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At least 1,531 records · Page 85Linked to original sources
PubMed2005

Effect of a gentle Iyengar yoga program on gait in the elderly: an exploratory study.

OBJECTIVE: To determine if a tailored yoga program could improve age-related changes in hip extension, stride length, and associated indices of gait function in healthy elders, changes that have been linked to increased risk for falls, dependency, and mortality in geriatric populations. DESIGN: Single group pre-post test exploratory study. A 3-dimensional quantitative gait evaluation, including kinematic and kinetic measurements, was performed pre- and postintervention. Changes over time (baseline to postintervention) in primary and secondary outcome variables were assessed using repeated-measures analysis of variance. SETTING: Yoga exercises were performed in an academic medical center (group classes) and in the subjects' homes (yoga home-practice assignments). Pre- and postassessments were performed in a gait laboratory. PARTICIPANTS: Twenty-three healthy adults (age range, 62-83 y) who were naive to yoga were recruited; 19 participants completed the program. INTERVENTION: An 8-week Iyengar Hatha yoga program specifically tailored to elderly persons and designed to improve lower-body strength and flexibility. Participants attended two 90-minute yoga classes per week, and were asked to complete at least 20 minutes of directed home practice on alternate days. MAIN OUTCOME MEASURES: Peak hip extension, average anterior pelvic tilt, and stride length at comfortable walking speed. RESULTS: Peak hip extension and stride length significantly increased (F1,18=15.44, P<.001; F1,18=5.57, P=.03, respectively). We also observed a trend toward reduced average pelvic tilt (F1,18=4.10, P=.06); adjusting for the modifying influence of frequency of home yoga practice strengthened the significance of this association (adjusted F1,17=14.30, P=.001). Both the frequency and duration of yoga home practice showed a strong, linear, dose-response relationship to changes in hip extension and average pelvic tilt. CONCLUSIONS: Findings of this exploratory study suggest that yoga practice may improve hip extension, increase stride length, and decrease anterior pelvic tilt in healthy elders, and that yoga programs tailored to elderly adults may offer a cost-effective means of preventing or reducing age-related changes in these indices of gait function.

Accidental Falls↗
PubMed1978

The hyperactive child at adolescence: cognitive, emotional, and social functioning.

In view of the paucity of detailed follow-up studies on hyperactive children, the performance of 15 adolescents diagnosed hyperactive 5 years previously was compared to that of a control group of equivalent age, sex, intelligence, and social class. Eleven cognitive tests measuring sustained attention, visual-motor and motor skills, abstraction, and reading ability, as well as three self-assessment tests examining self-esteem, activity level, social functioning, academic status, and career aspirations were administered. The hyperactives performed significantly worse than the controls on the sustained attention, visual-motor, and motor tasks, and on two of the four reading tests. They also gave themselves significantly lower ratings on some of the self-esteem and sociability items. It would appear that the hyperactives at adolescence still have attentional and stimulus-processing difficulties, which affect not only their academic performance but also their social functioning.

Achievement↗
PubMed2005

Benchmarks for work performance of pediatric psychologists.

OBJECTIVE: To establish benchmarks for work performance of pediatric psychologists. METHODS: All full members of the Society of Pediatric Psychology, Division 54 of the American Psychological Association (N = 1043), were recruited for participation in a mail survey. Four hundred and seventy surveys were returned (45%); 356 usable surveys (34%) were included in the analyses. Surveys assessed work-settings, academic appointments, salary, performance expectations and evaluations, and satisfaction. RESULTS: Most of the survey respondents, 63%, worked in a hospital setting. On average, survey respondents were directly accountable for generating half, 52%, of their salary. Salary covered by institutions was most frequently provided for nonrevenue generating activities such as administration and teaching. Most of the sample (78%) indicated clear performance expectations and criteria. CONCLUSIONS: Findings update and expand previously established benchmarks for work performance and have implications for the practice of pediatric psychology in an ever-changing health care environment.

Academic Medical Centers↗
PubMed1997

Pharmacy benefit management, cost-effectiveness analysis and drug formulary decisions.

