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P Blumberg

Publications and source records attributed to P Blumberg.

At least 19 recordsLinked to original sources
PubMed1999

Tracing the evolution of critical evaluation skills in students' use of the Internet.

This paper documents the evolving uses of the Internet made by public health graduate students and traces the development of their search methods and critical evaluative criteria. Early in the first semester and again six months later, twenty-four graduate students in a problem-based learning curriculum, which emphasizes evidence-based critical thinking skills, were required to describe their most helpful resources and to evaluate these resources critically. The answers were coded for the types of resources the students used, how frequently they were used, and why they were used. Student perception of the usefulness of resources, especially the Internet, and ability to evaluate these resources critically changed greatly. Initially, 96% of the students stated that the Internet was their most helpful resource. Six months later, these students continued to use the Internet; however, it was not their most useful source. At the later point, students had very specific uses for the Internet. Their most frequently used evaluation criterion was the reliability and objectivity of the source of the information. By the end of the first year of study, the majority of the students demonstrated an understanding of the principles of evidence-based practice and applied them to their research and analysis of information resources.

Curriculum↗
PubMed1997

Increased turnover of small proteoglycans synthesized by human osteoblasts during cultivation with ascorbate and beta-glycerophosphate.

The small proteoglycan decorin had been localized previously at the d-band in the gap zone of collagen fibrils in nonmineralizing tissues. In bone matrix this zone is proteoglycan free and is at least in some species the place where mineralization along collagen fibrils starts. To study the metabolism of the small proteoglycans decorin and biglycan under mineralizing conditions, osteoblasts from human nasal bone were cultured for several weeks in the presence or absence of beta-glycerophosphate and ascorbate. An immediate consequence of the treatment was a reduced expression of decorin, as judged by immune precipitation, whereas the biosynthesis of biglycan was not affected. Pulse-chase experiments were performed with osteoblasts embedded in floating type I collagen gels. In the presence of beta-glycerophosphate and ascorbate, a more rapid turnover of both proteoglycans was noted; the one of biglycan reached statistical significance. Indirect evidence for an enhanced rate of proteoglycan endocytosis was obtained. This effect was not seen in cultured skin fibroblasts. Thus, osteoblasts respond rapidly to mineralizing conditions with alterations of small proteoglycan biosynthesis and turnover.

Adolescent↗
PubMed1996

Modulation of collagen gel contraction by decorin.

The small dermatan sulphate protein decorin interacts via its core protein with fibrillar collagens, and its glycosaminoglycan chains were proposed to be capable of self-association. It was therefore of interest to study the role of decorin in the contraction of cell-populated collagen lattices. Stable transfection of dihydrofolate reductase-deficient CHO cells with decorin cDNA resulted in impaired collagen lattice contraction. Using normal human skin fibroblasts in serum-free cultures, inclusion of 0.3 microM decorin in the culture medium also led to a delayed collagen gel contraction. Protein-free dermatan sulphate and the dermatan sulphate-degrading enzyme chondroitin ABC lyase were ineffective. Potential interactions between dermatan sulphate chains were studied by gel filtration. A shift in the elution position of [35S]sulphate-labelled decorin-derived glycosaminoglycans by unlabelled decorin could be observed only when the chains were prepared by trypsin. Chains liberated by beta-elimination or by cathepsin C were eluted at identical positions in the presence or absence of decorin. It is therefore unlikely, that the effect of decorin on collagen-gel retraction is brought about solely by glycosaminoglycan-glycosaminoglycan interactions.

Adolescent↗
PubMed1995

Using a new program evaluation model to chart the outcomes of an educational intervention in residency training.

The purpose of this article is to introduce a new outcome-oriented, utilization-focused, and practical approach to program evaluation: Charting the Outcomes of Educational and Clinical Approaches (COECA) model. It provides a framework that encourages stakeholders to consider academic dissemination, product development, and implementation as three primary outcomes when evaluating educational and clinical approaches. The model then identifies measurements of the impact of each of these primary outcomes. Finally, it outlines three secondary outcomes that focus on education, clinical service, and administration. As an example, this article discusses the application of the model to an educational intervention in residency training. This intervention has been implemented at two sites. Secondary outcomes include increased competency of residents and a change in responsibilities among health care team members. The COECA model provides an easy-to-apply and efficient method for documenting actual progress and determining potential for further development.

