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Effects of rational emotive education on the rationality, neuroticism and defense mechanisms of adolescents.

The purpose of this study was to assess the efficacy of rational emotive education (REE) as a mental health prevention program for adolescents. The subjects included 109 eleventh- and twelfth-grade students enrolled in four introductory psychology courses, and who were divided into experimental and control classes. Experimental subjects received 12 biweekly sessions of REE. Subjects were pre- and posttested on three measures of psychosocial adaptation: the Rational Behavior Inventory (RBI), the Defense Mechanism Inventory (DMI), and the Eysenck Personality Inventory (EPI). The effects of REE upon behavior were also examined by comparing academic effort grades, number of detentions, and grade point averages. Overall results showed significant positive changes in use of more adaptive defense mechanisms and in academic effort grades in the predicted direction. No significant changes occurred on the other measures. However, as a distinctive group, 17-year-olds demonstrated a significant reduction in neuroticism scores and a significant increase in academic effort grades.

Adaptation, Psychological

The importance of an introduction to scientific methodology and research evaluation in the nursing curriculum: an Icelandic experience.

This article briefly presents a total academic program for preparing professional nurses at the University of Iceland and discusses the reasons for teaching an introductory course in scientific methodology and research evaluation in its curriculum. It is argued that scientific methodology and research evaluation adds a necessary component to the qualification of the nursing graduate and an ability to participate in clinical research and advancement of research-based practice.

Curriculum

Multicenter randomized effectiveness/implementation trial of a digital self-management support tool to improve the quality of life during adjuvant hormonal therapy for patients with early breast cancer: The HOPE trial.

BACKGROUND: For patients with hormone receptor (HR) positive early breast cancer (BC), adjuvant endocrine therapy (ET) represents the cornerstone of treatment. However, 75% of patients experience ET-related symptoms that negatively affect their quality of life (QOL). Despite their high prevalence, these symptoms are often underestimated and under-addressed during consultations. As a result, non-adherence to ET is common and remains a major barrier for optimal disease and survival outcomes. METHODS: National, prospective, randomized, open-label hybrid type 1 effectiveness/implementation trial conducted in France comparing a personalized digital health pathway plus standard of care (SoC) vs. SoC alone in patients with HR+ early BC reporting ET-related symptoms. 180 patients will be randomized 1:1 to receive either 12 weeks of the digital health pathway or 12 weeks of SoC. The intervention is anchored by the Resilience© digital companion including remote symptom and needs assessment, an introductory nurse-navigator phone call, and access to personalized, symptom-specific online educational and self-management programs (physical activity, yoga, meditation or cognitive behavioral therapy). In both arms, patients will be invited to wear a wearable device to objectively monitor behavioral parameters. The primary endpoint is the ET symptoms scale of the European Organization for Research and Treatment of Cancer (EORTC) QLQ-BR45 over 12-weeks. Secondary endpoints include other QOL domains, self-reported ET adherence, eHealth literacy, self-efficacy, and evaluation of the implementation process. DISCUSSION: This study should provide evidence on the effectiveness and real-world implementation of a personalized digital health pathway to improve QOL in patients experiencing ET-related symptoms. TRIAL REGISTRATION: ClinicalTrials.gov NCT06781996; Protocol version 3.0.

Humans

Enrolling community physicians and their patients in a study of prevention in the elderly.

Enrollment of senior citizens in a community Medicare demonstration project to explore the efficacy of preventive health screening and health education was accomplished by using a two-stage process. This process consisted of initial communication with community physicians through the University of California at Los Angeles Clinical Faculty Association to establish credibility for the program. Physicians who agreed to participate then selected potential participants to receive, by mail, a description of the study and an introductory letter from their own physician. Followup and actual enrollment of participants was then handled by the study team. A total of 57.6 percent of the elderly people approached agreed to participate in the study.

Aged

Schizophrenia, genetic retrenchment, and epidemiologic renaissance. The Sixth Biennial Winter Workshop on Schizophrenia, Badgastein, Austria, January 26-February 1, 1992.

