Objectives: 1. Determine the aerobic fitness level of women with fibromyalgia; 2. Ascertain current exercise patterns; 3. Evaluate perceived exertion. Methods: Ninety-five women were tested utilizing ...modified Balke treadmill protocol and Gould metabolic chart. Ratings of perceived exertion RPE were measured Bord, 1982 and weekly Training Index TI calculated Hagberg, 1986. Results: 1.78 83% were not engaging in regular exercise; 2.61 65% were below average aerobic fitness; 3.48 51% perceived themselves to be working at the expected intensity; 4.28 29% were unable to reach anaerobic threshold but perceived themselves to be working at a higher than expected intensity. Conclusions: 1. Most fibromyalgia patients are unfit and not engaging in regular exercise; 2. RPE is an appropriate method for monitoring intensity for only 50% of the patients tested.
Autism involves not only developmental delays but also aberrant behavior, both of which change in nature over time. Rating instruments may be useful to assess maladaptive and adaptive behaviors of ...autistic children in a standardized way and, perhaps, to measure change due to treatment. With the expansion of basic science, knowledge, and technology, there is increasing evidence that autism is etiologically heterogeneous. Currently, there is no biological marker specific to autism, although hyperserotonemia is a consistent finding in one third of autistic children. An aim of basic science research has been to develop a rational pharmacotherapy based upon the underlying neurochemistry. However, at the present time, this approach has not always been successful. It is expected that the development and use of more restrictive criteria, delineation of subtypes of autism, and interaction of descriptive, behavioral, clinical, and basic research will lead to more effective planning for treatment. The relationship of assessment to treatment response is presented and discussed.
Objective.—
To determine how pediatric residents' perceptions of continuity clinic experiences vary by level of training, after controlling for the effect of continuity setting.
Method.—
...Cross-sectional survey of pediatric and combined pediatric trainees in US residency programs.
Results.—
Survey responses were received from 1355 residents in 36 training programs. Residents' continuity experiences were in hospital-based and community settings. Numbers of patients seen increased between PGY-1 and PGY-3 years, but not in the PGY-4 and PGY-5 years. Compared to PGY-1 residents, PGY-2 and PGY-3 residents were more likely to report more encounters with established patients, but were not more likely to feel like the primary care provider. There were no significant differences by training level in terms of involvement in panel patients' laboratory results, hospitalizations, or telephone calls, although nursery involvement decreased with increasing training level. Autonomy was directly related to training level. The perception of having the appropriate amount of exposure to practice management issues was low for all respondents.
Conclusions.—
Residents perceived that they had greater autonomy and continuity with patients as they become more senior, yet they were not more likely to feel like the primary care provider. Lack of increased involvement in key patient care and office responsibilities across training years may reflect a need for changes in resident education. These data may be helpful in formulating recommendations to program directors with regard to determining which Accreditation Council for Graduate Medical Education competencies should be emphasized and evaluated in the continuity experience.
Full text
Available for:
GEOZS, IJS, IMTLJ, KILJ, KISLJ, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK
Objective.—
To identify factors associated with resident satisfaction concerning residents' continuity experience.
Design and Methods.—
Continuity directors distributed questionnaires to residents at ...their respective institutions. Resident satisfaction was defined as satisfied or very satisfied on a Likert scale. The independent variables included 60 characteristics of the continuity experience from 7 domains: 1) patient attributes, 2) continuity and longitudinal issues, 3) responsibility as primary care provider, 4) preceptor characteristics, 5) educational opportunities, 6) exposure to practice management, and 7) interaction with other clinic and practice staff. A stepwise logistic regression model and the Generalized Estimating Equations approach were used.
Results.—
Thirty-six programs participated. Of 1155 residents (71%) who provided complete data, 67% (n = 775) stated satisfaction with their continuity experience. The following characteristics (adjusted odds ratio OR and 95% confidence interval CI) were found to be most significant: preceptor as good role model, OR = 7.28 (CI = 4.2, 12.5); appropriate amount of teaching, OR = 3.25 (CI = 2.1, 5.1); involvement during hospitalization, OR = 2.61 (CI = 1.3, 5.2); exposure to practice management, OR = 2.39 (CI = 1.5, 3.8); good balance of general pediatric patients, OR = 2.34 (CI = 1.5, 3.6); resident as patient advocate, OR = 1.74 (CI = 1.2, 2.4); and appropriate amount of nursing support, OR = 1.65 (CI = 1.1, 2.6). Future career choice, type of continuity site, and level of training were not found to be statistically significant.
