Thursday, December 1, 2011

Hiring The Right Sales Person

Sales is one of the most crucial positions you will ever have to hire for, after all they are not only the face of the company but also the ones that bring in the revenue. The sales field is so diverse and unique that each position requires a different type of personality and set of skills, depending on the company and the products they are selling. Often times candidates are better prepared for interviews than the interviewer themselves, but that doesn't necessarily make a candidate qualified. So the better prepared you are, the better the chance of finding the right candidate you will have.

Before you even think about sorting through the hundreds of resumes that you probably already have in your inbox, you must first take some time to prepare yourself before going into the battlefield. First and foremost you need to get together with your sales team and create an "ideal candidate" profile; deciding what would make a salesperson successful in your company. Just because someone was the #1 sales person at cruise line does not mean that they will be a top seller in your organization that sales computers. So, identify some key players in your team, see what qualities have made them successful, what qualities have hindered them, go through candidates that haven't worked out in the past and see why they didn't last. Once you have created the "ideal" candidate, you can begin the hunt for your next star. After all, you can't find what you need if you don't know what you are looking for.

Being able to identify and differentiate a good resume from a bad one is a key step in your search for the next superstar. A resume is the first indicator of many things such as communication, but also their attention to detail, written skills, presentation, how they sell themselves, how successful they have been in other positions and employment longevity along with many other things. Reviewing the resume carefully and knowing exactly what you are looking for in your next hire will allow you to only move forward with those that you truly feel will add value to you team. Although a resume is only a limited representation of a candidate, it is one of the most important ones too. So, if a resume looks like they only spent an hour on it; chances are they probably did.

This to me is one of the easiest parts of the process as far as deciding whether or not I will continue on to a face to face interview or not. When you think of a great sales person you think of someone you can click with, someone that's engaging, personable, likeable and a great communicator. If you feel like you have to drag answers out of them during the phone screening, if the conversation doesn't flow naturally, if they are not enthusiastic and spark your interest than most likely your clients that they will be selling too will see them the same way. At the end of the day people don't buy from a name brand they buy from the people they like and people they feel comfortable with. So if they can't sell themselves, you cannot expect them to successfully sell your products/services to anyone else.

This is where it can get tricky. A lot of people present well, have great personalities and might have relevant experience but might not be the best for your position. Don't be afraid to ask questions and really dig into their metrics; how they measured in comparison to others and really put them in the hot seat. The truth only has one face, so no matter how many different ways you ask the same question the answer should remain consistent. Ask questions that will that will expose synergies, strengths, specifics, situational questions, their drive, their competiveness, passion and accomplishments. But never settle for just a superficial answer; ask what they did to get there, how they accomplished it, what made them different, how they remain competitive, etc... It's a job interview and you are in control, so take control and keep asking until you feel you are satisfied with the answer. The interviewer should only talk 10% of the time; the rest should come from the candidate.

At the end of the day you can only uncover so much during the hiring process, but the more you can uncover and the more prepared you are to interview, the better off you will be and the more educated the hiring decisions you make will be. So take your time in creating an ideal candidate profile, review resumes very thoroughly, don't be afraid to ask uncomfortable questions, and always remain open minded on where your next superstar can come from. The identifying and hiring process is an important part of finding great sales people but what happens after you hire them? How are you keeping them satisfied, challenged, and motivated? Recruiting goes far and beyond just interviewing. Good luck and happy hunting.
Thanks to Carlos Morgan / Next Top Recruiter / America's Next Top Recruiter

What Your Boss Needs To Know About Engagement

On October 28, Gallup posted an article with the sobering headline "Majority of American Workers Not Engaged in Their Jobs." This should disturb every American worker and business leader. In an earlier report, Gallup estimated that worker disengagement accounts for more than $300 billion annually in lost productivity in the U.S. alone. In fact, according to Gallup, only one-third of workers are enthusiastic about the work they do and feel they are contributing to their organizations in positive way. Even worse, middle-aged and highly educated workers are least likely to be engaged. These are precisely the people who should be operating at peak creativity and productivity.

So, what is going on? A survey by the American Psychological Association (APA) provides some insights. For one thing, 36% of workers feel stress, and nearly half of those say it's because of low wages. This is not surprising, given that real wages have remained stagnant while worker productivity has steadily climbed over the past two decades (pdf). But pay isn't the major source of dissatisfaction. Workers reported that they were discontented at work because of limited opportunities for growth or advancement (43%), heavy workload (43%), unrealistic expectations (40% ), and long hours (39%).

Perhaps the most sobering finding of the APA survey is that 48% of employees do not feel valued at work. So, although companies often tout the importance of their people, the everyday experience of many doing the work is something quite different. Inevitably, people feel underappreciated, disrespected and disengaged. The economic cost to organizations is unacceptable, and the emotional cost to individuals is unforgivable.

What can be done? In his book, The Coming Jobs War, Jim Clifton, the chairman of Gallup, suggests some macro-level solutions. He says that countries and cities must produce good jobs. To do this, society must invest in the education of those future job creators, and in the education of those who will fill those good jobs. And companies must stop trying get by with too-lean workforces. As the APA survey shows, much of the engagement-killing stress that workers feel comes from being asked to do too much with too little.

