Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “PERSONALITY”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 1,225 records · Page 68Linked to original sources
PubMed1992

Personality disorder diagnoses in patients with bulimia nervosa: clinical correlates and changes with treatment.

BACKGROUND: In view of reports of a high incidence of Axis II disorders among patients with bulimia nervosa, we assessed personality diagnoses and traits in a sample of bulimic patients both preceding and following treatment for the eating disorder. METHOD: The Personality Disorder Examination, a structured interview to assess DSM-III-R personality disorders, was administered to 34 in-patients and 49 outpatients with bulimia nervosa entering treatment. Thirty of 49 outpatients were reassessed after 6 weeks of treatment with desipramine or placebo. RESULTS: At initial assessment, 38% of inpatients (N = 13) and 29% of outpatients (N = 14) fulfilled criteria for at least one personality disorder, most frequently borderline personality disorder. There were significant correlations between Personality Disorder Examination trait scores and clinical measures of eating disorder and depressive symptoms. Of 30 outpatients who were reinterviewed following treatment, 3 of 9 patients lost one or more personality diagnoses at post-treatment assessment, and 2 of 21 patients without initial Personality Disorder Examination diagnoses received one or more diagnoses at the second interview. Changes in Personality Disorder Examination trait scores, but not diagnoses, were correlated with changes in some clinical measures. CONCLUSION: These data suggest that the assessment of Axis II disorders in patients with bulimia nervosa is problematic and raise the possibility that personality features in this group may be influenced by the course of their Axis I disorder.

Adult↗
PubMed2006

[The personality change in epilepsy patients].

UNLABELLED: Personality disorders in epilepsy patients are frequent, and cause behaviour that is quite often troublesome for social environment of patients. The peculiarity of the clinical picture and mechanism of disorder formation has caused great interest. The term 'characteropathy in epilepsia patient', with characteristic viscosity as its important basic symptom, was eliminated from present medical terminology. Current worldwide international disease classification systems (DSM-IV and ICD-10) do not distinguish the separate form of personality disorders related to epilepsy. THE AIM: of the work is to analyse personality change in epilepsy patients on the basis of information from the patients and their relatives by means of the Adjective Check List (ACL) by Gough and Heilbrun, with taking into consideration the incidence of depression and the phenomenon of 'out-of-body experience'. MATERIAL AND METHODS: 40 patients with idiopathic generalized epilepsy with tonic - clonic seizures in age 19-55 years (mean 28 years) and 30 persons of age - matched control groups were examined. Each examined person and relative filled in ACL form two times in order to answer a question about the features of actual and premorbid patient's personality. The change of personality was evaluated according to ACL criteria and the psychoterapeutic criteria. In analysis were also taken into account the incidence of depression and the phenomenon of 'out-of-body experience'. RESULTS: The personality change in epilepsy patients was more frequent than in the control group and more frequent concerned need scales of ACL (endurance, deference, self- and others understanding, and aggression scale). In the grave epilepsy group considerable behavioral and interpersonal relationships change (more subordination tendency), features of dementia, and often phenomenon 'out-of-body experience' were observed. The range of personality change in the mild epilepsy group, like in control group, included the adaptation of family functioning principles to the patients' needs, the change of patients' emotional reaction and the meaning of life. In this group depression was often, but the phenomenon 'out-of-body experience' hardly ever appeared. CONCLUSIONS: The personality change in epilepsy patients was found in more than 80% of patients and concerned need scales of ACL (endurance, deference, self- and others understanding and aggression scale), and thematic scales (self ideal, self-control, and self-confidence scale). In the grave epilepsy group considerable behavioral changes, features of dementia, and often the phenomenon 'out-of-body experience' were observed. In the mild epilepsy group the changes were limited to alter of conviction and emotional response, often depression appeared, but hardly ever the phenomenon 'out-of-body experience' was observed.

Adult↗
PubMed1985

[DSM III personality diagnosis in a group of chronic offenders].

