Search PubMed⌕ Search

Biomedical subjects

C M Brooks

Publications and source records attributed to C M Brooks.

At least 55 records · Page 3Linked to original sources

Promoting self-management in adults with asthma: an overview of the UAB program.

Most asthma self-management programs have focused on children, but the prevalence and impact, both personal and economic, of adult asthma is substantial. Moreover, failure to adhere to treatment regimens appears to be a significant problem in adult asthma. It appears important, therefore, to develop asthma self-management programs for adults. The UAB program is based on the Health Belief Model for health behavior and on the PRECEDE Model for patient education. A needs assessment and a review of existing educational materials were used to specify the content of a self-care workbook. This workbook seeks to increase cognitive skills, encourage daily self-assessment of asthma, demonstrate success in asthma self-management, and promote effective social support. The overall intervention integrates this workbook with systematic reinforcement of self-monitoring and self-management. A prospective controlled study is comparing patients receiving this "special intervention" with "usual care" patients who receive only routinely available pamphlets providing information about asthma. Patients are randomly assigned to treatments by the closed envelope technique. Sample sizes were determined on the basis of statistical power. Outcomes in five areas are assessed: (1) health care utilization, (2) functional status, (3) knowledge, (4) adherence, and (5) psychological reactions.

Academic Medical Centers↗

Leisure time physical activity assessment of American adults through an analysis of time diaries collected in 1981.

One of the 1990 Health Objectives established by the U.S. Department of Health and Human Services is for 60 per cent of adults 18-65 years of age to be participating regularly in vigorous physical exercise. Unfortunately, no valid and practical measurement system is available that will allow assessment of leisure time physical activity participation of large populations. Consequently, not only is it difficult to assess progress toward the 1990 goal, an accurate baseline from which to measure potential progress does not exist. This paper presents a time diary technique for measuring aggregate population physical activity participation and utilizes actual time diaries collected from adults by the Institute for Social Research in 1981 to arrive at a possible baseline. The results indicated that time diaries are a viable method for assessing aggregate physical activity behavior of large populations. American Adults were quite sedentary in 1981. Over a period of one week, 31% undertook no leisure time physical activity. Only 14 per cent expended more than 1600 kcals/week in leisure time physical activity, and 10 per cent met the DHHS physical activity requirements.

Adult↗

Selection and acquisition of audiovisual materials by health professionals.

Audiovisual (AV) materials are widely used in the education of health professionals, and health science educators are usually the people who select audiovisual teaching materials. However, little is known about the selection process and there are few parameters that can be used for guidance. No previous research was uncovered that documented the selection/acquisition of materials by users. This paper reports a survey of health science educators and resource consultants at forty-five academic health centers in the United States, on their experiences in identifying, selecting, and using AV materials. The results provide a baseline of information on which future research can build.

Audiovisual Aids↗

Nutrition knowledge of senior medical students: a collaborative study of southeastern medical schools.

The Southeastern Regional Medical-Nutrition Education Network (SERMEN) comprises 11 medical schools with varied nutrition training programs. A faculty representative from each school rated 41 topics in nutrition as to their importance for medical practice. From the seven topics unanimously chosen, a 90-item examination was prepared using the University of Alabama School of Medicine's Nutrition Test-Item Bank. Thirteen additional items surveyed student attitudes toward their nutrition training. Twenty-one percent of senior students from 10 SERMEN schools took the examination. Results showed significant variation in knowledge levels among the schools on the overall examination and on the seven topics. Eighty-five percent were dissatisfied with the quantity and 60% with the quality of their medical-nutrition education. Knowledge scores correlated with the students' assessments with r values of 0.28 and 0.35, respectively (p less than 0.001). Findings indicate significant variation in nutrition knowledge of US medical students.

Attitude of Health Personnel↗

A consideration of the ethics of brain death--what are the ethical guidelines for physician, family and society in dealing with brain death?

