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At least 721 records · Page 40Linked to original sources

PubMed1998

The effect of joint mobilization as a component of comprehensive treatment for primary shoulder impingement syndrome.

Primary shoulder impingement syndrome is a common shoulder problem which, if treated ineffectively, can lead to more serious pathology and expensive treatment. This study examined whether subjects receiving joint mobilization and comprehensive treatment (hot packs, active range of motion, physiologic stretching, muscle strengthening, soft tissue mobilization, and patient education) would have improved pain, mobility, and function compared with similar patients receiving comprehensive treatment alone. Subjects were eight men and six women (mean age = 52.9 years) with primary shoulder impingement syndrome (superolateral shoulder pain, decreased active humeral elevation, limited overhead function). Following random assignment to experimental (N = 7) and control groups (N = 7), three blinded evaluators tested 24-hour pain (visual analog scale), pain with subacromial compression test (visual analog scale), active range of motion (goniometry), and function (reaching forward, behind the head, and across the body in an overhead position) before and after nine treatments. One-tailed analyses of covariance (baseline values as covariates) showed that the experimental group had less 24-hour pain and pain with subacromial compression test but no differences in range of motion and function (Mann-Whitney U) compared with controls. The experimental group improved on all variables, while the control group improved only on mobility and function (one-tailed, paired t tests; Wilcoxon matched pairs). Age, side of dominance, duration of symptoms, treatment attendance, exercise quality, and adherence had no effect on the outcomes. Results may be affected by inadequate sample size, minimal capsular tightness, insensitive functional scale, nonspecific motion measurements, position at which mobilization treatment was given, or a strong effect of comprehensive treatment. Mobilization decreased 24-hour pain and pain with subacromial compression test in patients with primary shoulder impingement syndrome, but larger replication studies are needed to assess more clearly mobilization's influence on motion and function.

Female↗

PubMed1987

Inducing comprehension in the bilateral poor reader.

The comprehension effects of changes in the spatial configuration of prose were examined with reading disabled children who differed in laterality preference. Specifically, 24 learning disabled boys were presented with prose materials in a standard, phrased, and backward (right to left) fashion. Measures of comprehension showed that text in the phrased and backward conditions differentially facilitated comprehension for the more bilateral subjects but had little effect on more right lateralized subjects. The results were discussed in terms of the instructional implications of alterations in the visual-spatial arrangement of prose materials for bilateral readers.

Child↗

PubMed1991

A comprehensive worksite smoking control, discouragement, and cessation program.

The effectiveness of a comprehensive program of worksite smoking control, discouragement, and cessation was compared with a program of smoking cessation alone. Two comparable oil refineries served as the research sites. Outcome variables consisted of employee self-reported smoking rate assessed by the use of a smoking questionnaire and unobtrusive observations of smoking behavior before and after the intervention. One company was randomly assigned to the comprehensive program of smoking control, discouragement, and cessation while the other company only received smoking cessation. Humorous antismoking posters emphasizing the benefits of quitting smoking were distributed throughout the first worksite and changed every 2 weeks. Large banners stating "Go SmokeFree" were also placed at all locations to this plant and left up for the duration of the study. Three weeks after the initiation of the smoking discouragement program at one refinery, a group smoking cessation program was begun at both plants. At a 5-month follow-up, participants in the smoking cessation treatment at the plant receiving the comprehensive program achieved a 5-month abstinence rate of 43% in comparison with a rate of 21% at the refinery receiving only smoking cessation.

Adult↗

PubMed1995

A multiple-level, comprehensive approach to the prevention of fetal alcohol syndrome (FAS) and other alcohol-related birth defects (ARBD).

A comprehensive program for the prevention of fetal alcohol syndrome (FAS) and alcohol-related birth defects (ARBD) must consider multiple approaches and utilize knowledge from a variety of academic disciplines. Issues related to culture, society, behavior, belief systems, and medicine must all be considered for both etiology and solutions. A broad paradigm such as a public health model integrates various elements of approach. Because FAS and other levels of ARBD form a spectrum, from severe to negligible damage, a variety of drinking patterns with various characteristics and etiologies have to be addressed. This paper describes a multiple-level, comprehensive program with primary, secondary, and tertiary prevention components. Practical recommendations are proposed for addressing ARBD in a variety of arenas. While secondary and tertiary prevention hold promise for short-term reduction of FAS and ARBD prevalence, comprehensive prevention serves both short- and long-term effects. Multiple level prevention efforts are well served by clear and compelling vision and mission statements, and require careful evaluation.

