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All three groups demonstrated sparse recall and recognition of events from the last three decades and all demonstrated evidence of mild temporal gradients erectile dysfunction uncircumcised buy discount viagra with fluoxetine online. Because diencephalic and basal forebrain groups often have frontal involvement other uses for erectile dysfunction drugs buy viagra with fluoxetine from india, we expected that these groups might demonstrate heightened tendencies towards false-positive errors on tests of recognition memory impotence guidelines purchase viagra with fluoxetine 100/60mg visa, but this did not turn out to be the case. Our comparison of amnesic groups suggests that the pattern of performance is largely similar among patients who are matched for baseline intelligence when tests are used that focus on quantitative aspects of performance. Aside from these clinical comparisons, several studies have compared the performance of medial temporal and diencephalic amnesics on experimental paradigms in an attempt to identify information processing domains in which these subgroups may differ. Most prominently, Parkin and colleagues have suggested that medial temporal and diencephalic amnesics differ in their memory for the temporal context in which target information is presented. Although in several studies, memory for temporal context has been linked to frontal dysfunction (Shimamura et al. Furthermore, similar impairments in temporal memory were observed in two patients with diencephalic lesions who showed no evidence of impairment on tasks of executive functioning (Parkin et al. Based on these findings, Parkin and colleagues suggested that amnesics with diencephalic damage present with a qualitatively distinct memory deficit from that seen in amnesics with medial temporal lobe damage. According to their view, structures within the diencephalon, possibly through connections with dorsolateral frontal cortex, may be critically involved in the encoding of temporal information. In the face of diencephalic lesions, contextual input to the hippocampal system is greatly (and selectively) impoverished. In contrast, lesions of the hippocampal system are thought to interfere with consolidation of all types of information, contextual as well as item-related. Their findings for temporal context were generally consistent with those of Parkin, in that diencephalic patients performed worse than medial temporal patients. The inverse pattern was observed with respect to spatial (position) memory, where the medial temporal group performed worse than the diencephalic group. The latter finding was seen as support for the idea that the hippocampus plays a pivotal role in spatial memory (see also Chalfonte et al. Despite reports of some differences between diencephalic and medial temporal amnesic patients, the similarities in the cognitive presentation of these patient groups are striking. Some researchers have argued that these commonalities are to be expected because the medial temporal and diencephalic structures are part of the same functional system required for the encoding of episodic information (Delay & Brion, 1969). Recently, Aggleton & Brown (1999) have argued that the core structures within this system are the hippocampus, fornix, mammillary bodies, anterior thalamus and possibly, more diffusely, the cingulum bundle and prefrontal cortex. According to their model, lesions anywhere in this system can cause deficits in episodic memory. Aggleton & Brown also postulate the existence of a second memory system, consisting of the perirhinal cortex and its connections to the medial dorsal thalamus. This system is thought to be involved in the detection of stimulus familiarity, a process that can support performance on recognition tasks, but not on recall tasks. Aggleton & Shaw (1996) provided evidence in support of this view in a meta-analysis of studies in which the Recognition Memory Test (Warrington, 1984) was given to amnesic patients. They found that patients with lesions restricted to the hippocampus, fornix or mammillary bodies performed at a normal level, even though their recall was as severely impaired as was that of patients with more extensive medial temporal lesions. These include several studies of patients with selective fornix lesions (Hodges & Carpenter, 1991; McMakin et al. Findings in the latter case are especially striking, as the patient was tested on a very extensive battery of recognition tests that varied the nature of to-be-remembered information, list length, retention interval and task difficulty. Despite this evidence, the notion that different memory circuits subserve qualitatively distinct memory processes remains highly controversial. An alternative view, articulated most forcefully by Squire and colleagues (Squire & Zola, 1998; Zola & Squire, 2000), is that the hippocampus is important not only for recall but also for recognition. By this view, differences between patients with selective hippocampal lesions and more extensive medial temporal lobe lesions are only a matter of severity. Supporting this notion are findings from three patients with selective hippocampal lesions (Reed & Squire, 1997), who showed moderate levels of impairment not only in recall but also in recognition. Further, they raise the possibility that partial damage to the hippocampus may disrupt the functioning of connected structures (such as the perirhinal cortex) more than complete damage. Another possibility, until now not considered, is that the location of lesion within the hippocampus affects the pattern of deficit. Clearly, a resolution of this debate will require convergent evidence from animal and human studies. In this context, careful analysis of patients with selective lesions to the hippocampal circuit, using state-of-the-art measures of structural integrity as well as indices of metabolic activity, will be of great importance. Initial attempts to classify patients according to site of neuropathology in medial temporal, diencephalic and basal forebrain regions seemed promising, but subsequent investigations revealed that much of the variability between patients was due to extraneous factors rather than core features of the memory disorder. Recent clinical comparisons have emphasized similarities in the neuropsychological profiles of amnesic subgroups. Experimental studies focused on isolated aspects of information processing have revealed only subtle differences between these groups. Against this background, the current emphasis on differentiating the role of specific regions within the medial temporal lobe and its afferents may lead to a more useful framework for patient classification. Regardless of whether this framework turns out to be correct, detailed description of the anatomical and cognitive characteristics of amnesic patients remains an important endeavor. Such studies may lead to better clinical diagnosis and treatment of patients with memory disorders and may contribute a unique source of information to the cognitive neuroscience of memory. Demonstration eines Gehirnes mit Zerstorung der vorderen und inneren Theile der Hirnrinde beider Schlafenlappen. Neuropsychological deficits in patients with an anterior communicating artery syndrome: a multiple case study. Encoding strategies and recognition of faces by alcoholic Korsakoff and other brain damaged patients. A case study of the forgetting of autobiographical knowledge: implications for the study of retrograde amnesia. Neuropsychological and neuropathological sequelae of cerebral anoxia: a critical review. Spatial location memory in amnesia: binding item and location information under incidental and intentional encoding conditions. Multi-modal amnesic syndrome following bilateral temporal and frontal damage: the case of patient D. The pattern of neuropsychological impairment associated with left posterior cerebral artery infarcts.
