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Luft JG, Popik B, Gonçalves DA, Cruz FC, de Oliveira Alvares L. Distinct engrams control fear and extinction memory. Hippocampus 2024. [PMID: 38396226 DOI: 10.1002/hipo.23601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Revised: 12/06/2023] [Accepted: 02/04/2024] [Indexed: 02/25/2024]
Abstract
Memories are stored in engram cells, which are necessary and sufficient for memory recall. Recalling a memory might undergo reconsolidation or extinction. It has been suggested that the original memory engram is reactivated during reconsolidation so that memory can be updated. Conversely, during extinction training, a new memory is formed that suppresses the original engram. Nonetheless, it is unknown whether extinction creates a new engram or modifies the original fear engram. In this study, we utilized the Daun02 procedure, which uses c-Fos-lacZ rats to induce apoptosis of strongly activated neurons and examine whether a new memory trace emerges as a result of a short or long reactivation, or if these processes rely on modifications within the original engram located in the basolateral amygdala (BLA) and infralimbic (IL) cortex. By eliminating neurons activated during consolidation and reactivation, we observed significant impacts on fear memory, highlighting the importance of the BLA engram in these processes. Although we were unable to show any impact when removing the neurons activated after the test of a previously extinguished memory in the BLA, disrupting the IL extinction engram reactivated the aversive memory that was suppressed by the extinction memory. Thus, we demonstrated that the IL cortex plays a crucial role in the network involved in extinction, and disrupting this specific node alone is sufficient to impair extinction behavior. Additionally, our findings indicate that extinction memories rely on the formation of a new memory, supporting the theory that extinction memories rely on the formation of a new memory, whereas the reconsolidation process reactivates the same original memory trace.
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Affiliation(s)
- Jordana Griebler Luft
- Laboratório de Neurobiologia da Memória, Departamento de Biofísica, Instituto de Biociências, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Bruno Popik
- Laboratório de Neurobiologia da Memória, Departamento de Biofísica, Instituto de Biociências, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Débora Aguirre Gonçalves
- Laboratório de Neurobiologia da Memória, Departamento de Biofísica, Instituto de Biociências, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Fabio Cardoso Cruz
- Departamento de Farmacologia, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Lucas de Oliveira Alvares
- Laboratório de Neurobiologia da Memória, Departamento de Biofísica, Instituto de Biociências, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
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Manning L, Morris W, Birchmore I. Organizational unlearning: A risky food safety strategy? Compr Rev Food Sci Food Saf 2023; 22:1633-1653. [PMID: 36965177 DOI: 10.1111/1541-4337.13124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Revised: 01/26/2023] [Accepted: 01/29/2023] [Indexed: 03/27/2023]
Abstract
Strategically unlearning specific knowledge, behaviors, and practices facilitates product and process innovation, business model evolution, and new market opportunities and is essential to meet emergent supply chain and customer requirements. Indeed, addressing societal concerns such as climate change and net zero means elements of contemporary practice in food supply chains need to be unlearned to ensure new practices are adopted. However, unlearning is a risky process if crucial knowledge is lost, for example, if knowledge is situated in the supply base not the organization itself, or there is insufficient organizational food safety knowledge generation, curation, and management when new practices/processes are designed and implemented. An exploratory, critical review of management and food safety academic and gray literature is undertaken that aims to consider the cycle of unlearning, learning, and relearning in food organizations and supply chains with particular emphasis on organizational innovation, inertia, and the impact on food safety management systems and food safety performance. Findings demonstrate it is critical with food safety practices, such as duration date coding or refrigeration practices, that organizations "unlearn" in a way that does not increase organizational, food safety, or public health risk. This paper contributes to extant literature by highlighting the organizational vulnerabilities that can arise when strategically unlearning to promote sustainability in a food supply context. Mitigating such organizational, food safety, and public health risk means organizations must simultaneously drive unlearning, learning, and relearning as a dynamic integrated knowledge acquisition and management approach. The research implications are of value to academics, business managers, and wider industry.
