Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “FEEDBACK”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 523 records · Page 29Linked to original sources
PubMed2004

Effectiveness of the combination of feedback and educational recommendations for improving drug prescription in general practice.

BACKGROUND: Although there is a great concern regarding rational use of drugs, the available evidence for the most appropriate strategies to improve prescribing is scarce. GOAL: The goal of this study was to evaluate the effectiveness of the combination of feedback of individualized prescribing data and educational recommendations for improving the quality of prescribing in general practice. METHOD: A quasiexperimental intervention study was conducted in which prescribing rates of 282 family physicians before and after the intervention were compared. Physicians assigned to the individualized feedback group (n = 195) received individual instruction with specific recommendations for improvement according to their baseline prescribing quality levels, whereas physicians in the minimal intervention group (n = 87) only received standard nonindividualized prescribing data for the practice group as a whole. RESULTS: A trend toward increasing high pharmacologic intrinsic value in both groups was observed. Overprescription of antibiotics showed a decrease in the individualized feedback group (P = 0.006) and it did not change in the minimal intervention group. A different trend in the values in each group was observed with nonsteroidal antiinflammatory drugs, although it was not statistically significant. Overprescription of antiulcerative agents decreased among physicians in the individualized feedback group (P = 0.003); however, there were not statistically significant differences as compared with the minimal intervention group. Changes in indicators of drug selection were more favorable for the group with individualized feedback, although no statistically significant differences were observed. Pharmaceutical expenditure increased significantly in the minimal intervention group as compared with the individualized feedback group, with an approximate difference of dollars 7.87 per inhabitant and trimester (P = 0.003). CONCLUSION: The intervention showed that improving the quality of prescribing was feasible, particularly in overprescribing, and was associated with considerable savings in pharmaceutical costs.

Adult↗
PubMed2004

Development of negative feedback during successive growth cycles of black cherry.

Negative feedback between plant and soil microbial communities can be a key determinant of vegetation structure and dynamics. Previous research has shown that negative feedback between black cherry (Prunus serotina) and soil pathogens is strongly distance dependent. Here, we investigate the temporal dynamics of negative feedback. To examine short-term changes, we planted successive cycles of seedlings in the same soil. We found that seedling mortality increased steadily with growth cycle when sterile background soil was inoculated with living field soil but not in controls inoculated with sterilized field soil. To examine long-term changes, we quantified negative feedback across successive growth cycles in soil inoculated with living field soil from a mature forest system (more than 70 years old) versus a younger successional site (ca. 25 years old). In both cases negative feedback developed similarly. Our results suggest that negative feedback can develop very quickly in forest systems, at the spatial scale of a single seedling.

Biomass↗
PubMed1991

Cognitive feedback for use with FES upper extremity neuroprostheses.

This paper describes the development of two sensory substitutions systems that provide cognitive feedback for FES hand grasp restoration neuroprostheses. One system uses an array of five electrodes to provide machine status information and a spatially encoded representation of the command signal that a quadriplegic individual generates to achieve proportional grasp control. Only one electrode site is active at any given instant, and a second informational channel is superimposed on the spatial position channel by modulating the frequency of the stimulus pulses. The frequency modulated feedback channel signals six levels of force developed at the finger tips during prehension activities. The second sensory system is an integral part of an implanted FES system and utilizes a single subdermally placed electrode to display machine status information and a five-level frequency code for feedback of the user generated grasp control signal. The multielectrode feedback system was implemented for laboratory studies using surface mounted electrodes, although its design will ultimately incorporate subdermal electrodes to provide a highly cosmetic and unencumbering system. An evaluation of the effectiveness of grasp force and command signal feedback provided by this multielectrode system in assisting an FES hand system user to regulate grasp force during a laboratory task, showed increased consistency of performance and an economy of grasp effort between 25 and 30%. Alternative strategies for feedback information and coding algorithms are discussed.

Algorithms↗
PubMed2001

Characteristics of somatosensory feedback in postural control during standing.

