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Biomedical subjects

W H Sledge

Publications and source records attributed to W H Sledge.

At least 37 records · Page 2Linked to original sources
PubMed1993

Normative implications of the relationship between reading vocabulary and Boston Naming Test performance.

The 60-item Boston Naming Test (BNT) was published in 1983 with norms described as provisional. One recent finding (Thompson & Heaton, 1989) suggests that verbal intelligence, and the Wechsler Adult Intelligence Scale (WA1S)-Revised Vocabulary subtest, in particular, is strongly correlated with BNT performance, and that education is moderately so. High false-positive rates for naming deficit may conceivably result from the application of the published norms with subjects of lower verbal abilities or limited educational backgrounds. To further explore the relationship of naming to other verbal abilities, analyses were undertaken of the correlations between Level 7-9 Gates-MacGinite Reading Vocabulary Test (G-MRVT) and BNT data from 97 schizophrenic, bipolar, and normal subjects. Reading vocabulary is strongly correlated with BNT performance, and the nature of this relationship is essentially the same across the three diagnostic groups. Application of the published norms would have resulted in a high false-positive rate for naming deficit in all groups among subjects with reading vocabularies equivalent to twelfth grade or less. As a word-recognition based reading exercise, the G-MRVT is likely to provide a brain-compromise-resistant index against which the adequacy of naming performances can be assessed. Accordingly, G-MRVT based BNT performance expectation guidelines are presented for use as a complement to the published norms. Other implications are discussed.

Journal Article↗
PubMed1990

Training and career activity. The experience of the Yale Advanced Track Program.

The Advanced Track Program of the Yale psychiatric residency is examined by a study of the career patterns of 132 graduates of the program over a 9-year period (1973 to 1982). The findings demonstrate that specific track training sequences are associated with subsequent career activities and that track graduates differ significantly from each other along dimensions of professional activities, work settings, treatment modalities, and patient characteristics. These differences are discussed from the vantage of the relationship between training and professional activity.

Adult↗
PubMed1990

Effect of time-limited psychotherapy on patient dropout rates.

The authors conducted an archival study of 149 new clinic patients at a large community mental health center. The dropout rate for patients in brief psychotherapy in which the length of therapy was specified at the outset of treatment (time-limited psychotherapy) (32%) was about one-half the dropout rate for patients in brief (67%) and long-term (61%) individual psychotherapy. The difference in dropout rates could not be explained by patient demographic or diagnostic variables or by therapist characteristics measured in the study. The results suggest that setting a specific time limit on individual psychotherapy at the outset of treatment can reduce the patient dropout rate in a public mental health clinic.

Ambulatory Care↗
PubMed1989

Audiotape playback as a technique in the treatment of schizophrenic patients.

The authors report on the use of playing back audiotaped portions of the speech of two schizophrenic patients during psychotherapy. They believe that this audiotape replay was instrumental in organizing the patients' thoughts and spoken communications and that it might also have facilitated the patients' participation in psychotherapy. The usefulness of this strategy is illustrated with clinical material.

Adult↗
PubMed1989

Effect of patient gender on evaluation of intern performance.

To explore the effect of patient gender on the perceptions of intern performance, 366 patients were interviewed during hospitalization in acute medical services. Women reported being more satisfied with the care they received than did men. In particular, women were more satisfied than men with their intern's demonstration of personal concern. The women placed more importance on personal manner and concern, and their greater satisfaction with these behaviors may have contributed to higher ratings of overall satisfaction. In contrast, the men seemed less satisfied with their intern's personal concern; they also tended to weigh such concern less in determining overall satisfaction. Men considered the presentation of information by the physician and the establishment of dialogue with the physician as more important. The amount of such dialogue may have been inadequate to generate higher levels of overall satisfaction for the men patients.

Aged↗
PubMed1988

Adolescent elopement from a psychiatric hospital. Multiple dimensions.

The authors report an unusual epidemic of elopement from an adolescent ward of a psychiatric hospital and demonstrate the utility of the single case study method with the hospital ward as the unit of study. The authors found that elopement was associated with patient factors (such as the absence of the diagnosis of affective disorder and a previous history of running away from psychiatric treatment) and patient-therapist interaction factors (separations from treatment team members), both of which seemed to interact with the milieu. The authors discuss how the single case study permits examination of multiple levels of sociopsychological processes.

Adolescent↗
PubMed1988

A curriculum for education in geriatric psychiatry.

The authors present recommendations for educating medical students and psychiatric residents in geropsychiatry. They are primarily concerned with the objectives and methods rather than the content of training. Proposals are structured in terms of training objectives and educational settings in which such training takes place. The proposals are intended to be specific enough to be truly useful and at the same time sufficiently generalizable to adapt to geropsychiatric training in a variety of institutions. Priority is given to integrating knowledge of normal and abnormal aging with the clinical skills and empathy necessary to approach patients with competence and understanding.

Aged↗
PubMed1988

Four-year evaluation of a psychiatric clerkship: 1982-1986.

The authors describe a psychiatric clerkship organized to achieve goals relevant to all medical students, regardless of their future specialty choice. The clerkship had been in place for 8 years in 1986, and standardized program evaluations were available for 4 years. A survey of the diverse clinical settings used for the clerkship showed that each had unique strengths and weaknesses but that each could meet the core goals of the clerkship, indicating that this clerkship design would also be feasible in a smaller department with any one or two of the settings available.

Attitude↗
PubMed1987

Evaluation of intern performance by medical inpatients.