Authorship↗
PubMed1992

An exploratory study of the adequacy of residency education in geriatrics: a methodological description.

This study describes a method to evaluate the educational strengths and needs in a family practice residency program. Patient encounter data and a detailed questionnaire to elicit perceptions of residents and faculty were used, followed by site visit meetings using a standardized protocol to discuss the results. These separate data sets validate each other and together triangulate the support of the conclusions. The results of this study indicate that both faculty and residents in a university-affiliated residency program can benefit from increased development in geriatrics. Although this method of studying the adequacy of residency education involved geriatrics, a similar process could be applied equitably to other curricular domains.

Educational Measurement↗
PubMed1991

Investigating whether teachers should be given assessments of students made by previous teachers.

Based upon a consideration of data from the literature, a survey, and a problem-solving discussion at a national meeting, the authors suggest the following recommendations concerning the provision to faculty of previous assessment information on students. Students' problems noted by faculty should be shared with the faculty who subsequently teach them. Students must be central to the entire process of disclosing earlier assessments and should be encouraged to initiate the process. The data should be provided by all appropriate faculty and should be distributed to the student advisor and the dean's office for dissemination to the course director of the next unit. Confidentiality must be assured. The rationale for such a policy is discussed.

Attitude↗
PubMed1990

Influence of collagen lattice on the metabolism of small proteoglycan II by cultured fibroblasts.

Small dermatan sulphate proteoglycan II from cultured human skin fibroblasts interacts with type I collagen in vitro and in vivo. When fibroblasts are maintained in a type I collagen lattice the proteoglycan remains exclusively within the lattice, and its association with fibrils can be demonstrated immunocytochemically. On the basis of [35S]sulphate incorporation, small proteoglycan II comprises about 80% of total proteoglycans secreted by cells in monolayer culture. In a collagen lattice, fibroblasts down-regulate its synthesis to the level of large chondroitin sulphate/dermatan sulphate and of heparan sulphate proteoglycans, the synthesis of which remains unaffected. Compared with the product from monolayer cultures, small proteoglycan II from collagen gels contained a longer polysaccharide chain which is characterized by a larger proportion of disulphated and a smaller proportion of monosulphated glucuronic acid-containing disaccharides. The half-life varied between 60 and 110 h. It is suggested that the compositional differences between the proteoglycan from monolayer cultures and from cells in a collagen lattice are related to the slower intracellular trafficking of the proteoglycan under the latter culture conditions.

Adult↗
PubMed1990

[Pathogenesis and treatment of Zencker's diverticulum].

The aims of this study were: 1) To measure pharyngeal and upper oesophageal function manometrically at the same time as recording video images of the patient swallowing barium, in normal controls and patients with Zenker's diverticulum, and, 2) In those patients who progressed to surgery to biopsy the cricopharyngeus and compare the findings with biopsies from normal controls. Subjects were seated in front of a fluoroscope and video images of a barium swallow were synchronised with a multichannel recording catheter which contained 3 perfused side holes 1 cm apart (situated in the pharynx) and a 4 cm long perfused sleeve pressure sensor (positioned across the upper oesophageal sphincter). The coordination of the upper sphincter with swallowing, its relaxation, the pressures generated in the distal pharynx and the maximum luminal area of the open upper sphincter, were calculated for different volumes of barium swallowed in 11 patients with a Zenker's diverticulum (mean age 71 years, range 50-99) and 9 normal controls (mean age 65 years, range 55-86). Seven patients progressed to cricopharyngeal myotomy and their biopsies were compared with biopsies from 9 normal controls. In patients with Zenker's diverticulum intrapharyngeal pressures during barium swallows were significantly greater (p less than .05) and maximal luminal areas of the open sphincter were significantly less (p less than .05) than in control patients. In patients having a cricopharyngeal myotomy, intrapharyngeal pressures and maximum luminal areas returned to normal after surgery. The cricopharyngeus muscle of patients with a Zenker's diverticulum showed significantly increased fibrosis compared with normal controls.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1988

Influence of chlorate on proteoglycan biosynthesis by cultured human fibroblasts.

