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H C Barry

Publications and source records attributed to H C Barry.

35 records · Page 2Linked to original sources

Exercise and aging. Issues for the practitioner.

The elderly present the health care system with a number of challenges, the most important of which centers on the declining functional capacity associated with aging. It remains to be clarified the degree to which these changes are related to the interactions among aging, disease, illness, injury, lifestyle, genetics, and other variables. While these issues are being clarified, however, it is clear that a well-designed exercise program that is of low to moderate intensity may be the single, most cost-effective means of maintaining function. The exercise program needs to be goal-oriented and goal congruent, yet it must be individualized to account for existing impairments. General guidelines, such as those in Table 7, may be useful in maintaining a perspective on the regimen. Regardless of the degree of functional limitations, all elderly can derive some benefit from engaging in an exercise program. The emphasis of any regimen should be on quality-of-life issues, such as improving flexibility, strength, and mobility. For the vast majority of elderly, a simple walking program is probably the safest, most effective form of activity.

Aged↗

Exercise prescriptions for the elderly.

The decline in physical function that occurs with aging affects all systems, especially the cardiovascular and musculoskeletal systems. Exercise may improve cardiovascular fitness, increase bone density, improve flexibility and enhance mental outlook. Exercise of adequate intensity should be performed three to five times per week. Elderly persons require longer periods of activity because of their inability to tolerate intense levels of exertion.

Aged↗

Orthopedic aspects of Paget's disease of bone.

The special features of fractures, usually in the femur of the tibia, and their treatment in Paget's disease of bone are discussed. Osteotomy of the femur or tibia for marked deformity, and joint replacement of the hip or knee for painful arthritis can be carried out quite successfully. The high incidence of sarcomas arising in the humerus, the development of multiple sites of malignant change, and some features of tumors on the skull are noted.

Bone Neoplasms↗

Pesticide residues in total-diet samples.

Small amounts of pesticide residues were found in food samples from 18 markets consisting of 82 foods collected from three different geographical areas. The samples were separated into twelve similar classes of foods, made ready to eat, and analyzed by methods capable of detecting small quantities of 50 common pesticide chemicals.

Food Analysis↗

Training medical students in evidence-based medicine: a community campus approach.

BACKGROUND AND OBJECTIVES: Clinicians need skills in critical appraisal of medical literature to improve quality of care. This report on evidence-based medicine (EBM) curricula describes 1) the role of family medicine educators, 2) timing, 3) value of a standard format across multiple communities, and 4) outcomes in attitudes and skills. METHODS: In 1992, a nine-session curriculum delivered across six community campuses was introduced during the third year of medical school in the College of Human Medicine at Michigan State University. Evaluation compared 1) responses on the Association of American Medical Colleges graduation questionnaires from classes who received the curriculum with the 1994 class who did not (424 students), 2) responses to questions on group process performance, and 3) focused surveys of two classes. RESULTS: Trained classes reported higher levels of confidence in critical appraisal and research skills than the 1994 class and other schools. Respondents reported the small-group process as effective, greater appreciation of the training after 1 year of residency than at graduation, and no change in research activity. CONCLUSIONS: Family medicine educators can lead a new curriculum in EBM and maintain consistent standards across multiple communities. Many questions remain concerning the ideal curricular design to help clinicians apply the best research to patient care.

Curriculum↗

Family physicians' use of medical abstracts to guide decision making: style or substance?

BACKGROUND: Many physicians rely on the abstracts of research articles to guide their clinical decision making. This need for expediency is one basis for many journals to reformat their abstracts. METHODS: To determine whether the format of medical abstracts affects physician decision making, we surveyed family physicians in Michigan, Pennsylvania, and Virginia. All participants were members of the American Academy of Family Physicians. The survey included three case scenarios (corneal abrasion, fibromyalgia, and hyperlipidemia) followed by structured and open-ended assessments of usual management. After assessing their usual management in each scenario, the respondents were provided with an abstract of a valid research paper. The format of abstracts (unstructured, IMRAD [introduction, methods, results, and discussion], structured, and POEM [patient-oriented evidence that matters]) were randomly assigned. After reading the abstract, we assessed changes in management of the case scenario. RESULTS: Two hundred eighty-nine family physicians responded to the survey. At baseline, 187 (65%) of physicians patched corneal abrasions. After reading the abstract, 142 (76%) would no longer use eye patches. Two hundred forty-five (83%) of physicians did not use the combination of fluoxetine and amitriptyline for managing fibromyalgia. After reading the abstract, 179 (73%) would use combination therapy. Two hundred thirty-four (84%) of physicians used "statins" when managing hyperlipidemia. After reading the abstract, 211 (90%) would continue using statins. The format of abstract had no significant effect on physicians' decision making. CONCLUSIONS: Whereas the format of abstract in this study had no effect on physician decision making, having valid information available in the context of a clinical scenario appeared to influence decisions.

Abstracting and Indexing↗