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11.
12.
Sheri A Keitz Gloria J Holland Evert H Melander Hayden B Bosworth Stephanie H Pincus 《Academic medicine》2003,78(9):910-917
PURPOSE: The U.S. Department of Veterans Affairs (VA) supports 8,700 resident positions nationally to enhance quality of care for veterans and to educate physicians. This study sought to establish a yearly quality indicator to identify and follow strengths and opportunities for improvement in VA clinical training programs. METHOD: In March 2001, the VA Learners' Perceptions Survey, a validated 57-item questionnaire, was mailed to 3,338 residents registered at 130 VA facilities. They were asked to rate their overall satisfaction with the VA clinical training experience and their satisfaction in four domains: faculty/preceptor, learning, working, and physical environments using a five-point Likert scale. Questionnaires were received from 1,775 residents (53.2%). A full analysis was conducted using 1,436 of these questionnaires, whose respondents were categorized in four training programs: medicine (n = 706), surgery (n = 291), subspecialty (n = 266), and psychiatry (n = 173). RESULTS: On a scale of 0 to 100, residents gave their clinical training experience an average score of 79. Eighty-four percent would have recommended VA training to peers, and 81% would have chosen VA training again. Overall, 87% were satisfied with their faculty/preceptors, 78% with the learning environment, and 67% with the working and physical environments. The survey was sensitive to differences in satisfaction among the trainee groups, with residents in internal medicine (IM) the least satisfied. CONCLUSION: The VA Learners' Perceptions Survey is the first validated survey to address comprehensive satisfaction issues in clinical training. The survey highlights strengths and opportunities for improvement in VA clinical training and is the first step toward improving education. 相似文献
13.
Claudio Babiloni Giuliano Binetti Emanuele Cassetta Gloria Dal Forno Claudio Del Percio Florinda Ferreri Raffaele Ferri Giovanni Frisoni Koichi Hirata Bartolo Lanuzza Carlo Miniussi Davide V Moretti Flavio Nobili Guido Rodriguez Gian Luca Romani Serenella Salinari Paolo M Rossini 《Clinical neurophysiology》2006,117(2):252-268
OBJECTIVE: The present study tested the hypothesis that cortical electroencephalographic (EEG) rhythms. change across normal elderly (Nold), mild cognitive impairment (MCI), and Alzheimer's disease (AD) subjects as a function of the global cognitive level. METHODS: Resting eyes-closed EEG data were recorded in 155 MCI, 193 mild AD, and 126 age-matched Nold subjects. EEG rhythms of interest were delta (2-4 Hz), theta (4-8 Hz), alpha 1 (8-10.5 Hz), alpha 2 (10.5-13 Hz), beta 1 (13-20 Hz), and beta 2 (20-30 Hz). EEG cortical sources were estimated by LORETA. RESULTS: Occipital delta and alpha 1 sources in parietal, occipital, temporal, and 'limbic' areas had an intermediate magnitude in MCI subjects compared to mild AD and Nold subjects. These five EEG sources presented both linear and nonlinear (linear, exponential, logarithmic, and power) correlations with the global cognitive level (as revealed by mini mental state examination score) across all subjects. CONCLUSIONS: Cortical EEG rhythms change in pathological aging as a function of the global cognitive level. SIGNIFICANCE: The present functional data on large populations support the 'transitional hypothesis' of a shadow zone across normality, pre-clinical stage of dementia (MCI), and AD. 相似文献
14.
Systolic and diastolic blood pressures were measured on 254 monozygotic (MZ) and 260 dizygotic (DZ) male twin pairs, during middle age (average age 48 years) and at two later age points. Genetic and environmental components of covariation were modeled by time series. For both measures, shared environmental influences were absent and specific environmental influences were largely time-specific. Although heritability was about 0.5 at each time point, genetic variation present at middle age contributed only about 60% to that present 9 years later, the remaining 40% being new. Fifteen years later, at the third time point, no new genetic variation was evident, variation in individual differences being entirely attributable to genetic differences laid down at the two earlier ages. © 1993 Wiley-Liss, Inc. 相似文献
15.
Sports anemia. 总被引:13,自引:0,他引:13
E P Balaban 《Clinics in Sports Medicine》1992,11(2):313-325
It is apparent that exercise can influence erythropoiesis and red cell survival in a variety of fascinating ways. A number of mechanisms have been reviewed that could lead to mild changes in the Hb or red cell mean corpuscular volume. In addition, athletes may be at high-risk to develop decreased iron stores. Nevertheless, iron deficiency anemia is uncommon and the ritual of routine iron supplementation is not recommended. Clearly, most of the mechanisms discussed lead to only subtle changes in the overall red cell numbers and indices. Yet there is a small subset of athletes who will have red cell changes that can only be attributable to participation in sports. The diagnosis of sports anemia, however, remains one of exclusion. 相似文献
16.
