Biomedical subjects

Farah Ahmad

Publications and source records attributed to Farah Ahmad.

13 recordsLinked to original sources

PubMed2006

Are physicians ready for patients with Internet-based health information?

BACKGROUND: An increasing number of patients bring Internet-based health information to medical consultations. However, little is known about how physicians experience, manage, and view these patients. OBJECTIVE: This study aimed to advance the understanding of the effects of incorporating Internet-based health information into routine medical consultations from physicians' perspectives, using a qualitative approach. METHODS: Six focus groups were conducted with 48 family physicians practising in Toronto. The data were analyzed using qualitative methods of content analysis and constant comparison, derived from grounded theory approach. RESULTS: Three overarching themes were identified: (1) perceived reactions of patients, (2) physician burden, and (3) physician interpretation and contextualization of information. Physicians in our study generally perceived Internet-based health information as problematic when introduced by patients during medical consultations. They believed that Internet information often generated patient misinformation, leading to confusion, distress, or an inclination towards detrimental self-diagnosis and/or self-treatment. Physicians felt these influences added a new interpretive role to their clinical responsibilities. Although most of the physicians felt obliged to carry out this new responsibility, the additional role was often unwelcome. Despite identifying various reactions of patients to Internet-based health information, physicians in our study were unprepared to handle these patients. CONCLUSION: Effective initiatives at the level of the health care system are needed. The potential of Internet-based health information to lead to better physician-patient communication and patient outcomes could be facilitated by promoting physician acknowledgment of increasing use of the Internet among patients and by developing patient management guidelines and incentives for physicians.

Attitude of Health Personnel↗

PubMed2006

Screening of free-living rhizospheric bacteria for their multiple plant growth promoting activities.

Plant growth promoting rhizobacteria (PGPR) are known to influence plant growth by various direct or indirect mechanisms. In search of efficient PGPR strains with multiple activities, a total of 72 bacterial isolates belonging to Azotobacter, fluorescent Pseudomonas, Mesorhizobium and Bacillus were isolated from different rhizospheric soil and plant root nodules in the vicinity of Aligarh. These test isolates were biochemically characterized. These isolates were screened in vitro for their plant growth promoting traits like production of indoleacetic acid (IAA), ammonia (NH(3)), hydrogen cyanide (HCN), siderophore, phosphate solubilization and antifungal activity. More than 80% of the isolates of Azotobacter, fluorescent Pseudomonas and Mesorhizobium ciceri produced IAA, whereas only 20% of Bacillus isolates was IAA producer. Solubilization of phosphate was commonly detected in the isolates of Bacillus (80%) followed by Azotobacter (74.47%), Pseudomonas (55.56%) and Mesorhizobium (16.67%). All test isolates could produce ammonia but none of the isolates hydrolyzed chitin. Siderophore production and antifungal activity of these isolates except Mesorhizobium were exhibited by 10-12.77% isolates. HCN production was more common trait of Pseudomonas (88.89%) and Bacillus (50%). On the basis of multiple plant growth promoting activities, eleven bacterial isolates (seven Azotobacter, three Pseudomonas and one Bacillus) were evaluated for their quantitative IAA production, and broad-spectrum (active against three test fungi) antifungal activity. Almost at all concentration of tryptophan (50-500 microg/ml), IAA production was highest in the Pseudomonas followed by Azotobacter and Bacillus isolates. Azotobacter isolates (AZT(3), AZT(13), AZT(23)), Pseudomonas (Ps(5)) and Bacillus (B(1)) showed broad-spectrum antifungal activity on Muller-Hinton medium against Aspergillus, one or more species of Fusarium and Rhizoctonia bataticola. Further evaluation of the isolates exhibiting multiple plant growth promoting (PGP) traits on soil-plant system is needed to uncover their efficacy as effective PGPR.

Ammonia↗

PubMed2006

Plant growth promoting potential of free-living diazotrophs and other rhizobacteria isolated from Northern Indian soil.

The viable count of free-living diazotrophic bacteria in different crop rhizospheres varied from 1.11 x 10(4) to 8.5 x 10(5) CFU/g of soil. The majority of the diazotrophs phenotypically belong to either Azotobacter chroococcum, non-A. chroococcum type and to a heterogenous group tentatively named putative nitrogen-fixing (PNF) bacteria. In this study, 25 isolates of the PNF group were screened for their multiple plant growth-promoting (PGP) traits and grouped into 5 PGP types. An isolate, PNF(11) showed promising PGP potential in vitro and was characterized as a species of Achromobacter by 16S rRNA analysis. The isolate PNF(11) along with three other previously isolated PGP bacteria, Azotobacter sp. (AZS(3)), fluorescent pseudomonas (Ps(5)), Bacillus sp. (Bc(1)) were selected for crop inoculation response in green house experiment on Vigna radiata var.T44. Plants from inoculated and control pots were sampled and analyzed at 30, 45 and 60 days after sowing for various vegetative, nodule-related data and yield parameters. The findings indicated that selected isolate of PNF bacteria, and other PGP isolates with multiple activities significantly improve the plant growth parameters, yield parameters of Vigna radiata T44 over control and also show good compatibility with Bradyrhizobium inoculation.

