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Results: 1 to 7 of 7

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Teaching medical students about medically unexplained illnesses: a preliminary study.
Friedberg F, Sohl SJ, Halperin PJ
(2008) Med Teach 30: 618-21
MeSH Terms: Adult, Education, Medical, Family Practice, Fatigue Syndrome, Chronic, Female, Fibromyalgia, Health Knowledge, Attitudes, Practice, Humans, Male, Pilot Projects, Prejudice, Problem-Based Learning, Program Evaluation, Psychiatry, Somatoform Disorders, Students, Medical
Show Abstract · Added March 5, 2014
BACKGROUND - This study examined how an interactive seminar focusing on two medically unexplained illnesses, chronic fatigue syndrome (CFS) and fibromyalgia, influenced medical student attitudes toward CFS, a more strongly stigmatized illness.
METHODS - Forty-five fourth year medical students attended a 90 minute interactive seminar on the management of medically unexplained illnesses that was exemplified with CFS and fibromyalgia. A modified version of the CFS attitudes test was administered immediately before and after the seminar.
RESULTS - Pre-seminar assessment revealed neutral to slightly favorable toward CFS. At the end of the seminar, significantly more favorable attitudes were found toward CFS in general (t (42) = 2.77; P < 0.01) and for specific items that focused on (1) supporting more CFS research funding (t (42) = 4.32; P < 0.001; (2) employers providing flexible hours for people with CFS (t (42) = 3.52, P < 0.01); and (3) viewing CFS as not primarily a psychological disorder (t (42) = 2.87, P < 0.01). Thus, a relatively brief exposure to factual information on specific medically unexplained illnesses was associated with more favorable attitudes toward CFS in fourth year medical students.
CONCLUSION - This type of instruction may lead to potentially more receptive professional attitudes toward providing care to these underserved patients.
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16 MeSH Terms
The cumulative effect of core lifestyle behaviours on the prevalence of hypertension and dyslipidemia.
Villegas R, Kearney PM, Perry IJ
(2008) BMC Public Health 8: 210
MeSH Terms: Alcohol Drinking, Blood Pressure, Cardiovascular Diseases, Cross-Sectional Studies, Diet, Dyslipidemias, Exercise, Family Practice, Female, Health Behavior, Humans, Hypertension, Ireland, Life Style, Male, Middle Aged, Prevalence, Risk Factors, Smoking, Surveys and Questionnaires
Show Abstract · Added December 10, 2013
BACKGROUND - Most cardiovascular disease (CVD) occurs in the presence of traditional risk factors, including hypertension and dyslipidemia, and these in turn are influenced by behavioural factors such as diet and lifestyle. Previous research has identified a group at low risk of CVD based on a cluster of inter-related factors: body mass index (BMI) < 25 Kg/m2, moderate exercise, alcohol intake, non-smoking and a favourable dietary pattern. The objective of this study was to determine whether these factors are associated with a reduced prevalence of hypertension and dyslipidemia in an Irish adult population.
METHODS - The study was a cross-sectional survey of 1018 men and women sampled from 17 general practices. Participants completed health, lifestyle and food frequency questionnaires and provided fasting blood samples for analysis of glucose and insulin. We defined a low risk group based on the following protective factors: BMI <25 kg/m2; waist-hip ratio (WHR) <0.85 for women and <0.90 for men; never smoking status; participants with medium to high levels of physical activity; light alcohol consumption (3.5-7 units of alcohol/week) and a "prudent" diet. Dietary patterns were assessed by cluster analysis.
RESULTS - We found strong significant inverse associations between the number of protective factors and systolic blood pressure, diastolic blood pressure and dyslipidemia. The prevalence odds ratio of hypertension in persons with 1, 2, 3, > or = 4 protective factors relative to those with none, were 1.0, 0.76, 0.68 and 0.34 (trend p < 0.01). The prevalence odds ratio of dyslipidemia in persons with 1, 2, 3, > or = 4 protective factors relative to those with none were 0.83, 0.98, 0.49 and 0.24 (trend p = 0.001).
