University of Medicine and Dentistry of New Jersey

About: University of Medicine and Dentistry of New Jersey is a based out in . It is known for research contribution in the topics: Population & Pregnancy. The organization has 14634 authors who have published 19610 publications receiving 1041794 citations.

Understanding Healing Relationships in Primary Care

Abstract: PURPOSE Clinicians often have an intuitive understanding of how their relationships with patients foster healing. Yet we know little empirically about the experience of healing and how it occurs between clinicians and patients. Our purpose was to create a model that identifies how healing relationships are developed and maintained. METHODS Primary care clinicians were purposefully selected as exemplar healers. Patients were selected by these clinicians as having experienced healing relationships. In-depth interviews, designed to elicit stories of healing relationships, were conducted with patients and clinicians separately. A multidisciplinary team analyzed the interviews using an iterative process, leading to the development of case studies for each clinician-patient dyad. A comparative analysis across dyads was conducted to identify common components of healing relationships RESULTS Three key processes emerged as fostering healing relationships: (1) valuing/creating a nonjudgmental emotional bond; (2) appreciating power/consciously managing clinician power in ways that would most benefit the patient; and (3) abiding/displaying a commitment to caring for patients over time. Three relational outcomes result from these processes: trust, hope, and a sense of being known. Clinician competencies that facilitate these processes are self-confidence, emotional self-management, mindfulness, and knowledge. CONCLUSIONS Healing relationships have an underlying structure and lead to important patient-centered outcomes. This conceptual model of clinician-patient healing relationships may be generalizable to other kinds of healing relationships.

Forgetting as an Active Process: An fMRI Investigation of Item-Method–Directed Forgetting

Abstract: Using event-related functional magnetic resonance imaging (fMRI), we examined the blood oxygen level-dependent response associated with intentional remembering and forgetting. In an item-method directed forgetting paradigm, participants were presented with words, one at a time, each of which was followed after a brief delay by an instruction to Remember or Forget. Behavioral data revealed a directed forgetting effect: greater recognition of to-be-remembered than to-be-forgotten words. We used this behavioral recognition data to sort the fMRI data into 4 conditions based on the combination of memory instruction and behavioral outcome. When contrasted with unintentional forgetting, intentional forgetting was associated with increased activity in hippocampus (Broadmann area [BA] 35) and superior frontal gyrus (BA10/11); when contrasted with intentional remembering, intentional forgetting was associated with activity in medial frontal gyrus (BA10), middle temporal gyrus (BA21), parahippocampal gyrus (BA34 and 35), and cingulate gyrus (BA31). Thus, intentional forgetting depends on neural structures distinct from those involved in unintentional forgetting and intentional remembering. These results challenge the standard selective rehearsal account of item-method directed forgetting and suggest that frontal control processes may be critical for directed forgetting.

Functional image-guided surgery of intracranial tumors located in or near the sensorimotor cortex

Abstract: Object. The purpose of this study was to evaluate the efficacy of noninvasive preoperative functional imaging data used in an interactive fashion in the operating room. The authors describe a method of registering preoperative functional magnetic resonance (fMR) imaging localization of sensorimotor cortex with a frameless stereotactic surgical navigation device. Methods. The day before surgery, patients underwent blood oxygen level—dependent fMR imaging while performing a finger-tapping motor paradigm. Immediately afterward an anatomical stereotactic MR image was acquired. Raw fMR imaging data were analyzed offline at a separate workstation, and the resulting functional maps were registered to a high-resolution anatomical scan. The fused functional—anatomical images were then downloaded onto a surgical navigation computer via an ethernet connection. At surgery, the brain was exposed in the standard fashion, and the sensorimotor cortex was identified by direct cortical stimulation, the use of somatosensory...