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The function of dreaming.

Theories on the function of REM sleep and dreaming, with which it has a contingent relationship, remain diverse. They include facilitation of memory storage, reverse learning, anatomical and functional brain maturation, catecholamine restoration, psychoanalytical (wish fulfilment or otherwise). It is possible that one function is grafted onto another as the personality develops. Given a close relationship between REM sleep and dreaming, and given that the neonate spends 18 hours asleep per day, of which 12 hours are spent in REM sleep, it is logical to look in the neonate for a primary function of dreaming. The two constants in the dreaming process are: 1) the dreamer is always present as first person observer; 2) there is always a topographical setting. Based on the foregoing, it is proposed that a major function of REM sleep is the development and maintenance of a sense of personal identity, through creating a 'being there' environment at regular intervals during prolonged periods of absence from a waking state in topographical surrounds. The infant cannot forget who he/she is. Thus, he/she develops a clear sense of his/her own identity, or the 'I'ness of me', and a sense of his/her separateness from the topographical world. At the same time, by largely forgetting the dreams, he/she is not burdened by the need for an elaborate method of storage of the vicarious and bizarre experiences.

Aging↗

[The effect of vitamin administration on mental development in mentally retarded children].

Vitamin administration in severely mentally retarded children in order to improve their IQ and other forms of personality development has not such a favourable effect as in children with minor cerebral dysfunction. The author administered vitamins A, B, C, D and E to 18 imbecile children. As compared with a control group not given vitamins, no marked changes were observed. This leads to the view that the favourable action of vitamins in children with minor cerebral dysfunction is sometimes assumed in severely mentally affected children where the final effect is in the optimal case nil.

Child↗

Management and prevention of personal problems in older adolescents via schematic maps and peer feedback.

The purpose of the present study was to provide a basis for enhancing personal development in older adolescents by examining the usefulness of two information-processing tools in solving personal problems: schematic maps and peer feedback. Ninety-five college students were assigned to either a schematic map group or an essay group, and further subdivided into groups that worked alone or with a vicarious partner. Assessment consisted of analyzing and generating alternatives to a scenario involving a college student with a drinking problem. Results indicated that alternative generation, an important step in the problem-solving process, is susceptible to experimental manipulation. Schematic maps facilitate the generation of wider-ranging, viable, synergistic alternatives to an uncomfortable situation. Maps help illustrate the complex systems within which problems occur and how patterns of behavior are maintained through reinforcement. Peer feedback may provide information about strategies for the development of additional options.

Adolescent↗

Academic opportunities in radiology education and education research.

Education can be the focus of a rewarding and successful career in academic radiology. Educational opportunities for academic radiologists include teaching medical students, residents, nursing students, physician assistant students, radiology technologist students, and other allied health profession students. Teaching can occur in large or small groups, or as a one-on-one encounter. Teaching is the very best way to learn a subject well; thus, educators are often considered experts in their fields. Educators can develop innovative teaching materials that are passed on to generations of students. Opportunities in educational administration and personal development are available both locally and nationally. Participation in radiology education research allows a radiologist to contribute to the body of knowledge in radiology education and advance the field of radiology education through science.

Career Choice↗

Coordinating integrated services: a pilot study with participants of a co-ordinators course.

The aim of this study was to explore developments in integrative practice in cancer care. Views were drawn from a small focus group (n=4), with students from a coordinators course. The role of a coordinator or team leader has been suggested as pivotal to service integration and organisation [National guidelines for the use of complementary therapies in supportive and palliative care. The Prince of Wales's foundation for Integrated Health & The National Council for Hospice and Specialist Palliative Care Services London POWFIH, 2003; Mackereth, European Journal of Oncology Nursing 8 (2004) 1]. The participants suggested that there are areas which need to be developed to achieve this goal, including evidence based practice, standardisation of training, and ongoing support, and personal development.

Attitude of Health Personnel↗

The use of portfolios for assessment of the competence and performance of doctors in practice.

BACKGROUND: The use of portfolios can potentially provide flexibility in the summative assessment of doctors in practice. An assessment system should reflect and reinforce the active and planned professional development goals of individual doctors. This paper discusses some of the issues involved in developing such a system. RESULTS: To provide a complete picture of an individual doctor's practice, we suggest that a portfolio should encompass: (1) evidence covering all three domains of patient care, personal development and context management; (2) evidence that the person continuously undertakes critical assessment of their own performance, identifies and prioritises areas requiring enhanced performance and takes action to improve them as appropriate; (3) evidence that has been generated by assessments that are acceptably reliable, and (4) evidence which, taken in its entirety, is sufficient, valid, current and authentic. We include a suggested outline of the components of such a portfolio and suggest some criteria to determine the effectiveness of learning cycles. Portfolio reliability and validity requires sufficient evidence on which to base a judgement combined with reliable processes. CONCLUSION: Carefully specified portfolios can contribute to a system that ensures all doctors take an active part in identifying and meeting their own learning needs. Such a system, if properly implemented, would have a greatly beneficial impact on continuous quality improvement for the profession in general.

