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This study examined physician‐patient communication as it relates to expectations that patients and physicians hold for themselves and each other. Dimensions of mutual role expectation were determined to be physician as humanistic practitioner, physician authority, patient in the sick role, and patient as consumer. The study tested five hypotheses. Results showed patients had significantly higher expectations for patients in the sick role than had physicians. Other role expectations varied significantly by age within physician and patient groups. The implications of these differences for physician‐patient communication are discussed. 相似文献
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Maximal-intensity isometric and dynamic exercise performance after eccentric muscle actions 总被引:3,自引:2,他引:1
A well-documented observation after eccentric exercise is a reduction in maximal voluntary force. However, little is known about the ability to maintain maximal isometric force or generate and maintain dynamic peak power. These aspects of muscle function were studied in seven participants (5 males, 2 females). Knee extensor isometric strength and rate of fatigue were assessed by a sustained 60 s maximal voluntary contraction at 80 degrees and 40 degrees knee flexion, corresponding to an optimal and a shortened muscle length, respectively. Dynamic peak power and rate of fatigue were assessed during a 30 s Wingate cycle test. Plasma creatine kinase was measured from a fingertip blood sample. These variables were measured before, 1 h after and 1, 2, 3 and 7 days after 100 repetitions of the eccentric phase of the barbell squat exercise (10 sets x 10 reps at 80% concentric one-repetition maximum). Eccentric exercise resulted in elevations in creatine kinase activity above baseline (274+/-109 U x l(-1); mean +/- s(x)) after 1 h (506+/-116 U x l(-1), P < 0.05) and 1 day (808+/-117 U x l(-1), P < 0.05). Isometric strength was reduced (P < 0.05) for 7 days (35% at 1 h, 5% at day 7) and the rate of fatigue was lower (P < 0.05) for 3 days at 80 degrees and for 1 day at 40 degrees. Wingate peak power was reduced to a lesser extent (P < 0.05) than isometric strength at 1 h (13%) and, although the time course of recovery was equal, the two variables differed in their pattern of recovery. Eccentrically exercised muscle was characterized by an inability to generate high force and power, but an improved ability to maintain force and power. Such functional outcomes are consistent with the proposition that type II fibres are selectively recruited or damaged during eccentric exercise. 相似文献
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The past decade has witnessed increased interest in the visual search behaviour of athletes. Little is known, however, about the relationship between anxiety and eye movements in sport performers or about the extent to which athletes' planned and actual visual search strategies correspond. To address these issues, we conducted two studies. In Study 1, eight expert female gymnasts were presented with three digital slides of a model performing a skill that is known to be anxiety-provoking in this sport--namely, the 'back flip' on the beam. By varying the height of the beam and the presence or absence of safety mats, the slides differed in the amount of anxiety that they elicited vicariously in the viewer. In the study, the gymnasts were asked to imagine themselves in the position of the depicted model and to describe the anxiety that they felt. As they viewed the slides, their eye movements were recorded. As predicted, anxiety was associated with an increase in the number of fixations to peripheral areas. In addition, the more 'threatening' slides elicited significantly more fixations than the less feared images. In Study 2, the plans of 15 equestrian performers (5 expert, 5 intermediate and 5 novice) were elicited as they engaged in a virtual 'walk' around a computerized show-jumping course. Contrary to expectations, the congruence between intended and actual search behaviour was not significantly greater for expert riders than for the less skilled groups. Also, the fact that the top riders allocated more fixations to slides than the less skilled performers challenged the prediction that expertise would be associated with economy of visual search. Finally, as expected, the expert riders were significantly less dependent on the overall 'course plan' than the intermediate and novice equestrian performers when inspecting the fences. 相似文献
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In this article, Anthony Feiler, senior lecturer in the Graduate School of Education at the University of Bristol, and Elaine Logan, lecturer in early years education at the City of Bristol College, present a case study of a child who made strong progress with literacy during his first year at school. The child and his family participated in the Literacy Early Action Project (LEAP), a home-visiting scheme for children judged by school staff to be at risk of struggling with literacy. A teaching assistant made weekly home visits during the year and developed literacy support activities with the child's mother and grandparents. Five key factors underpinning the child's progress are identified here: the flexibility in the teaching assistant's approach that enabled extended family members to become engaged in literacy support; the teaching assistant's sensitivity to family culture; the playful approach to learning adopted by the teaching assistant; putting the child at the centre of the intervention; and the existence of a school culture that strongly promoted involvement for parents. Anthony Feiler and Elaine Logan conclude that teaching assistants in the UK might be given more scope to develop support strategies for early childhood education that involve collaborative work with parents. 相似文献