Our own research points to some micro-level solutions. In The Progress Principle, we report that, of all the workday events that engage people deeply, the single most important is simply making progress on meaningful work. And we found two classes of actions that managers can perform each day to drive progress and engagement: catalysts and nourishers. Catalysts, such as providing clear goals and necessary resources, directly support progress in the work. Catalysts impact engagement indirectly by facilitating progress.

Nourishers act directly on engagement by boosting inner work life — the continuous flow of emotions, perceptions, and motivations that people experience throughout their work days. Nourishers include actions like showing respect, offering recognition for good work, and providing emotional support when people confront particularly difficult situations. If employees receive nourishers regularly, their inner work lives soar. They are happy, they perceive their organizations positively, and they stay motivated - in other words, they are engaged in their work.

So, if people are to be fully engaged at work, they must first have meaningful work to do. This does not necessarily mean that leaders must articulate a lofty mission, like curing diabetes. It does mean that all employees should see how their daily actions contribute to something of value, like a useful product or service. Second, there should be a regular supply of catalysts to progress, so that people can succeed at that meaningful work.

And finally, for employees to stay fully engaged, their inner work lives must be consistently nourished with respect, recognition, and encouragement. Simple, no-cost managerial actions could do much to improve the engagement of that 48% of workers who today feel undervalued. As evidenced in the words of this software developer from our research, even a brief interaction can make a big difference:

I got a nice 'attaboy' from the Project Manager about the work I put in on the database [...] I've been working so hard on. She seemed to be really pleased, and she thanked me for sticking with the assignment. Her nice words made my day go much better!

Do you feel undervalued and overburdened at work? Whether you are a leader or individual contributor, what are your solutions to this crisis?

Teresa Amabile is Edsel Bryant Ford Professor of Business Administration at Harvard Business School. She researches what makes people creative, productive, happy, and motivated at work. Steven Kramer is a psychologist and independent researcher. They are coauthors of The Progress Principle (Harvard Business Review Press, 2011)

Thanks to Teresa Amabile & Steve Kramer / Blogs HBR / Harvard Business School Publishing


Nurturing Employee Engagement In Flat Organizations

Established organizations continue to flatten the organizational pyramid through eliminating managerial layers and upping the subordinate/superior ratio from the classic 6:1 to 12:1 and higher. Newer companies stay flat from the get-go.

One consequence is that a traditional workplace acknowledgement - the promotion - is becoming rarer as opportunities for internal upward mobility are reduced.

A promotion typically entails (along with more responsibility): a new title, more personal workspace, more money, a new peer group and increased authority. With this reward not as readily available to a manager as a tool for attracting and keeping people, the manager must use personal leadership to meet the responsibilities of company growth and employee retention.

A leader is always looking to align an employee's personal goals and growth with company objectives. And an employee wants to know that the manager has the employee's best interests at heart. Given that most adults spend close to 50% of the waking hours "on the job" (plus thinking about it during off-hours as well), a leader's ability to identify common ground between employee and company is key.

This common ground encompasses three company elements: culture, challenge and compensation.

* Culture – Does the company's day-to-day environment of communication, teamwork, openness, attitude and trust encourage the employee to contribute and meet their job responsibilities?
* Challenge – Is the employee learning new skills and acquiring knowledge during the course of meeting their job requirements?
* Compensation – Given the culture and opportunity for personal/professional growth, are the compensation and benefits fair?

A leader will take these three elements and frame each of these as personal questions:

* In our company's culture, am I encouraging trust and openness through my thoughts and deeds? Am I communicating the necessary information for my team to understand the importance of their work within the overall company and that team members regularly receive feedback around their contribution?
* In creating challenge and helping my people grow, do I give them projects that expand their role and create opportunity to learn new skills and acquire new knowledge?
* Am I doing everything I can to compensate my team members through pay, vacation, perks (ballgame tickets, flexibility for personal appointments etc.) in return for their commitment to me and the company?

Surveys show employees don't quit companies – they quit their boss! A leader, committed to their team members and focused on synthesizing and nurturing these three elements, will improve their odds of keeping good employees producing for their team and their company.
Bernie is an executive coach and business development consultant with 30 years of corporate experience spanning multiple business sectors. His business acumen includes leading sales, marketing, product management and technical services organizations, with companies ranging from entrepreneurial startups to small- and medium business to international enterprises, across industry sectors such as information technology, resources and manufacturing, consulting and engineering services. Bernie is known for his ability to identify and clarify the key issues in situations faced by his clients, and draws on his extensive management and coaching experience to provide a strong leadership performance context to his coaching engagements.

Tuesday, November 29, 2011

What's The Difference Between A Psychologist And A Psychiatrist?

Question: What's the Difference Between a Psychologist and a Psychiatrist?

The question sounds like the setup for a joke, but it's an important difference to understand, whether you are a student of psychology or a consumer searching for a mental health provider. The terms "psychologist" and "psychiatrist" are often used interchangeably to describe anyone who provides therapy services. While psychologists and psychiatrists both conduct psychotherapy and research, there are significant differences between the two professions.

