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Biomedical subjects

A Bennett

Publications and source records attributed to A Bennett.

318 records · Page 18Linked to original sources
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Obese women's perceptions of their physicians' weight management attitudes and practices.

BACKGROUND: Obesity has reached epidemic proportions in the United States. Primary care physicians will see increasing numbers of patients with long-term weight management problems. OBJECTIVE: To examine obese women's perceptions of their physicians' weight management attitudes and practices. DESIGN AND SETTING: Women who participated in obesity trials at a university clinic completed a questionnaire that assessed their views of weight control provided by their primary care physician. PARTICIPANTS: The patients were 259 women whose age was 44.0 +/- 10.0 years; weight, 96.7 +/- 13.2 kg; and body mass index (calculated as weight in kilograms divided by the square of height in meters), 35.2 +/- 4.5 (all data given as mean +/- SD). MAIN OUTCOME MEASURES: Using 7-point scales (1 indicates low; and 7, high), patients rated their satisfaction with care provided for their general health and that for their obesity. They also identified methods their physician recommended for weight management and the frequency of negative interactions with their physician concerning weight control. RESULTS: Participants were generally satisfied with the care they received for their general health and with their physicians' medical expertise (mean scores, 6. 1 and 6.2, respectively). They were significantly (P<.001) less satisfied with care for their obesity and with their physicians' expertise in this area (mean scores, 4.1 and 4.3, respectively). Almost 50% reported that their physician had not recommended any of 10 common weight loss methods, and 75% indicated they looked to their physician a "slight amount" or "not at all" for help with weight control. Only a small minority of patients (0.4%-8.0%) reported frequent, negative interactions with physicians concerning their weight. CONCLUSIONS: The last finding helps allay concerns that obese patients are routinely treated disrespectfully by physicians when discussing weight. The challenge, however, for primary care physicians appears to be providing patients better assistance with weight management.

Adult↗
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Inspector nurse.

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Accreditation↗
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Improving clinic efficiency of a family medicine teaching clinic.

BACKGROUND: Teaching clinics are the heart of training programs in family practice. It is in these training clinics where residents develop their ambulatory practice habits. Yet, little is known about the efficiency of these teaching clinics. METHODS: We conducted a time-and-motion study of patient flow in a residency teaching clinic. RESULTS: During each half-day session, 7.8 +/- 1.9 providers were scheduled in clinic, and 55.5 +/- 12.9 patients were seen. First-year residents saw 3.55 patients per half-day session, second-year residents saw 4.75 patients, third-year residents saw 8.0 patients, faculty saw 8.22 patients, and urgent care saw 8.35 patients. The number of patients scheduled was highly correlated with the number of providers in clinic. Of the patients scheduled, 25% failed to keep their appointment, and 31% arrived late. Neither rates of no-show patients nor rates of late patients varied by level of provider. The mean time patients spend in the clinic was 80.5 +/- 30 minutes, with 17 +/- 10 minutes spent registering, 18 +/- 17 minutes spent being roomed, and 19 +/- 16 minutes spent waiting for the provider. The physician spent 27 +/- 16 minutes with the patient, including both face-to-face time and precepting time. Patients who arrived on time waited significantly longer than those who arrived late. Waiting time did not vary significantly by level of physician. The time patients spent with their doctor did vary significantly by level of physician; first-year residents spent more time with their patients than upper-level residents or faculty. CONCLUSIONS: Significant variation exists in the patient flow through the clinic. Patient volumes are significantly correlated to the number of providers in clinic. Long waiting times are due in part to long processing times and in part to long waits in the exam room. Concerted multidimensional efforts are needed to smooth out patient flow and improve clinic efficiency.

Appointments and Schedules↗
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Prediction of phototoxic potential using human A431 cells and mouse 3T3 cells.

An assay using established cell lines, human A431 epidermal cells and mouse 3T3 fibroblasts, has been developed to predict the phototoxic potential of compounds. The test determines the viability of the two cell lines in response to UV light in both the presence and absence of the test compound. The end point for cytotoxicity is determined from the mitochondrial dehydrogenase conversion of a tetrazolium salt (MTT) to a colored formazan product. The cytotoxicity of the test compound is established prior to UV exposure, and the highest no-effect concentration observed is then applied to cells that are subsequently exposed to different periods of UVA and UVA plus UVB light. A phototoxic effect is considered to have occurred when a biologically significant enhancement of toxicity is shown for the UV light with the compound present when compared to that of UV light alone. The test system has been validated with 30 compounds classified as strong, idiosyncratic, and negative based on the frequency of reported adverse reactions in humans. The in vitro phototoxicity assay was able to highlight the potential for phototoxicity in the strong category of phototoxic compounds and several of the idiosyncratic compounds. Only one of the negative compounds produced any activity in the assay in terms of enhancing UV toxicity. Some of the compounds were shown to protect the cells from the toxic effects of UV exposure.

Animals↗
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Guidelines for health education in maternal and child health.

Guidelines are presented for specifying objectives, identifying resources, selecting methods and evaluating the health education component for maternal and child health programmes. Examples of the application of the principles are integrated with the Guidelines. Diagnostic, planning, organizational, administrative and evaluative procedures are presented around a model of health education which emphasizes: a) the careful delineation of the health problem; b) the specification of behaviours influencing the health problem; c) setting priorities among target behaviours on the basis of their relative epidemiological importance and their changeability; and d) the identification of factors that predispose, enable and reinforce the behaviour.

Child↗
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Sexual networking in provincial Thailand.

Thailand is currently experiencing a major HIV epidemic, spread primarily through heterosexual contact. Patronage of prostitutes is relatively common. In-depth, open-ended interviews were conducted in a Central Thai province with a purposive sample of 181 urban men who had had sexual relations with at least two different women during the prior year. Additional qualitative information is provided by interviews with 50 women. The most common network pattern for men was a combination of commercial and noncommercial sexual relationships. Men reported that they commonly used condoms when they engaged in sex with prostitutes, but condom use was lowest for men who were the most frequent patrons. In noncommercial, nonmarital relationships, men screen partners for risk rather than practice safe sex, and condom use is generally low. Persons involved in noncommercial sexual networks are largely unaware that their partner may link them to a larger network of sexual contacts and associated risks of HIV infection. Men who have both commercial and noncommercial sexual partners can be found throughout the social strata. A program that focuses only on the closed commercial sex network will address only partially the real risk situations.

Condoms↗
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Informed care.

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Adult↗