CONCLUSION - Our findings of a strong inverse association between low risk behaviours and two of the traditional risk factors for CVD highlight the importance of 'the causes of the causes' and the potential for behaviour modification in CVD prevention at a population level.
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20 MeSH Terms
The comprehensiveness of family cancer history assessments in primary care.
Murff HJ, Greevy RA, Syngal S
(2007) Community Genet 10: 174-80
MeSH Terms: Adult, Data Collection, Demography, Documentation, Family Practice, Female, Humans, Interviews as Topic, Male, Mass Screening, Medical History Taking, Medical Records, Neoplasms, Risk Assessment, United States
Show Abstract · Added March 5, 2014
BACKGROUND - Accurate family history information is required for adequate breast and colorectal cancer risk assessments. Few studies have examined the comprehensiveness of the family medical history interview in primary care.
METHODS - We compared family cancer history information collected through a self-completed survey with that documented within medical charts for 310 patients.
RESULTS - Forty-three percent (18/42) of individuals at increased risk for breast or colorectal cancer based on their family history had documentation of this risk within their chart. Age of cancer diagnosis was recorded for 40% (50/124) of affected relatives identified by chart review compared with 81% (203/252) identified through the survey (p < 0.0001).
CONCLUSIONS - Over half of the individuals at increased risk for breast or colorectal cancer based on their family history did not have documentation of this risk within their medical record, and the age of relatives at diagnosis was frequently missing.
Copyright 2007 S. Karger AG, Basel.
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15 MeSH Terms
Mother-to-child HIV transmission prevention in Thailand: physician zidovudine use and willingness to provide care.
Bhatta MP, Stringer JS, Phanuphak P, Vermund SH
(2003) Int J STD AIDS 14: 404-10
MeSH Terms: Adult, Anti-HIV Agents, Attitude of Health Personnel, Drug Utilization, Family Practice, Female, Gynecology, HIV Infections, Health Knowledge, Attitudes, Practice, Humans, Infectious Disease Transmission, Vertical, Logistic Models, Male, Multivariate Analysis, Obstetrics, Physicians, Practice Patterns, Physicians', Pregnancy, Pregnancy Complications, Infectious, Surveys and Questionnaires, Thailand, Zidovudine
Show Abstract · Added March 5, 2014
We conducted a mail survey of Thai physicians involved in obstetric care to assess attitudes and practices regarding zidovudine use during pregnancy and willingness to provide care for HIV-infected women in 1999. Of 845 respondents, 57% reported using perinatal zidovudine prophylaxis, an increase from 20% reported in 1997. Highest failure-to-use rates (52%) were among the respondents from Central and Southern Thailand and lowest failure rate was among those from the North (37%). Predictors of failure to use zidovudine in a multivariable logistic regression analysis were not knowing a source from which to obtain zidovudine (odds ratio [OR]=3.1), working in smaller hospitals (district/provincial/private hospitals) (OR=2.0), being from Eastern/Central/Southern Thailand (OR=1.4), unwillingness to perform caesarean section delivery on a HIV-positive women (OR=1.8), having provided antenatal care to fewer than 100 women in 1998 (OR=1.7), and unfamiliarity with Pediatric AIDS Clinical Trial Group 076 protocol (OR=2.9). A number of respondents described themselves as unwilling to perform pelvic examinations (15%), vaginal delivery (29%), or caesarean sections (37%) on HIV-infected pregnant women. About 39% of the respondents advocated elective terminations of pregnancy for HIV-infected women. Our survey indicates an increasing willingness of Thai physicians to use antiretroviral therapy to prevent mother-to-child HIV transmission and to provide obstetric care to HIV-infected women. However, availability and affordability remained major barriers to more widespread antiretroviral use in 1999.
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22 MeSH Terms
Prenatal HIV counseling, testing, and antiretroviral prophylaxis by obstetric and family medicine providers in Alabama.