Alcohol Drinking↗

PubMed1984

Comprehensive toxicology screening: the frequency of finding other drugs in addition to ethanol.

The efficacy of performing a comprehensive toxicology screen whenever ethanol is found was evaluated in 289 consecutive emergency-room cases. Males predominated in both the "pure" (ethanol only) and the "mixed" (ethanol plus other drugs) groups. The mean ethanol concentration was significantly higher for pure cases than for mixed cases (P less than 0.01). For half of the 289 cases comprehensive screening demonstrated at least one to four other drugs per case in addition to ethanol. Barbiturates, narcotic analgesics, and stimulants in that order were the most frequently found classes of drugs. The age range 21 to 40 years accounted for most of the mixed ingestions, and ethanol concentrations less than 0.20% were more commonly associated with other drugs than were those above 0.20%. Whenever ethanol is found, comprehensive toxicology screening may yield important additional information.

Adolescent↗

PubMed1999

[The deterioration of regimen comprehension in self-attending elderly patients and the effect of tutorials by pharmacists].

The purpose of this study was to assess whether regimen comprehension deteriorates in the elderly without obvious mental disability. Eligible patients were elderly who could visit hospitals by themselves. We recruited 138 patients (age: 43-89, 75 males and 63 females, underlying diseases: hypertension, hyperlipidemia, arrhythmia etc.) from our outpatient clinic. The participants were tested with a regimen comprehension scale (RCS: Jpn J Geriat 1997; 34:209-214). The differences in scores among individuals increased with age. Scores of 5 or less were recorded in 10 of 69 patients aged 65 or more, but in non of 69 patients aged less than 65 (p < 0.01). The 60 patients who could not get full marks were classified into 2 groups: the tutored group (T) who were tutored by pharmacists about taking drugs, and the non-tutored group (N). Both group were tested again with RCS to evaluate the effect of tutorial. In T-group (n = 28), the second scores increased significantly (from 7.2 +/- 0.9 to 8.6 +/- 2.0 (m +/- SD); p < 0.01). Although the second scores showed a tendency to increase in N-group (n = 29), there was no statistical significance. In 7 patients who obtained less than a score of 5 on the RCS and age- and gender-matched controls who received full marks on the RCS, the HDS-R test failed to show any differences between the two groups. Thus, we concluded that even in the self-attending elderly patients, the regimen comprehension deteriorated with age, and tutorials were considered to be effective.

Adult↗

PubMed1999

Comparative localization of auditory comprehension by using functional magnetic resonance imaging and cortical stimulation.

OBJECT: The authors previously described a functional magnetic resonance (fMR) imaging task for the localization of auditory comprehension in which focal activation of posterior temporal and inferior frontal regions of the left hemisphere was reliably demonstrated. Because this study was conducted in neurologically normal volunteers, it was not possible to determine whether the activated regions were critical to the performance of language tasks; that is, whether the fMR imaging activations provided a valid measure of language processing. A direct comparison of fMR imaging language activation with cortical stimulation must be completed before it can be used with confidence in presurgical planning, and this comparison is performed in the present study. METHODS: The authors report on a series of 33 consecutive patients who underwent dominant hemisphere resection and in whom fMR imaging mapping of auditory comprehension was performed at the Yale neurosurgical program. In 23 of the 33 patients fMR imaging activation was consistent with the typical results obtained in normal participants in the earlier study. In 16 of these 23 patients language mapping was performed using either intra- or extraoperative cortical stimulation. Cortical stimulation failed to localize language areas in two of the 16 patients. Electrical stimulation that was performed in proximity to the fMR image activations interfered with auditory comprehension, object naming, or speech production in 12 of the remaining 14 patients. Five of the 10 cases in which evocation of reliable fMR imaging activation failed were attributable to technical problems and/or patient head movement. CONCLUSIONS: Cortical stimulation results and fMR imaging findings were consistent in all but two patients. However, the spatial extent of the activation produced by fMR imaging and the spatial extent of stimulation-induced language disruption that was caused by direct cortical stimulation did not always correspond. Problems in defining the extent of activation by both methods are discussed.

Adolescent↗

PubMed2001

Comprehension skill, inference-making ability, and their relation to knowledge.