Fabaceae↗

PubMed2005

Cross-cultural perspectives on research participation and informed consent.

This study examined Portuguese Canadian and Caribbean Canadian immigrants' perceptions of health research and informed consent procedures. Six focus groups (three in each cultural group) involving 42 participants and two individual interviews were conducted. The focus groups began with a general question about health research. This was followed by three short role-plays between the moderator and the assistant. The role-plays involved a fictional health research study in which a patient is approached for recruitment, is read a consent form, and is asked to sign. The role-plays stopped at key moments at which time focus group participants were asked questions about their understanding and their perceptions. Focus group transcripts were coded in QSR NUDIST software using open coding and then compared across cultural groups. Six overriding themes emerged: two were common in both the Portuguese and Caribbean transcripts, one emphasized the importance of trust and mistrust, and the other highlighted the need and desire for more information about health research. However, these themes were expressed somewhat differently in the two groups. In addition, there were four overriding themes that were specific to only one cultural group. In the Portuguese groups, there was an overwhelming positive regard for the research process and an emphasis on verbal as opposed to written information. The Caribbean participants qualified their participation in research studies and repeatedly raised images of invasive research.

Adult↗

PubMed2005

A tailored intervention to promote breast cancer screening among South Asian immigrant women.

This study developed and evaluated a socioculturally tailored intervention to improve knowledge, beliefs and clinical breast examination (CBE) among South Asian (SA) immigrant women. The intervention comprised a series of socioculturally tailored breast-health articles published in Urdu and Hindi community newspapers. A pre- and post-intervention design evaluated the impact of the mailed articles among 74 participants. The mean age of participants was 37 years (SD 9.7) and they had lived 6 years (SD 6.6) in Canada. After the intervention, there was a significant increase in self-reporting 'ever had' routine physical checkup (46.4-70.8%; p < 0.01) and CBE (33.3-59.7%; p < 0.001). Also, the total summed scores of accurate answers to 12 knowledge items increased (3.3-7.0; p < 0.001). For constructs of health belief model, participants rated their level of agreement for a number of items on a scale of 1-4 (disagree to agree). After the intervention the following decreased: misperception of low susceptibility to breast cancer among SA immigrant women (3.0-2.4; p < 0.001); misperception of short survival after diagnosis (2.7-1.8; p < 0.001); and perceived barriers to CBE (2.5-2.1; p < 0.001). Self-efficacy to have CBE increased (3.1-3.6; p < 0.001). The change scores of five predictor variables were entered in a direct logistic regression to predict the uptake of CBE among participants who never had it prior to the intervention. The model, as a set, was statistically reliable [chi2(5, n = 48) = 14.2 , p < 0.01] and explained 35% of variance in the outcome; perceived barriers remained an independently significant predictor. The results support the effectiveness of written socioculturally tailored language-specific health education materials in promoting breast cancer screening within the targeted population. Future research should test the intervention in other vulnerable populations.

Adult↗

PubMed2004

Eating Disorders.

HEALTH ISSUE: Eating disorders are an increasing public health problem among young women. Anorexia and bulimia may give rise to serious physical conditions such as hypothermia, hypotension, electrolyte imbalance, endocrine disorders, and kidney failure. KEY ISSUES: Eating disorders are primarily a problem among women. In Ontario in 1995, over 90% of reported hospitalized cases of anorexia and bulimia were women. In addition to eating disorders, preoccupation with weight, body image and self-concept disturbances, are more prevalent among women than men.Women with eating disorders are also at risk for long-term psychological and social problems, including depression, anxiety, substance abuse and suicide. For instance, in 2000, the prevalence of depression among women who were hospitalized with a diagnosis of anorexia (11.5%) or bulimia (15.4 %) was more than twice the rate of depression (5.7 %) among the general population of Canadian women. The highest incidence of depression was found in women aged 25 to 39 years for both anorexia and bulimia. DATA GAPS AND RECOMMENDATIONS: Hospitalization data are the most recent and accessible information available. However, this data captures only the more severe cases. It does not include the individuals with eating disorders who may visit clinics or family doctors, or use hospital outpatient services or no services at all. Currently, there is no process for collecting this information systematically across Canada; consequently, the number of cases obtained from hospitalization data is underestimated. Other limitations noted during the literature review include the overuse of clinical samples, lack of longitudinal data, appropriate comparison groups, large samples, and ethnic group analysis.

