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Biomedical subjects

A M Barclay

Publications and source records attributed to A M Barclay.

16 recordsLinked to original sources
PubMed1996

The provision of labor and delivery services by graduates of four Kansas family practice residencies.

The provision of labor and delivery services by family physicians is especially important in largely rural states such as Kansas. The decline in the number of family physicians offering labor and delivery services threatens those who depend on access to primary health care in rural areas. A survey was mailed to all 370 of the University of Kansas School of Medicine-Wichita (UKSM-W) family practice residency graduates. Two hundred sixty-five (72%) graduates responded, of whom 206 are in private practice. Eighty percent of responding graduates practice in communities of less than 100,000, and 72% of those physicians provide labor and delivery services. Although 48 of 206 graduates have ceased delivering babies, 131 still do so, averaging 41 deliveries per year. Sixty-five graduates perform C-sections, averaging 12 per year. CONCLUSIONS. UKSM-W graduates afford rural patients considerable access to care. Income, work hours, and practice satisfaction were similar in all three groups (no delivery, delivery without cesarean section, and cesarean section). Policy makers are justified in expanding educational programs in family practice that emphasize complete care of the pregnant woman.

Cesarean Section↗
PubMed1990

Down syndrome.

Explore the source record for details and available documents.

Adolescent↗
PubMed1990

A randomized study of cancer screening in a family practice setting using a recall model.

A randomized controlled study that evaluated a recall system and patient education material by mail in 178 asymptomatic female family practice patients aged 50 to 69 years showed no effect on the proportion of patients who had cancer screening tests (P = .20) and a significant adverse effect on the mean number of tests performed (P = .05) after 4 months. In a subgroup of previous compliers (those who had one or more tests 12 months before the study), however, there was a lower proportion of patients receiving one or more tests (P = .019) with a lower mean number of tests (P = .007) than previous compliers in the control group. Recall strategies for cancer screening tests need to be more extensively studied in the United States before they are routinely adopted in family practice.

Aged↗
PubMed1988

Falls in the elderly. Is prevention possible?

Many elderly persons who fall have multiple problems, which often present in a nonspecific manner. Identification of the cause of the falls is not always possible but is well worth attempting in view of the often disastrous consequences. Because the home is the most common site of falls, various safety measures are recommended to help compensate for the normal frailties of aging.

Accident Prevention↗
PubMed1988

The recognition of threatening facial stimuli.

Two studies examined the information that defines a threatening facial display. The first study identified those facial characteristics that distinguish between representations of threatening and nonthreatening facial displays. Masks that presented either threatening or nonthreatening facial displays were obtained from a number of non-Western cultures and scored for the presence of those facial features that discriminated between such displays in the drawings of two American samples. Threatening masks contained a significantly higher number of these characteristics across all cultures examined. The second study determined whether the information provided by the facial display might be more primary nonrepresentational visual patterns than facial features with obvious denotative meaning (e.g., diagonal lines rather than downturned eyebrows). The subjective response to sets of diagonal, angular, and curvilinear visual stimuli revealed that the nonrepresentational features of angularity and diagonality in the visual stimulus appeared to have the ability to evoke the subjective responses that convey the meaning of threat.

Aggression↗
PubMed1988

Tic disorders of childhood.

Tic disorders may be classified as simple tics, chronic motor tics or Tourette syndrome, the most severe of the three types. Tourette syndrome is rather uncommon and is often misdiagnosed. Tic disorders of childhood probably have an organic etiology and a genetic component. An increased incidence of obsessive-compulsive behavior, attention deficit disorder and other abnormalities have been reported in Tourette patients. Haloperidol is often useful in controlling severe tic symptoms, while stimulant drugs may worsen the symptoms.

Attention Deficit Disorder with Hyperactivity↗
PubMed1985

Psychotropic drugs in the elderly. Selection of the appropriate agent.

Caution is required when prescribing psychotropic drugs to elderly patients, because of altered pharmacokinetics. Benzodiazepines with a relatively short half-life, such as temazepam (Restoril), alprazolam (Xanax), and lorazepam (Ativan), are better hypnotics for the elderly than those with a long half-life. Lorazepam and clorazepate dipotassium (Tranxene) are appropriate anxiolytics for elderly patients. Antipsychotics have anticholinergic and extrapyramidal symptoms in varying degrees. Thiothixene (Navane) and haloperidol (Haldol) in low doses are the drugs of choice despite their extrapyramidal symptoms. Trazodone (Desyrel) is a good antidepressant for the elderly because of its minimal anticholinergic effects, although it is quite sedating. Desipramine (Norpramin) is the least sedating and has the fewest anticholinergic effects of the tricyclic antidepressants and therefore may be better tolerated. Monoamine oxidase inhibitors and lithium should be used with great caution.

Age Factors↗
PubMed1982

Obstructive epiglottitis in adults.

Acute epiglottitis, considered primarily a disease of infancy and early childhood, is seen rarely in adulthood but may be increasing in incidence. Although it may appear more slowly in adults, it is imperative to establish a rapid diagnosis and promptly assure care for this life-threatening disease. Epiglottitis may cause total obstruction of the upper airway, and it often falls to the primary care physician to discriminate this disease from the many self-limiting infections of the upper airway. The diagnosis should be considered if dysphagia and sore throat are not accompanied by hoarseness. Management of the airway is the first priority, but intravenous antibiotic use is justified.

Acute Disease↗