Pharmacy benefit management companies (PBMs) have evolved over the past decade in response to the increased demand for health care cost containment. Their activities include the implementation of drug formularies and the negotiation of rebates from manufacturers. Our analysis of this industry is based on interviews and materials provided by the top five ranked PBM companies which account for over 80% of beneficiaries covered within formulary plans. The formularies of these companies are relatively inclusive, but they are becoming more restrictive over time. At present the use of cost-effectiveness (C-E) studies in the formulary decisions of PBMs has been limited. In this regard, the surveyed PBMs emphasized that most C-E studies have not compared therapeutic substitutes in populations with characteristics that are similar to those of their clients. Pharmacy benefit management companies also have had strong incentives to focus narrowly on drug costs because they typically manage drug benefits on a "carved-out" basis. However, PBMs anticipate a growing future role in the integrated management of patient care (disease management) for certain high cost chronic diseases and conditions. All of the leading firms we surveyed have disease management programs in development. The importance of C-E studies to PBM decisions is expected to increase significantly as disease management programs are implemented. The data infrastructure inherent to the PBM industry and the increasing number of employees with advanced training in pharmacoeconomics will permit firms to perform their own internal C-E studies. They are also establishing various alliances and joint ventures with drug manufacturers, health maintenance organizations, and academic institutions to perform these analyses. The leading PBMs tend to favor active participation in the development of methodological approaches to C-E studies over government regulations such as those proposed by the FDA in 1995.

Cost Control↗
PubMed1996

A comparative analysis of embryo implantation potential in patients with severe teratozoospermia undergoing in-vitro fertilization with a high insemination concentration or intracytoplasmic sperm injection.

The objective of this study was to assess fertilization, implantation and pregnancy rates in infertile patients with severe teratozoospermia [P (poor prognosis) pattern sperm morphology assessed by strict criteria] treated by in-vitro fertilization (IVF) using a high insemination concentration (HIC), or by intracytoplasmic sperm injection (ICSI). This was a retrospective cohort study performed in an academic tertiary institution. The outcome of 115 consecutive ICSI cycles was compared to that of a similar number of cycles of IVF with HIC performed during a similar time frame and matched by woman's age and basal serum (cycle day 3) follicle stimulating hormone concentrations. The inclusion criteria were sperm morphology </=4% normal forms (P pattern) and >/=1x10(6) total motile spermatozoa per ejaculate. The diploid fertilization rate in the HIC-IVF group was 86% and in the ICSI group 68% (P < 0.05). Importantly, an equal number of embryos was transferred to both groups of patients. The morphological quality of the embryos (proportion of transfers having superior morphology embryo scores) was significantly better in the ICSI group than in the patients receiving HIC-IVF. Although there was a clear trend for better implantation and pregnancy rates in the ICSI group, these differences were not statistically significant. We conclude that, although HIC-IVF resulted in a higher fertilization rate than ICSI in patients with severe teratozoospermia, ICSI produced a significantly higher proportion of morphologically superior embryos with a tendency towards a higher implantation potential. Therefore, teratozoospermic patients having adequate numbers of motile spermatozoa should be offered ICSI as an alternative to modified (HIC) IVF treatment.

Cohort Studies↗
PubMed1995

Recent cognitive perspectives on learning--implications for nurse education.

Nurse educators must keep abreast of contemporary learning theory so that their teaching reflects current ideas of best practice. In view of this, it is important to report on recent developments in the field of learning. Of particular significance is the fact that behaviouristic explanations of learning have largely been replaced with cognitive perspectives which emphasise the complexity of the learning process. Memory, learning, problem solving and expertise have all been investigated from a cognitive stance. The highlights of this work include, firstly, the portrayal of learning as an active, constructivist, cumulative and self-regulated process leading to the development of understanding and complex, skilled performance. Secondly, the highly important role played by knowledge in learning has been identified and described. Lastly, novice-expert differences in problem solving and academic and practical performance more generally, are well understood as a result of investigations of expertise in many domains. In this paper, these three significant perspectives from cognitive psychology will be examined and their implications for the education of undergraduate nurses described. Developments in the field of nursing that reflect or challenge a cognitive outlook are also identified.

Clinical Competence↗
PubMed2005

The polycystic ovary syndrome associated with morbid obesity may resolve after weight loss induced by bariatric surgery.

