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60 records · Page 4Linked to original sources
PubMed1995

A quarter-century of experience with career change education: an option for turning specialists into generalists.

The Physician Refresher program, now 25 years old, at the Medical College of Pennsylvania offers training to clinically inactive physicians. The authors examined the characteristics of program participants to determine whether specialists who took the program to prepare for a change to a primary care career made the intended change. Application data from all registrants between 1982 and 1993 were compared with data on previously reported groups from 1968-1975 and 1976-1981. Specialist registrants' subsequent practice activities were documented from the AMA Medical Directory and the American Board of Medical Specialties Directory; a telephone survey elicited their reasons for making or not making the career change to primary care. During the last decade of the program women registrants constituted 36% of the total; international medical graduates (IMGs) 43%; and clinically inactive physicians 38%. Specialists outnumbered those in primary care by two to one. Although 65% of specialists planned to switch to primary care, ultimately only 27% of the total did so; many, especially the IMGs, were serving the disadvantaged. Those who did not switch cited a variety of disincentives, including individual educational needs not met by a general refresher course. If the medical profession accepts the need to devise programs that "retool" specialists to provide primary care, those programs should be specifically designed to address the individual needs of the specialists involved. Concomitantly, the incentives to make the switch need to be enhanced.

Adult↗
PubMedDate not supplied

Clinical trial of an Internet-based case management system for secondary prevention of heart disease.

PURPOSE: Despite demonstrated benefits of cardiac rehabilitation and risk factor reduction, only 11% to 38% of eligible patients with cardiovascular disease (CVD) participate in cardiac rehabilitation programs. Women and older adults are particularly less likely to participate in cardiac rehabilitation. In an effort to broaden access to cardiac rehabilitation, the authors developed an alternative Internet-based program that allows nurse case managers to provide risk factor management training, risk factor education, and monitoring services to patients with CVD. METHODS: The evaluation consisted of a randomized, clinical trial involving 104 patients with CVD, 53 of whom used the program as a special intervention (SI) for 6 months and 51 of whom received usual care (UC). RESULTS: The results indicate that fewer cardiovascular events occurred among the SI subjects (15.7%) than among the UC subjects (4.1%) (P =.053), resulting in a gross cost savings of $1418 US dollars per patient. With a projected program cost of $453 USD per patient, the return on investment is estimated at 213%. More weight loss occurred in the SI group (-3.68 pounds) than in the UC group (+.47 pounds) (P =.003). The differences between the two groups in terms of blood pressure, lipid levels, depression scores, minutes of exercise, and dietary habits were not statistically significant. CONCLUSION: An Internet-based case management system could be used as a cost-effective intervention for patients with CVD, either independently or in conjunction with traditional cardiac rehabilitation.

Adult↗
PubMed1988

Decree No. 15-88, February 1988.

This Decree approves the Plan of Operations entered into by the Government of Honduras and the UN Children's Fund (UNICEF) with respect to women and children for the years 1987-91. The general objective of the Plan is to monitor and improve the situation of women and children in Honduras by means of providing the following services: 1) early attention to and development of children; 2) basic services for rural women and children; and 3) intersectoral social planning and promotion of infancy. Among the specific services to be provided are literacy training and adult education for women, infant nutrition, and programs of social support for women and children. Further provisions of the Decree set forth the details of the Plan for the year 1987, as well as provisions on past agreements between the Government of Honduras and UNICEF, monitoring and evaluation, and the contributions of the Government of Honduras and UNICEF, among other things. UNICEF's contribution is US$1,465,000.

Adolescent↗
PubMed1988

Measures to promote literacy and primary education among women, 1988.

In 1988, the Government of Nepal introduced the following measures to promote literacy and primary education among women: 1) provision of scholarships for 5% of female enrollees; 2) provision of school uniforms for deserving primary school girls; 3) promotion of women's teacher training programs; 4) nonformal education programs for adult women; and 5) initiation of a campaign to encourage parents in remote areas to send their daughters to school.

Adolescent↗
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↗
PubMed1995

Chronic psychological effects of exercise and exercise plus cognitive strategies.

Psychological changes associated with 16-wk moderate and low intensity exercise training programs, two of which possessed a cognitive component, were evaluated. Subjects were healthy, sedentary adults, 69 women (mean age = 54.8 +/- 8.3 yr) and 66 men (mean age = 50.6 +/- 8.0 yr). Participants were randomly assigned to a control group (C), moderate intensity walking group (MW), low intensity walking group (LW), low intensity walking plus relaxation response group (LWR), or mindful exercise (ME) group-a Tai Chi type program. Women in the ME group experienced reductions in mood disturbance (tension, P < 0.01; depression, P < 0.05; anger, P < 0.008; confusion, P < 0.02; and total mood disturbance, P < 0.006) and an improvement in general mood (P < 0.04). Women in the MW group noted greater satisfaction with physical attributes (body cathexis, P < 0.03), and men in MW reported increased positive affect (P < 0.006). No other differences were observed between groups on measures of mood, self-esteem, personality, or life satisfaction. Equivocal support is provided for the hypothesis that exercise plus cognitive strategy training programs are more effective than exercise programs lacking a structured cognitive component in promoting psychological benefits.

Adaptation, Psychological↗