Education, Training, and Credentials

The simplest answer lies in the educational background required for each profession. A psychiatrist has a degree in medicine and a psychologist has a doctoral-level degree in psychology. However, there are a number of other distinctions that make each profession quite unique.

Psychologists receive graduate training in psychology and pursue either a Ph.D. (Doctor of Philosophy) or Psy.D. (Doctor of Psychology) in clinical or counseling psychology. Doctorate programs typically take five to seven years to complete and most states require an additional one or two year long internship in order to gain licensure. Other states require an additional year or two of supervised practice before granting full licensure.

The title of "psychologist" can only be used by an individual who has completed the above education, training, and state licensure. Informal titles such as "counselor" or "therapist" are often used as well, but other mental health care professionals such as licensed social workers can also claim these titles.

Psychiatrists are physicians that have specific training in the assessment, diagnosis, treatment and prevention of mental illnesses. Psychiatrists attend medical school and receive an M.D. After finishing their medical training, they also complete an additional four years of residency training in mental health. In addition to this, some receive additional training in a specific area of interest such as geriatric psychiatry, child and adolescent psychiatry, addictions and other areas.

Prescribing Medications

A second important distinction between the two careers is that psychiatrists can prescribe medications, while in most states psychologists cannot. However, there has been a recent push to grant prescribing powers to psychologists. Some states such as New Mexico and Louisiana now grant prescribing privileges to medical psychologists holding a post-doctoral masters degree or equivalent in clinical psychopharmacology.

Kevin McGuinness, chairman of the Commissioned Corps Mental Health Functional Advisory Group, writes, "For those interested in a career in psychology as a prescriber, it is important to know that certain federal employees and uniformed commissioned officers (Army, Air Force, Public Health Service, Navy, etc.) that are licensed in one state as a medical psychologist may prescribe an any other state to which they are assigned by the federal government."

Which is Better?

If you are considering a career as a therapist, you will need to determine which career path is best for you. Are you interested in conducting psychotherapy, administering psychological tests and conducting research? If so, a career as a psychologist may be the best choice for you.

On the other hand, if you have an interest in medicine and want to be able to prescribe medications to your patients, a career in psychiatry might be your ideal choice.

If you do not want to invest five to eight years in graduate training, consider pursuing a career as a licensed social worker or counselor. These professionals are also qualified to provide mental health services depending up training and experience. Both social work and counseling typically require two or three years of graduate study.

Psychiatric nursing is another great career option for students interested in medicine. Advanced Psychiatric Nurses hold a master's degree or higher in psychiatric-mental health nursing and are able to assess patients, diagnose disorders, provide psychotherapy and prescribe medications.


K.M. McGuinness, personal communication, May 19, 2011.)

Cloud, J. (2010). Psychology vs. Psychiatry: What's the Difference, and Which Is Better? Time.

Richmond, R. L. (n.d.) Psychology and Psychiatry. A Guide to Psychology and Its Practice.

Thanks to Kendra Cherry - About Guide / Psychology About / The New York Times Company


4 Simple Ways to Boost Your Holiday Sales

U.S. consumers are expected to spend 2.8 percent more on holiday gifts this year than they did in 2010, according to the National Retail Federation. But with much of that money destined for big-box stores that offer deep discounts on merchandise, how can your small, independent business make a dent in the market?

Here are four simple ways to boost your holiday sales.

  1. Create custom gift lists. Start your holiday marketing by sending out targeted gift recommendations according to relationships (Mom, Dad, sister, etc.) to your email newsletter subscribers, and posting your suggestions on your website. Carefully curate your recommendations based on the gifts' intended recipients: If you own a jewelry store, might a customer want to buy a pearl necklace for his mother, or a new watch for his brother? Check out Amazon's Gift Central for inspiration. You can also allow web users to create their own wish lists, which they can email to friends and relatives.
  2. Offer free gift-wrap services. Many customers give preference to stores that prioritize customer service. Offering free gift-wrap services adds convenience at a minimal cost to you. Some shopping blogs, such as the OC Register's OC Deals, make lists of stores that offer free gift-wrapping in their area, which can help you draw in additional new customers.
  3. Sell gift cards. If you're not already offering gift cards, now's the time to start. Many holiday shoppers would rather be safe than original — and they opt for gift cards instead of presents. According to the National Retail Federation, 77 percent of shoppers bought at least one gift card last holiday season. Gift cards can be good for retailers' bottom line, too: A 2008 Consumer Reports survey found that approximately $8 billion worth of gift cards purchased during the prior year were never redeemed.
  4. Guarantee on-time delivery. If you run an e-commerce site, it's essential to guarantee that all gift orders arrive at their destinations before Christmas. Now's the time to make sure everything's in stock and to add a holiday shipping timetable to your website that clearly states the purchase deadline in order for gifts to arrive by Dec. 25. Prepare to offer a refund on shipping charges — as well as a store credit, as Best Buy does — on any product that doesn't arrive on time. Or, if the customer prefers, provide a full refund.
Thanks to Kathryn Hawkins / Blog Intuit / Intuit, Inc.