A distinctive feature of these workshops, in addition to those noted in the introductory overview, is the selection of a relatively isolated location for a 1-week period. This, together with a rich and varied program and an ethos of informality, encourages participants to discuss not only the work presented but also their unpublished work and their intuitions based on preliminary data and analyses. Such an interchange is of inestimable value to the schizophrenia research community. In scientific terms, a panel of concluding discussants (Drs Kendell, Torrey, and Waddington) were in some measure of agreement that genetics, particularly molecular genetics, appears to be experiencing a period of retrenchment, while epidemiology is experiencing something of a renaissance. Maternal influenza was a prominent theme, although the data were far from consistent. It was argued by Dr Wessely that risk for schizophrenia putatively attributable to maternal influenza might be 5% to 10% of all cases, indicating a modest effect. Eclectically, Dr Kendell believed the effect to be "real" but slight and fragile, it being sought against large aggregates that almost inevitably result in differing findings from differing countries or from different data bases within a given country. Gender differences were also among the more prominent themes, not just in an epidemiologic context but also in a variety of other studies. This points anew to disturbances in schizophrenia of factors that regulate, or are intimately associated with, sexual dimorphism in brain development. Abnormalities in cerebral asymmetry continue to pervade a variety of research findings and point further to neurodevelopmental anomalies.(ABSTRACT TRUNCATED AT 250 WORDS)

Humans

The scope of a laboratory animal program needed at a veterinary school.

The discipline of laboratory animal medicine is one of the most rapidly expanding specialties within the veterinary profession. Veterinary schools should fully accept the responsibility for introductory instruction in laboratory animal medicine in the professional curriculum. Such instruction should articulate the varied opportunities that exist for the laboratory animal veterinarian within the biomedical research community, and provide an overview of the normal biological characteristics and pathologic conditions of the common laboratory animal species. In addition, the opportunity should exist within the veterinary school for graduate and undergraduate students utilizing experimental animals to receive a comprehensive introduction to laboratory animal biology, care, and management. Instructional responsibility for such courses should be accepted by faculty veterinarians with advanced training in laboratory animal medicine. Veterinarians with advanced training in this specialty are uniquely qualified to make substantial contributions to biomedical research by promoting the health and welfare of the research animal.

Animals

A systems approach to the development and evaluation of a minicourse for nurses.

An autotutorial, audiovisual minicourse was designed to: 1) inform nurses and other hospital personnel to handle effectively problems associated with contamination and decontamination of respiratory therapy equipment according to the best procedures currently availabel, 2) investigate how different instructional methods are related to student achievement, and 3) determine an effective approach for implementing this educational modality. The subjects-137 allied health students, predominantly nurses, enrolled in introductory microbiology in the Department of Biology, Georgia State University, Atlanta, during the Spring Quarter 1974-were randomly placed in four treatment groups: 1-programmed instruction (PI), 2-audiovisual (AV), 3-AV-PI combined, 4-no exposure to the mini-course-control group. Achievement was measured by comparing pre- and posttest scores on a subject matter achievement test. An analysis of variance revealed that not all treatment population means were equal. Tukey's Honestly Significant Difference Test showed that all three groups exposed to one or both methods of the minicourse scored higher than the control group, with the AV-PI group scoring highest.

Audiovisual Aids

Joint mobilization for children with central nervous system disorders: indications and precautions.

Because clinicians are introducing joint mobilization into treatment programs for children with cerebral palsy, we felt that a review of the procedure and its scientific basis would be timely. The goals of the introductory section of this article are to define joint mobilization as it has been used for adults with musculoskeletal disabilities, to discuss various rationales for its effects, to describe contraindications and precautions for its use, and to discuss its efficacy as reported in the research literature. The latter part of the article deals with the use of joint mobilization for children with central nervous system (CNS) disorders. In an effort to understand precautions for the use of joint mobilization in children, musculoskeletal development will be described both for typically developing children and for children with spastic cerebral palsy. Indications for using joint mobilization techniques in children with spasticity will be outlined. Specific neurodevelopmental disabilities for which joint mobilization would be strongly contraindicated will be listed. Finally, future research directions in evaluating reliability of assessment of joint dysfunction and efficacy of joint mobilization in children will be discussed.