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One group of head injury patients erectile dysfunction doctor philadelphia cheap viagra with fluoxetine 100 mg visa, comprising one-third of the sample erectile dysfunction treatment unani purchase viagra with fluoxetine 100mg overnight delivery, showed an initial improvement from baseline to impotence unani treatment in india discount 100 mg viagra with fluoxetine with amex 6 months but then a decline in memory performance by 1 year. A third group, which consisted of around half the sample, showed a steady improvement in memory functioning over the three time periods. A similar degree of diversity in recovery of memory function after severe head injury has been recorded by other researchers. While around half of the patients showed no change in memory test scores, around one-third of the sample improved and the remainder showed a decline. Although they combined memory test scores with other cognitive test indices into an overall neuropsychological impairment index, it is worth noting that they found three patterns of recovery-a slight improvement in cognitive functioning over the retest periods, similar to that found in normal control participants, a marked improvement over the 2 year period, and limited improvement. Some head-injury patients who were severely impaired at 6 months postinjury still showed significant recovery after this time. There was no clear indication as to factors that might determine the variability in recovery profiles found in their study. Hokannen & Launes (1997) carried out prospective cognitive testing in a group of 12 patients (four with confirmed Herpes Simplex Virus) who had significant residual disability following encephalitis. Testing was carried out approximately 3 weeks and then 3 years after the illness-onset. Of the four anterograde memory tests given, only a verbal paired-associate learning test showed significant improvement across the two learning sessions. The two cognitive tasks to show an improvement over the 3 year period were a digit symbol substitution task and a test of verbal fluency. The topic of confabulation has featured in many single-case studies, but has seldom been the focus of group studies. One exception to this trend is a recent study of recovery of confabulation by Schnider et al. They found that performance on a test of temporal context memory paralleled recovery of confabulation in a group of patients that primarily included those with head injury and those with subarachnoid haemorrhage. This suggests that temporal context memory mechanisms, which have tended to be associated with frontal lobe functioning, may be critical to processes underlying the occurrence of confabulation. At the theoretical level, prognostic indices may offer clues as to the pathophysiological mechanisms that play a part in contributing to the chronic memory deficits that patients will be left with as part of their residual disability. In this section, we will primarily be dealing with the prognosis of memory function in naturally evolving neurological disease states. The prediction of recovery of memory function after brain surgery, such as for temporal lobe epilepsy, is a major topic in its own right and has been well covered elsewhere (Helmstaedter, 1999; Oxbury, 2000). She found that scores on the Rivermead Behavioural Memory Test in the early stages were a good predictor of independence at follow-up. By contrast, variables such as duration of coma or particular components of the Glasgow Coma Scale have generally shown an inconsistent relationship with final levels of recovery of memory function. More general pathophysiological indices have also shown a variable relationship with memory outcome. Fewer studies have been published on acute prognostic indices for recovery of memory function in other aetiologies. In a study that specifically looked at patients who had various forms of encephalitis, Hokkanen & Launes (1997) assessed duration of ictal amnesia once disorientation had subsided, and this turned out to be at a mean of 26 days after the onset of the illness. Their measure of duration of ictal amnesia was akin to duration of posttraumatic amnesia as assessed in head injury patients, but it also included a preictal component. The authors reported that grade of recovery at discharge from hospital (ranging from alert and orientated to comatose) predicted longer-term level of recovery of memory function at the final 12 month assessment. Site of lesion did, however, appear to play a role in predicting recovery of amnesia and confabulation in the study by Schnider et al. While only a limited number of studies that are germane to this topic have been carried out, we thought it would be useful to demarcate this aspect of recovery of memory function and note some recent studies using advanced imaging procedures, if only because of the potential benefits that may accrue for our understanding of the neural mechanisms underlying recovery of memory function. Brown, 1998), and have usually reported bilateral medial temporal lobe abnormality during the amnesic phase, although unilateral (usually left) temporal lobe hypoperfusion, thalamic changes and frontal abnormalities have also been reported. Over a 2 year period, retrograde amnesia but not anterograde amnesia showed major improvements. This study, therefore, helps to highlight the distinctive contributions of hippocampal and neocortical mechanisms to anterograde and retrograde memory functioning. Of the 10 patients studied, three showed bilateral hippocampal abnormalities, but in four patients the lesion was restricted to the left hippocampus. One of the patients with bilateral hippocampal changes was studied 2 h after the onset of the attack. A potentially important application of modern brain imaging procedures to the study of recovery of memory function also relates to functional activation studies of those patients who have recovered from an initially dense amnesia, or those who are left with selective memory loss as part of their neurological condition. Such studies may highlight those areas of the brain that act as neural compensatory mechanisms, and so offer clues as to the basis of recovery of function in brain disease. Very few such studies have yet been carried out, but one exception is that by Maguire (2001), in which a patient with developmental amnesia was found to show greater bilateral temporal lobe involvement during an autobiographical memory task compared to matched control participants. From the methodological point of view, there are a number of factors that need to be borne in mind when studying recovery of function in the dynamic phase: 1. Use of appropriate parallel forms of memory tests, including tasks matched for difficulty (such as when testing recall and recognition memory). The administration of nonmemory tasks, such as tests of attention and executive function, which may help to shed light on the nature of any improvement or absence of improvement in memory functioning. The gathering of data from matched control participants, to ensure that there is appropriate control for practice effects (cf. Allowance for medical and other variables that may introduce "noise" into the assessment of memory functioning in the acute phase of recovery. This may range from the effects of medication and the presence of seizure activity to tiredness that results from disturbed sleep habits in the early stages of an illness/injury. From the theoretical point of view, the key questions that remain to be answered in the area of recovery of memory function include the following: 1. Answers to this question will require multidisciplinary approaches that include sophisticated brain imaging techniques and that allow consideration of issues of neural plasticity that have emerged in other areas of brain function, such as sensory and motor recovery. Evidence that is gathered will help to resolve the related question as to how one can explain individual variability in recovery of memory function. Answers to this question will require experimental designs and procedures that allow for associations and dissociations to emerge between discrete memory processes, and also between memory and nonmemory functions. What are the natural rates of recovery of memory function in various neurological conditions Can the natural rate of recovery of memory function be accelerated by physical.