A group of chronic offenders (n = 44) was investigated and their personality disorders coded according to two different methods, namely the ICD 9 (International Classification of Diseases 9) and the American DSM III (Diagnostic and Statistical Manual III). The total number of personality disorders diagnosed by DSM III was less than by ICD 9. This cannot be attributed only to the fact that according to DSM III cyclothymic disorders do not have a direct correlate in axis II-personality disorders, but are, instead, assigned to the group of affective disorders. The majority of persons in whom the diagnosis of cyclothymic personality disorders was made on ICD 9 were rated as having one of the "extroverted personality disorders" in DSM III. If the personality disorders are combined to form three groups - (a) eccentric (close to psychoses), (b) extroverted and (c) introverted - then the overall correlation between ICD 9 and DSM III is considerable. The DSM III system promises a higher reliability due to the existence of criteria for inclusion and exclusion. The diagnosis "borderline personality disorder" was compared with the DIB Gunderson interview (kappa 0.89). In the international classification DSM III borderline personality disorder was equivalent to a diagnosis of cyclothymic, irritable, hysteric or sociopathic personality disorder.

Borderline Personality Disorder↗
PubMed1993

The Roscommon Family Study. III. Schizophrenia-related personality disorders in relatives.

OBJECTIVES: We sought to clarify the familial relationship between five putative schizophrenia-related personality disorders (schizotypal [SPD], paranoid, schizoid, avoidant, and borderline) and schizophrenia, other nonaffective psychoses, and affective illness. DESIGN: A case-controlled epidemiologic family study using DSM-III-R criteria. PARTICIPANTS: Five hundred thirty-four probands selected from a psychiatric case register or electoral register, of whom 415 were personally interviewed, and 2043 living and traceable relatives, of whom 1753 were personally interviewed. RESULTS: Compared with relatives of unscreened controls, relatives of probands with schizophrenia had a highly significantly increased prevalence of SPD, and modest, but significant, increased prevalences of paranoid, schizoid, and avoidant personality disorders. Borderline personality disorder was rare, with a modest clustering of cases in relatives of affective disorder probands. The prevalence of SPD was also significantly elevated in relatives of probands with SPD and with other nonaffective psychoses but not in relatives of probands with psychotic or nonpsychotic affective illness. In contrast to the pattern seen for schizophrenia, the prevalence rate of SPD was substantially greater in parents than in siblings of schizophrenic probands. CONCLUSIONS: Schizotypal personality disorder has a strong familial relationship with schizophrenia. Paranoid, schizoid, and avoidant, but not borderline, personality disorders may have a significant familial relationship with schizophrenia. Schizotypal personality disorder also reflects the familial liability to other psychotic disorders but probably not to affective illness. Fitness effects may substantially influence the pattern of schizophrenia-related personality disorders in relatives.

Adolescent↗
PubMedDate not supplied

Neuroticism and personality disorder in depression.

Neuroticism and DSM-III personality disorder were studied in 39 depressed inpatients. Interrelationships between these variables and their relationship to depressive typology were compared. The relationship of neuroticism, DSM-III personality type and adequacy of personality to MAOI treatment are also examined. Neuroticism scores were unaffected by short-term treatment, and no differences in neuroticism were observed between melancholics and nonmelancholics, or between endogenous and nonendogenous depressives. Higher neuroticism scores were associated with DSM-III personality disorder. Personality disorder occurred significantly more often in nonmelancholia; borderline, antisocial and histrionic personality disorders occurred exclusively in nonmelancholia, while passive-aggressive, dependent and avoidant disorders occurred in both kinds of depression. Response to MAO inhibitor treatment was similar in patients with high and low neuroticism, adequate and inadequate personality, DSM-III personality disorder and no DSM-III personality disorder. Ambiguities of Eysenck's neuroticism scale are discussed in relationship to depression.

Antisocial Personality Disorder↗
PubMed2005

The PDD-MRS: an instrument for identification of autism spectrum disorders in persons with mental retardation.

