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PubMed1990

Detectability as a function of target location: effects of spatial configuration.

Marked differences in detectability as a function of spatial location, a "detectability gradient," are observed when subjects are required to detect a briefly exposed target pattern of uncertain location in the presence of a number of nontarget patterns. Target detectability also is inversely related to the number of nontarget patterns which are present in this search paradigm. These previous findings provide strong evidence for a serial process in which increasing probability of error occurs during a scan of a rapidly degrading neural representation of the visual image following a brief exposure to the stimuli. It is not yet established whether this scan is attentional or perceptual in nature. The present experiments test the hypothesis of an attentional scan by presenting the target and nontarget patterns in spatially segregated groups. If the scan is attentional, then target detectability under these circumstances would be expected to exhibit the characteristic phenomenon of "group processing"--a close clustering of detection performance for targets located within a group and large differences in detectability across groups. As no evidence for group processing was observed, the results fail to support the view that the scan is attentional in nature but are fully consistent with a nonattentional scan.

Adult↗
PubMed1999

Respiratory symptoms and lung function in two prebake aluminum smelters.

BACKGROUND: Respiratory symptoms are known to occur in some aluminum smelter employees working in the potroom department but little is known about the respiratory health of employees in other departments. METHODS: This cross-sectional study examined the prevalence of work-related respiratory symptoms and levels of lung function in different departments of two aluminum smelters compared to administration employees. Multiple logistic regression was performed with each of four work-related symptoms as outcomes and multiple linear regressions were performed with FEV1 and FVC as outcomes. RESULTS: There were 1,529 male participants in the two smelters representing a response rate of 89.6%. After adjusting for age and smoking, work-related respiratory symptoms were reported significantly more often among the ingot mill, anode, and potroom groups in Smelter A. In Smelter B, ingot employees were more likely to report work-related wheeze and potroom employees were more likely to report work-related rhinitis. Symptoms tended to increase with increasing time in the potrooms but were more likely to occur in new employees in the ingot mill and anode process groups. After adjusting for age, height, and smoking, there were no significant differences between the process groups for either FEV1 or FVC at Smelter A, and at Smelter B potroom employees had slightly greater FEV1 and FVC than the administration employees. CONCLUSIONS: Work-related respiratory symptoms among aluminum smelter workers are not reported only by potroom employees but also by ingot mill and anode employees.

Adult↗
PubMed2005

A trained spin-glass model for grouping of image primitives.

A method is presented that uses grouping to improve local classification of image primitives. The grouping process is based upon a spin-glass system, where the image primitives are treated as possessing a spin. The system is subject to an energy functional consisting of a local and a bilocal part, allowing interaction between the image primitives. Instead of defining the state of lowest energy as the grouping result, the mean state of the system is taken. In this way, instabilities caused by multiple minima in the energy are being avoided. The means of the spins are taken as the a posteriori probabilities for the grouping result. In the paper, it is shown how the energy functional can be learned from example data. The energy functional is defined in such a way that, in case of no interactions between the elements, the means of the spins equal the a priori local probabilities. The grouping process enables the fusion of the a priori local and bilocal probabilities into the a posteriori probabilities. The method is illustrated both on grouping of line elements in synthetic images and on vessel detection in retinal fundus images.

Algorithms↗
PubMed1988

A systems model of short-term, open-ended group therapy.

Because of rapid patient turnover and periodic therapist rotations, inpatient psychotherapy groups with open membership can sometimes appear to be forever beginning or forever ending. Described here is a model of group process that identifies four distinct stages of group development experienced by open-ended groups. Each of the four stages--called rebeginning, subgrouping, work phase, and termination--is characterized by attention to a particular boundary issue. In stages 1 to 3, the group members gradually move from establishing the group's separateness from other hospital systems to establishing alliances with the therapist and with each other to developing mutually supportive relationships. When several members are discharged, the group enters stage 4, during which it renews its efforts to fortify its external boundary. Therapeutic interventions appropriate to each stage of group development are discussed.

Adult↗
PubMedDate not supplied

Training medical students in evidence-based medicine: a community campus approach.

BACKGROUND AND OBJECTIVES: Clinicians need skills in critical appraisal of medical literature to improve quality of care. This report on evidence-based medicine (EBM) curricula describes 1) the role of family medicine educators, 2) timing, 3) value of a standard format across multiple communities, and 4) outcomes in attitudes and skills. METHODS: In 1992, a nine-session curriculum delivered across six community campuses was introduced during the third year of medical school in the College of Human Medicine at Michigan State University. Evaluation compared 1) responses on the Association of American Medical Colleges graduation questionnaires from classes who received the curriculum with the 1994 class who did not (424 students), 2) responses to questions on group process performance, and 3) focused surveys of two classes. RESULTS: Trained classes reported higher levels of confidence in critical appraisal and research skills than the 1994 class and other schools. Respondents reported the small-group process as effective, greater appreciation of the training after 1 year of residency than at graduation, and no change in research activity. CONCLUSIONS: Family medicine educators can lead a new curriculum in EBM and maintain consistent standards across multiple communities. Many questions remain concerning the ideal curricular design to help clinicians apply the best research to patient care.