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Affiliation(s)
- Louise Manning
- Lincoln Institute for Agri-food Technology, University of Lincoln, Lincoln, UK
| | - Wyn Morris
- Aberystwyth University, Hugh Owen Building, Penglais Campus, Aberystwyth, Ceredigion, SY23 3DY, UK
| | - Ian Birchmore
- Aberystwyth University, Hugh Owen Building, Penglais Campus, Aberystwyth, Ceredigion, SY23 3DY, UK
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Ohta R, Ryu Y, Sano C. Family Medicine Education at a Rural Hospital in Japan: Impact on Institution and Trainees. Int J Environ Res Public Health 2021; 18:6122. [PMID: 34204070 DOI: 10.3390/ijerph18116122] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Revised: 05/21/2021] [Accepted: 06/04/2021] [Indexed: 11/21/2022]
Abstract
Family medicine is vital in Japan as its society ages, especially in rural areas. However, the implementation of family medicine educational systems has an impact on medical institutions and requires effective communication with stakeholders. This research—based on a mixed-method study—clarifies the changes in a rural hospital and its medical trainees achieved by implementing the family medicine educational curriculum. The quantitative aspect measured the scope of practice and the change in the clinical performance of family medicine trainees through their experience of cases—categorized according to the 10th revision of the International Statistical Classification of Disease and Related Health Problems. During the one-year training program, the trainees’ scope of practice expanded significantly in both outpatient and inpatient departments. The qualitative aspect used the grounded theory approach—observations, a focus group, and one-on-one interviews. Three themes emerged during the analysis—conflicts with the past, driving unlearning, and organizational change. Implementing family medicine education in rural community hospitals can improve trainees’ experiences as family physicians. To ensure the continuity of family medicine education, and to overcome conflicts caused by system and culture changes, methods for the moderation of conflicts and effective unlearning should be promoted in community hospitals.
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Petit KM, Covassin T. College Athletic Trainers' Perceptions of Rest and Physical Activity When Managing Athletes With a Sport-Related Concussion. J Sport Rehabil 2020; 30:395-400. [PMID: 32736343 DOI: 10.1123/jsr.2019-0084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2019] [Revised: 04/09/2020] [Accepted: 05/08/2020] [Indexed: 11/18/2022]
Abstract
CONTEXT Cognitive and physical rest are commonly utilized when managing a sport-related concussion (SRC); however, emerging research now suggests that excessive rest may negatively impact recovery. Despite current research recommendations, athletic trainers (ATs) may be behind in implementing this emerging research into clinical practice. OBJECTIVE To assess college ATs' perceptions and implementation of an emerging SRC management approach (cognitive and physical rest and activity). DESIGN Cross-sectional study. SETTING Survey. PARTICIPANTS A total of 122 (11.8%) ATs (53.3% female; 10.8 [9.8] y experience; 8.7 [6.9] SRCs managed annually) responded to the survey, which was randomly distributed to 1000 members of the National Athletic Trainers' Association, as well as 31 additional ATs from varying universities. MAIN OUTCOME MEASURES A 5-point Likert scale assessed the ATs' perceptions and clinical practices as they relate to specific athlete behaviors (ie, texting, sleeping). The ATs were asked about their willingness to incorporate physical activity into clinical practice. RESULTS Playing video games (95.9%) and practicing (93.4%) were the activities most perceived to extend SRC recovery. However, sleeping more than usual (7.4%) and increased time in a dark environment (11.5%) were viewed as less likely to extend recovery. ATs restricted practicing (98.4%) and working out (91.8%) for athletes with SRC, while sleeping more than usual (6.6%) and increased time in a dark environment (13.1%) were less restricted. About 71% of the ATs would implement light physical activity for athletes with a symptom score of 1 to 5, 31% with scores of 6 to 10, and 15% with scores of 11 to 20. About 43%, 74%, and 97% believe that light, moderate, and vigorous physical activity, while symptomatic, will extend recovery, respectively. CONCLUSIONS The ATs were receptive to including light physical activity into their SRC management, although only in certain situations. However, most ATs' beliefs and clinical practices did not completely align with emerging research recommendations for the management of SRCs.
