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Biomedical subjects

K Kaufman

Publications and source records attributed to K Kaufman.

At least 19 recordsLinked to original sources
PubMed1996

Human posterior cricoarytenoid muscle compartments. Anatomy and mechanics.

OBJECTIVE: To document the presence and functional significance of distinct anatomical compartments in the human posterior cricoarytenoid muscle (PCA). DESIGN: Anatomic study of human cadaver larynges. SUBJECTS: Seventeen fresh larynges, harvested at autopsy from 8 men and 9 women, with no history of laryngeal disease or surgery. INTERVENTIONS: Twenty-three PCA muscles from 12 human cadaver larynges were dissected. Computed tomographic scanning and rigid body mechanical analysis were used to compute 3-dimensional motion with simulated individual contraction of PCA compartments in 5 fresh larynges. RESULTS: Discrete medial and lateral bellies with different orientations of muscle fibers were found in every muscle. The 2 bellies insert on opposing aspects of the muscular process of the arytenoid. Very little linear translation was effected by either muscle. The axes of rotation attributable to the 2 bellies differed significantly, with the medial belly effecting rotation about a more vertical axis. The axis of rotation for the lateral muscle belly was nearer the anterior posterior axis than that of the medial belly. CONCLUSIONS: These data indicate that PCA muscle contraction results in arytenoid rotation about a variable oblique axis without significant lateral gliding. There are 2 bellies within the human PCA muscle with differing mechanical actions on the cricoarytenoid joint.

Aged↗
PubMed1996

A strategy to promote research-based nursing care: effects on childbirth outcomes.

Studies at area hospitals revealed many gaps between research evidence and intrapartum nursing practices. A randomized controlled trial involving 20 hospitals was used to evaluate the effectiveness of a marketing strategy to promote research-based nursing care. It was hypothesized that the strategy would result in lower rates of epidural analgesia, through increasing the amount of support nurses provided to their patients. Other outcomes included rates of narcotic analgesia, episiotomy, and operative delivery. The marketing strategy was unsuccessful in improving intrapartum nursing care. Much more research is needed about the factors that facilitate improvements in nursing practice.

Analysis of Variance↗
PubMed1993

Part-time faculty in academic medicine: present status and future challenges.

OBJECTIVE: To determine the number, personal and professional characteristics, and attitudes of part-time medicine faculty. PARTICIPANTS: Part-time faculty in departments of medicine were identified by the chairs of medicine and faculty roster representatives of the Association of American Medical Colleges for each U.S. medical school and by a survey of faculty. MEASUREMENTS: A 79-item questionnaire including questions about working conditions, attitudes toward professional and personal issues, and institutional policies. RESULTS: A total of 245 eligible questionnaires were returned (69% of the estimated number of eligible part-time faculty). Sixty-three percent were men and 27% were women. Women faculty worked an average of 35 h/wk, combining their careers with childbearing, whereas men worked 51 h/wk, divided between their faculty position and private practice. Respondents' work time was devoted to teaching and patient care, with no time dedicated for research. Most faculty (86%) were in nontenured track positions; approximately one half (47%) developed the position themselves. Only 8% reported that existing institutional policies allowed part-time faculty more time to reach promotion and tenure standards. A high degree of career satisfaction existed (mean score, 8.6 on a 10-point scale) even though faculty believe that part-time status makes promotion more difficult and negatively influences colleagues' perceptions of them. CONCLUSION: We estimate that more than 400 faculty work part time in departments of medicine in U.S. medical schools. The majority are men who combine academic careers with private practice. Most part-time faculty work as clinician/teachers in nontenure track positions and are satisfied with their careers.

Adult↗
PubMed1993

Aortic "recoarctation" at rest versus at exercise in children as evaluated by stress Doppler echocardiography after a "good" operative result.

The mechanism for exercise systolic hypertension after a "good" operative repair of coarctation of the aorta remains speculative. Twenty-four children (mean age +/- SD 10.3 +/- 3.8 years) were studied with continuous-wave Doppler echocardiography while they performed continuous, graded, maximal treadmill exercise. Patients were free of "recoarctation" based on conventional resting echocardiography. Measurements of ascending and descending aortic peak instantaneous systolic velocity were obtained at rest, throughout exercise and during recovery. Results were compared with 24 age- and gender-matched control subjects. Fifteen patients were normotensive (group 1) (peak systolic blood pressure, 147 +/- 21 mm Hg) and 9 developed systolic hypertension during exercise (group 2) (196 +/- 32 mm Hg) (p < 0.05) (control subjects, 143 +/- 21 mm Hg). Descending aortic peak systolic velocity at rest ranged from 1.50 +/- 0.27 m/s in the control group to 2.57 +/- 0.57 m/s (group 1) and 2.93 +/- 0.43 m/s (group 2) (p < 0.05, group 2 vs control). Differences were amplified at peak exercise with systolic velocity increasing to 4.26 +/- 0.61 m/s in group 2 but only to 3.61 +/- 0.70 m/s in group 1 and 2.26 +/- 0.38 m/s in control subjects (p < 0.05, group 2 vs group 1 and control). Seven patients developed a descending aortic diastolic velocity during exercise. Stepwise linear regression analysis identified 2 variables to be significant determinants of peak exercise systolic blood pressure in the "total" patient group: (1) age at exercise testing, and (2) descending aortic peak systolic velocity at peak exercise (r2 = 0.88, p < 0.001) (group 2, alone - r2 = 0.98, p < 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1993