The Scale of Pervasive Developmental Disorder in Mentally Retarded Persons (PDD-MRS) is described. The PDD-MRS is a simple classification and screening instrument devised for identification of autistic disorders (of the entire spectrum) in persons with mental retardation from mild to profound levels, age-range 2-55 years. The norms of the scale are based on the research protocols of 1230 Dutch persons with mental retardation. The scale's sensitivity for the entire normative sample was found to be 92.4%; calculated separately for persons at all levels of mentally retarded functioning, male and female persons, speaking and non-speaking persons and five age categories, the sensitivity figures range between 87.0 and 100.0%. The specificity of the scale is also 92.4%; for the aforementioned subgroups separately, the specificity figures range between 84.6 and 95.5%. Roughly similar values for sensitivity and specificity were found when using the scale with severely visually impaired/blind persons; severely hearing-impaired/deaf persons; persons with Down syndrome; male persons with fragile X syndrome. The original version of the PDD-MRS dates from 1990; since then the scale has been widely used in the Netherlands and Belgium. The PDD-MRS should be regarded as a useful instrument for identifying PDD in persons with mental retardation.

Adolescent↗
PubMed2005

A case study of personal exposure to nitrogen dioxide using a new high sensitive diffusive sampler.

Personal NO(2) exposure measurements were achieved during two campaigns in a large northern France city. These campaigns were following an innovating approach based on sequential exposure measurements by diffusive samplers distinguishing four categories of microenvironments ("home", "other indoor places", "transport" and "outdoors"). The objective of these campaigns was to obtain NO(2) personal exposure data in different microenvironments and to examine the determinants of personal exposure to this pollutant. Each campaign comprised two 24-h sampling periods: one during a working day and the second during the weekend. The average total NO(2) personal exposure ranged from 17 microg m(-3) for the summer weekend samplings to 38 microg m(-3) for the winter weekday samplings. The highest levels were found in transports and outdoors, the intermediate ones in other indoor places and the lowest in homes. Despite their weak levels, indoor environments contributed for more than 78% to total NO(2) personal exposure because of more time spent in these living places. A Multiple Correspondence Analysis (MCA) highlighted the determinants of NO(2) personal exposure in the "home" and "transport" microenvironments. This led to a classification of NO(2) personal exposure levels according to different means of transport: from the lowest to the highest exposure levels, train, tramway or underground, bicycle, car or motorcycle. In homes, the rise of NO(2) personal exposures is mainly due to the use of gas stoves and gas heating and the absence of automatic airing system. A classification of NO(2) personal exposure levels was set up according to the characteristics of homes. An analysis of correlations between the home NO(2) personal exposures and outdoor concentrations measured by fixed ambient air monitoring stations showed weak relations suggesting that the data of these stations are poor predictors of NO(2) personal exposures in homes.

Air Pollutants↗
PubMed2003

Short report: migration among persons living with HIV.

Data from the first national probability sample of persons with HIV, the HIV Cost of Services and Utilization Survey (HCSUS), are used to examine migration patterns among persons with HIV/AIDS in the USA. Persons with serious illness may choose to relocate to receive better care or support. This migration has implications for the distribution of resources. This study describes the frequency and reasons that persons with HIV move to different communities. An analytic file of 3014 respondents was obtained from the first national probability sample of persons with HIV/AIDS, the HCSUS. A migration section of the baseline questionnaire questioned respondents on their residential history. Persons were defined as movers if they moved across state lines or to a non-contiguous county after knowing they were HIV positive but before the HCSUS baseline interview. Forty percent of movers said that their HIV status was a very important factor in their decision to move. Although earlier studies of limited generalizability found movement among the HIV population from urban to rural counties, this study found only eight percent of HIV migration was from urban to rural counties, just slightly more than the migration from rural to urban counties. In addition, the vast majority of people who were moving were not moving to return home. Major factors in the decision to move included being near caregivers and being in a community with shared needs and interests. Significant numbers of persons also moved to obtain care from a physician knowledgeable in HIV treatment or to get away from discrimination. Financial assistance and the availability of Medicaid also played a prominent role in many decisions to move. Persons with HIV/AIDS are more likely to move than non-infected persons in the general population. Moreover, they are almost twice as likely to be moving out-of-state. Persons with HIV who move are similar to persons with HIV who do not move on most demographic characteristics including age, region of the country, and income.

