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Biomedical subjects

M J Fuhrer

Publications and source records attributed to M J Fuhrer.

At least 37 records · Page 2Linked to original sources
PubMed1988

Information sources that influence physiatrists' adoption of new clinical practices.

As part of a mail survey of physiatrists' views of conducting research, respondents were queried regarding information sources that influenced their introducing a clinical innovation into their practices in the past two years. Complete information was obtained from 356 individuals. The reported practice innovations were categorized as follows: (a) evoked potentials (6% of respondents); (b) electrophysiologic diagnostic procedures other than evoked potentials (19%); (c) other diagnostic/assessment procedures (11%); (d) transcutaneous nerve stimulation (6%); (e) physical treatment procedures other than transcutaneous nerve stimulation (22%); (f) medication (5%); (g) psychologic or social intervention (4%); and (h) altered methods of service delivery (27%). Considered across all practice innovation categories, the average relative importance (in descending order) of the information sources was as follows: (1) discovery in the individual's own practice; (2) a meeting, lecture, or continuing education course; (3) a clinical coworker; (4) a write-up in the clinical literature; (5) the individual's own research; (6) a patient; (7) a write-up in the research literature; (8) a textbook; and (9) the representative of a drug firm or equipment manufacturer. Additional findings concern variables which distinguished a group of 43 individuals who reported introducing no innovation into their practices for the preceding two years, compared to the 356 individuals who did so.

Communication↗
PubMed1987

Vocational development following severe spinal cord injury: a longitudinal study.

Vocational development of individual with spinal cord injury was studied from shortly after injury to two years after discharge from inpatient rehabilitation. Objectives included examining differences in the course of vocational development by level of functional independence, and predicting vocational outcomes two years after injury. Thirty-three spinal cord injury patients (17 quadriplegics, 16 paraplegics) were followed during the study. The Goldberg Scale of Vocational Development was used to measure changes in vocational development over time. The Barthel Index was used to measure level of functional independence. Results revealed that vocational development was markedly depressed during initial inpatient rehabilitation and for six months after injury. Gradual improvement occurred after six months, but two years after discharge the level of vocational development remained lower than that before injury. Changes in vocational development over time did not differ significantly by level of functional independence. Best predictors of successful vocational outcomes were educational attainment, educational plans made before injury, and origin of interests in work.

Activities of Daily Living↗
PubMed1987

Postdischarge outcomes for ventilator-dependent quadriplegics.

Based on data contributed to the National Spinal Cord Injury Data Base between the years 1975 and 1981, outcomes were assessed for 34 patients who had been injured approximately a year earlier and who were ventilator dependent when discharged from inpatient rehabilitation. Their outcomes were compared with those of 196 patients who required mechanical respiration some time during acute care or rehabilitation, but who were free of such assistance at discharge. Statistically significant differences were obtained between the groups in levels of spinal cord injury, duration of acute care hospitalization, duration of total hospitalization, extent of self-care capability, hours/week of hired attendant care, and hours of actual physical assistance/day. The groups did not differ significantly in terms of duration of inpatient rehabilitation, duration of rehospitalization, and vocational or prevocational status at follow-up.

Adult↗
PubMed1985

Grant application and review procedures of the National Institute of Handicapped Research: survey of applicant and peer reviewer opinions.

A mail survey was conducted to document the experience, critical comments, and recommendations of a sample of applicants and peer reviewers who participated in the 1983 grantee selection process conducted by the National Institute of Handicapped Research. Questionnaires were sent to 46 applicants and 36 peer reviewers who participated in seven priority areas involving competition for either a research and training center or a rehabilitation engineering center. Questionnaires were returned by 37 (80%) of the applicants and 27 (75%) of the reviewers. The peer reviewers were generally more satisfied with their experience. Their negative criticism was concerned largely with the excessiveness of the work load. The reviewers were unanimous in stating that federal personnel made no effort to influence their judgments. The majority of applicants agreed that the criteria for evaluating proposals were stated clearly, but they disagreed with how some of the criteria were weighted. The applicants' strongest dissatisfaction was with the time allowed to prepare applications and with the selection of peer reviewers. Analysis of the collective publication record of successful applicants and of the peer reviewers indicated that the reviewers had contributed significantly less to the literature of the relevant priority area.

Persons with Disabilities↗
PubMed1985

Issues in the federal funding of rehabilitation research.

An allocation model for funding health research is the framework for highlighting issues concerned with the federal financing of research related to the rehabilitation of handicapped individuals. Discussion focuses upon the policies and practices of the National Institute of Handicapped Research (NIHR) because of its prominent role among the federal agencies that support rehabilitation research. Separate consideration is given to the influence of the 1978 amendments to the Rehabilitation Act, the National Council on the Handicapped, the NIHR long-range plan, the Interagency Committee for Handicapped Research, and procedures for establishing NIHR's annual priorities. NIHR's conduct of peer review is critically reviewed, as is the agency's history of annual appropriations. Reasons are discussed why rehabilitation research has been inadequately funded, and steps are recommended for increasing its federal support.

