Biomedical subjects

Charles Woods

Publications and source records attributed to Charles Woods.

13 recordsLinked to original sources

PubMed2007

Thymic carcinoma in a child with HIV infection.

HIV infection predisposes to cancer during childhood. In addition to the AIDS-defining non-Hodgkin lymphoma (NHL) and Kaposi sarcoma, a range of other lymphoid malignancies and solid tumors have been described. We report the first case of an HIV-positive child with thymic carcinoma in the setting of regressing thymic cysts. The tumor expressed CKIT but failed to respond to imatinab mesylate after a transient response to multiagent chemotherapy. This case extends the spectrum of pediatric malignancy in the setting of HIV and suggests that patients with presumed benign thymic cysts require ongoing surveillance.

Antineoplastic Agents↗

PubMed2006

Long-term impact of four different strategies for delivering an on-line curriculum about herbs and other dietary supplements.

BACKGROUND: Previous research has shown that internet education can lead to short-term improvements in clinicians' knowledge, confidence and communication practices. We wished to better understand the duration of these improvements and whether different curriculum delivery strategies differed in affecting these improvements. METHODS: As previously described, we conducted a randomized control trial comparing four different strategies for delivering an e-curriculum about herbs and other dietary supplements (HDS) to clinicians. The four strategies were delivering the curriculum by: a) email over 10 weeks; b) email within one week; c) web-site over 10 weeks; d) web-site within one week. Participants were surveyed at baseline, immediately after the course and 6-10 months after completing the course (long-term). Long-term outcomes focused on clinicians' knowledge, confidence and communication practices. RESULTS: Of the 780 clinicians who completed the course, 385 (49%) completed the long-term survey. Completers and non-completers of the long-term survey had similar demographics and professional characteristics at baseline. There were statistically significant improvements from baseline to long-term follow-up in knowledge, confidence and communication practices; these improvements did not differ by curriculum delivery strategy. Knowledge scores improved from 67.7 +/- 10.3 at baseline to 78.8 +/- 12.3 at long-term follow-up (P < 0.001). Confidence scores improved from 53.7 +/- 17.8 at baseline to 66.9 +/- 12.0 at long term follow-up (P < 0.001); communication scores improved from 2.6 +/- 1.9 at baseline to 3.6 +/- 2.1 (P < 0.001) at long-term follow-up. CONCLUSION: This e- curriculum led to significant and sustained improvements in clinicians' expertise about HDS regardless of the delivery strategy. Future studies should compare the impact of required vs. elective courses and self-reported vs. objective measures of behavior change.

Adult↗

PubMed2006

Dietary supplement use among health care professionals enrolled in an online curriculum on herbs and dietary supplements.

BACKGROUND: Although many health care professionals (HCPs) in the United States have been educated about and recommend dietary supplements, little is known about their personal use of dietary supplements and factors associated with their use. METHODS: We surveyed HCPs at the point of their enrollment in an on-line course about dietary supplements between September, 2004 and May, 2005. We used multivariable logistic regression to analyze demographic and practice factors associated with use of dietary supplements. RESULTS: Of the 1249 health care professionals surveyed, 81 % reported having used a vitamin, mineral, or other non-herbal dietary supplements in the last week. Use varied by profession with highest rates among nurses (88%), physician assistants or nurse practitioners (84 %) and the lowest rates among pharmacists (66%) and trainees (72%). The most frequently used supplements were multivitamins (60%), calcium (40%), vitamin B (31%), vitamin C (30%), and fish oil (24%). Factors associated with higher supplement use were older age, female, high knowledge of dietary supplements, and discussing dietary supplements with patients. In our adjusted model, nurses were more likely than other professionals to use a multivitamin and students were more likely to use calcium. CONCLUSION: Among HCPs enrolled in an on-line course about dietary supplements, women, older clinicians, those with higher knowledge and those who talk with patients about dietary supplements had higher use of dietary supplements. Additional research is necessary to understand the impact of professionals' personal use of dietary supplements on communication with patients about them.

Adult↗

PubMed2006

Expertise about herbs and dietary supplements among diverse health professionals.

BACKGROUND: Herbs and other dietary supplements are among the most commonly used complementary medical therapies. However, clinicians generally have limited knowledge, confidence and communication about herbs and dietary supplements (HDS). We compared diverse clinicians' expertise about HDS to better target future curricula. METHODS: We conducted a cross-sectional survey of physicians, pharmacists, nurses, dietitians and trainees in these professions prior to e-curriculum about HDS in 2004-2005. The survey had 28 questions about knowledge, 19 questions about their confidence and 11 questions about their communication practices about HDS. RESULTS: Of the 1,268 participants, 25% were male; the average age was 40 years. Mean scores were 66% correct for knowledge; 53/95 on the confidence scale and 2.2 out of possible 10 on the communication practices scale. On average, scores were lowest for those who used fewer HDS; and trainees and nurses compared with physicians, pharmacists and dietitians (P < 0.01 for all comparisons). CONCLUSION: Clinicians have moderate levels of knowledge and confidence, but poor communication skills about HDS. Future curricula about HDS should target nurses, students, practitioners and those not currently using HDS. Research is needed to determine the most cost-effective educational strategies for diverse health professionals.

Adult↗

PubMed2006

Randomized controlled trial comparing four strategies for delivering e-curriculum to health care professionals [ISRCTN88148532].

