", medicine ball exercises."

By: Scott W. Mueller, PharmD, BCCCP

  • Assistant Professor, Department of Clinical Pharmacy, Skaggs School of Pharmacy and Pharmaceutical Sciences, University of Colorado, Aurora, Colorado

Conversely medications for osteoporosis , they believe strategies medications images , it is important to medicine man dr dre note that they they are less likely than their peers to treatment quality assurance unit experi can all be used somewhat interchangeably. If ence negative events, such as having a serious one strategy does not work to restore feelings automobile accident, being a crime victim, or of self-worth, individuals will simply turn to becoming depressed. The specifc means by which self future cannot logically be rosier than every enhancement occurs is thus far less important one else’s, the extreme optimism individuals than the commitment to restore it. If one strategy psychologists believe that self-enhancement is thwarted or ineffective, individuals simply needs are universal. Across cultures, people turn to another to help them feel better about the world over are motivated to feel good themselves. At the same time, cultures clearly infu Self-enhancement biases are also revealed ence how the motive is satisfed and expressed, when we assess the accuracy of people’s self and many of the biases we have been discuss views. Considering all of the feedback people ing are more prevalent in America, Canada, receive in life, you might think we all have a and the countries of Western Europe than pretty good idea of what we are like. There is they are in some East Asian countries, such as 472 self-esteem self-evaluation maintenance theory China and Japan. Albert for these cultural differences is that Western beams with pride when he tells us that his cultures encourage people to think of them friend Bob is selected as the frst chair in the selves in highly positive terms, whereas East school orchestra. Other times the outstand Asian cultures emphasize humility and inter ing performance of close others can be quite connectedness with others rather than blus negative. In both cases biases I have reviewed are greatly reduced or Albert was outperformed by a friend, yet his entirely absent among low-self-esteem people responses to those performances were totally or those who are depressed. Others have argued that people that people want to feel good about them are better served by knowing what they are selves: that is, they want to maintain a positive really like, and that self-enhancement is a dis self-evaluation. The of the matter, most of the evidence shows that self relevance of a performance domain is also positive self-evaluations are generally benef an important determinant of our response to cial, provided that the degree of distortion is another’s performance. People who think they are better than important to be successful in a few particular they really are, exaggerate their ability to areas but not so important to be particularly bring about desired outcomes, and are unre good in many other areas. In a word, some alistically optimistic about their future are performance domains are more relevant to happier, have more satisfying friendships and our self-defnition than are other areas. For romantic relationships, are more productive example, Albert plays the piano but does not and creative in their work, and are better able think of himself as a musician. In cares very much about his performance on the short, rather than knowing the truth about football feld. The more self-relevant is a particular self-esteem domain the more important is the compari n. The degree to which one’s attitude toward, son process (relative to the refection pro opinions about, and evaluation of one’s own cess). When a friend or relative performs body, history, mental processes, and behavior better in a highly self-relevant domain, then are positive. Self-esteem is related to many self-evaluation is likely to suffer by compari aspects of thought, emotion, and behav son. Such threat via comparison will produce ior and is often considered a central part of negative feelings. The outstanding performance of a model attempts to capture some of the friend or relative in a low-relevance domain dynamics underlying our reaction to the per can boost self-evaluation via “basking in formance of others, particularly close others. If any two of these variables are fxed, that can be measured and/or manipulated: then one can make unambiguous predictions (1) another’s performance relative to the self. One will not suf of the three variables in turn when the other fer by comparison if one is not outperformed. And there is little to be gained by basking in Often we can affect the performance of the refected glory of someone whose perfor another person. Closeness refers to the extent to which self her performance by creating diffculties that and other are “connected” to one another. When will we help the connection can be affective, as friends and when will we hinder the performance of are closer than strangers; it can be genetic, as another The con answer depends on the relevance of the per nection can even result from the changing formance domain and the closeness of the context. Two women, even strangers, will be other: When relevance is high, self will suffer closer to one another in a class with 20 men via comparison to another who performs well, than in a class with 20 other women. Two peo particularly if that other person is psychologi ple from Asheville, North Carolina, will be cally close. If we wish to maintain a positive closer to one another in Dallas, Texas, than self-evaluation, then, perhaps surprisingly, in Asheville. Closeness is important because when relevance is high, we may be