There is at present considerable confusion with respect to ethical guidelines that should govern the behavior of society and the physician confronted by problems resulting from recent attainments of medicine and science. The use of life supporting devices raises the problem of determining when death has occurred and what is proper ethical procedure in dealing with the deficient half life caused by "Brain Death." Some guidance is obtained from a consideration of the nature of life, the nature of death, the nature of man, and the essence lost in death of man. A parallel consideration of the nature of ethics, the bases of ethics and of ethical decision can be helpful. An individual may have ideals which control behavior, even elevate ethical standards; others entertain concepts that destroy social ethics. Ethics control and direct social interactions; ethics determine the quality of social behavior--ethics are established by societies not by individuals. Numerous commissions have endeavored to define the requirements of physicians for diagnosing brain death and for appropriate subsequent actions. The rationales presented, however, are not invariably accepted by lay society. The problem is created by numerous trends. Among them are the "rightest" movement which, though possessing many virtues, has its excesses such as expressed in the "right to life movement." These have not been beneficial and have necessitated "right to death movements." Opposition is also due to the fact that society's concepts of the medical profession have changed. The practice of organ transplantation has created problems. Finally, the concept of death as other than evil is no longer generally accepted. As more biological manipulations are possible ever more difficult ethical problems will arise. It is a certainty, however, that when brain death has occurred life of man and that of the individual has ended. Although others might not agree, our ethic requires us to use life assist techniques to preserve the vegetative man, the individual who can still breathe spontaneously though lacking consciousness and behavioral ability. All the codes of medical ethics state that a physician shall not kill--this does not mean he cannot permit the terminal phases of death when the essence of human life is lost. A major question is the ethical responsibility of one society toward another. Can an affluent society squander its resources in the preservation of ineffectual life in the body after "brain death" when others are without the medical assistance which would permit total living?

Attitude to Death↗

The nature of life and the nature of death.

Life is defined as a "condition" that distinguishes animals and plants from inorganic materials and dead organisms. Life is comprised of processes and is a maintained state. The most sophisticated form of life is man and our though focuses upon the nature of the life and death of man. Man demonstrates three lives or aspects of life: Life of the body--the physical, life of the mind and life of the spirit. Physical life is basic existence; the mind contributes effectiveness and scope; the spiritual entity contributes maximum living. Physiology: The existence of life physical is demonstrated by the presence of functions. Living tissues and organisms exhibit: Irritability: the ability to be excited or detect stimuli and to respond thereto; Growth and reproduction: this consists of the power of multiplication and duplication, regeneration and differentiation; Adaptability: permitting both change and maintenance of balances (homeostasis); and finally and most characteristic of all is Metabolism: the transformation of energy and the use of materials. These properties, however, can be retained for a while by tissues after death of the organism so there is another mystery of life which we understand only in part. Life consists of structure and processes operating under integrative control. This integrative power is the secret we do not understand--we know it confers all the life properties, the continuous flow of processes related to the organism's need for survival. Death is failure not so much of process but of integrative drive and coordination--but, of course, structure and process can fail too, destroying integrated activity. The total organism is under integrative control by brain and mind, the autonomic nervous system and by the neuroendocrine-endocrine complex, all acting in unison. These physical processes contribute to the existence of the life of the mind and spirit and are in turn powerfully affected by intellect and morale. However, we do not understand the driving force which converts inorganic matter, organizes it and then propels it into life. Life seems to be only a continuation of a heritage--life creating life. Philosophy: The life of the mind requires acquisition of knowledge, curiosity, cultivation of the power to reason, use of thought and contemplation, all under discipline. True life of the mind may not exist and may cease to be even though physical existence may be present. Somewhat the same can be said of the life of the spirit; it also is not automatically genetically granted in completed form.(ABSTRACT TRUNCATED AT 400 WORDS)

Animals↗

An innovation in nutrition education: development of a national nutrition test-item bank.

A NNTIB prototype has been developed and implemented at the University of Alabama in Birmingham School of Medicine. The further development of the Bank as a shared national resource was considered at a workshop carried out in conjunction with the 1983 ASCN meeting. Through this forum it was confirmed that the concept of a NNTIB is both valid and viable, receiving the support of a variety of nutrition educators and the endorsement of the ASCN Committee on Nutrition Education. The general recommendations of the workshop participants were that a modification of the test-item bank prototype be used as the model for the development of a national bank. A key recommendation was the development of a committee to oversee the acceptance and review of test items included in the NNTIB. Recognizing that the major constraints in the development of a national bank are likely to be logistical, mechanical, and fiscal, it is our belief that each of the limitations could be overcome if the Bank were adopted by a parent society with a long-term commitment to its continued support and development. After such support has been identified and pilot trials have been carried out, the implications of the NNTIB for advances in the field of nutrition go well beyond improved quality of testing materials and extend into the critical area of the establishment of standards of nutrition education and certification of competency. The development of the NNTIB offers a challenge to nutrition educators, national nutrition organizations, and interested governmental agencies for their involvement and support.

