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Biomedical subjects

C A Woodward

Publications and source records attributed to C A Woodward.

At least 19 recordsLinked to original sources
PubMed1991

Degradation of organic sulfur compounds by a coal-solubilizing fungus.

Paecilomyces sp. TLi, a coal-solubilizing fungus, was shown to degrade organic sulfur-containing coal substructure compounds. Dibenzothiophene was degraded via a sulfur-oxidizing pathway to 2,2'-dihydroxybiphenyl. No further metabolism of that compound was observed. Ethyl phenyl sulfide and diphenyl sulfide were degraded to the corresponding sulfones. A variety of products were formed from dibenzyl sulfide, presumably via free radical intermediates. Diphenyl disulfide and dibenzyl disulfide were cleaved to the corresponding thiols and other single-ring products. It was concluded that degradation of organic sulfur compounds by Paecilomyces involves an oxidative attack localized at the sulfur atom.

Biodegradation, Environmental↗
PubMed1990

Charting the winds of change: evaluating innovative medical curricula.

The increased interest, in North America and around the world, in problem-based and community-oriented medical curricula has sparked interest in the evaluation of these innovative programs. In January 1989, the Josiah Macy Jr. Foundation sponsored a conference to consider designs for evaluation studies and the potential distinctive outcomes of the innovative curricula that might be foci of these studies. After defining an "innovative curriculum," the participants identified seven characteristics of "important evaluation studies," particularly endorsing studies that compare curricula as whole entities. The participants then identified 26 areas where differences between graduates of innovative and traditional curricula might be expected, and five equally important areas where differences are not expected. Distinctive outcomes of innovative curricula were anticipated in areas such as interpersonal skills, continuing learning, and professional satisfaction. Overall, these recommendations are offered to stimulate creative evaluations of the growing number of innovative programs in medical education.

Clinical Clerkship↗
PubMed1989

Correlates of certification in family medicine in the billing patterns of Ontario general practitioners.

There is conflicting evidence as to whether physicians who are certified in family medicine practise differently from their noncertified colleagues and what those differences are. We examined the extent to which certification in family medicine is associated with differences in the practice patterns of primary care physicians as reflected in their billing patterns. Billing data for 1986 were obtained from the Ontario Health Insurance Plan for 269 certified physicians and 375 noncertified physicians who had graduated from Ontario medical schools between 1972 and 1983 and who practised as general practitioners or family physicians in Ontario. As a group, certificants provided fewer services per patient and billed less per patient seen per month. They were more likely than noncertificants to include counselling, psychotherapy, prenatal and obstetric care, nonemergency hospital visits, surgical services and visits to chronic care facilities in their service mix and to bill in more service categories. Certificants billed more for prenatal and obstetric care, intermediate assessments, chronic care and nonemergency hospital visits and less for psychotherapy and after-hours services than noncertificants. Many of the differences detected suggest a practice style consistent with the objectives for training and certification in family medicine. However, whether the differences observed in our study and in previous studies are related more to self-selection of physicians for certification or to the types of educational experiences cannot be directly assessed.

Canada↗
PubMed1989

Effect of medicolegal liability on patterns of general and family practice in Canada.

As part of the Federal/Provincial/Territorial Review on Liability and Compensation Issues in Health Care, in 1988 we surveyed Canadian general practitioners and family physicians to determine the effect of liability concerns on their practices in the previous 5 years. Questionnaires were sent to a random, stratified national sample of 1295 physicians, with a response rate of 64.6%. However, a high proportion of the returned questionnaires were ineligible because the physicians were not in general or family practice, were not involved in direct patient care, or had died or moved; thus, the corrected response rate was 50.8%. The newsletter of the Canadian Medical Protective Association was the source of information on liability most frequently cited (by 88.1% of the physicians) and most influential (to 62.4%). Only 15.5% of the physicians cited personal involvement with medicolegal issues as a source of information; the rate was higher for Ontario physicians and those in urban areas generally. A total of 74.6% of the respondents had altered their style of practice in the previous 5 years, and 56.3% reported changes in the scope of their practice. Concern about litigation was the most important reason for changing style of practice and reducing or eliminating administration of anesthesia, whereas lifestyle and other issues along with liability concerns most influenced decisions to reduce obstetric care and emergency department work. Our findings suggest that physicians' perceptions of liability issues have had a profound influence on primary care practice in Canada in the past several years.

