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Biomedical subjects

L Robbins

Publications and source records attributed to L Robbins.

At least 19 recordsLinked to original sources
PubMed1998

Developing musculoskeletal education programs for physicians and the general public: findings from a needs assessment.

OBJECTIVE: To assess the educational needs and learning preferences of primary care physicians and the general public in receiving musculoskeletal health education. METHODS: Prospective surveys were mailed simultaneously to 2,250 primary care physicians and 2,250 members of the general public. The surveys included questions about demographics, motivation for attending programs, and preferred education program formats. RESULTS: The 68 responding physicians attend continuing medical education programs mainly based on topics, speakers, and timing. They prefer lectures and find question and answer sessions least helpful in supporting learning. The 96 responding members of the general public attend programs mainly based on topics, speakers, and fees. The general public stated that question and answer sessions best support learning in programs. A large percentage of responding physicians provide health education to their patients, but a small percentage of the general public respondents stated that they receive health education from physicians. DISCUSSION: Responses from physicians and the general public were generally not surprising but revealed interesting contrasts between learning preferences. While physicians and the general public both value speakers and topics, the physicians want to increase their knowledge about disease, whereas the general public wants practical information. Physicians and the general public also appear to take different approaches to learning. The contrast between availability and provision of health education is also striking. We cannot generalize our results with absolute confidence because the return rates for the surveys were so low. Nonetheless, we support the need to educate physicians and the general public in ways that match their preferred learning methods and educational needs.

Adult↗
PubMed1996

Menstrual migraine with features of cluster headache. A report of 10 cases.

Ten patients with menstrually related migraine headaches and significant features of cluster headache are described. The mean age of onset of the headache was 29 years. The duration of the pain was more typical for migraine, with an average of 3 days. The pain was sharp with associated tear formation and nasal congestion. Eight of the women described significant nausea. Only one reported any type of cluster headache outside of the menstrual time. Four patients experienced tension headaches, and four also had migraines not related to menses (without cluster features). Preventive medications were generally not helpful. The abortive medications that did help included sumatriptan, Cafergot PB suppositories, and corticosteroids. Oxygen was useful in two patients. While analgesics did help three patients, lidocaine nasal spray was ineffective in four of the women.

Adolescent↗
PubMed1995

Dominant lethal studies in male mice after exposure to a 50 Hz magnetic field.

The potential mutagenicity of power frequency magnetic fields was investigated using a dominant lethal assay in mice. A total of 42 male mice were exposed for 8 weeks to a 50 Hz sinusoidal magnetic field at 10 mT (rms) and 47 males acted as simultaneous cage controls. Each male was subsequently mated with two females on weeks 1, 3, 5, 7, and 9 post-exposure. The numbers of pregnant females, corpora lutea, and live and dead implants were recorded. Multiple logistic regression analyses examined the effects of exposure on pregnancy rate, pre-implantation survival and post-implantation survival. There were no statistically significant differences in overall response between exposed and control groups, nor was there any significant effect of exposure in any post-exposure week. Thus, exposure to power frequency magnetic fields at 10 mT for the approximate period of spermatogenesis did not appear to induce dominant lethal mutation in the germ cells of male mice.

Animals↗
PubMed1995

Intranasal lidocaine for cluster headache.

Thirty male patients with cluster headache were given 4% lidocaine solution to use intranasally as an abortive therapy. Four sprays of lidocaine were used ipsilateral to the pain, and two more were used, if necessary. Twenty-seven percent of the men reported moderate relief, 27% obtained mild relief, and 46% stated that they had no relief from the lidocaine, Side effects were minimal. In this study, intranasal lidocaine was only a marginally helpful therapy for cluster headache. However, because of the ease of administration and lack of side effects, lidocaine may remain worthwhile as an adjunctive medication.

Administration, Intranasal↗
PubMed1994

Effects of prenatal exposure to 50 Hz magnetic fields on development in mice: I. Implantation rate and fetal development.

