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PubMed1985

Pre-admission academic predictors of the goals of a primary care-oriented medical school.

This study investigated the relationship of two widely-used preadmission academic predictors (undergraduate grade point average and the Medical College Admission Test) to a sequence of four goals for a primary care-oriented medical school. Graduates from the first four classes of a new medical school (n = 237) were used in the study. Correlation and multiple regression analysis were performed. It was concluded that pre-admission academic variables (undergraduate GPA and MCAT) are useful in screening for academic success in medical school (especially for preclinical courses) and licensability (especially NBME Part 1 and 2). Furthermore, no useful predictor of residency performance or choice of a primary care specialty was identified. Provisos related to the conclusions and future research directions are discussed.

Career Choice↗
PubMed2006

Nursing and midwifery: Millennium Development Goals and the global human resource crisis.

The World Health Organization Global Advisory Group for Nurses and Midwives and wider stakeholders met in May 2005 against a background of concern over the disappointing progress being made towards the Millennium Development Goals (MDGs). The meeting considered the urgent need to address human resource issues, particularly those related to nursing and midwifery, if the MDGs are to be achieved.

Forecasting↗
PubMed1991

Nursing diagnosis vs goal-oriented treatment planning in inpatient child psychiatry.

The sharp rise in acute psychiatric beds for children and youth has opened up practice opportunities for child psychiatric nurses. But there is pressure from third party payers to reduce the length of stay on these services which increases demand for effective and efficient care. Timely evaluation, stabilization and discharge of children requires multidisciplinary teamwork. This paper considers the merit of nursing diagnosis in this setting and compares it to a method of multidisciplinary goal setting. The use of nursing diagnoses in child inpatient psychiatry carries some risk of creating parallel systems of care and isolating nurses from the treatment team.

Adolescent↗
PubMed1990

Relationship of quality goals and measurement performance to the selection of quality control procedures for multi-channel haematology analysers.

An approach is described for selecting QC procedures based on goals for analytical quality, the performance characteristics of the measurement procedure (imprecision, bias, frequency of errors), and the performance characteristics of the control procedure (probabilities for error detection and false rejection). Performance characteristics of stable sample QC procedures and patient data QC procedures (retained patient specimens, Bull's single-rule algorithm, Bull's multi-rule algorithm) are compared to determine when to apply these different QC procedures to multichannel hematology analysers. Precise, stable methods may be controlled using Bull's single-rule algorithm; less precise, less stable methods require Bull's multi-rule algorithm, retained patient specimens, or stable sample QC procedures; imprecise and unstable methods are best controlled using stable sample QC procedures. "Multi-stage" designs may employ stable samples for "startup" testing, retained patient specimens for short term monitoring, and Bull's single-rule algorithm for long term monitoring.

Algorithms↗
PubMedDate not supplied

Modified orthodontic treatment goals in a patient with multiple complicating factors.

This paper reviews orthodontic care in patients who are in nontraditional categories. Specific orthodontic management of a patient who had severe hemophilia, seropositivity for anti-HIV Ab, and Hepatitis B surface antigen is reviewed. The importance of defining acceptable treatment goals in these patients is of paramount importance.

Adolescent↗
PubMedDate not supplied

Priorities for oral health goals in a sample of older adults.

This study was conducted to identify oral health factors that are important to people who are elderly. By identifying factors valued by patients who are older, dental professionals can gain better insights into the preferences and priorities that patients use in making dental treatment decisions. To determine which factors are important to this population, we compiled a list of oral health goals identified through a literature review. To supplement this initial list, we undertook line-by-line (open) coding of transcripts of two sets of semi-structured interviews. The first set of interviews explored the decision of older adults to seek treatment in response tooth pain. The second set of interviews elicited anticipated responses to three scenarios involving extensive restoration and one scenario involving extraction and prosthetic replacement among older patients at a dental school.

Age Factors↗
PubMed1994

Perceived locus of causality, goal orientations, and perceived competence in school physical education classes.

Ryan & Connell (1989) have demonstrated that different types of behavioural regulation can be located on a continuum of perceived autonomy or perceived locus of causality. The present study applied their formulation in the context of school physical education (PE) and examined the relationships of perceived autonomy, perceived competence and goal orientations with intrinsic interest across two PE activities. School students aged 12-14 years (N = 85) completed an adapted version of the Self-Regulation Questionnaire (Ryan & Connell, 1989) and measures of perceived competence and intrinsic interest separately for two PE activities. They also completed the British version of the Task and Ego Orientation in Sport Questionnaire (Duda, Fox, Biddle & Armstrong, 1992). Students appeared to be differentially motivated for the two activities due to different perceptions of autonomy. Structural equation modelling analysis showed that perceived autonomy and task orientation had direct effects on intrinsic interest for both the activities. Perceived competence, however, was positively associated with intrinsic interest only for one of the activities. The implications of the results for the practice of physical education are discussed.

