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Using the ACNP Proficiency Testing Program to develop critical thinking. American College of Nuclear Physicians.

UNLABELLED: Critical thinking is cited as one of the essential skills for clinical practice. Educators need to be aware of barriers that may hinder the development of this skill in students and cultivate strategies to encourage it. This article describes one strategy to develop critical thinking. METHODS: Students participated in a critical thinking exercise by imaging the American College of Nuclear Physicians (ACNP) Renal Imaging Proficiency Test Phantom, critiquing their results, and comparing their results to results collected nationally in other nuclear medicine facilities and the true values reported by the ACNP. Students were instructed to review pertinent imaging principles before discussing the imaging results. They also were supplied with a list of questions pertinent to the review. RESULTS: Students experienced the complexity of designing a SPECT imaging protocol and how the final results are affected by the choices made by the technologist. They learned the importance of and method for proper matrix selection, determination of pixel size and the necessity for quality control. CONCLUSION: The imaging exercise was a successful means of helping students connect clinical practice with theory through the use of critical thinking.

Computer Simulation↗

Plant Methods: putting the spotlight on technological innovation in the plant sciences.

Plant Methods is a new journal for plant biologists, specialising in the rapid publication of peer-reviewed articles with a focus on technological innovation in the plant sciences. The aim of Plant Methods is to stimulate the development and adoption of new and improved techniques and research tools in plant biology. We hope to promote more consistent standards in the plant sciences, and make readily accessible laboratory and computer-based research tools available to the whole community. This will be achieved by publishing Research articles, Methodology papers and Reviews using the BioMed Central Open Access publishing model. The journal is supported by a prestigious editorial board, whose members all recognise the importance of technological innovation as a driver for basic science.

Editorial↗

Attitudes toward younger and older adults learning to use computers.

Person perception and direct attitude paradigms were employed to examine age bias in the achievement-oriented setting of computer learning. Two samples of volunteers (80 undergraduates and 120 science museum visitors) evaluated a target person (a man or woman, aged either 25 or 70 years) described as being enrolled in a computer course and made causal attributions after outcome feedback. Age effects were significant, but gender effects were not observed. Older adults were considered less likely to succeed in the course and less typical for their age group, although the older course enrollees were viewed as more competent overall than their younger peers in the course. In the undergraduate sample only, causal attributions indicated that the success of older adults was less related to the task than for young adults, and that their failure was less related to lack of effort and more related to their age. Analyses of the direct attitude items yielded predictably stronger age effects in both studies, accounting for 61-80% of the variance.

Adolescent↗

Medical applications in the TANDEM-16 multiple computer system environment.

This paper addresses the question of reliability and the TANDEM-16 approach to facilitate reliable computers. Specifically, the use of the TANDEM-16 within the medical environment is described. Three current applications within the Medical Computing Resources Center at The University of Texas Health Science Center at Dallas are developed, each characterized by different reliability considerations.

Computers↗

Citation classics in critical care medicine.

OBJECTIVE: The number of citations an article receives after its publication reflects its impact on the scientific community. Our purpose was to identify and examine the characteristics of the most frequently cited articles in the field of critical care medicine. DESIGN: The 74 top-cited articles in critical care journals were identified by a computer search using the database of the Science Citation Index Expanded (SCI-EXPANDED, 1945 to present) and the Web of SCIENCE. The 45 top-cited critical care articles in all other biomedical journals were identified using the database SciSearch (1974 to present) with the key word "Critical Care". RESULTS: The most cited articles received 3402 and 2860 citations, respectively. The citation classics in critical care journals were published between 1968 and 1999 in six high-impact journals, led by Critical Care Medicine (37 articles), followed by the Journal of Trauma (21), and American Journal of Respiratory and Critical Care Medicine (9). Seventy articles were original publications, two were reviews or guidelines, and two were editorials. The top 45 classic articles in non-critical care journals were published in 13 different journals, led by the New England Journal of Medicine (11 articles), followed by JAMA and Lancet (6 articles each). The United States of America contributed most of the classic articles. Pathophysiology of the lung, sepsis and scoring systems were the primary focus of classic publications. CONCLUSIONS: Our analysis gives a historical perspective on the scientific progress of critical care medicine and allows for recognition of important advances in this specialty.

Bibliometrics↗

Regression models of ultimate methane yields of fruits and vegetable solid wastes, sorghum and napiergrass on chemical composition.