Curriculum↗
PubMed2003

Rebellion in group.

Rebellion is a strategy of social action: to overthrow the group's status quo or to adamantly oppose its revision. Rebellion occurs when other avenues of influence seem futile or unattractive-a judgment that depends on the group's genuine receptivity to discussion and change, and equally, on the state of mind of the rebel. There are different pathways of rebellion: defiance, secession/exile, anarchy, or revolution. Although rebellion represents an individual's mental attitude toward a group, it is useful to think of group process and rebellion as an attempt to move the group in a different direction. Similar to other group members, the therapist has rebellious feelings and thoughts, and may take on the multiple roles of defiant instigator, exiled outcast, anarchist, and revolutionary.

Cooperative Behavior↗
PubMed2000

Respiratory symptoms and lung function in alumina refinery employees.

OBJECTIVES: Employees in alumina refineries are known to be exposed to a number of potential respiratory irritants, particularly caustic mist and bauxite and alumina dusts. To examine the prevalence of work related respiratory symptoms and lung function in alumina refinery employees and relate these to their jobs. METHODS: 2964 current employees of three alumina refineries in Western Australia were invited to participate in a cross sectional study, and 89% responded. Subjects were given a questionnaire on respiratory symptoms, smoking, and occupations with additional questions on temporal relations between respiratory symptoms and work. Forced expiratory volume in 1 second (FEV(1)) and forced vital capacity (FVC) were measured with a rolling seal spirometer. Atopy was assessed with prick skin tests for common allergens. Associations between work and symptoms were assessed with Cox's regression to estimate prevalence ratios, and between work and lung function with linear regression. RESULTS: Work related wheeze, chest tightness, shortness of breath, and rhinitis were reported by 5.0%, 3.5%, 2.5%, and 9.5% of participants respectively. After adjustment for age, smoking, and atopy, most groups of production employees reported a greater prevalence of work related symptoms than did office employees. After adjustment for age, smoking, height, and atopy, subjects reporting work related wheeze, chest tightness, and shortness of breath had significantly lower mean levels of FEV(1) (186, 162, and 272 ml respectively) than subjects without these symptoms. Prevalence of most work related symptoms was higher at refinery 2 than at the other two refineries, but subjects at this refinery had an adjusted mean FEV(1) >60 ml higher than the others. Significant differences in FVC and FEV(1)/FVC ratio, but not FEV(1), were found between different process groups. CONCLUSIONS: There were significant differences in work related symptoms and lung function between process groups and refineries, but these were mostly not consistent. Undefined selection factors and underlying population differences may account for some of these findings but workplace exposures may also contribute. The differences identified between groups were unlikely to be clinically of note.

Air Pollutants, Occupational↗
PubMed2003

Getting the basics right. Care delivery in nursing homes.

In this study, the key exemplar processes of care in facilities with good resident outcomes were described. It follows that with description of these processes, it is feasible to teach facilities about the basics of care and the ways to systematically approach care so they can adopt these care processes and improve resident outcomes. However, for this to happen key organizational commitments must be in place for staff to consistently provide the basics of care. Nursing leadership must have a consistent presence over time, they must be champions of using team and group processes involving staff throughout the facility, and they must actively guide quality improvement processes. Administrative leadership must be present and express the expectation that high quality care is expected for residents, and that workers are expected to contribute to the quality improvement effort. If facilities are struggling with achieving average or poor resident outcomes, they must first make an effort to find nursing and administrative leaders who are willing to stay with the organization. These leaders must be skilled with team and group processes for decision-making and how to implement and use a quality improvement program to improve care. These leaders must be skilled at building employee relations and at retention strategies so residents are cared for by consistent staff who know them. The results of this study illustrate the simplicity of the basics of care that residents in nursing facilities need. The results also illustrate the complexity of the care processes and the organizational systems that must be in place to achieve good outcomes. Achieving these outcomes is the challenge facing those currently working in and leading nursing facilities.

Aged↗
PubMed2003

A physician peer support writing group.