In the present study, the function of the somatosensory feedback system in postural control was investigated. For the sake of simplicity, the present study considered only balancing in the anteroposterior direction using the ankle strategy, in which the ankle moment is mainly used to maintain balance. To suppress the vestibular and visual feedback paths, a subject stood on a force-measuring platform with a fixed back support. Because the subject's body was immovable under these conditions, the subject controlled a computer model that simulated the subject's load at the ankles. Information about the sway angle of the model was fed through the somatosensory feedback path. Frequency response functions of the ankle moment in response to the sway angle were calculated. The experimental results suggest that the human somatosensory feedback system has derivative characteristics and, consequently, can maintain an upright posture by itself. The results were compared with those of previous studies on vestibular and visual feedback systems. The comparison reveals that subject-to-subject variance in the somatosensory system is significantly smaller than that in the other systems. This may indicate that the somatosensory feedback is the most automatic of the systems and plays a dominant role when a subject maintains an upright posture using the ankle strategy.

Adult↗
PubMed1998

EEG-based communication and control: short-term role of feedback.

When people learn to control the amplitudes of certain electroencephalogram (EEG) components (e.g., the 8-12 Hz mu-rhythm over sensorimotor cortex) and use them to move a cursor to a target on a video screen, feedback about performance is normally provided by cursor movement and by trial outcome (i.e., success or failure). We assessed the short-term effects of this feedback on EEG control. After subjects received initial training with feedback present, feedback was removed intermittently for periods of several minutes. Subjects still displayed EEG control when feedback was removed. Removal of cursor movement alone appeared to have effects comparable to removal of both cursor movement and trial outcome. These results show that, in the short-term at least, mu-rhythm control is not dependent on the sensory input provided by cursor movement. They also suggest that feedback can have inhibitory as well as facilitory effects on EEG control, and that these effects vary across subjects. This finding has implications for the design of training procedures.

Adult↗
PubMed1995

Individual and group dose-responses to intravenous omeprazole in the first 24 h: pH-feedback-controlled and fixed-dose infusions.

1. Individual responses to intravenous boli of omeprazole have shown considerable variability. Data on the individual responses to the new omeprazole infusion formulation are lacking. 2. Individual dose-responses in the first 24 h of fixed-dose and pH-feedback-controlled infusions of omeprazole were assessed in two randomised, third-party blinded, cross-over studies, using two separate groups of eight healthy subjects. In study A, feedback-controlled infusions of omeprazole (target pH 5, dose range 0-12 mg h-1) and fixed-dose infusions (8 mg h-1) were compared, both with an initial bolus of 80 mg. Omeprazole plasma concentrations were measured. Study B assessed the effect on individual pH-control of a loading bolus of either 40 mg or 80 mg omeprazole, followed by feedback-controlled infusions. 3. Study A: the median % time of pH > 5 was 71.2 (total range: 48.9-83.2) with feedback infusions and 57.9 (28.0-95.3) with fixed-dose infusions (P = 0.06). The mean 24 h infusion doses were 173.1 mg (44.5-253.1) in the feedback group and 192 mg in the fixed-dose group. The AUC of omeprazole plasma concentrations ranged widely, but correlated with the % time of pH > 5 during fixed-dose infusions. Study B: initial boli of 40 mg and 80 mg of omeprazole resulted in similar 24 h median % of time with pH > 5, 69.2 (49.9-78.8) and 69.6 (44.4-87.7), respectively. Mean omeprazole doses infused by feedback pump were 187.6 mg (83.1-253.6) after 40 mg boli and 159.9 mg (61.8-227.0) after 80 mg boli.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1990

Feedback regulation of pancreatic exocrine secretion in animal and man.

This chapter focuses on studies dealing with the feedback mechanism of pancreatic exocrine secretion in animal and man. Clear evidence is presented that this feedback mechanism is working in the rat and the pig and that this feedback is mediated in the rat by the gastrointestinal hormones pancreozymin (enzyme secretion) and secretin (volume and bicarbonate secretion). Two novel peptides have been described--the 'CCK-releasing peptide' originating from the small intestinal mucosa, and the 'monitor peptide' cosecreted together with the enzymes in the pancreatic juice--to account for the stimulation of pancreatic enzyme secretion by the release of CCK. A similar feedback regulation of pancreatic secretion is working in man. It remains as yet controversial whether the feedback in humans is regulated via hormonal or neural pathways. It is also a matter of debate whether this feedback regulation of pancreatic enzyme secretion could be utilized for therapeutic aims in the treatment of pain in patients with chronic pancreatitis.