Several fractions of fruits and vegetable solid wastes (FVSW), sorghum and napiergrass were analyzed for total solids (TS), volatile solids (VS), total organic carbon, total kjeldahl nitrogen, total soluble carbohydrate, extractable protein, acid-detergent fiber (ADF), lignin, cellulose and ash contents. Their ultimate methane yields (B(o)) were determined using the biochemical methane potential (BMP) assay. A series of simple and multiple regression models relating the B(o) to the various substrate constituents were generated and evaluated using computer statistical software, Statistical Package for Social Sciences (SPSS). The results of simple regression analyses revealed that, only weak relationship existed between the individual components such as carbohydrate, protein, ADF, lignin and cellulose versus B(o). A regression of B(o) versus combination of two variables as a single independent variable such as carbohydrate/ADF and carbohydrate+protein/ADF also showed that the relationship is not strong. Thus it does not appear possible to relate the B(o) of FVSW, sorghum and napiergrass with single compositional characteristics. The results of multiple regression analyses showed promise and the relationship appeared to be good. When ADF and lignin/ADF were used as independent variables, the percentage of variation accounted for by the model is low for FVSW (r(2)=0.665) and sorghum and napiergrass (r(2)=0.746). Addition of nitrogen, ash and total soluble carbohydrate data to the model had a significantly higher effect on prediction of B(o) of these wastes with the r(2) values ranging from 0.9 to 0.99. More than 90% of variation in B(o) of FVSW could be accounted for by the models when the variables carbohydrate, lignin, lignin/ADF, nitrogen and ash (r(2)=0.904), carbohydrate, ADF, lignin/ADF, nitrogen and ash (r(2)=0.90) and carbohydrate/ADF, lignin/ADF, lignin and ash (r(2)=0.901) were used. All the models have low standard error values, which indicate the amount of spread is less. Thus, considering only the higher r(2) values, six models are proposed for predicting the B(o) based on FVSW data and sorghum and napiergrass data. It would be more convenient if B(o) could be predicted by analyzing the chemical composition of the substrate rather than performing the long-term batch fermentation. To test the validity of the regression models, chemical constituents of FVSW that were not included in the regression analyses were determined and their experimental B(o) were determined by BMP assay. All the six models were used to predict the B(o) from the chemical constituents of these FVSW. It was found that most of the predicted values were within 20% of the experimental B(o) in models 1, 3 and 6. Since models 3 and 6 used the same variables namely, total soluble carbohydrate, ADF, lignin/ADF, nitrogen and ash, B(o) can be predicted from these five chemical constituents which accounts for more than 90% of the variation in B(o) (r(2)>90).

Fruit↗

Future directions for depicting credibility in health care web sites.

OBJECTIVES: The purpose of the paper was to determine appropriate terminology, criteria, implementation, and develop a theoretical framework by which credibility in health care web sites can be depicted. Future research directions for evaluating credibility in health care web sites was also discussed. METHOD: A comprehensive literature review of published articles, policy papers, and grey literature using relevant search terms was conducted. Sources for articles reviewed included MEDLINE (from 1966 to present), PsycINFO (from 1840 to present), ERIC (from 1966 to present), and the Association for Computing Machinery (ACM) databases. The Web of Science citation service was continuously searched using a subscription service from 2002 to 2004. The search engine Google was also implemented. RESULTS: A common term, credibility, was purposed for use in this context. A comprehensive set of credibility criteria, presented within a theoretical framework was also developed. Implementation by means of a browser-based graphic icon was purposed. CONCLUSIONS: Relevancy and readiness of the purposed common terminology, criteria, and implementation within the theoretical framework must be further researched. More knowledge of consumers' behaviour regarding use of online health content and collaboration with others when implementing such information should be considered in future research.

Canada↗

Correlation between buccolingual inclination and wear of mandibular teeth in ancient and modern Japanese.

This study compared the correlation between the buccolingual inclination and the wear score of the mandibular teeth in Jomon (one of the ancestors of modern Japanese who lived from 5000 to 300 BC) and modern Japanese. Data were obtained from 40 modern male Japanese and 39 male Jomon skulls housed in the University Museum of the University of Tokyo and National Science Museum, Tokyo. For each specimen, three computed tomograms of coronal sections of the mandibular body were available. The second premolar, first molar and second molar of Jomon stood more vertically than those of modern Japanese. There were significant correlations between tooth wear and the buccolingual inclination of mandibular molars. When ancient and modern populations were compared, tooth wear was significantly greater and buccolingual tooth inclination was more vertical in the ancient people, who probably applied stronger masticatory forces than modern people. The results suggest that the mandibular molar orientation is more buccal and there is greater tooth wear in the first and second molars of people with strong masticatory function.

Bicuspid↗

Lingual thyroid: iodine 131: a viable treatment modality revisited.