CONTEXT: The polycystic ovary syndrome (PCOS) is frequently associated with obesity. However, there are very few data about PCOS in morbid obesity, especially with regard to its evolution after bariatric surgery. OBJECTIVE: The objective of this study was to evaluate the response of PCOS to the sustained and marked weight loss achieved by bariatric surgery in morbidly obese women. DESIGN: This was a longitudinal prospective nonrandomized evaluation. SETTINGS: The study was performed at an academic hospital. PATIENTS: Thirty-six consecutive premenopausal women submitted to bariatric surgery were screened for PCOS, which was present in 17. INTERVENTIONS: Bariatric surgery was performed. MAIN OUTCOME MEASURES: Hyperandrogenism, menstrual function, and insulin resistance were estimated before and at least 6 months after bariatric surgery in 12 patients with PCOS. RESULTS: Weight loss (41 +/- 9 kg after 12 +/- 5 months) was paralleled by decreases in the hirsutism score (from 9.5 +/- 6.8 to 4.9 +/- 4.2; P = 0.001), total (69 +/- 32 to 42 +/- 19 ng/dl; P < 0.02) and free testosterone (from 1.6 +/- 0.7 to 0.6 +/- 0.3 ng/dl; P < 0.005), androstenedione (from 4.1 +/- 1.5 to 3.0 +/- 0.9 ng/ml; P < 0.02), and dehydroepiandrosterone sulfate (from 2000 +/- 1125 to 1353 +/- 759 ng/ml; P < 0.005); amelioration of insulin resistance estimated by homeostasis model assessment (from 6.0 +/- 3.0 to 1.6 +/- 1.0; P < 0.001); and restoration of regular menstrual cycles and/or ovulation in all patients. CONCLUSIONS: The PCOS is a frequent finding in women with morbid obesity and may resolve after weight loss induced by bariatric surgery.

Adult↗
PubMed2002

Is past academic productivity predictive of radiology resident academic productivity?

RATIONALE AND OBJECTIVES: The authors performed this study to determine whether academic productivity in college and medical school is predictive of the number of publications produced during radiology residency. MATERIALS AND METHODS: The authors reviewed the records of 73 radiology residents who completed their residency from 1990 to 2000. Academic productivity during college, medical school, and radiology residency, other postgraduate degrees, and past careers other than radiology were tabulated. The personal essay attached to the residency application was reviewed for any stated academic interest. Residents were classified as being either previously productive or previously unproductive. Publication rates during residency and immediately after residency were compared for the two groups. For the productive residents, a correlation analysis was used to examine the relationship between past frequency of publication and type of previous activity. Least-squares regression analysis was used to investigate the relationship between preresidency academic productivity, advanced degrees, stated interest in academics, and other careers and radiology residency publications. RESULTS: There was no statistically significant difference in the number of articles published by those residents who were active and those who were not active before residency (P = .21). Only authorship of papers as an undergraduate was weakly predictive of residency publication. CONCLUSION: These selected measures of academic productivity as an undergraduate and during medical school are not helpful for predicting publication during residency. There was no difference in publication potential between those residents who were academically productive in the past and those who were not.

Achievement↗
PubMed2002

Intra- and intercultural comparisons of the personality profiles of medical students in Argentina and the United States.

This study was designed to compare the personality profiles of medical students in Argentina and the United States. The ultimate purpose of the research was to study the value of personality measures in predicting academic and professional performances. Participants were 421 medical students in Argentina (254 women, 167 men) and 623 medical students in the United States (207 women, 416 men). Eight personality measures were administered: Perception of Stressful Life Events, Test Anxiety, General Anxiety, Loneliness, Self-Esteem, Locus of Control, Extraversion, and Neuroticism. Intracultural comparisons showed some minor gender differences in personality profiles within each culture (e.g., in the United States, women scored higher than men on the Perception of Stressful Life Events and General Anxiety scales, and in Argentina, women scored higher on the Test Anxiety scale). Intercultural comparisons of personality profiles showed that Argentine medical students obtained higher average scores than did their American counterparts on the Perception of Stressful Life Events, Test Anxiety, General Anxiety, External Locus of Control, Extraversion, and Neuroticism scales. Argentine students scored lower on the Loneliness scale than did their American counterparts. Psychometric findings supported the measurement properties of the personality measures in the two cultures (e.g., construct validity, and internal consistency aspect of reliability). Further study of the implications of the findings in predicting academic attainment in medical school and to physician performance is recommended.

Argentina↗
PubMed1997

Insulin-like growth factors and insulin-like growth factor binding proteins in androgen-dominant ovarian follicles from testosterone-treated female-to-male trans-sexuals.