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Crop rotation of fallow, wheat, and sorghum is an excellent practice in some areas. Date of planting wheat seed depends on the locality, type of wheat, and the hessian fly problem. However, moisture, rather than plant food nutrients, is the limiting factor in production in most seasons under dryland farming. Yield response to nitrogen fertilizer is determined by moisture, soil, type of seedbed, and crop stand. Nitrogen may be supplied with anhydrous ammonia, nitrogen solution, or in dry forms as ammonium nitrate, urea or in mixed fertilizers. Nitrogen fertilizer and potash may be broadcast and worked into the seedbed before seeding or applied at time of seeding by using a combination fertilizer-grain drill, or applied as a top-dressing during the winter just prior to spring growth. It can be grazed without apparent injury to the grain crop, provided it is not grazed severely over an extended period of time, or too late in the spring. Grazing should be discontinued just before plants begin to grow erect in preparation for jointing. Harvesting the grain should be delayed until the wheat is sufficiently mature to store well, with moisture content of 13. Yields depend on climatic conditions, variety or cultivar of wheat planted, size of kernel, and number of kernels per head. In 1979 the world low production yield figure was 160 kg/ha in Jordan, the international production was 1,782 kg/ha, and the world high production yield was 7,000 in U. The economic stability of many nations is affected by the exchange in wheat and other commodities (Reed, 1976). Research reiterated by Palz and Chartier (1980) indicated that straw from winter wheat, summer wheat, winter barley, summer barley, winter rye, and oats all gave calorific values based on moisture-free dry matter of 17. Briggle (1980) adds that wheat is an energy frugal crop, produced with the energy equivalent of less than 5 barrels oil/ha compared to corn at closer to 10 barrels and potatoes at nearly 25. Extension agents should be consulted concerning diseases in an area before growing wheat. Diseases caused by bacteria include the following: Pseudomonas atrofaciens (Basal glume rot or bacterial black-tip) and Xanthomonas transluscens f. Diseases caused by viruses include the following: Wheat mosaic, Wheat streak mosaic, Wheat striate mosaic, and Yellow dwarf. Insect pests encountered in various areas include: English grain aphid is the most common aphid affecting wheat, attacking the heads and being very damaging when populations become high prior to the late-dough stage. Other insects and cutworms, darkling beetles, hessian fly, and salt marsh caterpillars, may cause damage during the seedling stage. A great number of species of nematodes have been isolated from wheats in various parts of the world. Chemical Analysis of Biomass Fuels Analysing 62 kinds of biomass for heating value, Jenkins and Ebeling (1985) reported a spread of 17. Analysing 62 kinds of biomass for heating value, Jenkins and Ebeling (1985) reported a spread of 16. Most bromes are highly palatable during succulent growth, even the ones classed as weeds. Species of major value in agriculture are field bromegrass, California brome, rescuegrass, smooth brome, mountain brome, cheatgrass, downy brome, Japanese chess, and hairy chess. It produces large quantities of leafy forage, relished by all kinds of livestock while immature. The mature foliage is less palatable, but the seed heads are palatable and nutritious. Growth starts early in the spring, producing much leafy forage relished by livestock. Because of rapid seedling growth and a well-branched, deep root system, mountain brome is excellent where a rapid cover development is needed. This grass is frequently seeded with alfalfa or sweet clover in the Pacific Northwest. The mixture is ideal both for prevention of erosion and as a well balanced animal diet. Bromus glabrescens Honda Bromus tatewakii Honda Poaceae Smooth bromegrass We have information from several sources: Handbook of Energy Crops-James A. When seeded in late summer it develops an extensive fibrous root system, making it excellent for erosion control. Although most used for erosion control and soil improvement, it furnishes palatable pastilrage during the spring. They are prolific seed producers and may become dominant in overgrazed perennial pastures. The leaves and peeled hypocotyls are eaten in the Moluccas after soaking and boiling (Hou, 1958). The phlobaphene coloring matter is used in China and Malaya for black dye (Burkill, 1966). Folk Medicine Reported to be astringent (Duke and Wain, 1981), the bark is used for diarrhea and fever in Indonesia (Perry, 1980).
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Left hemisphere damage and selective impairment of auditory verbal short-term memory: a case study erectile dysfunction doctor in houston order viagra with fluoxetine us. Mental representation in unilateral neglect and related disorders: the twentieth Bartlett memorial lecture erectile dysfunction pills cialis viagra with fluoxetine 100/60 mg free shipping. Remembering what but not where: independence of spatial and visual working memory erectile dysfunction 43 buy viagra with fluoxetine 100/60 mg cheap. Object and spatial visual working memory activates separate neural systems in human cortex. Visual perception and verbal descriptions as sources for generating mental representations: evidence from representational neglect. The bailiwick of visuo-spatial working memory: evidence from unilateral spatial neglect. The prefrontal landscape: implications of functional architecture for understanding human mentation and the central executive. Distinguishing the functional roles of multiple regions in distributed neural systems for visual working memory. Hemifield-specific visual recognition memory impairments in patients with unilateral temporal lobe removals. Group aggregates and individual reliability: the case of verbal short-term memory. Blindsight and shape perception: deficit of visual consciounsness or of visual function Semantic priming in the neglected visual field: evidence from lexical decision task. Effects of orbital frontal and anterior cingulate lesions on object and spatial memory in rhesus monkeys. Interhemispheric differences in the localization of psychological processes in man. Redefining the functional organisation of working memory processes within human lateral prefrontal cortex. Development of memory for pattern and path: further evidence for the fractionation of visual and spatial short-term memory. Spatial localization in patients with unilateral posterior left or right hemisphere lesions. Multiple visuo-spatial working memory buffers: evidence from spatio-temporal patterns of brain activity. Double dissociation of spatial and object visual memory: evidence from selective interference in intact human subjects. Awareness of controlesional information in unilateral neglect: effects of verbal cueing, tracing, and vestibular stimulation. Sie Seelenblindheit als Herderscheinung und ihre Beziehung zur Alexie und Agraphie. It includes knowledge of the meaning of words, objects and other stimuli perceived through the senses, as well as a rich abundance of facts and associated information. Semantic knowledge about Paris includes recognizing the verbal label as meaning a place, and as referring to the capital of France. It also includes knowing where Paris is located on a map of France, knowing that the Eiffel Tower, Arc de Triomphe and Notre Dame are situated there, knowing that the river Seine runs through it, knowing that it is where the storming of the Bastille took place, where most people speak French, where some people smoke Gaulloise cigarettes, where people drive on the right, etc. Semantic memory is immensely important because it constitutes the knowledge base that allows us to communicate, use objects, recognize foods, react to environmental stimuli and function appropriately in the world. In recent years there has been increased clinical recognition of neurological patients who exhibit impaired semantic memory. Although in some patients this constitutes one component of a multifaceted cognitive disorder, in other patients, semantic memory impairment is highly selective and other aspects of cognition are notably spared. The remarkable nature of such circumscribed semantic memory loss has been conveyed eloquently by Patterson & Hodges (1995). Their theoretical importance stems from the fact that semantic memory does not break down in an all-or-none fashion. Patients may know some words but not others, may recognize one exemplar of an object but not another, and may retain partial information about a concept while other information is lost. Identification of the underlying principles that govern what is lost and retained has clear implications for how information is organized and represented. Moreover, semantic memory deficits may occur in the context of apparently well preserved day-to-day memorizing, the converse of the situation in classical amnesia. This apparent double dissociation seems, at least at first sight, to provide support for the distinction between semantic and episodic memory (Tulving, 1972) and permits the opportunity to address the relationship between the two. This is because deficits in neuropsychological function depend on the topography of brain lesions, not the underlying aetiology. The diverse conditions associated with impairments of semantic memory include degenerative brain disorders, herpes simplex encephalitis, head trauma and temporal lobe epilepsy, a common underlying feature being disease or injury to the temporal neocortex. Semantic Dementia Semantic dementia might reasonably be regarded as the prototypical semantic memory disorder. It is a relatively rare clinical syndrome, resulting from focal degeneration of the temporal neocortex and associated with a non-Alzheimer pathology, in which there is a circumscribed and progressive loss of semantic knowledge. The name "semantic dementia" was introduced in 1989 to encapsulate the multimodal nature of the semantic disorder (Snowden et al. Patients with selective semantic loss, described in seminal papers by Warrington (1975) and Schwartz et al. Patients commonly present to medical attention complaining of problems in "memory". However, in keeping with the fact that medial temporal lobe structures are relatively preserved, patients are not amnesic in the classical sense. They remember appointments and day-to-day events and find their way around without becoming lost. Typically, their presenting difficulty is in remembering the meaning of words or in recognizing the faces of acquaintances. On examination they exhibit profound naming difficulties and make semantically related errors. They also have difficulty understanding words and may frequently ask what words mean. Deficits may include a difficulty in recognizing nonverbal environmental sounds, such as the ring of a doorbell or telephone, visual percepts such as objects, and tactile, gustatory and olfactory stimuli (Snowden et al.