Adult↗
PubMed2006

Associations between personal exposures and fixed-site ambient measurements of fine particulate matter, nitrogen dioxide, and carbon monoxide in Toronto, Canada.

A longitudinal study investigating personal exposures to PM(2.5), nitrogen dioxide (NO(2)), and carbon monoxide (CO) for cardiac compromised individuals was conducted in Toronto, Canada. The aim of the study was (1) to examine the distribution of exposures to PM(2.5), NO(2), and CO; and (2) to investigate the relationship between personal exposures and fixed-site ambient measurements of PM(2.5), NO(2), and CO. In total, 28 subjects with coronary artery disease wore the Rupprecht & Patashnick ChemPass Personal Sampling System one day a week for a maximum of 10 weeks. The mean (SD) personal exposures were 22 microg m(-3) (42), 14 p.p.b. (6), and 1.4 p.p.m (0.5) for PM(2.5), NO(2), and CO, respectively. PM(2.5) and CO personal exposures were greater than central fixed-site ambient measurements, while the reverse pattern was observed for NO(2). Ambient PM(2.5) and NO(2) were correlated with personal exposures to PM(2.5) and NO(2) with median Spearman's correlation coefficients of 0.69 and 0.57, respectively. The correlations between personal exposures and ambient measurements made closest to the subjects' homes or the average of all stations within the study were not stronger than the correlation between personal exposures and central fixed-site measurements. Personal exposures to PM(2.5) were correlated with personal exposures to NO(2) (median Spearman's correlation coefficient of 0.43). This study suggests that central fixed-site measurements of PM(2.5) and NO(2) may be treated as surrogates for personal exposures to PM(2.5) and NO(2) in epidemiological studies, and that NO(2) is a potential confounder of PM(2.5).

Aged↗
PubMed1994

A concept analysis of personal knowledge: application to nursing education.

A concept analysis of personal knowledge is completed using the Walker and Avant method. The analysis is based on Polanyi's concept of personal knowledge with a working definition being extrapolated from his writings combined with Belenky and colleagues' concept of constructed knowledge. The goal is to construct a definition of personal knowledge which recognizes the multifaceted processing used by humans in the endeavour to perceive new patterns, and which is free from discrimination based on age, sex, culture, discipline, world view or learning style. Knowledge is defined as pattern recognition which may be probabilistically rather than exactly predictive. Personal knowledge is defined as recognition of a new pattern through processing by the human being. The processing may consist of any combination of human and environmental interaction, 'rational intuiting', appraisal, active comprehension and personal judgement, all in a setting of departure from the current conceptual framework. The pattern may be new to the person or to humanity. Personal knowledge is denoted by perception of the person. The antecedents, attributes and consequences are taken from the literature. The empirical referents are hypothesized from a review of the nursing, social work and education literature. After defining personal knowledge and differentiating it from other phenomena, it is integrated into nursing education. An educator accepting personal knowledge as an expectation for students approaches the teaching/learning situation by planning to create an atmosphere in which individual growth and illumination can occur. Therein personal knowledge is integrated into nursing education using the most barrier-free theoretical frameworks in the areas of learning, curriculum and instruction.

Attitude of Health Personnel↗
PubMed2004

Estimated hourly personal exposures to ambient and nonambient particulate matter among sensitive populations in Seattle, Washington.