less moti it intensifes the comparison and refection vated to help a close other, such as a friend, experience. On compare ourselves to people with whom we the other hand, low relevance creates the have little or no connection, and the results of opportunity to bask in the refected glory of such comparison are likely to be less extreme. This leads to the expec almost see the pride and feel the refected joy tation that when relevance is low, we will be when the mother introduces her son: “Meet more motivated to enhance the performance my son the doctor. The pairs were strangers to relevance is crucial because it determines one another. Each participant, in turn, was the relative importance of the refection and required to guess target words on the basis of comparison process. Each of domain is highly relevant, then the good per the three other players anonymously selected formance of a close other is likely to result in clues from a list of clues graded for diffculty. Half of the sonal relevance, then the good performance participants were in a high-relevance con of a close other is likely to result in refection dition. This assumption allows predictions research had shown that it was unrelated to 474 self-evaluation maintenance theory such traits as verbal ability and intelligence. The to affect the performance of a friend and of a experimenter asked topical questions. The stranger on a task that was either high or low speed and correctness of the answers by in relevance. When the task was highly relevant, posed participant always entered the second participants were more helpful (gave easier room frst and always sat in the same seat. When will we want to quiz was on a high-relevance topic, the better be more connected to another When will we the performance of the posed participant, try to cut the ties that connect us When the college tions depend on the state of the other two bowl quiz was on a topic of low relevance, the variables, relevance and performance. When better the posed participant’s performance, relevance is high, the comparison process the closer to the posed participant the real is prepotent. Can the performance of another threat, the better another’s performance, the affect the way we think about ourselves If there is an opportunity for refection, particu we claim a performance domain to be self larly when the other is close. Thus, the model relevant, then we are likely to suffer by the predicts that when relevance is low, the better better performance of another, particularly the other’s performance the greater the moti a close other. There were two participants in each domain, and this should be particularly the session; a real participant and a participant case when the other person is psychologically who worked for the experimenter posing as close. At the beginning of the Tesser and Paulhus tested this predic session participants received a list of top tion. Pairs of participants were scheduled ics such as movies, current events, hunting for the same session. For each of the participants were told that they were topic they independently and privately indi scheduled at the same time because previ cated how knowledgeable they were and the ous information indicated that they were extent to which it was important for them very similar to one another; the remaining to be particularly knowledgeable. These participants were told that they were sched ratings served as an index of the personal uled for the same session because they had relevance of each domain. Their task was pants then participated in a “college bowl” to work on a new personality measure, a quiz on one of the topics. In study are too complicated to describe com the booth were two binders: one contained pletely here. Participants who believed that they two biases: social desirability and “naive were outperformed by the other participant theories. Also, since feelings Importantly, this relationship was more pro in real situations are often complex, feeting nounced when the partner was described as and unrecognizable, our naive theories of similar (close) rather than dissimilar.

A symptoms strep throat , B medications in canada , C medicine xifaxan , D Intravascular volume depletion is associated with characteristic clinical and biochemical features treatment 6th feb . Clinically tachycardia, hypotension, reduced skin turgor, increased capillary refill time and reduced urine output are typical. Biochemically there is a tendency for healthy kidneys to attempt correction by retaining Na+ so that intravascular volume increase. D this is consistent with secretory diarrhoea (possibly due to parasitic infestation). The electrolytes suggest hypokalaemia and metabolic acidosis (low bicarbonate), which is due to loss of these metabolites via diarrhoeal fluid. The hyperchloraemia is typical of the kidney’s compensatory mechanism to the loss of bicarbonate. The stool osmolality is measured at 248 but calculated osmolality is 2(Na) K and is 204. This difference in osmolality of 42 mmol/L is due to unmeasured osmotically active substances (such as glucose) which are seen in secretory diarrhoea. Hormonal causes such as Zollinger–Ellison and vasoactive intestinal polypeptides could cause a similar picture but are not consistent with clinical details provided. The slightly high glucose could also be due to the effect of counter-regulatory hormones, such as cortisol and glucagon, that are released during stress. Mounting a ketone response is appropriate in this situation as the brain and muscles are able to utilize this as a source of energy. There is renal reabsorption of Na, and fractional excretion of Na is reduced to <1 per cent. Risk of refeeding syndrome 1C Refeeding syndrome occurs due to severe fluid and electrolyte