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PubMed2005

Perceptual learning improves contrast sensitivity and visual acuity in adults with anisometropic amblyopia.

To evaluate the effects of perceptual learning on contrast-sensitivity function and visual acuity in adult observers with amblyopia, 23 anisometropic amblyopes with a mean age of 19.3 years were recruited and divided into three groups. Subjects in Group I were trained in grating detection in the amblyopic eye near pre-training cut-off spatial frequency. Group II received a training regimen of repeated contrast-sensitivity function measurements in the amblyopic eye. Group III received no training. We found that training substantially improved visual acuity and contrast-sensitivity functions in the amblyopic eyes of all the observers in Groups I and II, although no significant performance improvement was observed in Group III. For observers in Group I, performance improvements in the amblyopic eyes were broadly tuned in spatial frequency and generalized to the fellow eyes. The latter result was not found in Group II. In a few cases tested, improvements in visual acuity following training showed about 90% retention for at least 1 year. We concluded that the visual system of adult amblyopes might still retain substantial plasticity. Perceptual learning shows potential as a clinical tool for treating child and adult amblyopia.

Adolescent↗
PubMed1984

Effects of dance on anxiety.

The study investigated the effects of modern dance on anxiety. State anxiety was assessed before and after a 3-mo. education programme, using the Spielberger State-Trait Anxiety Inventory. The target group followed a class in modern dance. Control groups were (1) a physical education group to control for the effects of exercise, (2) a music group to control for aesthetic sensitivity training, and (3) a mathematics group. Several concomitant variables were measured: age, sex, attitude towards dance, and previous experience in sport, dance, and relaxation. Dance training significantly reduced anxiety, but no control activities did so. Examination of the concomitant variables showed that the result could not be accounted for by any obvious artifacts.

Adult↗
PubMed2003

Early preventive attachment-oriented psychotherapeutic intervention program with parents of a very low birthweight premature infant: results of attachment and neurological development.

The birth of a very small preterm infant (< or = 1500 grams) can be a traumatizing experience for many parents. A developmental risk model is presented that is the background to an early attachment-oriented preventive psychotherapeutic intervention. This comprehensive parent-centered intervention program is composed of supportive group psychotherapy, attachment-oriented focal individual psychotherapy, a home visit and video-based sensitivity training. The intervention aims at improving parental coping, the process of attachment and parent-infant interaction. In a prospective longitudinal design mothers were randomly assigned to a control (N = 44) and an intervention group (N = 43) after preterm delivery. Results show that the percentage of secure (control vs. intervention group: 77.8% vs. 59.4%) and insecure (control vs. intervention group: 8.3% vs. 31.3% avoidant, 13.9% vs. 9.4% ambivalent) attachment quality in high-risk preterm infants is comparable to results from studies with term infants. There was no significant statistical difference in terms of quality of attachment of the preterm infants between the control group and the intervention group. However, only in the control group, impaired neurological development corresponded significantly with an insecure quality of attachment, but not in the intervention group, although there were significantly more neurologically impaired infants in the intervention group. This result is discussed as an effect of the intervention program.

Adaptation, Psychological↗
PubMed1999

Cultural sensitivity training among foreign medical graduates.

OBJECTIVES: To examine the effectiveness of culture sensitivity training for foreign-trained medical graduates licensed to practice in Ontario, Canada. DESIGN: A study of pretest-post-test design was conducted to determine the effect of cultural sensitivity training on newly immigrated physicians licensed in Canada. Twenty-four physicians, those who had passed the medical licensing exam in 1996 and had not yet started their residency program, were given 15 hours of cultural sensitivity training and were considered the experimental group. This group was compared with a control group of 24 physicians who had passed the licensing exam and were in the process of completing residency. SETTING: University of Toronto. SUBJECTS: Foreign-trained medical graduates. RESULTS: Both groups completed the Cross-Cultural Adaptability Inventory both before and after the training of the experimental group. Statistical significance in three subscales of the Open-Mindedness/Flexibility, Emotional Resilience and Perceptual Acuity dimensions were demonstrated in the experimental group as compared with the control group. CONCLUSIONS: In order for Canada to mould professional and effective physicians great care must be taken in the design and process of cultural sensitivity programmes to enhance both knowledge and skills. Follow-up should be undertaken to compare their effectiveness with the control group.

Canada↗
PubMed1988

Electrocardiographic prediction of coronary artery patency after thrombolytic treatment in acute myocardial infarction: use of the ST segment as a non-invasive marker.

