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21.
Tsuyoshi Takeda Hiroyuki Ishida Yukio Horiuchi Yasushi Nakao Yutaka Yabe 《Journal of orthopaedic science》1997,2(6):372-377
We examined radiographs of the elbows of the pitching arms of 79 professional baseball pitchers (mean age, 25.1 years; mean
duration of professional career, 4.7 years) and noted the frequency and size of spurs, bone fragments, and intra-articular
loose bodies according to site. The influence of duration of professional baseball career on these osteoarthritic changes
was also investigated. The olecranon tip was the most frequent site of spurs (62/79; 78.5%), and fragmentation of the spur
was detected in 17 joints. The frequency of spurs was also high at the medial margin of the olecranon, the tip of the coronoid
process, the medial margin of the sigmoid notch, the medial margin of the trochlea and the olecranon fossa. In 38 subjects,
spurs were observed at the distal portion of the radial notch of the ulna. However, few pitchers had osteoarthritic changes
in the humeral capitellum or radial head. Intra-articular loose bodies were detected in 4 of 79 joints (5.1%), and bone fragments
were present below the medial humeral epicondyle in 25 of 79 joints (31.6%). Osteoarthritic changes in the elbow joint appeared
to be attributable mainly to traction stress and impingement associated with extension and valgus strain. Significant osteoarthritic
changes were often found in professional pitchers whose careers exceeded 5 years. 相似文献
22.
The present article presents the future of clinical psychology board certification. With the increasing specialization in the field of professional psychology and the generic nature of state licensure, clinical psychology as a specialty will develop into a specialty area in a similar fashion as have specialties in medicine. A brief history of board certification in professional psychology by the American Board of Professional Psychology is reviewed and the process of becoming board certified in either clinical psychology or clinical child and adolescent psychology is discussed. 相似文献
23.
Shelley Allen Glenys Carlson Tamara Ownsworth Jenny Strong 《Australian Occupational Therapy Journal》2006,53(4):293-301
Aim: To present an evidence-based framework to improve the quality of occupational therapy expert opinions on work capacity for litigation, compensation and insurance purposes.
Methods: Grounded theory methodology was used to collect and analyse data from a sample of 31 participants, comprising 19 occupational therapists, 6 medical specialists and 6 lawyers. A focused semistructured interview was completed with each participant. In addition, 20 participants verified the key findings.
Results: The framework is contextualised within a medicolegal system requiring increasing expertise. The framework consists of (i) broad professional development strategies and principles, and (ii) specific strategies and principles for improving opinions through reporting and assessment practices.
Conclusions: The synthesis of the participants' recommendations provides systematic guidelines for improving occupational therapy expert opinion on work capacity. 相似文献
Methods: Grounded theory methodology was used to collect and analyse data from a sample of 31 participants, comprising 19 occupational therapists, 6 medical specialists and 6 lawyers. A focused semistructured interview was completed with each participant. In addition, 20 participants verified the key findings.
Results: The framework is contextualised within a medicolegal system requiring increasing expertise. The framework consists of (i) broad professional development strategies and principles, and (ii) specific strategies and principles for improving opinions through reporting and assessment practices.
Conclusions: The synthesis of the participants' recommendations provides systematic guidelines for improving occupational therapy expert opinion on work capacity. 相似文献
24.
目的:探讨精神疾病患者劳动能力鉴定状况及与其相关问题。方法:分析1998至2002年共187例精神疾病患者的劳动能力鉴定资料,并进行不同年代、不同诊断、不同级别的组问比较。结果:除1998年外,其余各年度基本资料相似;诊断以精神分裂症为主,精神发育迟滞为次;前者的平均年龄最大、病期最短、累计病休时间最长、残疾级别最低,后者反之。结论:劳动能力鉴定应按有关标准执行,但目前仍存在一些有待进一步完善的问题。 相似文献
25.
Driven by research findings regarding the positive relationship between training and enhancement of services, as well as literature on adult learning, the New England Head Start Teaching Center (NEHSTC) was created in 1992 to test the efficacy of participatory, hands-on training. The purpose of this paper is to examine the outcome evaluation results from 4 years of training at the NEHSTC, 1 of 14 federally funded sites, as well as to discuss the implications for delivering this type of participatory training throughout Head Start. Findings suggest that the NEHSTC was successful in implementing high quality, participatory training within the context of an ongoing Head Start program. Head Start staff who participated in the NEHSTC trainings demonstrated gains in knowledge, skills, and expertise compared to similar Head Start employees who did not receive training. Results also reveal a sustained effect of training over time, with NEHSTC participants continuing to demonstrate enhanced knowledge and skills 6 months after training. Similar positive outcomes of training were found for staff with varying levels of experience and holding different Head Start positions. Thus the participatory, hands-on training implemented by the NEHSTC was found to produce positive and lasting outcomes for diverse Head Start staff. An effective and cost efficient model of training Head Start personnel is particularly relevant and timely as Head Start strives to establish universal quality and expansion of services in the 21st Century. The findings are also relevant for improving the quality of all early care and education programs. 相似文献
26.