Animals↗
PubMed1980

On the role of reduced auditory feedback and kinesic self-stimulation during Stroop Color-Word Performance.

Feedback from one's own voice provides important vocal-motor cues for effective cognitive processing. Reduction of such feedback is known to disturb such functioning. Work in our laboratory has shown that kinesic self-stimulation also plays an important role in cognition, and appears to regulate the focusing of attention under conditions of distraction. The present study investigated the effects of both auditory feedback and kinesic self-stimulation in the regulation of cognitive interference during performance of the Stroop Color-Word Task. Twelve subjects were tested on the Stroop task under conditions of normal and occluded hearing. Kinesic self-stimulation and response errors during color-word performance were recorded on video tape. The findings indicated that not only did self-stimulation increase when voice feedback was reduced, but that this increase was associated with a reduction in specific types of color-word performance errors. Individual differences revealed that high kinesic responders made significantly fewer errors in task performance than did low kinesic responders. Results were interpreted as revealing a kinesic feedback mechanism which has adaptive significance in regard to self-editing when auditory feedback is reduced.

Adolescent↗
PubMed1982

Desire for personal feedback: who wants it and what does it mean for psychotherapy?

Individual differences in desire for feedback did not exhibit any significant correlations with a variety of self-report personality dimensions. Additional survey studies indicated that a higher proportion of individuals in nonclinical as compared to clinical samples reported a strong desire to receive feedback about themselves. Subsequent studies revealed that the higher as compared to lower desire for feedback individuals: (1) were more willing to seek psychological help and to participate in therapy once in treatment; (2) exhibited more positive expectancies for change at the beginning of therapy; and (3) were more "responsive" to diagnostic feedback. Within the limitations of the present findings, the potential "adaptiveness" of desire for feedback is discussed and the negative motivational therapeutic consequences associated with a low desire for feedback are explored.

Adult↗
PubMed1986

Information seeking of high- and low-anxiety subjects after receiving positive and negative self-relevant feedback.

The present paper reports an experiment in which subjects received fictitious intelligence test feedback that was either negatively or positively discrepant with their self-evaluation. They were then given an opportunity to choose among several articles containing information that either derogated intelligence tests (test-disparaging information) or argued for their validity (test-supporting information). The main finding of this study consists of an interaction between the personality factor anxiety and the feedback variable: High-anxiety subjects prefer test-disparaging information significantly more in the negative feedback condition than in the positive feedback condition, whereas low-anxiety subjects show no difference in preference for test-related information as a function of the feedback condition. These results are in line with past theoretical reasoning and experimental findings showing that high-anxiety subjects feel more threatened by negative self-relevant feedback than do low-anxiety subjects.

Adolescent↗
PubMed1999

Feedback inhibition of rat amiloride-sensitive epithelial sodium channels expressed in Xenopus laevis oocytes.

1. Regulation of the amiloride-sensitive epithelial sodium channel (ENaC) is essential for the control of body sodium homeostasis. The downregulation of the activity of this Na+ channel that occurs when the intracellular Na+ concentration ([Na+]i) is increased is known as feedback inhibition. Although intracellular Na+ is the trigger for this phenomenon, its cellular and molecular mediators are unknown. 2. We used the 'cut-open oocyte' technique to control the composition of the intracellular milieu of Xenopus oocytes expressing rat ENaCs to enable us to test several factors potentially involved in feedback inhibition. 3. The effects of perfusion of the intracellular space were demonstrated by an electromicrographic study and the time course of the intracellular solution exchange was established by observing the effect of intracellular pH: a decrease from pH 7.4 to 6.5 reduced the amiloride-sensitive current by about 40 % within 2 min. 4. Feedback inhibition was observed in non-perfused oocytes when Na+ entry induced a large increase in [Na+]i. Intracellular perfusion prevented feedback regulation even though the [Na+]i was allowed to increase to values above 50 mM. 5. No effects on the amiloride-sensitive current were observed after changes in the concentration of Na+ (from 1 to 50 mM), Ca2+ (from 10 to 1000 nM) or ATP (from nominally free to 1 or 5 mM) in the intracellular perfusate. 6. We conclude that feedback inhibition requires intracellular factors that can be removed by intracellular perfusion. Although a rise in [Na+]i may be the trigger for the feedback inhibition of the ENaC, this effect is not mediated by a direct effect of Na+, Ca2+ or ATP on the ENaC protein.

