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PubMedDate not supplied

[The creation of post-graduate medical teaching as social phenomenon in the middle of the twentieth century].

The explosive improvement in the middle of the twentieth century, in medical learning, induced, in medical practice, an unprecedented mutation. The adjustment of the physicians to this deep modification in each aspect of their practice, became, for the practitioners an absolute need and a deontological duty. From 1947, first in Paris, then, swiftly, all over France, the post-graduate medical teaching was created.

Education, Medical, Continuing↗
PubMed2004

Two brothers with trichiasis, entropion and corneal scarring, sensorineural hearing loss, progressive thinning of scalp hair, mild learning difficulties and distinct facial features. A new syndrome?

Two brothers with very similar phenotypes involving trichiasis (misdirected lashes), entropion with corneal abrasions, strabismus, progressive thinning of the scalp hair, sensorineural hearing impairment, mild learning difficulties, and inguinal hernias are described. They have similar, distinctive facial features with deep-set eyes, a high nasal bridge and a short philtrum. Both brothers are carriers of a maternally inherited apparently balanced translocation of chromosomes 11 and 18: 46,XY, t(11;18)(p13;q21)mat. However, this is thought to be coincidental, since their younger brother also carries this translocation and is phenotypically normal. Although they have many features that are found in the ectodermal dysplasia syndromes, their combination of features is distinct and has to our knowledge not been previously reported.

Adolescent↗
PubMed1976

[Group psychotherapy in psychiatry].

Psychiatry has learned to regard the human being not only as an individual but as a social being. Accordingly, group psychotherapy has come increasingly to the fore in recent years and decades. In general the term "group psychotherapy" means simultaneous psychotherapy of a number of patients by one or two therapists. Sociological-interactional-horizontal and deep psychological-motivational-vertical components combine in the therapeutic group to produce a resultant. Insight into unconscious motivations and social learning are stimulated in the therapeutic group. Through group psychotherapy, which can be administered as a treatment method alone or in combination with other therapies, inpatients and outpatients experience a framework which activates former experiences of collective life situations, e.g. in the family, and social valencies. Irrespective of the method of group psychotherapy (activity group psychotherapy, directive-suggestive group psychotherapy, group analysis, psychodrame or one of the accelerating methods) the group should always be group- and not leader-centered. Hitherto published results of group psychotherapy show that the treatment depends much more on the therapeutic commitment of the therapist (moderator, facilitator) than on the psychotherapeutic school to which the belongs.

Humans↗
PubMed2002

Error analysis of the nine-word California Verbal Learning Test (CVLT-9) among older adults with and without dementia.

The nine-word California Verbal Learning Test (CVLT-9; Libon et al., 1996; Spreen & Strauss, 1998) is a verbal list learning task used to assess declarative memory impairment among dementia patients. The present study sought to investigate the neuro-cognitive mechanisms that underlie the production of intrusions and perseverations on the list A, free recall learning trials, and the false positive responses made on the delayed recognition condition. Patients with probable Alzheimer's disease (AD), Ischaemic Vascular Dementia associated with periventricular and deep white matter changes (IVD), and individuals without dementia (NC) were studied. Between-group analyses showed that AD participants produced more initial intrusion errors, and perseverated on those same intrusion errors across list A learning trials than IVD or NC participants. Also, as participants with dementia produced initial free recall intrusion errors, the semantic organization of their responses on the 'animal' word list generation task declined (Giovannetti-Carew, Lamar, Cloud, Grossman, & Libon, 1997). On the delayed recognition test condition, within-group analyses revealed that the IVD group endorsed more list B interference foils, than other errors. AD participants endorsed semantically related foils and list B interference foils. In addition, as participants with dementia endorsed more list B interference foils, more perseverations were produced on the Graphical Sequence Test - Dementia Version (Lamar et al., 1997). These results were interpreted within the context of the semantic knowledge, and executive functions deficits that typify AD and IVD, respectively.

Aged↗
PubMed1996

Engagement in Academic Work: The Role of Learning Goals, Future Consequences, Pleasing Others, and Perceived Ability

Engagement in academic work was viewed from a multiple goals perspective. Two studies were conducted in which high school math students completed an instrument measuring five goals students might have for doing academic work (learning goals, performance goals, obtaining future consequences, pleasing the teacher, and pleasing the family), perceived math ability, self-regulatory activities, strategies (deep or shallow) used when studying for math, and the amount of effort and persistence expended on the class. Factor analysis indicated that the five goals scales and the perceived ability scale represented unique factors. The correlations among the variables revealed theoretically consistent interrelationships. Multiple regression analyses indicated that various goals (e.g., learning goals, obtaining future consequences, and pleasing the teacher), perceived ability, and some interactions accounted for significant amounts of variance in the task engagement measures (self-regulation, strategy use, effort, and persistence) and achievement. Results are discussed in relation to current theory and their practical implications.

