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Biomedical subjects

D C Vinson

Publications and source records attributed to D C Vinson.

29 records · Page 2Linked to original sources
PubMed1993

Medical students' attitudes toward pharmaceutical marketing: possibilities for change.

BACKGROUND: Concerns have been expressed about physicians' acceptance of gifts from pharmaceutical companies, but few studies have examined or attempted to change medical students' attitudes about accepting such gifts. METHODS: We used a questionnaire survey to measure attitudes about accepting such gifts. We then carried out a field experiment to compare changes in second-year medical students' attitudes, seven weeks after a one-hour lecture and discussion about the appropriateness of pharmaceutical gifts, to changes in first-year students who were not exposed to the program. RESULTS: Following the intervention, second-year students became less accepting of these marketing practices; first-year students showed no significant change. The difference between the groups after the intervention was statistically significant (P < .0001). CONCLUSIONS: If medical students' attitudes about accepting gifts from pharmaceutical companies need to be changed, this study suggests that the process may be fostered with little investment of curricular time.

Attitude of Health Personnel↗
PubMed1993

Outpatient management of alcohol abuse.

Patients with alcohol problems come to their primary care physicians at different points along the spectrum of experiences with alcohol; therefore, physicians need to be able to respond with a variety of interventions. In addition, patients present in different stages of change, and physicians need to be aware of where the patient is in that continuum. Evidence shows that less intensive, outpatient treatment may be as beneficial as inpatient treatment for some patients and that primary care physicians can offer some of their patients relatively simple interventions that are effective. Medications such as disulfiram offer little in the treatment of alcoholism but may be of benefit in selected situations. Of greater benefit are more complex psychosocial interventions carried out by a team of health care professionals.

Alcohol Deterrents↗
PubMed1993

Association between epidural analgesia during labor and fever.

BACKGROUND: Epidural analgesia has been associated in previous research with an increase in maternal temperature. METHODS: Three studies were done: a retrospective chart review of women in labor, a prospective cohort study of women in labor, and a case-control study of newborns with fever. The prospective study enrolled 28 women, 14 of whom received epidural analgesia. Maternal temperature was measured hourly with a tympanic membrane thermometer. Other variables examined included duration of labor, duration of ruptured membranes, and room temperature. To further explore the possible association between maternal epidural exposure and newborn fever, a case-control study of newborns with fever at birth was carried out. RESULTS: In both the retrospective and prospective studies of women in labor, the duration of epidural analgesia was correlated with maximum maternal temperature during labor, with an increase, in the prospective study, of 0.07 degrees C per hour of exposure to epidural analgesia (P = .002). Controlling for other variables did not change the magnitude of this effect or its statistical significance. Similar trends were seen in the newborn's first temperature in both the prospective study of women in labor and the case-control study of newborns, but the associations were not significant (P = .07 and .08, respectively). CONCLUSIONS: Epidural analgesia is associated with an increase in maternal temperature during labor and possibly with an elevation of newborns' first temperatures.

Analgesia, Epidural↗
PubMed1992

The information needs of family physicians: case-specific clinical questions.

BACKGROUND: Physicians must be able to rapidly obtain information that answers specific patient-related clinical questions. This study describes the information-seeking process in the office practices of family physicians. METHODS: We observed and recorded the information-seeking and information-obtaining behavior of 30 family physicians in their offices. RESULTS: Based on 172 hours of observation and 602 patient visits, family physicians sought answers to an average of only one clinical question for every 15 patients seen. Urban physicians sought answers to more questions than rural physicians (one question for every 9 patients, as compared with one question for every 24 patients; P less than .05). The frequency of seeking information was not related to the physician's age. Busier physicians (those seeing more patients per hour) tended to ask fewer questions (correlation coefficient (r) = -.34, P = .06). Drug-prescribing questions were the most common type; second most common were orthopedic questions. Colleagues and the Physicians' Desk Reference were the most often used resources. Eight percent of the questions were not answered. CONCLUSIONS: Among family physicians, patient-related questions are infrequently asked and highly specific. Most questions are rapidly answered using colleagues and books, not journals or computers.

Adult↗
PubMed1991

Admission alcohol level: a predictor of the course of alcohol withdrawal.

BACKGROUND: Little is known about how to predict the course of alcohol withdrawal. This study explores relationships between alcohol levels at admission to a detoxification unit and the severity and outcome of alcohol withdrawal. METHODS: A retrospective cohort study was conducted in two institutions, the Mid-Missouri Mental Health Center (MMMHC) and the Harry S Truman Memorial Veterans Hospital (HSTMVH), of individuals admitted during 1 year. RESULTS: The alcohol levels at admission of the 86 clients at the Mental Health Center and the 99 patients at the HSTMVH, correlated with withdrawal severity over the first 48 hours after admission (R2 = .26 at MMMHC, .41 at HSTMVH, P less than .0001 for both), and remained significantly associated even after adjustment for other variables. Furthermore, individuals who had lower alcohol levels at the time of admission were more likely to stay for rehabilitation following detoxification (P less than .001 for both institutions). CONCLUSIONS: A patient's alcohol level at the time of admission to a detoxification unit may help predict the severity of withdrawal and the treatment outcome.

Adult↗
PubMed1991

Acute bronchitis in children: building a clinical definition.

Much about acute bronchitis in children is uncertain, even its definition. This study was undertaken to help build a clinical definition to serve as a guide for further research. Charts of 180 children 1 to 12 years old were reviewed. Each had received a diagnosis of acute bronchitis (54 patients), upper respiratory infection with a cough (128 patients), or a new diagnosis of asthma (26 patients) during the previous 12 months. A history of sputum production (odds ration 25.0, p = 0.0001), the finding of rales or rhonchi on examination (OR 11.6, p less than 0.0001), and a past history of lower respiratory illness (OR 3.0, p = 0.01) were associated with a diagnosis of acute bronchitis, but fever and duration of illness were not. In addition, the diagnosis of acute bronchitis was strongly associated with a prescription for an antibiotic. In a child with a cough, acute bronchitis is more likely to be diagnosed if there is a history of sputum production, rales or rhonchi on examination, and a past history of lower respiratory disease.

Acute Disease↗
PubMed1989

Acute transient memory loss.

Anterograde amnesia refers to the inability to form new memories. Alcoholic blackout, benzodiazepine-induced amnesia and transient global amnesia are three disorders that result in acute transient memory loss. These disorders may be difficult to recognize, because the memory loss is not usually accompanied by other symptoms of neurologic impairment.

Acute Disease↗
PubMed1988

Physician burnout.

Explore the source record for details and available documents.

Burnout, Professional↗
PubMedDate not supplied

Reprint requests for family medicine literature: how do we respond?

Requesting and sending reprints of articles published in the medical literature is an established tradition. This survey of authors of family medicine literature found that 54% believed the tradition should be continued, and 43% felt reprints meet a real need. The authors responded to 90% of the requests. Those authors who paid the cost out of their own pockets were significantly more likely to view reprints as useful and more likely to respond to requests. Support for innovative ways of disseminating information, ways that may meet needs that reprints do not, is potentially available.

Authorship↗