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Biomedical subjects

B N Brin

Publications and source records attributed to B N Brin.

9 recordsLinked to original sources
PubMed1997

Men and women in optometry. II. Attitudes toward career and family.

BACKGROUND: Optometry has experienced a dramatic upward shift in the percentage of women entering the profession during the past 20 years. Our survey assessed the mechanisms for sustaining balance in professional and personal roles used by women optometrists and how these mechanisms may differ from those of their male colleagues. METHODS: A survey questionnaire was mailed to a large nationwide random sample of optometrists, composed of equal numbers of men and women. RESULTS: Data were analyzed from 353 men and 358 women; margin of error was +4%. Most of the respondents indicated they derived personal satisfaction from their career. A majority of both groups did not indicate that lack of time for their career was a source of frustration. However, significantly more women than men indicated some frustration in pursuing those activities that lead to career advancement. There were significant differences in response patterns of men and women about the effect of family, child care, and household work on their careers. CONCLUSIONS: Both men and women optometrists are satisfied with their careers and neither group feels compelled to choose between career and family. Optometrists do not fit into one pattern, but instead make individualized career choices on the basis of needs.

Attitude of Health Personnel↗
PubMed1995

Quality of life: a review.

BACKGROUND: Quality of life has become an important issue in evaluating clinical research outcomes, and in relationship to cost containment and managed care issues. METHODS: The literature on quality of life was reviewed to give the practicing optometrist an overview of the issue. RESULTS: Quality of life embraces a wide range of physical and psychological characteristics that describe a person's functional ability. There is no agreed upon definition of quality of life. This lack of agreement has led most researchers to adopt a multidimensional approach toward assessing quality of life since no single parameter has ever proven to be adequate. CONCLUSION: Quality of life measurement is an important issue in health care research and policy. In the future, awareness of quality of life issues will be of increasing importance for the optometrist.

Cost Control↗
PubMed1995

Referrals by optometrists to ophtholmologists and other providers.

BACKGROUND: This study reviews 33 years of research into referrals made by optometrists, estimates mean referral rates and seeks to interpret what they mean. METHODS: A search of the medical and optometric literature, 1961-1993, disclosed all reports on referrals by optometrists. Techniques of meta-analysis were employed to rationalize results from various research designs. Principal variable: percent of patients referred by optometrists to 1) ophthalmologists and 2) all providers. Mean referral rates were estimated by log-scale weighting and computed separately by type of practice. Also reviewed: referral rates by eye condition and anatomic site. RESULTS: We found 15 research studies in which referral rates were indicated or could be inferred. On average, optometrists referred 3.83 percent of their patients to ophthalmologists; 5.50 percent to all providers. Cataract and glaucoma were the most common conditions referred; anterior eye and retina the most common anatomic sites. CONCLUSIONS: No time trend was apparent. Referral rates varied by type of practice, with VA clinics high, HMOs and teaching clinics low, and private practices intermediate. Optometrists in private practice appear to be referring patients at rates consistent with referrals by optometrists who practice in more managed environments.

Eye Diseases↗
PubMed1995

Men and women in optometry. I: Economic issues and professional profiles.

BACKGROUND: Optometry is experiencing a sharp increase in the number of women entering practice. How is this demographic shift likely to affect the profession? This survey was designed to describe current economic and professional profiles of men and women in optometry. METHODS: A survey questionnaire was mailed to a nationwide random sample of optometrists, equal numbers of men and women. RESULTS: Data were analyzed from 353 men and 356 women. Margin of error: +/- 4 percent. On average, women optometrists are younger than men, work 9.4 percent fewer hours, and spend 8.1 percent more time away from their regular professional duties. In 1991 men's optometry income averaged $72,200; women's, $54,400. The income differential persisted after adjusting for age, practice setting, work week, time off, and specialty. Men are more likely to be in solo practice; women in group practice or salaried positions. Similar proportions of men and women are employed in corporate optometry. Few gender differences exist in patient services or other professional activities. CONCLUSIONS: Women optometrists have not yet gained economic equity with men. Male-female similarities in practice patterns suggest that optometry is unlikely to experience major changes in consequence of more women entering the profession.