Budgets↗
PubMed1981

Proposed rehabilitation research or demonstration projects: estimating target population size.

In connection with developing a benefit-cost approach to evaluating proposed rehabilitation research or demonstration projects, the need to estimate the numerical size of the associated target population is explained and a process is described for making such estimates. The process consists of 7 steps: (1) delineating project objectives, (2) specifying target group(s) in operational terms, (3) determining whether satisfactory target population prevalence estimates are available, (4) in the absence of such estimates, identifying a critical parent population and establishing its prevalence, (5) identifying an accessible population, (6) enumerating the number and proportion of target group members in the accessible population, (7) calculating the estimated target population by multiplying data yielded in steps (4) and (6), adjusting for inferred biases and indicating uncertainties of estimation. Consideration is given to the kinds of data bases upon which this estimation process depends, to the feasibility of providing such estimates, and to their probable accuracy.

Cost-Benefit Analysis↗
PubMed1981

Quality of life in benefit-cost analyses of rehabilitation research.

Traditionally, benefit-cost (B-C) models have been limited to the consideration of monetary benefits. This approach has been motivated by the fact that nonmonetary benefits are difficult to define and to quantify. Derived from the general theory of B-C analysis, a model is described which includes 3 categories of benefits, identified by a Delphi-like procedure administered to a broad representation of persons involved in the rehabilitation process. Whereas monetary benefits have the dollar readily available as a unit of measurement, scales for nonmonetary benefits must be developed. Methods for estimating the value and the relative importance of the various benefits are analyzed and a procedure for combining monetary and nonmonetary benefits is proposed.

Delphi Technique↗
PubMed1980

Cognitive factors and CS-UCS interval effects in the differential conditioning and extinction of skin conductance responses.

Mandel and Bridger (1967) found resistance to extinction of differentially conditioned skin conductance responses by subjects, who, according to a post-conditioning questionnaire, believed pre-extinction instructions that the shock-UCS would no longer be administered. The present study was intended to: (1) determine whether or not an extraordinarily noxious shock-UCS is required to produce such results; (2) eliminate possible retrospective falsification effects associated with the use of a post-conditioning questionnaire by monitoring subjects' UCS expectancies continuously throughout extinction as well as acquisition trials; (3) attempt to confirm that resistance to extinction is stronger with a 0.5 sec CS-UCS interval than with an 8 sec interval; and (4) test several predictions regarding UCS expectancies during the intertrial intervals of acquisition. After receiving 16 instructed acquisition trials, two groups (N = 20 in each) exposed to either a 0.5 sec or 8 sec CS-UCS interval were fully instructed regarding discontinuation of the UCS during the pending 20 extinction trials. Reliable differential conditioning was obtained during the first extinction trial block for subjects who, according to the expectancy monitoring measure as well as a post-conditioning questionnaire, did not expect UCS administration. The extent of resistance to extinction did not differ between the two groups. Consistent with predictions from a cognitive viewpoint, the expectancy monitoring data of the two groups differed significantly during the intertrial intervals of acquisition.

Adolescent↗
PubMed1979

Judgments of the potential benefits of rehabilitation research.

A critical step in a project to develop a benefit-cost approach to evaluating proposed rehabilitation research has been to specify the potential benefits of such research in a reasonably systematic and comprehensive manner. The purposes of this study were: (1) to assess the contemporary relevance of 46 benefit factors yielded by a 1973 survey: (2) to acquire judgmental data to reduce these factors to fewer and more generic 2nd-order factors: (3) to compare 7 different rehabilitation role groups in terms of how the potential benefits of rehabilitation research are valued. "Hierarchical clustering" analyses of similarity judgments by 96 participants yielded 18 2nd-order benefit factors. A number of reliable differences were identified among the role groups regarding the value placed upon specific potential benefits of rehabilitation research.

Cost-Benefit Analysis↗
PubMed1976

Interstimulus interval effects on habituation of flexor withdrawal activity mediated by the functionally transected human spinal cord.

The habituation of flexor withdrawal activity mediated by the functionally transected human spinal cord was investigated as a function of a wide range of different temporal intervals among the repetitive cutaneous stimuli. Nine patients with a chronic, transverse lesion of the cervical spinal cord were submitted to four daily habituation training series involving interstimulus intervals of either 1, 5, 25, or 125 seconds. The stimulus consisted of a 40-msec pulse train applied through surface electrodes to a midplantar site, and the response was expressed in terms of the goniometrically recorded dorsiflexion of the ankle. A reliable degree of habituation was found for the series involving the 1- and 5-second intervals. However, holding constant the number of stimuli involved in the comparisons, no habituation was found for the series involving intervals of 25 and 125 seconds.

Adult↗
PubMed1975

Effects of stimulus site on the pattern of skin conductance responses evoked from spinal man.

The spatial organization of sudomotor responses mediated by the cervically transected human spinal cord was investigated by recording skin conductance responses from the volar surfaces of the hands and feet of 10 patients after pulse trains applied separately to the skin of each extremity. Each stimulus site tended to be associated with a distinctive pattern of skin conductance responses.

Adolescent↗