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Yamaguchi T, Sakai I. The unlearning process of senior clinical nurses in rehabilitation wards. J Adv Nurs 2019; 75:2659-2672. [PMID: 31115087 PMCID: PMC6899509 DOI: 10.1111/jan.14050] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2018] [Revised: 02/20/2019] [Accepted: 03/12/2019] [Indexed: 11/25/2022]
Abstract
Aims The aim of this study was to create a model and verify its fitness for focusing on unlearning of senior clinical nurses who transferred from acute to rehabilitation wards. Background The processes by which nurses with experience in acute wards acquire expertise in rehabilitation wards, the ‘process of unlearning’, have not yet been clarified. Design This research used a cross‐sectional study. Methods Content analysis of interview data of 23 senior clinical nurses was used to reveal factors constituting nurses’ unlearning and a base model was created. Data were collected between May ‐ September 2016. For its verification, categories extracted through content analysis were used as latent variables and subcategories as observation variables. The model's fit was confirmed through a survey of 5,435 senior clinical nurses from July to September 2017. Results We extracted six categories—‘awareness’, ‘conflict’, ‘discard’, ‘acquisition’, ‘acceptance’ and ‘establishment’—and 22 subcategories of the factors constituting unlearning and created a base model. The effective response rate in the survey for verifying the fitness of the base model was 20.2%. The base model generally fulfilled the fitness, but we further studied the model fit with the data and modified it to comprise five categories, excluding ‘acceptance’, with 16 subcategories. The fitness of the modified model further improved. Through revalidation, we confirmed that the modified model satisfies the goodness of fit. Conclusion Our findings add to the development of rehabilitation nursing skills of nurses transferred from acute to rehabilitation wards in a Japanese community‐based integrated care system. Impact This study revealed the unlearning process of senior clinical nurses. The unlearning process identified in this study contributes to knowledge and skills acquisition specific to nurses specializing in rehabilitation. It will be used for developing a re‐education programme for rehabilitation nurses in the future.
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Affiliation(s)
- Tae Yamaguchi
- Department of Nursing, Faculty of Nursing and Nutrition, University of Nagasaki, Nagasaki, Japan
| | - Ikuko Sakai
- Graduate School of Nursing, Chiba University, Chiba, Japan
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Helfrich CD, Rose AJ, Hartmann CW, van Bodegom-Vos L, Graham ID, Wood SJ, Majerczyk BR, Good CB, Pogach LM, Ball SL, Au DH, Aron DC. How the dual process model of human cognition can inform efforts to de-implement ineffective and harmful clinical practices: A preliminary model of unlearning and substitution. J Eval Clin Pract 2018; 24:198-205. [PMID: 29314508 PMCID: PMC5900912 DOI: 10.1111/jep.12855] [Citation(s) in RCA: 69] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2017] [Revised: 11/02/2017] [Accepted: 11/03/2017] [Indexed: 11/29/2022]
Abstract
RATIONALE AND OBJECTIVES One way to understand medical overuse at the clinician level is in terms of clinical decision-making processes that are normally adaptive but become maladaptive. In psychology, dual process models of cognition propose 2 decision-making processes. Reflective cognition is a conscious process of evaluating options based on some combination of utility, risk, capabilities, and/or social influences. Automatic cognition is a largely unconscious process occurring in response to environmental or emotive cues based on previously learned, ingrained heuristics. De-implementation strategies directed at clinicians may be conceptualized as corresponding to cognition: (1) a process of unlearning based on reflective cognition and (2) a process of substitution based on automatic cognition. RESULTS We define unlearning as a process in which clinicians consciously change their knowledge, beliefs, and intentions about an ineffective practice and alter their behaviour accordingly. Unlearning has been described as "the questioning of established knowledge, habits, beliefs and assumptions as a prerequisite to identifying inappropriate or obsolete knowledge underpinning and/or embedded in existing practices and routines." We hypothesize that as an unintended consequence of unlearning strategies clinicians may experience "reactance," ie, feel their professional prerogative is being violated and, consequently, increase their commitment to the ineffective practice. We define substitution as replacing the ineffective practice with one or more alternatives. A substitute is a specific alternative action or decision that either precludes the ineffective practice or makes it less likely to occur. Both approaches may work independently, eg, a substitute could displace an ineffective practice without changing clinicians' knowledge, and unlearning could occur even if no alternative exists. For some clinical practice, unlearning and substitution strategies may be most effectively used together. CONCLUSIONS By taking into account the dual process model of cognition, we may be able to design de-implementation strategies matched to clinicians' decision-making processes and avoid unintended consequence.
