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Biomedical subjects

M Herbert

Publications and source records attributed to M Herbert.

At least 73 records · Page 4Linked to original sources
PubMed1993

Non-verbal communication: evaluation of a computer-assisted learning package.

A computer-assisted learning (CAL) package was developed on non-verbal communication. Its effectiveness was evaluated by comparing learning based on use of the package with that based on a didactic lecture covering the same topic. A class of 151 first-year medical students was divided into two groups, balanced for gender and home/overseas students. One group was asked to use the CAL package, the other group attended the lecture. Knowledge was assessed one week later by a written test, and reactions to using the CAL package were obtained via a questionnaire. Each group was then allowed and encouraged to use the other resource and then asked about their preferences for type of resource at the end of term. Mean score on the knowledge test was reliably better in the CAL group. In addition, scores increased as the time spent using the CAL package increased: this relationship was highly significant. Use of the CAL package varied from 15 to 120 minutes (median 45). Users reported that it was easy to operate, was an adequate or good resource for learning about the subject, and was a good or reasonable use of their time. After using both types of learning resource half the students judged the CAL package more useful for learning about the subject, and half preferred it to the lecture (the other half had the opposite judgement and preference). This study provides evidence that a CAL package can effectively substitute for traditional didactic teaching in a medical school. Good quality CAL, however, requires substantial resources and high calibre staff to develop and maintain it.

Computer-Assisted Instruction↗
PubMed1993

"What really happens in parent training?".

The purpose of this article was to describe the therapeutic processes involved in a parent-training program for families with conduct-disordered children. Videotaped transcriptions of over 100 hours of group discussion therapy sessions provided the data for this study. Findings indicated that the therapeutic process of helping parents learn to manage their children's behavior problems was based on a collaborative model. This model included six roles for therapists, which were labeled building a supportive relationship, empowering parents, teaching, interpreting, leading and challenging, and prophesizing. In addition, the script for parents included five recurring themes related to helping them cope more effectively. These were promoting parents' problem-solving, helping parents "come to terms" with their child, gaining empathy for their child, parents' accepting their own imperfection, and learning how to "refuel." Examples of each of these roles and themes are discussed.

Behavior Therapy↗
PubMed1992

Upstream curved sequences influence the initiation of transcription at the Escherichia coli galactose operon.

The two overlapping promoters that control mRNA synthesis at the galactose operon contain three phased stretches of adenine residues, located around positions -84.5, -74 and -63, with respect ot the start of the P1 promoter. As a result, the corresponding DNA sequence is bent, an anomaly that is relieved by the addition of small concentrations of drugs like distamycin A or netropsin. By abortive initiation assays performed on several DNA fragments derived from the wild-type promoter or from various mutants we show that the curved sequence increases the strength of the P1 promoter. In the absence of cyclic AMP (cAMP) and of the corresponding receptor protein (CRP), the upstream curved sequences enhance the rate of isomerization from the closed to the open complex at P1. This effect is abolished when distamycin A is bound in the bent region. In the presence of cAMP-CRP, a more drastic change is observed: activation of the gal P1 promoter takes place at a different formal step, depending whether the upstream curved sequence is present or not (enhancement of the rate of conversion from a closed to an open complex instead of an increase in the affinity of the enzyme during closed complex formation). These data, together with previous results obtained with other mutants of the gal control region, suggest that several closed complexes corresponding to different nucleoprotein arrangements are formed during open complex formation at gal P1, in the presence of CRP.

Base Sequence↗
PubMed1992

Psychomotor testing and the ability to perform an anastomosis in junior surgical trainees.

Ten junior surgical trainees underwent objective testing of manual dexterity and visuospatial ability and were required to carry out five consecutive anastomoses on fresh porcine jejunum. Anastomoses were scored by a single observer and a cumulative error score (CES) derived for each procedure. In the first anastomosis there was little correlation between the psychomotor test results and the anastomosis scores. In subsequent trials there were significant negative correlations between aspects of manual dexterity and the CES. Over the five anastomoses there were significant negative correlations between improvement and manual dexterity, but there was a positive correlation between improvement and visuospatial ability (rs = 0.76, P < 0.005). Visuospatial skills are more important than pure motor ability in predicting the capacity to perform an anastomosis and tests of manual dexterity may be misleading in this context.

Adult↗
PubMed1992

Substance abuse day treatment and managed health care.

Day treatment for substance abusers has been viewed by many as a viable treatment modality, particularly in light of the success of psychiatric day treatment programs. The available research also supports the efficacy of day treatment versus inpatient treatment for substance abusers. Nevertheless, day treatment programs for substance abusers have had difficulty gaining acceptance with treatment providers and patients alike. This paper offers several explanations for this lack of acceptance and proposes that managed care settings are ideally suited to pioneer substance abuse day treatment programs. Practical suggestions will also be offered to help market this treatment modality and minimize patient resistance.

Alcoholism↗
PubMed1992

Optimism, coping, psychological distress, and high-risk sexual behavior among men at risk for acquired immunodeficiency syndrome (AIDS).

In a cohort of gay men responding to the threat of acquired immunodeficiency syndrome (AIDS), dispositional optimism was associated with less distress, less avoidant coping, positive attitudes as a coping strategy, and fewer AIDS-related concerns. Men who knew they were seropositive for human immunodeficiency virus (HIV) were significantly more optimistic about not developing AIDS than men who knew they were seronegative for HIV. This AIDS-specific optimism was related to higher perceived control over AIDS and to active coping among seropositive men only and to health behaviors in both serostatus groups. There was no relation of optimism to risk-related sexual behavior. It is concluded that optimism is psychologically adaptive without necessarily compromising health behavior. It is also concluded that it is useful to distinguish between event-based optimistic expectations and dispositional optimism.