Clinical Competence↗

Influence of a nontraditional master's degree on graduates' career paths.

Graduates' assessments of the University of Texas at Austin's nontraditional M.S. degree program in pharmacy administration were studied. A survey was constructed to assess the impact of the master's program on career advancement, to examine why pharmacists enrolled in the program, and to determine if the curriculum provided knowledge or developed skills that were practical or beneficial. The survey was mailed in April 1999 to all persons who had completed the program between 1990 and 1998. A total of 56 graduates responded, for a response rate of 90.3%. The three reasons for entering the program most frequently cited as most important were career advancement, personal development, and the desire to change job responsibilities. Thirty-four respondents (60.7%) reported receiving a promotion or changing jobs for a higher position while they were enrolled in the program or after completing it. Of these 34 respondents, 29 (85.3%) attributed their promotion or new job to the master's degree. On average, graduates reported that the knowledge and skills obtained through the program had been useful in their practice. The benefits of the program that were cited most frequently were management skills, competencies in areas of pharmacy business, opportunity to advance career, job satisfaction, and competitive advantage when applying for a job. A nontraditional master's degree program in pharmacy administration had a positive impact on the career paths of graduates.

Adult↗

Early fluid retention and severe acute mountain sickness.

Field studies of acute mountain sickness (AMS) usually include variations in exercise, diet, and environmental conditions over days and development of clinically apparent edemas. The purpose of this study was to clarify fluid status in persons developing AMS vs. those remaining without symptoms during simulated altitude with controlled fluid intake, diet, temperature, and without exercise. Ninety-nine exposures of 51 men and women to reduced barometric pressure (426 mmHg = 16,000 ft. = 4,880 m) were carried out for 8-12 h. AMS was evaluated by Lake Louise (LL) and AMS-C scores near the end of exposure. Serial measurements included fluid balance, electrolyte excretions, and plasma concentrations, regulating hormones, and free water clearance. Comparison between 16 subjects with the lowest AMS scores near the end of exposure ("non-AMS": mean LL = 1.0, range = 0-2.5) and 16 others with the highest AMS scores ("AMS": mean LL = 7.4, range = 5-11) demonstrated significant fluid retention in AMS beginning within the first 3 h, resulting from reduced urine flow. Plasma Na+ decreased significantly after 6 h, indicating dilution throughout the total body water. Excretion of Na+ and K+ trended downward with time in both groups, being lower in AMS after 6 h, and the urine Na+-to-K+ ratio was significantly higher for AMS after 6 h. Renal compensation for respiratory alkalosis, plasma renin activity, aldosterone, and atrial natriuretic peptide were not different between groups, with the latter tending to rise and aldosterone falling with time of exposure. Antidiuretic hormone fell in non-AMS and rose in AMS within 90 min of exposure and continued to rise in AMS, closely associated with severity of symptoms and fluid retention.

Adaptation, Physiological↗

Habits and rituals.

On-going restructuring in the Danish care for the elderly is to a very high degree based on recognition of the significance of habits and rituals, as well on the knowledge of what is needed to alter them. Habits and rituals are concepts that are often confused in everyday patterns of thought. It is necessary to be able to distinguish between the two concepts before change can be effected. To varying degrees people are characterised by unconscious and conscious habits as well as inherited and personal rituals. Personal development, age, support from one's surroundings, and so on, determine the degree to which a person may continue or alter acquired patterns of habit and ritual.

Adaptation, Psychological↗

[Systematics and differentiation of personality disorders in children and adolescents with behavioral disorders].

The author discusses some problems of systematization and differential diagnoses of personality disorders which are accompanied by disturbances of behaviour in children and adolescents. An original classification of personality disorders and transient personality reactions in childhood and adolescence is proposed. Special attention is paid to the criteria of delineating pathological and nonpathological forms of personality disorders and personality reactions in this group of children as well as to the differential diagnosis of constitutional and organic psychopathy. On the other hand residual-organic psychopath-like conditions and psychogenic pathocharacterological personality development are analyzed.

Adolescent↗

Development of a personal dosimetry system based on optically stimulated luminescence of alpha-Al2O3:C for mixed radiation fields.

To develop a personal optically stimulated luminescence (OSL) dosimetry system for mixed radiation fields using alpha-Al2O3:C, a discriminating badge filter system was designed by taking advantage of its optically stimulable properties and energy dependencies. This was done by designing a multi-element badge system for powder layered alpha-Al2O3:C material and an optical reader system based on high-intensity blue light-emitting diode (LED). The design of the multielement OSL dosimeter badge system developed allows the measurement of a personal dose equivalent value Hp(d) in mixed radiation fields of beta and gamma. Dosimetric properties of the personal OSL dosimeter badge system investigated here were the dose response, energy response and multi-readability. Based on the computational simulations and experiments of the proposed dosimeter design, it was demonstrated that a multi-element dosimeter system with an OSL technology based on alpha-Al2O3:C is suitable to obtain personal dose equivalent information in mixed radiation fields.