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Affiliation(s)
- Christian D Helfrich
- VA Puget Sound Health Care System, Department of Veterans Affairs, Seattle, USA.,Department of Health Services, University of Washington School of Public Health, Seattle, USA
| | - Adam J Rose
- Section of General Internal Medicine, Department of Medicine, Boston University School of Medicine, Boston, USA
| | - Christine W Hartmann
- Center for Healthcare Organization and Implementation Research (CHOIR) Bedford VA Medical Center, Bedford, USA.,Boston University School of Public Health, Boston, USA
| | - Leti van Bodegom-Vos
- Department of Medical Decision Making, Leiden University Medical Center, Leiden, The Netherlands
| | - Ian D Graham
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Canada.,Centre for Practice-Changing Research, Ottawa Hospital Research Institute, Ottawa, Canada
| | - Suzanne J Wood
- Graduate Program in Health Services Administration, Department of Health Sciences, School of Public Health, University of Washington, Seattle, USA
| | - Barbara R Majerczyk
- VA Puget Sound Health Care System, Department of Veterans Affairs, Seattle, USA
| | - Chester B Good
- Center for Health Equity Research and Promotion, VA Pittsburgh healthcare System, Department of Veterans Affairs, Pittsburgh, USA.,Medical Advisory Panel for Pharmacy Benefits Management, Department of Veterans Affairs, Washington, USA.,University of Pittsburgh School of Medicine, Pittsburgh, USA
| | - Leonard M Pogach
- Office of Specialty Care, Veterans Health Administration, Washington, USA.,VA New Jersey Health Care System, East Orange, USA
| | - Sherry L Ball
- Louis Stokes Cleveland VA Medical Center, Department of Veterans Affairs, Cleveland, USA
| | - David H Au
- VA Puget Sound Health Care System, Department of Veterans Affairs, Seattle, USA.,Division of Pulmonary and Critical Care Medicine, Department of Medicine, University of Washington, Seattle, USA
| | - David C Aron
- Department of Medicine, Louis Stokes Cleveland VA Medical Center, Cleveland, USA.,Division of Clinical and Molecular Endocrinology and Adjunct Professor Dept. of Organizational Behavior, Weatherhead School of Management, Case Western Reserve University, Cleveland, USA
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Kitago T, Ryan SL, Mazzoni P, Krakauer JW, Haith AM. Unlearning versus savings in visuomotor adaptation: comparing effects of washout, passage of time, and removal of errors on motor memory. Front Hum Neurosci 2013; 7:307. [PMID: 23874277 PMCID: PMC3711055 DOI: 10.3389/fnhum.2013.00307] [Citation(s) in RCA: 79] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2013] [Accepted: 06/08/2013] [Indexed: 11/23/2022] Open
Abstract
Humans are able to rapidly adapt their movements when a visuomotor or other systematic perturbation is imposed. However, the adaptation is forgotten or unlearned equally rapidly once the perturbation is removed. The ultimate cause of this unlearning remains poorly understood. Unlearning is often considered to be a passive process due to inability to retain an internal model. However, we have recently suggested that it may instead be a process of reversion to habit, without necessarily any forgetting per se. We compared the timecourse and nature of unlearning across a variety of protocols where unlearning is known to occur: error-clamp trials, removal of visual feedback, removal of the perturbation, or simply a period of inactivity. We found that, in agreement with mathematical models, there was no significant difference in the rate of decay between subject who experienced zero-error clamp trials, and subjects who made movements with no visual feedback. Time alone did lead to partial unlearning (over the duration we tested), but the amount of unlearning was inconsistent across subjects. Upon re-exposure to the same perturbation, subjects who unlearned through time or by reverting to veridical feedback exhibited savings. By contrast, no savings was observed in subjects who unlearned by having visual feedback removed or by being placed in a series of error-clamp trials. Thus although these various forms of unlearning can all revert subjects back to baseline behavior, they have markedly different effects on whether long-term memory for the adaptation is spared or is also unlearned. On the basis of these and previous findings, we suggest that unlearning is not due to passive forgetting of an internal model, but is instead an active process whereby adapted behavior gradually reverts to baseline habits.