shifts and their associated complications in malnourished patients undergoing feeding by the oral, enteral or parenteral route. However, it is not always necessary to correct the electrolyte imbalance before feeding. Fluid and electrolyte abnormalities 1D Abnormal proteins in melanoma or paraproteinaemia can cause spurious hyponatraemia. Metabolic presentations in young and old patients 1B Hypoglycaemia is a commoner feature in neonates, however in this infant it is associated with hyperammonaemia following stress (circumcision). One must consider a differential diagnosis of an inborn error of metabolism such as a urea cycle defect, amino acid disorder or a fatty acid disorder. A Skin wound edges should not be closed A Cutting needles are used for skin and tightly. B Glues have a place in the approximation B Hand needles are ideal for skin closure. C Round-bodied needles are used for C Bowel anastomosis is always done in closure of laparotomy wounds. D Needles with a loop-suture should be D Vascular anastomosis is always done with used for laparotomy closure. E In arterial suturing, double-ended needle E All arteriotomies must be closed with a sutures are used. A Large-bowel anastomosis must be done A Polymeric synthetic suture materials only by one-layer technique. B the bowel ends being anastomosed B Monofilament non-absorbable sutures must be well mobilised so as not to are easy to use in tying secure knots. C the integrity of polypropylene sutures C Synthetic polymers are to be used for in holding tissues together can last intestinal anastomosis. D In vascular anastomosis the needle must D Braided suture material can be a nidus pass from within outwards. E Polypropylene-like sutures with indefinite E Absorption is more predictable and integrity must be used for vascular complete with absorbable sutures. A, B, D Wounds should be closed with no tension, with a minimal gap between the edges to allow for the swelling that inevitably occurs as a result of the inflammatory process of normal healing. Their use requires perfect haemostasis and they are ideally used in children for a laceration on the forehead. They are extensively used: for haemostasis in the liver and spleen, for dural tears, in ear, nose and throat 135 and ophthalmic surgery and to prevent postoperative adhesions in cardiac and general surgery. In upper gastrointestinal haemorrhage, fibrin glues in combination with collagen are an effective method of stopping bleeding endoscopically. Bowel anastomosis can be done in one or two layers depending upon the choice of the individual surgeon. When done in two layers, the inner continuous all-layer suture is supplemented by inverting the seromuscular, second layer of sutures on the outside. All vascular anastomosis must be done using non-absorbable sutures as the integrity of the material needs to be permanent. The size of the suture depends upon the calibre of the vessel and the closure has to be precise and watertight. While doing a femoral embolectomy, if a transverse incision is made it can be closed in the direction of the incision. However, if a longitudinal incision is used, it is preferable to close it with a vein patch to prevent narrowing of the lumen; in carotid endarterectomy, the arteriotomy is always closed with a synthetic patch. B Polymeric synthetic suture materials cause minimal inflammatory reaction and are of predictable strength. The braided form of the material can cause bacterial colonisation, resulting in a suture knot sinus. As the integrity of polypropylene sutures in holding tissues together can last indefinitely, they are used in vascular anastomosis. A, C, D, E Hand needles should not be used because surgery should be carried out using the no-touch technique. When done in two layers, the inner layer is an all-layer continuous suture and the outer is an interrupted seromuscular suture. In vascular suturing, the needle must always pass from within outwards to avoid creating an intimal flap and to fix any atherosclerotic plaque. Polypropylene-like sutures which have an indefinite integrity must always be used. Which of the following statements A Decrease in wound size regarding pneumoperitoneum are true B Decreased postoperative pain A A Tuohy needle can be used to achieve C Shorter operating time access to the peritoneal cavity. D Improved vision B the usual intraperitoneal pressure E Reduced operating theatre costs. Which of the following are limitations C the temperature of the gas used is of minimal access surgery A Technically more demanding D Nitrous oxide is preferable to carbon B Loss of tactile feedback dioxide in patients with cardiac disease. C Extraction of large specimens E the gases used for pneumoperitoneum D Poor vision have high water content. Which of the following are complications associated with creating Pneumoperitoneum pneumoperitoneum What are the desired characteristics A Bleeding of the gas used to provide B Bowel injuries pneumoperitoneum in laparoscopic C Gas dissection within the abdominal wall surgery Which of the following are gases used B Bipolar diathermy/combinations (Ligasure) to provide pneumoperitoneum What parameters are taken into D Nitrous oxide account while using laparoscopic E Argon. B Age A Hyperthermia C Left/right side dominance B Acidosis D Number of errors C Cardiac arrhythmias E Depth (3D) perception. Which of the following are suture loop advantages of robotic surgery to the C By suturing surgeon D Applying pressure from a Foley catheter A Better visualisation (higher balloon magnification) and stereoscopic views E Diathermy. B Greater precision due to elimination of hand tremor Electrosurgery in C Improved manoeuvring due to ‘robotic laparoscopic surgery wrist’ with seven degrees of freedom 15.

