Dealing with Vietnamese refugees. Our plans.
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Biomedical subjects
Publications and source records attributed to R J Pearson.
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Examples of retrospective studies are presented to demonstrate some facets of such studies, both good and bad, pointing out the need for good controls. Also important are a clear idea of the question to be answered, and careful planning around that answer as the study progresses.
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Teaching epidemiology to medical students is often seen as a difficult, if not impossible, task. After experimenting with several other approaches, faculty at the West Virginia University School of Medicine have developed a course centered around the production of a research proposal using National Institutes of Health criteria and format. The course content, while comprehensive, emphasizes the clinical uses of epidemiology. Lectures are combined with self-study and individualized teaching to assist the students as they explore their chosen topic. This problem-solving approach to teaching and learning epidemiology in medical school has proved both effective and more acceptable to students, as evidenced by the quality of their research proposals, National Medical Examination Board Scores, student evaluations, and improved faculty-student interaction.
Following the 1980 Graduate Medical Education National Advisory Committee report, postal questionnaires were sent to a random sample of physicians self-designated as preventive medicine specialists primarily in an effort to verify the committee's assumption that preventive medicine is not a clinical specialty. The questionnaires represented each of the preventive medicine subspecialties: general preventive medicine, public health, occupational medicine, and aerospace medicine. After three reminders, 419 out of 942 (44%) responded. Seventy percent of the physicians who responded engage in clinical activities for at least part of their workweek. Preventive medicine is practiced in a wide variety of settings. For the majority of preventive medicine physicians, prevention plays an important role in their practice. They perceive that they practice medicine differently from their colleagues who are not preventive medicine specialists because of their prevention focus. Many of these physicians have made career changes, and some have made many such changes, as board certification in one of the subspecialties does not preclude practice in another subspecialty. The specialty appears to allow considerable flexibility. The preventive medicine physician is prepared to incorporate prevention into clinical practice and seems well equipped to integrate community and individual clinical approaches.
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A questionnaire was sent in 1988 to all sites conducting mammographic studies registered with the radiologic licensing division of the West Virginia State Department of Health Laboratory Services to determine the number of women served and the costs of the procedures. The number of sites, 61, appears excessive in view of the small number of women many of them screened during the course of a year and the high charges. Copies of the report on the questionnaire results were sent to agencies and other groups within the state to urge initiation of a more cost-effective system; however, four years later the number of units had increased substantially, and no coherent plan had been formulated. The report was helpful to members of the state legislature in their decision to mandate insurance coverage for women according to the American Cancer Society guidelines.