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Cassie C Kennedy

Publications and source records attributed to Cassie C Kennedy.

5 recordsLinked to original sources
PubMed2006

Testosterone use in men and its effects on bone health. A systematic review and meta-analysis of randomized placebo-controlled trials.

CONTEXT: Androgen-deficient men are at increased risk of osteoporosis. The extent to which testosterone can prevent and treat osteoporosis in men remains unclear. OBJECTIVE AND DESIGN: We performed a systematic review and meta-analysis of randomized placebo-controlled trials in men to estimate the effect of testosterone use on bone health outcomes. DATA SOURCES: The review encompassed librarian-designed search strategies using MEDLINE (1966 to March 2005), EMBASE (1988 to March 2005), and Cochrane CENTRAL (inception to March 2005); a review of reference lists from included studies; and content expert files. DATA COLLECTION: Independently and in duplicate, we assessed the methodological quality of the eligible trials and collected data on bone mineral density and bone fractures at the longest point of complete follow-up. DATA SYNTHESIS: We included eight trials enrolling 365 patients. Two trials followed patients for more than 1 yr. Meta-analysis of these trials showed that, compared with placebo, im testosterone was associated with an 8% (95% confidence interval, 4%, 13%) gain in lumbar bone mineral density and transdermal testosterone had no significant impact. Testosterone use was associated with a nonsignificant 4% (95% confidence interval, -2%, 9%) gain in femoral neck bone mineral density with unexplained differences in results across trials (26% of these differences were not explained by chance alone). No trials measured or reported the effect of testosterone on fractures. CONCLUSIONS: Intramuscular testosterone moderately increased lumbar bone density in men; the results on femoral neck bone density are inconclusive. Without bone fracture data, the available trials offer weak and indirect inferences about the clinical efficacy of testosterone on osteoporosis prevention and treatment in men.

Bone Density↗
PubMed2006

Changing morning report: evaluation of a transition to an interactive mixed-learner format in an internal medicine residency program.

BACKGROUND: Morning report is an important conference for medical education, but direct comparisons of approaches to morning report have only rarely been reported. DESCRIPTION: During the 2003 to 2004 academic year, we conducted both our traditional single-learner-level morning report and a new highly interactive multiple-learner-level format. Attendees were rotating students, residents, and faculty on the inpatient general medicine services. EVALUATION: We conducted anonymous surveys of participants to record their evaluations of the morning report formats. We received evaluations from 293 (60%) of 490 students, residents, and faculty. Students, 1st-year residents, and faculty preferred the mixed-learner model significantly more than did senior residents. Overall, more than 80% of participants rated the interactive multilevel format as good or very good when asked about content, discussion quality, level, and usefulness. CONCLUSIONS: An interactive morning report involving learners across multiple levels was well-received and has several educational benefits, with a greater emphasis on collaborative case discussion and active learning. Education leaders should remain open to experimenting with even the most well-established institutional traditions as they continuously reevaluate the effectiveness of teaching conferences.

Communication↗
PubMed2005

Introduction of a 14-hour work shift model for housestaff in the medical ICU.

STUDY OBJECTIVE: To describe the outcomes of switching housestaff from a traditional model of "long-call" every 4 days to a 14-h work-shift model in a medical ICU (MICU) over a 5-week pilot period. DESIGN: Retrospective comparison of a 5-week pilot period for a 14-h work-shift model vs a 4-month period for the traditional model. SETTING: The MICU of a tertiary medical center. PARTICIPANTS: A total of 626 patients admitted to the MICU and 34 internal medicine residents taking care of them. INTERVENTIONS: None. MEASUREMENTS: Severity-adjusted patient outcomes, housestaff performance on end-of-rotation examinations, and scheduled duty hours during the 5-week 14-h work-shift pilot period compared to a 16-week traditional nonpilot work period. RESULTS: There were no statistically significant differences in patients' adjusted mortality rates, hospital lengths of stay, or housestaff performance on end-of-rotation knowledge assessment examinations between the pilot and nonpilot periods. During the pilot period, each resident was scheduled to work for an average of 61.3 h weekly, and each fellow for 65.3 h weekly. In comparison, each resident and fellow was scheduled to work for an average of 73.3 h weekly during the nonpilot period. CONCLUSIONS: The 14-h work shift is a feasible option for housestaff rotation in the MICU. Although the power of our study to detect significant differences in mortality, length of stay, and educational outcomes was low, there was no evidence of compromised patient care or housestaff education associated with the 14-h shift model over the course of this 5-week pilot study.

Adult↗