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Biomedical subjects

A Adelman

Publications and source records attributed to A Adelman.

33 records · Page 2Linked to original sources
PubMed1995

Traumatic memory and the intergenerational transmission of Holocaust narratives.

This paper investigates the roles of affect regulation, narrative cohesion, and symbolic representation in the intergenerational transmission of the Holocaust experience. A study of the reminiscences of mothers who are Holocaust survivors and their daughters' reflections about the Holocaust illustrates the process of the transmission of trauma by tracing the transgenerational evolution of narrative forms, dynamic themes, and affective organization. The quality of the survivor parent's organization and integration of affect has significant bearing on how her child assimilates her knowledge of the Holocaust and develops the capacity to tolerate and express painful emotions. Through the preservation, transformation, and transmutation of traumatic memory, children of survivors strive to assimilate, redeem, and transform their tragic historical legacy.

Affect↗
PubMed1987

Abdominal pain in the primary care setting.

The characteristics of and final diagnoses for patients presenting with abdominal pain were investigated. This retrospective study examined 556 charts of patients 18 years of age and older who presented over a two-year period to three family practice offices. The charts were abstracted for demographic factors, symptoms, physical findings, laboratory data, final diagnosis, and number of visits for abdominal pain. The final diagnosis was documented by radiologic, laboratory, surgical, or pathologic specimen confirmation except for the following diagnoses: acute gastroenteritis, pelvic inflammatory disease, irritable bowel syndrome, and abdominal pain, etiology undetermined. No cause for the abdominal pain was found for approximately one half of the cases. Most patients were female even when gynecologic problems were excluded. Nine percent of abdominal pain patients were admitted to the hospital for evaluation or surgery. An average of 1.8 tests were ordered per patient. Almost one half of the patients were seen only once for the problem. The results suggest that a large percentage of the patients who present with abdominal pain have a self-limited illness for which no definitive diagnosis is found.

Abdomen↗
PubMed1985

CTL and serologically defined antigens of B2m,H-3 region.

The antigens of the B2m,H-3 region of 13 chromosome 2 congenic strains and seven inbred strains have been studied by using CML and serologic techniques. Nine patterns of cross-reactivity have been defined by CML assays. These results are in agreement with an extend previously described cross-reactivity studies. The reactivities of three monoclonal antibodies previously thought to be reacting with B2M-B are shown to differ: Ly-m11 and J-5 react with cells of strain B10-pa,at and clone 23 does not. Two H-3 region loci are hypothesized on the basis of CML and serologic activity: B2m and H-3. The CTL responses to the B2M antigens are H-2K restricted; the CTL responses to H-3 antigens are H-2D restricted. The restriction of the response to the H-3 antigen requires effector-target identity of the H-2D molecule but not the B2M molecule of the class I antigen. These loci have been separated by recombination from H-42 in the production of the congenic strain B10.FS-a. A gene order of B2m, H-3, H-42 is suggested.

Animals↗
PubMed1983

Abdominal pain in a university family practice setting.

Abdominal pain is one of the most common complaints in the family practice setting. Abdominal pain has been the subject of many studies; however, the focus has been on abdominal pain as a final diagnosis rather than as a symptom or presenting complaint. A retrospective audit examined 133 charts of patients 18 years of age or older presenting to the University of Iowa Family Practice Center from July 1976 to October 1978. Abdominal pain, etiology undetermined, accounted for approximately one half of the final diagnoses. The patients tended to be young and female. Almost one half of the patients were seen only once for the problem. Conclusions concerning management are drawn, and suggestions for further studies are made.

Abdomen↗
PubMed1974

Late results of aortocoronary bypass grafts in 100 patients with stable angina pectoris.

From March 1969 to December 1972, 314 patients underwent elective aortocoronary saphenous vein bypass graft surgery at the Toronto General Hospital for the relief of stable disabling angina refractory to medical management. Inhospital mortality was 2.5%. Of these patients 100 agreed to return for follow-up hemodynamic and angiographic assessment at a mean interval of 19.7 months after operation. Seventy-four percent of patients were asymptomatic or had angina only with strenuous exertion at the time of follow-up. Seventy-five percent of the 142 grafts were patent, though a few had significant narrowings. Clinical improvement could be correlated with successful myocardial revascularization. Myocardial infarction was diagnosed by the presence of new Q waves after operation in 15% of patients. Many of these patients had patent grafts at follow-up and all were improved. Dyslipoproteinemia was not found to be a factor affecting late graft patency. Total left ventricular function was not shown to be improved by segmental revascularization. The trend toward improved survival in the intervening period for the total operated group is encouraging.