BACKGROUND AND OBJECTIVES: Barriers to publication can be overcome through a peer support writing group in an academic department of family practice. This study describes the experience and outcomes of a writing group in a family practice department. METHODS: A writing group was established to provide collaboration in identifying potential research and/or writing projects, to assist individual faculty to complete unfinished work for submission, to match journals appropriate to the individual group member's work, and to provide peer support for faculty members through attention to group process. Resource materials included instructions for authors for various journals and writing support literature. Minutes were taken at each meeting, and the manuscripts presented were tracked. Individual publication records in CVs and citations in Index Medicus were used to generate pre-group and post-group publication records for group participants and nonparticipants. RESULTS: The writing group met 23 times in 36 months. Attendance ranged from 3 to 10 participants. Fifty writing projects were discussed, and 12 of the discussed manuscripts were published in indexed journals. The seven most frequent attendees increased their publications as first author from one publication over the 3 years prior to the writing group to 10 publications over the first 3 years of the writing group. Comparison of the attendees' publication records with nonparticipant members of the department demonstrated an increase in publication success for participants. CONCLUSIONS: A peer support writing group, emphasizing group process and respectful collaboration, has increased the publication frequency of faculty in a Canadian department of family practice.

British Columbia↗
PubMed1995

A social skills group for boys with Asperger's syndrome.

A social skills group was conducted for 8 boys aged 8 to 12 years on a weekly basis for 14 sessions. In this descriptive paper we discuss the planning for the group, the teaching techniques used, the actual group process and a subjective assessment of outcomes. Possible directions for future interventions are also presented.

Autistic Disorder↗
PubMed1993

Pulmonary artery catheterization. Can there be an integrated strategy for guideline development and research promotion?

OBJECTIVES: To review the evidence regarding indications for pulmonary artery catheterization (PAC) in critically ill patients, and to propose a guideline-generating process that would encourage randomized controlled trials of PAC. DATA SOURCES: Computerized and manual search for randomized trials involving PAC as an integral part of the protocol, published as of October 1992. Manual search for guidelines endorsed by specialty societies and/or proposed by expert panels following an explicit group process. DATA SYNTHESIS: Four trials suggest benefit from PAC for pre- or perioperative management of high-risk surgical patients. Two others indicate that PAC for low-risk aortic aneurysm surgery confers no advantages. Use of PAC to guide therapy aimed at improved mixed venous oxygen saturation was beneficial compared with usual care with PAC in two small trials among patients with septic shock and severe trauma. Other PAC indications are either untested or inadequately tested by small trials. Large trials are needed, but trials to date have been impeded by clinicians' uncertainty about PAC and unwillingness to randomize critically ill patients. No published guidelines for PAC have used a formal group process and/or a hierarchical review of evidence to demarcate proven from unproven indications. CONCLUSIONS: We propose a research-promoting expert panel on indications for PAC. Aided by a critical literature review, experts would rate case scenarios on the need for routine PAC with or without a specified intervention strategy. Future trials should test indications where there is either consensus about the uncertainty of need for PAC, or interpanelist disagreement owing to inconclusive evidence. This process could facilitate practice guideline development, utilization management, and large trials of PAC and related interventions.

Cardiac Catheterization↗
PubMed2006

A study of the factors that influence how senior officers police crowd events: on SIDE outside the laboratory.

This paper fits into the SIDE perspective (Reicher, Spears, & Postmes, 1995; Postmes, Spears, Lea, & Reicher, 2000), which emphasises the importance of integrating the cognitive and strategic dimensions of group processes. Our study examines the decisions made by senior police officers during a simulation exercise of a crowd event. The analysis shows, firstly, that officers are deeply concerned about their accountability to a variety of audiences, both internal and external to the police force. Second, these different audiences pressure them to act in different, and sometimes contradictory, ways. What counts, then, is the overall balance between accountability concerns. Third, this balance - and, with it, police perceptions and decisions - alters in the course of an event. More specifically, with escalating conflict, the balance of accountability concerns moves increasingly in the direction of undifferentiated intervention against crowd members. In discussion, we consider both the theoretical implications of this analysis for research on group processes (in particular the importance of accountability issues once one moves beyond the laboratory and deals with groups that have a past and future and in which membership is more than simply an act of choice) and the practical implications in terms of crowd policing.

Adult↗
PubMed2006

Assessing the quality of radiographic processing in general dental practice.