Adenosine Triphosphate↗
PubMed1977

Structure-activity relationship of various corticosteroids on the feedback control of corticotrophin secretion.

Several steroids occurring in the pathway of corticosteroid biosynthesis were investigated for their ability to exert a fast or delayed feedback inhibition of stress-induced release of corticotrophin. Rats were injected subcutaneously with vehicle or a steroid either 10 min (fast feedback) or 4 h (delayed feedback) before they were subjected to stress which consisted of a 2 min exposure to ether vapour. 2 Changes in plasma corticosterone concentration and in vitro corticosterone production by excised adrenal glands were used as indices of corticotrophin release. 3 Among the steroids tested only 11beta, 21-dihydroxypregn-4-ene-3, 20-dione (corticosterone) and 11beta, 17alpha, 21-trihydroxypregn-4-ene-3, 20-dione (cortisol) inhibited the stress response 10 min after their administration. Therefore, it appears that the fast feedback mechanism is limited to steroids with a 21-hydroxyl and a 11beta-hydroxyl group. 4 In contrast, many steroids caused inhibition of the stress response 4 h after their administration. These steroids were corticosterone, cortisol, 21-hydroxypregn-4-ene-3, 20-dione (11-deoxycorticosterone), 17alpha, 21-dihydroxypregn-4-ene-3, 20-dione (11-deoxycortisol), 11beta-hydroxypregn-4-ene-3, 20-dione (11beta-hydroxyprogesterone) and 11beta, 17alpha-dihydroxypregn-4-ene-3, 20-dione (11beta, 17alpha-dihydroxyprogesterone). Thus, either the 21-hydroxyl group (e.g. 11-deoxycorticosterone) or the 11beta-hydroxyl group (e.g. 11beta-hydroxyprogesterone) is sufficient for delayed feedback activity. The 11alpha-hydroxyl group, e.g. 11alpha, 17alpha, 21-trihydroxypregn-4-ene-3, 20-dione (11-epicortisol) renders the steroid inactive on both feedback mechanisms. 5 18,21-Dihydroxypregn-4-ene-3, 20-dione (18-hydroxydeoxycorticosterone) was found to be the only steroid that is secreted by the adrenal gland of the rat in quantities sufficient to cause exaggeration of the stress-induced release of corticotrophin. This steroid has been implicated as a possible hypertensive agent, and its role in the control of corticotrophin secretion is discussed here.

Adrenal Cortex Hormones↗
PubMed2004

Neuronal nitric oxide synthase inhibition sensitizes the tubuloglomerular feedback mechanism after volume expansion.

BACKGROUND: In the kidney the neuronal isoform of nitric oxide synthase (nNOS) is located in the macula densa cells. These cells are known to be the sensor in the tubuloglomerular feedback. During volume expansion (VE), the tubuloglomerular feedback response is attenuated, allowing increased water and salt excretion. This study addressed the question whether inhibition of nNOS reestablishes the tubuloglomerular feedback response caused by acute extracellular VE. METHODS: In rats, VE was achieved by infusion of isotonic saline solution at 50 mL/hour x kg body weight. When urine flow was stabilized, the tubuloglomerular feedback response was evaluated by measuring changes in proximal tubular stop-flow pressure (PSF) in response to various loop of Henle perfusion rates. The loop of Henle was perfused with artificial ultrafiltrate and with addition of 1 mol/L non-specific NOS inhibitor, Nomega-nitro-l-arginine methyl ester (L-NAME). In additional rats the nNOS inhibitor, 7-nitro indazole (7-NI), was given intraperitoneally. Single nephron glomerular filtration rate (SNGFR) was also measured. GFR was determined after VE and nNOS inhibition. RESULTS: Acute VE decreased DeltaP(SF) and DeltaSNGFR while increasing the turning point, indicating decreased sensitivity of tubuloglomerular feedback response. After administration of L-NAME or 7-NI, DeltaP(SF) was maximally sensitized and the turning point and DeltaSNGFR were restored. GFR decreased after VE and nNOS inhibition compared to that after VE alone. CONCLUSION: These results suggest that a functioning nitric oxide system, especially through the nNOS, is important in mediating normal renal responses and that increased production of and/or sensitivity to nitric oxide during sustained VE plays an important role in the adaptive mechanism of the tubuloglomerular feedback.