Adult↗
PubMedDate not supplied

Use of the Apathy Evaluation Scale as a measure of motivation in elderly people.

Motivation plays an important part in an elderly individual's ability to recover from a disabling event. On the other hand, apathy is a lack of motivation. The Apathy Evaluation Scale (AES) is an 18-item instrument that rates a person's thoughts, actions, and emotions over the previous 4 weeks. The purpose of this study was to use the AES with 102 patients in a geriatric rehabilitation program to determine if it predicted improved function after rehabilitation. In addition, a short 7-item version of the AES was tested. A strong correlation was demonstrated between the 18-item AES and the 7-item AES, the Mini-Mental State Examination, and the Geriatric Depression Scale. In separate regression analyses, we found that admission function and both the 18-item and 7-item AES were significant predictors of discharge function, and that functional level at admission to rehabilitation accounted for 31% of the variance in function after rehabilitation. The findings suggest that the AES might be an appropriate measure of motivation in older adults and might predict success in rehabilitation. Moreover, the ability to identify patients with low motivation can alert healthcare providers to develop interventions to improve older adults' motivation and help them attain and maintain their highest functional level.

Aged↗
PubMedDate not supplied

Family practice patients' attitudes toward firearm safety as a preventive medicine issue: a HARNET Study. Harrisburg Area Research Network.

BACKGROUND: Firearm-related deaths are expected to outnumber motor-vehicle-related deaths within the next 5 years. The goal of this project was to document gun ownership and safety habits among patients of family physicians and to determine patients' attitudes toward physician counseling about firearm safety. METHODS: We conducted a cross-sectional survey of patients of 11 family practices affiliated with a research network. Patients (or parents of children) were asked to complete a 23-item questionnaire that asked about gun ownership, storage, sources of information about gun safety, and attitudes about gun safety, and the role of their physician. RESULTS: Of the 1359 questionnaires distributed, 1214 (89%) were returned. Gun ownership varied by location (urban, suburban, and rural) and ranged from 16% to 59%. Only 8% of respondents believed that their physician has a responsibility to discuss firearm safety. Most (91%) patients did not view their physician as a source of firearm safety information, and only 14% thought their physician was knowledgeable regarding gun safety. Most gun owners (71%) did not think they would follow their physicians' advice about gun storage. Most patients (5%) responded that gun safety should not be discussed during the office visit. CONCLUSION: With regard to firearm safety, family physicians lack credibility in the eyes of their patients. These patients do not appear to be receptive to information about firearm safety, and efforts to decrease firearm-related injury might be more effective if focused elsewhere.

Adult↗
PubMedDate not supplied

Computerized medical records in family medicine journals, 1981-1990: diffusion of an innovation.

This study examined whether references to computerized medical records in family medicine journals had increased over the past decade as an example of diffusion of innovations. The abstract and methods sections of articles in Family Medicine, the Journal of Family Practice, and the Journal of the American Board of Family Practice were reviewed from 1981 to 1990 for explicit references to computerized medical records. The proportion of articles citing computerized medical records did not significantly increase overall or in any one journal during this time. Articles referenced computerized medical records with regard to sample selection for research studies (54%), description of computerized medical record systems (26%), and generation of health maintenance reminders (4%). These results are discussed in the context of family medicine literature and in terms of factors that typically impede the diffusion of innovations.

Diffusion of Innovation↗
PubMedDate not supplied

Maintenance of clinical skills: a study of full-time physician teachers.

The ways in which full-time physician teachers of family medicine maintain their clinical skills were examined. A questionnaire survey of 500 randomly sampled physician teachers was conducted to examine their practice profile, both ambulatory and inpatient, and opinions as to the value of various activities in maintaining their clinical skills. Overall response rate was 84.4%, but only the responses of full-time teachers (69.6%) were used. Teachers spend 2.4 half days per week providing direct patient care and 3.1 half days per week supervising residents. Approximately 90% attend on an inpatient family medicine service, while about 60% admit and manage patients by themselves. A minimum of 2.3 half days per week of providing direct patient care was felt to be necessary to maintain clinical skills. Direct patient care was felt to be the single most important activity in maintaining clinical skills. While statistical differences among residency types existed, the faculty of the various types of residency programs had very similar practice profiles and opinions as to the maintenance of their clinical skills.

Clinical Competence↗