ulcerative colitis, a fiber-restricted diet lessens the pain and stress of defecation by decreasing the weight and bulk of the stool and delaying intestinal transit time.


A low-fiber diet contains approximately two grams of crude fiber. Foods included are refined bread and cereal products, cooked fruits and vegetables that are low in fiber, and juices. Nuts, legumes, and whole-grain bread and cereal products are restricted. Minimal-fiber diets consist of strained fruit and vegetable juices and white potatoes without skins. Milk is limited to two cups per day, as it indirectly contributes to fecal residue even though it contains no fiber. Continued use of a low-fiber diet in refined carbohydrates, however, is believed to cause diverticular disease of the colon. Reduced bulk causes the colonic lumen to narrow.


A high-fiber diet contains increased amounts of foods containing cellulose, hemicelluloses, lignin, and pectin, and reduced amounts of refined carbohydrates. Insoluble fibers increase the volume and weight of the residue to maintain the normal size of the colonic lumen and to increase gastrointestinal mobility. Soluble fibers, such as gums and pectins, reduce the rate of intestinal absorption, altering the metabolic effects. High-fiber intake necessitates increased fluids.


Certain individuals should not be encouraged to increase the amount of fiber in their diet. Those who have had gastric
surgery, vagotomy, pyloroplasty or Roux-en-Y, and some diabetics with gastroparesis diabeticorum have less acid secretion or decreased gastrointestinal motility and may encounter bezoar formation, a compacted mass that does not pass into the intestine. The high-fiber diet has been recommended, however, in the treatment or prevention of dumping syndrome, hyperlipidemia, gallstones, diabetes, and many other diseases and disorders.




Bibliography


"Dietary Fiber." MedlinePlus, May 8, 2013.



"Digestive System." MedlinePlus, January 14, 2013.



Dudek, Susan G. Nutrition Essentials for Nursing Practice. 6th ed. Philadelphia: Lippincott, Williams and Wilkins, 2010.



Kirschmann, John D. Nutrition Almanac. 6th ed. New York: McGraw-Hill, 2007.



Nix, Staci. Williams’ Basic Nutrition and Diet Therapy. 14th ed. New York: Elsevier Health Sciences, 2013.



Sizer, Frances, and Ellie Whitney. Nutrition: Concepts and Controversies. 13th ed. New York: Cengage Learning, 2013.



Whitney, Eleanor Noss, and Sharon Rady Rolfes. Understanding Nutrition. Updated 12th ed. New York: Cengage Learning, 2011.

Wednesday, 24 December 2014

What are hydroceles? |


Causes and Symptoms


Hydroceles occur in 1 percent of adult males. In patients between the ages of eighteen and thirty-five, the presence of an underlying testicular tumor must be ruled out. Accurate diagnosis can be carried out through physical examination. A hydrocele is a smooth, cystlike mass completely surrounding the testicle such that only the mass can be palpated; the testis, inside, cannot be felt. Hydroceles do not involve the spermatic cord. When a light is shined through the cyst, the light is readily transmitted. If the hydrocele is large or tense and the testis cannot be examined, ultrasound examination can eliminate the diagnosis of a testicular abnormality.








Treatment and Therapy

Removal, called hydrocelectomy, is primarily indicated for adult hydroceles
that produce discomfort, objectionable scrotal enlargement, or an uncertainty regarding underlying testicular abnormalities upon scrotal ultrasound or physical examination. The presence of a hydrocele does not necessarily require surgical intervention, drainage, or other intervention; it must be accompanied by some significant abnormality to require surgery.


Surgical excision is the most effective method for treatment and can be done on an outpatient basis. A 5.0- to 7.6-centimeter (2.0- to 3.0-inch) incision is made in the scrotum, and the wall of the hydrocele is identified and dissected free. The hydrocele sac is removed and its edges sewn or cauterized to eliminate bleeding. The testis is then returned to the scrotum, and the incision is closed. For large hydroceles, a small drainage tube is introduced into the scrotum to limit swelling.


The most frequent complication of hydrocele surgery is scrotal swelling, which may continue for eight weeks. Most patients return to full activity within seven to ten days of surgery, however, and recurrences are rare.


In addition to surgical removal, other treatment options include needle aspiration and aspiration with the injection of sclerosing agents. Needle aspiration is rarely effective and increases infection risk. Fluid usually reaccumulates within three months of aspiration. Aspiration with the injection of sclerosing agents such as tetracycline is successful in fewer than 50 percent of patients and usually requires multiple treatments.




Bibliography


Francis, John J., and Laurence A. Levine. "Aspiration and Sclerotherapy: A Nonsurgical Treatment Option for Hydroceles." Journal of Urology 189, 5 (May 2013): 1725–1729.



