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Biomedical subjects

D O Nutter

Publications and source records attributed to D O Nutter.

At least 19 recordsLinked to original sources
PubMed2000

Measuring faculty effort and contributions in medical education.

A national panel on medical education was appointed as a component of the AAMC's Mission-based Management Program and charged with developing a metrics system for measuring medical school faculty effort and contributions to a school's education mission. The panel first defined important variables to be considered in creating such a system: the education programs in which medical school faculty participate; the categories of education work that may be performed in each program (teaching, development of education products, administration and service, and scholarship in education); and the array of specific education activities that faculty could perform in each of these work areas. The panel based the system on a relative value scale, since this approach does not equate faculty performance solely to the time expended by a faculty member in pursuit of a specific activity. Also, a four-step process to create relative value units (RVUs) for education activities was developed. This process incorporates quantitative and qualitative measures of faculty activity and also can measure and value the distribution of faculty effort relative to a school's education mission. When adapted to the education mission and culture of an individual school, the proposed metrics system can provide critical information that will assist the school's leadership in evaluating and rewarding faculty performance in education and will support a mission-based management strategy in the school.

Education, Medical↗
PubMed1996

Medicine and management: a combined educational program.

Rapidly evolving characteristics of our health care system are creating new and expanding opportunities for physician managers. Formal graduate degree training in management has become desirable to prepare the physician for these new professional responsibilities. The Schools of Medicine and Management at Northwestern University instituted a formal combined degree program eight years ago. Directed by a physician holding faculty appointments in both schools, the program offers an integrated five year curriculum. During the past eight years, 16 students have matriculated in the program without attrition. Eleven students have completed both degrees on schedule. The results of a comprehensive telephone survey of all U.S. and Canadian medical schools concerning dual degree programs are presented. The advantages and disadvantages of pursuing management training at various stages of a physician's career are discussed.

Canada↗
PubMed1984

Analytic thinking: educating students for the practice of modern medicine.

The medical school curriculum is dominated by efforts to teach the mass of facts that comprise an ever-expanding pool of biomedical knowledge. As a result, little time remains for learning the scientific method, how to evaluate medical information, and how to apply analytic processes for the prevention, diagnosis, and management of disease. A new component in the medical curriculum at Emory University School of Medicine, a course titled Analytic Medicine, is proposed as a first step toward correcting these deficiencies. Analytic Medicine is intended to provide the opportunity and the necessary skills, through a problem-oriented approach, for medical students to learn to reason scientifically and to utilize analytic processes, including computers, in making clinical decisions.

Curriculum↗
PubMed1983

Medical education in the People's Republic of China.

The People's Republic of China is in the process of developing a comprehensive system of health care for one-quarter of the world's population. A continually evolving system of medical education that presently operates on three levels for the education and training of (a) "barefoot" or worker doctors, (b) "assistant" doctors, midwives, and nurses, and (c) both traditional and Western-style physicians has been a key factor in the process. Three aspects of Chinese medical education are noteworthy for the contrast they provide to medical education in the United States. In the first place, Chinese students enter medical college and become committed to a medical career immediately upon completion of secondary school. Second, Chinese medical colleges are independent of their universities, and all education for the health professions is integrated under a single college. A common curriculum and faculty are used for a considerable portion of each educational program. Finally, the entire medical curriculum is five to six years in duration, and postgraduate education is not required for the practice of medicine in China; nor is it available to the majority of graduates.

Allied Health Personnel↗
PubMed1981

Endurance training in the rat. I. Myocardial mechanics and biochemistry.

The effects of physical training and detraining on cardiac structure and myocardial mechanics were studied in young and adult male rats trained by graded treadmill running for 12 wk and compared with sedentary controls. Detraining was produced by training for 12 wk followed by 6 sedentary wk. A training effect was demonstrated by increased succinate dehydrogenase activity in skeletal muscle (trained 10.0 +/- 1.2 mumol . g-1 . min-1; sedentary 6.4 +/- 0.8 mumol . g-1 . min-1; P less than 0.05). Although heart weight-to-body weight ratios were increased in trained rats of both ages, left ventricular fiber diameters and myocardial RNA, DNA, and collagen content were unchanged by training. Active and passive mechanics (myocardial contractility and stiffness) were studied in left ventricular papillary muscles and did not differ significantly between groups, with the exception of depressed contractility observed in young trained rats [(e.g., papillary peak developed isometric tension at Lmax (length at peak tension)] was 2.64 +/- 0.24 g/mm2 in trained vs. 3.59 +/- 0.22 g/mm2 in sedentary (P less than 0.01). This difference was abolished by detraining. Papillary muscle contractile responses to calcium, norepinephrine, and hypoxia were not altered by training or detraining. In conclusion, moderate endurance training did not result in significant cardiac hypertrophy, altered myocardial stiffness, or consistent changes in myocardial contractility.

