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PubMed1983

Motor proficiency in children with psychosis.

Twenty-one children, aged 8 to 11 years, whose disorders were diagnosed as childhood psychosis, were tested by using the Bruininks-Oseretsky Test of Motor Proficiency. In addition, two reflex tests, one righting reaction, and a test for muscle tone were administered. The children showed large variations in all motor skill scores, which ranged from average to far below average. Total test battery scores indicated all children but one scored at or below the first percentile of the standardized sample. Delayed reflex integration and delayed mature righting reactions were observed and in some cases were associated with low motor test scores. Hypotonicity was observed in 12 of the 21 children. Results indicate that for children with psychoses, early intervention is important and carefully planned motor and reflex integration programs should be applied.

Child↗
PubMed1996

Characterization of defense-related genes ectopically expressed in viroid-infected tomato plants.

Differential hybridization was used to isolate genes induced by viroid infection in tomato plants. Four new cDNA clones encoding a peroxidase, a desaturase-like enzyme, a lipoxygenase, and a proteinase inhibitor, were selected and characterized. All of these genes display a characteristic expression pattern, showing constitutive expression in roots of healthy plants and being ectopically activated in aerial tissues upon viroid infection and ethephon treatment. Possible functions for these genes in the viroid-tomato interaction are proposed. The existence of an integrated program that compiles developmental and defense-related responses is also suggested to explain the characteristic expression pattern detected for these genes as well as for other defense-related genes.

Amino Acid Sequence↗
PubMed1998

Evaluation of cost of home therapy for patients with terminal diseases.

Palliative care and palliative medicine embrace the philosophy and the body of knowledge regarding the correct treatment of patients with terminal disease. Palliative treatments can be delivered intramurally (eg, in a hospice or palliative care unit) or at home (home care hospice). The optimal delivery pattern consists of the co-utilization of both care settings, to allow patients who need palliative, supportive, and terminal care to benefit from each setting. In obtaining the available resources, health service costs in Western countries have lately become exorbitant. Home care hospice is a system capable of defeating the challenge on two fronts: to meet the patients' needs and to fulfill this task through economically advantageous practices. Home care hospice is undoubtedly more cost-effective than conventional or generic home care, conventional care (hospitalization), and inpatient hospice care. Its advantage is more evident in the last 3 months of life, due to shorter hospitalization and nonutilization of high-technology interventions and high-cost drugs. The development of a range of palliative care programs integrating primary territorial care and specialized palliative services can constitute the ideal synthesis to respond to patients' needs in a threefold manner: firstly, the patient's right to qualified palliative and terminal care; secondly, the requirements of health services, and lastly, cost containment through a correct and tailored use of available resources.

Cost-Benefit Analysis↗
PubMed1989

Teaching third-year medical students how to care for terminally ill patients.

Most medical schools in the United States introduce students to the care of dying patients. In most cases, there is no immediate practical application of the material, and many medical students find it very difficult to interact with a terminally ill person in a clinical situation. The authors describe a successful seven-day course offered annually since 1979 to third-year medical students. The course is an integrated program for teaching the students an effective way to deal with terminal illness, using lectures, audiovisual aids, and group and individual sessions to enhance self-awareness and a practical application of the material in a clinical setting.

Education, Medical, Undergraduate↗
PubMed1993

Teaching scientific integrity and the responsible conduct of research.

Since 1990, federal guidelines have required "instruction about the responsible conduct of research" for science trainees who are supported by certain National Research Service Award (NRSA) training grants. This article reports how one school, The University of Chicago, responded to this requirement by developing a two-year "scientific integrity" program, targeted for but not limited to trainees on NRSA grants. The program features lectures the first year and seminars the next on a variety of topics related to the responsible conduct of research. This arrangement allows trainees to benefit both from the presentations of important university and outside speakers and from the intimate exchange possible only in smaller group settings. The program is an ongoing course rather than an intensive one- or two-day effort, and is intended not as an effort to reform dishonest persons who are likely to commit outright fraud but to serve the large group of honest trainees by helping them learn the important ethical issues and norms in the practice of good science, recognize areas of ethical conflict in research and scientific training, and understand their own values better. The authors discuss some major structural, procedural, and philosophical questions that had to be faced as the program was developed. They report the difficulties of evaluating such a program but believe that it and programs like it can have a variety of benefits, which they describe, for both the trainees themselves and the larger research community.(ABSTRACT TRUNCATED AT 250 WORDS)

Chicago↗
PubMed2002

Educational assessment center techniques for entrance selection in medical school.