AIDS Serodiagnosis↗
PubMed1989

Comparison of intradermal and intramuscular hepatitis B vaccination in university students.

Antibody levels following intradermal and intramuscular hepatitis B vaccination were compared in a group of university students matched for age and sex. Intradermal vaccination gave satisfactory antibody levels in females, but much lower levels than by the intramuscular route and an unacceptable failure rate in men. The cost implications of introducing a selective vaccination policy in health care workers are discussed.

Adult↗
PubMed1989

[The value of immunofluorescence on frozen sections and immunoperoxidase methods on paraffin sections with different types of glomerulonephritis comparative study].

171 kidney biopsies were tested with the peroxidase- antiperoxidase (PAP)-method on paraffin sections. A comparison of the PAP-results with corresponding ones for the immunofluorescence method (IMF) on frozen sections was possible in 131 of the biopsies. When results of the 2 techniques were compared, outcomes showed a very strong accordance for both methods in tissues of postinfectious and perimembraneous GN an a strong accordance in mesangioproliferative GN tissue. In membrano-proliferative GN the immunopathological findings were more readily delinated with the PAP-method than with IMF. Cases involving IgA-nephritis, focal sclerosis and lupus nephritis with smaller deposits did not show consistant reactivity in the PAP-method as compared with IMF. 40 kidney biopsies, not examined by IMF, were diagnosed as GN by light microscopy and could be shown in 29 cases to contain evidence of an immune pathogenesis with the PAP-method.

Biopsy↗
PubMed1988

Comparison of ioxaglate with diatrizoate in angiography of the internal mammary artery.

To compare ioxaglate with the traditional agent diatrizoate, 44 patients scheduled to undergo coronary angiography that included internal mammary artery (IMA) visualization were entered into a randomized double blind-parallel design protocol. Complete data were collected on 32 out of 44. Four patients were withdrawn because of angiographically normal coronary arteries; seven, because of unsuccessful IMA cannulation; and one, because of an anaphylaxis-like reaction to ioxaglate. No other serious adverse effects were seen with either agent. The major endpoints were patient and physician assessments of discomfort, rated independently on a 4-point scale. Ioxaglate caused significantly less discomfort (n = 17, median rating of "mild discomfort") than did diatrizoate (n = 15, median rating of "severe discomfort"; P less than 0.01); this effect was independent of patient sex, the number of injections, and the volume of dye injected. Radiographic quality was good with both agents. We conclude that ioxaglate is much better tolerated than diatrizoate during angiography of the IMA.

Diatrizoate↗
PubMed1988

[Vasopressin and colonic motility].

Vasopressin (VS) has been reported to stimulate colonic peristalsis in different therapeutic conditions. In order to determine the mechanisms involved in this effect, colonic function was studied with three different techniques staying: a) the transit time of radioopaque markers through the colon was measured in 7 healthy subjects after VS IM (0.3 U/kg of weight). A marked propulsive effect was observed. One hour after injection, 64.7 +/- 16.2 p. 100 of the markers (m +/- sem) had left the right colon vs 9.1 +/- 4.6 p. 100 after injection of NaCl (p less than 0.01) and 70.5 +/- 10.8 p. 100 of the markers emptied from the left colon vs 4.3 +/- 4.5 p. 100 after NaCl (p less than 0.01); b) an electromyographic study was carried out in 6 other healthy subjects with an intraluminal device equipped with contact electrodes, introduced into the left colon by colonoscopy. The injection of VS was followed by an increase in the number of the propagating electrical spike bursts that are known to correlate well with the propulsion of the colonic intraluminal contents. The number of bursts was 2.7 +/- 0.6 bursts/30 min after NaCl and 5.2 +/- 1.4 bursts/30 min after VS (p less than 0.02); c) finally, the outflow of ileostomies and colostomies was measured in respectively 3 and 8 subjects over one h after IM 0.3 U/kg of VS. A considerable increase in the outflow of intestinal fluids was observed: output from the colostomies was 10 +/- 10 ml/h after NaCl and 250 +/- 39 ml/h after VS (p less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1987

Influence of sympathetic nervous system on hypoglycaemic warning symptoms.

The effect of mild insulin-induced hypoglycaemia on symptoms, physiological changes, and adrenaline responses was assessed in 10 normal subjects and 15 insulin-dependent diabetic patients (5 with reduced awareness of hypoglycaemic symptoms). When blood glucose was maintained at 3.2 mmol/l, reaction time was prolonged in both normal and diabetic subjects and plasma adrenaline levels increased in the normals and some diabetics; there were no other physiological responses. 2 normals and 1 diabetic were aware that their blood glucose was low. When blood glucose was maintained at 2.5 mmol/l for 30 min, 9/10 normals but only 4/15 diabetics recognised hypoglycaemia. Increases in hypoglycaemic symptom score, tremor, and sweating, and falls in diastolic blood pressure were significant only in the normal subjects and the 4 "aware" patients. Adrenaline levels increased in all cases, but were more pronounced in the normals and aware diabetics. Reaction time remained prolonged in all groups. All measurements returned to baseline when blood glucose was raised to 4.5 mmol/l. Impairments in adrenaline response may be common, even in diabetic patients without autonomic neuropathy and in those who do not complain of hypoglycaemic unawareness; consequent failure to recognise a falling blood glucose may predispose to a risk of severe hypoglycaemia.

Adult↗