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For example erectile dysfunction treatment vitamins generic viagra with fluoxetine 100/60mg free shipping, one test asked structured questions about common events likely to erectile dysfunction ultrasound protocol viagra with fluoxetine 100 mg online have been experienced by most persons erectile dysfunction pills philippines order 100mg viagra with fluoxetine mastercard. In another test, 75 single-word cues were given (Crovitz & Schiffman, 1974), and participants attempted to recollect a specific episode from their lives that involved each word. Control subjects, like typical middle-aged individuals (McCormick, 1979), drew their memories predominantly from the recent past and from the remote past, and less often from the middle of their lives (Figure 4. Specifically, they drew most of their recollections from before 1950 and produced very few recollections from the period after 1960. Although these findings are consistent with the idea that remote episodic remembering is intact after damage to the hippocampal formation, it remains possible that more sensitive tests or more sensitive scoring methods will reveal some abnormality. The importance of these issues was underscored recently by a report in which five memory-impaired patients attempted to produce two autobiographical recollections from each of five periods of life (Moscovitch et al. These findings are not relevant in any clear way to the facts of medial temporal lobe amnesia. In addition, the amnesic patients tended to repeat details during the testing session, presumably due to their anterograde amnesia (patients = 4. These results suggest, in keeping with what has been found with less thorough scoring methods, that the hippocampal formation is not required to produce detailed episodic memories from early life. For example, when asked to point to a drawing of a seal among seven other drawings of animals that live in the water, E. First, patients with damage to the hippocampal region were impaired relative to controls on a recognition test, regardless of whether the test words were associated with "remembering" or "knowing" (Figure 4. Remembering and knowing have been linked to episodic and semantic memory, respectively. Thus, the hippocampal region appears to be important for memory, even in the absence of episodic remembering. Second, patients with damage to the hippocampal region were impaired at learning novel three-word sentences, despite extended training (Figure 4. Third, patients with damage to the hippocampal region acquired less knowledge about the world after the onset of amnesia than controls did during the same time period (Figure 4. This finding shows directly that the hippocampal region normally contributes to the acquisition of semantic memory. This finding shows that the medial temporal lobe is not essential for aspects of remote factual memory and that detailed recall of remote events is possible despite large medial temporal lobe lesions. This result shows that the hippocampus and the entorhinal cortex are not necessary for the recall of either remote factual knowledge or remote autobiographical events. In contrast, these structures are important for recalling more recent factual knowledge (Squire et al. The available data suggest that the hippocampus and related structures in the medial temporal lobe are needed for acquiring and, for a limited time after learning, retrieving memory for facts as well as memory for specific events. If the distinction between facts and events (semantic and episodic memory) does not illuminate the function of the medial temporal lobe or its anatomical components, it nevertheless seems likely that the different components of the medial temporal lobe do make different and specialized contributions to declarative memory. For example, the available data suggest that the parahippocampal cortex contributes especially to spatial memory, and the perirhinal cortex contributes especially to visual memory (Suzuki & Amaral, 1994; Zola & Squire, 2000). The hippocampus lies at the end of the processing hierarchy of the medial temporal lobe and is in a position to extend and combine the processing accomplished by structures that lie earlier in the hierarchy (Figure 4. It has been suggested that the hippocampus is especially well suited for one-trial learning and for rapidly forming conjunctions between arbitrarily different stimuli (for discussion, see Eichenbaum & Cohen, 2001; Squire, 1992). If so, it is possible that adjacent cortex might contribute more to other kinds of tasks. Nearly two-thirds of the cortical input to entorhinal cortex originates in the adjacent perirhinal and parahippocampal cortices, which in turn receive projections from unimodal and polymodal areas in the frontal, temporal and parietal lobes. The entorhinal cortex also receives other direct inputs from orbital frontal cortex, insular cortex and superior temporal gyrus. All these projections are reciprocal the socially acquired food preference task (Alvarez et al. If one assumes that the cortical lesion has fully disconnected the hippocampus from the neocortex, then this finding suggests that, in the case of this one-trial associative learning task, the adjacent cortex may not contribute much beyond what is contributed by the hippocampus itself. This result can be contrasted with delayed nonmatching to sample, where the effects of restricted hippocampal damage are exacerbated by damage to adjacent cortex (Zola-Morgan et al. A particularly interesting example comes from a task of paired-associate learning, which is acquired gradually by monkeys in more than 8000 trials (Murray et al. Following damage to perirhinal and entorhinal cortex, postoperative performance was much more severely impaired than after damage to the hippocampus and the immediately adjacent cortex (posterior entorhinal cortex and parahippocampal cortex). This finding suggests, in the case of the paired-associate task, that the perirhinal cortex may contribute more to performance than the hippocampus. The effects of separate and combined lesions can be studied within the same species and the same tasks with an eye towards revealing qualitative, distinct effects of hippocampal lesions and lesions of perirhinal or entorhinal cortices. It remains possible that there is no simple division of labor between these regions, and that differences in function may be better understood as 96 J. If so, distinctive contributions of different structures may be difficult to reveal by behavioral measures. Damage limited to the hippocampal region produces long-lasting memory impairment in monkeys. Preserved recognition in a case of developmental amnesia; Implications for the acquisition of semantic memory. Rats with lesions of the hippocampus are impaired on the delayed nonmatching-to-sample task. Neurotoxic hippocampal lesions have no effect on odor span and little effect on odor recognition memory but produce significant impairments on spatial span, recognition, and alternation. Recognition impaired and association intact in the memory of monkeys after transaction of the fornix. Under what conditions is recognition spared relative to recall after selective hippocampal damage in humans Hippocampectomy impairs the memory of recently, but not remotely, acquired trace eyeblink conditioned responses. Acquisition of post-morbid vocabulary and semantic facts in the absence of episodic memory. Differential modulation of a common memory retrieval network revealed by positron emission tomography. Impaired recognition memory on the Doors and People Test after damage limited to the hippocampal region.