5 Tips For Cleaning Up Your Writing Right Now

Here are five quantitative quick tips about improving your writing functionally, before you even get into improving the quality of your prose:

1. Always Use Serial Commas

The policy of preceding every item in a list but the last one with a comma is commonsensical (read a previous article about the serial comma). Confusion is possible when you don't and highly unlikely when you do. What if, using a non-serial-comma style, you write about more than two things when one of the things consists of more than one part or ingredient? ("The choices are roast beef, turkey, and ham and cheese.") Do you insert a serial comma for clarity (and introduce an inconsistency) or leave the sentence as is for readers to stumble on? Adherence to serial-comma style eliminates the dilemma.

2. Minimize Capitalization

Job titles are capitalized only before names. Names of academic majors aren't capitalized unless they are already proper nouns, like names of languages ("English") or references to regions ("Asian studies"). Generic names of entities ("the hospital," "the organization," and so on) are lowercased. Yes, capitalization is a minefield; when in doubt, look it up, and search on this site for "capitalization" for many articles on the topic (including this one).

3. Repair Comma Splices

A comma alone cannot separate two independent clauses in a sentence. Break the clauses into distinct sentences, or separate them with a semicolon or an em dash — or a comma and a conjunction (and, or, and so on) — but not with a comma alone. For more information on this topic read 5 Ways to Fix the Comma Splice.

4. Omit Extraneous Hyphens, and Insert Necessary Ones

"Decision making," "problem solving," and similar compound nouns require no hyphen, unless they precede a noun as a compound modifier ("decision-making procedure," "problem-solving aptitude"). "Near collision" and other similar constructions don't, either, with the same exception ("near-collision statistics"). Established compound modifiers usually don't require a hyphen even before a noun ("high school student"). Confused? Here's a simple rule: Look it up. (And check out this DailyWritingTips article and find others on the topic by searching on the site for "hyphens.")

5. Limit Displays of Emphasis

Words can be italicized to indicate that they are being used to refer to themselves, not the things they stand for ("Note the word emphasis"), or to signal a foreign term ("Wunderbar" means "wonderful"), or to make sure the reader understands that something is really important. Words can be initial-capped to indicate irony or other humorous intent. ("The rent-a-cop exuded the air of an Authority Figure.") Boldface is appropriate for introducing new vocabulary or otherwise calling attention to an unfamiliar term but is best limited to textbooks and guidebooks. But all-caps are invariably excessive, "scare quotes" are seldom necessary, and be judicious about otherwise calling attention to words and phrases. You can read a previous article on this post titled How to Add Emphasis to Your Writing.

Thanks to Mark Nichol / Daily Writing Tips


Heart Failure Treated 'In The Brain'

ScienceDaily (Mar. 25, 2008) — Beta-blockers heal the heart via the brain when administered during heart failure, according to a new study by UCL (University College London). Up to now, it was thought that beta-blockers work directly on the heart, but the new study shows that the drugs may also act via the brain, suggesting that future therapies to treat cardiovascular disease could be targeting the central nervous system.

Heart failure patients are routinely given beta-blockers, although doctors do not know exactly how these drugs boost cardiac performance and reduce the risk of death. The UCL study, based on the rat model of postmyocardial infarction-induced heart failure and published in the journal Circulation Research, has discovered that the beta-adrenoceptor blocker metoprolol acts directly in the brain to slow the progression of heart failure. The action seems to be localised to a group of brain cells that UCL researchers have identified previously as being crucial in the control of blood pressure and heart rate.

Professor Mike Spyer, UCL Vice-Provost and co-author of the study, says: "Our study shows the importance of the brain in regulating the cardiovascular system. This is often ignored by cardiologists who concentrate on the dynamics of cardiac contraction and the receptors on the heart that influence this, rather than how the nervous innervation of the heart is regulated."

Millions of heart failure patients worldwide are routinely treated with beta-blockers, which were pioneered in the 1970s for the treatment of arterial hypertension and are one of the most important advances in heart failure therapy. However, it has not entirely been clear how long-term treatment with beta-blockers slows the development of heart failure, improves heart function and exercise capacity and reduces the risk of sudden cardiac death.

Dr Alexander Gourine, UCL Department of Neuroscience, Physiology and Pharmacology, says: "Many people have assumed that beta-blockers have a direct salutary influence on the heart, but our findings challenge this view, suggesting that beta-blockers may act directly in the brain and this action could underlie their beneficial effect on the failing heart. This study suggests that novel ways might be found to treat cardiovascular disease aimed at sites within the brain."

Story Source: The above story is reprinted from materials provided by University College London.

Note: Materials may be edited for content and length. For further information, please contact the source cited above.

Thanks to Science Daily

It's Good To Talk: Changing How Nerves Communicate In Congestive Heart Failure

ScienceDaily (Jan. 4, 2010) — A team of researchers, led by Keiichi Fukuda, at Keio University School of Medicine, Tokyo, Japan, has now determined in rodents how congestive heart failure triggers substantive changes to the nerves that control heart function.

The research appears in the Journal of Clinical Investigation.

