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Anuradha Paranjape

Publications and source records attributed to Anuradha Paranjape.

6 recordsLinked to original sources

Repaving the road to academic success: the IMeRGE approach to peer mentoring.

In recent years, academic health centers have made a considerable effort to encourage medical students and physicians-in-training to consider academic medicine as a career choice. For physicians, selecting a career in academic medicine may be the first hurdle, but the challenge of successfully maintaining an academic career is perhaps a more formidable task. Mentoring is a much-needed response to this challenge. But the success of traditional mentoring programs at academic institutions is often limited by, among other things, the availability of senior faculty who can serve as mentors. The authors describe the formation and organization of the Internal Medicine Research Group at Emory (IMeRGE), an innovative peer mentoring group within the Division of General Medicine at Emory University. This group, born partially out of the mentoring needs of our women and minority faculty, shared the primary goal of fostering a collaborative atmosphere among junior faculty, while simultaneously acquiring experience through advanced faculty development. The authors present our methods of garnering division support for designated time and financial resources, defining member responsibilities, developing a curriculum, providing peer support, and seeking advisors with expertise in the areas on which we wished to focus. In addition to the development of IMeRGE, the authors provide an overview of the pros and cons of traditional mentoring versus peer mentoring; discuss the challenges faced by IMeRGE and strategies for addressing these issues; and present the paradigm of IMeRGE as a template for alternative forms of academic mentorship.

Academic Medical Centers↗

Utility of STaT for the identification of recent intimate partner violence.

Intimate partner violence (IPV) is an important issue with far-reaching health consequences. This study investigates the utility of STaT, a three-question IPV screening tool, for recent IPV identification in a sample of adult women in an innercity urgent care clinic. STaT score was calculated as the total number of affirmative responses to the three questions. Efficacy of STaT as an IPV screen was estimated by computing the sensitivity and specificity at possible cut points, based on participant's STaT score, and using Index of Spouse Abuse scores as a comparison standard. The sensitivities of STaT were 94.9%, 84.8% and 62% with the cut points set at scores of 1, 2 and 3, respectively. Thus, with the criterion for a positive screen set at a cut-point score of 1, STaT can be used to facilitate the identification of abused women in busy public healthcare settings.

Adolescent↗

Utilization of services by abused, low-income African-American women.

BACKGROUND: Little is known about health care and service utilization patterns among low-income African-American women, particularly those who report intimate partner violence (IPV). OBJECTIVES: (1) Identify utilization patterns among low-income African-American women. (2) Demonstrate utilization differences by IPV status. PARTICIPANTS: One hundred and fifty-three African-American women from medical care clinics at a large inner-city public hospital. DESIGN: Case-control study. Predictor variable IPV assessed by the Index of Spouse Abuse. Outcome variables, health care, and service utilization, determined using the Adult Service Utilization Form. RESULTS: Of the 153 participants, 68 reported high IPV levels. The mean age was 32 years, majority were poor and unemployed, and 15.7% were homeless. The overall utilization rates were low. When controlled for homelessness and relationship status, high IPV levels were associated with greater psychiatric outpatient utilization. We found differences in the use of other medical or community services by IPV group. CONCLUSIONS: Women reporting high IPV levels are more likely to receive mental health services than women reporting low IPV levels, but may not have access to other needed services. Primary care providers should assess the mental health, legal, and social service needs of abused women, which will facilitate receipt of services.

Adult↗

STaT: a three-question screen for intimate partner violence.

OBJECTIVE: To develop a simple, sensitive screening tool for lifetime intimate partner violence (IPV) in women. METHODS: In the emergency department (ED) of an urban teaching hospital, 75 English-speaking women between 18 and 64 years old were tested. The sensitivity and specificity of 43 dichotomous response-option, IPV screening questions were compared. The reference standard was lifetime IPV, determined by a semistructured interview, using preset criteria of specific violence acts or emotional control or both by an intimate partner. Questions with high sensitivity (>70%) were tested together against the reference standard. Answering yes to any question scored 1 point. Content area and the area under receiver-operator curve (AUROC) of the screening questions determined the final tool. RESULTS: Sixty-three percent of women reported lifetime IPV. Eight of the 43 screening questions had a sensitivity of >70%. After testing possible combinations, the final three-question screen, STaT had the highest AUROC. The STaT questions are: "Have you ever been in a relationship where your partner has pushed or Slapped you?" "Have you ever been in a relationship where your partner Threatened you with violence?" and "Have you ever been in a relationship where your partner has thrown, broken or punched Things?" The sensitivity (95% confidence intervals [95% CI]) of STaT for lifetime IPV is 96% (90%, 100%), 89% (81%, 98%), and 64% (50%, 78%) for a score of >/=1, >/=2, and 3, respectively. The corresponding specificity is 75% (59%-91%), 100%, and 100%. CONCLUSIONS: Three simple questions when used together can effectively identify lifetime IPV and will aid clinicians' efforts to identify abuse in women.

Adult↗

Feedback and reflection: teaching methods for clinical settings.

Feedback and reflection are two basic teaching methods used in clinical settings. In this article, the authors explore the distinctions between, and the potential impact of, feedback and reflection in clinical teaching. Feedback is the heart of medical education; different teaching encounters call for different types of feedback. Although most clinicians are familiar with the principles of giving feedback, many clinicians probably do not recognize the many opportunities presented to them for using feedback as a teaching tool. Reflection in medicine-the consideration of the larger context, the meaning, and the implications of an experience and action-allows the assimilation and reordering of concepts, skills, knowledge, and values into pre-existing knowledge structures. When used well, reflection will promote the growth of the individual. While feedback is not used often enough, reflection is probably used even less.

Clinical Medicine↗

Effect of relationship factors on safer sex decisions in older inner-city women.

OBJECTIVES: Heterosexual transmission of the human immunodeficiency virus (HIV) in older women is on the rise, yet little is known about safer sex practices in these women. We sought to determine the prevalence of and effect of relationship factors on safer sex practices among older women living in a high HIV incidence region. METHODS: In a cross-sectional study at an ambulatory medicine clinic of a large inner-city hospital, participants were women over age 50 seeking medical services at the study site. Measurements included (1) partner trust, (2) dependence on partner, (3) personally obtaining condoms, (4) safer sex (frequent condom use or abstinence), (5) knowledge of condom efficacy, and (6) perceived HIV risk. RESULTS: Of 155 participants in a current relationship, 81% were sexually active; however, only 13% of these women used condoms frequently. No significant differences were found between participants who did and did not practice safer sex with respect to their age, race, employment, marital status, knowledge of condom efficacy, or perceived HIV risk. Trust in partner was independently associated with lower odds of safer sex (OR 0.3, 95% CI 0.08-1.06). Personally obtaining condoms (OR 9.2, 95% CI 1.9-44.2) and dependence on partner for condoms (OR 12.3, 95% CI 3.0-50.3) were independently associated with higher odds of safer sex. CONCLUSIONS. Few older women in high HIV incidence areas practice safer sex. Relationship factors impact the risk of acquiring HIV through safer sex decisions. HIV prevention messages geared to older women should incorporate references to the role these factors can play in reducing their HIV risk.

Aged↗