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Biomedical subjects

P Leichner

Publications and source records attributed to P Leichner.

At least 37 records · Page 2Linked to original sources
PubMed1989

Geriatric psychiatry training in Canada: current teaching facilities and resources.

A survey of Canadian psychiatry residency programs requested information on training activities in geriatric psychiatry. Fourteen out of sixteen programs responded. On average ten hours of didactic instruction were provided per year over the four years of the residency program. Only one program had no facility that provided a rotation in geriatric psychiatry. The majority of programs have policies that encourage exposure of trainees to the care of the elderly. There is a concentration of teachers of this sub-specialty in a minority of centres. These findings are discussed in the light of current and future needs in the care of the elderly. Recommendations for meeting these are proposed.

Aged↗
PubMed1988

Salivary response to olfactory food stimuli in anorexics and bulimics.

Salivary response to olfactory food stimuli was assessed in controls and in anorexia nervosa and bulimia in-patients before and after two months of treatment. Before treatment, anorexics salivated less then controls while bulimics salivated more than controls. Following treatment, the salivary responses of eating-disordered subjects were much closer to controls. Salivary response to food was correlated with a measure of variability in caloric consumption. There may be two styles of dietary restraint: strict, unrelenting dieting, or the "dieting drone", exemplified by anorexic patients, and variable, "fence-sitting" dietary restraint, exemplified by bulimic patients. It is suggested that this two-style theory is able to account for past contradictory findings of heightened or suppressed saliva flow rates in dieters.

Adolescent↗
PubMed1988

Residents performance on the mental status examination.

Twenty-six residents watched a videotape of the mental status examination of a psychotic patient, then wrote their assessment of the patient's mental status. The residents' reports were independently graded by the authors. The residents' marks were compared to performance on departmental oral examinations. Results showed that global or qualitative assessment of mental status performance was reliable. Excellent interrater reliability was achieved when the assessment criteria for sub-items of the mental status were well defined.

Educational Measurement↗
PubMed1987

Sex-role conflicts in alcoholic women.

Institutionalized actively alcoholic women (N = 46) were compared to groups of nondrinkers (N = 24), social drinkers (N = 61), and remitted alcoholics (N = 29) (both institutionalized and noninstitutionalized) on scales of sex-role conflict, sex-role ideology, sex-role satisfaction, and depression. When the factors of age, socioeconomic status, and marital status were controlled, alcoholic women scored as more depressed and more sex-role undifferentiated than nonalcoholic women. Alcoholic women were also found to have a relatively traditional sex-role ideology, and remitted alcoholics expressed less satisfaction than other groups with some traditional female roles. Evidence was not found to support the theory that alcoholic women experience a greater degree of sex-role conflict (as measured by the Bem Sex-Role Inventory) than nonalcoholic women.

Adult↗
PubMed1986

The benefit of lithium carbonate adjunct in refractory depression--fact or fiction?

Our group attempted to validate previous claims of rapid success with lithium carbonate adjunct therapy in antidepressant-resistant depression. Seven depressed patients volunteered for a study of placebo controlled, double-blind design. During their treatment on general hospital psychiatric wards, these patients received antidepressant medication for a period of at least 21 days. While continuing to receive antidepressant medication after the 21 day period, four of the patients then received lithium carbonate, and three received placebo. This combination pharmacological therapy continued for a 48 hour period. After this time, six of the seven patients showed no significant improvement. The remaining patient, who had received lithium carbonate, improved markedly over the 48 hour period. However, this patient relapsed within one week. A review of the two most extensive studies claiming significant results with the lithium carbonate adjunct therapy was performed. We feel that they, as presented, leave serious doubt as to the validity of their conclusions. We conclude that on the basis of our work up to this point in time and the analysis of previous reports claiming otherwise, no valid evidence exists for a consistent therapeutic effect of lithium carbonate adjunct in antidepressant-resistant depression. It was also found that methodologic contamination necessitated the exclusion of an additional six patients from the double-blind trial. We conclude that in order to objectively examine the rapidly expanding field of biological psychiatry, teaching of clinical staff in basic research procedure should be stressed as a part of routine ward orientation.

Adult↗
PubMed1986

Is there a relationship between sexual abuse or incest and eating disorders?

The significance of sexual conflicts in many patients with eating disorders has been well documented. However, even when these have been considered to have some degree of etiological importance, the occurrence of actual sexual trauma or incest in the early lives of these patients has been generally neglected in the literature. At one point in time, it was noted that five of six patients on an inpatient unit for eating disorders revealed an early history of sexual abuse or incest. These five cases are described. A parallel is drawn between the psychological problems experienced by victims of childhood sexual abuse and by patients with anorexia nervosa and/or bulimia. Our suspicion that these experiences may not be atypical led to the present article, which has implications for the investigation and management of eating-disordered patients.

Adult↗
PubMed1986

The clinical oral examination in psychiatry: association between subscoring and global marks.

Fifteen academic psychiatrists rated a videotaped clinical oral examination done in the Royal College format. In addition to assigning an overall mark, the raters completed a detailed scoring form. The ratings of the case presentation and discussion accounted for most of the variance in the overall mark. The rating of the interview difficulty and establishment of rapport were weaker predictors. Implication of these findings for the trainees and the examiners are discussed.

Canada↗
PubMed1984

Residents training in the mental status examination.

One hundred and ninety-two Canadian psychiatry residents (43% of the total Canadian resident population) completed a questionnaire concerning their training in and use of the mental status examination (MSE). Residents perceive a number of deficiencies in their training for the mental status examination. They employ a wide variation in tests, and show a lack of sophistication in how to test for special dysfunctions. We discuss these data in the context of accumulated research on MSE. It should be possible to provide more systematic training in the MSE and we suggest modifications in resident training which might produce a more uniform and reliable MSE.