Heart function is controlled by both the sympathetic nervous system and the parasympathetic nervous system. In congestive heart failure, increased activation of the sympathetic nervous system causes damage to the heart muscle, a decline in heart function, and potentially lethal abnormal heartbeats.

In the study, failing rat heart muscle cells were found to secrete molecules known as gp130-signaling cytokines that caused sympathetic nerves to change the molecule that they used to communicate from norepinephrine to acetylcholine.

The clinical significance of these observations in rodents was highlighted by the fact that the sympathetic nervous system in the heart of patients with congestive heart failure showed evidence of the same switch to reliance on acetylcholine for communication.

Story Source: The above story is reprinted from materials provided by Journal of Clinical Investigation, via EurekAlert!, a service of AAAS.

Note: Materials may be edited for content and length. For further information, please contact the source cited above.

Thanks to Science Daily


Key Area That Could Sever Communication Between Brain And Heart In Disease Identified

ScienceDaily (Nov. 28, 2011) — A team of neuroscientists and anaesthetists, who have been using pioneering techniques to study how the brain regulates the heart, has identified a crucial part of the nervous system whose malfunction may account for an increased risk of death from heart failure. The findings, published online (ahead of print) in the Journal of Physiology, could lead to more targeted therapies to help reduce serious illness and death in cardiovascular disease.

The research team, led by Dr Tony Pickering and Professor Julian Paton from the University of Bristol and colleague Professor Robin McAllen from the Florey Neuroscience Institute in Melbourne, developed novel methods which enabled them to explore the activity of nerve cells as they control the beating heart.

The brain controls the heart through two divisions of the nervous system; parasympathetic (vagal) and sympathetic nerves. One of these nerves, the vagus, acts to slow heart rate as part of protective cardiovascular reflexes, which are vital for cardiac health. A loss of vagal control is a major risk factor in human cardiovascular diseases such as heart failure and hypertension.

Vagal information to the heart is transmitted through a special group of nerve cells that remarkably lie on and within the beating heart muscle. Until now, these important neurons have proved especially difficult to access and record in a system with preserved natural connections. However, academics at the Bristol Heart Institute and Bristol Neuroscience have developed a novel technique that allows the neurons to be held stable while the heart is still beating and their central neural connectivity remains intact.

Using this method the researchers were able to produce high-precision recordings from the cardiac ganglion neurons on the surface of the beating heart whilst retaining their inputs from the nervous system.

The results reveal how these neurons process their inputs and demonstrate that the ganglion plays a key role in regulating the level of vagal tone reaching the heart. This identifies the cardiac ganglion as a site at which the vagal transmission may fail and therefore a potential target for interventions to restore vagal control in cardiovascular diseases.

Dr Pickering, Wellcome Senior Clinical Research Fellow, Reader in Neuroscience and Consultant in Anaesthesia in the University of Bristol's School of Physiology and Pharmacology, said: "These findings are important because they clearly show the cardiac ganglion as a key player in determining the level of vagal tone reaching the heart.

"As loss of vagal tone is found in a number of cardiovascular diseases such as heart failure, following heart attack, in high blood pressure and diabetes, and is associated with poor prognosis and an increased risk of death, our results indicate that therapies targeted at the cardiac ganglion could restore vagal tone and potentially improve outcomes."

Helene Wilson, Research Advisor at the British Heart Foundation (BHF), said: "The vagus nerves are absolutely vital for the control of the speed and regularity of our heart's beat. We don't know a great deal about how the vagus nerves exert this control, and researchers have found it very hard to study it -- partly because of the motion of the heart as it beats. These researchers have now developed a technique to study the processes in an intact vagus nerve which is still attached to heart, and have already helped us understand the process better. New insights into how the vagus nerves transmit their effects on the heart could lead to important new ways to treat patients with diseases such as heart failure, arrhythmias and hypertension."

The study is a result of an international collaboration between the University of Bristol and academics at the Florey Neuroscience Institute in Melbourne. The work is funded by the British Heart Foundation, the Wellcome Trust, and the National Health and Medical Research Council (NHMRC) in Australia.

Story Source: The above story is reprinted from materials provided by University of Bristol.

Note: Materials may be edited for content and length. For further information, please contact the source cited above.

Thanks to Science Daily


Integrated 3-D Imaging Facilitates Human Face Transplantation

By combining conventional medical imaging with some of the same 3-D modeling techniques used in Hollywood blockbusters, researchers are offering new hope to victims of serious facial injuries. (Credit: Image courtesy of Radiological Society of North America)

ScienceDaily (Nov. 28, 2011) — By combining conventional medical imaging with some of the same 3-D modeling techniques used in Hollywood blockbusters, researchers are offering new hope to victims of serious facial injuries.

Results of a new study on human face transplantation, led by Darren M. Smith, M.D., plastic surgery resident at the University of Pittsburgh Medical Center (UPMC), were presented November 28 at the annual meeting of the Radiological Society of North America (RSNA).

Devastating injuries or defects of the face are extremely challenging, if not impossible, to satisfactorily reconstruct by traditional surgical techniques. In face transplantation, facial tissue from a donor is transferred to reconstruct the defect, restore essential life-sustaining functions -- such as breathing, chewing and speaking -- and, above all, reestablish normal human appearance.