Journal Article↗
PubMed1994

Two cases of deep dyslexia in unilingual hispanophone aphasics.

This paper addresses the interaction between a particular cognitive property inherent to the human brain, i.e., the capacity to learn how to process written information in a manner such that reading words aloud can become a standard aspect of overt behavior, and some of the culture-linked characteristics of the written codes invented by the species. First, the paper reiterates that the Spanish written code is transparent to the point of entailing full graphophonemic conversion, i.e., reading behavior is possible without access to one's memory of written words (to one's "logographic lexicon"). The Ardila claim (Ardila, 1991; Ardila, Rosselli, & Pinzon, 1989) that certain clinical forms of acquired reading disorders which have been reported to occur among various cultural subgroups do not occur among unilingual readers of Spanish is then summarized. This is followed by two brief case reports of acquired aphasia in native speakers and fluent readers of Spanish; prototypical "deep dyslexia" was documented to exist in both cases (Ruiz & Ansaldo, 1990). The Ardila claim is thereafter assessed by reference to the notions of surface, phonological, and deep dyslexia; parameters such as educational background are taken into account in this discussion.

Aphasia↗
PubMed2004

Orthographic learning at a glance: on the time course and developmental onset of self-teaching.

Experiment 1 examined the time course of orthographic learning among Grade 3 children. A single encounter with a novel orthographic string was sufficient to produce reliable recall of orthographic detail. Moreover, newly acquired orthographic information was retained 1 month later. These data support the logistic learning functions featured in contemporary connectionist models of reading rather than a "threshold" model of orthographic learning. Experiments 2 and 3 examined self-teaching among novice readers. In contrast to the findings from less regular orthographies such as English and Dutch, beginning readers of a highly regular orthography (Hebrew) appear to be relatively insensitive to word-specific orthographic detail, reading in a nonlexical "surface" fashion. These results suggest fundamental differences between shallow and deep orthographies in the development of orthographic sensitivity.

Child↗
PubMed1989

Magnetic resonance imaging evaluation of learning difficulties and incoordination in neurofibromatosis.

Areas of increased signal seen on magnetic resonance imaging (MRI) of the brain are frequently present in neurofibromatosis and are considered possible areas of dysplasia or heterotopias. Since Rosman and Pearce [Brain 1967; 90:829-838] have shown that neuronal heterotopias in deep cerebral white matter are associated with mental retardation in neurofibromatosis type 1 (NF-1), we hypothesized that these areas of increased signal seen on MRI should be associated with learning difficulties or incoordination in children with NF-1. Using MRI, we studied 31 children with NF-1 and attempted to correlate the presence of areas of increased signal with learning difficulties or incoordination. We found no association. This suggests that either these areas of increased signal are heterotopias which are not associated with learning difficulties or incoordination, or these areas of increased signal are not heterotopias and are not relevant to the study of learning problems or incoordination in children with NF-1.

Adolescent↗
PubMed2004

The dentofacial features of Sanjad-Sakati syndrome: a case report.

Sanjad-Sakati syndrome is an autosomal recessive disorder that was first reported by Sanjad et al. in 1988. It is characterized by congenital hypoparathyroidism, severe growth failure and dysmorphic features. The clinical features include deep set eyes, microcephaly, thin lips, depressed nasal bridge with beaked nose, external ear anomalies and learning difficulties. This report presents the case of a 4-year-old patient who was referred to our dental clinic because of pain in her mouth and poor dental health. Oral findings included micrognathic mandible and maxilla, microdontia, enamel hypoplasia as well as severely decayed teeth. Treatment was carried out under general anaesthesia to extract the most severely affected teeth and restore those which could be conserved. It was concluded that these patients have special dental needs; early diagnosis of the affected children is therefore important in order to commence preventive dental therapy and carry out appropriate dental treatment at the optimum time.

Child, Preschool↗
PubMedDate not supplied

Therapeutic touch and the terminally ill: healing power through the hands.