OBJECTIVE: Dutch higher education is freely accessible for those who have proper high school qualifications. However, admission to medical schools has been limited by government to regulate manpower planning. Selection has been carried out by a national lottery approach since 1972, but in 2000, the Dutch government asked medical schools to experiment with qualitative selection procedures at their own institutions. The University Medical Center Utrecht School of Medical Sciences has used a technique derived from assessment-center approaches to assist in the medical school admission process. Dutch assessment centers use observation procedures in which candidates act in simulated activities that are characteristic of the vacant position. DESCRIPTION: In April 2001, 61 candidates for 23 places were invited for selection days. After a selection interview, candidates were asked to perform activities that are characteristic of course requirements: (1) studying a three-to-five page text about diagnostic and therapeutic procedures of disease A during one hour; (2) explaining the studied procedures to another candidate and receiving information about disease B, studied by this other candidate, during one hour; (3) answering the questions of a standardized patient about disease A in 15 minutes; and (4) answering the questions of a standardized patient about disease B in 15 minutes. A three-person selection committee behind a one-way screen observed the two 15-minute interviews with the standardized patients. The selection committee independently scored content quality of the information that was given to the standardized patients as well as the quality of attitude towards and communication with both patients. The average scores for these three criteria were weighted equally to arrive at a total score. In addition, each candidate received a score resulting from the interview with the other candidate who explained disease B. This score was combined with the other three to a final score. DISCUSSION: The Utrecht medical curriculum may be viewed as a hybrid PBL program. Integration of basic and clinical sciences, patient contacts from the start, training of skills in communication with standardized patients, physical examination, extensive small-group teaching, structured independent studying, and collaboration to prepare for short presentations to peers were all characteristic of the medical school curriculum. Thus, the assessment-center technique reflected the characteristics of the medical school curriculum. First analyses showed satisfactory reliabilities of the three scores (0.79 to 0.92); the average agreement between raters was 0.60. Correlation analysis between scores supported the internal convergent and discriminant validity of the assessment activities. The predictive validity remains to be studied.

Educational Measurement↗
PubMed1992

Establishing an alternate level of care unit.

Timely discharge of patients is a major concern of hospitals due to the significant impact of reimbursement constraints. This presents special challenges for hospitals and their staff, who care for an increasing number of elderly patients who do not require acute care, but are waiting for placement in extended-care facilities. The authors describe development and economic impact of an alternate level of care unit, that provides an integrated program of services to address the needs of this patient population.

Aged↗
PubMed1996

Neurosurgery at the Montreal Neurological Institute and McGill University Hospitals.

For the past 60 years, the Montreal Neurological Institute and Hospital and three associated McGill University teaching hospitals have provided a broad course of instruction in neurosurgery and the related neurosciences. This integrated program offers a wealth of experience in adult and pediatric neurosurgery, based on a total of 140 beds, covering a full range of general and subspecialty neurosurgery. The institute, recognized for many years as a world center for epilepsy surgery, has traditional strengths in the treatment of brain tumors and cerebrovascular and spinal disorders; it has been at the cutting edge of brain imaging in all modalities applied to neurosurgical diagnosis and cerebral localization, including three-dimensional monitoring in the operating room. New approaches to stereotactic procedures have been developed in conjunction with imaging technology, including functional neurosurgery and the versatile McGill double rotation method for radiosurgery with a linear accelerator. Experience in managing trauma, pediatric cases, and general neurosurgical problems is gained at the Montreal General Hospital, the Montreal Children's Hospital, and the Jewish General Hospital. Well-established research units, including burgeoning groups in neurogenetics, molecular neurobiology, and neural regeneration, provide a wide variety of academic opportunities to provide trainees with a sound basis for coping with the rapidly advancing field of neurosurgery.

Academies and Institutes↗
PubMed2003

A controlled longitudinal study of the social functioning of children who completed treatment of cancer.

BACKGROUND: A follow-up assessment of social functioning was performed for children with cancer after completion of treatment. It was hypothesized that children who completed cancer treatment (CCT) would have more social problems than their peers who were not chronically ill (COMP) and that greater treatment intensity would be predictive of increasing social difficulties over time. PATIENTS AND METHODS: Peer, teacher, and self-reports of social functioning were obtained from 69 CCTs and 77 COMPs. Social reputation and social acceptance were evaluated cross-sectionally and longitudinally. RESULTS: Relative to COMPs, CCTs described themselves as more prosocial, were perceived by teachers as less aggressive, and were seen by peers as more sick, more tired, and as missing more school. Longitudinal analyses indicated that self-reported prosocial scores were significantly more stable over time for CCTs relative to COMPs. Children who received more intense treatment were perceived by peers as more prosocial and less aggressive, but as having fewer best friends 2 years after treatment ended. CONCLUSIONS: CCTs had minimal impact on their social functioning as a result of their experience with cancer for those children who have returned to school. These results suggest that routine interventions with regard to social functioning after treatment ends may not be warranted for most CCTs when an integrated program of psychosocial services coordinated by mental health professionals has been provided during treatment. However, children who have undergone especially intense treatment may be at some risk for social problems.

