The capacity ratio as a measure of solvency in experiential education

Objective. To determine the utility of the capacity ratio to measure and compare solvency in experiential education in 6 colleges and schools of pharmacy in the Northwestern United States.Methods. The 6 colleges and schools of pharmacy combined data on student placements needed, site availability, and changes made to placements during the 2009-2010 and 2010-2011 academic years and calculated capacity ratios for the advanced and introductory experience programs in the region. Comparisons also were made to previously published capacity results to determine whether the capacity ratio was useful in identifying trends and guiding preceptor and site development.Results. Capacity ratio calculations were successful in facilitating comparison of capacity within and across regions. Experiential education is solvent in the Northwest overall, but specific parts of experiential programs were found to have more capacity than others. Trends in the Northwest were consistent with capacity in other regions.Conclusions. The capacity ratio can determine and facilitate comparison of solvency within and across colleges and schools of pharmacy and thereby inform decisions about resource management in experiential education.     

Human fatty acid synthesis is stimulated by a eucaloric low fat, high carbohydrate diet.

A new experimental approach was used to determine whether a eucaloric, low fat, high carbohydrate diet increases fatty acid synthesis. Normally volunteers consumed low fat liquid formula diets (10% of calories as fat and 75% as glucose polymers, n = 7) or high fat diets (40% of calories as fat and 45% as glucose polymers, n = 3) for 25 d. The fatty acid composition of each diet was matched to the composition of each subject's adipose tissue and compared with the composition of VLDL triglyceride. By day 10, VLDL triglyceride was markedly enriched in palmitate and deficient in linoleate in all subjects on the low fat diet. Newly synthesized fatty acids accounted for 44 +/- 10% of the VLDL triglyceride. Mass isotopomer distribution analysis of palmitate labeled with intravenously infused 13C-acetate confirmed that increased palmitate synthesis was the likely cause for the accumulation of triglyceride palmitate and "dilution" of linoleate. In contrast, there was minimal fatty acid synthesis on the high diet. Thus, the dietary substitution of carbohydrate for fat stimulated fatty acid synthesis and the plasma accumulation of palmitate-enriched, linoleate-deficient triglyceride. Such changes could have adverse effects on the cardiovascular system.     

Participant evaluation of a CBT program for enhancing work function in schizophrenia

OBJECTIVES: While much has been written about the benefits of CBT for persons with schizophrenia, little has been published to date exploring participant evaluations of these programs. This paper reports on participant evaluations of such a program. METHODS: Forty-four participants with schizophrenia or schizoaffective disorder were surveyed regarding their satisfaction with a 6-month weekly group and individual CBT intervention developed as an adjunct to work therapy or the control condition support group during a randomized controlled feasibility study. RESULTS: Results suggest that all participants, those receiving the CBT intervention and the support group, were satisfied with their program, on average rating the program between "good" and "excellent." However, in comparison, the CBT intervention was associated with greater participant satisfaction than support alone, particularly the perception of the overall quality of services and assistance with problem-solving. CONCLUSIONS: It appears that participant evaluations can function as a source of useful data for evaluation of CBT interventions for persons who have schizophrenia. However, further study is needed to more fully identify and understand aspects of CBT that participants with schizophrenia evaluate as particularly positive or negative and to explore acceptable trade-offs among them.     

Intelligent multifunction myoelectric control of hand prostheses

Intuitive myoelectric prosthesis control is difficult to achieve due to the absence of proprioceptive feedback, which forces the user to monitor grip pressure by visual information. Existing myoelectric hand prostheses form a single degree of freedom pincer motion that inhibits the stable prehension of a range of objects. Multi-axis hands may address this lack of functionality, but as with multifunction devices in general, serve to increase the cognitive burden on the user. Intelligent hierarchical control of multiple degree-of-freedom hand prostheses has been used to reduce the need for visual feedback by automating the grasping process. This paper presents a hybrid controller that has been developed to enable different prehensile functions to be initiated directly from the user's myoelectric signal. A digital signal processor (DSP) regulates the grip pressure of a new six-degree-of-freedom hand prosthesis thereby ensuring secure prehension without continuous visual feedback.     

Multifocal Langerhans' Cell Histiocytosis Involving Bilateral Temporal Bones, Lungs, and Hypothalamus in an Adult

Multifocal Langerhans' cell histocytosis is a rare condition in adults. We present the case of a 31-year-old female who initially presented with a clinical appearance of acute mastoiditis. The patient ultimately had involvement of bilateral temporal bones, lungs, and hypothalamus. Treatment with methotrexate, steroids, and desmopressin acetate (DDAVP) resulted in initial clinical improvement though not resolution. The patient also underwent radiation therapy to the hypothalamic lesion. The literature is reviewed, focusing on the diagnostic challenge of this disease process in adults. The additional morbidity of surgery, specifically mastoidectomy, in the setting of Langerhan's cell histiocytosis is discussed.     

Narrative qualities in schizophrenia: associations with impairments in neurocognition and negative symptoms

Schizophrenia spectrum disorders often involve a profound diminishment in people's ability to coherently narrate their lives. Unknown is whether narrative difficulties of persons with schizophrenia differ from those with other disabilities, and how they relate to clinical or neurocognitive aspects of schizophrenia. To address both issues, personal narratives were obtained for 25 participants with schizophrenia spectrum disorders and a comparison group of eight legally blind participants and four with major depressive disorders. Flexibility of abstract thought and positive, negative, and emotional discomfort symptoms were assessed among the schizophrenia group. ANCOVA comparing scores on our scale to assess narrative development, controlling for age, found the schizophrenia group narratives significantly more impoverished than the comparison group on multiple dimensions, including self-worth and agency. Neurocognitive impairment and negative symptoms were significant predictors of impoverishment in the schizophrenia group. Results may highlight deficits that could be addressed in psychotherapy or rehabilitation to promote recovery.