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At least 343 records · Page 19Linked to original sources
PubMedDate not supplied

One step forward and two steps back: the dangers of walking backwards in therapy.

Walking backwards has been used in therapy to improve balance and gait. There has not been any systematic investigation into the effectiveness or safety of walking backwards. We present two cases in which walking backwards during physical therapy resulted in a fall and considerable morbidity. The only clear indication for treatment by walking backwards should be a task-specific need to do so, and only then if adequate safety can be assured.

Accidental Falls↗
PubMedDate not supplied

The road to JCAHO disease-specific care certification: a step-by-step process log.

In 2002, the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) implemented Disease-Specific Care (DSC) certification. This is a voluntary program in which organizations have their disease management program evaluated by this regulatory agency. Some of the DSC categories are stroke, heart failure, acute MI, diabetes, and pneumonia. The criteria for any disease management program certification are: compliance with consensus-based national standards, effective use of established clinical practice guidelines to manage and optimize care, and an organized approach to performance measurement and improvement activities. Successful accomplishment of DSC certification defines organizations as Centers of Excellence in management of that particular disease. This article will review general guidelines for DSC certification with an emphasis on Primary Stroke Center certification.

Benchmarking↗
PubMedDate not supplied

Measuring critical thinking: one step forward, one step back.

When critical thinking was identified as an explicit program outcome by the National League for Nursing in 1991, nursing programs were thrust into frenzied activity defining critical thinking and selecting instruments to evaluate it. This drove research on the measurement of critical thinking among nursing programs and the concomitant search for reliable and valid methodologies to systematically assess changes in critical thinking in their students. Although the ultimate goal of this process was curricular improvement, nearly 15 years later, faculty struggle to make sense of the data they have.

Attitude of Health Personnel↗
PubMed2004

Two steps forward, one step back: the pleiotropic effects of favoured alleles.

Pleiotropy is one of the most commonly observed attributes of genes. Yet the extent and influence of pleiotropy have been underexplored in population genetics models. In this paper, I quantify the extent to which pleiotropy inhibits the spread of alleles in response to directional selection on a focal trait. Under the assumption that pleiotropic effects are extensive and deleterious, the fraction of alleles that are beneficial overall is severely limited by pleiotropy and rises nearly linearly with the strength of directional selection on the focal trait. Over a broad class of distribution of pleiotropic effects, the mean selective effect of those alleles that are beneficial overall is halved, on average, by pleiotropy. The fraction of new mutant alleles that are beneficial overall and that succeed in fixing within a population is even more severely limited when directional selection is weak, but it rises quadratically with the strength of directional selection. Finally, the mean selective effect of mutant alleles that are beneficial and succeed in fixing is reduced by one-third, on average, by pleiotropy. These results help to shape our understanding of the evolutionary inertia caused by pleiotropy.

Alleles↗