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Biomedical subjects

N J Gilman

Publications and source records attributed to N J Gilman.

9 recordsLinked to original sources

Epidemiologic aspects of a St. Louis encephalitis outbreak in Mesa County, Colorado.

An epidemic of St. Louis encephalitis in 1985 in Mesa County, Colorado, led to 17 cases, including one fatality. Risk was associated with advanced age and residence in Grand Junction, the county's principal city. A trend was observed toward higher risk in females. However, increased risk in females was not associated with higher infection rates (increased exposure). Capture enzyme immunoassays detected specific immunoglobulin M (IgM) and immunoglobulin A after infection. A serosurvey of Grand Junction residents disclosed an infection rate of 4.0%, indicating that 1,123 epidemic St. Louis encephalitis infections may have occurred in the city. Evidence of previous St. Louis encephalitis virus infection was found in 11.2% of survey respondents who had neutralizing antibody to the virus without specific IgM. The prevalence of St. Louis encephalitis virus antibody was similar to rates observed in serosurveys undertaken 30 years earlier, indicating that the level of endemic St. Louis encephalitis transmission in the city had not changed appreciably in that interval.

Adolescent

A method of self-directed learning in continuing medical education with implications for recertification.

A method of self-directed learning for physicians that can be used to satisfy a portion of specialty board recertification requirements integrates contract learning (self-formulated learning plans), information brokering (linking physicians with consultants and community resources), and collegial networking (discussion groups). The method encourages physicians to focus on educational objectives, supplies learning resources, and promotes interactions with colleagues in study groups. Fifty-nine (53%) of the 102 learning goals update physicians' knowledge. Print sources and discussions with experts were the commonest resources used. Forty-five (49%) of 91 participants completed their learning plans. Forty-nine (74%) completed projects were judged successful in achieving their goals. Twenty-five (45%) of 56 physicians responding to a questionnaire stated that the method was superior to traditional continuing medical education. Fifty-two percent of the participants found the method as effective as traditional continuing medical education. Proof of accomplishment allows the method to be used as part of a specialty board recertification process.

Certification

Changing prescribing practices through individual continuing education.

In a study involving 94 practicing physicians, committees of clinical pharmacologists analyzed copies of prescriptions (and additional relevant clinical data) to identify problems in prescribing ("educational needs"). Only the ten most commonly prescribed drugs were studied in the samples of 200 prescriptions from each physician; 1061 problems were identified in the prescriptions of the 94 participants. One physician group (n = 41) received feedback (instructional packets) addressing specific problems in prescribing; a second sample consisting of 200 prescriptions was then collected and analyzed. The physicians in this group changed their prescribing practices 30% of the time in accordance with recommendations, whereas those in the group that received no educational feedback changed in only 3% of the cases. When a physician stated an intention to change, an actual change resulted 50% of the time. Individualized teaching in response to real events in practice is a practical and effective method of improving physician performance.

California

Continuing education and library services for physicians in office practice.

A program is described which incorporates library services into continuing medical education for physicians. The educational service is based on the actual needs of the physician rather than on his perceived needs. The needs assessment is accomplished by reviewing drug-prescribing habits. Current medical literature is then selected for the physician to coincide with his unique educational needs. The program is further designed to evaluate the change in the physician's drug-prescribing habits as a result of his study of the literature received.

Drug Prescriptions