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Biomedical subjects

Jeffrey C Schneider

Publications and source records attributed to Jeffrey C Schneider.

8 recordsLinked to original sources

Motivating elders to initiate and maintain exercise.

UNLABELLED: This article addresses the motivation of elders to initiate exercise. It is part of the study guide on geriatric rehabilitation in the Self-Directed Physiatric Education Program for practitioners and trainees in physical medicine and rehabilitation and geriatric medicine. This article specifically focuses on the health benefits of exercise, describes a theoretical model for assessing and improving an individual's motivation to pursue exercise, details the particular challenges elders face in initiating and adhering to an exercise program, and outlines professional interventions to address these obstacles. OVERALL ARTICLE OBJECTIVE: To explore the particular challenges elders face in motivation to exercise and to develop a systematic approach for counseling elders toward greater activity.

Aged↗

Reading habits of physical medicine and rehabilitation resident physicians.

OBJECTIVE: To investigate the focus and extent of the resident physician reading habits, to compare how these change over the years of their training, and to compare these habits with those of physiatrists in practice. DESIGN: A total of 1,076 surveys were sent to 80 physical medicine and rehabilitation residency programs accredited by the Accreditation Council for Graduate Medical Education. The questionnaire contained a list of 36 journals pertinent to the field of Physical Medicine and Rehabilitation. Resident physicians were asked to indicate which journals they read during the past year and how extensively they read them. Respondents were also asked whether they participated in a journal club and if they read as much as they would like. RESULTS: A total of 324 surveys (30.1%) were completed correctly. At least half of the surveyed resident physicians scanned or read six journals:Archives of Physical Medicine and Rehabilitation (85.2%), American Journal of Physical Medicine and Rehabilitation (80.6%), Journal of the American Medical Association (68.8%), New England Journal of Medicine (60.5%), American Journal of Sports Medicine (50.9%), and Rehab in Review (49.7%). Most resident physicians (93.9%) responded that they do not read as much as they would like, and 90.1% of resident physicians participate in some form of journal club. CONCLUSION: Most resident physicians in the field of physical medicine and rehabilitation tend to scan for important articles within one of six journals, with most of these physicians noting that they do not read as much as they would like. As the resident physicians advance in postgraduate-year level, the number of journals that they scan increases. The reading habits of the resident physicians were quite similar to those noted in our previous study of the reading habits of practicing physiatrists.

Adult↗

A mysterious temporal penetrating head wound without fracture.

Unwitnessed head injuries are often diagnostic and management dilemmas. Low-velocity penetrating head wounds are rare. This paper describes a case of an accidental low-velocity penetrating head wound through the soft tissue of the temporal region. This lesion resulted in a deep intra-cerebral haemorrhage, after the initial assessment revealed no evidence of skull fracture, missile or missile track. The diagnostic evaluation and medical course of this case are presented. This is the first case in the medical literature of a brain injury by an object that penetrated the calvarium at low velocity but which did not produce a fracture of the skull. The evolving diagnostic dilemma is outlined to its conclusion, through 3 years of follow-up observation.

Adult↗

Effects of methylphenidate on heart rate and blood pressure among inpatients with acquired brain injury.

OBJECTIVE: The purpose of this study was to evaluate the effects of methylphenidate on heart rate and blood pressure in patients with acquired brain injury. DESIGN: The records of 60 consecutive hospitalized patients with acquired brain injury were reviewed for treatment with methylphenidate. Seventeen patients met the inclusion criteria. Systolic blood pressure, diastolic blood pressure, and heart rate recordings were compared before and after the introduction of methylphenidate. RESULTS: There was no significant difference in mean systolic blood pressure, diastolic blood pressure, and heart rate when patients received (118 mm Hg, 74 mm Hg, and 88 bpm) and did not receive (118 mm Hg, 73 mm Hg, and 86 bpm) methylphenidate. It was unclear whether there was a true trend toward medication effect on heart rate and blood pressure during the peak dose period. CONCLUSIONS: This retrospective study points to safe sympathetic effects of methylphenidate, yet future prospective studies are warranted to clarify the effects of methylphenidate on heart rate and blood pressure in the acquired brain injury population.

Adult↗

Eye-movements and ongoing task processing.

This study tests the relation between eye-movements and thought processing. Subjects were given specific modality tasks (visual, gustatory, kinesthetic) and assessed on whether they responded with distinct eye-movements. Some subjects' eye-movements reflected ongoing thought processing. Instead of a universal pattern, as suggested by the neurolinguistic programming hypothesis, this study yielded subject-specific idiosyncratic eye-movements across all modalities. Included is a discussion of the neurolinguistic programming hypothesis regarding eye-movements and its implications for the eye-movement desensitization and reprocessing theory.