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Affiliation(s)
- Tomoko Kitago
- Motor Performance Laboratory, Department of Neurology, Columbia University College of Physicians and SurgeonsNew York, NY, USA
| | - Sophia L. Ryan
- Motor Performance Laboratory, Department of Neurology, Columbia University College of Physicians and SurgeonsNew York, NY, USA
| | - Pietro Mazzoni
- Motor Performance Laboratory, Department of Neurology, Columbia University College of Physicians and SurgeonsNew York, NY, USA
| | - John W. Krakauer
- Motor Performance Laboratory, Department of Neurology, Columbia University College of Physicians and SurgeonsNew York, NY, USA
- Department of Neurology, Johns Hopkins UniversityBaltimore, MD, USA
- Department of Neuroscience, Johns Hopkins UniversityBaltimore, MD, USA
| | - Adrian M. Haith
- Department of Neurology, Johns Hopkins UniversityBaltimore, MD, USA
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Kim JH, Richardson R. The effect of temporary amygdala inactivation on extinction and reextinction of fear in the developing rat: unlearning as a potential mechanism for extinction early in development. J Neurosci 2008; 28:1282-90. [PMID: 18256248 PMCID: PMC6671587 DOI: 10.1523/jneurosci.4736-07.2008] [Citation(s) in RCA: 91] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2007] [Revised: 11/29/2007] [Accepted: 12/18/2007] [Indexed: 11/21/2022] Open
Abstract
It is well accepted that fear extinction does not cause erasure of the original conditioned stimulus (CS)-unconditioned stimulus association in the adult rat because the extinguished fear often returns (e.g., renewal and reinstatement). Furthermore, extinction is NMDA and GABA dependent, showing that extinction involves new inhibitory learning. We have recently observed each of these extinction-related phenomena in 24-d-old but not in 17-d-old rats. These results suggest that different neural processes mediate extinction early in development. However, the neural processes underlying extinction in the developing rat are unknown. Therefore, the present study investigated amygdala involvement in extinction and reextinction during development. In experiment 1, temporary inactivation of the amygdala (using bupivacaine, a sodium channel modulator) during extinction training impaired extinction of conditioned fear in 17- and 24-d-old rats. In experiment 2, 17- and 24-d-old rats were conditioned, extinguished, and then reconditioned to the same CS. After reconditioning, the CS was reextinguished; at this time, some rats at each age had their amygdala temporarily inactivated. Reextinction was amygdala independent in 24-d-old rats, as previously shown in adult rats. However, reextinction was still amygdala dependent in 17-d-old rats. In Experiment 3, the age at conditioning, reconditioning, reextinction, and test was held constant, but the age of initial extinction varied across groups; reextinction was found to be amygdala independent if initial extinction occurred at 24 d of age but amygdala dependent if it occurred at 17 d of age. Consistent with previous findings, these results show that there are fundamental differences in the neural mechanisms of fear extinction across development.
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Affiliation(s)
- Jee Hyun Kim
- School of Psychology, The University of New South Wales, Sydney 2052, Australia.
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