Assortment Of Instruments Research Articles

Education and Medical Practice in Ancient Greece, the Alexandrian Period and the Western Roman Empire: Advantages and Disadvantages from a Contemporary Perspective

During pre-Hippocratic times, medical education and practice in Greece were influenced by supernatural and religious beliefs. With Hippocrates of Cos, the doctor ceased to be a religious healer to become a naturalist, since he studied disease for the first time as an objective natural phenomenon. Medical schools were founded with a model of education of disciples, with great ethical content, without study plans or formal title. They prioritized observation over theory. Aristotle influenced medicine for more than 2,000 years. Even though he was not a physician, his contributions to medicine were substantial. He was considered the founder of comparative anatomy, created the Lyceum of Athens and emphasized the importance of one's own observation and experience to be a good doctor and not just a philosopher. Later, the leading role in medical education passed into the hands of the School of Alexandria, where the first chair of anatomy in history originated. In the cities of Cos, Cnido, and Alexandria medicine was taught with an educational model that persisted until the first part of the Middle Ages, based on: freedom (teacher and student defined their own goals), disciple learning (started from observation: “see how I do it so you can do it later”): teaching-learning process based on the experience over the texts; strong ethical content (do good and do no harm). During the Roman Empire, the Greek knowledge was preserved and strengthened by the hand of Claudius Galenus and progress was made in the construction of the first hospitals, an assortment of instruments and medical specialization. Both periods, Greek and Roman, were independent of religious influences; a situation that propitiated an exercise and a rational medical education. However, with few exceptions, there was no place for women.

Computer Adaptive Testing for Patient-Reported Outcomes: Resources for Clinical Research

Background and Purpose. The physical therapy profession actively continues to develop systems of standardized outcomes to provide evidence of treatment efficacy and to improve rehabilitation practices. The emergence of patient-reported outcomes (PROs) of perceived health outcomes and health-related quality of life has gained increased importance in clinical research and practice. The objective of this report is to provide an introduction to the development of PROs using item response theory and computer adaptive testing, and to provide an overview of the National Institutes of Health's Patient-Reported Outcome Measurement Information System (PROMIS). PROs are increasingly relying on computer adaptive testing (CAT), a promising technology that helps resolve the classic conflict between practicality and precision faced by traditional outcome measures. CATs require a set of items developed using Item Response Theory in combination with CAT software. Method/Model Description and Evaluation. Item Response Theory (IRT) methods for instrument development in combination with computer adaptive testing approaches for administration are advancing PROs in health care. Outcomes. PROMIS is a system of PROs based on IRT/CAT that are available to clinical researchers for adoption. Discussion. CATs can be integrated seamlessly with electronic data capture systems and electronic health records to provide a means to implement standardized systems of PROs across multiple sites. Conclusion. Health care research and practice systems are using these emerging technologies for developing and administering standardized health outcomes, and physical therapists' professional education should begin to include the necessary knowledge to enable them to become competent users and developers of PROs using CATs. Key Words: Computer adaptive test, Patient-reported outcomes, Standardized assessment. BACKGROUND AND PURPOSE The physical therapy profession has a critical need for standardization of measures as it continues to build evidence to support practice. Standardization of health and rehabilitation outcomes in this profession is an active focus of efforts by the American Physical Therapy Association (APTA). From a clinical service perspective, processes to monitor interventions for individual patients have become seriously fragmented as different hospitals, clinics, and programs select outcome instruments that cannot easily be compared across systems. Using an assortment of instruments also complicates credentialing and training for a large clinical staff. In many instances, clinicians simply lack the time for administration of the best instrument due to time constraints or length of the instrument. Enhanced monitoring supported by standardized outcomes should result in better program decisions and improved service delivery for patients and help in the identification of evidence-based clinical pathways. From a clinical research perspective, a uniform approach to health outcomes measurement could enhance the comparability of measures across clinical research sites and projects and improve the generalizability of study results.1 Although efforts are under way to develop clinically meaningful outcomes with low administration burden, few instruments or batteries of instruments have been accepted or adopted by the physical therapy profession for clinical practice or research. Evaluations of the effectiveness of medical care have conventionally focused on clinical end-points, including laboratory tests, imaging, and clinical exams measuring changes at the body structure and function level. However, many outcomes associated with the use of medical and surgical devices, medications, or interventions are known only to the patient. Patient reported outcomes (PROs) enhance clinicians' understanding of the impact of illness, health, and interventions from the patient's perspective. For example, symptoms (eg, pain, fatigue), activity behaviors and participation, perceived health, and health-related quality of life are all experienced by the individual, and these patient perceptions are often determined using PROs. …

A Day in the Life of a Central Processing Technician

A Day in the Life of a Central Processing Technician

Compositional Parameters: "Projection 4" and an Analytical Methodology for Morton Feldman's Graphic Works