Epidemiological studies of particulate matter (PM) routinely use concentrations measured with stationary outdoor monitors as surrogates for personal exposure. Despite the frequently reported poor correlations between ambient concentrations and total personal exposure, the epidemiologic associations between ambient concentrations and health effects depend on the correlation between ambient concentrations and personal exposure to ambient-generated PM. This paper separates personal PM exposure into ambient and nonambient components and estimates the outdoor contribution to personal PM exposures with continuous light scattering data collected from 38 subjects in Seattle, WA. Across all subjects, the average exposure encountered indoors at home was lower than in all other microenvironments. Cooking and being at school were associated with elevated levels of exposure. Previously published estimates of particle infiltration (Finf) were combined with time-location data to estimate an ambient contribution fraction (alpha, mean = 0.66+/-0.21) for each subject. The mean alpha was significantly lower for subjects monitored during the heating season (0.55+/-0.16) than for those monitored during the nonheating season (0.80+/-0.17). Our modeled alpha estimates agreed well with those estimated with the sulfur-tracer method (slope = 1.08; R2 = 0.67). We modeled exposure to ambient and nonambient PM with both continuous light scattering and 24-hr gravimetric data and found good agreement between the two methods. On average, ambient particles accounted for 48% of total personal exposure (range = 21-80%). The personal activity exposure was highly influenced by time spent away from monitored microenvironments. The median hourly longitudinal correlation between central site concentrations and personal exposures was 0.30. Although both alpha and the nonambient sources influence the personal-central relationship, the latter seems to dominate. Thus, total personal exposure may be poorly predicted by stationary outdoor monitors, particularly among persons whose PM exposure is dominated by nonambient exposures, for example, those living in tightly sealed homes, those who cook, and children.

Air Pollutants↗
PubMed2001

Comparison of AIDS progression and survival in persons with pulmonary versus extrapulmonary tuberculosis in Los Angeles.

The objective of this research was to compare the demographics, acquired immune deficiency syndrome (AIDS) progression, and survival in persons with AIDS with pulmonary tuberculosis (PTB) versus extrapulmonary tuberculosis (EPTB), because there are limited population-based data on this topic. A population-based longitudinal study with 3 years of follow-up was performed. Data were collected every 6 months from medical records of persons with AIDS and TB treated at private and public medical facilities throughout Los Angeles County (LAC). Participants included a population-based sample of 216 persons with AIDS and PTB and 166 persons with AIDS and EPTB (including 113 persons with both PTB and EPTB), with an AIDS diagnosis reported in 1993. Compared to persons with AIDS with PTB, persons with AIDS and EPTB were 2.2 times more likely to be Latino than white (95% confidence intervals [CIs]: 1.2, 4.0) and 1.7 times more likely to be foreign-born (95% CIs: 1.1, 2.5). Compared to persons with AIDS with PTB, persons with AIDS and EPTB had similar antiretroviral and PCP prophylaxis use; lower CD4 counts at time of AIDS diagnosis (p = 0.0004); no differences in CD4 counts over the total follow-up period (p = 0.4); higher rates of total opportunistic infections (OIs) (incidence density ratio [IDR] = 2.0; 95% CIs: 1.6, 2.4); and comparable survival curves (p = 0.07). Persons with AIDS and EPTB had a more complicated medical course with lower CD4 counts at time of AIDS diagnosis and more OIs over the follow-up period than persons with AIDS and PTB, however the survival profiles for the two groups were comparable.

AIDS-Related Opportunistic Infections↗
PubMed1981

Personal identity in the light of brain physiology and cognitive psychology.

The concept of the person, and the notion that the latter is an entity separate and distinct from other persons, has persisted as one of the more secure "givens" of philosophical thought. We have very little difficulty, in observer language, in pointing to a person, describing his or her attributes, distinguishing him or her from other persons, etc. Likewise, it is ordinarily not much of a problem to subjectively experience, both sensorially and conceptually, the self - that is, to distinguish in agent language "my person" from the rest of the universe. The second of these two perspectives on the person defines the "I," "ego," or "identity." Several recent developments in experimental psychology and brain science - while not defeating the ordinary notion of the person on the merits of data per se - at least force a re-thinking of tacit assumptions basic to our sense of the concepts of both the person and personal identity. In this paper, I would like to show how the concept of the person needs revision, and at the same time to raise some objections to Shaffer's (1977) account of the consequences of brain bisection and brain transplant with respect to the fate of the person and his identity.

Brain↗
PubMed2004

Person-centredness in gerontological nursing: an overview of the literature.