Animals↗
PubMed1981

Endurance training in the rat. II. Performance of isolated and intact heart.

The effects of isotonic physical training and detraining on cardiac function were studied in young and adult male rats trained by graded treadmill running and compared with sedentary controls. Absolute left ventricular mass was not increased, and ventricular compliance was not altered by training. Ventricular function curves that plotted peak systolic pressure, maximum rate of rise of left ventricular pressure, cardiac output, coronary flow, or stroke work as a function of atrial filling height in the isolated perfused heart did not demonstrate a training effect in either age group. The cardiac response to hypoxia was also comparable in the trained and sedentary rats. The base-line heart rate of anesthetized rats, in which in situ cardiac function was studied, was lower in the trained rats (321 +/- 14 vs. 377 +/- 8, P less than 0.005). Resting hemodynamics and left ventricular function curves generated from pressure-flow data during volume infusion did not differentiate between the hearts of trained and sedentary rats. In conclusion, a moderate level of endurance training did not enhance cardiac contractility when this was assessed under nonexercise conditions in both the isolated perfused heart and intact in situ heart preparations.

Animals↗
PubMed1981

Regional vasomotor responses to the somatopressor reflex from muscle.

The present study was performed to determine whether qualitative and quantitative differences are present in the regional vasomotor responses to the somatopressor reflex evoked by stimulation of muscle afferents. Studies were performed in vagotomized, chloralose-anesthetized dogs with the carotid baroreceptor reflex intact. Regional vasomotor responses were determined in the isolated, innervated, constant flow-perfused vascular beds of hindlimb muscle, hindpaw, kidney, gut (superior mesenteric), and heart (circumflex coronary). Somatic afferent fiber stimulation evoked a significant systemic pressor response (+ 42%) and increased heart rate (+ 30%). An initial vasoconstrictor response occurred in all vascular beds studied, with peak reflex responses as follows: muscle +41%, paw +6%, kidney + 17%, gut + 17%, and coronary + 8%. A late, reflex vasodilator effect occurred in the hindpaw and was caused by secondary carotid baroreflex inhibition of vasomotor tone. A late vasodilator component in the coronary bed appeared to be secondary to the inotropic and chronotropic effects of the somatopressor reflex, since coronary vasodilation was eliminated by constant rate pacing and beta-adrenergic blockade, and was unaffected by vagotomy. Primary venodilation occurred in the perfused lateral saphenous venous system. Additional experiments demonstrated that spontaneous blood flow to muscle and kidney were significantly increased during the somatopressor reflex despite the generalized vasoconstrictor response.

Animals↗
PubMed1980

Transcutaneous Doppler method of measuring cardiac output--II. Noninvasive measurement by transcutaneous Doppler aortic blood velocity integration and M mode echocardiography.

In 15 patients with acute myocardial infarction (group I) and in 14 patients undergoing routine cardiac catheterization (group II) cardiac output values obtained by multiplying the 1 minute sum of the systolic integral of aortic blood flow velocity by the average systolic diameter of the aortic root were compared with values obtained with the thermodilution and Fick methods, respetively. Patients in group I were studied under various hemodynamic conditions, whereas those in group II were studied in the baseline state conditions, whereas those in group II were studied in the baseline state only. In group I, the correlation between the two methods was excellent (r values ranged from 0.96 to 0.99) except in one severely anemic patient whose Doppler signals were noisy, but at heart rates exceeding 150 beats/min it was not as good. In group II, the correlatin between the two methods was r = 0.96 with a standard error of the estimate of 0.226 liter. The Doppler method is totally noninvasive and is useful for monitoring changes in cardiac output in patients with acute myocardial infarction.

Adult↗
PubMed1979

Hypertrophic cardiomyopathy and human leukocyte antigen linkage: differentiation of two forms of hypertrophic cardiomyopathy.

To determine whether hypertrophic cardiomyopathy is associated with a human leukocyte antigen (HLA) phenotype, we tissue-typed 70 unrelated afflicted patients and 86 of their asymptomatic family members (from nine separate kindreds). Forty-five per cent of the white patients had B-12 antigen as compared to 23 per cent in matched control subjects; 69 per cent of black patients had a B-5-complex antigen as compared to 33 per cent in matched controls. Patients with a B-12 or B-5-complex antigen were nonhypertensive and had family members with the disease. Patients without these antigens were severely hypertensive and had no affected family members. Linkage analysis of six families revealed a lod score of 7.7 for asymmetric septal hypertrophy and the HLA region of chromosome 6. We conclude that there is a heritable, nonhypertensive form of hypertrophic cardiomyopathy linked to the HLA loci on chromosome 6 and that a sporadic form is associated with severe, systemic hypertension.

Adult↗