OBJECTIVE: To determine insulin-like growth factor (IGF)-I and IGF-II levels, IGF binding protein (IGFBP) profile, and IGFBP-4 protease activity in androgen-dominant follicular fluid (FF) from female-to-male trans-sexuals and to compare with those in follicles from normocycling women. DESIGN: Follicular fluid samples were obtained from four female-to-male trans-sexuals and 15 women with normo-ovulatory cycles at the Dijkzigt Academic Hospital. Western ligand blot analysis and protease assays were used to determine IGFBP profile, and immunoradiometric assays were used to detect IGF levels. SETTING: The study was performed in two academic medical centers. PATIENT(S): Female-to-male trans-sexuals and women with normo-ovulatory cycles. INTERVENTIONS: None. MAIN OUTCOME MEASURE(S): Determination of IGF levels and IGFBP profile. RESULT(S): Insulin-like growth factor I levels in FF from female-to-male trans-sexuals were not significantly different compared with levels in androgen-dominant FF and estrogen-dominant FF. Significantly lower levels of IGF-II were observed in FF from female-to-male trans-sexuals than in estrogen-dominant FF, whereas IGF-II levels in FF from female-to-male trans-sexuals were not significantly different than those in androgen-dominant FF. Similar IGFBP profiles from FF from female-to-male trans-sexuals and androgen-dominant FF were noted, with markedly elevated levels of the 31- and 24-kd IGFBPs and a 28-kd IGFBP, compared with estrogen-dominant FF. An IGFBP-4-specific metalloserine protease that is active in estrogen-dominant FF likewise was undetected in FF from female-to-male trans-sexuals. CONCLUSION(S): Follicles developing under the influence of exogenous androgens in ovaries in female-to-male trans-sexuals appear to be similar to androgen-dominant follicles in normo-ovulatory women with regard to IGF-I and IGF-II levels, IGFBP profile, and the absence of IGFBP-4 protease activity.

Androgens↗
PubMed1997

Methodologic problems encountered with cooximetry in methemoglobinemia.

The objectives of this study were to examine the reported accuracy of cooximetry in determination of methemoglobin levels, to report the apparent discrepant values of "measured" methemoglobin and carboxyhemoglobin, and to discuss the effect that methemoglobinemia has on pulse oximetry readings. Secondly, relative oxygen saturations measured by pulse oximetry and calculated from arterial blood gas samples were compared. A retrospective analysis was performed in an academic medical center with two patients who were diagnosed with acute methemoglobinemia after taking sulfa-containing medications. Serial pulse oximetry, arterial blood gas, and cooximeter analysis were performed for two patients. Cooximetry was performed using an IL-482 oximeter, arterial blood gas analysis was performed using a BLE 1400 oximeter, and pulse oximetry was performed using Ohmeda Biox S740, Hewlett Packard SPO2, or Marquette SPO2 models. Methemoglobin levels ranged from 6% to 48%, however, summation of methemoglobin and oxyhemoglobin were as high as 120%. As a result, negative values of carboxyhemoglobin were recorded by the cooximeter, generating a total sum of 100%. Comparison of pulse oximetry and arterial blood gas oxygen saturation (measured and calculated values, respectively) revealed significant discrepancies; methemoglobin was > 9%, whereas oxygen saturation uniformly was lower with pulse oximetry. Therefore, we recommend that when methemoglobin levels exceed 10%, cooximetry be used as a screen for methemoglobinemia and that serial cooximeter measurements be used to guide therapy and reliance on noninvasive pulse oximetry.

Adult↗
PubMed2006

Good for them or good for us? The role of academic guidance interviews.

CONTEXT: Weak students may pass unnoticed through their undergraduate programme until they fail a summative assessment. Early recognition and support of struggling students is crucial if they are to avoid subsequent failure at high stakes assessments. METHODS: We introduced a whole-class formative assessment 5 months before a summative assessment. Subsequently, we supported poorly performing students with academic guidance interviews and remedial support. RESULTS: The programme was evaluated by questionnaires issued to staff and students involved in the guidance interviews, and by recording the performance of students who had failed the formative assessment in the subsequent summative assessment. CONCLUSIONS: We conclude that the rescue of failing students requires early recognition and tailored intervention, with support for all participants.

Clinical Competence↗
PubMed2005

Perceived academic quality and approaches to studying at Danish schools of occupational therapy.

Students in the fourth semester of basic training programmes in occupational therapy at seven different institutions of higher education in Denmark were surveyed using the Course Experience Questionnaire [CEQ] and the Revised Approaches to Studying Inventory [RASI]. The CEQ proved to be a reasonably robust in this setting: most of the scales demonstrated satisfactory reliability, and a factor analysis confirmed its intended constituent structure. The CEQ also discriminated among students at the seven institutions in their patterns of scores. The RASI proved to be less satisfactory: many subscales did not demonstrate satisfactory reliability and its intended constituent structure was only partly confirmed by factor analysis. Moreover, the RASI failed to discriminate clearly among students at the seven institutions. The scores on the CEQ produced by students at four of the institutions raised concerns relating to the clarity of academic goals and standards, the teaching performance of staff, and the academic workload imposed on students. Nevertheless, students at five institutions produced relatively high ratings of their general satisfaction with their programmes, and students at all seven schools produced high ratings of the appropriateness of their assessments and the acquisition of generic skills.