"This surgery is for patients with devastating injuries to the face, who have lost their ability to smell, eat and engage socially and have no other conventional treatment options," said Vijay S. Gorantla, M.D., Ph.D., administrative medical director of the Reconstructive Transplantation Program at UPMC.

Clearly defining and understanding the complex tissue deficits and defects that accompany devastating facial injuries like electric burns, blast wounds and accidental trauma are critical for both technical success and objective analysis of the return of function after face transplantation.

Medical imaging plays a major role in the entire spectrum of face transplantation, ranging from patient selection, donor and recipient surgical planning, and postoperative assessment of returning motor and sensory function. Face transplantation is a lengthy, complicated procedure that involves reconstruction of multiple tissues -- such as skin, muscle, blood vessels, nerves and bone -- by a team of surgeons.

Currently, to prepare for facial transplantation, plastic or plaster models are first created based on 3-D CT or angiographic images or reconstruction. Following this, mock cadaveric dissections are performed to allow surgeons to plan for the donor and recipient surgeries. MRI and other imaging exams may also be used to provide supplemental information.

By combining information from multiple imaging exams and creating a sophisticated 3-D computer model, the researchers for this study were better able to assess the facial structure and contours, the underlying bone, muscles, nerves and vessels, as well as the extent of damage.

Using sophisticated computer modeling software, Drs. Smith and Gorantla, along with Joseph Losee, M.D., integrated information from 3-D CT, CT angiography, MRI and high-definition tractography to create a 3-D model of the patient's head and neck anatomy. The same type of modeling technology is often used in movies to animate computer-generated characters with detailed three-dimensional human features and realistic expressions.

"We have integrated data from multiple imaging sources into a single 3-D representation that allows for real-time user interaction and modification," Dr. Smith said. "In assessing eligibility for this procedure, it is critical to understand whether the patient has enough blood vessels and bone structure to support new facial tissue. This 3-D modeling helps us customize the procedure to the patient's individual anatomy so that the donor tissue will fit like a puzzle piece onto the patient's face."

Using computer modeling, the team also overlaid the patient model with a polygon mesh of a generic human face and then customized it to the recipient facial anatomy. Dr. Smith said the ability to manipulate this 3-D facial envelope over the residual face model allows the entire surgical team to participate in planning exactly where bone, blood vessel and nerves will be cut and connected, as well as to evaluate the outcomes of reconstructive transplantation, including nerve regeneration within the transplanted facial tissue.

"The goal of face transplantation is not just structural," Dr. Gorantla said. "It is about restoring function, so that patients are once again able to chew their food, smile and regain the most important aspect of a normal face -- to look human."

Story Source: The above story is reprinted from materials provided by Radiological Society of North America.

Note: Materials may be edited for content and length. For further information, please contact the source cited above.

Thanks to Science Daily


40 Percent Of Youths Attempting Suicide Make First Attempt Before High School, Study Finds

ScienceDaily (Nov. 28, 2011) — Thoughts about killing oneself and engaging in suicidal behavior may begin much younger than previously thought. While about one of nine youths attempt suicide by the time they graduate from high school, new findings reveal that a significant proportion make their first suicide attempt in elementary or middle school.

In a study published in the November issue of the Journal of Adolescent Health, nearly 40 percent of young adults who said they had tried suicide said that they made their first attempt before entering high school.

The researchers also found that suicide attempts during childhood and adolescence were linked to higher scores of depression at the time of the attempts, validating for the first time that young adults can reliably recall when they first attempted suicide.

"Young adults who end up having chronic mental health problems show their struggles early," said James Mazza, lead author and professor of educational psychology at the University of Washington. "This study suggests that implementation of mental health programs may need to start in elementary and middle schools, and that youth in these grades are fairly good reporters of their own mental health."

Adolescence can often be a struggle for some youth with ongoing pressures of drugs, alcohol, sexual relationships and sexual orientation. At the same time, they're becoming more autonomous.

"Adolescence is a time when kids are preparing to be more independent from their parents or guardians, but lack the experience of how to do this," said Mazza, a school psychologist. "And their support network -- their friends -- doesn't have the experience either, especially in crisis situations."

As part of an ongoing survey, Mazza and his collaborators asked 883 young adults aged 18 or 19 about their history of suicide attempts. Seventy-eight respondents, nearly 9 percent, said that they had tried suicide at some point.

Suicide attempt rates showed a sharp increase around sixth grade, about age 12, with rates peaking around eighth or ninth grade. For the 39 respondents reporting multiple suicide attempts, their first attempt was significantly earlier -- as young as 9 -- than those making a single attempt.

Mazza compared the young adults' recollection of their suicide attempts with their past depression scores, which were collected yearly as part of their participation in the Raising Healthy Children project led by Richard Catalano, professor of social work and the director of UW's Social Developmental Research Group.

Depression levels were higher at the time of the youths' reported first suicide attempts compared with their peers who had not attempted suicide. And Mazza found an increase in depression scores at the time of the attempt compared with depression scores the year before and after the attempt for the same child.

