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PubMed2001

The Stanley Foundation Bipolar Network. I. Rationale and methods.

BACKGROUND: The Stanley Foundation Bipolar Network (SFBN) was created to address the paucity of help studies in bipolar illness. AIMS: To describe the rationale and methods of the SFBN. METHOD: The SFBN includes five core sites and a number of affiliated sites that have adopted consistent methodology for continuous longitudinal monitoring of patients. Open and controlled studies are performed as patients' symptomatology dictates. RESULTS: The reliability of SFBN raters and the validity of the rating instruments have been established. More than 500 patients are in continuous daily longitudinal follow-up. More than 125 have been randomised to one of three of the newer antidepressants (bupropion, sertraline and venlafaxine) as adjuncts in a study of mood stabilizers and 93 to omega-3 fatty acids. A number of open clinical case series have been published. CONCLUSIONS: Well-characterised patients are followed in a detailed continuous longitudinal fashion in both opportunistic case series and double-blind, randomised controlled trials with reliable and validated measures.

Antimanic Agents↗
PubMed2004

Early convergence research and education supported by the National Science Foundation.

The following pages describe research grants awarded by the National Science Foundation that illustrate how different fields of science and technology can converge in order to increase human potential. Technological convergence involves the unification of the sciences of Nanotechnology, Biotechnology, Information Technology, and new technologies based on Cognitive Science (NBIC). Because it supports research across all major branches of science and technology, including the social and behavioral sciences, the NSF has been a focus of discussions about converging technologies to enhance human capabilities and serve human needs.

Biomedical Enhancement↗
PubMed2004

Processes and problems in the formative evaluation of an interface to the Foundational Model of Anatomy knowledge base.

The Digital Anatomist Foundational Model of Anatomy (FMA) is a large semantic network of more than 100,000 terms that refer to the anatomical entities, which together with 1.6 million structural relationships symbolically represent the physical organization of the human body. Evaluation of such a large knowledge base by domain experts is challenging because of the sheer size of the resource and the need to evaluate not just classes but also relationships. To meet this challenge, the authors have developed a relation-centric query interface, called Emily, that is able to query the entire range of classes and relationships in the FMA, yet is simple to use by a domain expert. Formative evaluation of this interface considered the ability of Emily to formulate queries based on standard anatomy examination questions, as well as the processing speed of the query engine. Results show that Emily is able to express 90% of the examination questions submitted to it and that processing time is generally 1 second or less, but can be much longer for complex queries. These results suggest that Emily will be a very useful tool, not only for evaluating the FMA, but also for querying and evaluating other large semantic networks.

Anatomy↗
PubMed1991

The ethical foundations of behavior therapy.

In this article, I am concerned with the ethical foundations of behavior therapy, that is, with the normative ethics and the meta-ethics underlying behavior therapy. In particular, I am concerned with questions concerning the very possibilty of providing an ethical justification for things done in the context of therapy. Because behavior therapists must be able to provide an ethical justification for various actions (if the need arises), certain meta-ethical views widely accepted by behavior therapists must be abandoned; in particular, one must give up ethical subjectivism, ethical skepticism, and ethical relativism. An additional task is to show how it is possible to provide a nonsubjective, nonskeptical, and nonrelativistic moral justification for an ethical statement. Although this is a monumental task, I provide a rough sketch of such a model, one that is congenial to the value judgments underlying behavior therapy.

Behavior↗
PubMed1996

Standardizing procedures for calculating rorschach interrater reliability: conceptual and empirical foundations.

Although the Rorschach test has demonstrated significant refinements in reliability, validity, and statistical power as a result of the procedural standardization and scoring innovations introduced by Exner's Comprehensive System, the issue of Rorschach interrater reliability remains unexplored. This article examines the psychometric foundations of Rorschach interrater reliability and applies notions from applied behavioral analysis to the treatment of Rorschach data. We empirically compare 3 methods of quantifying interrater agreement, their accuracy in estimating interrater agreement, and efficiency in reducing error in Rorschach research. Results indicate that the magnitude of differences between methods of quantifying interrater agreement and the associated reductions of error are significant. We propose a standard method for quantifying interrater agreement in Rorschach research.

Adolescent↗
PubMed1999

Recent status in the occurrence of leukemia in growth hormone-treated patients in Japan. GH Treatment Study Committee of the Foundation for Growth Science, Japan.