Graham, Sam D., Jr., et al., eds. Glenn’s Urologic Surgery. 7th ed. Philadelphia: Lippincott Williams & Wilkins, 2010.



"Hydrocele." Mayo Clinic, November 3, 2011.



Kay, K. W., R. V. Clayman, and P. H. Lange. “Outpatient Hydrocele and Spermatocele Repair Under Local Anesthesia.” Journal of Urology 130, no. 2 (August, 1983): 269-271.



Lyons, Sonja. "Hydrocele/Varicocele." HealthLibrary, September 26, 2011.



Sherwood, Lauralee. Human Physiology: From Cells to Systems. 7th ed. Pacific Grove, Calif.: Brooks/Cole/Cengage Learning, 2010.



Wampler, Stephen M., and Mikel Lianes. "Primary Care Urology: Common Scrotal and Testicular Problems." Primary Care: Clinics in Office Practice 37, 3 (September 2010): 613–626.

Tuesday, 23 December 2014

What is ethology? |


Introduction

Ethology, from the Greek ethos (“behavior" or "manner”), is the study of animal behavior.
It is concerned primarily with the accurate description and rigorous experimental evaluation of animals’ behavior under natural conditions. Unlike the field of behaviorism, which traditionally emphasized the sole importance of the environment on behavior, ethology also recognizes the genetic and physiological mechanisms that regulate behavioral processes. Ethologists operate under the primary assumption that much of behavior is hereditary and thus strongly influenced by the forces of natural selection. Natural selection is the process of differential survival and reproduction that leads to heritable characteristics that are best suited for a particular environment.






In their search for a common, unifying explanation of behavioral processes, ethologists have sought to address three specific issues: the accurate, nonanthropomorphic description of behavior under natural conditions; the underlying mechanisms that regulate and control behavior; and the adaptive significance of various behavior patterns.




Descriptive Approach

In its earliest stages, ethology was characterized by a highly descriptive approach. Early ethologists were concerned primarily with accurate and objective accounts of behavior. Behavior, however, unlike other aspects of an organism’s biology (such as morphology or physiology), was a difficult and elusive thing to characterize and thus required careful, unbiased approaches to understanding the ways in which animals responded to stimuli in their environment. Konrad Lorenz, one of the early founders of the field, insisted that the only way to study behavior was to make objective observations under completely natural field conditions. This approach, most evident in his classic studies on aggression and imprinting (the innate behavioral attachment that a young animal forms with another individual such as its mother, with food, or with an object during a brief critical period shortly after birth), greatly enhanced understanding of communication in the animal kingdom. In contrast to Lorenz’s very subjective approach, the rigorous field experiments of Nikolaas Tinbergen and Karl von Frisch
were similar to those that later would characterize modern ethology.


The classic work of all three of these early ethologists helped demonstrate how an animal’s sensory limitations and capabilities can shape its behavior. For example, in a series of classic learning experiments, von Frisch convincingly documented the unusual visual capabilities of the honeybee. He first trained honeybees to forage at small glass dishes of sugar water and then, by attaching different visual cues to each dish, provided the animals with an opportunity to learn where to forage through the simple process of association. From these elegant but simple experiments, he found that bees locate and remember foraging sites by the use of specific colors, ultraviolet cues, and polarized light, a discovery that revolutionized the way in which humans view the sensory capabilities of animals.




Mechanistic Behavior

With the classic work of Lorenz, Tinbergen, and von Frisch came an increasing appreciation for the ways in which physiological limitations define behavioral differences between species. This awareness eventually gave way to a mechanistic approach to behavior, in which ethologists sought to determine how internal factors such as physiology, development, and genetics regulate and control behavior. The physiologically oriented ethologists, for example, focused on the influence of neuronal pathways and sensory organs on behavior. They were concerned with topics such as the control of feeding in insects, echolocation in bats, electric field detection in fish, and infrared detection in snakes. Similarly, neurobiologists attempted to show how behavioral changes are linked to modifications in the function of nerves and neuronal pathways. By observing the response of individual nerves, neurobiologists can observe changes that occur in the nerves when an animal modifies its behavior in response to some stimulus. In a similar way, they can show how learning and behavior are affected when specific nerve fibers are experimentally cut or removed.




Adaptive Behavior

The third and perhaps most significant area in ethology is that which deals with the evolutionary (adaptive) significance of behavior. Since the seminal work of Charles Darwin, ethologists have maintained that a species’ behavior is controlled largely by its genes. Darwin argued that an animal’s behavior was no different from any other phenotypic characteristic (physical expression of the genes) in that it was heritable and therefore subject to the same kinds of selective processes that lead to evolutionary change among organisms. He considered instinctual (or innate) behavior a tremendous adaptation that frees some organisms from the risky and sometimes costly business of trial-and-error learning. At the same time, he recognized the adaptive plasticity that accompanies the more complex behaviors that involve various degrees of learning.


