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Biomedical subjects

A Tasman

Publications and source records attributed to A Tasman.

At least 19 recordsLinked to original sources
PubMed2000

The doctor-patient relationship in the new century.

The tremendous neuroscience advances and technological developments of the last several decades have led to an increasingly sophisticated appreciation of the nature of brain function and how it is modified. Even with these advances, our need to be skilled in developing and maintaining a therapeutic relationship with patients to maximize treatment effectiveness still exists. How to integrate our scientific advances with our humanistic approach to patient care, in light of evolving mental health care delivery systems changes and an increasingly well informed patient population, and to continue to provide a multi-focal approach to psychiatric education, remains the major challenge for psychiatry in the new century.

Delivery of Health Care↗
PubMed1999

Menstrual cycle synchronized changes in brain stem auditory evoked potentials and visual evoked potentials.

BACKGROUND: Several studies have reported changes in the spontaneous electroencephalogram of women across the menstrual cycle (MC), raising questions on whether sensory or cognitive evoked potentials would change with MC as well. Some of these studies have found changes synchronized with MC in visual event-related brain potentials (ERPs) and brain stem auditory evoked potentials (BAEPs), whereas others have reported none. METHODS: In the present study, we attempted to study the changes in P300 component of visual ERPs, and in BAEPs across the MC in healthy women. RESULTS: The latency of P300 was longer during the ovulatory phase. Decrease across the MC phases was found for the amplitude of BAEP waves I and III, and for the wave V latency and the III-V interpeak latency. CONCLUSIONS: The results indicate that there may be a small relationship between visual ERP or BAEP and MC phase.

Adult↗
PubMed1997

The multisite field trial of the consultation-liaison psychiatry assessment instrument.

A multisite field trial was conducted at 11 institutions to test the clinical reliability of a 29-item consultation-liaison (C-L) psychiatry assessment instrument. Twenty-five raters viewed videotapes of two "trainees" conducting clinical interviews with a simulated patient. One trainee was a medical student, the other was a fellow in psychiatry. Raters completed the 29-item assessment instrument for each trainee. The mean value scores reflected the skill of each trainee. The medical student had a mean score of 1.93, whereas the C-L fellow had a mean score of 3.13 which parallels the expected level of skill for the two interviewers. Eighty-six percent of the items (25/29) had a standard deviation (SD) of less than 1.0. Each of the remaining four items (14%) had a SD minimally greater than 1.0. These results reflect clear wording of items with measurable parameters defined for assessing trainees' skills. The authors present different uses for the assessment instrument, including giving feedback to trainees regarding interviewing techniques and skills; setting "gold" and "lead" standards for clinical C-L interviewing skills; and training supervisors in evaluation using a standardized assessment instrument.

Curriculum↗
PubMed1994

Reduced P3 amplitudes are associated with both a family history of alcoholism and antisocial personality disorder.

1. Previous research has demonstrated that the amplitude of the P3 component of the event-related electroencephalographic potential (ERP) is influenced by the presence/absence of a family history of alcoholism (FHA). The present study extended this line of research by examining the P3 effects of both FHA and antisocial personality disorder (ASP) in a 2 x 2 factorial design. 2. The task required subjects to judge the orientation of an infrequently-occurring outline drawing, representing an aerial view of a human head. 3. Analyses of P3 amplitudes elicited by this drawing revealed reductions attributable to the effects of both FHA and ASP, but not their interaction. These effects were most apparent at frontal electrode sites. Analyses of P3 latency revealed no consistent pattern of findings. However, the interval between P3 and manual reaction time was shorter in the ASP+ group relative to the ASP-group.

Adult↗
PubMed1994

The future of residency training in psychiatry.

Psychiatric residency training faces an uncertain future related both to ongoing changes in the health care delivery system and to the current state of knowledge within psychiatry itself. The author discusses issues concerned with financing, models of training, clinical settings, generalist versus subspecialist training, psychotherapy training, caring for the chronically mentally ill, selection, assessment of quality, and enhancement of the quality of training. He concludes that, whatever form health care takes, psychiatric educators must maintain a commitment to acquiring and communicating new knowledge as the essential basis for a high-quality education.