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One recent example of how working memory might be conceived by the lay public is illustrated in the film Memento erectile dysfunction juicing cheap viagra with fluoxetine 100mg with visa, directed by Christopher Nolan (2000) erectile dysfunction ugly wife discount viagra with fluoxetine 100mg with amex, where the metaphor of Polaroid photographs is used to impotence causes discount viagra with fluoxetine online mastercard convey how visual memories might be formed as the elements of the photograph gradually appear, and how the reverse operation of elements fading from the photograph represents a process of forgetting that is particularly rapid for the main character in the film. This presents forgetting as a passive loss of definition or decay until no information remains. However, for some considerable time research on this topic has shown it to be a metaphor that is very limited and quite misleading. Visuospatial working memory is an active system; it involves manipulating and recombining elements of information from the environment and from prior experience, as well as temporary retention. It is the interpretation by the cognitive system of the contents of the photograph that has meaning, and it is this interpretation that is held within working memory. The objects or the people in the photograph are identified and associated with a lifetime store of knowledge, and one important aspect of forgetting includes the loss or the change of how a scene is interpreted as well as the loss of detailed visual features. There is now general agreement among researchers that working memory supports visuospatial as well as verbal temporary storage, and that it is an active system. However, the cognitive architecture of working memory, and visuospatial working memory in particular, remains a topic for debate. We will discuss both the experimental and the neuropsychological evidence that impinge on this debate. First, we address the question of whether or not visuospatial working memory acts as a gateway between perception and long-term memory. This will be followed by a discussion as to whether it is best considered as a unitary system or as a multicomponent system. We will then consider the implications of the impairments of different aspects of visuospatial working memory and the neuroanatomical networks that might be associated with visuospatial working memory functions. This was the view in the widely cited model proposed by Atkinson & Shiffrin (1968). Also, it still appears as an assumption in a wide range of contemporary, introductory textbooks, as well as in some contemporary theory, including theories that incorporate multiple components of working memory. An illustration of this form of gateway concept is shown in the upper part of Figure 13. However, the transit function for working memory carries with it a number of implications for the status of the information it holds. One implication is that there is no direct access route between sensory input and long-term memory. However, this runs into difficulty when attempting to account for the wide range of evidence for implicit processing of sensory input that arises from studies that we discuss in detail later in the chapter, of patients with blindsight 274 S. These data suggest that the gateway can be circumvented under some circumstances, and this additional concept of a "leaky gateway" is illustrated in Figure 13. A second implication is that damage to the transit function should result in damage to the processing of sensory input. So, for example, should the visuospatial functions of working memory be damaged as a result of brain injury or disease, and if those visuospatial functions act as a gateway between sensory input and the store of prior knowledge, then the processing of sensory input should be impaired. However, as we discuss later in the chapter, patients that show visual or spatial representational and immediate memory impairments show no evidence of impairments in object identification or naming. This is rather more difficult for the gateway model to address, even with the additional direct route between sensory input and the store of knowledge. A further implication of working memory as a gateway is that its contents would comprise primarily raw sensory images of edges, contours, light, shade and colour. The successful perception of these raw sensory images as recognizable objects requires access to the store of knowledge that has accumulated from prior experience. However, the contents of working memory appear to comprise identified objects and scenes, rather than raw sensory images. This suggests that sensory input does not pass through working memory prior to the interpretation of that input. This in turn speaks to the view that the primary route for sensory input is that it first activates prior knowledge and experiences in long-term memory, and that it is the product of that activation which is held and manipulated within working memory. If you now close your eyes and consider the objects that are in your immediate environment, then you will draw on the contents of working memory for the recently perceived scene. In reporting the contents of working memory, the objects are identified-as a lamp, a computer screen, a pencil, a book, a grey plastic model of a brain-they are not raw sensory images comprising uninterpreted shades of colour, contrast, texture, edges and contours. It is possible to manipulate these objects in your representation-imagine the book on top of the lamp, the pencil falling on the floor, the model brain growing larger or turning a shade of pink. It is also possible to reach out and physically pick up and manipulate the objects without opening your eyes-physically reach out, pick up and squeeze the model brain, or open the book at the first page. We can perform the same mental operations on the contents of a representation retrieved from our knowledge base of past experience. We can represent mentally objects that are behind us in the immediate, familiar environment of an office, even if they have not been viewed recently-the phrenological head on the bookcase or the painting of the hill of Bennachie. We can also represent and mentally manipulate the landmarks in a familiar square in our home town, or imagine the impact of rearranging the layout of the furniture in our living room. This all points to the idea that working memory cannot be considered as a gateway between sensory input and long-term memory, but more as a system for representing interpreted objects and scenes, allowing us to interact with and mentally manipulate those objects. Visuospatial working memory, therefore, gives us a representation of the environment on which we can act mentally or enact physically. The idea that visuospatial working memory is best viewed as a workspace rather than a gateway is supported by evidence from experimental psychology, in particular the area of mental discovery. One experimental method for investigation of this topic involves presenting healthy volunteers with the names of a small number of generic shapes, such as "semi-circle, square, figure 8". The volunteers are then required to mentally manipulate the shapes and combine them in such a way as to form a recognizable object. On the whole, the volunteers were quite good at generating drawings of recognizable objects and allocating labels for their mental constructions (see also Anderson & Helstrup, 1993; Finke & Slayton, 1988; Pearson et al. However, Barquero & Logie also showed that when volunteers were asked to perform the same task Figure 13. Volunteers were provided with the names of generic shapes and their task was to manipulate the shapes mentally and combine them in a recognizable object. In this example, "semi-circle, square, figure 8" were combined to form a mouse 276 S. These results suggest that healthy adults can use working memory to manipulate shapes and generate new discoveries. However, they also suggest that when people attempt to manipulate mentally the shapes of real objects, then it is difficult to divest the object identity from the object shape. When the shapes are drawn on paper, they can be reinterpreted via the perceptual system. That is, the meaning which arises from object identification through perception becomes part of the mental representation held in working memory.
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Onchocerciasis has been known to erectile dysfunction treatment garlic purchase 100 mg viagra with fluoxetine mastercard be associated with posterior uveitis as well as keratitis and iritis erectile dysfunction in young order generic viagra with fluoxetine. Visceral larva migrans erectile dysfunction drugs without side effects order genuine viagra with fluoxetine, Toxocara canis, or Toxocara cati can cause complications involving endophthalmitis and retinal detachment. Subretinal granulomas and larval inflammation of the retina have been known to occur. The larvae of different species of worms can produce diffuse unilateral subacute neuroretinitis with the typical clinical picture of grayish white intraretinal and subretinal focal lesions. Differential diagnosis: Other causes of retinal inflammation and subretinal granulomas should be excluded. Treatment: Laser photocoagulation or surgical removal of the worm larvae may be indicated. Clinical course and prognosis: It is not uncommon for these disorders to lead to blindness. Epidemiology: Retinoblastoma is the most common malignant ocular tumor in children, occurring in approximately one of 20 000 births. Where retinoblastoma is inherited as an autosomal dominant trait, the siblings of the affected child should be regularly examined by an ophthalmologist. Every child presenting with strabismus should undergo examination of the fundus with the pupil dilated to exclude a retinoblastoma. Findings and diagnostic considerations: A grayish white, vascularized retinal tumor will be observed on ophthalmoscopy. Infiltration of the vitreous body, anterior chamber (pseudohypopyon), and orbit may occur. A retinoblastoma that also involves the fellow eye and pineal body is referred to as a trilateral retinoblastoma. A trilateral retinoblastoma is defined as additional manifestation of the tumor in the pineal body. Differential diagnosis: Several other disorders should be excluded by ophthalmoscopy. Treatment: Tumors less than four pupil diameters may be managed with radiation therapy delivered by plaques of radioactive ruthenium or iodine (brachytherapy) and cryotherapy. Prophylaxis: Following the diagnosis, the fellow eye should