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Biomedical subjects

J Yager

Publications and source records attributed to J Yager.

At least 73 records · Page 4Linked to original sources
PubMed1988

Behaviors and attitudes related to eating disorders in homosexual male college students.

To investigate whether homosexuality predisposes males to eating disorders, the authors studied 48 nonpatient homosexual male students at UCLA. The homosexual men had higher prevalences of binge-eating problems, of feeling fat in spite of others' perceptions, of feeling terrified of being fat, and of having used diuretics than other male students. They also scored higher on the Eating Disorders Inventory scales for drive for thinness, interoceptive awareness, bulimia, body dissatisfaction, maturity fears, and ineffectiveness. One of the 48 homosexual men and one of the 300 comparison group men met criteria for probable past histories of eating disorders.

Adult↗
PubMed1988

Psychiatrists' attitudes toward preventive intervention in routine clinical practice.

A sample of 189 psychiatrists were surveyed to determine their attitudes toward preventive activities with high-risk children in clinical practice. Respondents indicated generally positive attitudes toward the appropriateness and efficacy of such activities but expressed uncertainty about the ethicality of prevention and about the knowledge base on which such activities rest. Psychiatrists perceived serious barriers to preventive activities due to financial, educational, and time factors. Important attitudinal differences were related to the respondents' age, career aspirations, membership on an academic faculty, number of scholarly articles published, marital status, number of vacation days taken in the previous year, and training in child psychiatry. Psychiatrists whose personal health beliefs favored an internal locus of control were more positively inclined toward preventive activities.

Adult↗
PubMed1988

The treatment of eating disorders.

Anorexia nervosa and bulimia nervosa are common disorders among adolescent and young adult females, estimated to occur in up to 1% to 3% of these populations. A variety of medical and psychological approaches have been used in their treatment, including hospitalization; nutritional rehabilitation; medications; and psychodynamic, behavioral, cognitive-behavioral, family, and group psychotherapies. The author discusses controlled and uncontrolled studies of the different therapeutic approaches that have been used in these disorders and reviews what is known about their prognosis. Important treatment issues include the nature of the disorder, age, degree of malnutrition, motivation, capacity to engage in treatment, personality disturbance, affective state, family situation, and available treatment resources. Based on research data and clinical lore, prudent suggestions for treatment planning are presented.

Adolescent↗
PubMed1987

Life events do not predict symptoms: symptoms predict symptoms.

The effects of life events and previous symptoms on current symptom levels were examined in a model using data from a 3-year prospective study. Male psychiatric patients and nonpatients reported on life events and symptoms every 2 months on 18 occasions. Logistic regression analysis of these data revealed little dependence of psychiatric symptoms on preceding life events as measured by the Holmes and Rahe Schedule of Recent Experiences (SRE). The best predictor of the current symptom level was the level of previous symptoms. It is concluded that efforts to relate changes in the social environment to health must first consider the possible contribution of the antecedent symptom level to the variability in health outcome.

Adult↗
PubMed1987

The evolving subspecialization of psychiatry: implications for the profession.

Psychiatry is likely to evolve into a number of subspecialty areas, paralleling developments in other medical specialties. These changes are impelled both from within psychiatry, where the rapid increase in knowledge and skills makes mastery of the entire field by any one practitioner less possible, and from without, related to new expectations for psychiatric services from referral sources and patients, increasing competition by other physicians and nonphysician mental health care providers, and shifting reimbursement patterns. The authors discuss the advantages and disadvantages of subspecialization as well as implications for psychiatric practitioners and training programs.

Humans↗
PubMed1987

Are we training too many psychiatrists?

In contrast to the past decade's concerns about an undersupply of psychiatric manpower, the authors point out that the profession may soon be facing the prospect of an oversupply of psychiatrists. Given the present rate of producing psychiatrists, shifts in demands for psychiatric services, changing payment and access patterns regarding specialty medical care, increasing numbers of nonpsychiatrist mental health professionals, and a probable surfeit of primary care physicians, underemployment of psychiatrists may become commonplace. Future psychiatrists will likely be used more as consultants, and the profession will need fewer, but better trained, graduates. The authors present alternative proposals to deal with service needs related to such reductions.

Community Psychiatry↗
PubMed1987

A 20-month follow-up study of 628 women with eating disorders, I: Course and severity.

