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\"As Horn relates her funny and profound experiences as a choir member [of the Choral Society of Grace Church in New York], she treats us to an eclectic history of group singing and the music that moves us--whether we're hearing it for the first time or the hundredth--, the dramatic stories of conductors and composers, and discoveries from the new science of singing, including the remarkable physical benefits of song\"--Amazon.com.

In this randomized trial of deep-brain stimulation targeted to either the globus pallidus interna or the subthalamic nucleus in patients with advanced Parkinson's disease, the patients assigned to pallidal stimulation and those assigned to subthalamic stimulation had a similar improvement in motor function. In this trial of deep-brain stimulation targeted to either the globus pallidus interna or the subthalamic nucleus in patients with advanced Parkinson's disease, the patients assigned to pallidal stimulation and those assigned to subthalamic stimulation had a similar improvement in motor function. Randomized studies have shown that treatment with deep-brain stimulation, which involves the surgical implantation of a device that sends electrical impulses to specific parts of the brain, is superior to medical therapy for improving motor function and quality of life for patients with advanced Parkinson's disease. 1 , 2 The globus pallidus interna and the subthalamic nucleus are both accepted targets for deep-brain stimulation. The subthalamic nucleus is used more commonly as the target, despite the lack of evidence showing that neurostimulation of this target provides a better outcome. Our multicenter, randomized, blinded trial, called the Veterans Affairs Cooperative Studies Program (CSP) . . .

\"It's now known as New York City's Roosevelt Island. Originally called Blackwell's Island, it housed a lunatic asylum, prison, hospital, workhouse, and almshouse in the 19th century. This book re-creates what daily life was like on the island, what politics shaped it, and what constituted therapy and charity in the nineteenth century\"-- Provided by publisher.

The effects of constant-current deep brain stimulation (DBS) have not been studied in controlled trials in patients with Parkinson's disease. We aimed to assess the safety and efficacy of bilateral constant-current DBS of the subthalamic nucleus. This prospective, randomised, multicentre controlled trial was done between Sept 26, 2005, and Aug 13, 2010, at 15 clinical sites specialising in movement disorders in the USA. Patients were eligible if they were aged 18–80 years, had Parkinson's disease for 5 years or more, and had either 6 h or more daily off time reported in a patient diary of moderate to severe dyskinesia during waking hours. The patients received bilateral implantation in the subthalamic nucleus of a constant-current DBS device. After implantation, computer-generated randomisation was done with a block size of four, and patients were randomly assigned to the stimulation or control group (stimulation:control ratio 3:1). The control group received implantation without activation for 3 months. No blinding occurred during this study, and both patients and investigators were aware of the treatment group. The primary outcome variable was the change in on time without bothersome dyskinesia (ie, good quality on time) at 3 months as recorded in patients' diaries. Patients were followed up for 1 year. This trial is registered with ClinicalTrials.gov, number NCT00552474. Of 168 patients assessed for eligibility, 136 had implantation of the constant-current device and were randomly assigned to receive immediate (101 patients) or delayed (35 patients) stimulation. Both study groups reported a mean increase of good quality on time after 3 months, and the increase was greater in the stimulation group (4·27 h vs 1·77 h, difference 2·51 [95% CI 0·87–4·16]; p=0·003). Unified Parkinson's disease rating scale motor scores in the off-medication, on-stimulation condition improved by 39% from baseline (24·8 vs 40·8). Some serious adverse events occurred after DBS implantation, including infections in five (4%) of 136 patients and intracranial haemorrhage in four (3%) patients. Stimulation of the subthalamic nucleus was associated with dysarthria, fatigue, paraesthesias, and oedema, whereas gait problems, disequilibrium, dyskinesia, and falls were reported in both groups. Constant-current DBS of the subthalamic nucleus produced significant improvements in good quality on time when compared with a control group without stimulation. Future trials should compare the effects of constant-current DBS with those of voltage-controlled stimulation. St Jude Medical Neuromodulation Division.