I hope it has become apparent that the use of Therapeutic Touch can be a useful addition to more conventional hospice treatments. Also, it can be a very rewarding and fulfilling experience for the patient. It has been so for me. I feel extremely fortunate to have been given the opportunity of introducing Therapeutic Touch into the Allegheny Hospice, a program of Allegheny General Hospital in Pittsburgh, Pennsylvania. We are still in the early stages of implementation. Currently, we are initiating a research program to accomplish the following with respect to Therapeutic Touch: Demonstrate that Therapeutic Touch does, in fact, yield the same results when performed in a hospice setting as when performed in other settings established by prior research. Establish the degree to which drug levels can be reduced (if any) by the introduction of Therapeutic Touch into the treatment regimen and still maintain an acceptable level of pain control. Demonstrate that the quality of life can be improved for the patients and their families through the use of Therapeutic Touch over the current treatment methods not using Therapeutic Touch. Establish sufficient documentation for respective insurance providers to justify future payment for this treatment. It is envisioned that this program will be accomplished later this year. Our hospice organization is a very dynamic one, dedicated to bringing the best possible care to our patients. In addition to the aforementioned Therapeutic Touch research program, we have just embarked on another research effort to determine the advantages of using a "Low Pressure Air Mattress" to reduce the incidence and severity of skin breakdown. This has the potential to improve the quality of life not only of the patient but also of the care giver. In this day and age when many seem to have severely neglected the sick and elderly, there is a great opportunity for creative, compassionate people to become involved in hospice programs around the country. In so doing, you could render an invaluable service to your fellow, man, and, at the same time, achieve a deep sense of fulfillment. Anyone wishing to become involved in a hospice program or interested in learning Therapeutic Touch may contact me at Allegheny Hospice, a Allegheny Center, 6th floor, Pittsburgh, Pa., 15212.

Education, Nursing, Continuing↗
PubMed1990

The approaches to learning of specialist physicians.

Recent studies have provided information about the approaches to studying and learning used by medical students. However, no published work is available on the approaches of practising doctors. The Adelaide Diagnostic Learning Inventory for Medical Students (ADLIMS) was modified and administered to a random sample of 308 physicians (internists). Generally speaking, physicians seem to have lower scores on surface approach and higher scores on deep approach than students. Level of clinical experience did not appear to influence this finding. However, marked differences were apparent between the approaches adopted by physicians with additional postgraduate academic training and those without. The former had a much stronger tendency to use the more desirable deep approach. The latter seemed to rely more on the less desirable surface approach. Further longitudinal studies will be required to determine whether this difference is attributable to self-selection of those who have already developed a deep approach or is causally related to a training in research. Although these findings must be interpreted with caution, some implications are clear. Physicians should become more aware of the way they learn and about the way they teach. Inappropriate patterns of learning may be entrenched during the undergraduate and immediate postgraduate years. If validated, these findings may provide support for the inclusion of research projects in medical school and during specialist training.

Australia↗
PubMed1996

Changes in rabbit cerebellar cortical and interpositus nucleus activity during acquisition, extinction, and backward classical eyelid conditioning.

Multiple- and single-unit neuronal activities were recorded from cerebellar cortex (Larsell's lobule HVI and adjacent ansiform cortex) and the cerebellar interpositus nucleus during forward (CS-US), backward (US-CS), and explicitly unpaired classical eyeblink conditioning in several rabbits. Whereas learning-related activity was observed in the interpositus nucleus only during forward pairing of the conditioning stimuli, a variety of patterns of learning-related neuronal firings were observed in cerebellar cortex during forward, backward, and even unpaired presentations of the conditioning stimuli. These data suggest that the cerebellar cortex and the deep cerebellar nuclei play different roles during classical eyeblink conditioning.

Animals↗
PubMed2002

Fat content of chips, quality of frying fat and deep-frying practices in New Zealand fast food outlets.

OBJECTIVES: To collect baseline data on the fat content of hot chips, quality (degradation) of cooking fat, deep-frying practices and related attitudes in fast food outlets in New Zealand. To identify the key determinants of the fat content of chips and quality of cooking fat. METHODS: A nationally representative sample of fast food outlets (n=150, response rate 80%) was surveyed between September 1998 and March 1999. Data collected included a questionnaire, observation of cooking practices and analysis of cooked chips and frying fat. RESULTS: Only 8% of independent operators had formal training in deep frying practices compared with 93% of chain operators. There was a wide range of fat content of chips (5%-20%, mean 11.5%). The use of thinner chips, crinkle cut chips and lower fryer fat temperature were associated with higher chip fat content. Eighty-nine per cent of chain outlets used 6-10 mm chips compared with 83% of independent outlets that used chips > or = 12 mm. A wide range of frying temperatures was recorded (136-233 degrees C) with 58% of outlets frying outside the reference range (175-190 degrees C). As indices of fat degradation, fat acid and polar compound values above the recommended levels occurred in 54% and 5% of outlets respectively. Operators seemed willing to learn more about best practice techniques, with lack of knowledge being the main barrier to change. CONCLUSIONS AND IMPLICATIONS: Deep frying practices could be improved through operator training and certification options. Even a small decrease in the mean fat content of chips would reduce the obesogenic impact of this popular food.