Both Lorenz and Tinbergen also recognized the importance of evolutionary questions in behavior, but Tinbergen was the first to put such hypotheses to rigorous experimental tests. In a classic experiment on the evolutionary significance of spines in sticklebacks, he tested predation rates by pike on several species of these fish. He found predation rates to be lowest on the three-spined stickleback (a conspicuous species with large horizontal spines), moderate on the more cryptic ten-spined stickleback (which possesses ten smaller vertical spines on its dorsal surface), and highest for unarmored minnows.




Mechanisms of Heredity

More recently, behavioral geneticists have shown that much of learning, and of behavior in general, is intimately tied to mechanisms of heredity. The results of hybridization experiments and artificial breeding programs, as well as studies on human twins separated at birth, clearly demonstrate a strong genetic influence on behavior. In fact, it has been well documented that many animals (including both invertebrates and vertebrates) are genetically programmed (or have a genetic predisposition) to learn only specific kinds of behaviors. Such is the case for song learning in birds.


Thus, ethology places tremendous importance on the evolutionary history of an organism. It emphasizes the adaptive significance of the various types of behaviors, and it assumes that an animal’s behavior is constrained largely by its genetic and evolutionary background.




Learning Process Research

The field of ethology has contributed markedly to the understanding of several psychological and behavioral phenomena. One such area is the learning process. Learning is defined as any modification in behavior (other than that caused by maturation, fatigue, or injury) that is directed by previous experience.


The early experiments of the behaviorist psychologists on conditioning (the behavioral association that results from the reinforcement of a response with a stimulus) led to the notion that all behavior is learned. Traditionally, behaviorists maintained that all complex behaviors are learned by means of either classical or operant conditioning. Classical conditioning, first demonstrated by the Russian psychologist Ivan Petrovich Pavlov, is a form of associative learning in which an animal responds to an unrelated, novel stimulus after it is repeatedly paired with a more relevant stimulus. Operant conditioning, also a form of associative learning, occurs when an animal learns by manipulating some part of its environment (for example, the animal might ring a bell to receive a reward). This form of learning usually improves with experience and is therefore referred to as trial-and-error learning.


The primary objective of the approaches employed by the early behaviorists was to eliminate or control as many variables as possible and thereby remove any uncertainty about the factors that may influence the learning process. These approaches were especially successful at identifying the external mechanisms responsible for learning. Such techniques focused only on the input (stimulus) and output (response) of an experiment, however, and consequently deemphasized the importance of proximate mechanisms such as physiology and genetics. In addition, these approaches generally ignored the evolutionary considerations that ethologists considered so fundamental to the study of behavior.




Innate Behavior

In contrast, studies by the early ethologists suggested that much of behavior was dominated by innate processes that were constrained by the physiological and genetic design of the organism. Lorenz and Tinbergen, for example, demonstrated that many behavioral responses in the animal kingdom are fixed or stereotyped (instinctive) and are often elicited by simple environmental stimuli. They referred to such responses as fixed action patterns and to the stimuli that triggered them as sign stimuli.


The egg-rolling behavior of the greylag goose is perhaps one of the most widely cited examples of this kind of innate behavior. When one of these ground-nesting birds notices an egg outside its nest, it stands, walks to the egg, extends its bill in a very characteristic manner, and proceeds to roll the egg back to the nest. Although at first glance this may seem to represent a simple learned response, Lorenz and Tinbergen found this to be a highly ritualized behavior that was initiated by a very specific environmental stimulus. Through a series of clever experiments, Tinbergen showed that this behavior could be elicited by an egglike object (a ball) or even any object with a convex surface (a bottle or can), and that objects larger than eggs caused a more vigorous (supernormal) response. He also found that once the behavior was initiated, it always ran to completion. In other words, even when the egg was removed, the goose would continue with the motions as if it were returning the egg to the nest.


This and countless other examples of very ritualized behaviors, such as the avoidance response of ducklings to hawk models, the imprinting of young vertebrates on their mothers, the aggressive displays of male stickleback fish to the red bellies of other males, and the various courtship displays of a wide range of species, led early ethologists to conclude that much of behavior is governed by instinct.


These opposing views of ethologists and behaviorist psychologists eventually led to the misconception that learned behavior is governed entirely by the animal’s environment, whereas instinct is completely controlled by the genes. It is now widely accepted, however, that nearly all forms of behavior and learning involve certain degrees of both processes. Countless studies, for example, have demonstrated that numerous animals are genetically programmed to learn only certain behaviors. In contrast, it has been shown that instinct need not be completely fixed, but instead can be modified with experience.