"This suggests that kids are able to tell us, by their depression scores, that things aren't going well for them," Mazza said. "We're likely not giving kids enough credence in assessing their own mental health, and this study shows that we can rely on self-report measures to help identify youth who may be at risk for current mental health concerns, including possible suicidal behavior."

The National Institute on Drug Abuse funded the study. Other co-authors are Robert Abbott, UW educational psychology professor; and Richard Catalano, director, and Kevin Haggerty, assistant director, of UW's Social Developmental Research Group.

Story Source: The above story is reprinted from materials provided by University of Washington. The original article was written by Molly McElroy, News and Information.

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Depression Can Lead To Heart Disease, Study Suggests

ScienceDaily (Nov. 28, 2011) — Depression may have more far-reaching consequences than previously believed. Recent data suggests that individuals who suffer from a mood disorder could be twice as likely to have a heart attack compared to individuals who are not depressed.

This process has been poorly understood -- until now. A new study led by Concordia University has found that depressed individuals have a slower recovery time after exercise compared to those who are non-depressed.

These findings suggest that a dysfunctional biological stress system is at play among depressed individuals. Published in the journal Psychophysiology, the research warns of the importance of testing for cardiovascular disease among people suffering from major depression.

"There have been two competing theories as to why depression is linked to cardiovascular disease," says first author Jennifer Gordon, who is a PhD candidate at McGill University. "Depressed people may have poorer health behaviors, which may in turn lead to heart problems. The other possibility is physiological: a problem with the stress system known as the fight or flight response. Our study was the first to examine the role of a dysfunctional fight or flight response in depression in a large population."

Heart rate recovery is a powerful diagnostic tool

A total of 886 participants, who were on average 60 years old, took part in the study conducted by Concordia in association with the Montreal Heart Institute, McGill University, the Hôpital Sacré-Coeur de Montréal, the Université du Québec à Montréal and the University of Calgary.

Approximately 5 per cent of participants were diagnosed with a major depressive disorder. All individuals were asked to undergo a stress test after which their heart rate and blood pressure were recorded. Recovery heart rates and blood pressure levels were compared between depressed and non-depressed individuals.

"We found that it took longer for the heart rate of depressed individuals to return to normal," says senior author, Simon Bacon, a professor in the Concordia University Department of Exercise Science and a researcher at the Montreal Heart Institute. "Heart rate recovery from exercise is one way to measure the fight or flight stress response. The delayed ability to establish a normal heart rate in the depressed individuals indicates a dysfunctional stress response. We believe that this dysfunction, can contribute to their increased risk for heart disease."

"The take-home message of this study is that health care professionals should not only address the mental disorder, but also the potential for heart disease in patients who are suffering from major depression," adds Bacon. "Both of these health issues should be treated to minimize risk of severe consequences."

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Study Looks At The Nature Of Change In Our Aging, Changing Brains

ScienceDaily (Nov. 28, 2011) — As we get older, our cognitive abilities change, improving when we're younger and declining as we age. Scientists posit a hierarchical structure within which these abilities are organized. There's the "lowest" level -- measured by specific tests, such as story memory or word memory; the second level, which groups various skills involved in a category of cognitive ability, such as memory, perceptual speed, or reasoning; and finally, the "general," or G, factor, a sort of statistical aggregate of all the thinking abilities.

What happens to this structure as we age? That was the question Timothy A. Salthouse, Brown-Forman professor of psychology at the University of Virginia, investigated in a new study appearing in an upcoming issue of Psychological Science, a journal published by the Association for Psychological Science. His findings advance psychologists' understanding of the complexities of the aging brain.

"There are three hypotheses about how this works," says Salthouse. "One is that abilities become more strongly integrated with one another as we age." That theory suggests the general factor influences cognitive aging the most. The second -- based on the idea that connectivity among different brain regions lessens with age -- "is almost the opposite: that the changes in cognitive abilities become more rather than less independent with age." The third was Salthouse's hypothesis: The structure remains constant throughout the aging process.

Using a sample of 1,490 healthy adults ages 18 to 89, Salthouse performed analyses of the scores on 16 tests of five cognitive abilities -- vocabulary, reasoning, spatial relations, memory, and perceptual speed. The primary analyses were on the changes in the test scores across an interval of about two and a half years.

The findings confirmed Salthouse's hunch: "The effects of aging on memory, on reasoning, on spatial relations, and so on are not necessarily constant. But the structure within which these changes are occurring does not seem to change as a function of age." In normal, healthy people, "the direction and magnitude of change may be different" when we're 18 or 88, he says. "But it appears that the qualitative nature of cognitive change remains the same throughout adulthood."

The study could inform other research investigating "what allows some people to age more gracefully than others," says Salthouse. That is, do people who stay mentally sharper maintain their ability structures better than those who become more forgetful or less agile at reasoning? And in the future, applying what we know about the structures of change could enhance "interventions that we think will improve cognitive functioning" at any age or stage of life.