Diagnosis of an ACL disruption with KT-1000 arthrometer measurements.

The KT-1000 was used to measure anterior tibial displacement in three populations: normal subjects (n = 120), patients with unilateral acute anterior cruciate ligament (ACL) disruptions (n = 105), and patients with chronic unilateral ACL disruptions who were scheduled for ACL reconstructions (n = 159). All patients with ACL disruptions were measured with and without anesthesia. Tibial displacement under three loading conditions was measured: 89-N anterior displacement force, manual maximum displacement force, and quadriceps contraction to lift the leg. The measurements of the normal knee in the injured populations were not significantly different from those of the knees in the normal population on any test. The injured knee tested with and without anesthesia was significantly different from the normal knee on all tests. The right-left difference in the normal population as less than 3 mm in 98% of patients in the 89-N test, 97% in the manual maximum test, and 99% in the quadriceps active test. The largest amount of displacement and the greatest difference in displacement between the injured and the normal knee was produced by the manual maximum test. The manual maximum injured-minus-normal knee displacement was 3 mm or more in 99% of patients with chronic ACL disruptions and in 95% of patients with acute ACL disruptions.

Adolescent↗
PubMed1991

Mentors and role models for women in academic medicine.

Senior mentors and role models have a positive influence on the career advancement of junior professionals in law, business, and medicine. In medicine an increasing number of women are pursuing academic careers, but available senior mentors to provide career guidance are often lacking. We report on the results of a national survey of 558 full-time faculty women, aged 50 years and younger, in departments of medicine in the United States, regarding their experience with role models and mentors. Women with mentors report more publications and more time spent on research activity than those without mentors. Women with a role model reported higher overall career satisfaction. This report, with illustrative examples, may be helpful to other women pursuing academic careers and to physicians who serve as mentors or role models to others.

Data Collection↗
PubMed1990

Maladjustment in statistical minorities within ethnically unbalanced classrooms.

Ascertained if being a member of a statistical minority influences children's adjustment in school, as measured by the AML, a teacher-administered adjustment rating scale. Teachers from a southwest school district evaluated elementary students on aggressive, acting-out behaviors, moody-internalized behaviors, and learning difficulties. Analyses conducted on 376 students revealed significant effects of statistical minority status on certain dimensions of adjustment ratings for both Hispanic and Anglo students. Hispanic students in the statistical minority received poorer ratings on the moodiness dimension of the AML than nonminority Hispanic students. Anglo students in the statistical minority received poorer ratings on the aggression dimension of the AML than nonminority Anglo students. These results were interpreted in terms of cultural differences in coping with statistical minority status. Traits commonly exhibited within a culture may intensify and be perceived as maladaptive when stress resulting from being a minority occurs. Implications of the finding that statistical minority status within the school environment influences adjustment are discussed.

Adaptation, Psychological↗
PubMed1990

A randomized controlled trial of a nursery ritual: wearing cover gowns to care for healthy newborns.

The routine wearing of individual cover gowns by nurses and visitors for direct care of healthy newborns was usual practice on the maternity ward of a regional referral center. We conducted a randomized trial in which cover gowns were not provided for care of infants in the experimental group (n = 222), but were maintained for control infants (n = 230). The principal outcome measured was Staphylococcus aureus colonization of the newborn nares or umbilicus on day 3 or day of discharge. Twenty percent (n = 51) of the experimental group (no gown) had a positive culture compared with 21 percent (n = 47) of the controls. Of the infants with positive cultures, two in each group exhibited symptoms of overt S. aureus infection. Experimental infants were similar to controls with respect to feeding method, route of delivery, amount of time spent rooming-in, and average number of visitors per day. In the group of positively cultured infants, the mothers experienced longer labor, and more vaginal examinations in labor, and the number of males undergoing circumcision was higher. We concluded that routine use of cover gowns was unwarranted, and we have altered the ward policy accordingly. This also has had a positive economic effect.

Ceremonial Behavior↗