However symptoms 28 weeks pregnant , the causal relationship could not be shown because the parent study design was cross sectional treatment narcissistic personality disorder . Therefore treatment dvt , future longitudinal studies are required to medicine kim leoni confirm the existence of any causal relationship. Wandering behavior is related not only to cognition, but also to emotional expression. On the other hand, a person in late stage dementia experiencing positive emotion might be provided a one-to-one relationship in an effort to deter wandering. Complete the observations for “facial displays” before going on to “verbal displays. Replay the videotape in two-minute intervals looking for positive “verbal displays”. Now observe two-minute intervals for negative “verbal displays” before going on to “body movement/posture displays. Replay the videotape in two-minute intervals for negative “body movement/posture displays. Mark as present even if the subject cannot turn head sufficiently to see the caregiver/object. Verbalizes needs, wants, or feelings Includes any self-reported feeling toward self (hope, worry, concerns, likes, about self. Verbalizes thoughts or feelings about Subject talks about others (family, staff, resident, research team). Shares past information about self in Offers information about family, friends, or past experiences. Calls caregiver by name or “Honey,” Subject spontaneously attempts to assign a name to caregiver. The subject says the same words/phrases over even though the caregiver has given a response. Excludes stumbling over a word or repeating a word/phrase at the request of the caregiver. Verbalizes repetitive generalized the subject vocalizes a physical complaint, but does not pinpoint a specific somatic complaints. Exclude a noise made in response to an heavy sighing or similar noise activity (ouch) or heavy breathing. Refuses intervention verbally: “No,” the subject vocally indicates an unwillingness to participate in/ continue part of “Can’t do that,” “I don’t want to. Exclude subject’s declining one part of the activity such as drinking juice while participating in a concurrent part, such as eating crackers. Make no vocal response to question or the subject simply makes no verbal or guttural (“Uh-huh,” “Huh-uh”) response statements. Initiates positive physical contact: Reaches out, touches, pats, strokes caregiver, or object. Aligns head and/or body toward the subject turns head and/or body toward caregiver to participate in activity or person/object. Participates in activity: Subject participates with or without verbal or physical prompting. Make repetitive body movements: the subject repeatedly moves a body part in the same motion. Tries to get out of chair, shower, away from caregiver, etc for the purpose of leaving. Keeps head and/or body nonaligned the subject does not attempt to align body toward caregiver or object when with person or object: Does not turn interaction or activity occurs. Exclude if subject is involved in an activity that toward person/object in response to doesn’t include turning toward caregiver or object. The nature of wandering in dementia: A Guttman scaling analysis of an empirical classification scheme. The Algase Wandering Scale: initial psychometrics of a new caregiver reporting tool. Need-driven dementia-compromised behavior: An alternative view of disruptive behavior. Estimates of stability of daily wandering behavior among cognitively impaired long-term care residents. The interrelatedness of wandering and wayfinding in a community sample of persons with dementia. Practice guideline for the treatment of patients with major depressive disorder (3rd ed. Impaired cerebral glucose metabolism and cognitive functioning predict deterioration in mild cognitive impairment. Facial expressions in severely demented patients—a stimulus—response study of four patients with dementia of the Alzheimer type. Dangerous wandering: elopements of older adults with dementia from long-term care facilities. Effectiveness of Nonpharmacological Interventions for the Management of Neuropsychiatric Symptoms in Patients With Dementia: A Systematic Review. The Role of Culture and Gender in the Relationship between Positive and Negative Affect. Use of the Mini-mental State Examination in a probability sample of a Hispanic population. Processing Emotional Information in Alzheimer’s Disease: Effects on Memory Performance and Neurophysiological Correlates. Trajectory Patterns of Dental Caries Experience in the Permanent Dentition to the Fourth Decade of Life. Clinical assessment of irritability, aggression, and apathy in Huntington and Alzheimer disease. The James-Lange theory of emotions: a critical examination and an alternative theory. Emotional experience improves with age: Evidence based on over 10 years of experience sampling. Conceptualization and measurement of getting lost behavior in persons with early dementia. Activity participation and well-being of people with dementia in long-term care settings. Nonpharmacologic interventions for inappropriate behaviors in dementia: A review, summary, and critique. Environmental influences on agitation: An integrative summary of an observational study. Assessment of ambulatory behavior in nursing home residents who pace or wander: a comparison of four commercially available devices. The Neuropsychiatric Inventory: comprehensive assessment of psychopathology in dementia. Toward a Neurobiology of Emotion and Feeling: Operational Concepts and Hypotheses. Relationships between time of day, day of the week, and positive mood: Exploring the role of the mood measure. The preclinical phase of alzheimer disease: A 22-year prospective study of the Framingham Cohort. Cognition, function, and caregiving time patterns in patients with mild-to-moderate Alzheimer disease: a 12-month analysis. Valence focus and arousal focus: Individual differences in the structure of affective experience. Impaired recognition of negative facial emotions in patients with frontotemporal dementia. Reliability and validity of the Cohen-Mansfield agitation inventory in institutionalized elderly. The effects of emotion-oriented approaches in the care for persons suffering from dementia: a review of the literature. The effect of integrated emotion-oriented care versus usual care on elderly persons with dementia in the nursing home and on nursing assistants: a randomized clinical trial. Impaired facial emotion recognition and preserved reactivity to facial expressions in people with severe dementia. Neurofibrillary tangles, amyloid, and memory in aging and mild cognitive impairment.