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How The Brain Strings Words Into Sentences

Using magnetic resonance imaging of the brain, researchers can visualize the two main language processing regions, Broca's region (yellow) and Wernicke's region (purple). (Credit: Stephen Wilson)

ScienceDaily (Nov. 28, 2011) — Distinct neural pathways are important for different aspects of language processing, researchers have discovered, studying patients with language impairments caused by neurodegenerative diseases.

While it has long been recognized that certain areas in the brain's left hemisphere enable us to understand and produce language, scientists are still figuring out exactly how those areas divvy up the highly complex processes necessary to comprehend and produce language.

Advances in brain imaging made within the last 10 years have revealed that highly complex cognitive tasks such as language processing rely not only on particular regions of the cerebral cortex, but also on the white matter fiber pathways that connect them.

"With this new technology, scientists started to realize that in the language network, there are a lot more connecting pathways than we originally thought," said Stephen Wilson, who recently joined the University of Arizona's department of speech, language and hearing sciences as an assistant professor. "They are likely to have different functions because the brain is not just a homogeneous conglomerate of cells, but there hasn't been a lot of evidence as to what kind of information is carried on the different pathways."

Working in collaboration with his colleagues at the UA, the department of neurology at the University of California, San Francisco and the Scientific Institute and University Hospital San Raffaele in Milan, Italy, Wilson discovered that not only are the connecting pathways important for language processing, but they specialize in different tasks.

Two brain areas called Broca's region and Wernicke's region serve as the main computing hubs underlying language processing, with dense bundles of nerve fibers linking the two, much like fiber optic cables connecting computer servers. But while it was known that Broca's and Wernicke's region are connected by upper and a lower white matter pathways, most research had focused on the nerve cells clustered inside the two language-processing regions themselves.

Working with patients suffering from language impairments because of a variety of neurodegenerative diseases, Wilsons' team used brain imaging and language tests to disentangle the roles played by the two pathways. Their findings are published in a recent issue of the scientific journal Neuron.

"If you have damage to the lower pathway, you have damage to the lexicon and semantics," Wilson said. "You forget the name of things, you forget the meaning of words. But surprisingly, you're extremely good at constructing sentences."

"With damage to the upper pathway, the opposite is true; patients name things quite well, they know the words, they can understand them, they can remember them, but when it comes to figuring out the meaning of a complex sentence, they are going to fail."

The study marks the first time it has been shown that upper and lower tracts play distinct functional roles in language processing, the authors write. Only the upper pathway plays a critical role in syntactic processing.

Wilson collected the data while he was a postdoctoral fellow working with patients with neurodegenerative diseases of varying severity, recruited through the Memory and Aging Center at UCSF. The study included 15 men and 12 women around the age of 66.

Unlike many other studies investigating acquired language disorders, which are called aphasias and usually caused by damage to the brain, Wilson's team had a unique opportunity to study patients with very specific and variable degrees of brain damage.

"Most aphasias are caused by strokes, and most of the strokes that affect language regions probably would affect both pathways," Wilson said. "In contrast, the patients with progressive aphasias who we worked with had very rare and very specific neurodegenerative diseases that selectively target different brain regions, allowing us to tease apart the contributions of the two pathways."

To find out which of the two nerve fiber bundles does what in language processing, the team combined magnetic resonance brain imaging technology to visualize damaged areas and language assessment tasks testing the participants' ability to comprehend and produce sentences.

"We would give the study participants a brief scenario and ask them to complete it with what comes naturally," Wilson said. "For example, if I said to you, 'A man was walking along the railway tracks. He didn't hear the train coming. What happened to the man?' Usually, you would say, 'He was hit by the train,' or something along those lines."

"But a patient with damage to the upper pathway might say something like 'train, man, hit.' We found that the lower pathway has a completely different function, which is in the meaning of single words."

To test for comprehension of the meaning of a sentence, the researchers presented the patient with a sentence like, "The girl who is pushing the boy is green," and then ask which of the two pictures depicted that scenario accurately.

"One picture would show a green girl pushing a boy, and the other would show a girl pushing a green boy," Wilson said. "The colors will be the same, the agents will be the same, and the action is the same. The only difference is, which actor does the color apply to?"

"Those who have only lower pathway damage do really well on this, which shows that damage to that pathway doesn't interfere with your ability to use the little function words or the functional endings on words to figure out the relationships between the words in a sentence."

Wilson said that most previous studies linking neurodegeneration of specific regions with cognitive deficits have focused on damage to gray matter, rather than the white matter that connects regions to one another.

"Our study shows that the deficits in the ability to process sentences are above and beyond anything that could be explained by gray matter loss alone," Wilson added. "It is the first study to show that damage to one major pathway more than then other major pathway is associated with a specific deficit in one aspect of language."

The study was primarily funded by grants from the National Institutes of Health and included the following co-authors: Sebastian Galantucci, Maria Carmela Tartaglia, Kindle Rising, Dianne Patterson (both at the UA's department of speech, language and hearing sciences), Maya Henry, Jennifer Ogar, Jessica DeLeon, Bruce Miller and Maria Luisa Gorno-Tempini.

Story Source: The above story is reprinted from materials provided by University of Arizona. The original article was written by Daniel Stolte, University Communications.

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