Pregnant CD1 mice were exposed or sham-exposed from day 0 to day 17 of gestation to a 50 Hz sinusoidal magnetic field at 20 mT (rms). Preimplantation and postimplantation survival were assessed and fetuses examined for the presence of gross external, internal, and skeletal abnormalities. There were no statistically significant field-dependent effects on preimplantation or postimplantation survival, sex ratio, or the incidence of fetuses with internal or skeletal abnormalities. Magnetic field exposure was, however, associated with longer and heavier fetuses at term, with fewer external abnormalities. The results lend no support to suggestions of increased rates of spontaneous abortion or congenital malformation following prenatal exposure to power frequency magnetic fields.

Abnormalities, Radiation-Induced↗
PubMed1994

Effects of prenatal exposure to 50 Hz magnetic fields on development in mice: II. Postnatal development and behavior.

To investigate the potential of magnetic fields to act as a behavioral teratogen, pregnant CD1 mice were exposed or sham-exposed for all of gestation to a 50 Hz/20 mT magnetic field. Maturation of offspring was assessed using a range of standard developmental indices (eye opening, pinna detachment, hair coat, tooth eruption, sexual maturity, and weight) and simple reflexive behaviors (air righting, surface righting, forepaw grasp, cliff avoidance, and negative geotaxis). Activity and coordination levels were explored in juvenile and adult mice using an open field arena, a head-dip board, an accelerating Rotarod, and a residential activity wheel. All assessments were carried out without knowledge of exposure condition. Results from 168 sham-exposed mice from 21 litters and from 184 exposed mice from 23 litters were compared using survival analysis techniques and multivariate regression methods. Three possible field-dependent effects were found: Exposed animals performed the air righting reflex earlier (P < 0.01); exposed males (but not females) were significantly lighter in weight (P = 0.008) at 30 days of age; and exposed animals remained on a Rota-rod for less time as juveniles (P = 0.03). Some of these results have not been reported in other studies and may reflect spurious statistical significance, although some effect of magnetic field exposure cannot be ruled out. Overall, these results suggest that prenatal exposure to a 50 Hz magnetic field does not engender any gross impairments in the postnatal development or behavior of mice. This does not preclude such exposure affecting more subtle aspects of behavior.

Animals↗
PubMed1994

Precipitating factors in migraine: a retrospective review of 494 patients.

The predominance of certain triggers for migraine was assessed in 494 migraine patients. Stress (62%) was the most frequently cited precipitant. Weather changes (43%), missing a meal (40%), and bright sunlight (38%) were also prominent factors. Sexual activity (5%) was the precipitant cited by the least number of patients. Significant differences were found between men and women in their responses to weather changes, perfumes, cigarette smoke, missing a meal, and sexual activity. Spring was cited by 14% of patients as a time for increased migraine attacks, followed by fall (13%), summer (11%), and winter (7%).

Adolescent↗
PubMed1994

An analogue study of the factors influencing competency decisions.

Forensic psychiatrists who were members of the American Academy of Psychiatry and the Law analyzed case histories to make a competency or incompetency decision. The case histories were created to alter background information, diagnostic information, information about the defendants' understanding of the adversarial process, courtroom behavior, and the nature of the crime. The information that had the most influence on the decisions of the forensic psychiatrists included the cognitive status of the defendant, psychotic features, courtroom behavior, and understanding of the adversarial process. Relationship with the lawyer, alcohol/drug use history, psychiatric history, and criminal history had less influence. The forensic psychiatrists tended to "error" toward a decision for competency unless compelling evidence was presented to the contrary.

Adult↗
PubMed1994

Predicting treatment outcome for incompetent defendants.