Francisco M. Averhoff Edward Brink Bette Pollard Karen Resha Gloria Bryan Margaret V. Vaillancourt 《The Journal of school health》1997,67(7):304-308
ABSTRACT: On March 11–12, 1996, a workshop on how to implement new adolescent immunization (AI) recommendations was held in Atlanta, Ga. Sponsored by the Centers for Disease Control and Prevention, it was a collaborative effort of the National Immunization Program, the Division of Adolescent and School Health/National Center for Chronic Disease Prevention and Health Promotion, and the Hepatitis Branch/National Center for Infectious Diseases. The workshop brought together organizations and individuals interested in adolescent health and immunizations so they could address how new Al recommendations can be implemented most effectively. This article offers an overview of their discussions and suggestions, including issues of cooperation, education, legislation, and Al program development among health provider organizations, health departments, schools, community groups and various other agencies relating to adolescent health services. 相似文献
17.
Traumatic anterior shoulder instability has been shown to be associated with a spectrum of capsulolabral pathology, including separation of the labrum (Bankart lesion), capsular rupture, and humeral avulsion of the glenohumeral ligaments (HAGL lesion). We describe a case of combined Bankart and HAGL lesions, a condition that has not been described before. Careful anatomic repair of both components of this bipolar capsular injury resulted in an excellent outcome. 相似文献
18.
19.
Adult outcomes of attention deficit hyperactivity disorder and conduct disorder: are the risks independent or additive? 总被引:1,自引:0,他引:1
Tracy D Gunter Stephan Arndt Kristin Riggins-Caspers Gloria Wenman Remi J Cadoret 《Annals of clinical psychiatry》2006,18(4):233-237
METHODS: Data were obtained from a longitudinal study sample of 754 adoptees and categorized based on review of the available adoption agency, medical, and psychiatric records of the biological parents. Categorical data were analyzed using chi2 or Fisher's exact tests, as appropriate. Logistic regression analyses were used to assess the relative contribution of variables. RESULTS: There was not a statistically significant difference in the frequency or type of self-reported adult disruptive behavior, arrests, jail stays, felony arrests, or frequency of conduct disorder (CD) when inattentiveness, impulsivity, and hyperactivity were analyzed individually. The contributions of attention deficit hyperactivity disorder (ADHD) were independent and no additional increased risk for future illegal behavior was conferred by the combination of the disorders. While the effect of CD on illegal behavior was correlated with substance abuse and dependence, ADHD continued to be a significant contributor after controlling for substance abuse and dependence. CONCLUSIONS: Data indicated that ADHD and CD are related but different disorders conferring risk for adult illegal behavior or arrest. In this sample, inattention was the most common domain impaired among those with ADHD, followed closely by hyperactivity, with impulsivity reported least often among those endorsing symptoms of ADHD. 相似文献
20.
Jos A. Brieva Ernesto Roldn Carmen Rodríguez Gloria Navas 《European journal of immunology》1994,24(2):362-366
Human B cells capable of spontaneous IgG secretion are commonly found in circulation and in lymphoid tissues such as tonsil and bone marrow (BM). The present study compares the mechanisms that regulate tonsil, blood and BM B cells capable of spontaneous IgG secretion. The BM cell subset produced IgG during a markedly longer period of time (14 days) than did tonsil and blood cell subsets (2–3 days). Blood and BM, but not tonsil, B cell IgG secretion depended on the presence of adherent cells, as demonstrated by adherent cell depletion and re-addition experiments. Stromal BM cells supported linear IgG secretion by non-adherent BM cells for 2 weeks, but were unable to prolong the short-term IgG secretion by tonsil and blood cells. Different factors induced IgG secretion in each of the three B cell populations as optimal IgG secretion by tonsil, blood or BM cell subsets required either tumor necrosis factor-α, interleukin-6 or fibronectin + interleukin-6, respectively. Finally, these populations also showed differences in the expression of adhesion molecules; the tonsilar cell subset was PNA+/? CD44+ CD49d+ CD49e? Leu-8+/?, the blood cell subset was PNA? CD44+/? CD49d+ CD49e? Leu-8+ and the BM cell subset was PNA? CD44+/? CD49d+ CD49e? Leu-8?. These results suggest that the mechanisms controlling the final differentiation and the expression of adhesion molecules in these B lymphocytes exhibit territorial specificity. 相似文献