Biomedical subjects

D Holbert

Publications and source records attributed to D Holbert.

40 records · Page 3Linked to original sources

PubMedDate not supplied

Distortion product otoacoustic emissions in normal-hearing children with homozygous sickle cell disease.

The purpose of this study was to investigate distortion product otoacoustic emissions (DPOAEs) in young normal-hearing children with sickle cell disease (SCD). It was hypothesized that the prevalence of DPOAEs and response amplitudes would be lower than those in children with normal hemoglobin due to suspected compromised cochlear function as a result of vaso-occlusive events characteristic of SCD. Twenty African-American children with SCD and 15 African-American children with normal hemoglobin participated. Distortion product OAEs were evoked by 13 primary tone pairs with f2 frequencies ranging from 1000 to 4500 Hz. The primary tones were presented at L1 and L2 levels of 70 and 60 dB SPL (high) and 50 and 40 dB SPL (low), respectively. The findings of this study were completely unexpected and contrary to our original hypotheses. The likelihood of detecting a DPOAE response was not related to the clinical status of the children. Distortion product OAE amplitudes were significantly larger for children with SCD (p =.01).

Adolescent↗

PubMedDate not supplied

Specialty career decision making of third-year medical students.

Medical Students who are deciding which specialty to enter sometimes do not choose the one they actually prefer. The purposes of this study were to compare specialty preferences of students with their choices, as well as to identify the factors on which decisions about entering family medicine are based. Of North Carolina's 429 third-year medical students, 59% responded in 1985 to a career preferences questionnaire that assessed the process of specialty decision making. Internal medicine was the most frequently chosen specialty when another was preferred. The frequency with which family practice was the career choice was affected little by differences between preferences and choices. Six factors were identified, with the curriculum as the major factor separating those who chose family practice from those who chose other primary care or non-primary care specialties. Based on these results, six suggestions are offered for medical school administrators and faculty desiring to increase the number of students selecting family practice.

Career Choice↗

PubMedDate not supplied

The medical record and the medical interview: an evaluation of student case histories.

This study assessed the results of a second-year family medicine course designed to improve student abilities in writing complete assessments and plans from interviews with standardized patients. Sixty-six students attended lectures on the patient's perception of the symptoms of the major causes of death, learned techniques of medical interviewing, saw a model interview by their tutor, received model faculty histories based on American Board of Family Practice Office Record Review Criteria, and received critiques of their own histories. Students in the highest decile recorded twice as much information as those in the lowest decile and recorded as many history items as the faculty member who recorded the most history items. The faculty, however, recorded a more complete list of diagnoses, differential diagnoses, and investigations. Students in the lowest decile recorded the least information and the least number of assessments and plans and did not respond to written critiques. Students in the lowest decile could improve if they were identified early in the course and worked intensively with role models.

Curriculum↗

PubMedDate not supplied

Cognitive failure to thrive in high-risk infants: the importance of the psychosocial environment.

We evaluated early social risk assessment as a predictor of cognitive development in high-risk infants. A social worker assessed social risk in 122 infants before discharge from a neonatal intensive care unit. Infants were evaluated at ages 12 and 36 months adjusted for prematurity. We found no difference in 12-month cognitive development among medical, neurologic, or social risk groups. However, from 12 to 36 months there was a significant decline in mean developmental quotient in the groups with social risk alone, neurologic and social risk, and medical and social risk, but not in the groups with medical or neurologic risks without social risk. Social risk assessment correctly predicted 36-month cognitive outcome in 71% of infants who had normal findings at 12 months. We conclude that neonatal social risk assessment can help identify infants at highest risk for cognitive retardation and is particularly important for infants who have medical or neurologic problems.

Chi-Square Distribution↗