Aluminum Oxide↗

Gender-specific risk factors for mortality associated with incident coronary heart disease--a prospective community-based study.

BACKGROUND: Risk factors for mortality in community-residing persons developing congestive heart failure (CHF) and acute myocardial infarction (AMI) may differ for males and females. METHOD: Persons from the Groningen Longitudinal Aging Study with incident CHF (N=274) or AMI (N=198) were identified between 1993 and 1998 and their survival status was collected in 2001. Risk factors are assessed prior to the cardiac diagnosis. RESULTS: The 1-, 5-, 7-year survival rates were 65, 53, 50% for AMI and 74, 45, 32% for CHF. Multivariate analyses showed that male gender, high age, smoking, diabetes and low physical function were risk factors for mortality among persons with CHF. For AMI, 1 month mortality was related to high age and baseline low body mass index, while longer term mortality was related to male gender and high age. In addition, diabetes increased longer term mortality among females but not among males with AMI. Depression was not a risk factor for mortality for either condition in either gender. CONCLUSION: Males with CHF or AMI have worse survival rates compared to females. Risk factors for mortality are predominantly similar for males and females, except for diabetes which is a risk factor among females, but not males with AMI.

Aged↗

The medical interview: a core curriculum for residencies in internal medicine.

A core curriculum for teaching medical interviewing is presented that enhances the internist's skills in a broad range of interactions with patients. Learning these skills is now left to chance and is often deficient. Four objectives are developed: patient-centered interviewing and treatment; an integrated (biopsychosocial) approach to clinical reasoning and patient care; personal development of humanistic values; and psychosocial and psychiatric medicine. Teaching options include real and simulated encounters with patients, observation with discussion, and use of groups. A general strategy for implementing the curriculum at the local level requires the intellectual and financial support of the dean and department chairman, and a multidisciplinary faculty committed to developing, implementing, and evaluating the curriculum. At many programs, faculty development will be necessary.

Curriculum↗

Lead the way, Leader.

Effective leaders show objectivity, creativity, and knowledge. They develop personal leadership styles from existing models and use their strength to motivate staff, accomplish organizational goals, and develop future leaders.

Humans↗

The development of multi-level critical care competency statements for self-assessment by ICU nurses.

Multi-levelled critical care competency statements were developed based on the levels of novice to expert (Benner, 1984). These competency statements provide a framework for the development of knowledge and skills specific to critical care. The purpose of this tool is to guide personal development in critical care, facilitating the assessment of individual learning needs. Competency levels are attained through the completion of performance criteria. Multi-levelled competency statements define clear expectations for the new orientee, in addition to providing a framework for the advancement of the intermediate and experienced nurse.

Attitude of Health Personnel↗

Assistive listening devices and systems (ALDS) enhance the lifestyles of hearing impaired persons.

Assistive listening devices and systems (ALDS) help hearing impaired listeners overcome noise, reverberation, and distance. ALDS deliver speech from the lips of the talkers to the ears of the listeners. Thus, hearing impaired persons can function in the mainstream of society. ALDS include hardwire, infrared, FM, loops, and signaling and alerting devices. They help hearing impaired persons develop and maintain listening and talking skills. As a result, they can function at optimal levels of personal, social, educational, vocational, spiritual, and recreational activities. The use of "self-wiring," windscreens, and remote microphone technology make it possible for hearing impaired persons to enjoy communication in one-to-one situations; small and large groups; large listening areas; and settings such as television listening, communicating in an automobile, and counseling with medical, educational, vocational, and spiritual advisers. ALDS, combined with hearing aids, offer state-of-the-art listening and talking opportunities.

Adult↗

[Development of preventive courses for parents in a socialist society].

After discussing the most important of the known parent training techniques the article draws attention to their innovatory value in connection with parent training work in socialist society. The basic purpose of such prophylactic parent courses and the methodological principles upon which they may be developed and organized are considered. Attention is finally drawn to the limits imposed by the dialectics of personality development on the success of such courses.

Child Rearing↗

Development of a personal digital assistant-based wireless application in clinical practice.

PURPOSE: Our study aims to develop a personal digital assistant (PDA)-based wireless application in medical information processing by using Bluetooth and IEEE 802.11b wireless standards and SyncML codes. METHODS: In this study, an "integrated database access module" is used to provide a unified integrated access interface while consistency of wireless data transmission is achieved by using the standardized SyncML protocol. A prototype of the system has been developed, implemented, and tested for its mobility, usability, stability, and performance with questionnaire survey. RESULTS: Response time for browsing/searching was usually less than 3s. The average time intervals needed for data transmissions were 68.6+/-8.5s for Bluetooth and 47.0+/-4.8s for 802.11b. The five-point Likert scale (from 1=least to 5=most) questionnaire survey of 30 medical professionals yielded a high degree of satisfaction with the system's mobility (4.18+/-0.89), usability (4.69+/-0.90), stability (3.81+/-0.94), and performance (3.97+/-0.88). CONCLUSION: The results of our study suggested that PDA applications which exploit wireless communication are convenient and feasible in clinical practice.

Computers, Handheld↗