Canada↗
PubMed1984

A study of the reliability of the clinical oral examination in psychiatry.

A study of the variability between raters in scoring an oral clinical examination in psychiatry in the format of the certification by the Royal College of Physicians and Surgeons of Canada is reported. A video-taped examination from another centre was rated independently by academic psychiatrists, nonacademic psychiatrists and residents. Considerable inter-rater differences between and within these groups were found. In particular, the averaging of the marks of pairs of raters as occurs in the actual certification resulted in the outcome depending to a considerable degree on the chance pairings of raters. These findings support a number of previous studies and emphasize the need to train examiners and to develop clearer rating criteria.

Canada↗
PubMed1984

Criteria for selecting residents: a reassessment.

A questionnaire was distributed to the 16 directors of psychiatry residency programs and to 199 psychiatry residents in Canada. Both groups were asked to assess the importance of 32 criteria for selecting residents on a scale of 1 to 5, and to rank order 8 selection criteria. Our results confirmed previous investigators' findings that the personal interview and letters of recommendation are the most valued tools. Yet neither have been demonstrated to have predictive value. This lack of predictive value is discussed in the context of research into improving resident selection techniques. A multi-centre study of resident selection is proposed.

Attitude of Health Personnel↗
PubMed1984

Opinions on the role of the internship in psychiatric postgraduate education.

Presently in Canada the value of the straight internship in psychiatry and the need for a mandatory rotation in psychiatry during a rotating internship are sources of active debate between the licensing bodies and psychiatric programs and organizations. The importance of the internship as it pertains to the total psychiatric education process has been discussed in a number of research articles from the United States. The conclusions from these studies range from recommendations that rotating internships be discontinued because they may cause empathic blunting among trainees, to strong endorsements of its necessity. The present study examined residents' and residency directors' views of the types of internships in Canada. One hundred and ninety-nine residents and thirteen residency directors completed a questionnaire in 1980. The majority of residents (74.3%) and residency directors (77%) felt that the rotating-mixed internship should be a requirement prior to taking post-graduate training in psychiatry. Most also felt that this type of internship should contain a mandatory one to two months psychiatry rotation. Opinions on the value of the straight internship in psychiatry were mixed for both residents and residency directors. Statistical analyses were carried out comparing the opinions of residents having had a rotating internship versus those having had a straight internship: foreign medical graduates (FMG's) versus Canadian medical graduates (CMG's); and male versus female. As would be expected, the residents who had previously completed a straight internship favoured this type of internship and were more critical of the rotating type.(ABSTRACT TRUNCATED AT 250 WORDS)

Attitude of Health Personnel↗
PubMed1983

Selective tumor localization in experimental hepatoma by radiolabeled antiferritin antibody.

The in vivo localization of 131I-radiolabeled antiferritin and normal IgG in the H-4-II-E rat hepatoma model was investigated by serial necropsy. Groups of 14 to 18 animals were injected with 500 microCi (200 micrograms) of normal and antiferritin IgG. The total dose from the nonpenetrating beta radiation was calculated for tumor and normal tissue, and expressed as a targeting ratio of antiferritin to normal IgG for each organ studied. The results demonstrate 2.9 times greater dose deposition in tumors of animals treated with 131I-antiferritin than with 131I-normal IgG. 131I-antiferritin deposited equivalently in primary tumors and metastatic lesions of similar size. The specific binding in tumors could be competitively inhibited by the addition of unlabeled antiferritin but not unlabeled normal IgG. Specific targeting with 131I-antiferritin comparison to 131I-normal IgG did not occur in any normal tissue. There was considerable variation in the dose deposition in different normal tissues.

Animals↗
PubMed1983

Psychiatric training in gender specific psychology and goals for women in therapy.

A questionnaire addressing itself to the necessity of psychiatric training in gender specific issues and therapists' attitudes towards women in treatment was answered by almost half the total number of residents in psychiatric programs across Canada in the spring of 1980. Although the majority felt that training in gender specific psychology was a necessity, our survey indicated only a small proportion of Canadian programs (2 out of the 16 psychiatric schools) have incorporated this into their present curricula. An overview of the survey showed residents to agree with the following attitudes regarding women in therapy: 1) women's conflicts should be considered in the framework of their developmental life cycle and reproductive issues; 2) women do not present the same conflicts, goals and values as men; 3) therapy should help women to become more autonomous and assertive in the home and at work; and 4) women's primary goal should not necessarily be seen as that of caregivers and homemakers. Further, the residents expressed the beliefs that sex role ideology could interfere with therapy and that the "traditional hierarchy of power" should not be replicated between therapist and patient.

Adult↗
PubMed1983

Factors effecting the recruitment of residents: the residents' and residency directors' view.

A survey of the opinions of Canadian psychiatric residents (N = 199) and their residency directors (N = 13) was conducted regarding six hypothesized reasons for the decline in psychiatric career choice by medical students. The residents felt that the adverse effects of undergraduate education and the negative socialization experience in medical school were particularly important. Of less importance was the competition from family practice programs and medical school admission policies that pre-screened biosocial students out. Little importance was attached to the relatively low financial benefits of this specialty and to new immigration laws. The experience of negative socialization was found to be significantly more important to Canadian medical school graduates than foreign graduates. The residency directors placed less emphasis on the importance of undergraduate education than did the residents.

Attitude of Health Personnel↗