Journal Article↗

PubMed2004

Predictors of clinical breast examination among South Asian immigrant women.

To determine predictors of clinical breast examination (CBE) among South Asian immigrant women residing in Toronto, Canada. A cross-sectional self-administered survey with women patients visiting family physician group practices. Fifty-four women participated in the study (response rate 77%). Twenty women (38.5%) "ever had" CBE. Compared to women who never had CBE, women who had CBE were statistically older, had lived more years in Canada, had better knowledge of breast cancer, had lower perceived barriers to CBE, and were more likely to have ever had a periodic health exam. No significant differences were found between the two groups for education, employment, English language abilities, perceived health, and perceived benefits of CBE. A direct logistic regression with five predictor variables, significant at a univariate level, was statistically reliable, chi(2) (5, n=51) = 34.7, p < 0.001 and explained 67% of the variance in the CBE status. Age and perceived barriers to CBE remained significant over and above other predictor variables. The odds of "ever had" CBE increased with age and decreased with more perceived barriers. The study highlights the need for education interventions on breast cancer and screening among SA recent immigrant women.

Adult↗

PubMed2004

Popular health promotion strategies among Chinese and East Indian immigrant women.

PURPOSE: To advance understanding about the popular health promotion strategies and factors associated with the successful transfer and uptake of health messages among Chinese and Indian immigrant women. METHODS: Eight focus groups were conducted with 46 immigrant women, 24 from Mainland China and 22 from India, who had lived less than 5 years in Canada. Audiotaped data were transcribed, translated and analyzed by identification of themes and subcategories within and between groups. RESULTS: In both ethnic groups, discussions on promoting health messages had five major themes, i.e., sources, barriers, facilitators, credibility and ways to improve access along with group specific sub-themes. Despite identification of several diverse sources of health information in the adopted country, Indian and Chinese immigrant women perceived most strategies as not very effective. The reasons of perceived ineffectiveness were barriers to accessing and comprehending the health messages; and limited prior exposure to institution based or formal health promotion initiatives. These women were more familiar with informal means of obtaining health information such as social networks, mass media and written materials in their mother tongue. CONCLUSION: Existing health communication and health promotion models need to be re-orientated from a one-way information flow to a two-way dialogue model to bridge the gap between program efficacy and effectiveness to reach underserved immigrant women. An "outside the box" approach of non-institutional informal health promotion strategies needs to be tested for the studied groups.

Adult↗

PubMed2004

Voices of South Asian women: immigration and mental health.

PURPOSE: This qualitative research aimed to elicit experiences and beliefs of recent South Asian immigrant women about their major health concerns after immigration. METHODS: Four focus groups were conducted with 24 Hindi-speaking women who had lived less than five years in Canada. The audiotaped data were transcribed, translated, and analyzed by identification of themes and subcategories. RESULTS: Mental health (MH) emerged as an overarching health concern with three major themes i.e. appraisal of the mental burden (extent and general susceptibility), stress-inducing factors, and coping strategies. Many participants agreed that MH did not become a concern to them until after immigration. Women discussed their compromised MH using verbal and symptomatic expressions. The stress-inducing factors identified by participants included loss of social support, economic uncertainties, downward social mobility, mechanistic lifestyle, barriers in accessing health services, and climatic and food changes. Women's major coping strategies included increased efforts to socialize, use of preventative health practices and self-awareness. CONCLUSION: Although participant women discussed a number of ways to deal with post-immigration stressors, the women's perceived compromised mental health reflects the inadequacy of their coping strategies and the available resources. Despite access to healthcare providers, women failed to identify healthcare encounters as opportunities to seek help and discuss their mental health concerns. Health and social care programs need to actively address the compromised mental health perceived by the studied group.

Adaptation, Psychological↗

PubMed2003

Physician-patient interaction: a gynecology clinic in Turkey.