Adult↗
PubMed1991

Cause-specific mortality among physicians with differing life-styles.

We compare the mortality experience of medical school graduates from Loma Linda University (LLU [n = 4342]) and the University of Southern California (USC [n = 2832]) with each other and with that of contemporaneous, white, American men. When compared with US white men from the general population, both USC and LLU graduates had below expected deaths for all causes (USC, standardized mortality ratio [SMR] = 76; LLU, SMR = 56), although deaths due to cerebrovascular disease, airplane accidents, and suicides were elevated for USC (SMRs = 132, 360, and 218, respectively). The LLU graduates had a risk similar to that of the USC graduates for fatal cancer, with a mortality ratio (MR) of 0.92 (95% confidence interval, 0.67 to 1.26); but half the risk of fatal atherosclerotic disease, with MRs of 0.58 (0.46 to 0.73) and 0.66 (0.43 to 0.99) for coronary and cerebrovascular disease, respectively; and three times the risk of fatal airplane accidents. The overall mortality rate of LLU physicians was only 75% as high as that of the USC physicians and only 56% as high as that of the US male population at large. We attribute this reduced mortality mainly to the low cardiovascular mortality rates, which may be accounted for by the life-style of the substantial proportion of Seventh-day Adventists among LLU graduates.

Accidents↗
PubMed1990

The causes of bone scintigram hot spots in fluoride-treated osteoporotic patients.

We previously described new bone formation in fluoride-treated osteoporotic patients. Since then, several investigators have contended that fluoride-induced "hot spots," as seen on bone scintigrams, represent stress fractures. To further evaluate this issue we analyzed scintigrams, radiographs, and quantitative computer tomography (CT) scans of the spine and femoral condyles from 129 patients, obtained before and during therapy. Hot spots, new or of increased intensity, were more than twice as common in the weight-bearing peripheral skeleton than in nonweight-bearing sites (p less than 0.001). The hot spots were usually diffuse, multiple, bilateral, and mostly seen early in therapy, a pattern quite different from that expected of stress fractures. Previously, we postulated that mechanical stress and fluoride act synergistically to stimulate new bone formation. If this hypothesis were correct, we would expect to see a greater increase in femoral condyle bone density in patients with hot spots. Consistent with this hypothesis, patients who developed hot spots in the knees had a greater increase in condylar density (22 +/- 2.5 vs. 9 +/- 3.3 mg/cc) than those without hot spots and stress fractures were not seen in either group. Additionally, patients with more than 5 hot spots in the peripheral skeleton had greater increases in spinal and condylar density than those with fewer than 5 hot spots. Finally, stress fractures were found in less than 2% of our patients. While we do not exclude the possibility that some additional patients may have had stress fractures, our data support the hypothesis that the great majority of hot spots seen on the scintigrams are the sites of new bone formation.

Adult↗
PubMed1988

U.S. lung cancer mortality and declining cigarette tobacco consumption.

The usual method for estimating population exposure to cigarette tobacco has been annual per capita consumption of cigarettes, expressed as pack-years or numbers of cigarettes consumed. This technique is shown to result in an inaccurate estimate of exposure. It underestimates by 11 years the latency period from peak exposure to peak mortality. Over the years, cigarettes changed markedly. Filters came into prominence and tobacco was "fluffed". On average, tobacco content of cigarettes decreased 39.1% from 1953 to 1981. National per capita consumption of cigarette tobacco declined by 43%. Total exposure to cigarette tobacco has been declining for males for approximately 35 years; for females for 20 years. As of 1982, the secular trend for lung cancer mortality was declining for women below age 45 and for most age groups of men below 65. We appear to be at the threshold of a reversal in overall lung cancer mortality.

Adult↗
PubMed1976

Management of the multiproblem seductive patient.

A seductive gesture by a patient towards a physician is not uncommon in clinical practice, and presents a variety of problems in maintenance of the doctor-patient relationship and management of the patient's medical problems. Medical, psychological, and social factors must be considered in resolving these problems. This Grand Rounds presents such a case and discusses alternative approaches to patient management and the role of other health professionals in the care of such patients.

Adult↗