The predictive value of the measurement of changes in ST segment elevation was assessed as a non-invasive marker of coronary artery reperfusion after thrombolytic treatment. Forty five patients with acute myocardial infarction (23 anterior, 22 inferior) of less than six hours' duration were given thrombolytic treatment by either the intravenous (n = 28) or the intracoronary route (n = 17). A proportional value for the shift in ST segment, termed the fractional change, was calculated both from 12 lead electrocardiograms and from the Holter tape for each patient. Coronary artery patency in an initial group of 22 patients (training group) was associated with a fractional change value of greater than or equal to 0.5 (100% specific, 88% sensitive by Holter analysis; 100% specific, 94% sensitive by 12 lead electrocardiogram). This rule performed well when it was applied to a test group of 17 patients (100% specific, 93% sensitive by Holter analysis; and 67% specific, 93% sensitive by 12 lead electrocardiogram). Linear discriminant analysis was then used to determine which features gave the best separation of those in whom there was reperfusion and those in whom there was not. This gave 100% specificity and 100% sensitivity when applied to the training group for either the 12 lead electrocardiogram or Holter monitoring. When it was applied to the test group, the sensitivity was maintained at 100%, but the specificity dropped to 33% irrespective of whether the basis of the test was Holter monitoring or the 12 lead electrocardiogram. These results suggest that a fractional change of >/= 0.5 calculated from a single lead showing myocardial injury is a useful non-invasive marker of reperfusion. The technique can be applied to either 12 lead electrocardiograms or Holter monitoring. The use of a more complex classification increased the sensitivity of the test at the expense of its specificity.

Adult↗
PubMed1975

Combined inpatient and outpatient group psychotherapy: a therapeutic model for psychosomatics.

A special strategy of psychotherapeutic approach to psychosomatic patients is described including a 3-month period of inpatient and a 2-year period of outpatient group psychotherapy. Additional therapeutic procedures applied during the time of hospitalization are a special kind of sensitivity training ('sensual awareness' -- 'konzentrative Bewegungstherapie') and analytic ergotherapy. The therapeutic techniques used are psychoanalytic with special regard to the scenic figures which arise during the course of a session. The 'scenic function of the ego' represented in, e.g., certain body movements, sitting-arrangments, and talking-sequences offers the opportunity of a possible access to the often poor phantasy life of the psychosomatic patient, suffering from what we call the Pinocchio syndrome. The key structure of the model implies the arrangement fixed prior to the onset of therapy between patients and therapist, to stay together as a closed in- and outpatient group for 2 years. This enables the patients to take the risk of new emotional experiences under the cover of protected living conditions in the hospital, as well as the chance to check and confirm these experiences under the pressure of the regular social conditions they live in.

Hospitalization↗
PubMed2006

Diagnostic accuracy of lower extremity X-ray interpretation by 'specialized' emergency nurses.

OBJECTIVES: In the quest for a cost-effective and quality-preserving solution to manage crowding in the emergency department, the possibility of deploying regular emergency nurses for the treatment of acute ankle injuries was investigated. The aim of this study is to compare the diagnostic accuracy of emergency nurses with that of senior house officers in interpreting ankle and foot radiographs. METHODS: A prospective study comparing the assessment of 60 radiographs (30 feet and 30 ankles) by 16 emergency nurses before and after an educational session was performed. Each subset of 30 radiographs contained 12 fractures, hand-picked by a radiologist to represent everyday traumatology in the emergency department. The control group consisted of eight senior house officers representing everyday expertise. The outcome of the diagnostic assessment, represented as the pooled sensitivity and specificity for both groups, was compared using Z-statistics. RESULTS: Before the training session, the specialized emergency nurse group showed a sensitivity of 0.87 (confidence interval 0.83-0.91) compared with 0.93 (confidence interval 0.88-0.96) for the control group (P = 0.05). The specificity of specialized emergency nurses was 0.87 (confidence interval 0.81-0.92) compared with 0.93 (confidence interval 0.89-0.95) for the senior house officers (P < 0.05). After the training session, specialized emergency nurse diagnostic parameters did not differ significantly from the control group, displaying a sensitivity of 0.89 (confidence interval 0.86-0.92) and specificity of 0.92 (confidence interval 0.87-0.95). CONCLUSION: Before the training session, the specialized emergency nurse group showed a significantly lower accuracy than the SHO group. After training, however, the diagnostic accuracy did not differ significantly between groups. Therefore, we conclude that emergency nurses are able to accurately interpret foot and ankle radiographs after a short educational session.

Adult↗
PubMed1999

Ethnocultural considerations in group psychotherapy.

The increasingly heterogeneous populations of the industrialized countries necessitate a reappraisal of the sociocultural norms and group-therapeutic approaches that were based primarily on White Judeo-Christian values. This author reviews the literature on the treatment of ethnically different patients and discusses socio-cultural phenomena relevant to group therapy that differ from the mainstream culture. The culturally determined contrasts in perception, attitude, communication, and behavior, which minority members may exhibit in the group, are examined. The specific demands on the therapist working with ethnic group members are highlighted along with the modifications in therapeutic technique. Recommendations for a culturally sensitive and broader training of group therapists are offered.

Adult↗