Adolescent↗
PubMedDate not supplied

Remodeling a clinical ladder: an action research design.

The purpose of this study was to evaluate descriptors of practice designed to help nurses and managers assist the nurse along the advanced beginner to expert continuum. This study was part of a larger action research program integrating a registered nurse (RN) performance appraisal and clinical ladder. Informants selected descriptors corresponding to their routine practice from randomized lists in each nursing domain. Analysis demonstrated distinctive selection patterns in proficient and expert nurses in all but one domain. Findings supported the use of descriptors in locating an individual on the developmental continuum.

Career Mobility↗
PubMed2005

Bilateral cochlear implantation: current concepts.

PURPOSE OF REVIEW: Recent experience has shown an advantage of bilateral cochlear implantation over unilateral implantation. These documented benefits include improved speech perception in noisy environments and improved sound localization. Recently, investigators have studied the long-term benefit, evaluation of neural integration, programming, vestibular effects, and complications of bilateral cochlear implantation. This article summarizes the current research endeavors to improve our understanding and utilization of bilateral cochlear implantation. RECENT FINDINGS: Numerous positive benefits of bilateral cochlear implantation have been confirmed. Patients receive significant head shadow benefit from bilateral implantation, and obtain nominal benefits from summation and squelch effects. Sound localization benefits have been confirmed. Speech perception in noise with bilateral implantation is significantly better than unilateral implantation and continues to improve 24 months after implantation. Areas for further improvement have also been identified. Despite technological improvements in speech processing strategies, measured intraaural time differences in bilateral cochlear implant recipients remain considerably greater than those with normal hearing. Programming challenges persist to optimize sound processing with bilateral implants. Vestibular effects of bilateral cochlear implantation appear safe but need further study. Important considerations including the duration of implant function, long-term complication rate, and improvements in implant technology will continue to strongly influence the role of bilateral cochlear implantation. SUMMARY: Bilateral cochlear implantation provides advantages over unilateral implantation including improved speech perception in noise and improved sound localization. Further research is needed to define the optimal indications and to maximize the benefit of bilateral implantation.

Cochlear Implantation↗
PubMed2026

Nurse-Led Home-Based Mobile Health Cardiac Rehabilitation Program for Patients With Chronic Heart Failure: A Randomized Controlled Trial.

This 12-week randomized controlled trial evaluated a nurse-led mHealth intervention for patients with chronic heart failure, conceptually informed by Riegel's middle-range theory of self-care of chronic illness. The program integrated wearable activity tracking with weekly nurse-led behavioral coaching, reflecting the core self-care processes of monitoring, maintenance, and management. Compared with usual care, the intervention significantly improved daily step count, 6-minute walk distance, metabolic equivalents, and left ventricular ejection fraction. Findings highlight the effectiveness of theory-informed, nurse-delivered mHealth strategies in enhancing physical activity and cardiopulmonary function, while underscoring the critical role of advanced practice nurses in home-based chronic disease management.

Aged↗
PubMed2002

Large-scale mapping and predictive modeling of submerged aquatic vegetation in a shallow eutrophic lake.

A spatially intensive sampling program was developed for mapping the submerged aquatic vegetation (SAV) over an area of approximately 20,000 ha in a large, shallow lake in Florida, U.S. The sampling program integrates Geographic Information System (GIS) technology with traditional field sampling of SAV and has the capability of producing robust vegetation maps under a wide range of conditions, including high turbidity, variable depth (0 to 2 m), and variable sediment types. Based on sampling carried out in August-September 2000, we measured 1,050 to 4,300 ha of vascular SAV species and approximately 14,000 ha of the macroalga Chara spp. The results were similar to those reported in the early 1990s, when the last large-scale SAV sampling occurred. Occurrence of Chara was strongly associated with peat sediments, and maximal depths of occurrence varied between sediment types (mud, sand, rock, and peat). A simple model of Chara occurrence, based only on water depth, had an accuracy of 55%. It predicted occurrence of Chara over large areas where the plant actually was not found. A model based on sediment type and depth had an accuracy of 75% and produced a spatial map very similar to that based on observations. While this approach needs to be validated with independent data in order to test its general utility, we believe it may have application elsewhere. The simple modeling approach could serve as a coarse-scale tool for evaluating effects of water level management on Chara populations.

Biomass↗
PubMed1999

New processing tools for weak and/or spatially overlapped macromolecular diffraction patterns.

Tools originally developed for the treatment of weak and/or spatially overlapped time-resolved Laue patterns were extended to improve the processing of difficult monochromatic data sets. The integration program PrOW allows deconvolution of spatially overlapped spots which are usually rejected by standard packages. By using dynamically adjusted profile-fitting areas, a carefully built library of reference spots and interpolation of reference profiles, this program also provides a more accurate evaluation of weak spots. In addition, by using Wilson statistics, it allows rejection of non-redundant strong outliers such as zingers, which otherwise may badly corrupt the data. A weighting method for optimizing structure-factor amplitude differences, based on Bayesian statistics and originally applied to low signal-to-noise ratio time-resolved Laue data, is also shown to significantly improve other types of subtle amplitude differences, such as anomalous differences.