In this study we investigated the relation between young children's comprehension skill and inference-making ability using a procedure that controlled individual differences in general knowledge (Barnes & Dennis, 1998; Barnes, Dennis, & Haefele-Kalvaitis, 1996). A multiepisode story was read to the children, and their ability to make two types of inference was assessed: coherence inferences, which were essential for adequate comprehension of the text, and elaborative inferences, which enhanced the text representation but which were not crucial to understanding. There was a strong relation between comprehension skill and inference-making ability even when knowledge was equally available to all participants. Subsidiary analyses of the source of inference failures revealed different underlying sources of difficulty for good and poor comprehenders.

Child↗

PubMed2004

[The development and effects of a comprehensive communication course for nursing students].

PURPOSE: The purposes of this study were to: (a) develop a comprehensive communication course combined with a group program for improving communication skills; and (b) examine the effects of the comprehensive communication course on interpersonal communication, relationship change, self-esteem, and depression in nursing students. METHOD: The experimental group consisted of 82 nursing students, and the control group, 108 nursing students. Both groups each took communication courses from March to June, 2002 and 2003. A group program for improving communication skills was conducted for each 8 subgroups of the experimental group for 90 minutes once a week during the 6 weeks, while the existing communication lecture was conducted for the control group. Both groups were post-tested after the intervention for verifying the difference of variables between the two groups, and the experimental group was also pre-tested for verifying the difference between before and after the treatment. RESULT & CONCLUSION: Interpersonal communication score of the post-test in the experimental group was significantly higher than in the control group and the depression score of the post-test in the experimental group was significantly lower than in the control group. Interpersonal communication, relationship change and self-esteem scores were significantly increased and the depression score was significantly decreased in experimental group after the treatment. In conclusion, the comprehensive communication course that was developed in this study had positive effects on communication skills in nursing students.

Adolescent↗

PubMed2004

[Effects of a comprehensive rehabilitation program for mastectomy patients].

PURPOSE: The purpose of this study was to investigate the effect of a comprehensive rehabilitation program on physical function, immune response, fatigue and quality of life in mastectomy patients. METHOD: The subjects included fifty-five patients with breast cancer (27 in the control group and 28 in the experimental group). The subjects in the experimental group participated in a comprehensive rehabilitation program for 10 weeks, which was composed of 1 session of education, 2 sessions of stress management, 2 sessions of exercise, and 1 session of peer support group activity per week. RESULT: The results revealed an increase in shoulder extension, abduction, external rotation, and internal rotation of the affected upper extremity, and in shoulder extension and abduction of the healthy upper extremity. Also an increase in quality of life and a decrease in fatigue were significantly higher in the experimental group than the control group. However, the results revealed that the natural killer cell ratio of the experimental group increased but there was no significant difference from that of the control group. CONCLUSION: The 10-week comprehensive rehabilitation program showed a large affirmative effect on physical function, fatigue and quality of life of breast cancer patients after a mastectomy.

Exercise Therapy↗

PubMed2006

[The effects of a comprehensive life style modification program on glycemic control and stress response in type 2 diabetes].

PURPOSE: This study was to evaluate the effects of a comprehensive life style modification program on glycemic control and stress response in type 2 diabetes. METHOD: The participants(n=34) with type 2 diabetes were divided into either a usual care(control) or treatment(experimental) group. The experimental group(n=21) received a program that was based on a comprehensive life style modification protocol at a weekly meeting for 16 weeks. They also participated in individually prescribed exercise and diet along with stress management and self monitoring. The participants were followed for 6 months, during which postprandial glucose, HbA1C, and stress response inventory were measured. RESULT: The experimental group showed a significant lower postprandial glucose and stress response compared to those of the control group. However, there was no significant change in the HbA1C value in either group. CONCLUSIONS: These results suggest that a type 2 diabetes comprehensive lifestyle modification program may lead to clinical improvement in glycemic control and reduce the stress response.

Aged↗

PubMed2005

Incidence of contrast nephropathy in patients receiving comprehensive intravenous and oral hydration.

