Freud, civilization, religion, and stoicism.

Freud's debt to stoicism has been seldom discussed. His attitude toward science had a distinct ethical slant taken from the ancient world, via Freud's humanistic education. Freud's method involved detachment but did not imply moral coldness and indifference any more than stoicism did. The stoics wanted to be therapists of the mind just as physicians cared for the body. For both Freud and the stoics, reason was in battle with the passions and required clear sight to have a chance of prevailing over them. In contrasting religious worldviews with the scientific approach, Freud failed to see his own approach as ethical. Freud made extensive forays at individual and collective levels but in the years since Freud's death, the psychoanalytic vision has narrowed. At 150 years after his birth, the authors can still admire Freud's exceptional ethical courage and recognize that if psychoanalysis is to survive, it needs to regain his cultural range and spirit of critical inquiry. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Squamous cell carcinoma arising from a nonhealing wound and osteomyelitis treated with Mohs micrographic surgery: a case study

The treatment of choice for squamous cell carcinoma arising from chronic ulcer at the lower extremity has traditionally been amputation. Recently, Mohs micrographic surgery has been used as a limb-saving option in selected patients. One of these patients, a 69 year-old white male, presented with a two-year history of a progressive non-healing would and osteomyelitis. A four-month history of an enlarging mass within the ulcer suggested squamous cell carcinoma, which was confirmed by biopsies. The patient was treated with Mohs micrographic surgery for local eradication of the tumor, intravenous antibiotics, and skin grafting.     

Discovering functionally independent mental processes: The principle of reversed association.

A joint aim of cognitive psychology and neuropsychology has been the decomposition of mental function—the isolation and characterization of basic processes underlying behavior. By convention, the principal techniques used to identify such processes are based on functional dissociation—the observation of selective effects of variables on tasks. Yet, despite their widespread use, the inferential logic associated with these techniques is flawed. The aims of this article are twofold: (a) to review and make explicit the inferential limits of single and double dissociation; and (b) to introduce a new technique that overcomes these limits. Called reversed association, this new technique is defined as any nonmonotonic relation between two tasks of interest. We argue that reversed association, in place of functional dissociation, offers a sounder basis for inferring the number of functionally independent processes underlying performance and, having fewer assumptions, offers researchers greater scope for discovering such processes and determining their nature and effects. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

New goals for HCI training: How to mix old and new skills in the trainee

The development of human‐computer interaction systems and the acquisition of skills associated with such systems typically occur in the context of previous experience. What is learned in one situation may facilitate or impede learning in another situation. The aim of this article is to discuss the role of experience in human‐computer interaction. The ACT? theory of skill acquisition and transfer is extended to account for the effects of old skills on the learning of new tasks. The extended model predicts a number of changes in performance that will occur when a new task involves the combination of old and new skills, including the suggestion that the learning rate of the new task will be slower than the rate at which the old skills were originally acquired. Two experiments are reported, the results of which support most of the model's predictions. The results also suggest that the minimum performance time of a task may be increased if performance of the task involves combining old and new skills. Implications of the effects of such combinations are considered with respect to the best methods of training for human‐computer interaction systems and the development of such systems.     

Angiogenesis in wound repair: angiogenic growth factors and the extracellular matrix

Angiogenesis is critical to wound repair. Newly formed blood vessels participate in provisional granulation tissue formation and provide nutrition and oxygen to growing tissues. In addition, inflammatory cells require the interaction with and transmigration through the endothelial basement membrane to enter the site of injury. Angiogenesis, in response to tissue injury, is a dynamic process that is highly regulated by signals from both serum and the surrounding extracellular matrix (ECM) environment. Vascular endothelial growth factor, angiopoietin, fibroblast growth factor, and transforming growth factor beta are among those most potent angiogenic cytokines in wound angiogenesis. The cooperative regulation of them is essential for wound repair. Migration of endothelial cells and development of new capillary vessels during wound repair is dependent on not only the cells and cytokines present but also the production and organization of ECM components both in granulation tissue and in endothelial basement membrane. The ECM regulates angiogenesis by providing scaffold support and signaling roles. They also serve as a reservoir and modulator for growth factors. Laminins are the major noncollagenous ECM of endothelial basement membrane. Two newly recognized laminins, 8 and 10, are the major laminins produced by human dermal microvascular endothelial cells. Laminin 10 is highly expressed in blood vessels around skin wounds. Laminin 8 promotes dermal endothelial cell attachment, migration, and tubule formation. Integrins with either beta 1 or alpha v subunits are the major cellular surface receptors for ECM molecules and mediate the interactions between cells and ECM during wound angiogenesis.     

Screening for skin cancer in primary care settings

OBJECTIVE: To estimate the frequency of recorded screening for skin cancer in primary care settings. DESIGN: Retrospective observational cohort study. SETTING: Two academically affiliated Department of Veterans Affairs Medical Centers. SUBJECTS: Two hundred randomly selected patients at least 50 years old and receiving care at outpatient medical clinics. MAIN OUTCOME MEASURE: Frequency of documented skin examinations, in comparison with other tests routinely done as screening, during a 2-year period. METHODS: Medical record review to identify how often selected components of the physical examination and specific procedures were documented during ambulatory visits. RESULTS: Among the 200 subjects, the frequency of documented examinations and procedures included fecal occult blood testing in 120 (60%), rectal examination in 128 (64%), and sigmoidoscopy in 93 (47%), prostate examination was performed in 114 (59%) of 193 men. In contrast, skin examination was documented in only 56 (28%) of 200 subjects (P < .001 for each comparison with other tests). As an estimate of the "true" frequency of screening for skin cancer, 35 (18%) of 165 patients without skin-related complaints had a documented skin examination. CONCLUSION: Skin cancer screening is infrequently documented and therefore possibly omitted in the context of primary care visits.