Computer Graphics↗
PubMed2006

Automated contour detection in X-ray left ventricular angiograms using multiview active appearance models and dynamic programming.

This paper describes a new approach to the automated segmentation of X-ray left ventricular (LV) angiograms, based on active appearance models (AAMs) and dynamic programming. A coupling of shape and texture information between the end-diastolic (ED) and end-systolic (ES) frame was achieved by constructing a multiview AAM. Over-constraining of the model was compensated for by employing dynamic programming, integrating both intensity and motion features in the cost function. Two applications are compared: a semi-automatic method with manual model initialization, and a fully automatic algorithm. The first proved to be highly robust and accurate, demonstrating high clinical relevance. Based on experiments involving 70 patient data sets, the algorithm's success rate was 100% for ED and 99% for ES, with average unsigned border positioning errors of 0.68 mm for ED and 1.45 mm for ES. Calculated volumes were accurate and unbiased. The fully automatic algorithm, with intrinsically less user interaction was less robust, but showed a high potential, mostly due to a controlled gradient descent in updating the model parameters. The success rate of the fully automatic method was 91% for ED and 83% for ES, with average unsigned border positioning errors of 0.79 mm for ED and 1.55 mm for ES.

Algorithms↗
PubMed1980

Knowledge of diabetes mellitus, diets and nutrition in diabetic patients.

A multiple choice questionnaire was used to test the level of knowledge abut diabetes mellitus and diet-nutrition in diabetic patients (n = 317), non-diabetic patients (n = 70), nursing personnel (n = 53) and third-year medical students (n = 43). The results concerning diabetes were better than those for diet-nutrition. A score of greater than or equal to 80% in diet-nutrition was considered necessary for proper management of the diet at home. This level was reached by 84% of the students, 26% of the nursing personnel, 29% of the insulin-treated diabetics (n = 178, 9% of the tablet-treated diabetics (n = 124) and 4% of the non-diabetic patients. It was concluded that the piecemeal instruction system used to teach the diabetic patients is inefficient and should be replaced by a formal educational program integrated into the patient care system. The level of knowledge among nursing personnel needs to be improved.

Aged↗
PubMed1990

Epidemiologic survey of children with end-stage renal disease.

We performed an epidemiologic study on the basis of a questionnaire survey of 162 children with end-stage renal disease (ESRD). Sixty-nine (43%) of our 162 children, including 25 detected at mass screening of urine, were found by chance hematuria and/or proteinuria. The three major causes of ESRD in our children were chronic glomerulonephritis (CGN) in 56, congenital anomalies of the urinary tract in 30, and nephrotic syndrome (NS) in 27. The renal pathology in 39 children with CGN or NS was focal glomerular sclerosis in 15, diffuse mesangial GN in 7, IgA GN in 5, membranoproliferative GN in 3, membranous GN in 3, and unclassified in 6. Forms of dialysis initiated were hemodialysis in 91 children, continuous ambulatory peritoneal dialysis (PD) in 66, and intermittent PD in 5. Renal transplantation was performed on 38 children, and the graft and the patient survival rates were 76% and 89%, respectively. The survival rate of our 162 children for a mean follow-up of 8.1 years was 77%. In conclusion, an integrated program of maintenance dialysis and transplantation provides a favorable life for children with ESRD.

Adolescent↗
PubMed2006

daime, a novel image analysis program for microbial ecology and biofilm research.

Combinations of microscopy and molecular techniques to detect, identify and characterize microorganisms in environmental and medical samples are widely used in microbial ecology and biofilm research. The scope of these methods, which include fluorescence in situ hybridization (FISH) with rRNA-targeted probes, is extended by digital image analysis routines that extract from micrographs important quantitative data. Here we introduce daime (digital image analysis in microbial ecology), a new computer program integrating 2-D and 3-D image analysis and visualization functionality, which has previously not been available in a single open-source software package. For example, daime automatically finds 2-D and 3-D objects in images and confocal image stacks, and offers special functions for quantifying microbial populations and evaluating new FISH probes. A novel feature is the quantification of spatial localization patterns of microorganisms in complex samples like biofilms. In combination with '3D-FISH', which preserves the 3-D structure of samples, this stereological technique was applied in a proof of principle experiment on activated sludge and provided quantitative evidence that functionally linked ammonia and nitrite oxidizers cluster together in their habitat. This image analysis method complements recent molecular techniques for analysing structure-function relationships in microbial communities and will help to characterize symbiotic interactions among microorganisms.

Biofilms↗