This study examined the prediction of outcome in a sample of defendants hospitalized for treatment of incompetency. Defendants' demographic characteristics and scores on 18 scales of the Computer-Assisted Determination of Competency to Proceed instrument (CADCOMP) were used to predict competency restoration and length of stay (LOS). During the period of study, almost 90 percent of the defendants were restored to competency after a mean stay of over 280 days. Demographic characteristics were unrelated to outcome. Several CADCOMP scales, including two scales measuring psycholegal ability and one measuring psychopathology, were correlated with both outcome criteria. Discriminant analysis using the CADCOMP scales accurately classified 76.7 percent of the defendants into short and long stay groups. Although promising, the findings are nevertheless consistent with prior research in suggesting that examiners should exercise caution in providing feedback to the courts concerning competency restoration and the period of time needed for treatment.

Adolescent↗
PubMed1993

An organizational model for developing multidisciplinary clinical research in the academic medical center.

OBJECTIVE: To assess the impact of a new organizational model designed to stimulate multidisciplinary clinical research. METHODS: We conducted a prospective, 3 1/2-year followup of a research training program for residents, fellows, faculty, nurses, and allied health professionals in rheumatology and orthopedic surgery. Program components included a multidisciplinary clinical research conference, a clinical research methods curriculum, consultations, a patient registry, and regular meetings of a Research Methodology Core group. Measures included participation in each program component and the number of new investigators who developed funded clinical research projects. RESULTS: The multidisciplinary clinical research conference was attended by 369 new health professionals; 218 professionals participated in at least one of the courses; and 280 consultations were provided to 108 professionals. Thirteen new investigators developed 17 new grant proposals, of which 14 were externally funded. Investigators who successfully procured funding for new projects demonstrated significantly more participation in program components compared with those who did not (P < 0.001 overall). CONCLUSION: Participation in the program was significantly correlated with the development of new prospective patient-based studies. We conclude that our model has the potential to foster such research in other settings.

Academic Medical Centers↗
PubMed1993

Adapting the systemic lupus erythematosus self-help (SLESH) course for Latino SLE patients.

The Systemic Lupus Erythematosus Self-Help (SLESH) Course is an effective self-management program that provides knowledge and enabling skills to people with systemic lupus erythematosus (SLE) and their families to assist them in coping with the disease. However, many acknowledge that the program has largely failed to meet the needs of people from diverse cultural backgrounds. In order to better understand how the SLESH Course can be more responsive to the needs of people from diverse cultural groups, we conducted a case study to analyze the content, process, and logistics of the course. The purpose of our study was to determine the essential variables to be considered in adapting the program for Latino SLE patients. Utilizing a three-phase approach that involved key-informant interviews, focus groups, and evaluation of skill-building activities, we found that culturally determined health beliefs, language of preference, and outreach efforts are the key variables that must be considered in adapting the SLESH Course for the target population. Culturally determined health beliefs, such as the importance of family roles rather than individual need and an emphasis on the interdependency of family members, need to be considered in adapting self-help programs like the SLESH Course for Latino SLE patients.

Adaptation, Psychological↗
PubMed1993

A musculoskeletal outreach screening, treatment, and education program for urban minority children.

PURPOSE: A hospital-based outreach program was initiated to screen minority children in medically underserved areas of New York City for musculoskeletal diseases. We examine the number of such diseases in this population, and evaluate the program's success to facilitate referral and follow-up of children with referral conditions. METHODS: Screenings were conducted at schools and day-care centers. Children requiring further evaluation were referred to the sponsoring hospital, a major referral center for musculoskeletal diseases. Bilingual educational strategies, transportation reimbursement, and coverage for uninsured children were used to foster participation and increase follow-up. RESULTS: A total of 2,523 children were screened, 168 (6.7%) of whom were referred for one of 45 different musculoskeletal disorders, including scoliosis and back problems, foot problems, in- and out-toeing, knee or hip pain, and problems of joint range of motion. Sixty-seven percent of those referred had a follow-up medical consultation. CONCLUSIONS: A substantial proportion of urban minority children have previously undiagnosed musculoskeletal disorders that, if left untreated, have the potential to lead to significant disability in later life. Targeted screening programs can be effective in identifying such disorders, and providing and opportunity for early diagnosis, treatment, and education.

Adolescent↗