Animals↗
PubMed1991

A multinephron model of renal blood flow autoregulation by tubuloglomerular feedback and myogenic response.

Tubuloglomerular feedback implies that a primary increase in arterial pressure, renal blood flow, glomerular filtration and increased flow rate in the distal tubule increase preglomerular resistance and thereby counteract the primary rise in glomerular filtration rate and renal blood flow. Tubuloglomerular feedback has therefore been assumed to play a role in renal autoregulation, i.e., the constancy of renal blood flow and glomerular filtration at varying arterial pressure. In evaluating this hypothesis, the numerous tubular and vascular mechanisms involved have called for mathematical models. Based on a single nephron model we have previously concluded that tubuloglomerular feedback can account for only a small part of blood flow autoregulation. We now present a more realistic multinephron model, consisting of one interlobular artery with an arbitrary number of evenly spaced afferent arterioles. Feedback from the distal tubule was simulated by letting glomerular blood flow exert a positive feedback on preglomerular resistance, in each case requiring compatibility with experimental open-loop responses in the most superficial nephron. The coupling together of 10 nephrons per se impairs autoregulation of renal blood flow compared to that of a single nephron model, but this effect is more than outweighed by greater control resistance in deep arterioles. Some further improvement was obtained by letting the contractile response spread from each afferent arteriole to the nearest interlobular artery segment. Even better autoregulation was provided by spreading of full strength contraction also to the nearest upstream or downstream afferent arteriole, and spread to both caused a renal blood flow autoregulation approaching experimental observations. However, when the spread effect was reduced to 25% of that in each stimulated afferent arteriole, more compatible with recent experimental observations, the autoregulation was greatly impaired. Some additional mechanism seems necessary, and we found that combined myogenic response in interlobular artery and tubuloglomerular feedback regulation of afferent arterioles can mimic experimental pressure-flow curves.

Animals↗
PubMed2005

Voice responses to changes in pitch of voice or tone auditory feedback.

The present study was undertaken to examine if a subject's voice F0 responded not only to perturbations in pitch of voice feedback but also to changes in pitch of a side tone presented congruent with voice feedback. Small magnitude brief duration perturbations in pitch of voice or tone auditory feedback were randomly introduced during sustained vowel phonations. Results demonstrated a higher rate and larger magnitude of voice F0 responses to changes in pitch of the voice compared with a triangular-shaped tone (experiment 1) or a pure tone (experiment 2). However, response latencies did not differ across voice or tone conditions. Data suggest that subjects responded to the change in F0 rather than harmonic frequencies of auditory feedback because voice F0 response prevalence, magnitude, or latency did not statistically differ across triangular-shaped tone or pure-tone feedback. Results indicate the audio-vocal system is sensitive to the change in pitch of a variety of sounds, which may represent a flexible system capable of adapting to changes in the subject's voice. However, lower prevalence and smaller responses to tone pitch-shifted signals suggest that the audio-vocal system may resist changes to the pitch of other environmental sounds when voice feedback is present.

Adult↗
PubMed1985

The hearing aid feedback path: mathematical simulations and experimental verification.