Adult↗
PubMed1981

Departmental resources and statistics of academic pathology.

The resources needed to operate an academic pathology department have not been evaluated for several years. Fifty academic pathology departments in this country returned a 14-page questionnaire that included information about procedures, personnel, space, and patient load. These data were summarized using means, percentiles, ratios, and linear regression analyses. The average academic pathology department performed more than 5,000 procedures for 1,200 inpatients and outpatients per day and produced 42 publications per year. The results of this study may assist members of the academic pathology community in assessing current and future needs.

Pathology↗
PubMed1973

Effects of reinforcement on children's academic behavior as a function of self-determined and externally imposed contingencies.

This experiment was designed to compare the effects of contingent reinforcement under conditions of self-determined and externally imposed performance standards. A major purpose was to examine the maintenance of self-imposed performance standards over time. Children in one contingent reinforcement condition self-determined their academic performance standards. The same performance standards were externally imposed upon children in a second contingent reinforcement condition who were yoked to subjects in the first condition. Children in a no-reinforcement control condition performed in the absence of external reward. Behavioral productivity of the self-determination condition was greater than that of the no-reinforcement condition. Further, no attenuation of the efficacy of contingent reinforcement occurred when performance standards were self-determined rather than externally imposed. Over six sessions, children became progressively more lenient in their self-imposed performance demands in the absence of social surveillance.

Journal Article↗
PubMed2001

Why academic divisions of hematology/oncology are in trouble and some suggestions for resolution.

PURPOSE: Academic divisions of hematology/oncology seem to have difficulty recruiting and retaining excellent productive clinicians. A major reason for this is that salaries do not compete with the private sector for similar work. METHODS: We reviewed divisional finances productivity, and experiences from faculty members leaving. RESULTS: The academic salaries are approximately one third of practice because the chemotherapy concession has been given to the academic hospital. In addition, there may be substantial problems in under-billing, lack of attention to detail in billing, and poor collection practices. CONCLUSION: Academic practice still has much to offer, including opportunities for research and multidisciplinary team management, although the differences may narrow over the coming years. Attention to detail in the billing, collection for work performed, and increasing academic salaries to levels nearer to private practice are necessary components of the solution to recruit and retain quality productive clinicians.

Faculty↗
PubMedDate not supplied

Use of the restricted academic task in ADHD dose-response relationships.

Behavioral assessment techniques have been shown to make a significant contribution in the evaluation of stimulant medication response in children with attention-deficit/hyperactivity disorder. This article examines the role of a behavioral measure consisting of standardized observation of a child while he or she performs an academic-like task (Restricted Academic Task). This technique is reliable and valid for repeated administrations across medication dosages and placebo. It can assist in optimizing medication dosage for individual children, given its sensitivity to dosage effects. It also allows the capture of medication-related changes in an area of functioning that is not directly assessed by parent and teacher judgments and ratings. In this way the Restricted Academic Task may have greater ecological validity than the results of other, more traditional in-clinic measures. Finally, given the idiosyncratic nature of stimulant medication effects on individual children, it contributes to the explication of a specific child's behavioral dose-response relationship.

Adolescent↗
PubMed2002

Chronic drug use and cognitive impairments.

Reports regarding the effects of chronic drug use on human cognition and comparisons of different drug user groups have been inconsistent. Methodological flaws may account for some inconsistencies. To determine the effects of chronic drug use on cognition, drug users (n=192) were tested 17.1+/-0.3 days (mean+/-S.E.) and 99.4+/-1.7 days on average after their last use of drugs before beginning treatment. Drug users were categorized as stimulant, alcohol, or polydrug users. Their performance on tests of academic achievement, verbal memory, and abstraction was compared to performance of community-dwelling controls (n=137). The groups were matched on selected demographic and psychiatric characteristics. Historical records of achievement test scores were used to attempt to control for premorbid intellectual ability. Drug users showed impairments on each of the achievement tests (P<.001), as well as poorer total recall (P<.01) and abstraction ability (P<.05). Stimulant users performed worse on several tests relative to the other drug use groups. Only one of six tests demonstrated improvements following about 3 months of abstinence. Thus, chronic drug use is associated with cognitive impairments that do not improve substantially even after several months of abstinence.

Achievement↗