be examined with the pupil dilated every three months for five years. Clinical course and prognosis: Left untreated, a retinoblastoma will eventually metastasize to the brain and cause death. Etiology: Astrocytomas belong to the phakomatoses and are presumably congenital disorders that develop from the layer of optic nerve fibers. Calcifying astrocytic hamartomas in the region of the basal ganglia or ventricles can cause epilepsy and mental deficiency. Findings and diagnostic considerations: Astrocytomas are either incidental findings in ophthalmic examinations performed for other reasons, or they are diagnosed in patients presenting with reduced visual acuity. Ophthalmoscopy will reveal single or multiple "mulberry" tumors one to two pupil diameters in size. The tumors are inherently fluorescent when observed in blue light in fluorescein angiography with a blue filter. A possible Toxocara canis granuloma should be confirmed or excluded by serologic studies. Symptoms: Loss of visual acuity will result where exudative retinal detachment develops. Findings and diagnostic considerations: Retinal hemangiomas are characterized by thickened tortuous arteries and veins. Cerebral hemangiomas, renal cysts, hypernephromas, and pheochromocytomas should also be excluded. However, exudative retinal detachment will develop as the treatment increases this risk. The prognosis for visual acuity is poor in the disorder where retinal detachment develops. After this characteristic crossing, the fibers of the optic nerve travel as the optic tract to the lateral geniculate body. All the retinal nerve fibers merge into the optic nerve here, and the central retinal vessels enter and leave the eye here. The complete absence of photoreceptors at this site creates a gap in the visual field known as the blind spot. There is a wide range of physiologic variability in the size of the optic disk; its area may vary by a factor of seven, and its horizontal diameter by a factor of two and one-half. Margin: the margin of the optic disk is sharply defined and readily distinguished from the surrounding retinal tissue. On the nasal side, the greater density of the nerve fibers makes the margin slightly less distinct than on the temporal side. A common clinical observation is a crescent of pigment or irregular pigmentation close to the optic disk on the temporal side; sometimes the sclera will be visible through this crescent. The rim has a characteristic configuration: the narrowest portion is in the temporal horizontal region followed by the nasal horizontal area; the widest areas are the vertical inferior and superior areas. Optic cup: this is the slightly eccentric cavitation of the optic nerve that has a slightly flattened oval shape corresponding to that of the neuroretinal rim. The size of the optic cup correlates with the size of the optic disk; the larger the optic disk, the larger the optic cup. Because enlargement of the optic cup means a loss of nerve fibers in the rim, it is particularly important to document the size of the optic cup. This is specified as the horizontal and vertical ratios of cup to disk diameter (cup/disk ratio). Due to the wide range of variability in optic disk size, it is not possible to specify absolute cup/disk ratios that indicate the presence of abnormal processes. Central retinal artery and vein: these structures usually enter the eye slightly nasal to the center of the optic disk. However, arterial pulsation is always abnormal and occurs with disorders such as increased intraocular pressure and aortic stenosis. Cilioretinal vessels are aberrant vessels originating directly from the choroid (short posterior ciliary arteries). Resembling a cane, they usually course along the temporal margin of the optic disk and supply the inner layers of the retina. Both groups of vessels originate from the ophthalmic artery, which branches off of the internal carotid artery and enters the eye through the optic canal. The central retinal artery and vein branch into the optic nerve approximately 8 mm before the point at which the optic nerve exits the globe.
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Cotton Production Guidelines for North Carolina Australian Cotton Cooperative Research Centre National Cotton Council erectile dysfunction hormonal causes generic viagra with fluoxetine 100/60 mg on line. Euphorbiaceae Amla impotence natural remedies order viagra with fluoxetine online pills, emblic We have information from several sources: Emblic-Julia Morton erectile dysfunction treatment shots discount viagra with fluoxetine 100/60 mg line, Fruits of warm climates FactSheet contributed by Dr. They produce good growth on sands of low fertility, and are used primarily for erosion control in sandy areas. For this purpose, dividing and transplanting clumps of the grasses is the most effective method of establishing stands. If planted not more than 3 feet apart, spaces between plants are rapidly filled in. Both are tropical, perennial herbs, the tops growing each year from underground rhizomes. Poaceae Hurricane grass, Seymour grass, Barbados sourgrass, Pitted bluestem, Comagceyana Source: James A. References Uses Much valued as a good fodder grass, both for grazing and for stacking. Satisfactory for lawns, as it sends out numerous creeping shoots which root at the nodes. Germplasm Reported from the Africa, Mediterranean, and Near East Centers of Diversity, comagueyana or cvs thereof is reported to tolerate drought, grazing, and slope. Both apomictic and sexual reproduction have been observed in India, the latter predomina. Considered one of the better pasture grasses in the West Indies, Uganda and India. Ecology Ranging from Warm Temperate Moist through Tropical Very Dry to Wet Forest Life Zones, comagueyana is reported to tolerate annual precipitation of 5 to 40 dm (mean of 7 cases = 13. Rather common in disturbed as well as undisturbed areas, along roadsides, and in rather dry areas. Harvesting Mature plants stand repeated cutting, continuous grazing and trampling. Because of its ability to withstand being trampled and its habit to send out rooting shoots, it is used for lawns. An excellent pasture grass in many tropical areas of the world, as West Indies, East Africa, India, in the last where it is suggested for reseeding degraded grassland. Biotic Factors Following fungi have been reported on this grass: Balansia sclerotica, Claviceps purpurea, Physoderma bothriochloae, Puccinia cesatii, P. Anacardiaceae Cashew, Cashew Apple, Cashew Fruit, Cashew Nut We have information from several sources: Magness, J. Cashew Links: California Rare Fruit Growers - Anacardium Cashew-from Mark Reiger, Dept of Horticulture, University of Georgia. Cashew Information from the University of California Fruit & Nut Research and Information Center. Pineapple Information from the University of California Fruit & Nut Research and Information Center the Pineapple Page News and information about pineappe (Edited and Maintained by Duane P. Common (Indian) Name: Hindi: Kalmegh, Kiryat, Mahatit, Gujrati: Kiriyata, Olikiriyat Marathi: Olen Kirayat, Canarese: Nelabevu gida Sanskrit: Bhuinimb, Kirata, Mahateet Malyalam: Nilaveppu, Kiriyatta, Telugu: Nela Vemu Tamil: Nilavempui Family: Acanthaceae Distribution: Kalmegh is an annual herb found through India, specially in dense forests. Medicinal Properties: According to Ayurveda the plant is bitter, acrid, cooling, laxative, vulnerary, antipyretic, antiperiodic, anti-inflammatory, expectorant, depurative, soporific, anthelmintic, digestive and useful in hyperdispsia, buring sensation, wounds, ulcers, chronic fever, malarial and intermittent fevers, inflammations, cough, bronchitis, skin diseases, leprosy, colic, flatulence, diarrhoea, dysentery, haemorrhoids etc. In Bengal (India), household medicine known as "Alui" is prepared from fresh leaves and is given to children suffering from stomach complaints. Recent experimental finding indicated that Kalmegh is having antityphoid and antibiotic properties. The leaves contain the maximum active principle content while in the stem it is in lesser amount. Any soil having fair amount of organic matter is suitable for commercial cultivation of this crop. References Uses Considered one of the best grazing grasses in northern Nigeria and northern Ghana. Description Tall annual or perennial, tussock grass; culms erect, up to 3 m tall, more or less stout, about 0. Squamulatus and bisquamulatus are "dry ground" varieties which grow best on well-drained sandy clays of medium to high fertility (Bowden, 1963). Reported from the Africa Center of Diversity, gamba grass or cvs thereof is reported to tolerate drought, fire, frost, high pH, heavy soil, low pH, poor soil, savanna, slope, and waterlogging. In grassy places, damp places, low-lying meadows, edge of thickets; often forming large areas. Adapted to a wide range of soil types, with different ecotypes adapted to various soils varying from sandy to heavy black cracking clays. Clean seedbed required, but sowing should not be delayed more than 2 months after beginning of rains (in India). May also be propagated by splints, those from mature woody stumps doing best (Bowden, 1963). Harvesting Plants persist well under grazing, but are only palatable before flowering. The flowering stems, which are produced in quantity, are hard and should be removed by mowing or burning. Frequent burning tends to suppress this grass and allows it to be replaced by less useful species. In one experiment (Bowden, 1963) over three years, plots were cut only when grass reached 6, 9, 12 and 15 dm, necessitating 12, 9, 8 and 7 cuts respectively. According to Bogdan (1977), this is one of the high yielding grasses of West Africa, being outyielded by Melinis minutiflora, Panicum maximum and/or Pennisetum purpureum. Seed yields up to 30 kg/ha per cut with 3 cuts per year have been recorded in Brazil. In pure stands in Ghana, dry matter yields per harvest from March 12 to November 12 (in 5 harvests) averages 7,478 kg/ha, with total harvest being 37,391. Widely cultivated and used grass used in tropical Africa (Nigeria and Ghana), Brazil, India, and Australia for fodder, grazing, hay and to some extent for erosion control. Biotic Factors Following fungi have been reported on this grass: Fusarium moniliforme (on seed), Phyllachora assimilis, Puccinia erythraeensis, P. In: Office of Technology Assessment, Background papers for innovative biological technologies for lesser developed countries. The effect of quantity, source, and time of application of nitrogen fertilizers on the yield and quality of Andropogon gayanus at Shika, Nigeria.
