Search PubMed⌕ Search

Biomedical subjects

M Glasser

Publications and source records attributed to M Glasser.

80 records · Page 5Linked to original sources
PubMedDate not supplied

Assessment and treatment of geriatric depression in primary care settings.

OBJECTIVE: To examine primary care physicians' practices relating to the diagnosis and management of geriatric depression, attitudes regarding responsibilities for and barriers to management, self-assessments of their needs in providing this care, and physician characteristics that correlate with attitudes and practices. DESIGN: Descriptive and analytic needs assessment. SETTING: A midwestern city and surrounding county and the suburb of another midwestern city. MEASUREMENTS: A self-administered survey consisting mainly of close-ended, Likert scale questions. PARTICIPANTS: One hundred forty-one family physicians and general internists (53.2%) responded. Respondents were 75.4% male and 50.8% general internists and ranged in age from 29 to 75 years (mean, 43 years; SD, 11 years). RESULTS: No standard test to screen for depression was used by 66.7% of respondents. The 2 most common laboratory studies ordered were thyroid studies (41.1%) and chemistry panels (37.6%). Selective serotonin reuptake inhibitors were most commonly prescribed for depression (53.2%). Although 98.6% of respondents agreed that treatment of depression in elderly patients was important, 29.0% reported that depressed elderly patients frustrated them, and 24.2% were too pressured for time to routinely investigate depression in the elderly. The most frequently identified needs in caring for these patients were increased time with patients (97.1%); increased reimbursement for counseling (87.8%); greater emphasis in medical training on the link between physical and mental health (85.6%); improved patient compliance with treatment (84.3%); and more training and attention to depression in residency (82.1%). In general, family physicians were more active and positive in their approach toward geriatric depression. CONCLUSIONS: Potential interventions to improve the diagnosis and management of geriatric depression include the following: use of screening instruments in a more efficient and timely manner; increased reimbursement for counseling of patients; more educational programs at the undergraduate, graduate, and continuing medical education levels; and clinical practice guidelines specific to geriatric depression.

Aged↗
PubMedDate not supplied

Relationship of pregnanediol level to cognitive behavior and mood.

This work examines data secured from a larger study relating cognitive behavior and mood in women to variation in estrogen level. The larger study noted that performance tended to be better during the luteal phase. The present analysis looks at the relationship of urinary pregnanediol levels with mood and cognitive behaviors. Thirty women with non-oral contraceptive-controlled menstrual cycles were tested during the luteal phase on a battery of cognitive tests and a variation of the Clyde Mood Scale. The cognitive tests were selected based upon the automatization versus perceptual restructuring dimensions described by Broverman and colleagues. Pregnanediol levels were measured in 24-hour urine specimens collected on the same day. Results show a significant relationship of pregnanediol level with mental subtraction and with time estimation. Perceptual restructuring tasks in general (perceptual restructuring index) showed a significant positive relationship with pregnanediol levels. Mood, however, was not found to be related to pregnanediol levels.

Adult↗
PubMedDate not supplied

Medical student evaluation of family nurse practitioners as teachers.

BACKGROUND: Demands on family medicine faculty to generate clinical revenue may negatively impact the undergraduate medical education program. To minimize this possibility and better model interprofessional education, family nurse practitioners (FNPs) were hired as clinicians and teachers as part of a longitudinal family medicine clerkship. This paper reports the results of a pilot study of student evaluations of nurse practitioner teaching. METHODS: All M3 and M4 students were asked to evaluate one of three FNPs who had precepted them multiple times during their previous year of ambulatory care practice. Two previously studied closed-ended questionnaires were used to assess quality of teaching by the FNPs. Students also responded to a series of open-ended questions. RESULTS: Ninety-one percent of 97 students responded to the survey. Responses to the closed-ended questions as well as comments by the students and physicians were positive regarding the teaching by FNPs. The teaching skills most highly regarded by the students tended to be different than those most highly regarded in physicians. CONCLUSIONS: This pilot study suggests FNPs can be successfully integrated into undergraduate medical education settings, offering teaching strengths that complement those of physicians. Integrating the two professions in a family medicine clerkship may prove beneficial to students and expand departmental teaching resources without further straining finances. Efforts at evaluating the teaching contributions of FNPs at other institutions are needed to substantiate the present study results.

Ambulatory Care↗
PubMedDate not supplied

Gender and the educational experience in a primary care training setting.

As the number of women entering medical school increases, patient contacts with female physicians will similarly increase. As a result, educators have begun to consider the relationship between gender and both performance and career preference. The current study explores the relationship between a student's gender and the educational experience of the student. In the setting of established primary care teaching physicians' offices at the University of Illinois College of Medicine at Rockford, gender and diagnosis data were collected on all patient encounters over the course of one year for the 129 students enrolled in the program. Women medical students were 29% less likely than chance to see male patients, and male students were 5% less likely than chance to see female patients in this setting. This finding was especially marked for encounters with younger adult patients and for sexually sensitive examinations, but was noted with all groups of adult patients. The qualitative effect of this on both educational experiences and health care delivery needs to be addressed.

Adolescent↗
PubMedDate not supplied

The integration of the student into ambulatory primary care: a decade of experience.

This paper presents a functioning model for interfacing health care delivery and medical education. The Community Health Center (CHC) of the University of Illinois College of Medicine-Rockford (UICOM-R) program is an instructive solution to many of the present and anticipated needs identified in undergraduate medical education. In this discussion the CHC program is summarized relative to its personnel, economic standing, and curricular objectives and policies. The views and experiences of students, faculty, and patients relative to the program are presented. At a time when the future of medical education is so closely tied to the cost of health care delivery, and there is a call for "retooling" academic programs, the Rockford program may provide a model for the education of physicians for the twenty-first century.

Ambulatory Care↗
PubMedDate not supplied

The role of the superego in exhibitionism.

The exhibitionist's relationship to his superego is a definitive feature of his general psychopathology of which the exhibitionistic act is only one manifestation. This relationship involves a compelling and persistent active defiance of those aspects of the superego which impose moral and ethical restrictions on behavior and a pervasive resistance to those aspects of the superego which demand adequate standards of functioning and conduct. Some of the implications of this as regards the treatment of exhibitionists are discussed.

Adult↗
PubMedDate not supplied

Medical students' understanding of ethical issues in the ambulatory setting.

BACKGROUND: The education of medical students concerning ethical issues focuses mainly on critically ill hospitalized patients. However, in the outpatient setting physicians encounter many problems that require ethical decision making. The present study is an assessment of medical students' awareness and understanding of ethical issues commonly encountered in the ambulatory setting. METHODS: A questionnaire was designed to evaluate general knowledge of medical ethics using 12 clinical vignettes. These vignettes depict situations in the ambulatory setting which involve ethical problems. The questionnaire was distributed to medical students who were asked to state whether an ethical issue was present, its significance, and what the specific issue was. RESULTS: Students' abilities to identify that an ethical issue was involved in each vignette ranged from 34.2% to 96.4%. A majority of students identified the presence of an ethical dilemma in seven out of 12 vignettes. The significance rating varied from 2.8 to 4.4 on a scale of 1 to 5. The results indicate that traditional education in medical ethics does not necessarily prepare students to recognize these problems in the clinical setting. CONCLUSIONS: The medical students surveyed for this study seem to be variably prepared to recognize obvious ethical dilemmas in the ambulatory setting. Medical education must prepare students to recognize and appropriately manage these commonly encountered situations.

Beneficence↗