Evidence for gender differences in physicians' communication with their patients comes primarily from Western countries. Little is known about whether these gender differences would also be observed in Turkey, where there are explicit rules about male-female conduct. The purpose of this study was to observe male and female gynecologists' communication with their patients in a gynecology clinic at a state hospital in Istanbul, Turkey. Four male and three female gynecologists were observed in their interaction with 70 patients over 10 days. The observations were conducted during both the history taking and the actual examination sessions by a woman researcher. The results reported in this paper are based on the extensive field notes taken during the observations. Important differences were revealed in interactions between male vs female gynecologists and their patients. Namely, interactions differed in terms of conversation initiation, communication style, use of technical and colloquial language, frequency of eye contact, patience, and provision of information. Communication characteristics specific to interactions between male gynecologists and their patients included a 'blaming the victim' approach, differential treatment of patients, and underestimation of patients' abilities. Environmental factors that affected physicians' interaction with their patients are reported in conjunction with physicians' use of these external factors to explain the problems they experienced in physician-patient interaction. The discussion focuses on alternative explanations for and future research implications of the observed differences between male and female gynecologists in this setting.

Communication↗

PubMed2003

Women's hysterectomy experiences and decision-making.

The goal of the study was to examine women's experiences with gynaecologic symptoms and how they decided to undergo hysterectomy. For this purpose, twenty-nine women were interviewed in hospital within three days of undergoing hysterectomy. The interviews elicited information about the nature of the problem that caused the women to seek medical help, actions taken to solve their problem, their relationship with their gynaecologist, information seeking patterns and decision-making about hysterectomy. Although findings revealed that the symptoms women suffered had a negative impact on their lives, most women delayed seeking medical help and attributed their symptoms to factors other than a physical problem in their reproductive system. Most of the participants' information about the symptoms and possible treatments came from their consulting other women with similar problems. The women reported that their gynaecologist did not initiate a comprehensive discussion about other treatments and their advantages and disadvantages. Only women who had informed themselves about other treatments actively discussed alternatives to hysterectomy with their physicians. The women's decision-making process about undergoing hysterectomy was difficult and depended primarily on the women's illness experiences, age, wish for future children, information they gathered from their gynaecologist and from other women. The findings are discussed in relation to the importance of information provision by gynaecologists and its effects on women's decision-making about hysterectomy.

Adult↗

PubMed2002

Preferences for gender of family physician among Canadian European-descent and South-Asian immigrant women.

OBJECTIVE: The aim of this study was to investigate expressed preferences for family physician (FP) gender among Canadian European-descent (CED) and Canadian South-Asian (CSA) immigrant women. METHOD: An 'on-site' survey was conducted in community-based institutions in Toronto in order to determine preferences for the gender of FP under various health care scenarios: overall health care; gender-sensitive examinations; emotional problems; general ailments; and life-threatening conditions. RESULTS: Ninety-four women responded to this survey (CED = 50, CSA = 44), response rate 77.3%. For all health care scenarios, CED and CSA women similarly expressed either a preference for a female FP or no preference. More than two-thirds of women preferred a female FP for gynaecological examinations (CED, 72.9%; CSA, 83.7%) or examinations with private body part exposure (CED, 72%; CSA, 81.8%). For 'emotional problems', half of the women preferred a female FP and the other half had no preference. A similar pattern was observed for 'overall health care', with some shift to female physician preference among CSA women (60.5%) compared with CED women (53.2%). For the 'overall health care' scenario, CED and CSA women who preferred a female FP had a higher frequency of seeing female physicians within the last 5 years (CED, P < or = 0.01; CSA, P < or = 0.05), and attributed 'positive' social skills more to female physicians (CED, P < or = 0.01; CSA, P < or = 0.01) compared with women with no preference for the gender of the FP. Yet, CED women with a female FP preference were more likely to have a concurrent female FP (P < or = 0.01), and to rate past experiences with female physicians as high (P < or = 0.01) and with male physicians as low (P < or = 0.05) compared with CED women with no preference. In the CSA group, women with a preference for a female FP were more likely to be unemployed (P < or = 0.01) and have low social support (P < or = 0.01). CONCLUSIONS: Despite similar physician gender preference patterns, factors associated with these preferences show some differences between CED and CSA women.

Adult↗

PubMedDate not supplied

Breast and cervical cancer screening in Hispanic women: a literature review using the health belief model.

The aim of this study was to review published studies that examined factors influencing breast and cervical cancer screening behavior in Hispanic women, using the Health Belief Model (HBM). MEDLINE and PsycINFO databases and manual search were used to identify articles. Cancer screening barriers common among Hispanic women include fear of cancer, fatalistic views on cancer, linguistic barriers, and culturally based embarrassment. In addition, Hispanic women commonly feel less susceptible to cancer, which is an important reason for their lack of screening. Positive cues to undergo screening include physician recommendation, community outreach programs with the use of Hispanic lay health leaders, Spanish print material, and use of culturally specific media. Critical review of the literature using the theoretical framework of the Health Belief Model identified several culturally specific factors influencing cancer screening uptake and compliance among Hispanic women. Future interventions need to be culturally sensitive and competent.

Adult↗