Cooking↗
PubMed2005

Epistemological beliefs and approaches to learning: their change through secondary school and their influence on academic performance.

BACKGROUND: In recent decades, two lines of research, phenomenographic and meta-cognitive, have examined students' approaches and epistemological beliefs about learning. To date there has been very little research describing the change in epistemological beliefs in European secondary students, or analysing interrelationships between epistemological beliefs and approaches in order to explain their influence on academic performance. AIMS: The first aim of this investigation is to analyse the change in epistemological beliefs and learning approaches in secondary students as they progress through their studies. The second aim is to examine the effects of epistemological beliefs on learning approaches, and learning approaches on academic performance. SAMPLE: About 1,600 Spanish students, boys and girls, from several secondary schools took part in the study. They were between 12 and 20 years old and their average age was 14.79 years. METHODS: Measures of epistemological beliefs (EQ: Epistemological Questionnaire), learning approaches (LPQ: Learning Process Questionnaire), and academic performance were obtained. Confirmatory factor analysis was used to examine the dimensionality of the EQ and LPQ questionnaires. In order to achieve our two aims, different statistical techniques were used: MANOVA and ANOVA for our first aim, and structural equation modelling for our second aim. RESULTS: Throughout secondary education epistemological beliefs undergo change, becoming more realistic and complex, and deep-approach scores decline significantly. It was shown that, as predicted, epistemological beliefs influenced academic achievement directly, and also indirectly via students' learning approaches. CONCLUSIONS: Our findings point to two conclusions. First, epistemological beliefs and learning approaches change as pupils advance in their studies. Second, the relationship between epistemological beliefs and academic achievement is mediated by approaches to learning.

Achievement↗
PubMed2003

New technology for endoscopic retrograde cholangiopancreatography: improving safety, success, and efficiency.

Known and documented factors attributable to ERCP-related complications include the experience and technique of the endoscopist as well as anatomic and pathologic factors pertaining to the papilla. In an effort to minimize trauma, facilitate deep entry to the biliary system, and improve the efficiency of therapeutic ERCP, new cannulation, sphincterotomy, and guide wire devices have been developed, based on principles of safe and successful therapeutic ERCP learned over the years. By totally re-engineering familiar accessories into smaller, more flexible, and more versatile devices, the 0.025-inch guide wire-based DASH system attempts to minimize the trauma at deep CBD cannulation and thereby increase the safety and success of achieving deep cannulation and sphincterotomy. Limited clinical experience to date suggests that the DASH system can provide full-function ERCP while reducing risks and costs. Attention to cannulation has led to the development of the RX Biliary System which provides the endoscopist and the assistant with increased control of the guide wire and exchange compared with traditional devices, resulting in less stress, less hand and wrist force used for contrast injection, and easier guide wire management, all of which have been shown in clinical trials to improve the speed and efficiency of ERCP while reducing complications.

Catheterization↗
PubMed2000

Lessons learned from a 6-year clinical experience with superior vena cava Greenfield filters.

PURPOSE: Therapy to prevent pulmonary embolism (PE) resulting from upper extremity deep venous thrombosis (UEDVT) remains controversial despite an increasing incidence of DVT of upper extremity origin. The purpose of this study was to evaluate the results of 72 superior vena cava Greenfield filters (SVC-GFs) placed in patients at risk for PE arising from UEDVT. METHODS: During the past 78 months, we placed SVC-GFs in 72 patients with UEDVT in whom anticoagulation was either deemed contraindicated (n = 67) or proved ineffective in preventing recurrent PE (n = 4) or extension of the thrombus (n = 1). There were 25 male (35%) and 47 (65%) female patients whose ages ranged from 25 to 99 years (mean, 74 years). Follow-up ranged from 10 days to 78 months (mean, 7.8 months). Sequential chest radiographs revealed no filter migration or displacement in 26 patients. RESULTS: Thirty-four patients died in the hospital of causes unrelated to the SVC filter or recurrent thromboembolism (mean time to death, 20 days). Follow-up of the surviving 38 patients ranged from 1 month to 78 months (mean, 22 months); none of these patients were seen with any evidence of PE. One SVC-GF was incorrectly discharged into the innominate vein and left in place. This vein remains patent 2 months after insertion without evidence of filter migration. CONCLUSIONS: We think that insertion of SVC-GFs is a safe, efficacious, and feasible therapy and may prevent recurrent thromboembolism in patients with UEDVT who are resistant to anticoagulation or have contraindications to anticoagulation.

Adult↗