Biomechanical Phenomena

Forensic methods and the podiatric physician.

This is an introductory study of forensic podiatry. To elevate forensic podiatry to the level of forensic odontology and forensic anthropology, the podiatric medical profession must begin educational programs and research. A system for monitoring the activities of podiatrists involved in forensic medicine must be established to ensure that the high degree of integrity to which the profession is committed is maintained. By following these guidelines, the author believes that sometime in the future a podiatrist will be on the staff of every major police department in the country. At that point, the podiatric medical profession will have achieved unsurpassed status, recognition, and prestige.

Forensic Medicine

Development and validation of a food use checklist for evaluation of community nutrition interventions.

We developed a new dietary assessment instrument, the Food Behavior Checklist (FBC), which measures food use related to adopting lower-fat and higher-fiber diets. The FBC is a simplification of the 24-hour diet recall that consists of 19 simple yes/no questions about foods consumed during the previous day. To develop the FBC, an expert committee generated a list of foods based on our intervention program, and we used focus groups and random-digit dialing pretests to refine the format and clarify items. To validate the FBC, we compared responses of 96 women on the FBC to information collected during a professionally administered 24-hour diet recall. For most items, agreement between the FBC and 24-hour recall, based on the kappa statistic, was good to excellent. Agreement was poor for items requiring detailed knowledge about food composition (e.g. high-fiber cereal). There was a trend to over-report general food categories (e.g. luncheon meats) but not specific food items (e.g. ice cream). In an embedded randomized study, we found that a set of introductory items designed to serve as a memory retrieval cue did not improve agreement between the FBC and 24-hour recall. These data provide preliminary evidence supporting the use of short checklist questionnaires on the previous day's food use as a means to assess diet at the group or community level. This relatively inexpensive and rapid measure can be used to inform the design of public health nutrition programs and as an evaluation tool in intervention research.

Diet

Attitudes toward death in adolescent offspring of Holocaust survivors.

Introductory remarks are directed toward a brief review of the literature on the psychological problems of the survivors of the Nazi Holocaust, and the paucity of research on offspring of these survivors. A discussion of three adolescents who were in a residential treatment program in Jerusalem, Israel, is proffered. Biographical data, diagnostic categories, review of TAT responses, their ability or inability in forming relationships, and some examples of dreams are presented. A section is devoted to some general underlying assumptions--including an analysis of the concepts "survivor guilt," "repressed agression," and "isolation of affect".

Adolescent

Use of a computer simulation to evaluate a seminar on child abuse.

A computerized patient simulation was used to evaluate the effectiveness of a seminar on child abuse in changing students' behavior in assessing the problem and developing a treatment plan. The CAMPS system (DACIS Software) was selected because it allows students freedom to follow any pathway in selecting over 500 items of history, physical examination, laboratory, and treatments. In interacting with this simulation, students demonstrated how they integrate their knowledge into a clinical setting. The three-hour seminar covered the topics of physical and sexual abuse, patient neglect, and utilization of community resources for treatment. The control (n = 43) and experimental (n = 38) groups, enrolled in an introductory course in pediatrics, were given references to read about child abuse as part of the core curriculum, but they may or may not have had exposure to patients in their clinical work. Only the experimental group attended the seminar. As part of the course evaluation program, both groups interacted with eight computer simulations, two of which involved cases of child abuse. In the classic case of child abuse, the control and experimental groups had similar results. In the more difficult diagnostic problem (shaken baby), the groups differed significantly in total score, cost of the evaluation, and percentage of correct diagnosis.

Child

Acquisition of mature functional responsiveness in T cells: programming for function via signaling.

