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Biomedical subjects

J T Moore

Publications and source records attributed to J T Moore.

At least 73 records · Page 4Linked to original sources
PubMed1981

Geriatric medicine training in a family medicine residency.

While the need for training programs in geriatric medicine is widely recognized, there are substantial obstacles to developing such training. Obstacles include shortage of faculty members and negative attitudes toward geriatrics on the part of students. For the past two years, family medicine residents have participated in a required rotation in geriatric medicine at the Duke University Medical Center. The program has been successful as measured by regular monthly evaluations of the resident on the rotation, resident acceptance, requests by other learners in the university to participate, and career choices of graduates of the program.

Aged↗
PubMed1981

Assessment of elderly patients at home: a report of fifty cases.

Fifty elderly patients were assessed at home by physicians trained in geriatric medicine. The patients had been referred by physicians, relatives, or community services. Reasons for referral usually were nonspecific and involved either a request for overall assessment or recommendations about placement. Assessment included medical, psychiatric, social and functional components. Mental impairment and impairment in the activities of daily living were common. New medical or psychiatric diagnoses were contributed in 36 instances. The most frequent previously unnoticed pathologic disorders were mental impairment and depression. Assessment resulted in specialists' advice concerning such matters as the medication program, placement, increased support, further diagnostic work and, in two instances, prompt admission to a hospital.

Activities of Daily Living↗
PubMed1981

Change in functional disability of geriatric patients in a family medicine program: implications for patient care.

Multi-dimensional functional impairments of a sample of 130 new patients, aged 60 years and older, at a family medicine center were previously described. Of these, 48 persons representing the combinations of impairment originally present were selected by means of modified random sampling for follow-up 13 to 27 months later (m = 20 months). Patients were assessed both at the time of the initial visit and on follow-up with the Older Americans Resources Services (OARS) Multi-dimensional Functional Assessment Questionnaire, an instrument permitting assessment of functional status in five areas of personal functioning: social, economic, mental health, physical health, and the ability to perform activities of daily living (ADL). Fourteen of the 130 initial subjects died during the follow-up interval. Impairments in mental health, physical health, and ADL were associated with increased risk of mortality; but impairments in social and economic functioning did not increase risk. For the survivors there was decline in economic and mental functioning and little, if any, change in social resources or the ability to perform activities of daily living. However, there was notable improvement in their physical functioning.

Activities of Daily Living↗
PubMed1980

A conceptual framework for teaching geriatrics in a family medicine residency.

There is increasing recognition of the need for educational programs in geriatric medicine, a previously neglected area of medical education. Such training is particularly important in family medicine residencies because primary care physicians have provided the bulk of health care to the elderly and probably will continue to do so. There are many advantages to using a competency-based curriculum model in developing such an educational program in geriatric medicine. The competency-based model clearly states educational objectives and identifies pertinent instructional resources and evaluation methods. A competency-based curriculum model is described which divides competencies under four major goals: understanding principles of geriatric medicine, obtaining and interpreting data, managing geriatric patients, and working as a member of a health care team. Sample objectives for each goal are described, and experience using this model in a family residency is reviewed.

Competency-Based Education↗
PubMed1980

Functional disability of elderly family medicine patients in acute care hospital and nursing homes.

This report describes the functional impairments of elderly patients from a family medicine program who were admitted either to an acute care hospital or long-term care facilities over the course of a year. Assessments were performed in the areas of social and economic resources, mental health, physical health, and the ability to perform routine activities needed for independent living. The presence of significant functional impairment in many of the areas suggests the need for the family physician to develop skills in working as a member of a health care team in order to design and implement a comprehensive treatment plan for elderly patients admitted either to hospitals or long-term care facilities.

Activities of Daily Living↗
PubMed1980

Sexual problems among family medicine patients.