Compositional Parameters: Projection 4 and an Analytical Methodology for Morton Feldman's Graphic Works 1 Ryan Vigil The revolutionary moment in Morton Feldman's development can be traced to the composition of Projection i, for solo cello, in 1950. Written in a graphic styleof notation, Projection I is specificwith regard to timbre, and rhythm, but general with regard to pitch. The piece carries no dynamic indications, leaving this element of themusic entirely undetermined. As can be seen in Example 1,which reproduces the first page of Projection i, Feldman's notation of pitch reduces the options to three categories: high, middle, and low.Within these ranges, the limits of which "may be freely chosen by the player," any tone may be sounded.1 The significance of this approach in the context of the compositional picture in 1950 can hardly be overstated. At a timewhen 234 PerspectivesofNew Music many composers chose to exert more and more control, devising methods of composition whereby every aspect of the work was thoroughly under their command?or, at least, largely determined by an overarching compositional system?Feldman employed a procedure wherein he had lessdirect control over themusic. Composed between 1950 and 1951, the Projection series represents Feldman's firsteffortswithin this new compositional orientation. Later graph pieces include the Intersection series (1951-53), Altantis (1959) for orchestra, The Straits of Magellan (1961) for flute, horn, trumpet, harp, electric guitar, piano, and double bass, and The King of Denmark (1964) for solo percussion. Throughout this period Feldman continued to write pieces with a traditional approach to notation; yet, while he later expressed misgivings about certain aspects of the graphic approach, the fact that he continued towrite graph pieces for nearly fifteenyears after his firstexperiments with the idiom indicates that he continued to see the graph as a viable and significant compositional tool.2 In addition to Projection i, the Projection series includes Projection 2 (January 3, 1951), for flute, trumpet, piano, violin, and cello; Projection 3 (January 5, 1951), for two pianos; Projection 4 (January 16, 1951), for violin and piano; and Projection 5 (dated simply 1951), for three flutes, trumpet, two pianos, and three cellos. The predilection for piano and cello is clear?the former appears in all but the firstpiece, and the latter is featured in three out of the five. Projection 2 and Projection 5 are scored for the largest ensembles (made up of five and nine players, respectively); Projection 3 and Projection 4 are duets. Each piece in the series presents a unique instrumentation. Not only do all fivepieces use a different assortment of instruments, but each one embodies a different "type" of ensemble: Projection 1 is the only solo piece in the set; Projection 2 is scored for amedium-sized ensemble where no instrument is present more than once; Projection 3 is a duet for two identical instruments; Projection 4 is a duet for two different instruments; Projection 5 is for the largest ensemble and includes multiple parts for flute,piano, and cello (including three parts for both flute and cello). It appears as ifFeldman is testing the graphic approach to see if it can accommodate these very different combinations. But it is clear that the goal isnot sheer variety?in fact, the number of different instruments he uses is rather small.While the various combinations do seem to ensure that the series, taken as a whole, inhabits a range of different timbral regions and various types of musical space (from solo instrument to nine-piece chamber ensemble), Feldman seems concerned that the music not get too far away from itself. In this sense, the only piece whose instrumentation cannot be explicitly linked to all of the others is Projection i, since it is the only solo piece, and itdoes not include piano. PHOJtCJtONl n o3 pT~d p~1 !M ! I r?-i r~B I i_"_q _s L_i... xu p-CLJ a !j| *L_i b_I L_a.ia. s EXAMPLE 1: PROJECTION i, PAGE 1 uj 236 PerspectivesofNew Music In general, the notational approach remains consistent throughout the series. Each instrument reads a line ofmusic that proceeds from left to right through a series of equal-sized rectangles; each rectangle...

Oertli Expands the Assortment of Instruments for Micro Surgery

Oertli Expands the Assortment of Instruments for Micro Surgery

Ruth B. Simon

Following the 1999 death of physician John L. Simon, a paid obituary in the New York Times described his professional accomplishments. It neglected to mention, however, that he may have unwittingly provided the impetus for his first wife, Ruth B. Simon, to launch a trail-blazing career as a researcher in seismology.⇓ Ruth B. Simon, circa 1978. Ruth took her first job in seismology at Lamont Geological Observatory (known today as Lamont-Doherty Earth Observatory) in the late 1950s—out of necessity, former colleagues recall, after she was divorced from John and left supporting two children. Simon joined the Seismological Society of America in 1957 and remained a member until 2003. Simon's job at Lamont involved reading the large volume of seismographic records that were collected on a daily basis from a diverse assortment of instruments, including Wood-Anderson, Benioff long- and short-period, and Press-Ewing seismometers. She also prepared the monthly seismic bulletin under the supervision of Frank Press. Simon came to the job with expertise in the interpretation of a different sort of wiggly line: she had experience interpreting electrocardiograms. Working from her desk in Lamont Hall, she read the records and made calculations to determine distance …

Excision of Flap Tears

SUMMARY The arthroscopic excision of flap tears of the meniscus requires an understanding of the development and structure of these tears, a knowledge of the various portals and approaches needed to gain access to them, and a good assortment of instruments.

MILDEW ON THE LITTLE BLACK BAG

Tradition has associated the physician with a little black bag. His mode of dress, his walk, his horse and buggy, or his automobile does not always notify the neighbors that the doctor is making a house call, but a man carrying a little black bag is the universal signal that here comes, or there goes, the doctor. The bag may be delapidated, stamped with the marks of age, and overworked, but it is equally stamped with the symbol of medicine. No one, not the patient or even the physician, knows exactly what the bag contains. It seems almost a trick of magic, the number and assortment of instruments, medicines, and needles that the doctor can extract one by one, from the bag's interior. The physician and his black bag are a team. Friends, inseparable. A house call without the bag is a disappointment to the patient, the family, and the