The results discussed here provide strong evidence that different T-cell effector gene programs are activated by different signals, and that in several cases their responses to the same exogenous stimuli shift during the development and antigen responses of the cells. T-cell responses are thus conditional and plastic at the individual cell level. In the formalism of the introductory section, the results support elements of Models 2 and 3, and suggest a fusion between them as differentiation is explained in terms of alteration in the relative strengths of different intracellular signaling pathways. Returning to an initial question, how are different functional capabilities assigned nonrandomly to cells with different antigen recognition specificities? This question has not been answered, but it can be reformulated. If all virgin T cells can transiently make IL-2, then we must ask what features of cell biology explain the preferential preservation of IL-2 inducibility in CD4+ cells as opposed to CD8+ cells. If the capacity to induce IL-4 expression is not acquired in the thymus, then we may ask whether the initial opening of this locus depends on a CD4-transmitted signal. Similarly, the CD8 molecule itself might participate in inducing the initial differentiation events that render CTL-p inducible for granzyme C and perforin. This would be in accord with a large literature showing that CD8 engagement is much more important in the initial induction of CTL activity than in the exercise of function by pre-primed CTL effectors. The subtext of each of these "questions", however, is that intrathymic events may not directly affect the genes used by terminal effectors for function at all. They may instead bias a cell's complement of triggering receptors, thus rendering it differentially sensitive to particular signals generated during antigen reception. This view is extreme, and will probably turn out to be an overstatement. But it does inspire a unique set of investigations into the basis of T-cell function. It lends urgency to the question of whether CD4+ and CD8+ cells differ in their G proteins, kinases, or inducible proto-oncogenes. If they do, we can then ask whether such differences themselves arise in the periphery, or whether they can be traced back to thymocytes fresh from positive selection--or before.

Animals

Human sexuality course evaluation.

A three-day human sexuality program was offered in 1974 to medical, nursing, and graduate psychology students for the second consecutive year at the University of Cincinnati. The program was designed to cover a wide range of topics; supply accurate information; encourage participants to question, explore, and assess their own sexual attitudes; and help participants develop a more tolerant attitude toward sexual beliefs, attitudes, and behaviors of others. The Sexual Knowledge and Attitude Test and an evaluation form were used to measure students' pre- and postcourse knowledge, attitudes, and opinions. The total group of 186 subjects registered a significant difference between mean scores of the pre- and postcourse tests. When examined separately, nursing and medical students showed significant changes in attitudes and knowledge scores. Results of the three-day program were compared with those of a five-day program given the previous year. A profile analysis showed the differences in nursing and medical students in pre- and postcourse scores. An evaluation form demonstrated how each group of students felt about the course. This study documented that human sexuality content should be included in nursing and medical curriculums and demonstrated that an introductory concentrated course is an effective interdisciplinary experience for nursing and medical students.

Attitude of Health Personnel

[Preparation, characterization and control of antiserums].

The development of radio immunoassay and its application to the estimation of new substances (e.g. drugs, enzymes, viral antigens, etc.) will shed further light on the various problems which we have discussed in this introductory report. For each group of substances there will no doubt be special difficulties. If these technics have become very popular, this seems to be for two main reasons: the potential selection of individual immune response, and better understanding of the role of the parameters which control the various stages of radio-immunoassay. I am sure that the reports programmed here will provide an important contribution to advances in our knowledge in this promising field.

Antibody Specificity

Neurosurgery image manager.

Computer technology has become standard in many areas of medical practice, but computer-assisted instruction has not replaced standard textbooks and didactic lectures. This paper describes the development of a computer image-based educational system designed for neurosurgical instruction. The advantages and applications of this system for both clinical and academic use and the required software and hardware requirements are delineated. This computerized tutorial can organize and manipulate large amounts of data. The Neurosurgery Image Manager system contains an introductory help section, a self-assessment test in neurosurgery, and a data base of images from the video disc "The Slice of Life," produced at the University of Utah. Questions are taken from the Self-Assessment in Neurological Surgery series. Additionally, the system contains a reference index for all material in the tutorial, a scored clinical problems section, and a several hundred word glossary. The system is programmed using the Macintosh Hypercard authoring system. Large data bases can be manipulated and linked with graphics, text, and peripherals. Images are stored using the MacVision II digitizing system. The hardware necessary to operate the system and the method of implementation of Neurosurgery Image Manager are described. The prototype Neurosurgery Image Manager has been accepted by the Joint Committee on Education of the American Association of Neurological Surgeons and Congress of Neurological Surgeons as one of the computer formats for the next self-assessment tests.

Computer Graphics