The influence of chlorate, an inhibitor of sulfate adenylyltransferase, on biosynthesis and secretion of proteoglycans was investigated in cultured human skin fibroblasts. At up to 10 mM concentrations, chlorate caused a reduction of [35S]sulfate incorporation into small chondroitin sulfate/dermatan sulfate proteoglycan by up to 96%. Incorporation of [3H]leucine and [3H] glucosamine was only slightly affected. No influence was seen on the polymerization degree of the polysaccharide chain as judged by gel filtration, and on the kinetics of secretion of the proteoglycan. Concomitant with reduced sulfation, however, was an increased sensitivity toward chondroitin AC lyase which suggests a diminished epimerization of D-glucuronic acid to L-iduronic acid residues. Agarose gel electrophoresis revealed that all polysaccharide chains of control chondroitin sulfate/dermatan sulfate proteoglycan exhibited a similar sulfation degree. Chlorate treatment led to the formation of polysaccharide chains of widely varying degree of sulfation, but fully sulfated chains were synthesized even in the presence of 3 mM chlorate, and sulfate-free chondroitin was not detected. Studying the effects of chlorate treatment on the synthesis of other proteoglycan types it was found that, in cell-associated galactosaminoglycans, 6-sulfation of N-acetylgalactosamine residues was less affected than was 4-sulfation. In case of heparan sulfate the synthesis of sulfamate groups was less impaired than sulfate ester formation. Nitrous acid degradation at pH 4.1 indicated the presence of unsubstituted amino groups. Chlorate treatment may be considered as a means for the production of proteoglycans with defined structural alterations.

Adult↗
PubMed1988

Evaluation of medical student performance in the clinical years.

The analysis of a system for evaluating student clinical clerkship performance shows that residents and attendings make use of only a single dimension, from "good physician" to "bad physician." Further analyses show that this dimension is defined differently by different specialties, and that the results of evaluations from all clerkships are required to provide full and adequate assessment of students' abilities.

Aptitude↗
PubMed1988

A comparison of student satisfaction with their preclinical environment in a traditional and a problem based curriculum.

Students in a problem based and a traditional preclinical curriculum rated descriptors three times in terms of what they expect to experience, what they would like, and what they actually experienced. The problem based students were satisfied with the essential aspects of their curriculum; the traditional curriculum students were less satisfied with the essential elements of their curriculum.

Career Choice↗
PubMed1983

A study on interaction techniques of nursing faculty in the clinical area.

In order to better understand the nature of clinical teaching, 44 two-hour observations of instructors in clinical and field settings were conducted. The instructors were teaching clinical nursing courses from the sophomore through the senior level. The observers recorded the frequency of 16 techniques using a category system as well as data concerning the student-teacher ratio, type of class, and other information. The results show that one third of the interactions between student and faculty lasted one minute or less and one third lasted one to six minutes. Majority were initiated by the faculty member with a 1:1 ratio. Analysis of the types of techniques most frequently used across all courses were either leading/direct questions or information giving. Discussion and implication of the results of this study are discussed in light of the realities of clinical experiences for the baccalaureate nursing student; e.g., effects on problem-solving abilities of students; need to improve clinical teaching interaction skills; and curriculum change. This study describes the interaction techniques that nursing faculty used with students in clinical and field settings. Improving clinical teaching is currently a priority for nurse educators. Many people assume that they have a good idea of what transpires between faculty and students in clinical settings. Yet very little is actually documented on this topic. Before improvements can be made, we should have a more complete understanding of what is happening. This can best be accomplished by observing and documenting faculty interactions with students. Therefore, the need to obtain better information about faculty-student interactions in clinical and field settings was the impetus for this quantitative descriptive study.(ABSTRACT TRUNCATED AT 250 WORDS)

Clinical Competence↗