Person-centred practice is a recurring theme in gerontological nursing literature. While there are many descriptive accounts of attempts at developing person-centred practice, in reality, there are few studies that identify the benefits of this way of working. Thus far, systematic research into person-centred nursing practice is poorly developed. This paper aims to explore the concept of person-centredness and person-centred practice in order to add clarity to discussions about the term in the context of gerontological nursing. This literature-based exploration discusses the meaning of the word 'person' and the way this word is translated into person-centred practice. It is argued that there are four concepts underpinning person-centred nursing: (i). being in relation; (ii). being in a social world; (iii). being in place and (iv). being with self. The articulation of these concepts through existing models of person-centred practice in nursing raises the recurring themes of knowing the person, the centrality of values, biography, relationships, seeing beyond the immediate needs and authenticity. There is a need for further research and development work in gerontological nursing to distinguish between person-centred practice and good quality care for older people.

Aged↗
PubMed2006

Personal growth and its correlates during residency training.

OBJECTIVES: To explore the characteristics of and factors associated with personal growth during residency training. METHODS: In 2003, 359 house officers on 7 internal medicine residency training programmes in the USA were surveyed about their training experiences and issues related to their personal growth. Factor analysis and internal reliability testing were used to develop a 'personal growth scale'. Logistic regression models were then used to identify independent associations between individual variables and 'high' versus 'low' personal growth scores. RESULTS: A total of 281 house officers (80%) responded. The personal growth scale had a Cronbach's alpha of 0.81. Factors that were independently associated with achieving high amounts of personal growth during residency training included: agreeing that reflection is important during residency training (odds ratio [OR] 2.9, 95% confidence interval [CI] 1.1-7.4); being male (OR 2.6, 95% CI 1.4-4.5); being non-white (OR 2.2, 95% CI 1.3-3.9); having a strong desire to develop personally and professionally (OR 2.2, 95% CI 1.1-4.1), and feeling highly supported by one's programme director (OR 2.1, 95% CI 1.2-3.9). Independent predictors of scoring below the median on the personal growth scale included feeling emotionally isolated at work (OR 0.4, 95% CI 0.2-0.7) and noting that negative or disappointing experiences had been powerful (OR 0.4, 95% CI 0.2-0.9). CONCLUSIONS: Disparate amounts of personal growth occur among trainees during residency training. Residency programmes interested in promoting personal growth among their trainees may wish to focus on modifiable factors that are associated with personal growth, such as fostering supportive relationships and encouraging reflection.

Adult↗
PubMed2006

Personal growth during internship: a qualitative analysis of interns' responses to key questions.

BACKGROUND: During clinical training, house officers frequently encounter intense experiences that may affect their personal growth. The purpose of this study was to explore processes related to personal growth during internship. DESIGN: Prospective qualitative study conducted over the course of internship. PARTICIPANTS: Thirty-two postgraduate year (PGY)-1 residents from 9 U.S. internal medicine training programs. APPROACH: Every 8 weeks, interns responded by e-mail to an open-ended question related to personal growth. Content analysis methods were used to analyze the interns' writings to identify triggers, facilitators, and barriers related to personal growth. RESULTS: Triggers for personal growth included caring for critically ill or dying patients, receiving feedback, witnessing unprofessional behavior, experiencing personal problems, and dealing with the increased responsibility of internship. Facilitators of personal growth included supportive relationships, reflection, and commitment to core values. Fatigue, lack of personal time, and overwhelming work were barriers to personal growth. The balance between facilitators and barriers may dictate the extent to which personal growth occurs. CONCLUSIONS: Efforts to support personal growth during residency training include fostering supportive relationships, encouraging reflection, and recognizing interns' core values especially in association with powerful triggers.

Attitude of Health Personnel↗
PubMed1995

Attitudes of beginning medical students toward older persons: a five-campus study. The University of California Academic Geriatric Resource Program Student Survey Research Group.