Patients, as the recipients of medical care, have a unique and crucial perspective from which to judge the performance of physicians. In this study, 27 interns (postgraduate year 1 residents) were evaluated by a sample of 212 medical inpatients at two university-affiliated hospitals using a previously validated questionnaire constructed from patients' comments. Patients were generally very satisfied with the performance of their interns and valued traditional clinical skills and interpersonal skills equally. The most important and characteristic attributes of the interns as rated by patients were demonstrating personal concern, skill in treating disease, providing information about findings, preparation for impending events, availability, manner of communication, trust, and comforting and listening skills. Encouraging mutuality by the interns was not often done and was not believed to be particularly important by patients. Older patients and whites were more satisfied with their interns, whereas college-educated, employed, and male patients were less satisfied. Implications of the findings for understanding and teaching about the physician-patient relationship are discussed.

Clinical Competence↗
PubMed1987

Applicants' choice of a residency training program.

The authors present results from a survey of senior medical students in the class of 1981 concerning their selection of residency training programs in psychiatry. Generally, students were more influenced by clinical training opportunities and quality of life factors and not much influenced by the philosophy of the program. The implications of the findings are discussed from the perspectives of both advising and recruiting medical students.

Adult↗
PubMed1985

Reintroducing the internship: reactions of three departments of psychiatry.

The reintroduction of the internship requirement has caused a number of changes in psychiatric education in the past decade. Many psychiatric educators and departments of psychiatry have been faced with the challenges of organizing internships and establishing an internship curriculum. This has been especially challenging because the psychiatrists involved have seldom had full postgraduate training in the fields being organized and have not previously administrated clinical services in those areas. The authors discuss the goals of the internship for future psychiatrists and the pros and cons of university versus community general hospital based internships for future psychiatrists, and find several potential advantages to the latter. Also discussed are their consistent observations of internship programs for future psychiatrists over the past decade in three geographically separate regions and in state and private institutions. They and most other faculty members in their respective departments believe that the reinstitution of the internship has had largely beneficial effects on future psychiatrists.

Hospitals, Community↗
PubMed1983

Educational objectives in psychiatric residency training: a survey of training directors and residents.

The authors surveyed 200 physicians completing their psychiatric residencies on the importance and achievement of 124 core training objectives. One hundred thirty (65%) of the residents and all 23 of the training directors of the programs selected responded. As a group, residents viewed a substantial number of the objectives as less important, and less well accomplished, than did their training directors. The discordantly rated objectives fell in several basic areas of psychiatric competence, such as the management of schizophrenia and drug side effects. Certain objectives were rated at a lower level of accomplishment by residents from smaller programs. Possible factors accounting for these differences are briefly considered.

Curriculum↗
PubMed1982

Syncope in aircrew.

In a study of 47 aviator patients consecutively referred to U.S. Air Force School of Aerospace Medicine for evaluation of alteration of consciousness, 34 cases of syncope were identified. Mechanisms of etiology included 24 with vasovagal syncope, 4 with micturition syncope, and 6 with miscellaneous causes. Each diagnostic group was separately compared to a group of 26 control (nonsyncopal) patients. Clinical findings of the different diagnostic groups are presented. Notable differences in antecedent factors, clinical findings, and consequences of syncope are discussed.

Adult↗
PubMed1980

Self-concept changes related to war captivity.

A questionnaire was mailed to all US Air Force repatriated prisoners of the Vietnam was (POWs) still on active duty, and to matched controls, in the fall of 1976. Results were analyzed to determine long-term consequences of the war imprisonment experience. We hypothesized that individuals experiencing the greatest stress and frustration might believe they gained more psychologically than those less stressed. The questionnaire results indicated a distinct subgroup of POWs for which this was particularly true, although the subjective sense of feeling somehow "benefited" by the experience was by no means universal. This study supports the hypothesis that the subjective sense of having benefited from the experience of war imprisonment is positively correlated with the harshness of the experience.

Adult↗
PubMed1980

The psychiatrist's role in aerospace operations.

This paper presents two unique aspects of aerospace psychiatry: the influence of the specialized stressors and occupational requirements of an aviation career and the ambiguous role of the aerospace psychiatrist. Aerospace psychiatrists have multiple, sometimes conflicting, responsibilities to the organization and society (the social control task) and to the individual aviator (the humanistic and medical tasks). In the two case reports below the authors describe airmen who had vasovagal syncope and how the psychiatrist intervened and resolved these conflicting tasks.

Adult↗
PubMed1979

Vasovagal syncope in aircrew. Psychosocial aspects.

Twenty-four aircrew members with the diagnosis of vasovagal syncope were compared to 26 controls on variables of personality characteristics, psychosocial antecedents to the onset of their conditions, and hyperventilation experience. The syncope group was found to be younger, slightly less adaptable, and to have significantly more negative feelings about their work. The authors argue that syncope in aircrew should be considered from a psychosocial perspective as well as from a medical-neurological perspective.

Adaptation, Psychological↗
PubMed1979

Intensive psychiatric care for adolescents and young adults: a model for treatment and evaluation.

The authors' model for the hospital treatment of severely disordered adolescents and young adults calls for a categorization of the patient's major characteristics that are relevant to treatment along six axes: symptoms and signs, previous course of the disorder, social functioning, work or school functioning, family or other living situation, and sense of identity. They present a case study of a 19-year-old male patient to demonstrate how the model works.

Adolescent↗