Anesthesia↗
PubMed1989

The McMaster M.D. program: a case study of renewal in medical education.

This paper presents four aspects of health professions education at McMaster University: (1) a review of the key elements of the history and distinctive approach of the Doctor of Medicine (M.D.) program; (2) a description of the process and substance of curriculum change over the past decade, focusing on a major revision of the M.D. program that began in 1983; (3) a summary of the findings of follow-up studies of McMaster M.D. program graduates; and (4) an analysis of the current context within which the Faculty of Health Sciences (of which the M.D. program is a part) is operating and a description of strategies for renewal that are being implemented. The evidence and experience to date support the assertion that satisfactory--and in some ways special--physicians can be prepared using the "McMaster approach" to medical education, but that continuous review and periodic major revisions of the educational program are both necessary and possible; they must occur in concert with developments in other sectors of Faculty of Health Sciences activities.

Attitude of Health Personnel↗
PubMed1989

Methodologic note for child epidemiological surveys: the effects of instructions on estimates of behavior prevalence.

This paper examines the effects of a change in the wording of the Child Behavior Checklist (CBCL) instructions for the 0 category on the reported prevalence of behaviors among normal children by their parents. Convenience samples of parents were randomly allocated to complete CBCL items using either the standard instructions "not true" or "never or not true" to describe the 0 category. Adding the word "never" to describe the 0 category decreased parents' use of that category and increased their use of the adjacent, 1, category. Implications of these findings are discussed.

Adolescent↗
PubMed1988

Questionnaire construction and question writing for research in medical education.

This booklet describes the basic principles of questionnaire construction and design using examples applicable to research in medical education. It is intended for medical educators and researchers who plan to construct questionnaires to gather data about a course, curriculum component or medical education programme. An easy-to-use list of problems to consider when writing questions for a questionnaire is provided. As well, information is provided about the structure of a questionnaire and of the covering letter sent to potential respondents.

Education, Medical↗
PubMed1988

Ontario Child Health Study: patterns of ambulatory medical care utilization and their correlates.

Data from a large epidemiologic survey of Ontario children 4 to 16 years of age are presented concerning the frequency and correlates the use of ambulatory medical care services during a 6-month period in which a universal, first-dollar health insurance plan was used. Patterns of use of ambulatory medical care are described for three settings: doctor's offices, emergency rooms, and hospital outpatient departments. A group of children who are frequent users of ambulatory medical care (defined as using three or more services in 6 months) consumed nearly two thirds of all services. Two regression equations are presented--one predicting use/nonuse of ambulatory medical care and the other predicting the total number of visits for medical care. Although only a small proportion of the variance in use/nonuse and amount of use was explained, the major determinant of both ambulatory medical care use and frequency of use was the child's physical health status as perceived by the parent. Younger child, urban area of residence, the number of chronic medical problems of the child, and higher level of maternal education also contributed to the explanation of use v nonuse. Among ambulatory medical care users, high users were more likely to be described as having mental health problems and have parents who had been treated for "nerves." Family size and socioeconomic variables were not important factors in use, suggesting that universal health insurance reduces some barriers to ambulatory medical care for children.

Adolescent↗
PubMed1987

Career choices of McMaster University medical graduates and contemporary Canadian medical graduates.

