Biomedical subjects
Publications and source records attributed to C Levitt.
An approach to preconception health promotion by obtaining a history and through physical examination and laboratory investigation is outlined. The controversies are explained, and the current programs that have been developed in the United Kingdom, Canada, and the United States are described. All women of childbearing age should have access to prepregnancy intervention; however, presently, barriers to its comprehensive implementation exist.
Explore the source record for details and available documents.
Pregnancy, childbirth, postpartum, and infant care are a continuum in the family life cycle for which the family physician is especially qualified to provide primary, comprehensive care. The purpose of this paper is to document and share the controversies, wisdom, and knowledge about caring for women and their families before, during, and after pregnancy. Family physicians can be leaders in developing an appropriate perinatal care system for the community. The level of care the family physician chooses to provide is discretionary. However, the family physician should be invested in ensuring that all families receive the greatest benefit from pregnancy, birth, and the newborn experience. Interest in perinatal care in family medicine is increasing, as reflected by the growing numbers participating in the Society of Teachers of Family Medicine Working Group on Family-Centered Perinatal Care. The authors of this article, who are active in this working group, hope that this information is useful in designing a balanced curriculum and delivery system for perinatal care in family medicine training programs.
Explore the source record for details and available documents.
A recently introduced rodenticide containing N-3-pyridylmethyl N'-p-nitrophenyl urea (PNU), Vacor, was accidently ingested by a 25-month-old child, resulting in acute vomiting, lethargy, seizures, and hypoglycemia, as well as chronic evidence of autonomic and peripheral neuropathy and glucose intolerance. Treatment with niacinamide (nicotinamide), may have been of benefit since all problems were resolved within three months of ingestion. This agent (PNU) is remarkably similar chemically and toxicologically to alloxan and streptozocin, both potent beta-cell toxins. These similarities are not only important in regard to the antodite for PNU, but they also suggest that the toxin m,y cause long-term endocrinologic, neurlogic, and oncologic problems.
Explore the source record for details and available documents.
A philosophy of family-centered maternity and newborn care requires that there be open communication between a woman, her family and health professionals; that the woman be able to choose people to support her, and have those people present during labour and birth; and that the mother and infant remain in close contact whenever possible following birth. Using data from a 1993 survey, the authors conclude that Canadian hospitals still have a long way to go before putting these ideals into practice.
Explore the source record for details and available documents.
Pregnancy, childbirth, postpartum, and infant care are a continuum in the family life cycle for which the family physician is especially qualified to provide primary, comprehensive care. The purpose of this paper is to document and share the controversies, wisdom, and knowledge about caring for women and their families before, during, and after pregnancy. Family physicians can be leaders in developing an appropriate perinatal care system for the community. The level of care the family physician chooses to provide is discretionary. However, the family physician should be invested in ensuring that all families receive the greatest benefit from pregnancy, birth, and the newborn experience. Interest in perinatal care in family medicine is increasing, as reflected by the growing numbers participating in the Society of Teachers of Family Medicine Working Group on Family-Centered Perinatal Care. The authors of this article, who are active in this working group, hope that this information is useful in designing a balanced curriculum and delivery system for perinatal care in family medicine training programs.
Clinical teachers often work with residents whom they view as "difficult." For some, it is a knowledge deficit that first alerts them to a problem; for others, it is an attitudinal problem or distressing behavior. The goal of this article is to describe a framework for identifying residents' problems and to outline strategies for intervention. When teachers first suspect a problem, they should try to define the resident's troubling behavior, assess other contributing factors, and evaluate the potential impact of the problem. Following this initial process, teachers should try to confirm their suspicions by determining the resident's perception of the problem, relevant life history, and perceived strengths and weaknesses. They should also examine their own strengths and weaknesses and obtain other teachers' views of the perceived difficulty. In designing an intervention, teachers should carefully define the goal and time frame of the intervention, determine how the problem will be addressed, and decide how the intervention will be documented and evaluated. Although residents' difficulties are often seen as residing within the resident alone, teacher and systems factors must be considered, and the resident should be involved in every step of the process.
BACKGROUND AND OBJECTIVES: This study compared the effectiveness of two booster strategies designed to improve retention of skills and knowledge in neonatal resuscitation by family practice residents. METHODS: Residents were randomly allocated to one of three groups: video, hands on, or control. Residents in the two experimental groups received a "booster" 3-5 months after the Neonatal Resuscitation Program (NRP) course. All participants completed the follow-up test 6-8 months after taking the course. The main outcome measures consisted of the NRP written examination and the performance checklists. RESULTS: A total of 44 residents completed the study (video, n = 13; hands-on, n = 14; control, n = 17). Overall, participants had significantly lower scores at follow-up than at baseline, indicating deterioration in both neonatal skills and knowledge. Residents in the hands-on booster group made significantly fewer errors across all five checklists in life-supporting but not in lifesaving scores than those allocated to the control and video groups. CONCLUSIONS: The beneficial effect of mannequin practice or video boosters on skills and knowledge retention was less than what had been anticipated, and no benefit could be demonstrated in comparison to the control group. Deteriorating knowledge and skills remain a major concern, since boostering by hands-on or video at 3-5 months do not seem to have an impact on the retention of knowledge or lifesaving skills.