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Biomedical subjects

A P Jonas

Publications and source records attributed to A P Jonas.

6 recordsLinked to original sources
PubMed2000

Managing pain in the dying patient.

End-of-life care can be a challenge requiring the full range of a family physician's skills. Significant pain is common but is often undertreated despite available medications and technology. Starting with an appropriate assessment and following recommended guidelines on the use of analgesics, family physicians can achieve successful pain relief in nearly 90 percent of dying patients. Physicians must overcome their own fears about using narcotics and allay similar fears in patients, families and communities. Drugs such as corticosteroids, antidepressants and anticonvulsants can also help to alleviate pain. Anticonvulsants can be especially useful in relieving neuropathic pain. Side effects of pain medications should be anticipated and treated promptly, but good pain control should be maintained. The physical, psychologic, social and spiritual needs of dying patients are best managed with a team approach. Home visits can provide comfort and facilitate the doctor-patient relationship at the end of life.

Analgesia↗
PubMed1992

Substance abuse.

The three types of drugs commonly used in sports--therapeutic drugs, performance-enhancing drugs, and recreational drugs--have been discussed and presented in a way that should be helpful to health care providers dealing with athletes. The goal of this article has been not only to present information concerning drugs but also to raise the awareness level so that abuse of all types of drugs will be considered by athletic trainers, physicians, and health care providers when they deal with athletes. The role of the physician in the area of drug abuse is no different than the physician's role in dealing with any health problem, diagnosis, and management. The responsibility of the physician who deals with athletes always has been, is, and always will be the health and safety of the athlete.

Adrenal Cortex Hormones↗
PubMed1985

Occupational stress, personal strain, and coping among residents and faculty members.

Differences in ratings by 155 individuals at four levels of medical experience (faculty members and first-, second-, and third-year residents) on measures of occupational stress, personal strain, and availability of coping resources were examined. Multivariate and univariate analyses of data indicated significant differences in the measures among the experience levels. Measures of the availability of coping resources reflected the major source of differences, with the first-year residents reporting significantly fewer overall coping resources than faculty members. No significant differences were detected among the four groups on overall measures of occupational stress and personal strain. There were differences between first-year residents and faculty members on the subscales measuring physical environment stress, physical strain, recreation, and self-care. The findings suggest that residency education interferes with first-year residents' abilities to cope and places their physical well-being at risk. The findings support the need for residents to employ coping strategies during the residency years and provide empirical guidance regarding the kind of coping strategies needed.

Adaptation, Psychological↗
PubMedDate not supplied

Transmission of Strongyloides steracolis person to person.

A case of presumed person-to-person transmission of Strongyloides steracolis is described. The index case was immunocompromised following high dose glucocorticosteroid therapy for myelodysplasia, which resulted in reactivation of latent strongyloides infection with the hyperinfestation syndrome. Physicians unfamiliar with this disease should realize that a history of foreign travel is unnecessary to acquire this parasite, and that transmission to persons in close proximity to the index case does occur and warrants treatment.

Aged↗
PubMedDate not supplied

Influence of income, hours worked, and loan repayment on medical students' decision to pursue a primary care career.

OBJECTIVE: To assess the specialty plans of current fourth-year medical students and, for those not choosing primary care specialties, to investigate the potential effect that changes in key economic or lifestyle factors could have in attracting such students to primary care. DESIGN AND PARTICIPANTS: A survey study was sent to 901 fourth-year medical students in the 1993 graduating classes of six US medical schools. OUTCOME MEASURES: Comparisons were made between students choosing and not choosing primary care specialties. For the non-primary care students, we also evaluated whether alteration of income, hours worked, or loan repayment could attract them to primary care careers. RESULTS: Of the 688 responses (76% response rate), primary care specialties were chosen by 27% of the students and non-primary care specialties by 73%. One quarter (25%) of the non-primary care students indicated they would change to primary care for one of the following factors: income (10%), hours worked (11%), or loan repayment (4%). For students whose debt was $50,000 or greater, the loan repayment option became much more important than for students with lesser debt. In all, a total of 45% (n = 313) of the students indicated either they were planning to enter primary care (n = 188) or they would change to a primary care specialty (n = 125) with appropriate adjustments in income, hours worked, or loan repayment. CONCLUSION: Significant changes in economic and lifestyle factors could have a direct effect on the ability to attract students to primary care. Including such changes as part of health system reform, especially within the context of a supportive medical school environment, could enable the United States to approach a goal of graduating 50% generalist physicians.

Career Choice↗