影响医疗服务满意度评价因素初步分析 总被引:45,自引:0,他引:45
目的 分析病人对医疗服务满意度评价的影响因素。方法 采用随机抽样的方法 ,对 5 10人进行了问卷抽样调查。结果 影响病人对医院服务满意度评价的因素依次为 :医生的医疗技术不高占 39 5 % ,医院服务态度不好占 2 2 8% ,医药费太高占 2 1 1% ,看病排队占 16 6 %。病人对医生服务态度好的评价标准依次是 :耐心倾听病人诉说占 6 1 6 % ,责任心强、看病认真占 30 6 % ,对病人热情、主动占 7 8%。结论 可靠的医疗技术和良好的服务态度是影响病人对医院服务满意度评价的最重要的两个因素。耐心倾听病人诉说是影响医生服务态度的最重要因素。病人的年龄、职业、文化、经济收入等因素对医疗服务的满意度评价均有作用 相似文献
27.
28.
临床医学专业学位教育的困境与发展走向 总被引:9,自引:2,他引:7
自临床医学研究生、临床医学专业学位教育实施以来,社会评价并不高,甚至存在相当数量的负面评价。究其因,一是源于对临床医学专业学位教育的认识误区,二是源于我国目前临床医学专业学位教育制度本身的缺陷。目前,我国高等医学教育体系尚不完善,专业学位教育、研究生教育及毕业后职业技能基本培训之间关系错综复杂,功能定位不清,形成相互干扰和冲突。建议进一步梳理思路,正确认识专业学位教育、研究生教育和住院医师规范化培训的教育特征与功能定位,建立各自恰当的培养目标与培养模式,最终实现在全国建立先进、科学、完善、与国际接轨的完整的医学教育体系。 相似文献
29.
D Drotar 《Journal of pediatric psychology》1991,16(1):1-11
Described five professional challenges that will affect the future development of pediatric psychology: specialization and professional identity, relationships with other professions, securing resources necessary for effective functioning, the conflict between clinical service delivery and prevention, and development of training models. To meet these challenges, pediatric psychologists need to maintain strong connections with other psychologists, develop new models of collaborative training, practice, and research, emphasize prevention activities, and enhance the scientific basis of pediatric psychology through innovative training programs and support for faculty development. 相似文献
30.
SRTR Center-Specific Reporting Tools: Posttransplant Outcomes 总被引:3,自引:2,他引:1
D. M. Dickinson T. H. Shearon J. O'Keefe H. -H. Wong C. L. Berg J. D. Rosendale F. L. Delmonico R. L. Webb R. A. Wolfe 《American journal of transplantation》2006,6(5P2):1198-1211
Measuring and monitoring performance—be it waiting list and posttransplant outcomes by a transplant center, or organ donation success by an organ procurement organization and its partnering hospitals—is an important component of ensuring good care for people with end-stage organ failure. Many parties have an interest in examining these outcomes, from patients and their families to payers such as insurance companies or the Centers for Medicare and Medicaid Services; from primary caregivers providing patient counseling to government agencies charged with protecting patients.
The Scientific Registry of Transplant Recipients produces regular, public reports on the performance of transplant centers and organ procurement organizations. This article explains the statistical tools used to prepare these reports, with a focus on graft survival and patient survival rates of transplant centers—especially the methods used to fairly and usefully compare outcomes of centers that serve different populations. The article concludes with a practical application of these statistics—their use in screening transplant center performance to identify centers that may need remedial action by the OPTN/UNOS Membership and Professional Standards Committee. 相似文献
The Scientific Registry of Transplant Recipients produces regular, public reports on the performance of transplant centers and organ procurement organizations. This article explains the statistical tools used to prepare these reports, with a focus on graft survival and patient survival rates of transplant centers—especially the methods used to fairly and usefully compare outcomes of centers that serve different populations. The article concludes with a practical application of these statistics—their use in screening transplant center performance to identify centers that may need remedial action by the OPTN/UNOS Membership and Professional Standards Committee. 相似文献