Background Deep brain stimulation (DBS) improves motor symptoms in Parkinson's disease (PD), but questions remain regarding neuropsychological decrements sometimes associated with this treatment, including rates of statistically and clinically meaningful change, and whether there are differences in outcome related to surgical target. Methods Neuropsychological functioning was assessed in patients with Parkinson's disease (PD) at baseline and after 6 months in a prospective, randomised, controlled study comparing best medical therapy (BMT, n=116) and bilateral deep brain stimulation (DBS, n=164) at either the subthalamic nucleus (STN, n=84) or globus pallidus interna (GPi, n=80), using standardised neuropsychological tests. Measures of functional outcomes were also administered. Results Comparison of the two DBS targets revealed few significant group differences. STN DBS was associated with greater mean reductions on some measures of processing speed, only one of which was statistically significant in comparison with stimulation of GPi. GPi DBS was associated with lower mean performance on one measure of learning and memory that requires mental control and cognitive flexibility. Compared to the group receiving BMT, the combined DBS group had significantly greater mean reductions at 6-month follow-up in performance on multiple measures of processing speed and working memory. After calculating thresholds for statistically reliable change from data obtained from the BMT group, the combined DBS group also displayed higher rates of decline in neuropsychological test performance. Among study completers, 18 (11%) study participants receiving DBS displayed reliable decline by multiple indicators in two or more cognitive domains, a significantly higher rate than in the BMT group (3%). This multi-domain cognitive decline was associated with less beneficial change in subjective ratings of everyday functioning and quality of life (QOL). The multi-domain cognitive decline group continued to function at a lower level at 24-month follow-up. Conclusions In those with PD, the likelihood of significant decline in neuropsychological functioning increases with DBS, affecting a small minority of patients who also appear to respond less optimally to DBS by other indicators of QOL. Trial registration number NCT00056563 and NCT01076452.

Computer technology can significantly affect the work of counselors in the areas of information retrieval and dissemination, distance learning, college and career exploration, and training and supervision. This article focuses on different ways school counselors can utilize computer technology to work more efficiently and help students succeed. (Contains 26 references.) (GCP)

A computer training intervention for certified school counselors in elementary, middle, and high schools was evaluated for its effects on general self-efficacy, as well as computer skills, knowledge, and attitudes. The intervention was delivered to 72 school counselors working in public schools in Orlando, Florida. The training workshop served as the treatment intervention to teach counselors how to implement computer skills, such as using electronic mail, searching the Internet, developing Power Point presentations, and creating Web page designs. Further, this intervention attempted to improve attitudes regarding computer technology and the self-efficacy of school counselors. Hypotheses were tested based on data derived from a pretest-posttest control group design. A quasi-experimental design was used with pre and post measures of self-efficacy (The Self-efficacy Scale-General subscale), computer knowledge and skills (The School Counselor Computer Competency Scale), and attitudes (Attitudes Toward Computer Technologies). Subjects participated in one of two experimental groups. One (E1) was a treatment group and participants took part in a one-day workshop and the second (E2) served as the control group. The primary analysis conducted to determine if a difference existed between the treatment and control groups used a 2 (Group) x 5 (Factors) MANOVA utilizing the Wilks Lambda test statistic. A criterion p-value of .05 was used to determine the overall significance of the test. Given the significant multivariate test, each of the dependent variables was analyzed using a univariate t-test to determine on which of these variables the groups significantly differed. Results indicated that the school counseling training intervention showed significant differences in computer knowledge, skills, and comfort anxiety levels after participants experienced the treatment intervention. However, it was not effective in changing school counselors' perception of self-efficacy or perceptions of the usefulness of computer technologies. The results from this study play a part in adding information to the limited data available on school counselors and the impact of computer technology. Technology is constantly changing and there are new computer advances every year. The key is to find practical ways for school counselors to utilize these advancements to create more efficient and effective school guidance programs.

We don't know how many white collar crimes have been committed or how many arrests have been made in connection with those crimes. If you call the state attorney general's office, the F.B.I. or the Securities and Exchange Commission, no one will be able to tell you how many white collar crimes were committed in any year, or provide any arrest statistics. The investigators there could be doing a great job, but they might also be concentrating on a few, select cases for years, letting countless others go by. In order for such a reporting system to work, however, every state and federal agency investigating white collar crime needs to submit information about these crimes. And of course, we would need to establish what exactly constitutes a white collar crime. Congress enacted the National Hate Crimes Statistics Act in 1990 requiring the Justice Department to gather information on crimes based on race, religion, sexual orientation or ethnicity; perhaps a similar mandate could be passed for white collar crime. Don't get me wrong, murder is horrifying, and it's right to hold murderers and the police departments investigating them accountable. But unlike many murderers sitting in prison for life, these gentleman bandits, these intelligent, educated men and women who slowly and methodically plan the crimes that wreck the future of untold numbers of people, know exactly what they are doing and who will be hurt. Their crimes of cold, selfish greed reflect, in their own way, even more indifference to life than murder.

THIS week, Bernard Ebbers, the former chairman and founder of WorldCom, was sentenced to 25 years in prison for his role in an...