BACKGROUND: Contrast-induced nephropathy (CIN) remains a major complication of percutaneous coronary interventions (PCI) and a common cause of acute renal failure. The most effective preventive strategy is unknown. OBJECTIVES: This study sought to estimate the incidence of CIN in patients receiving comprehensive intravenous and oral volume supplementation for PCI during which iopromide (Ultravist 370, Schering, Berlin, Germany) was used. METHODS: We prospectively studied the development of CIN in 425 consecutive patients undergoing PCI, applying comprehensive intravenous and oral hydration in all patients. Baseline renal function was assessed by calculating the glomerular filtration rate (GFR) with the use of the abbreviated Modification of Diet in Renal Disease Study equation. CIN was defined as an increase in serum creatinine of at least 0.5 mg/dl (44 mmol/l) within 48 hours. RESULTS: Mean patients' age (mean +/- SD) was 64 +/- 10 years. A total of 133/425 patients (31%) were 70 years or older, 107 (25%) were women, 70 (16%) were diabetics, 218 (51%) had prior myocardial infarction, and 43 (10%) underwent PCI for an acute ST-segment elevation myocardial infarction. Mean GFR was 89 ml/min/1.73 m2. Glomerular filtration rate was below 60 ml/min/ 1.73 m2 in 43 patients (10%). During PCI 226 +/- 80 ml of iopromide were used. With the comprehensive hydration strategy used, CIN developed in only 6 of 425 (1.4%; 95% confidence interval 0.5-3.1%) patients. No patient required dialysis. CONCLUSIONS: Applying the combination of intravenous and oral volume supplementation results in a very low incidence of CIN following PCI. Hydration remains the cornerstone for the prevention of CIN.

Acute Kidney Injury↗

PubMed2001

[Types of comprehension processes and the preliminary knowledge-use effect: analogical transfer of learning from text].

This study examined what types of comprehension strategies promote the spontaneous transfer in a later problem solving task. In Experiment 1, 40 undergraduates read and comprehended an abstract text (cooperatively with a partner or individually) with a think-aloud method, and solved a target problem later. The comprehension processes for the text were found to be classified into three categories; GID (generate examples, integrate them, and develop them into other examples) type, GI (generate examples and integrate them, but not develop them into other examples) type, and GN (generate examples but not integrate them) type. The learners of GID type performed better than the others in the transfer task. In Experiment 2, 66 undergraduates read one of three types of texts composed in accordance with the comprehension processes found in Experiment 1, and solved the target problem. None of the types of texts promoted spontaneous transfer in the target problem. These results suggest that learning with GID strategy leads to spontaneous transfer only if learners spontaneously produce elaborations.

Adult↗

PubMed2003

[The lambda in the rorschach comprehensive system].

The purpose of the present study was to investigate the relationships between Lambda (L) and other variables in the Rorschach comprehensive system. Individual Rorschach tests based on the comprehensive system was administrated to 102 female normal adults (over 20 years old). High L group and Low L group were defined on the basis of median value. The two groups were compared on major variables. The high L group had significantly higher values on variables such as DQo, D, Dd, S, Hd than the low L group. In contrast, the low L group had significantly higher values on variables such as DQ+, Blends, M, FM + m, Sum C', "active", H, COP than the high L group. Clinician who use the Rorschach test should consider these variables in relation to L, when interpreting the structural summary of the comprehensive system.

Adult↗

PubMed2025

From Diagnosis, Therapy Decision-Making to Genetic Risk Assessment: The Impact of ctDNA Testing on Comprehensive Cancer Management-A Case Report.

Circulating tumor DNA (ctDNA) testing is a minimally invasive alternative to tissue biopsy and is ideal for inaccessible tumors or limited samples. It captures tumor heterogeneity over time and different anatomic locations, unlike the static snapshot provided by a biopsy. In this report, we describe a 68-year-old female with an initial diagnosis of metastatic pancreatic adenocarcinoma (a pancreas head mass with multiple bilateral lung nodules). Mutation profiling of the pancreatic mass biopsy using a comprehensive cancer next-generation sequencing (NGS) panel was unsuccessful due to insufficient tissue. Consequently, ctDNA testing using a pan-cancer NGS panel was performed, and an EGFR p.L858R variant at 2.15% was identified. Interestingly, this activating variant is highly specific to non-small cell lung cancer (NSCLC), which raised the possibility of a synchronous tumor unrelated to the pancreatic mass. Immunohistochemistry showed the EGFR variant in station 7 lymph nodes but not in pancreatic biopsy tissue, supporting the inference that the variant originated from the lung mass. Droplet digital PCR on the limited pancreatic biopsy identified a KRAS p.Q61 variant, which was absent by ctDNA testing, suggesting a pancreatic primary with low ctDNA levels. In addition to diagnosing a primary lung cancer, ctDNA testing guided treatment decisions. With a primary EGFR p.L858R-mutant NSCLC, osimertinib was administered, resulting in a partial response within 10 months. In addition, given the synchronous primary pancreatic adenocarcinoma, germline testing was performed, revealing a CDKN2A p.I49T variant consistent with melanoma-pancreatic cancer syndrome, prompting comprehensive cancer surveillance and familial testing. This case illustrates how ctDNA testing enabled a comprehensive evaluation by clarifying the diagnosis, identifying actionable biomarkers, and facilitating genetic risk assessment, ultimately having a significant impact on the patient's clinical management.