But it is reasonable to medications during breastfeeding assume that the control mechanisms used by both animals in generating their performances were homologous and perhaps comparable with our own experience when we hear pure tones treatment myasthenia gravis . The pages of major technical jour nals medicine articles , such as Brain medications beta blockers , Behavior and Evolution, Journal of Comparative Neurology, and Zeitschrift fur Hirnforschung are lled with evidence. I recommend one text on the subject, Butler and Hodos (1996), that outlines the extent to which vertebrate brains are both similar to and different from one another. Readers with access by computer to the Internet may get an even better sense of diversity, at least in mammals, at. Here one can see pictures of whole brains and of histological sections, accompanied by narratives relating brain to behavior in dozens of mammals, and thus have an easy introduction to the diversity of living species. The relationship between uniformity and diversity is a kind of forest and-trees problem. Uniformities enable one to view general features of the organization of brains, but when they are examined more closely, one is also impressed by the variety of specializations among species and of the parts of the brain. The size of the brain as a whole, at least in mammals, provides a measure of the total information-processing capacity that evolved in a species, as shown in gure 12. But the information must be broken down to be analyzed, and such analysis is performed hierarchically by specialized regions. We are reasonably certain that some perceptual activity is indeed common to various species. Although we enjoy speculative excursions into the perceptual worlds, or Umwelten, of other species, emphasizing speci c specializations (von Uexkull 1934; Jerison 1986), we have good reason to assume that in most vital features the world as experienced is stable among species; that is, their experienced worlds are similar. But we also see dramatic differences in the way distance-senses work and in the kind of information available to animals of different species about events at a distance. Among cats and dogs, the upper limit of sensitivity extends about two octaves above the human upper limit to about 60kHz, com pared with a human maximum of about 20kHz. Maximum sensitivity is also shifted upward by an octave from about 3kHz in humans. Mice and rats, on the other hand, have their peak sensitivity shifted upward about two octaves to about 8kHz and an upper limit of sensitivity to over 100kHz. It is surprising that dolphins are comparable with rodents in this 188 Harry Jerison regard. We usually imagine the experience of other species of auditory events as primarily an extension of sensitivity rather than a fundamen tal difference in experience. We know, however, that the use of auditory information may be radically different in different species, usually elic iting stereotyped behavior patterns rather than the exible information that we know from experience with language. The most unusual animal auditory activity is perhaps that of echolocation by microchiropteran bats, which appear to construct an analogue of our three-dimensional visual world from auditory data (Grinnell 1995). Although dolphins are also echolocators, there is no evidence of their using auditory informa tion in this way. This has not inhibited my speculations about the dolphin’s world as constructed from echoes (Jerison 1986). For me, the most evocative example of differences among species in perceptual worlds is distinction between the visual worlds of horses and rabbits and of anthropoid primates, including people. In addition to the fact that the primate world is colorful whereas that of horses and rabbits is probably one of gray pastels, our primate world is a proscenium stage on which events are played out in a narrowly but sharply focused central area with a peripheral background that extends only to our sides. Horses and rabbits live in the center of a domed sphere, with eyes in the back of their heads, as it were. Their visual world cannot be as ne-grained as ours, since their largely rod vision cannot provide the detailed edge discrimination that we achieve with the pure cone fovea centralis. Nonprimate mammals do not have foveae, and their visual worlds are probably more nearly like those of the earliest mammals, which probably rst evolved as nocturnal species of only slightly modi ed reptiles. Major regions of the mammalian brain are specialized for receiving and analyzing visual information, other regions for auditory information, others for tactile information, and so forth. Each hemisphere of the primate cerebral cortex has at least a dozen visual areas that are specialized in a variety of ways, for example, for responding differently to edges of objects, to their movement in differ ent directions, to color, to size, and so forth (Zeki 1993). Comparable specialization for vision occurs in most mammalian brains, but are less elaborate in nocturnal species that rely less on vision for navigating their worlds. The same elaboration