Choice Behavior↗

Reading habits of practicing physiatrists.

OBJECTIVE: Over the past 30 yr, the number of ACGME accredited specialties has quadrupled, and the number of journals cataloged on MEDLINE has doubled. Given this increase of information, this study sought to determine the amount and extent that pertinent journals are read by specialists in the field of physical medicine and rehabilitation. DESIGN: From a randomly selected list of board-eligible physiatrists and diplomates of the American Board of Physical Medicine and Rehabilitation, 1204 resident physicians, fellows, and attending physicians were sent questionnaires concerning their reading habits. The questionnaire contained a list of 36 journals adapted from a list of journals previously published as being pertinent to physical medicine and rehabilitation. Physicians were asked to specify which journals they read over the past year and how extensively these were read. Respondents were also asked to note whether they participated in an academic or private practice and if they read as much as they would like. RESULTS: The results revealed that very few journals were always read thoroughly, with the modal response among the more popular journals being that of "always scanned the table of contents and read the most important articles." Academic physiatrists were noted to read more than their private practice counterparts. Of the subspecialists who replied, 67% read a journal pertinent to their subspecialty. Eighty-three percent of all respondents reported that they did not read as much as they would like. CONCLUSION: Physiatrists are rarely able to completely read the most relevant journals in their field. When reading journals, most physiatrists only scan the table of contents and read the most important abstracts.

Attitude of Health Personnel↗

Contractures in burn injury: defining the problem.

This study prospectively examined the incidence and severity of large joint contractures after burn injury and determined predictors of contracture development. Data were collected prospectively from 1993 to 2002 for consecutive adult burn survivors admitted to a regional burn center. Demographic and medical data were collected on each subject. The primary outcome measures included the presence of contractures, number of contractures per patient, and severity of contractures at each of four joints (shoulder, elbow, hip, knee) at time of hospital discharge. Logistic regression analysis was performed to determine predictors of the presence and severity of contractures and a negative binomial regression was performed to determine predictors of the number of contractures. Of the 985 study patients, 381 (38.7%) developed at least one contracture at hospital discharge. Among those with at least one contracture, the mean is three contractures per person. The shoulder was the most frequently contracted joint (38%), followed by the elbow (34%) and knee (22%). Most contractures were mild (60%) or moderate (32%) in severity. Statistically significant predictors of contracture development were length of stay (P < .005) and extent of burn (P = .033) and graft (P < .005). Predictors of the severity of contracture include graft size (P < .005), amputation (P = .034), and inhalation injury (P = .036). More than one third of the patients with a major burn injury developed a contracture at hospital discharge, which highlights the importance of therapeutic positioning and intensive therapy intervention during acute hospitalization. Furthermore, this challenges the burn care community to find new and better ways of preventing contractures after burn injury.

Adult↗

A descriptive review of neuropathic-like pain after burn injury.

This study reviews the natural history of neuropathic-like pain after burn injury. We undertook a retrospective chart review during a 24-month period of patients treated at an outpatient burn center. The medical records of patients with neuropathic-like pain complaints, including the sensation of pins and needles, burning, stabbing, shooting, or "electric" sensations, were included for analysis. Medical and demographic data were collected. We identified 72 patients for inclusion in the study. The age was 44 +/- 2 years (mean +/- SEM), and TBSA burned was 18 +/- 3%. The first complaint of neuropathic-like symptoms was at 4.3 +/- 0.5 months after injury. Documentation of improvement in the symptoms occurred at 7.0 +/- 0.8 months. Symptoms persisted for 13.1 +/- 2.2 months after the injury. Patients were followed for 14.5 +/- 2.2 months. Documented initial pain severity score was 7 +/- 1 of 10. Typical exacerbating factors included temperature change, dependent position, light touch, and weight-bearing activities. Common alleviating factors included rest, massage, compression garment use, and elevation. Treatment regimens often included gabapentin (38%) and steroid injections (21%). Hypertrophic scarring (43%), pruritus (40%), and psychiatric diagnoses (36%) were common associated problems. There is a patterned natural history for neuropathic-like pain after burn injury. This clinical entity involves significant pain complaints and persists, on average, for greater than 1 year after injury, which underscores the importance of long-term outpatient care after burn injury. Furthermore, an understanding of the natural history will assist clinicians in prognosticating and caring for burn survivors with pain after wound closure.

Adult↗