A national sample of 628 women with eating disorders completed questionnaires in 1982 and again in 1984. According to initial simulated DSM-III diagnoses, 34 had anorexia nervosa with bulimic features, 392 had normal-weight bulimia, and 202 had a subdiagnostic eating disorder. Most respondents in the latter two groups met some criteria for alternative eating disorders. At follow-up, 29% of the anorexia nervosa group and 43% of the normal-weight bulimia group had improved enough to be classified as having a subdiagnostic disorder. Respondents who sought professional help between the initial survey and follow-up reported no more improvement than those who did not seek help.

Adult↗
PubMed1987

Psychiatric residency training and the changing economic scene.

Efforts to contain the cost of medical care are having a profound impact on psychiatric residency training programs, which must cope with diminishing levels of funding from both federal and private sources. The programs are also being buffeted by other forces that help shape psychiatry's manpower needs, such as the corporatization of American medicine, new models of health care delivery, the regulation of medical care, the trend toward subspecialization, a perceived oversupply of physicians, and the growing number of mental health professionals who are not physicians. The author discusses how these developments are impinging on residency training programs and what the programs can do to meet the challenges they pose. He believes psychiatry will be best served by resisting tendencies to compromise on the quality of training for its future practitioners.

Cost Control↗
PubMed1987

Induced pasteurellosis and pulmonary vascular adrenoceptor function in bull calves.

Effects of Pasteurella haemolytica inoculation on pulmonary vascular function were studied in 5 conscious standing Jersey bull calves. Instruments were implanted in each calf to measure pulmonary arterial, pulmonary arterial wedge, left atrial, and systemic arterial pressures and cardiac output. Each calf was challenge exposed with 5 sequential 3-minute infusions of isoproterenol (a beta agonist) or phenylephrine (an alpha agonist) for maximal doses of 1.8 micrograms of isoproterenol or 2.3 micrograms of phenylephrine/kg of body weight/min. The calf was allowed 1 hour to recover, was anesthesized, and administered a 20-ml intratracheal infusion of live P haemolytica (10(6) colony-forming units/ml) followed by a 20-ml saline flush. The pulmonary hemodynamic response to isoproterenol and phenylephrine was examined again in each calf 4 days later. Calves developed a pneumonic pasteurellosis involving 26 to 43% of the lungs. There was a significantly (P less than 0.05) reduced resistance in the pulmonary arterial compartment after inoculation. Isoproterenol infusion decreased resistance in the pulmonary arterial, pulmonary venous, and systemic vascular compartments. The decrease in the pulmonary venous compartment in response to isoproterenol was significantly (P = 0.01) smaller after P haemolytica inoculation. After administration of 1.8 micrograms of isoproterenol/kg/min, resistance in the pulmonary venous compartment was 0.90 +/- 0.22 (mean +/- SD) before and 1.25 +/- 0.39 after Pasteurella inoculation. Phenylephrine resulted in an increase in pulmonary arterial, pulmonary venous, and systemic vascular compartments. There was a mild (P = 0.08) decrease in the pulmonary arterial compartment response to phenylephrine. Seemingly, Pasteurella inoculation blunted beta-receptor function in the pulmonary vascular bed, mainly in the veins, contributing to edema.

Animals↗
PubMed1986

Initial clinical judgments by internists, family physicians, and psychiatrists in response to patient vignettes: I. Assessment of problems and diagnostic possibilities.

A sample of 146 physicians from internal medicine, family medicine, and psychiatry responded to two written clinical vignettes describing patients with combinations of commonly seen somatic and psychologic complaints. The physicians included housestaff of all levels of training, full-time academic faculty, and community-based clinical faculty. Enormous variation was seen in all specialties in the numbers and types of problems and diagnoses suggested by the physicians. Aside from one or two areas, there were few differences among the specialties or by level of training with regard to the numbers or types of problems identified and tentative diagnoses recorded. The variability within specialty groups was greater than among the groups. Physician behavior in response to one vignette was highly correlated with responses to the second vignette.

Adult↗
PubMed1986

Initial clinical judgments by internists, family physicians, and psychiatrists in response to patient vignettes: II. Ordering of laboratory tests, consultations, and treatments.

In response to two written clinical vignettes describing patients with commonly seen somatic and psychologic complaints, 146 physicians from internal medicine, family medicine, and psychiatry recorded the tests and initial treatments they would order. As with the problems and diagnoses suggested by the physicians, enormous variation was seen in all specialties. The number and to some extent the nature of tests, procedures, and initial treatments ordered varied by specialty and within specialty subgroups (i.e., housestaff, full-time academic, and volunteer clinical faculty members). Physician test ordering responses to one vignette was highly correlated with responses to the second vignette, suggesting that test ordering among physicians is partly based on personal habits and characteristics and not alone on the patient's signs and symptoms.