Congresses as Topic↗

Functional significance of coactivation of vagal and sympathetic cardiac nerves.

Simultaneous recording of activity in the vagal and sympathetic supplies to the heart has revealed that in reflexly and centrally evoked activity these two "antagonists" do not necessarily change action reciprocally. Coactivation occurs in chemoreceptor reflexes and related reactions, upon stretching of the sinoatrial nodal region of the right atrium and when certain hypothalamic regions are stimulated. The objective of the present work was to assay the physiological importance of coactivation of the two potentially antagonistic cardiac nerves in anesthetized dogs. Output from the heart was monitored by recording volume flow in the thoracic aorta just below the aortic arch; cardiac contractility was measured as left ventricular dp/dt. Tape recordings of vagus and sympathetic nerve activity during chemoreceptor and baroreceptor reflexes, during reciprocal and nonreciprocal changes produced by hypothalamic stimulation, and during hypoxia and hypercapnia were used to trigger stimulators feeding a stimulus per action potential to cardiac vagus and sympathetic nerves after central connections were cut. The vagus stimulation alone produced a decrease in aortic blood flow; stimulation of the sympathetic nerve alone resulted in increased aortic blood flow. Simultaneous stimulation of vagus and sympathetic, however, produced an even greater cardiac output (measured by aortic blood flow). Intermediate degrees of heart rate and strength of myocardial contraction were maintained in coactivation. Obviously, an association of increased vagus and sympathetic actions, which can be effected reflexly or by action of higher centers, is of physiological benefit. In control reactions that relate cardiac function to body need, both reciprocal and synergistic actions (coactivation) of cardiac nerves are used.

Animals↗

A computer-based test item-bank for cognitive assessment of medical students during a clinical medicine clerkship.

The development and utilization of multiple-choice test items and the utilization of computer technology have significantly altered evaluation practices in medical schools. This paper describes the development and implementation of a computer-based multiple-choice test item-bank for use in a junior medicine clerkship. The computer program, ITEM-BANK, is an interactive system that stores and edits test items and constructs and prints an original copy of each test. Tests can be produced almost immediately by the clerical staff and the total developmental costs have been minimal. The program has reduced the amount of teaching time required to develop tests, and has enhanced the learning of essential information by medical students and residents. Teaching staff and student response has been enthusiastic and positive. Statistically significant Pearson correlation coefficients have been obtained between student performance on these tests and clinical evaluation and NBME Part II scores. The program has made a valuable contribution to the improvement of evaluation procedures in the Internal Medicine clerkship.

Alabama↗

Early and late contributions to our knowledge of the autonomic nervous system and its control made by German scientists.

A summary is given of the German contribution to the development of our knowledge of the autonomic system. Although no major contributions were made in the early centuries and even during and immediately following the Renaissance and the Reformation (1517), there ultimately was a development of strength in the physiological sciences during the eighteenth and nineteenth centuries which remained dominant even during the early decades of the twentieth century. Discovery of the inhibitory action of the vagus nerves by the Weber brothers in 1845 and the description of the depressor reflex and the principle of "feedback" by Cyon and Ludwig in 1866 are examples of high attainment in the study of autonomic nervous system physiology. Many of the other discoveries and subsequent development which occurred in Germany are described. The present symposium has demonstrated the present high attainment in this field.

Animals↗

Introduction: control of the autonomic nervous system and the multiple integrative roles it plays in regulating cardiovascular functions.

Interest in the control and action of the autonomic nervous system on cardiovascular system function has waxed and waned over the years [3]. At present it has reached a new intensity. Old concepts are being reinvestigated and new fields are being explored. As is usually the case in physiology, many are following a reductionist approach and studying the minutia of structure and function of autonomic neurons and neuron complexes. Others are approaching the totality and dealing with the autonomically controlled cardiovascular components of reactions and behavior. The topics chosen for discussion in this symposium are representative of those under intensive consideration at the present time.

Animals↗