Biomedical subjects
Publications and source records attributed to C Greene.
Aneurysms of the gluteal arteries are an uncommon complication of trauma to the gluteal region. A case report is presented following a gunshot wound to the buttock in a 36-year-old female. Diagnosis and management are discussed, with a review of the recent surgical literature.
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A recent study investigated the relationship between learning environment and work excitement among a group of nurses. In a secondary analysis of the original survey of 268 nurses, approximately 20% were very excited about their work. The learning environment variables (availability of learning opportunities; stimulating, motivating, challenging environment; and opportunity to work with other professionals) were found to be related to the level of work excitement among nurses. Results of this study suggest that enhancement of the learning environment can lead to higher levels of work excitement. Nurses in staff development can use the knowledge obtained in this study to assist nurses to find excitement in their work through new learning and work behaviors. The results suggest the importance of unit-based learning opportunities and flexible work groups that include other health professionals.
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An epidemiology teaching course for third-year medical students was developed at the University of Vermont's College of Medicine by staff members of the Vermont Department of Health in conjunction with clinical faculty members. The course consists of analyses of actual community health problems encountered by the health department, evaluation of published clinical studies, and design of studies on current public health issues in Vermont. In the course's first year, 54 percent of the students gave it an overall assessment of average or above average. A striking improvement was found in the second year; 98 percent of the students rated their overall assessment as average or better. Sessions rated the best by students were the critical appraisal of clinical studies, followed by sessions on study design and outbreak investigations. The Vermont course communicates epidemiologic concepts to students by stressing their clinical relevance and by putting the concepts into a recognizable public health context. Students are required to grapple with epidemiologic issues as participants. This approach to teaching epidemiology combines faculty having both public health and clinical perspectives, emphasizes relevance to future practice, and requires students to actively work through epidemiologic problems. The Vermont experience has shown that combining health department and clinical faculty resources can result in a useful format for teaching epidemiology to medical students.
A new statistical method, developed for detection of changes in reporting, has proved useful in analysis of provisional data reported by state health departments to the National Notifiable Diseases Surveillance System (NNDSS). In this system, data from the current four-week period can be compared with data from the previous, same, and subsequent four-week periods from each of the preceding five years, and reports exceeding historical limits are highlighted in a horizontal bar graph. To evaluate the usefulness of this method at the state level, we applied it to weekly reports of seven notifiable diseases in six states over a four-month period. Participating state health departments investigated all events exceeding historical limits and reported known outbreaks that were not identified by the method. During the four-month period, the method identified 27 episodes of disease reports exceeding historical limits. Of these, 14 (52%) represented outbreaks. None was detectable by analysis of aggregate national surveillance data. Five outbreaks known to state health department officials were not identified by the method, because of increased disease activity during the baseline period or lack of timely provisional reporting of outbreak-related cases. Methods for detection of increases in reporting at the state level may identify events of public health importance that are obscured in aggregate national data and may supplement other local sources of information available to state health departments in the recognition of significant public health events.