Adult↗
PubMed1986

Factors associated with life satisfaction among practicing internists.

The present study explored the relationship between satisfaction with life in general among 211 practicing internists and characteristics of their work, health, and life styles. Using a forced stepwise multiple regression analysis, 67% of the total variance in life satisfaction was accounted for by study variables. More satisfied physicians were more likely to be older, married, engaged in sexual intercourse more often, argued with or emotionally withdrew from family or friends less often, had fewer health problems, were less anxious and depressed, and experienced less job stress and more job satisfaction. Characteristics of the work setting, type of work activity (teaching, research, or patient care), number of patients seen, or hours worked per week were unrelated to satisfaction with life. The findings point to the importance of studying family life, mental health, and social relations in addition to work-related variables in order to understand and assess the quality of life among physicians.

Adaptation, Psychological↗
PubMed1986

Ongoing evaluation in psychiatry: the first step toward quality.

Concern about quality control in psychiatric training has been heightened by the lack of standardized assessment within residencies to ensure that graduates reach a level of competence commensurate with the ability to practice independently and the high failure rate on the American Board of Psychiatry and Neurology examination. An APA task force explored the paucity of evaluation of both training programs and residents and made 10 recommendations for improving the quality of residency training. The authors describe the evaluative components of these recommendations and the political steps taken to gain professional consensus for their requirement in all training programs.

Accreditation↗
PubMed1986

Anorexia nervosa in a woman totally blind since the age of two.

A 28 year-old woman, blind since the age of two, had become anorexic at 21. She had eating problems as a child, and weight preoccupation from her teens onwards. Psychiatric admission with other anorexic patients preceded the illness. Inability to see oneself does not protect against anorexia nervosa.

Adult↗
PubMed1986

Health habits and coping behaviors among practicing physicians.

Practicing physicians on the full-time academic and clinical (volunteer) faculty of an urban university department of medicine (N = 211) completed questionnaires that examined their coping behaviors, health habits, life satisfaction, job stress, conflict between work and home life, health status and moods. Attempts to organize and restructure work activities were more frequently practiced by physicians who were more satisfied with work. Socializing, exercising and discussing feelings with others were not associated with any measures of physician health status, job stress, conflict or satisfaction. Those with higher scores on a health habits index tended to be less anxious, experienced less job stress, less conflict between work and home life and were more satisfied with their lives in general. Full-time academic faculty engaged in fewer positive or negative coping behaviors than clinical faculty. There were few strong intercorrelations among the various positive and negative coping behaviors or health habits; physicians often simultaneously engaged in both positive and negative activities, indicating complex patterns of coping behaviors that were not dramatically associated with life or work satisfaction.

Activities of Daily Living↗
PubMed1986

Bethanechol chloride can reverse erectile and ejaculatory dysfunction induced by tricyclic antidepressants and mazindol: case report.

A 43-year-old man who experienced profound dose-related erectile and ejaculatory dysfunction without loss of libido on three separate antidepressants and on the anorectic agent mazindol is described. Bethanechol chloride 20 mg p.o., taken 1 to 2 hours prior to sexual activity, permitted satisfactory erection and ejaculation during sexual intercourse, while the patient continued to take protriptyline or mazindol. Bethanechol chloride may prove to be of use in treating sexual dysfunction associated with drugs or conditions which increase sympathetic tone.

Adult↗
PubMed1985

Health status, job satisfaction, job stress, and life satisfaction among academic and clinical faculty.

The present study compares academic and clinical faculty affiliated with a major teaching hospital in terms of work characteristics, job stress, conflict between work and personal life, job and life satisfaction, and perceived health. There were no significant differences between the two physician groups on job satisfaction, total stress, anxiety, or depression scores. However, academic faculty reported working longer hours, taking less vacation time, and spending more time in research and teaching, but seeing fewer outpatients. Academic physicians experienced more conflict between work and personal life, were burdened by a variety of time pressures, and were less satisfied with their finances, but experienced fewer recent episodes of physical illness than clinical faculty. However, compared with what is known about the general population, both physician samples seemed equally or more satisfied with their health and their lives.

Adult↗