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Biomedical subjects

T J Coates

Publications and source records attributed to T J Coates.

At least 109 records · Page 6Linked to original sources
PubMed1989

Physicians and acquired immunodeficiency syndrome. What patients think about human immunodeficiency virus in medical practice.

Are patients concerned about going to a physician who is infected with human immunodeficiency virus (HIV) or one who is treating HIV-infected patients? To answer these questions, we surveyed a nationwide sample of 2000 interviews (response rate, 75%). Forty-five percent of all respondents believed that physicians who were HIV infected should not be allowed to continue to practice. More than half of those who had seen a physician in the past 5 years said they would change physicians if they knew their physician were HIV infected, while one fourth said they would seek care elsewhere if their physician were treating people with HIV disease. These data suggest that patients are concerned about HIV in their physicians' offices. The American Medical Association recommends that HIV-infected physicians continue to practice as long as there is no risk to their patients. Physicians and the public need to be educated about this policy and its appropriateness.

Acquired Immunodeficiency Syndrome↗
PubMed1989

Voluntary screening for human immunodeficiency virus (HIV) infection. Weighing the benefits and harms.

Voluntary screening for human immunodeficiency virus (HIV) infection may help prevent the spread of the HIV epidemic if persons who test positive alter behaviors that may transmit infection. Protecting persons from unknowingly being exposed to HIV infection must be balanced against respecting the autonomy of individuals being screened. Seropositive patients may feel a stigma and be subjected to discrimination if confidentiality of test results is breached. In patients without high-risk behaviors, the positive predictive value of HIV testing may be substantially increased if tests are done in reference laboratories and if further confirmatory tests are run on a second blood specimen. For persons with high-risk behaviors, HIV testing can be recommended to those who want to reduce uncertainty about their HIV status or whose medical care would change if they were seropositive. Health care workers can maximize benefits of screening and minimize harm by educating and counseling patients before HIV testing, discussing the confidentiality of HIV test results, urging patients to disclose positive test results to sex partners, and advising patients on how to reduce high-risk behaviors.

Acquired Immunodeficiency Syndrome↗
PubMed1989

Training physicians in counseling about smoking cessation. A randomized trial of the "Quit for Life" program.

STUDY OBJECTIVE: To test whether physicians who receive a continuing education program ("Quit for Life") about how to counsel smokers to quit would counsel smokers more effectively and have higher rates of long-term smoking cessation among their patients who smoke. DESIGN: Randomized trial with blinded assessment of principal outcomes. SETTING: Four health maintenance organization medical centers in northern California. SUBJECTS: Eighty-one internists assigned by blinded randomization to receive training (40) or serve as controls (41). Consecutive samples of smokers visiting each physician (mean, 25.6 patients per experimental and 25.2 per control physician). INTERVENTIONS: Internists received 3 hours of training about how to help smokers quit. Physicians and their office staff also were given self-help booklets to distribute free to smokers and were urged to use a system of stickers on charts to remind physicians to counsel smokers about quitting. MEASUREMENTS AND MAIN RESULTS: On the basis of telephone interviews with patients after visiting the physician, we determined that internists who attended the Quit for Life program discussed smoking with more patients who smoked, spent more time counseling them about smoking, helped more patients set dates to quit smoking, gave out more self-help booklets, and made more follow-up appointments to discuss smoking than did internists in the control group. One year later, the rate of biochemically confirmed, long-term (greater than or equal to 9 months) abstinence from smoking was 1% higher among all patients of trained internists than among patients of controls (95% CI, -0.1% to +2.3%), and 2.2% (+0.2% to +4.3%) higher among the patients who most wanted to quit smoking. CONCLUSIONS: This continuing education program substantially changed the way physicians counseled smokers. As a result, a few more patients who wanted to quit smoking achieved long-term abstinence.

Attitude of Health Personnel↗
PubMed1989

Smoking counseling and preventive medicine. A survey of internists in private practices and a health maintenance organization.

