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Biomedical subjects

J Moskowitz

Publications and source records attributed to J Moskowitz.

At least 19 recordsLinked to original sources

Enhancing the clinical research pipeline: training approaches for a new century.

There is growing concern that the numbers of physician-scientists being trained in U.S. academic health centers will not be sufficient to continue the rate of current progress in biomedical research. The authors believe that the needs of current trainees and junior faculty must be addressed immediately, and that programs to train the next generation of patient-oriented researchers must be established without delay. The authors describe a two-pronged approach to this looming crisis. First is a description of innovative educational programs implemented at one academic health center from the K-12 level through the medical-school curriculum. Second, programs are discussed that have been developed to facilitate the recruitment, training, and retention of physician-scientists in the early parts of their professional careers. Four models of training "translational" investigators are presented, along with case studies of how these models have been implemented in real-life productive and professionally satisfying collaborations within one academic health center. The authors conclude by stating that to be prepared for the effects of future knowledge on human disease and preventive health, academic health centers must enhance training opportunities for physician-scientists.

Humans↗

How do academic health centers value and encourage clinical research?

To investigate whether there is a misalignment of the perceived values of and incentives for clinical research within U.S. academic health centers (AHCs), in 1999 the authors surveyed medical school deans, academic administrators, department chairs, and faculty members at 80 AHCs that are the members of the University HealthSystem Consortium, a not-for-profit consortium of AHCs. A total of 358 faculty from 58% of the institutions surveyed responded, with a mean of 3.76 responses/institution. There was general agreement that clinical research offers AHCs a considerable spectrum of benefits, including prestige, recruitment and retention of faculty, criteria for promotion of faculty, and financial support. Investigator-initiated research and government-funded research ranked highest in terms of their desirability compared with industry-sponsored and contract research. This preference was agreed upon across all categories of respondents and types of research (translational, clinical tests, and outcomes). Significant differences existed between the perceptions of deans/AHC administrators, who stated that they were increasing their emphasis on clinical investigation in the areas of research space (56% of responders), administrative support (81%), and patient recruitment (61%) and the perceptions of their departmental chairs/faculties in the same areas (34%, 52%, and 40%, respectively; p <.05). Faculty opinions documented few new investments in the actual infrastructure dedicated to clinical research. The authors conclude that their findings, which they consider reasonably representative, strongly suggest that the value of clinical research to AHCs is well understood. Their findings also identify important opportunities for AHCs to provide a wider range of incentives for the conduct of clinical research.

Academic Medical Centers↗

Biomedical research leaders: report on needs, opportunities, difficulties, education and training, and evaluation.

The National Association of Physicians for the Environment (NAPE) has assumed a leadership role in protecting environmental health in recent years. The Committee of Biomedical Research Leaders was convened at the recent NAPE Leadership Conference: Biomedical Research and the Environment held on 1--2 November 1999, at the National Institutes of Health, Bethesda, Maryland. This report summarizes the discussion of the committee and its recommendations. The charge to the committee was to raise and address issues that will promote and sustain environmental health, safety, and energy efficiency within the biomedical community. Leaders from every important research sector (industry laboratories, academic health centers and institutes, hospitals and care facilities, Federal laboratories, and community-based research facilities) were gathered in this committee to discuss issues relevant to promoting environmental health. The conference and this report focus on the themes of environmental stewardship, sustainable development and "best greening practices." Environmental stewardship, an emerging theme within and outside the biomedical community, symbolizes the effort to provide an integrated, synthesized, and concerted effort to protect the health of the environment in both the present and the future. The primary goal established by the committee is to promote environmentally responsible leadership in the biomedical research community. Key outcomes of the committee's discussion and deliberation were a) the need for a central organization to evaluate, promote, and oversee efforts in environmental stewardship; and b) immediate need to facilitate efficient information transfer relevant to protecting the global environment through a database/clearinghouse. Means to fulfill these needs are discussed in this report.

Biomedical Technology↗

Eye movement impairment and schizotypal psychopathology.