The Foundation for Growth Science in Japan has monitored the safety and efficacy of GH treatment in GH-deficient patients since 1975. Data were collected from more than 32,000 patients up to December 31, 1997. New leukemia was observed in 14 patients and myelodysplastic syndrome (MDS) in one patient. The types of leukemia were acute lymphocytic leukemia (n = 6; 40%), acute myelocytic leukemia or MDS (n = 7; 47%), and chronic myelocytic leukemia (n = 2; 13%). Leukemia developed in 9 patients during GH treatment and in 6 after the cessation of GH treatment. Six patients had known risk factors for leukemia, such as Fanconi's anemia and previous radiation or chemotherapy. Patient-years of GH therapy was defined as the time from the first dose of GH to the date of the last visit during GH therapy, and patient-years of risk was defined as the time from the first dose of GH to December 31, 1997. The incidence of leukemia of patient-years of GH therapy and patient-years of risk in GH-treated patients without risk factors was 3.0/100,000 and 3.9/100,000, respectively, a figure similar to the incidence in the general population aged 0-15 yr. We conclude that the incidence of leukemia in GH-treated patients without risk factors is not greater than that in the general population aged 0-15 yr, and a possible increased occurrence of leukemia with GH treatment appears to be limited to patients with risk factors.

Adolescent↗
PubMed2006

Are medical students adequately trained to prescribe at the point of graduation? Views of first year foundation doctors.

BACKGROUND: Drugs are the major therapeutic intervention provided by most doctors throughout their careers. The General Medical Council expects all medical students to be competent to prescribe at the point of graduation. AIMS: The aim of this study was to assess the views of Foundation Year 1 (FY1) doctors who had recently graduated from the University of Edinburgh about their training and competence in relation to the use of drugs based on their early clinical experience. METHOD: A questionnaire was constructed based on Tomorrow's Doctors 2002 and distributed to FY1 doctors who graduated in August 2005. RESULTS: Responses were received from 100 (39.8%) of the doctors who graduated in 2005. Only 32% respondents considered themselves 'competent to prescribe' at the point of graduation. Less than 50% of respondents felt comfortable in providing information about possible treatments to allow patients to make informed decisions about their care. The majority of respondents complained about a lack of formal teaching and practice at basic clinical skills relating to drug therapy. CONCLUSION: Many graduates feel under-prepared to take on prescribing responsibilities after graduation. These findings emphasise the need to ensure that all medical curricula are able to provide sufficient learning opportunities and robust assessment in this important area of clinical practice.

Adult↗
PubMed1991

Organ doses received by atomic bomb survivors during radiological examinations at the Radiation Effects Research Foundation.

When evaluating the risks of oncogenesis and cancer mortality following exposure to the radiations of the atomic bombs (A-bombs), the medical X-ray doses received by the A-bomb survivors must also be estimated and considered. Using a human phantom, dosimetry was performed to estimate the X-ray doses received by A-bomb survivors during medical examinations at the Radiation Effects Research Foundation (RERF) as part of the long-term follow-up on the Adult Health Study (AHS). These examinations have been estimated to represent nearly 45% of the survivors' cumulative medical irradiation dose. Doses to the salivary glands, thyroid gland, lung, breast, stomach and colon were measured using thermoluminescent dosimeters. The results, which are reported here, will aid in estimating organ doses received by individual AHS participants.

Abdomen↗
PubMed2003

Laying the foundations for good medical practice: a new educational resource.

Balancing service commitments with educational development is never easy. The European Working Time Directive and the Chief Medical Officer's report on senior house officer training bring new challenges. The Royal College of Physicians has developed 'Laying the Foundations for Good Medical Practice', a resource that enables tutors to teach generic skills to small groups of trainees in a fun and interactive way.

Education, Medical, Continuing↗
PubMed2003

Foundations for low-loss fiber gradient-index lens pair coupling with the self-imaging mechanism.

A fiber-optic collimator that emits a Gaussian beam with its beam waist at a certain distance after the exit face of the lens is labeled a self-imaging collimator. For such a collimator, the waist of the emitted Gaussian beam and its location are partly dependent on the properties of the gradient-index (GRIN) lens. Parameters for the self-imaging collimator are formulated in terms of the parameters of a GRIN lens (e.g., pitch, core refractive index, gradient index, length) and the optical wavelength. Next, by use of the Gaussian beam approximation, a general expression for the coupling power loss between two self-imaging-type single-mode fiber (SMF) collimators is, for the first time to our knowledge, derived as a function of three types of misalignment, namely, separation, lateral offset, and angular tilt misalignment. A coupling experiment between two self-imaging collimators with changing separation distance is successfully performed and matches the proposed self-imaging mechanism coupling loss theory. In addition, using a prism, lateral offset, as well as angular tilt, misalignments are experimentally simulated for a two self-imaging collimator coupling condition by a single collimator reflective test geometry. Experimental results agree well with the proposed loss formulas for self-imaging GRIN lenses. Hence, for the first time to our knowledge, the mathematical foundations are laid for employing self-imaging-type fiber collimators in SMF-based free-space systems allowing optimal design for ultra-low-loss coupling.