Achievement↗
PubMed1998

Utility of relaxation training with children in school settings: a plea for realistic goal setting and evaluation.

BACKGROUND: School-based relaxation training programmes are a popular means of helping children with anxiety problems such as headaches and test anxiety. AIMS: Our major objective is to evaluate the empirical status of school-based relaxation training programmes. CONTENTS: Focusing on progressive muscle relaxation training, we show how this adult training procedure has been modified for use with children. Several training issues are discussed including the questions of live versus recorded instruction and individual versus group instruction. We also discuss the evaluation of relaxation training programmes in school settings, highlighting issues of reliability and validity. CONCLUSIONS: Our review of studies examining the efficacy of school-based relaxation training shows that improvements are usually modest and of dubious clinical or educational significance. Consequently we suggest that when relaxation training is used with school children treatment goals should be more modest or, that if improvements in specific performance areas are sought, then more comprehensive treatment packages be developed which can influence the successful performance of children in target areas and reduce anxiety to normal levels.

Child↗
PubMed2006

A kinematic analysis of how young adults with and without autism plan and control goal-directed movements.

We examined the planning and control of goal-directed aiming movements in young adults with autism. Participants performed rapid manual aiming movements to one of two targets. We manipulated the difficulty of the planning and control process by varying both target size and amplitude of the movements. Consistent with previous research, participants with autism took longer to prepare and execute movements, particularly when the index of difficulty was high. Although there were no group differences for accuracy, participants with autism exhibited more temporal and spatial variability over the initial phase of the movement even though mean peak accelerations and velocities were lower than for control participants. Our results suggest that although persons with autism have difficulty specifying muscular force, they compensate for this initial variability during limb deceleration. Perhaps persons with autism have learned to keep initial impulses low to minimize the spatial variability that needs to be corrected for during the online control phase of the movement.

Acceleration↗
PubMed1999

Natural goal-directed movements and the triphasic EMG.

Triphasic electromyographic (EMG) patterns have been described as characteristic of rapid, discrete, uniplanar, goal-directed movements. This experiment examined the effects of Response Type (experimenter- vs. subject-determined), Hand (preferred vs. nonpreferred), and Practice (early vs. late) on performance accuracy, and specific temporal EMG and kinematic measures during a dart throw. EMG was recorded from triceps (main agonist), brachioradialis, and biceps (main antagonist). The number of trials in which a triphasic EMG occurred varied systematically across conditions. The experimenter-determined, early practice condition resulted in greatest frequency (92%) of trials displaying a triphasic EMG and least accurate performance. In contrast, the lowest frequency (79%) of triphasic EMG and most accurate performance occurred in the subject-determined, late practice condition. The association among 14 temporal EMG, and kinematic measures for each trial of the dart throw was analyzed with multivariate factorial ANOVA. Four clusters of variables emerged: initial phase, braking phase, terminal phase, and movement speed and duration. Variables contributing to the initial-phase cluster were most strongly associated within the experimenter-determined, early practice condition, and the strength of association was directly related to diminished performance accuracy. Paradoxically, best performance accuracy (subject-determined, late practice) was identified with a weaker association among variables representing the initial phase.

Adult↗
PubMedDate not supplied

Audacious goals for health and biomedical informatics in the new millennium.

The 1998 Scientific Symposium of the American College of Medical Informatics (ACMI) was devoted to developing visions for the future of health care and biomedicine and a strategic agenda for health and biomedical informatics in support of those visions. This symposium focus was prompted by the many major changes currently underway in health care delivery, education, and research, as well as in our health and biomedical enterprises, and by the constantly increasing role of information technology in both shaping and enabling these changes. The three audacious goals developed for 2008 are a virtual health care databank, a national health care knowledge base, and a personal clinical health record.

Artificial Intelligence↗
PubMed2001

A goal-driven neural propositional interpreter.

This work presents ARQ-PROP-II, the propositional version of a neural engine for finding proofs by refutation using the Resolution Principle. This neural architecture does not require special arrangements or modules to do forward or backward reasoning, being driven by the goal posed to it. ARQ-PROP-II is capable of integrated monotonic reasoning with complete and incomplete knowledge. The neural mechanism presented herein is the first to our knowledge that does not require that the knowledge base be either pre-encoded or learnt.

Goals↗
PubMed2001

The effects of frontal lobe lesions on goal achievement in the water jug task.