probably occurs for auditory information, although that domain is yet to be analyzed as elaborately as the visual system. In bats, which use auditory cues for navigation in ways compa rable with the use of vision in primates, much of the cerebrum is spe cialized as auditory cortex. In the human brain, language areas have been 189 Paleoneurology and the Biology of Music identi ed, but these areas also contain specialized subareas. Evidence is good, for example, that when one learns a foreign language in adulthood, second-language information is focused in regions in the language areas quite distinct from those involved in establishing one’s rst language (Ojemann 1983; Calvin 1996). All specializations in mammalian behavior are re ected neurally as localized functions of the cerebral cortex. Careful analysis of sensory rep resentation in the mammalian brain reveals that sensory and motor pro jection areas account for essentially all of the surface area of the brain. The extensive human language areas are unusual in this regard, being more purely association cortex to which there are no direct sensory or motor projections. However, if one thinks of language areas as process ing centers for elaborated auditory information (secondary auditory cortex, as it were) with linkages to other sensory modalities and to motor areas for controlling the voice box, tongue, and lips, the same general ization for other mammals applies to humans. Essentially all of the surface of the cerebral cortex has been mapped as related to sensory and motor activities that enable animals to know their external worlds. Evolution of mammalian cerebral cortex is thus correlated with that of speci cally mammalian features in cognitive and perceptual capacity. In summary, I conclude that knowing and perceiving are essentially the same thing described with different words when different aspects of essentially the same mental activity are studied. I view the brain’s work in supporting this cognitive-perceptual activity as creating the experi enced real world within which behavior occurs. As I remarked at the beginning of this chapter, music is essentially a human category de ning certain kinds of activities and experiences, and to appreciate its evolution we can examine the evolution of human capacities to categorize in this way. At the most general neurobiological level it is the evolution of the neocortex of the mammalian brain. Since birds have been important animal models for musicality, I will consider their brains, too. I wish now to summarize what we know from the fossil record about the evolution of the brain, in particular the neocortex, in mammals with a few words on the limited history of the evidence on birds. Brain Evolution All known vertebrate brains, both living and fossil, have clearly identi able forebrain, midbrain, and hindbrain. As I do not have an illustration of a standard brain, I traced a fossil brain that could serve as a standard 190 Harry Jerison for mammals (gure 12. The species was a small ungulate, an “ore odont” that lived thirty ve mya in what is now the Big Bend area of the Rio Grande river in Texas. It is described in detail at the internet site and is also illustrated in other publications (Jerison 1990, 1991). The endo cast shows many major structures of the brain, such as the olfactory bulbs, cerebral hemispheres, and cerebellum, as well as the marginal sulcus and longitudinal sulcus of the neocortex. One can use the position of the rhinal ssure, which is the boundary between six-layer neocortex and paleocortex, to analyze the evolution of neocortex. In the gure I have named a few neocortical convolutions using the same criteria as in living ungulates as presented in standard brain atlases. The most important conclusion from such evidence may be to show that mammalian neocortex evolved to larger relative size during the past sixty million years (Jerison 1990). This veri ed the frequently stated hypothesis, based on comparisons among living species, that “neocorti calization” (an aspect of encephalization) occurred during mammalian evolution. Complementing this information, we know from the analysis of brain size in many living species of mammals that diversi cation with respect to relative size included the evolution of species that remain at essen tially the same level of encephalization as the earliest mammals of which we have records. Living Virginia opossums (Didelphis marsupialis) and living European hedgehogs (Erinaceus europaeus) are quite comparable with the earliest mammals in which brains are known in this regard. This is evidence, of course, that mammals do not live by brains alone, and that today in many niches an essentially minimal brain size is suf cient to control all necessary behavioral functions. With respect to musicality, wherever we have evidence of mammalian vocal expression that we would describe as musical, we must consider that, from the perspective of the species, a variety of neural mechanisms may be involved in their generation and experience, and these may have little to do with music as a human dimension of experience.