Physicians could help a large number of patients quit smoking by taking time to advise them about quitting, helping them plan a date to quit, giving them self-help materials, following up, and referring some to smoking cessation programs. To determine the attitudes and practices of internists concerning smoking cessation and selected preventive medical practices, we surveyed a random sample of internists in private practice and in a large health maintenance organization (Kaiser-Permanente Medical Group) in the San Francisco Bay area. Overall, internists consider counseling about smoking to be at least as worthwhile as many other practices, such as screening for breast cancer, and more worthwhile than periodic physical examinations. Despite these beliefs, 57% to 65% of internists reported that they spend two minutes or less counseling smokers during new patient visits. Many internists never use recommended strategies for counseling about smoking: 33% to 44% never help patients plan dates to quit, 68% to 75% never make follow-up appointments with patients primarily about smoking, and 27% to 48% never give smokers self-help pamphlets about quitting. Although they believe that counseling about smoking is worthwhile, internists are not doing as much as they could to help their patients quit.

Attitude of Health Personnel↗
PubMed1989

Older Americans and AIDS: transmission risks and primary prevention research needs.

The growing number of AIDS cases among older Americans (50 years and older) is of increasing concern. In the context of primary prevention, findings are reviewed that bear on the modes of HIV transmission (blood transfusion, sexual) among older individuals and knowledge of the magnitude of the AIDS problem represented by these routes of infection. Lastly, a proposed research agenda is focused on questions of primary prevention of HIV transmission.

Acquired Immunodeficiency Syndrome↗
PubMed1989

Stress reduction training changed number of sexual partners but not immune function in men with HIV.

We tested the impact of stress management training on sexual behavior and immune functioning in 64 gay men infected with human immunodeficiency virus (HIV). Subjects randomized to the stress management group met for eight two-hour sessions and one all day retreat to learn systematic relaxation, health behavior change, and stress management skills. Compared to those randomized to a wait list control, treatment subjects reported significantly fewer sexual partners in the prior month at post-test (1.10 vs 2.29 for controls). There were no differences between groups in lymphocyte numbers and function.

Adult↗
PubMed1989

Reducing smoking among pregnant adolescents.

Pregnant adolescents who smoke present a double obstetrical risk. Not only is the adolescent mother at risk from the biological, social, educational, and economic factors associated with childbearing at a young age, she and her developing infant also risk the complications associated with maternal smoking. This paper describes a psychosocial intervention designed to reduce smoking in a group of pregnant adolescents. Five modules are presented. Each is designed to: (1) heighten awareness of the issue, (2) provide motivational messages, (3) enhance the adolescent's social skills, and (4) teach specific smoking-cessation skills.

Adolescent↗
PubMed1988

Internists and nicotine gum.

Nicotine gum may be a useful aid to help patients quit smoking. The effectiveness of the gum and incidence of side effects may depend on using the gum properly. To describe internists' current practices of prescribing nicotine gum and other drugs for smoking cessation, we surveyed randomly selected internists. Most internists prescribe nicotine gum to fewer than 25% of patients who try to quit smoking. Contrary to current recommendations, nearly half of internists would suggest gum to help patients cut down on smoking, and a majority would limit its use to less than three months. There is no evidence that sedatives are useful for smoking cessation, but one fourth of internists had recently prescribed them for that purpose. There is a widespread need for physician education about how to use nicotine gum more effectively.

Attitude of Health Personnel↗
PubMed1988

Behaviors of treated hypertensive patients and patient demographic characteristics.

The relationships between self-reported hypertension-related patient behaviors and patient demographic characteristics were examined in a sample of 2,044 patients being treated for hypertension in 111 primary care medical practices. The patient behaviors of sodium intake, weight, alcohol, exercise, relaxation and adherence to medication regimen could be predicted to some extent by patient demographic characteristics. Whether patients recalled receiving advice from their physicians about these behaviors could also be predicted by patient demographic characteristics. Patients demographically similar to physicians, i.e., male, younger, more educated and White, reported receiving more advice from their physicians. Patients with behavioral problems who received relatively less advice from their physicians included: less educated younger patients whose sodium intake was relatively high; younger and less educated over-weight women; overweight Black patients; and older women who exercised less than average.

Aged↗