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Confabulation is a product of a failure of temporal consciousness to erectile dysfunction treatment washington dc order 100 mg viagra with fluoxetine visa conduct a fine-grained search through long-term memory erectile dysfunction treatment atlanta purchase viagra with fluoxetine 100/60mg with amex. Dalla-Barba and colleagues further suggest that confabulation in the semantic domain should be interpreted as arising from a dysfunctional (but not totally lost) knowing consciousness impotence cures buy viagra with fluoxetine 100/60mg without prescription. Cases of completely lost knowing consciousness would result in omissions, rather than confabulations, in the semantic domain. The notion of some kind of disturbance in temporality as an underlying mechanism for confabulation is appealing, in that many confabulations can be traced back to real memories which are misplaced in time. However, some of the more bizarre instances may not necessarily conform to this rule. Although one might argue that even the most bizarre ideas and beliefs patients hold may have originated from dreams, fantasies or current perceptions, this argument is impossible to prove and may not lend support to the idea of temporal confusion, but rather speak to a deficit in source monitoring (see below). Furthermore, accounts that rely solely on deficits in temporality run into trouble when accounting for confabulation associated with semantic memory. Most of the temporality hypotheses refer to distortions in a personal temporal frame of reference, which should lead to confabulations that are restricted to the episodic domain. Moreover, Moscovitch & Melo (1997) showed that the number of confabulations associated with distortion of content can exceed those on which there is distortion of time, although the two likely interact with one another. This may result from confusion in terms of time and context (source monitoring), or even in terms of whether they refer to experienced events or merely imagined ones (reality monitoring; Johnson et al. Failure of several different mechanisms might underlie the production of confabulation, including failure in encoding, retrieval, motivation and evaluative processes (Johnson et al. Thus, for example, deficits in judgment or even motivation could lead to the use of lenient decision criteria for the reality of an event. Equally, disruption in retrieval processes could result in faulty access to stored information that could potentially be helpful in identifying the source of a particular event. Finally, faulty acquisition could produce memories that lack the type of cues, such as perceptual details, that help determine source in normal memory processes (Johnson & Raye, 1998). These processes are not viewed as mutually exclusive, and it is suggested that a confluence of factors may produce different kinds of confabulations, differing on aspects such as plausibility. For example, failing to distinguish dreams from real events may result in highly implausible confabulations, while confusing different real events may yield believable confabulations. It should be noted, however, that deficits in source monitoring can occur in patients who show little if any spontaneous confabulation, suggesting that additional or different processes from source moitoring are implicated (see Schnider et al. Retrieval Deficit Because confabulation affects remote memories acquired long before brain damage occurred as much as recent, anterograde memories that were acquired subsequently, many theorists have concluded that confabulation is related to a deficit in retrieval rather than encoding. Two types of retrieval are distinguished: (a) associative-cue-dependent or direct retrieval, in which a cue elicits a memory almost automatically and which is thought to be dependent primarily on the medial temporal lobes and related structures. These strategic retrieval processes operate at input to frame the memory problem and initiate search, constrain it, and guide it towards local, proximal cues that can activate associative memory processes. Once a memory is recovered, strategic processes operate at output to monitor the recovered memory and determine whether it is consistent with the goals of the memory task and with other knowledge, thereby verifying whether the recovered memory is likely true or false. Moscovitch & Melo (1997) conclude that the search component is probably one of the defective processes in confabulators, based primarily on the finding that prompting led to a substantial increase in both veridical and false memories in confabulators, but not in non-confabulating amnesics or normal controls. It appears that as well as having a severe strategic search deficit, confabulators also have a monitoring deficit. Monitoring may involve two separate processes: (a) keeping track of actions and of expected events so as not to repeat them, which perhaps is mediated by the mid-dorsolateral prefrontal region, closely related to regions involved in making decisions about temporal order; (b) editing memories and inhibiting false ones, and perhaps initiating search process that are mediated by the ventromedial prefrontal cortex (see Schnider & Ptak, 1999, for a related distinction; and a recent paper by Moscovitch & Winocur, 2002, for an elaboration on this idea). Burgess & Shallice, 1996, for a related model based on retrieval processes in normal subjects). Confabulating patients have been reported who have intact executive functions, as determined by their performance on a variety of nonmemory tasks sensitive to frontal damage. To counter this objection, Moscovitch & Melo (1997) suggested that the crucial lesion in the medial frontal cortex may not affect performance on standard tests of executive function which typically are more sensitive to lateral frontal lesions (see also Schnider et al. Review of Recent Empirical Evidence for Theories of Confabulation Considering the large literature on confabulation, it is surprising that only a few studies have attempted to investigate experimentally the underlying mechanisms of the disorder. Methodological issues, such as finding a sufficiently large sample of subjects with well-defined confabulation make it difficult to run large-scale well-controlled studies. This problem is compounded by the temporal dynamics of the disorder, which tends to resolve within a few months in most cases. Furthermore, experimental manipulations and between-subject comparisons are difficult to perform, because confabulation is a positive sign that may or may not be produced, even in the same patient under the same conditions, and because confabulations are unique to the individual and rich in content that is often personal. It may be for these reasons that most studies in the field are single-case studies that are often descriptive in nature, at least with respect to the confabulations themselves. However, there are several group and single-case studies in which experimental manipulations have been attempted. Compensation One of the early questions to receive experimental attention was whether confabulation reflects a need to cover up gaps in memory that arise from amnesia. Although the authors rightly conclude, based on analysis of means of wrong answers, that gap filling is not a common mechanism of either provoked or spontaneous confabulations, they do not discuss the great variability in responses within each group. For example, one of their spontaneous confabulators produced confabulations on 8/15 items, while two others had 0/15. The findings suggest that confabulations that are produced because of suggestion or a memory lapse may not be directly related to the neurological condition, but rather may arise from aspects of personal style, such as leniency, the need to conform to apparent social demand, etc. From clinical observation, it seems that compensation does not occur as a primary cause of spontaneous confabulation, but comes into play once confabulation has begun and the individual becomes aware (or is made aware) that the responses given are implausible or inconsistent (Moscovitch, 1989). Thus, if a patient produces an erroneous memory (either spontaneously or in response to a prompt), this memory is considered a primary confabulation; it has no compensatory function and merely reflects the defective neuropsychological processes associated with confabulation. It is important to note that the patient genuinely believes that the memory is true. One account for this strong belief in the confabulation is that this false memory is as vivid (Dalla-Barba, 1993b) or as impoverished in detail (Johnson et al. This patient gave "remember" judgments for all of the confabulations he produced, a finding that is indicative of an abundance of episodic details that accompanies the recall of these false memories (although for contradictory observations, see Papagno & Baddeley, 1997). These attempts often give rise to secondary confabulation and may have the same underlying mechanisms that promote gap-filling of the type seen in both confabulators and controls. Temporality and Source Monitoring Another hypothesis that has attracted much research is the temporality hypothesis discussed earlier. This research has evolved from the frequent observation that confabulations can be traced to an original true memory that is misplaced in time or in context.