Patients with prefrontal cortex lesions are impaired on a variety of planning and problem-solving tasks. We examined the problem-solving performance of 27 patients with focal frontal lobe damage on the Water Jug task. The Water Jug task has never been used to assess problem-solving ability in neurologically impaired patients nor in functional neuroimaging studies, despite sharing structural similarities with other tasks sensitive to prefrontal cortex function, including the Tower of Hanoi, Tower of London, and Wisconsin Card Sorting Task (WCST). Our results demonstrate that the Water Jug task invokes a unique combination of problem-solving and planning strategies, allowing a more precise identification of frontal lobe lesion patients' cognitive deficits. All participants (patients and matched controls) appear to be utilizing a hill-climbing strategy that does not require sophisticated planning; however, frontal lobe lesion patients (FLLs) struggled to make required "counterintuitive moves" not predicted by this strategy and found within both solution paths. Left and bilateral FLLs were more impaired than right FLLs. Analysis of the left hemisphere brain regions encompassed by the lesions of these patients found that poor performance was linked to left dorsolateral prefrontal cortex damage. We propose that patients with left dorsolateral prefrontal cortex lesions have difficulty making a decision requiring the conceptual comparison of nonverbal stimuli, manipulation of select representations of potential solutions, and are unable to appropriately inhibit a response in keeping with the final goal.

Brain Diseases↗
PubMed1998

Near-saddle-node bifurcation behavior as dynamics in working memory for goal-directed behavior.

In consideration of working memory as a means for goal-directed behavior in nonstationary environments, we argue that the dynamics of working memory should satisfy two opposing demands: long-term maintenance and quick transition. These two characteristics are contradictory within the linear domain. We propose the near-saddle-node bifurcation behavior of a sigmoidal unit with a self-connection as a candidate of the dynamical mechanism that satisfies both of these demands. It is shown in evolutionary programming experiments that the near-saddle-node bifurcation behavior can be found in recurrent networks optimized for a task that requires efficient use of working memory. The results suggests that the near-saddle-node bifurcation behavior may be a functional necessity for survival in nonstationary environments.

Animals↗
PubMed2006

A state-space analysis for reconstruction of goal-directed movements using neural signals.

The execution of reaching movements involves the coordinated activity of multiple brain regions that relate variously to the desired target and a path of arm states to achieve that target. These arm states may represent positions, velocities, torques, or other quantities. Estimation has been previously applied to neural activity in reconstructing the target separately from the path. However, the target and path are not independent. Because arm movements are limited by finite muscle contractility, knowledge of the target constrains the path of states that leads to the target. In this letter, we derive and illustrate a state equation to capture this basic dependency between target and path. The solution is described for discrete-time linear systems and gaussian increments with known target arrival time. The resulting analysis enables the use of estimation to study how brain regions that relate variously to target and path together specify a trajectory. The corresponding reconstruction procedure may also be useful in brain-driven prosthetic devices to generate control signals for goal-directed movements.

Animals↗
PubMed1987

Brief goal-limited couple therapy in the treatment of homosexuals.

Brief goal-limited homosexual couple therapy can provide a useful adjunct to individual therapy of homosexuals. Utilization of couple therapy in the treatment of two male homosexual patients is described. Some general differences are noted in the treatment of homosexual couples as contrasted with heterosexual couples. The therapeutic effect of this type of intervention combined with individual therapy is discussed.

Adult↗
PubMed1989

Rehabilitation: small goals, sustained interventions.

Rehabilitation to restore and maintain functioning in older people is relatively new. Traditionally, ageist prejudices and the medical preoccupation with cure have led to neglect of chronic disabilities in older people. With a focus on an aging population, however, a new approach to rehabilitation is taking shape at the confluence of geriatric and psychosocial approaches. Significant components of this emerging approach are: setting small goals as incentives for motivating the patient, the timing of the disability within the individual's life course, coping behavior and the way the disability is defined, the importance of social support to the recovery potential, and the incorporation of sustained interventions into daily routines and life-styles. This article illustrates this approach with examples from common disabling conditions, proposing that the quality of aging can be markedly enhanced for older people suffering from functional disability.

Aged↗
PubMed2004

Ethnicity, goal striving and schizophrenia: a case-control study of three ethnic groups in the United Kingdom.

BACKGROUND: The need to achieve is common to all societies, and failure to do so may have a highly detrimental psychological impact. For those on the margins of mainstream society, especially migrants or descendants of migrants, the impact of failed or poor achievements may increase their vulnerability to mental illness. AIMS: In a prospective study of schizophrenia in three ethnic groups (White, Indian and African-Caribbean) we studied the impact of goal striving and investigated whether the gap between the poor achievement and the high aspirations of members of some minority ethnic groups was potentially a factor contributing to the development of the illness. METHODS: The patients and age- and sex-matched controls from their respective communities were asked to rate their perceived current levels of achievement and their past and future expectations in five domains--social standing, housing, education, employment and financial status on a 10-point scale. RESULTS: The control subjects from the three ethnic groups scored similarly in most areas, supporting the validity of inter-ethnic comparisons. The gap between achievement and expectations did not appear to cause high disappointment levels in any group, and in fact only in the domain of housing did the African-Caribbean patients assess their current achievement as being significantly lower than that of their matched controls. CONCLUSIONS: Poor housing conditions may be one of the risk factors contributing to the high incidence of schizophrenia in African-Caribbeans.

Achievement↗