Nichols SA, Bhatta MP, Lewis J, Vermund SH
(2002) Am J Med Sci 324: 305-9
MeSH Terms: AIDS Serodiagnosis, Alabama, Anti-HIV Agents, Directive Counseling, Family Practice, Female, HIV, HIV Infections, Humans, Infectious Disease Transmission, Vertical, Patient Acceptance of Health Care, Patient Education as Topic, Perinatal Care, Practice Patterns, Physicians', Pregnancy, Pregnancy Complications, Infectious, Prenatal Care, Preventive Health Services, United States, Zidovudine
Show Abstract · Added March 5, 2014
BACKGROUND - The study reported here assessed the implementation of recommendations for routine universal prenatal counseling and voluntary HIV testing among Alabama physicians who provide prenatal care and determined factors associated with noncompliance.
METHODS - Voluntary, confidential mailed survey of obstetrics and family medicine practitioners.
RESULTS - Of the 138 physicians who responded to a mailed survey in Alabama, 17 (12.3%) indicated that they did not offer universal HIV counseling and testing to pregnant women. Factors associated with failure to offer universal HIV counseling and testing included having more than 50% of patients refuse HIV counseling and testing when offered and never knowingly having given prenatal/perinatal care to women with HIV. Low/medium familiarity with the US Public Health Service recommendations for perinatal zidovudine use to reduce HIV transmission and physician specialty are also suggested as predictors of not offering universal testing.
CONCLUSIONS - Despite the well-established benefits of antiretroviral prophylaxis to prevent vertical transmission of HIV, some physicians in Alabama have been slow to adopt universal testing of their pregnant patients for HIV in the prenatal period. Practitioner education is as important as patient education in eliminating pediatric HIV in the Deep South.
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20 MeSH Terms
Educational programs to enhance medical expertise in tropical diseases: the Gorgas Course experience 1996-2001.
Freedman DO, Gotuzzo E, Seas C, Legua P, Plier DA, Vermund SH, Casebeer LL
(2002) Am J Trop Med Hyg 66: 526-32
MeSH Terms: Adult, Curriculum, Demography, Education, Medical, Education, Medical, Continuing, Family Practice, Humans, Middle Aged, Pediatrics, Peru, Philosophy, Medical, Specialization, Tropical Medicine
Show Abstract · Added March 5, 2014
In 1995, the American Society of Tropical Medicine and Hygiene (ASTMH) adopted defined criteria for accreditation of clinical training programs in tropical diseases. The first data on the development, enrollment, and outcomes of such a program are presented. A nine-week Diploma course, the Gorgas Course in Clinical Tropical Medicine, given on-site in the tropics (Lima, Cusco, and Iquitos, Peru) has trained 157 individuals from 38 countries from 1996 through 2001. The average age of participants was 38.3 with 11.3 years since graduation. Graduates were 44.5% primary care physicians, 22.2% infectious diseases specialists, 12.7% emergency medicine specialists, 13.5% other specialists, and 7.1% nurses. Residents and fellows accounted for 32.8% and full-time academic faculty for 11.0%. Approximately half of all eligible Gorgas graduates have taken the ASTMH certification examination. In response to the enrollees' profiles and needs, adult learning theory has been extensively used in course design. Stable professional relationships between multiple educational partners are required for an endeavor of this scope.
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13 MeSH Terms
Introducing handheld computing into a residency program: preliminary results from qualitative and quantitative inquiry.
Manning B, Gadd CS
(2001) Proc AMIA Symp : 428-32
MeSH Terms: Attitude of Health Personnel, Attitude to Computers, Data Collection, Family Practice, Hospital Information Systems, Hospitals, Community, Humans, Information Services, Internship and Residency, Microcomputers, Pennsylvania
Show Abstract · Added January 20, 2015
Although published reports describe specific handheld computer applications in medical training, we know very little yet about how, and how well, handheld computing fits into the spectrum of information resources available for patient care and physician training. This paper reports preliminary quantitative and qualitative results from an evaluation study designed to track changes in computer usage patterns and computer-related attitudes before and after introduction of handheld computing. Pre-implementation differences between residents and faculty s usage patterns are interpreted in terms of a "work role" construct. We hypothesize that over time residents and faculty will adopt, adapt, or abandon handheld computing according to how, and how well, this technology supports their successful completion of work role-related tasks. This hypothesis will be tested in the second phase of this pre- and post-implementation study.
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11 MeSH Terms