The MD program at McMaster University, Hamilton, Ont., differs from that at most other Canadian universities in the profile of students admitted and in its teaching methods. To investigate influences of selection policy outcomes and the education program, the career choices of 408 McMaster graduates were compared with those of 1620 graduates of other Canadian English-language schools by analysis of data from the CMA's Physician Manpower Data Bank. Compared with graduates of other schools, McMaster graduates were more likely to have chosen internal medicine, less likely to have chosen surgery and equally likely to have chosen primary care as their medical field. Of those in primary care, a higher proportion of McMaster graduates than other graduates held certification in family medicine. This was largely responsible for the overall higher rate of certification in the McMaster group. While the nature of practice and time spent on patient care did not differ between the two groups, several variables, including time spent on professional activities other than patient care, proportion involved in research and classroom teaching, and proportion of salaried physicians employed by universities, indicated a higher than average level of interest in academic medicine among the McMaster graduates. This could be partially explained by differences in the student profile if students who are interested in education are more likely to choose an educationally innovative medical school.

Canada↗
PubMed1985

Measuring physicians' performances by using simulated patients.

The authors in this paper discuss a new approach to the assessment of physicians' performances in practice using undetected standardized (simulated) patients. Case-specific performance criteria were established for seven standardized patients by eight family physicians and two specialists. The patients were then introduced into the practices of the family physicians and of a second cohort of seven family physicians. No differences were found between the criteria-setting and the noncriteria-setting physicians; but large differences were found among the criteria, the physicians' performances as indicated by the patient, and the data recorded by the physicians on the patient chart. Depending on the method used to score the performance and the recorded data, about 30 to 45 percent of the procedures were not performed, and 50 to 70 percent of the criteria were not recorded. The implications of the study for assessment of physician performance are discussed.

Clinical Competence↗
PubMed1985

Measurement of physician performance by standardized patients. Refining techniques for undetected entry in physicians' offices.

The article describes the development of methods to use live simulated patients for assessment of quality of care of primary physicians. Methods used to train patients and achieve undetected entry into physicians' practices are described. The study demonstrated that patients can be entered into practices with a low rate of detection (13%) and that they are able to recall the details of the encounter with a high degree of reliability.

Humans↗
PubMed1985

Temporal relationships and characterisation of extracellular proteases from benign and virulent strains of Bacteroides nodosus as detected in zymogram gels.

Extracellular proteases produced by Bacteroides nodosus in a peptone rich modified trypticase-arginine-serine broth medium were separated and characterised by relative mobility (Rf) in electrophoretic zymogram gels. One benign and two virulent protease banding patterns were established with isolates from sheep, cattle and goats. They correlated with other laboratory tests for virulence but were independent of serogroup. The electrophoretic zymogram method was unable to differentiate intermediate from virulent strains. The time required for the production of maximum levels and numbers of protease bands was four to five days for benign and five to six days for virulent B nodosus. Elevated temperatures (above 45 degrees C) and pH extremes (below pH 6 and above pH 9) modified the electrophoretic banding patterns. The molecular weights of the proteases ranged from 8000 to 43,000 daltons and the isoelectric points from pH 4.90 to 5.90. They are serine proteases and this property can be utilised in affinity purification of these molecules.

Animals↗
PubMed1978

Aspects of consumer satisfaction with brief family therapy.

In an evaluative study of brief family therapy, 279 families were administered a Family Satisfaction Questionnaire in their own homes, six months after treatment terminated. This questionnaire was designed to assess several aspects of the families' satisfaction with services received. The identified patient in all families was a child with academic and/or behavioral problems at school. A variety of outcome measures were also obtained both at treatment termination and at the six-month follow-up. Families were generally satisfied with the overall services received but expressed widely varying degrees of satisfaction with various aspects of treatment. Very little dissatisfaction was expressed regarding the availability of services (less than 7 per cent), but a sizeable proportion of families (45 per cent) did not feel that the services provided were comprehensive and adequate. Despite concerns regarding comprehensiveness and adequacy of the service, the majority of families were functioning well at the time of follow-up as assessed by a number of independent measures. Global satisfaction should not be regarded as the only index of treatment effectiveness, as many families who were dissatisfied experienced successful treatment outcomes.

Adolescent↗