Humans↗

PubMed1996

Comprehensive medical rehabilitation in the 1990s: the community integration rehabilitation model.

The development of new models of understanding the disabling process, the changing system of financing health care in the United States, and the increasing incidence of disability is challenging rehabilitation to define new models of care delivery. Current models of comprehensive medical rehabilitation include multidisciplinary therapy in inpatient, outpatient, home and community settings. Managed care and the development of capitated funding systems for health care financing will challenge rehabilitation to prevent disability in a population. This article proposes a model system for comprehensive rehabilitation in managed care: the Community Integration Rehabilitation Model. This system advocates the development of a continuum of services including a strong community-based rehabilitation system, that is, a shift in emphasis to expanding opportunities for independent and productive community living as well as management of disease and impairment for individuals with disabilities, and the forging of partnerships between institution-based rehabilitation and its community. Comprehensive rehabilitation is redefined as a continuum of disability prevention and treatment across the lifespan of a population.

Community Health Services↗

PubMed1998

SGML-based construction and automatic organization of comprehensive medical textbook on the Internet.

The amount of knowledge required in practical medicine is large and ever increasing. Medical staff must select and use appropriate pieces of the knowledge from this flood of medical information. Recent Internet technology may be solving these problems because it makes information open to the public immediately after it is created and enables many people to share it. Medical resources on the Internet are however currently not always well organized, because these are often voluntarily provided by the experts of a particular field. We therefore decided to create a comprehensive medical database on the Internet, which is well organized, and of a high quality for practical medical use. In order to make full use of the benefits provided by electronic media, we created a new structured data set of information. We then commissioned authors to write manuscripts from which we created Standard General Mark-up Language (SGML) documents. We then wrote a translation program that took the SGML and automatically created a fully inter-linked HyperText Mark-up Language (HTML) document. The translation program generated 4,814 HTML files created from 1,373 number of SGML documents. The total data size including pictures was about 640 MB. 205,775 related links were created. We then published our electronic medical textbook described in HTML publicly on the Internet. Using SGML-based structured data, we constructed a complex electronic medical textbook created organically from simple SGML instances. Our electronic medical textbook is systematic and comprehensive, and has a homogeneous structure. We believe that this is the first comprehensive medical textbook available on the Internet. Furthermore, it was found that our approach to the electronic medical textbook has two major advantages. One is automatic generation of inter-links among documents, and another is easy to maintain documents. In addition, once we construct the electronic textbase in SGML format, the data can be utilized to various application programs on different platforms. Making use of this feature, we are now planning to develop a new style of electronic textbook, which is closely integrated with a Hospital Information System (HIS). The plan would provide medical staff with on-demand access to the electronic medical textbook while using HIS terminals.

Hypermedia↗

PubMed1999

Comprehensive education plan for a discrete stroke population: needs, considerations, and gaps.

The patient population which has the most to gain from comprehensive stroke education is the one which has experienced a stroke with minimal deficit and carries an increased risk for experiencing a second more severe stroke. This is the patient population the author selected, yet little published information is available. Given that in Canada stroke carries the third highest rate of mortality and the highest risk of morbidity there is a role for an advanced practice nurse to develop and deliver a comprehensive stroke education program for this population. This is of special significance given the understanding that stroke is considered to be one of the most preventable diseases. The practice environment for this patient population is shifting out of the hospital and into the community. The learning needs and issues as well as the identification of appropriate patient focussed outcomes needs to be examined. A comprehensive plan for the delivery of patient focussed education which includes content, setting, and timing for this target population needs to be developed, piloted and reported on. Nurses have been identified as appropriate for delivering patient education. An advanced practice nurse is poised to address this need and develop a model for others to incorporate in their practice.

Humans↗