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Biomedical subjects

S Prager

Publications and source records attributed to S Prager.

7 recordsLinked to original sources
PubMed1996

Group peer review: a questionnaire-based survey.

OBJECTIVE: This paper presents the findings from a questionnaire-based survey of psychiatrists designed to elucidate the positive and negative aspects of group peer review and its perceived place in accountability procedures, and to provide information about how accountability through group peer review might be improved. METHOD: Three hundred and eighty-eight psychiatrists were surveyed via mailout questionnaire. Demographic data, details of groups, and perceptions of beneficial and detrimental effects of group peer review were sought from group participants and non-participants. Attitudes of participants were compared with those of non-participants. Features of groups related to satisfaction in participants were examined. RESULTS: The majority of the 170 respondents participating in groups regarded peer review as a means of maintaining and improving skills, sharing ideas and methods, receiving constructive criticism and feedback, of educational benefit and an important source of professional accountability. Non-participants, while less positive overall, responded equally that participation in peer review groups would be an effective response to accountability procedures. Potential detrimental effects and problems with the functioning of peer review groups were elucidated. CONCLUSIONS: Group peer review contributes significantly to professional accountability and education in well-functioning groups. Further strategies for the facilitation of group functioning and for the processing of problems arising in group peer review need to be developed to optimise its contribution to the maintenance and improvement of professional standards.

Adolescent Psychiatry↗
PubMed1996

Group peer review in psychiatry: the relationship to quality improvement and quality care.

OBJECTIVE: This study sought to elucidate the contribution of peer review groups involving psychiatrists to quality improvement and quality care. METHOD: Audio-taped interviews of groups engaged in peer review were analysed using a qualitative methodology. Participants' views of the ways in which they experienced and conceptualised peer review were explored. RESULTS: The views of participants in peer review groups were analysed, and categories evolved which identified differences in how they perceived the structure and function of group peer review. CONCLUSIONS: Participants in the groups studied perceived peer review as a professional growth forum within a quality improvement framework providing critical review of treatment, continuing education, and a sense of collegiality. Boundaries of acceptable practice were tested and defined. At its best, participation in peer review groups enhanced reflective practice which achieved new understandings of clinical work. In this regard, peer review is seen as a highly desirable method for the maintenance of professional standards.

Attitude of Health Personnel↗
PubMed1993

Sensory impairment in late-life schizophrenia.

We reviewed 27 published studies examining a possible association between sensory (visual or hearing) impairment and late-life psychosis with paranoid features. A majority of these investigations supported the postulated association between hearing impairment and late-onset schizophrenia or paranoid disorder. Many of the published studies, however, had important methodological limitations. In a case-control study, we assessed visual and hearing impairments in 87 middle-aged and elderly subjects (16 with late-onset schizophrenia, 25 with early-onset schizophrenia, 20 with mood disorder, and 26 normal comparison subjects). Visual and hearing impairments were assessed in a blind manner by means of standardized quantitative assessments. Compared with normal subjects, both of the schizophrenia groups and the mood disorder group had greater impairment in most variables of corrected visual acuity and in self-reported hearing deficit, but not in uncorrected (constitutional) visual acuity or on pure-tone audiometry. Our results suggest that the observed relationship between sensory impairment and late-life psychosis may be due, at least in part, to a suboptimal correction of sensory deficits in older psychiatric patients.

Aged↗
PubMed1992

[Radiobiological research to optimize high-dose-rate afterloading therapy with Ir-192 in extragenital tumors].

Since the introduction of the high-dose rate afterloading therapy a higher biological effectivity of this method has been well known in comparison with the low-dose contact therapy. This will practically taken into account by reducing the dose and more fractionating of the total dose. With our test we want: firstly to prove the influence of the therapy break on the duration of the radiation reaction. Secondly we want to prove the influence of the dose rate on the efficiency of the radiation reaction. We have tried to answer the question by the animal model guinea pig skin. We examined early reactions as well late reactions.

Animals↗
PubMed1979

Diffusion-controlled reactions on spherical surfaces. Application to bacteriophage tail fiber attachment.

We have explored the kinetic implications of a model that may account for the acceleration of tail fiber (F) attachment to baseplates (B) by whiskers (W) on bacteriophage T4. The model assumes that a W-F complex is formed initially, and that the tethered fiber then undergoes rotational diffusion until a B-F encounter takes place. In the absence of whiskers, B-F complexes must form unassisted. Formation of a W-F intermediate will accelerate F attachment to B if (a) the bimolecular rate constant for W-F complex formation is larger than that for direct B-F interaction and (b) subsequent rotational diffusion of the tip of F to B is not much slower than the dissociation of W-F. Condition a was investigated by applying a recent theory of orientational effects on translational diffusion-controlled reactions. This theory suggests that substantial rate enhancement is expected if the reaction half-angle theta 0 is larger for W-F than for B-F complex formation. Condition b was investigated by calculating the mean and the variance of the time required for the diffusion of a molecule (the proximal tip of the fiber) on a spherical surface (whose radius is the distance from the tip to the whisker tethering point) into a circular sink (the baseplate site). The mean time is on the order of the inverse rotational diffusion coefficient, DR, of the fiber, but is sensitive to theta 0. Both conditions are satisfied for plausible choices of parameters. The solution to the diffusion equation we have obtained should have application to other physical situations, such as the rate of quenching of a fluorophore as it diffuses on the surface of a spherical membrane into proximity with a quencher.

Diffusion↗