Voices from the Newspaper Club: Patient Life at a State Psychiatric Hospital (1988-1992).

The authors conducted a qualitative analysis of thirty-seven issues of The DDU Review, a newsletter produced by residents of the Dual Diagnosis Unit, a residential unit for people who had diagnoses of developmental disability and serious mental illness in the Central State Hospital (Indiana, USA). The analysis of the newsletters produced between September 1988 and June 1992 revealed three major themes: 1) the mundane; 2) good behavior; and 3) advocacy. Contrary to the authors' expectations, the discourse of medicalization-such as relations with physicians, diagnoses, and medications-receive little attention. Instead, the patient-journalists focus on prosaic aspects of institutional life. The patients used their writing as a form self-definition and advocacy. The authors argue that even though it is tempting to consider the patients' emphasis on good behavior as evidence of institutional control, internalized discipline, and medicalization, a more nuanced interpretation, which focuses on how the patients' understood their own experiences, is warranted. Researchers must also recognize the ways in which The DDU Review reveals the patient-journalists' experience of an institutional life that includes non-medical staff (attendants, secretaries, and therapists), varied social relationships among patients, and negotiated freedoms.

Modeling Gene Expression: Lac operon.

Gene regulation is an essential process for cell development, having a profound effect in dictating cell functions. Bacterial genes are often regulated through inducible systems like the Lac operon which plays an important role in cell metabolism. An accurate model of its regulation can reveal the dynamics of gene expression. In this paper, a mathematical model of this system is constructed by focusing on regulation by the Lac repressor. The results show, as expected, that the concentration of lactose approaches zero while glucose concentration approaches the initial concentration of lactose by the action of ß-galactosidase, expressed by the Lac operon. Addition of PD control improves stability of the system, with the phase margin increasing from 45° to 90°. Modeling the dynamics of gene expression in inducible operons like Lac operon can be essential for its applications in the production of recombinant proteins and its potential usage in gene therapy.

An Essential Hospice Experience Course for Preclinical Students.

This article proposes an undergraduate hospice experience course as a new model of experiential learning, one that would provide effective preparation for students entering medical school and that would help them become better doctors. Medical humanities scholars scrutinize narrative models for inspiration and understanding, in order to develop teaching strategies that recognize the importance of the end of life and caring for patients appropriately. The written narrative, however, should not stand alone: the spoken, or shared narrative-the story as it is told by patients, friends, and family members-is equally important. Therefore, the authors urge that undergraduate premedical students spend time with patients who are dying. The Medical Humanities program at Indiana University-Purdue University Indianapolis (IUPUI) offers an experiential learning course that couples student volunteer hospice service with reflective analysis of the relationship between the end of life, medicine, and patient care and that emphasizes the value of the shared story. This article examines the development and implementation of the upper-level undergraduate Hospice Experience course as an invitation to a larger conversation about this important topic.

An investigation of the mechanisms underlying the effects of viewing distance and stimulus length on attentional asymmetries during line bisection.

Clinical neglect patients overattend to stimuli on their right, whereas the general population overattend to the left (pseudoneglect). Both phenomena are affected by viewing distance, whereby the attentional biases are attenuated as the stimulus moves from near to far space. Both are also affected by stimulus length and reduce in strength, or even reverse (the crossover effect), as length decreases. To gain an insight into the cognitive/neural mechanisms that underlie the effects of viewing distance and stimulus length, in two experiments we examined the interaction between the variables. In Experiment 1 we asked university students (n = 20) to perform a horizontal landmark bisection task with lines presented at varying lengths (1.2°, 6.3°, and 18.4° of viewing angle) and distances (450 and 1,350 mm). A crossover effect and pseudoneglect were observed for the short and the long lines, respectively. An effect of viewing distance was only observed for long lines. Experiment 2 was the same, except that the lines were rotated to form vertical lines. No crossover effect was observed for the short lines, but an upward bias was observed for the long lines. Once again, an effect of viewing distance was only apparent for the long lines. These results demonstrate that the crossover effect is not a general property of short lines and is specific to the horizontal dimension. Models of crossover therefore need to incorporate processes related to left-right asymmetries. The results also demonstrate that viewing distance only affects long lines, and that this happens irrespective of orientation. A model of viewing distance is discussed that incorporates a right hemisphere mechanism specialized for an interaction between the ventral and dorsal streams.

The content of hope in ambulatory patients with colon cancer.

Although hope is a pervasive concept in cancer treatment, we know little about how ambulatory patients with cancer define or experience hope. We explored hope through semistructured interviews with ten patients with advanced (some curable, some incurable) colon cancer at one Midwestern, university-based cancer center. We conducted a thematic analysis to identify key concepts related to patient perceptions of hope. Although we did ask specifically about hope, patients also often revealed their hopes in response to indirect questions or by telling stories about their cancer experience. We identified four major themes related to hope: 1) hope is essential, 2) a change in perspective, 3) the content of hope, and 4) communicating about hope. The third theme, the content of hope, included three subthemes: a) the desire for normalcy, b) future plans, and c) hope for a cure. We conclude that hope is an essential concept for patients undergoing treatment for cancer as it pertains to their psychological well-being and quality of life, and hope for a cure is not and should not be the only consideration. In a clinical context, the exploration of patients' hopes and aspirations in light of their cancer diagnosis is important because it provides a frame for understanding their goals for treatment. Exploration of the content of patients' hope can not only help to illuminate misunderstandings but also clarify how potential treatments may or may not contribute to achieving patients' goals.