OBJECTIVES: To determine if a commercial device (Vischeck) for monitoring film processing quality was a practical option in general dental practice, and to assess processing quality among a group of GDPs in the West Midlands with this device. DESIGN: Clinical evaluation. SETTING: General dental practice, UK, 2004. METHOD: Ten GDP volunteers from a practice based research group processed Vischeck strips (a) when chemicals were changed, (b) one week later, and (c) immediately before the next change of chemicals. These were compared with strips processed under ideal conditions. Additionally, a series of duplicate radiographs were produced and processed together with Vischeck strips in progressively more dilute developer solutions to compare the change in radiograph quality assessed clinically with that derived from the Vischeck. RESULTS: The Vischeck strips suggested that at the time chosen for change of processing chemicals, eight dentists had been processing films well beyond the point indicated for replacement. Solutions were changed after a wide range of time periods and number of films processed. The calibration of the Vischeck strip correlated closely to a clinical assessment of acceptable film quality. CONCLUSIONS: Vischeck strips are a useful aid to monitoring processing quality in automatic developers in general dental practice. Most of this group of GDPs were using chemicals beyond the point at which diagnostic yield would be affected.

General Practice, Dental↗
PubMed2003

Techniques used by "expert" and "non-expert" tutors to facilitate problem-based learning tutorials in an undergraduate medical curriculum.

BACKGROUND: There is inconclusive debate within the literature as to whether the best problem-based learning (PBL) tutors are subject experts or not. The debate hinges on whether knowledgeable tutors are tempted to intervene too often in PBL discussions compared to non-expert tutors, and whether the latter may not be able to sufficiently challenge the students' level of understanding. PURPOSE: To describe approaches used by tutors in PBL tutorials and to identify differences between tutors from medical and non-medical backgrounds. METHODS: The research reported in this paper was undertaken during the academic session 1999-2000 at the University of Liverpool Faculty of Medicine. A qualitative exploratory case study method was used and two PBL groups were observed. One of these groups had a medically qualified tutor and the other had a tutor from a humanities background. The focus of the observation was the discourse between tutor and students, which was analysed using a framework drawn from linguistics. Results were fed back to both the tutors and the students to check their perceptions of the interactions. RESULTS: Analysis of the tutorial group interaction revealed that tutors from both backgrounds used similar techniques to raise students' awareness, facilitate the group process and direct students' learning. Differences were noted between the two tutors: the medical tutor set out to raise students' awareness by using questioning techniques herself, whereas the non-medical tutor expected students to question each other. The non-medical tutor was observed to facilitate the group process more often than the medical tutor. CONCLUSIONS: Qualitative analysis of spoken discourse in PBL tutorials provides valuable insights into the processes involved in PBL, thereby generating material which is useful for both training of and giving feedback to PBL tutors.

Cohort Studies↗
PubMed1996

Exploratory factor analysis of students' ratings of a problem-based learning curriculum.

PURPOSE: To identify the factor structure underlying medical students' initial experience with a problem-based learning (PBL) curriculum and to examine the stability of this structure as students acquire further experience with PBL. METHOD: The PBL curriculum at the Michigan State University College of Human Medicine begins in the students' second year and is divided into 11 domains. In 1992-93 students were asked to evaluate their learning experiences in the first and last domains of their first PBL semester, by using a five-point Likert scale to rate 19 items. Principal-components analysis and varimax rotation were used to identify the factors underlying the students' ratings. RESULTS: Ratings of the first and last domains were available from 101 and 71 students, respectively. Analysis yielded four meaningful factors: learning materials, small-group process, tutor effectiveness, and academic support. These four factors shifted in relative importance as the students progressed through the curriculum: for the first domain, tutor effectiveness accounted for the highest percentage of variance in the data; for the last domain, this factor ranked third, after learning materials and small group process. Internal reliabilities for the ratings of the last domain of the semester were higher and more consistent, ranging from .92 to .97. CONCLUSION: The students' initial dependence on the tutor progressed to an emphasis on learning resources. This shift is congruent with the theoretical model of the dynamics of PBL. The results suggest that the survey instrument provides a reliable measure of the multidimensional constructs underlying students' experience with PBL.

Curriculum↗
PubMed1977

The mental health center and the women's liberation group: an intergroup encounter.

When two separate and independent organizations must work together to accomplish a mutual task, difficulties often arise which remain poorly understood. The analysis of intergroup phenomena involves an exploration of interaction within and between groups; such relationships include problems arising from differences in tasks, structure, and culture of the two groups, definition of the intergroup task, choice of group representatives, and the possibilities and problems of dual group membership for the negotiators. While the literatures on group process and organization development contain some work on intergroup phenomena (e.g., Aldrich, 1971; Baker and O'Brien, 1971; Klein et al., 1971; Mills, 1975; Walton, 1972), much conceptual work remains to be done. We will focus upon one type of intergroup relationship--that between a traditional human service organization and a social movement group--in which dual membership is a particular problem, and in which conflict may be neutralized by the form of the negotiations. A case example of an interaction between a mental health center and a women's liberation group will provide one example of such negotiations. The analysis is presented within the framework of the open system model of Miller and Rice (1967) and Rice's general model of intergroup relations (1965, 1969).

Community Mental Health Services↗