Conclusions.—
Pediatric resident satisfaction was significantly associated with 7 variables, the most important of which were the ability of the preceptor to serve as a role model and teacher. The type of continuity site was not significant. Residency programs may use these data to develop interventions to enhance resident satisfaction, which may lead to enhanced work performance and patient satisfaction.
Full text
Available for:
GEOZS, IJS, IMTLJ, KILJ, KISLJ, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK
498.
Assessing depression in fibromyalgia patients Burckhardt, Carol S.; O'Reilly, Connie A.; Wiens, Arthur N. ...
Arthritis and rheumatism,
March 1994, Volume:
7, Issue:
1
Journal Article
Purpose. This study investigated the relationships among four methods of detecting depression in patients with fibromyalgia.
Methods. Data were obtained from 100 women (mean age 43 years) who had ...been diagnosed with fibro‐myalgia. Instruments included a computerized Diagnostic Interview Schedule (C‐DIS), Beck Depression Inventory (BDI), an adjusted “disease‐free” BDI (BDI‐A), and Minnesota Multiphasic Personality Inventory depression subscale (MMPI‐D). Chance‐corrected concordance, sensitivity, specificity, and accuracy among the four methods were calculated.
Results. The C‐DIS detected 22% and BDI‐A 29% with current major depression. The BDI and MMPI‐D yielded higher estimates of 55% of the 44%, respectively. Agreement on the diagnosis among the four methods was significantly greater than chance. When compared with the C‐DIS, the BDI was the most sensitive instrument and the BDI‐A most specific.
Conclusions. The C‐DIS and BDI‐A appear to be more reliable methods for determining the presence of major depression in women with fibromyalgia than are the MMPI‐D or standard BDI.
Full text
Available for:
BFBNIB, FZAB, GIS, IJS, KILJ, NUK, OILJ, SBCE, SBMB, UL, UM, UPUK
Chronic inflammation and dietary fat consumption correlates with an increase in prostate cancer. Our previous studies in the colon have demonstrated that -tocopherol treatment could upregulate the ...expression of peroxisome proliferator-activated preceptors (PPAR) , a nuclear receptor involved in fatty acid metabolism as well modulation of cell proliferation and differentiation. In this study, we explored the possibility that -tocopherol could induce growth arrest in PC-3 prostate cancer cells through the regulation of fatty acid metabolism. Growth arrest (40%) and PPAR mRNA and protein upregulation was achieved with -tocopherol within 6 h. -Tocopherol-mediated growth arrest was demonstrated to be PPAR dependent using the agonist GW9662 and a PPAR dominant negative vector. -tocopherol was shown not to be a direct PPAR ligand, but rather 15-S-HETE (an endogenous PPAR ligand) was upregulated by -tocopherol treatment. 15-Lipoxygenase-2, a tumor suppressor and the enzyme that converts arachidonic acid to 15-S-HETE, was upregulated at 3 h following -tocopherol treatment. Expression of proteins downstream of the PPAR pathway were examined. Cyclin D1, cyclin D3, bcl-2, and NF B proteins were found to be downregulated following -tocopherol treatment. These data demonstrate that the growth arrest mediated by -tocopherol follows a PPAR - dependent mechanism.
The Ras(17N) dominant negative antagonizes endogenous Ras function by forming stable, inactive complexes with Ras guanine nucleotide exchange factors (GEFs; e.g., SOS1). We have used the ...growth-inhibitory phenotype of Ras(17N) to characterize two aspects of Ras interaction with GEFs. First, we used a nonprenylated version of Ras(17N), designated Ras(17N/186S), which no longer associates with the plasma membrane and lacks the growth-inhibitory phenotype, to address the importance of Ras subcellular location and posttranslational modification for its interaction with GEFs. We observed that addition of an N-terminal myristylation signal to Ras(17N/186S) restored the growth-inhibitory activity of nonprenylated Ras(17N). Thus, membrane association, rather than prenylation, is critical for Ras interaction with Ras GEFs. Second, we used a biological selection approach to identify Ras residues which are critical for Ras(17N) growth inhibition and hence for interaction with Ras GEFs. We identified mutations at residues 75, 76, and 78 that abolished the growth-inhibitory activity of Ras(17N). Since GEF interaction is dispensable for oncogenic but not normal Ras function, our demonstration that single-amino-acid substitutions at these three positions impaired the transforming activity of normal but not oncogenic Ras provides further support for the role of these residues in Ras-GEF interactions. Finally, Ras(WT) proteins with mutations at these residues were no longer activated by mammalian SOS1. Altogether, these results suggest that the Ras intracellular location and Ras residues 75 to 78 are critical for Ras-GEF interaction.
PDF