A self-administered questionnaire assessing sexual satisfaction and presence of a number of common sexual problems was developed. Following assessment of reliability and validity, the questionnaire was administered to 142 patients seen in a family medicine center. While 56 percent of patients reported one or more sexual problems, such problems were noted in the medical record in 22 percent of the cases. The nature of many of the problems (ie, techniques of foreplay, fear of pregnancy, and differences in attitudes and expectations between partners) suggests an effective role in treatment for the primary care physician.

Adolescent↗
PubMed1980

Management of senile dementia.

An accurate and complete history, including accounts from the family and friends, is invaluable in assessing the patient with senile dementia. While the underlying condition is at present irremediable, active efforts to maximize the remaining mental and physical function, together with family counseling and guidance, can do much to reduce risk to the patient and stress on the supporters. This may enable the demented patient to be active and remain in the community for a longer period.

Aged↗
PubMed1979

Opiate addiction and suicidal behaviors.

The authors tested the hypothesis that people addicted to opiates manifest more psychopathology in areas that have been identified as predictors for high risk of suicidal behavior than do normal control subjects. They gave 278 patients in a methadone maintenance program and 207 normal control subjects the index of Potential Suicide (IPS), a scale designed to assess suicidal risk. Using discriminate function analysis, the authors found that 87% of 100 of the methadone patients and 98% of 100 of the normal control subjects were correctly identified on the basis of the IPS data.

Adult↗
PubMed1979

Geriatric training in family medicine: the natural history of a developing program.

During the past three years, the Duke-Watts Family Medicine Program and the Duke University Center for the Study of Aging and Human Development have developed training in geriatric medicine as an integral part of the family medicine residency program. This paper traces the following steps in the development of this program: a survey of resident and faculty interest, institution of a conference series, identification of potential training sites, development of elective rotations, and use of consultants. Principles found helpful in establishing training in geriatrics for family medicine residents include the following: involve residents in planning, start with modest goals, make the program relevant and practical, build on local strengths, include other health care professional trainees, and use ambulatory, acute hospital, and long-term care sites in the training rpogram.

Curriculum↗
PubMed1978

Functional disability of geriatric patients in a family medicine program: implications for patient care, education, and research.

While the elderly comprise a large proportion of patients seen in ambulatory care settings, characteristics of these patients have not been well documented. This paper summarizes results of a survey of functional impairment of elderly patients seen in a family medicine center. Assessments were performed in the areas of social and economic resources, mental health, physical health, and the ability to perform routine activities needed for independent living. Results of the survey suggest that family physicians need to know how to perform a multidimensional functional assessment in order to formulate a comprehensive treatment plan for elderly patients.

Activities of Daily Living↗
PubMed1978

Recognition of depression by family medicine residents: the impact of screening.

Psychiatric problems are often encountered in general medical settings, yet physicians frequently fail to identify such problems. Validated questionnaires assessing psychiatric symptoms have been shown to be more sensitive than physicians in detecting cases of psychiatric morbidity. This study deals with depression, the psychiatric problem most frequently seen in primary care settings. A self-administered depression questionnaire was used to alert residents to possible cases of depression. Relay of information from the questionnaire significantly increased resident recognition of depression.

Adult↗
PubMed1977

Sensitizing medical students to impression formation processes in the patient interview.

Medical students in a course that included instruction in patient interviewing participated in an experiment devised to alert them to sources of bias which might influence their judgements and management of patients. Students were randomly assigned to one of four groups and exposed to either a videotaped or audiotaped interview of the same patient presented as either normal weight or overweight. Questionnaire responses of students in the two audio groups indicated no detectable differences in the sound tracks of the overweight and normal weight versions of the interview, and these groups were combined for subsequent analysis. A discriminant analysis indicated that students exposed to the overweight video version formed impressions and assessed patient treatment and outcome differently from those exposed to either the video normal or audio versions of the interview. Implications of these findings for medical education are discussed, and suggestions are made for incorporating such sensitization experiments in the medical curriculum.

Attitude of Health Personnel↗