OBJECTIVE: Eye movement dysfunction in relation to a smooth pursuit task has been documented in schizophrenic patients and in patients with the related personality disorder, schizotypal personality disorder. To investigate which quantitative measures are associated with the eye movement dysfunction and whether the dysfunction is more related to the psychotic-like or the deficit-like symptoms of schizotypal personality disorder, ratings of eye movements in several groups of subjects were compared. METHOD: The study groups consisted of 26 patients with schizotypal personality disorder, 42 patients with other personality disorders (22 who also had two or more schizotypal personality traits and 20 who had fewer than two), and 37 normal comparison subjects. Smooth pursuit eye tracking of sinusoidal and constant velocity targets was recorded by an infrared eye tracking system. Two raters evaluated pursuit gain and large and small saccades in the direction of the target and in the direction opposite to that of the target (quantitative ratings) and constant velocity (qualitative rating). RESULTS: Patients with schizotypal personality disorder and patients with other personality disorders and two or more schizotypal traits, but not those with fewer than two schizotypal traits, had significantly poorer qualitative ratings of tracking than the normal comparison subjects. Neither gain nor any of the saccadic measures significantly differed between groups. The number of large saccades in the direction of the target was the only quantitative variable that predicted low qualitative ratings. Qualitatively poor tracking was associated with the deficit-like, but not the psychotic-like, symptoms of schizotypal personality disorder. CONCLUSIONS: Patients with schizotypal personality disorder demonstrate qualitatively poorer tracking than comparison groups, and the impaired tracking is associated with deficit-like symptoms.

Adult↗

Effect of concurrent distraction on communication failures in schizophrenic patients. II. Medication status correlations.

In order to examine the effects of irrelevant distracting information on speech disorder, medicated (n = 13) and unmedicated (n = 18) schizophrenics were compared to a mixed affective sample (n = 15) on the frequencies of linguistic measures of verbal communication disorder. Patients conversed with an interviewer during the presence and absence of irrelevant information inserted into their conversation. Affective patients manifested no distraction-related increase in communication disorder. Schizophrenics on medication manifested a small, but nonsignificant, increase in communication disorders during the concurrent distraction condition. Unmedicated schizophrenics manifested a substantial increase in their communication disorders during distraction. These data suggest that medication reduces the extent to which speech processes in schizophrenia are vulnerable to overload-related deterioration and provide confirmation of the hypothesis that some component of positive thought disorder in schizophrenia is due to medication-responsive attention deficits.

Adult↗

Attentional markers of vulnerability to schizophrenia: performance of medicated and unmedicated patients and normals.

Medicated and unmedicated schizophrenic patients (both n's = 14) were compared to a normal control sample (n = 15) on two attentional tasks hypothesized to be markers of vulnerability to schizophrenia. These tasks, the continuous performance test and the visual backward masking task, were found to be more deviant in schizophrenic patients than in normals. In addition, the group mean levels of performance did not differ consistently across medication status within the medicated patients. It was found, however, that the association between these tasks varied as a function of medication status, with unmedicated patients more similar to normals than to medicated patients. The implications of these results for the two tasks as markers are discussed, with special focus on those earlier studies that did not evaluate unmedicated patients.

Attention↗

Biofeedback for disorders of initiating and maintaining sleep.

Sleep disturbances are a frequent reason for pediatric consultation. When the disturbance persists in the form of delays in entering or maintaining sleep (DIMS), a vicious cycle develops. As part of the cycle, vigilance or arousal occurs, further inhibiting sleep occurrence. Persistent DIMS requires treatment to interrupt this self-perpetuating sequence. Interruption requires reduction in psychophysiological arousal and deconditioning of the events surrounding sleep. Electromyographic (EMG) and thermal biofeedback in conjunction with relaxation training were used with three children who maintained high levels of arousal resulting from stresses common to their developmental stages. Within seven sessions, all three patients showed attenuation of arousal and symptom abatement marked by uninterrupted sleep.

Adolescent↗

Recombinant DNA research; proposed actions under guidelines. National Institutes of Health, PHS, DHHS.

This notice sets forth proposed actions to be taken under the National Institutes of Health (NIH) Guidelines for Research Involving Recombinant DNA Molecules. Interested parties are invited to submit comments concerning these proposals. These proposals will be considered by the Recombinant DNA Advisory Committee (RAC) at its meeting on October 6, 1989. After consideration of these proposals and comments by the RAC, the Acting Director of the National Institutes of Health will issue decisions in accordance with the NIH Guidelines.

DNA, Recombinant↗

Thermal biofeedback in the treatment of symptoms associated with reflex sympathetic dystrophy.

A 12-year-old male, unresponsive to therapy for symptoms associated with reflex sympathetic dystrophy, was treated by thermal biofeedback techniques. Within the first four treatment sessions, transfer of training from digital warming to warming the affected knee area produced skin temperature elevation around the gastrocnemius and patellar areas. Attenuation of localized vasospasm and cold intolerance resulted, followed by total abolition within ten sessions. After symptom alleviation, a return to premorbid activity levels was reported. Implications for use of thermal biofeedback as a primary noninvasive technique for treatment of symptoms associated with reflex sympathetic dystrophy are discussed.

Biofeedback, Psychology↗