Sociobiology

A second area of ethology that has received much attention from a variety of behavioral researchers and in some cases has sparked considerable controversy is sociobiology. In the early 1970s, Edward O. Wilson
and Robert Trivers of Harvard University initiated a new area of behavioral research when they began their investigations of the evolutionary basis of social behavior in animals. Their attention focused on the evolutionary enigma presented by altruistic
behaviors—acts that one organism performs (often at its own expense) to benefit another. Examples include alarm calls in the presence of a predator and nest-helping behavior. The most extreme cases of such behavior are found in those insect societies in which only a few individuals reproduce and others work to maintain the colony. Through careful experimentation and observation, it was soon determined that such unselfish behaviors are directed toward related individuals and that such behaviors probably evolve because they promote the survival of other individuals who also possess the genes for those same altruistic acts.


Although they initially sparked much debate, studies of the evolutionary basis for social behavior eventually strengthened the ethologists’ long-held notion that much of behavior is coded in the genes.




Research Debates

Although ethology had its beginnings with the work of Darwin and other early naturalists, it was von Frisch, Lorenz, and Tinbergen who conducted the first formal ethological studies and who received a joint Nobel Prize for their pioneering work in 1973. Their approach represented a considerable departure from that of behaviorist psychologists, and the differences between the two fields sparked a heated debate during the 1950s and 1960s, often referred to as the nature-versus-nurture controversy. Although this debate eventually led to the decline and virtual demise of behaviorism, it also helped shape modern ethology into a rigorous biological discipline that now holds a compatible niche within the realm of psychology.


Although the early ethologists argued that behaviorists treated their study organisms as “black-boxes” and ignored the genetic, physiological, and evolutionary backgrounds of their subjects, the behaviorists leveled several criticisms in return. In addition to their disbelief in the genetic control of behavior, they were most critical of the methodological approaches employed by ethologists. In contrast with the rigorously controlled laboratory experiments of psychologists, in which blind observers (observers unaware of the experimenters’ hypotheses or experimental design) were often used to collect data, behaviorists held that early ethologists conducted nearly all their studies under natural conditions without any regard for experimental control. In addition, their observations were often highly subjective and almost never quantified. Even when attempts were made to quantify the behavior, they never involved the rigorous statistical and analytical techniques of the behaviorists.


Furthermore, although the early ethologists argued that much of behavior is shaped by evolution and constrained by an organism’s physiological hardware, little evidence was initially available to support these contentions. Behaviorists, for example, held that ethologists often observed a behavior and casually assigned some adaptive significance to it without testing such evolutionary hypotheses.


These criticisms forced early ethologists to improve their approaches to data collection, experimental design, and data analysis, and as their approaches to the study of behavior were strengthened, so were their original hypotheses about the underlying control of behavior. Thus, as ethologists gained ground, behaviorism began to fall out of favor with most of the scientific community.


The basic views of early ethologists are still well preserved in all prominent areas of ethological research. In fact, the work of nearly all modern ethologists can best be characterized by the two basic sets of questions they seek to answer: the “how questions,” concerning underlying proximate causes, and the “why questions,” concerning ultimate causes (or evolutionary bases). The first of these is pursued by traditional ethologists and neurobiologists, while the latter is primarily the realm of behavioral ethologists. The fields of ethology and comparative psychology have begun to complement each other, and, increasingly, researchers from the two areas are merging their efforts on a diversity of research topics.




Bibliography


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Fisher, Arthur. “Sociobiology: A New Synthesis Comes of Age.” Mosaic 22 (1991): 2–9. Print.



Gould, James L. Ethology: The Mechanisms and Evolution of Behavior. New York: Norton, 1982. Print.



Grier, James W. Biology of Animal Behavior. 2nd ed. New York: McGraw-Hill, 1992. Print.



Hötzel, Maria José, and Luiz Carlos Pinheiro Machado Filho, eds. Applied Ethology. Wageningen: Wageningen, 2013. Print.



Krebs, J. R., and N. B. Davies. An Introduction to Behavioral Ecology. 2nd ed. Oxford: Blackwell, 1991. Print.



McFarland, David, ed. The Oxford Companion to Animal Behavior. Rev. ed. New York: Oxford UP, 1987. Print.



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Plaisance, Kathryn S., and Thomas A. C. Reydon, eds. Philosophy of Behavioral Biology. New York: Springer, 2012. Print.



Raven, Peter H., and George B. Johnson. Biology. 7th ed. New York: McGraw-Hill, 2005. Print.



Ristau, Carolyn A., ed. Cognitive Ethology: The Minds of Other Animals. New York: Psychology, 2014. Print.

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