OBJECTIVE: To examine the attitudes of beginning medical students toward older persons and their medical care. DESIGN: Cross-sectional survey. SETTING: Five University of California medical schools. PARTICIPANTS: Beginning medical school students from the Class of 1994. MEASUREMENTS: Demographic characteristics, personal contacts with older persons, and previous coursework or research experience with older persons were assessed. Knowledge with regard to aging was measured with a group of 10 questions, which were modified from the Facts on Aging Quiz. The attitudes of students toward older persons were assessed using the Aging Semantic Differential (ASD), the Maxwell-Sullivan Attitude Scale (MSAS), and two case scenarios. RESULTS: Ninety-two percent of the participants (554 of 603) responded; 93% of these responses were usable. Students were much less likely to admit an acutely ill 85-year-old woman to an intensive care unit, intubate her, and treat her aggressively than they were to treat an acutely ill 10-year-old girl with underlying chronic leukemia. In multivariate models, male gender and younger student age were both independently predictive of less favorable attitudes regarding a 70-year-old person on the ASD Instrumental-Ineffective subscale. Asian-Americans and males had less favorable attitudes on the Autonomous-Dependent and the Personal Acceptability-Unacceptability subscales. More knowledge with regard to aging was predictive of more favorable attitudes on the Autonomous-Dependent and Personal Acceptability-Unacceptability subscales. Male gender and Asian-American ethnicity were significantly associated with less favorable attitudes on the two scales derived from the MSASs. Students who had previously visited a long-term care facility were more likely to disagree that it takes too much time to care for older persons. CONCLUSION: Beginning medical students have already formed some unfavorable attitudes about older persons. Few independent predictors (either sociodemographic or students' previous experiences) of student attitudes could be identified that would help in the selection of students who had more favorable attitudes toward older persons. Hence, attempts to generate physicians with good attitudes must rely on curricular efforts during medical school and residency training.

Adult↗
PubMed1998

Management of older persons after myocardial infarction.

OBJECTIVE: To review the management of the older person after myocardial infarction (MI). DATA SOURCES: A computer-assisted search of the English language literature (MEDLINE database) followed by a manual search of the bibliographies of pertinent articles. STUDY SELECTION: Studies on the management of persons after MI were screened for review. Studies in persons older than 60 years and recent studies were emphasized. DATA EXTRACTION: Pertinent data were extracted from the reviewed articles. Emphasis was on studies involving older persons. Relevant articles were reviewed in depth. DATA SYNTHESIS: Available data about therapy of persons after MI, including control of risk factors, use of aspirin and beta-blockers, and indications for use of angiotensin-converting enzyme inhibitors, long-term anticoagulant therapy, nitrates, calcium channel blockers, hormone replacement therapy, antiarrhythmic drugs, the automatic implantable cardioverter-defibrillator, and revascularization, with emphasis on studies involving older persons, were summarized. CONCLUSIONS: Risk factors for coronary artery disease should be controlled after MI in older persons. A serum low-density lipoprotein (LDL) cholesterol >125 mg/dL after MI should be treated with lipid-lowering drug therapy to decrease the serum LDL cholesterol to <100 mg/dL. Aspirin in a dose of 160 mg to 325 mg daily should be given indefinitely. Indications for long-term anticoagulant therapy with warfarin after MI to maintain an international normalized ratio between 2.0 and 3.0 include secondary prevention of MI in persons unable to tolerate daily aspirin, persistent atrial fibrillation, and left ventricular thrombus. Beta-blockers should be given indefinitely. Angiotensin-converting enzyme inhibitors should be given to persons who have congestive heart failure, an anterior MI, or a left ventricular ejection fraction < or = 40%. Calcium channel blockers should not be used unless there is persistent angina pectoris despite beta-blockers and nitrates. Antiarrhythmic drugs other than beta-blockers should not be used. An automatic implantable cardioverter-defibrillator should be used in persons who have a history of ventricular fibrillation or serious sustained ventricular tachycardia or who are at very high risk for developing sudden cardiac death. Until data from the Heart Estrogen/ Progestin Replacement Study are available, use of an estrogen/progestin regimen is recommended in the treatment of postmenopausal women after MI unless they are at increased risk for developing breast cancer. The two indications for revascularization in older persons after MI are prolongation of life and relief of unacceptable symptoms despite optimal medical management.

Adrenergic beta-Antagonists↗