PURPOSE: Lingual thyroid has a reported incidence between 1:10 and 1:100,000. When symptomatic, patients may present with dysphagia, choking, and/or dyspnea. Current surgical treatment options range from tumor extirpation or transposition to excision and reimplantation. Tracheotomies are often performed postoperatively for reliable airway control. Iodine 131 (131I) has not been a popular modality of treatment for lingual thyroid because of theoretical fears of increased airway obstruction from thyroiditis. We believe that these fears were not substantiated, and that symptomatic patients needed a reliable, nonsurgical treatment option. Therefore, our goal was to further investigate the use of 131I for the treatment of symptomatic lingual thyroid. PATIENTS AND METHODS: A 6-year retrospective chart review was performed. From 1994 to 2000, 2 patients with symptomatic lingual thyroid presented to the Arkansas Cancer Research Center Head and Neck Oncology clinic, University of Arkansas for Medical Sciences, Little Rock, AR. Patients underwent pretreatment computed tomography, and iodine 123 scans. They then received 1 oral dose of 131I. Doses ranged from 30 to 85 mCi. Patients were then followed daily for signs of airway compromise. RESULTS: Complete resolution of symptoms was seen 2 months after treatment. Patients did not complain of any increased airway compromise during treatment initiation. Patients remain symptom-free and are maintained on thyroid hormone replacement. CONCLUSIONS: Iodine 131 ablation of lingual thyroid is a safe and effective treatment in symptomatic patients and should be included in the algorithm when formulating a treatment plan.

Aged↗

Hypergeometric generating functions for values of Dirichlet and other L functions.

Although there is vast literature on the values of L functions at nonpositive integers, the recent appearance of some of these values as the coefficients of specializations of knot invariants comes as a surprise. Using work of G. E. Andrews [(1981) Adv. Math. 41, 173-185; (1986) q-Series: Their Development and Application in Analysis, Combinatories, Physics, and Computer Algebra, Conference Board of the Mathematical Sciences Regional Conference Series in Mathematics 66 (Am. Math. Soc, Providence, RI); (1975) Problems and Prospects for Basic Hypergeometric Series: The Theory and Application of Special Functions (Academic, New York); and (1992) Illinois J. Math. 36, 251-274], we revisit this old subject and provide uniform and general results giving such generating functions as specializations of basic hypergeometric functions. For example, we obtain such generating functions for all nontrivial Dirichlet L functions.

Journal Article↗

Brachytherapy technology and physics practice since 1950: a half-century of progress.

The 50-year tenure of Physics in Medicine and Biology has coincided with some of the most important developments in radiological science, including the introduction of artificial radioactivity, computers and 3D imaging into medicine. These events have profoundly influenced the development of brachytherapy. Although it is not the dominant radiotherapy modality, it continues to play an important role in cancer therapy, more than a century after its introduction. This paper reviews the impact of three broad categories of innovation introduced since 1950 from the North American perspective: the introduction of artificial radioactivity, computer- and image-based treatment planning, and basic single-source dosimetry.

Animals↗

Geobase: a simple geographical information system on a personal computer.

Spatially distributed data are often encountered in the biological sciences. Representation and analysis of such data requires specific tools. A simple geographical information system is presented, which allows representation and elementary analysis of geographically coded information. The system handles two kinds of data: maps and facts, where map data describe the basis on which the fact data are located. Maps consist of objects described through a set of coordinates, while for facts a coordinate pair is associated with an unlimited number of data records containing five fields: a date, an element from a list, a two-character code, an integer number and a real number. The input data can be displayed interactively on screen by logically combining selection criteria for each field. The facts corresponding to the selected criteria are either displayed as such, or are clustered and displayed as polygons or pies. A short example showing a possible application of the program is presented and advantages as well as limitations are discussed.

Algorithms↗

Spinach plastid genes coding for initiation factor IF-1, ribosomal protein S11 and RNA polymerase alpha-subunit.

The nucleotide sequence of 2.5 kbp from the cloned SalI fragments 8 and 11 of spinach plastid DNA has been determined. This region was found to encode three open reading frames for hydrophilic polypeptides of 77, 138, and 335 amino acids. Using the computer search algorithm of Lipman and Pearson (Science 227, 1435, 1985), these genes were identified as coding for homologues of E. coli initiation factor IF-1 (inFA), 30S ribosomal protein S11 (rps11), and the alpha-subunit of DNA-dependent RNA polymerase (rpoA). The spinach plastid gene organization is inFA - 381 bp spacer - rps11 - 72 bp spacer - rpoA. The genes are transcribed in vivo and appear to encode functional proteins. These findings imply that plastid chromosomes code for components of the organelle transcription apparatus.

Amino Acid Sequence↗

Traumatic amputations in the workplace.