Journal Article↗
PubMed2006

Analytical modeling of adaptive optics: foundations of the phase spatial power spectrum approach.

End-to-end simulation of adaptive optics (AO) systems allows high-fidelity modeling of system performance, but at the cost of long computation time. Analytical modeling, on the other hand, can provide much faster first-order performance estimates for a rapid exploration of the AO parameter space. In this paper, we present the foundations of a modeling method for the AO optical transfer function, based on an analytical description of the residual phase spatial power spectrum. The method has been implemented in an IDL-based code, PAOLA, and comparison with end-to-end simulations demonstrates the validity of the analytical approach.

Journal Article↗
PubMed1995

Ability to obtain health care: recent estimates from the Robert Wood Johnson Foundation National Access to Care Survey.

This DataWatch presents findings on Americans' ability to obtain health care. Data from the 1994 National Access to Care Survey sponsored by The Robert Wood Johnson Foundation suggest that earlier studies have underestimated the access problems facing Americans by not asking about supplementary services such as prescription drugs, eyeglasses, dental care, and mental health care or counseling. Using this more inclusive definition of health care needs, we estimate that 16.1 percent of Americans were unable to obtain at least one service they believed they needed. While income is highly correlated with unmet need, most persons reporting access problems are not poor.

Adolescent↗
PubMedDate not supplied

Leveraging the nation's anti-bioterrorism investments: foundation efforts to ensure a revitalized public health system.

The emerging potential threats of bioterrorism combined with critical existing epidemics facing the United States call for immediate and urgent attention to the U.S. public health system. The foundation world is helping to answer that call and is sounding the alarm that our health defenses must be able to do "double duty" to protect us from the full spectrum of modern health threats. This Special Report presents a selective sample of recent and ongoing grant activities designed to revitalize and modernize the public health infrastructure, which is vital to protecting the nation's health and ensuring its safety.

Bioterrorism↗
PubMedDate not supplied

Evidence-based guidelines as a foundation for performance incentives.

Clinical guidelines, which increasingly build upon impartial analysis of evidence from well-designed studies, have become highly credible sources of information about what forms of care are effective. Consequently, they are attractive as foundations for performance incentives. Unfortunately, they are often complex, and frequently it is infeasible to gather the information required to assess compliance with guidelines at reasonable cost. I discuss the problems in implementing evidence-based guidelines and steps that could be taken to make them more useful as a basis for performance measurement.

Costs and Cost Analysis↗
PubMed2006

Prevalence and correlates of restless legs syndrome: results from the 2005 National Sleep Foundation Poll.

PURPOSES: The purpose of this analysis was to investigate the prevalence and correlates of restless legs syndrome (RLS) symptoms in the 2005 National Sleep Foundation (NSF) Sleep in America 2005 Poll. The NSF poll is an annual telephone interview of a random, representative sample of US adults. METHODS: The NSF 2005 poll included 1,506 adults. Their mean age was 49 years, and 775 were women. RESULTS: Symptoms of RLS that included unpleasant feelings in the legs for at least a few nights a week, which were worse at night, were reported by 9.7% of individuals in this poll, including 8% of men and 11% of women. Those from the northeast United States were much less likely to be at risk than those from other regions of the country (p < 0.05). Those who were unemployed (p < 0.05) or smoked daily (p < 0.5) were more likely to be at risk for RLS, as were those with hypertension, arthritis, gastroesophageal reflux disease, depression, anxiety, and diabetes (p < 0.05 for all). Adults who were at risk for RLS appeared to also be at increased risk for sleep apnea and insomnia (p < 0.05), and were more likely to stay up longer than they planned, to take longer than 30 min to fall asleep, to drive when drowsy, and to report daytime fatigue than those who were not at risk (p < 0.05 for all). They were also more likely to report being late to work, missing work, making errors at work, and missing social events because of sleepiness than other respondents in the poll (p < 0.05 for all). CONCLUSIONS: RLS is significantly associated with medical and psychiatric conditions, other sleep disorders, unfavorable lifestyle behaviors, and adverse effects on daytime function. Chest physicians who practice sleep medicine need to be able to identify and manage RLS, which is prevalent and is associated with considerable morbidity.

Adult↗