Acoustic feedback in hearing aids has received little attention in the literature. Feedback occurs when stability conditions of the open-loop transfer function of an in situ hearing aid are violated. Solving the feedback problem will first require knowledge of the open-loop transfer function. Included in the open-loop transfer function is the acoustical path by which sound emanating from the earmold vent returns to the microphone (i.e., the feedback path). Reported herein are two different mathematical procedures for simulating transfer functions of the feedback path of an eyeglass-type hearing aid. In one procedure the vent exit was modeled as a point source of sound located on a flat plane, while it was treated as a point source on a sphere in the other. Results of laboratory experiments indicate that the mathematical models accurately predict those acoustic phenomena for which they were intended: point sources on plane and spherical baffles. Results of manikin experiments showed both models to be less accurate for simulating the feedback path around the human head. The maximum difference between experiment and theory was 6 dB at one frequency. Surprisingly, the flat-baffle model produced better agreement with experimental results than did the sphere model.

Acoustics↗
PubMed2000

Improving doctors' prescribing behaviour through reflection on guidelines and prescription feedback: a randomised controlled study.

BACKGROUND: It is difficult to put research findings into clinical practice by either guidelines or prescription feedback. AIM: To study the effect on the quality of prescribing by a combined intervention of providing individual feedback and deriving quality criteria using guideline recommendations in peer review groups. METHODS: 199 general practitioners in 32 groups were randomised to participate in peer review meetings related to either asthma or urinary tract infections. The dispensing by the participating doctors of antiasthmatic drugs and antibiotics during the year before the intervention period provided the basis for prescription feedback. The intervention feedback was designed to describe the treatment given in relation to recommendations in the national guidelines. In each group the doctors agreed on quality criteria for their own treatment of the corresponding diseases based on these recommendations. Comparison of their prescription feedback with their own quality criteria gave each doctor the proportion of acceptable and unacceptable treatments. MAIN OUTCOME MEASURE: Difference in the prescribing behaviour between the year before and the year after the intervention. RESULTS: Before intervention the mean proportions of acceptably treated asthma patients in the asthma group and urinary tract infection (control) group were 28% and 27%, respectively. The mean proportion of acceptably treated patients in the asthma group was increased by 6% relative to the control group; this difference was statistically significant. The mean proportions of acceptable treatments of urinary tract infection before intervention in the urinary tract infection group and asthma (control) group were 12% for both groups which increased by 13% in the urinary tract infection group relative to the control group. Relative to the mean pre-intervention values this represented an improvement in treatment of 21% in the asthma group and 108% in the urinary tract infection group. CONCLUSIONS: Deriving quality criteria of prescribing by discussing guideline recommendations gave the doctors a basis for judging their treatment of individual patients as acceptable or unacceptable. Presented with feedback on their own prescribing, they learned what they did right and wrong. This provided a foundation for improvement and the process thus instigated resulted in the doctors providing better quality patient care.

Asthma↗
PubMed1998

A biomathematical model of time-delayed feedback in the human male hypothalamic-pituitary-Leydig cell axis.

We develop, implement, and test a feedback and feedforward biomathematical construct of the male hypothalamic [gonadotropin-releasing hormone (GnRH)]-pituitary [luteinizing hormone (LH)]-gonadal [testosterone (Te)] axis. This stochastic differential equation formulation consists of a nonstationary stochastic point process responsible for generating episodic release of GnRH, which is modulated negatively by short-loop (GnRH) and long-loop (Te) feedback. Pulsatile GnRH release in turn drives bursts of LH secretion via an agonistic dose-response curve that is partially damped by Te negative feedback. Circulating LH stimulates (feedforward) Te synthesis and release by a second dose response. Te acts via negative dose-responsive feedback on GnRH and LH output, thus fulfilling conditions of a closed-loop control system. Four computer simulations document expected feedback performance, as published earlier for the human male GnRH-LH-Te axis. Six other simulations test distinct within-model coupling mechanisms to link a circadian modulatory input to a pulsatile control node so as to explicate the known 24-h variations in Te and, to a lesser extent, LH. We conclude that relevant dynamic function, internodal dose-dependent regulatory connections, and within-system time-delayed coupling together provide a biomathematical basis for a nonlinear feedback-feedforward control model with combined pulsatile and circadian features that closely emulate the measurable output activities of the male hypothalamic-pituitary-Leydig cell axis.

Circadian Rhythm↗