Delivery of Health Care↗
PubMed1993

Strategic issues for the successful merger of residency training programs.

Retrenchment in federal financing, more stringent residency accreditation standards, fewer psychiatric residents, and other factors are putting increased pressure on psychiatric residency training programs to collaborate with or even merge with other residency programs. To improve the likelihood that a collaboration or merger of psychiatric residencies will work, administrators must address such issues as educational philosophy, goals of education and training, governance of the combined program, the impact on faculty and trainees, and the separate institutional cultures. Experiences from the merger of the residency programs at the Institute of Living and the University of Connecticut illustrate some of the factors.

Connecticut↗
PubMed1993

Ensuring services for persons with chronic mental illness under national health care reform.

People with chronic mental illness present complex challenges for the design of health care financing reforms. In this position statement from the committee on psychiatry and community of the Group for the Advancement of Psychiatry, the authors describe chronic and severe mental illnesses as psychiatric illnesses that require acute and ongoing psychiatric assessment and treatment, as chronic medical diseases that require ongoing rehabilitative services, and as persistent disabilities that need ongoing supportive care and social services. Any proposal for health care reform must ensure parity of chronic psychiatric illnesses with other psychiatric conditions. It must also reimburse psychiatric rehabilitation at parity with other medical rehabilitation and provide equal access to and reimbursement for broad ancillary health services that reduce costs and improve quality of life.

Chronic Disease↗
PubMed1993

Investor-owned psychiatric hospitals and universities: can their marriage succeed?

Economic and competitive pressures have spurred a growing number of affiliations between university medical centers and for-profit health care corporations. University facilities can benefit from such partnerships through strengthened financial support, increased marketing and administrative expertise, and economies of scale. The university connection gives the investor-owned hospital enhanced status, sends a message of clinical excellence, and involves the hospital in educational and research programs that aid in physician recruitment and further enhance its reputation. However, the university's goals of education, research, and public service are not always compatible with the investor-owned hospital's goal of maximizing profits. The authors review the benefits and problems that result from affiliations between university medical centers and investor-owned corporations and discuss principles to be considered in structuring such partnerships.

Cost-Benefit Analysis↗
PubMed1992

Variation in evoked potential measures over the menstrual cycle: a pilot study.

The P3 component of a visual event related potential (ERP) was studied for five consecutive weeks in six women with normal menstrual cycles. Serum concentrations of luteinizing hormone (LH), estradiol (E2) and progesterone were studied during the same period. Increases in P3 amplitude, although nonsignificant, were noted in the week preceding onset of menses. No significant changes in reaction times to target/nontarget stimuli were noted over the same time period.

Adult↗
PubMed1991

Psychiatrists' attitudes toward prescribing medication for patients treated by nonmedical psychotherapists.

Although many psychiatrists prescribe medications for patients whose primary therapist is a nonmedical professional, few guidelines exist for this practice. Two-thirds of a sample of Connecticut psychiatrists surveyed by mail provided medication backup services, but only one-third considered the practice generally ethical. Seventy-five percent of respondents who provided this service reported that the arrangement was initiated by the nonmedical therapist. Many of the respondents were concerned about the prescribing psychiatrist's legal responsibility for the therapist's activities, but responses suggested that few psychiatrists use a consistent method to evaluate the therapist's qualifications. The authors propose areas that need further study before professional guidelines can be developed.

Attitude of Health Personnel↗
PubMed1990

Psychotherapy training for the psychiatrist of the future.

There is uncertainty about the future role of psychodynamic psychotherapy in psychiatric practice and education. The Association for Academic Psychiatry and the American Association of Directors of Psychiatry Residency Training formed a joint task force to review the issue. It developed a rationale for continued training in expressive psychotherapy and a model curriculum for such training that is both effective and realistic in terms of the diverse demands and structures of modern residencies. A minimum curriculum was also designed for resource-poor programs.

Adult↗