The purpose of this study was to identify variables associated with traumatic amputations in the workplace. Case files of work-related amputations in Minnesota during 1977 were accessed in cooperation with the Workers' Compensation Division of Minnesota. Data analysis was conducted by computer using the Statistical Package for Social Sciences. Of the 109 amputation cases, a mean age of 31 years (range 16 to 80) was identified; 50% of all cases were below the age of 25 years. By gender, males accounted for five times as many cases as females. Operatives incurred the largest number of amputations (40%); yet, they account for only 14% of the total work force. Manufacturing accounted for a majority (43.4%) of the traumatic amputations while including only 18 percent of the work force. Prevention strategies employed subsequent to the injuries included: training only (32.1%), engineering controls (10.1%), and mixed strategies (3.0%); further analysis revealed that although application of passive controls to the specific source (eg, machine) of the injury would have been most appropriate, training was frequently the only intervention incorporated. Recommendations, including Haddon's strategies for prevention and control of amputations are presented.

Accidents, Occupational↗

How do nurses deal with their own grief when a patient dies on an intensive care unit, and what help can be given to enable them to overcome their grief effectively?

There is an expectation that nurses are good at caring for relatives on the death of a patient. Who, though, cares for the nurses? Using both a quantitative and a qualitative approach, this study looks at how nurses overcome their own grief when a patient dies on an intensive care unit. Information was first collected using a questionnaire. Personal grief, however, is a very emotive area, so a proportion of the nurses from the initial study were then asked to take part in a semi-structured interview, to explore their feelings in more depth. The quantitative data were analysed using the computer software Statistical Package for the Social Sciences and the results were related to the interview responses. This showed how nurses deal with their grief, and that many, but not all, felt that the informal support network already present was sufficient. Some nurses, however, felt that a support group would also be helpful and some felt the availability of a counsellor would be useful. All nurses felt that more training about how to deal with their own grief was needed.

Adaptation, Psychological↗

The knowledge and practices of primary care givers regarding home-based care of HIV/AIDS children in Blantyre (Malawi).

Knowledge is one of the major factors that promotes adherence to treatment regimens. With the current trends worldwide of home and community-based services for the management of HIV/AIDS patients, knowledge of care givers about the home care of these patients will determine the success of the programs. The purpose of this descriptive study was to explore the knowledge and practices of primary care givers of HIV/AIDS children in the provision of home care services. In this study an attempt was made to describe the factors which are associated with knowledge. Thirty-six primary care givers were randomly selected from three major home based care centres in Blantyre City, Malawi. A structured interview schedule was used to collect data. Data were analysed manually and by computer, using the Statistical Package for Social Science (SPSS). The findings revealed a gap in knowledge since in many instances taking a child to the hospital for the management of minor ailments was the action of choice, thus perpetuating the problem of overburdening hospital resources. Lack of prior preparation for home based care was found to be the major factor contributing to the lack of knowledge. Recommendations proposed include the need to put into place mechanisms that will ensure that all the primary care givers are adequately prepared in good time for home care service. Ensuring regular home visits was also thought to be helpful for efficient and effective supervision and reinforcement of information given to fill the gaps in knowledge wherever necessary.

Acquired Immunodeficiency Syndrome↗

Health promotion for older Americans in the 21st century.

OBJECTIVES: To provide a broad overview of the role of the individual, the physical environment, and the social environment on health and functioning in older adults (65 and older), and to highlight interventions and recommendations for action on each of these levels. DATA SOURCES: Published studies and government reports on health and functioning in older Americans and on the individual, social, and physical environmental contributors to health were identified through journal and government documents review and computer library searches of medical and social science data bases for 1980-1999. STUDY SELECTION: Preference was given to published studies and government reports that focused specifically on behavioral and environmental contributors and barriers to health promotion in Americans 65 and older and/or that highlighted creative interventions with relevance to this population. Both review articles and presentations of original research were included, with the latter selected based on soundness of design and execution and/or creativity of intervention described. DATA EXTRACTION: Studies were examined and their findings organized under three major headings: (1) behavioral risk factors and risk reduction, including current government standards for prevention and screening; (2) the role of the physical environment; and (3) the role of the social environment in relation to health promotion of older adults. DATA SYNTHESIS: Although most attention has been paid to the role of behavioral factors in health promotion for older adults, a substantial body of evidence suggests that physical and social environmental factors also play a key role. Similarly, interventions that promote individual behavioral risk reduction and interventions targeting the broader social or physical environment all may contribute to health in the later years. CONCLUSIONS: With the rapid aging of America's population, increased attention must be focused on health promotion for those who are or will soon be older adults. Promising intervention strategies addressing the individual, the physical environment, and the social environment should be identified and tested, and their potential for replication explored, as we work toward a more comprehensive approach to improving the health of older Americans in the 21st century.

Aged↗