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Firstly best erectile dysfunction pills at gnc generic 100/60 mg viagra with fluoxetine free shipping, the social protection system is not only designed to erectile dysfunction psychological causes treatment purchase viagra with fluoxetine 100/60mg with amex reduce poverty erectile dysfunction doctor in delhi order viagra with fluoxetine now, but also to prevent vulnerable people from falling into poverty, promote their social mobility, and facilitate the consolidation of the middle-class. In addition, it also focuses on especially vulnerable populations such as indigenous and Afro-Colombian peoples, internally displaced populations, victims and former combatants. The experience of accessing the system varies across these groups, and is likely to present unique challenges (or opportunities). First, Juan and Adela would need to make sure that their socioeconomic information is up to date. The profile includes several dimensions considered relevant to characterize the household in terms of their basic human capital endowments, assets and available resources. For each dimension/variable, we choose the most frequent outcome, with only a few exceptions. In the case of urban and rural poverty, for example, most of the poor live in urban areas but poverty rate is higher in rural areas. The head of household, Juan, is a 46-year-old agricultural worker, who has completed basic primary education. His work is seasonal, and Juan goes through stretches of unemployment of variable duration. He has considered taking some training, but has a hard time fulfilling basic requirements and accessing training opportunities. His wife, Adela (37), has completed secondary school, and runs a small food service business from home. The business has been expanding slowly, and is successful, but to expand it further she would need to access credit, and she does not know where to start. She is helping with child rearing, but also requires help from Adela for her own basic care. What kind of barriers or challenges are they most likely to encounter in the process They would need to identify whether they are eligible for the programs they are interested in, verify whether the program is available in their area, and navigate the different program rules regarding enrollment windows and additional eligibility requirements. Program supply is not harmonized and no or few mechanisms exist to facilitate access across programs that could be complementary. Scholarship programs like Ser Pilo Paga, have a completely different enrolment window, with different physical and virtual channels to access the benefits. While the program accepts new applicants/registrations, it faces a limited budget that does not allow it to increase the number of actual beneficiaries. It is their responsibility to provide all programs and services with their new address, family composition information, and other information. The final objective is to make it possible for the Rodriguez family and others like them to move more easily within the system as needed. The government should focus on designing innovative mechanisms and strengthening management tools that can deliver well-sequenced, more effective combinations of programs (or "integrated packages") that address the different challenges faced by individuals and households, while also simplifying the process for the user. Delivering services to citizens effectively is critical for creating trust and shaping perceptions of the public sector. This may be due to various internal and external circumstances, but improvements in service delivery can play a role in shaping perceptions and building trust in the public sector. In designing public service delivery programs, governments tend to map processes which reflect their own institutional requirements and assumptions about users, instead of the actual needs of the end users. Even when user feedback is requested, it is rare that it leads to direct change in implementation or delivery. This is particularly acute in social sectors, where the client-provider power relationship is more asymmetrical. Shifting towards a citizen-centered service delivery system could positively impact delivery performance, final outcomes and user satisfaction. Since the first wave of expansion of the social protection system in the early 2000s, many reforms have been made to the institutional arrangements of the sector, seeking to enhance the coordination of social policies and programs. Re-imagining public service delivery from the point of view of the users can help generate solutions that create value for users, and improve efficiency of the system. Especially in the provision of social programs and services, where those in charge of designing the service are generally removed from the realities of their potential users, understanding who the users are, what they need, how they make decisions and what their habits and expectations are can make the difference. In a dynamic social protection system, users are the focus of services and programs (Box 5. The experience of the Rodriguez family and the processes described above highlight two areas 15 Heintzman and Marson (2005). The first group of theories seeks to explain declines in confidence primarily based on societal changes in identities and values. Heintzman and Marson focus on the latter strand, and particularly on the administrative/service delivery level micro-performance of government as an important approach to improving citizen trust and confidence. Canada Citizen First studies the government of Canada has a long history of focusing on public management improvements. The citizen-centered service research agenda made a significant leap in the late 90s early 2000s with the acknowledgement that a lot of research until then had not been actionable. As a result, they launched the "action-research" initiatives, including the now famous Citizen First Surveys, designed to track service delivery from the client ("outside-in") perspective. The surveys provided new insight into the challenges faced by citizens when accessing services, something that had largely gone unnoticed because of the previous focus on their experience once they had reached the point of service. The Citizen First study highlighted that 16 percent of the time citizens needed to access multiple services at once, often spread across agencies and levels of government, the burden of navigating the system fell entirely on citizen. Three main drivers of citizen satisfaction with access were identified: (i) knowing where to start and how to get service, (ii) easily find out information, (iii) ability to contact staff. This and other findings have driven changes in service design that have led to improvements in performance and citizen satisfaction. The Common Measurement Tool, a multi-channel instrument with core questions to allow programs to benchmark their results against others, is another important element of this agenda. To promote more frequent updates by beneficiaries, Conpes explicitly calls upon social programs to establish clear duration and entry/exit requirements. A combination of programs, or "integrated packages" should be used to address individual and household needs over the life cycle. These are designed "around" a user need or life-event and, because of this, tend to be more effective than individual programs. For example, entry/exit criteria may need to be harmonized, or referral protocols across programs introduced.