BACKGROUND: Internet education is increasingly provided to health professionals, but little is known about the most effective strategies for delivering the content. The purpose of this study is to compare four strategies for delivering an Internet-based (e-) curriculum on clinicians' knowledge (K), confidence (CONF), and communication (COMM) about herbs and other dietary supplements (HDS). METHODS: This national randomized 2 x 2 factorial trial included physicians, pharmacists, nurses, nutritionists and trainees in these fields. Participants were randomly assigned to one of four curriculum delivery strategies for 40 brief modules about HDS: a) delivering four (4) modules weekly over ten (10) weeks by email (drip-push); b) modules accessible on web site with 4 reminders weekly for 10 weeks (drip-pull); c) 40 modules delivered within 4 days by email (bolus-push); and d) 40 modules available on the Internet with one email informing participants of availability (bolus-pull). RESULTS: Of the 1,267 enrollees, 25% were male; the average age was 40 years. The completion rate was 62%, without significant differences between delivery groups. There were statistically significant improvements in K, CONF and COMM scores after the course (P<0.001 for all), although the difference in COMM was small. There were no significant differences in any of the three outcomes by delivery strategy, but outcomes were better for those who paid for continuing education credit. CONCLUSION: All delivery strategies tested similarly improved K, CONF, COMM scores about HDS. Educators can use the strategy that is most convenient without diminishing effectiveness. Additional curricula may be necessary to make substantial changes in clinicians' communication practices.

Adult↗

PubMed2006

Career goals in the high risk adolescent.

Possessing a career goal might serve as a protective factor for an adolescent's healthy development. This could be especially important in adolescents who engage in high risk behaviors. The relationship between high risk adolescents' future career goals and selected predictor variables were examined. Almost half (49%) the students indicated a career goal. Students who reported a job were 5.1-fold more likely to have listed a future career goal. Females, those aged 18 years, and those whose mothers were employed were twice as likely to have a career goal. Considerations for fostering career goals for high risk students are warranted.

Adolescent↗

PubMed2006

Herb use among health care professionals enrolled in an online curriculum on herbs and dietary supplements.

BACKGROUND: Although many adults in the United States use herbs, little is known about the personal use of herbs by health care professionals (HCPs) and factors associated with use. METHODS: We performed a cross-sectional study of HCPs prior to their enrollment in an online course about herbs and dietary supplements between September 2004 and May 2005. We used multivariable logistic regression to analyze demographic and practice factors associated with herb use. RESULTS: Of the 1249 health care professionals surveyed, 51% reported using an herb in the last week. The rates of use were highest among physician assistants or nurse practitioners (PA or NP) (63%), clinical nurses (59%), and HCP students (52%), while physicians (48%), dietitians (40%), and pharmacists (37%) had lower rates. Among health care professionals who reported herb use, the most common herbs taken were green tea (24%), flax seed (18%), chamomile (11%), and aloe vera (8%). Factors associated with herb use included older age, being a nurse, a HCP student, an NP or PA compared with being a physician, being non-Caucasian, living outside of North Carolina and having increased knowledge of herbs and dietary supplements.

Adult↗

PubMed2005

Electives in complementary medicine: are we preaching to the choir?

CONTEXT: Many medical schools offer electives on complementary medicine, but little is known about the characteristics of students who sign up for such electives compared with those who do not. OBJECTIVE: Compare enrollees to nonenrollees in an elective course on therapeutic touch and healing touch (TTHT). DESIGN: Cross-sectional survey. SETTING: Wake Forest University School of Medicine, second-year course on medicine as a profession. SUBJECTS: Second-year medical students who returned surveys: 22 who signed up for an elective on TTHT and 58 who did not. INSTRUMENT: Anonymous surveys included questions about demographics, attitudes, practices, and the Maslach Burnout Inventory (MBI). RESULTS: Those who signed up for the elective were more likely to be women (73% for TTHT vs 33% for others, P < .01). Nearly all students thought that being centered and compassionate were very important. Students who signed up for TTHT were less likely to report feeling confident in being able to be centered when it was quiet (41% vs 64%, respectively, very confident, P < .04) and less confident in their ability to demonstrate nonverbal comforting behaviors (9% vs 43%, respectively, very confident, P = .02). Only 18% of elective vs 66% of others reported being centered during patient encounters (P < .001). The TTHT students and their classmates reported comparable levels of burnout. CONCLUSIONS: Elective students were no more likely than classmates to believe that it is very important to be centered and to extend compassion toward patients; they reported being less confident and practicing these skills less often than their classmates. Burnout was not less common among those in the elective. Electives may not be "preaching to the choir." Future studies need to determine whether training enhances confidence and skills and whether it protects against developing burnout.

Adult↗

PubMed2005

Microbial DNA typing by automated repetitive-sequence-based PCR.

Repetitive sequence-based PCR (rep-PCR) has been recognized as an effective method for bacterial strain typing. Recently, rep-PCR has been commercially adapted to an automated format known as the DiversiLab system to provide a reliable PCR-based typing system for clinical laboratories. We describe the adaptations made to automate rep-PCR and explore the performance and reproducibility of the system as a molecular genotyping tool for bacterial strain typing. The modifications for automation included changes in rep-PCR chemistry and thermal cycling parameters, incorporation of microfluidics-based DNA amplicon fractionation and detection, and Internet-based computer-assisted analysis, reporting, and data storage. The performance and reproducibility of the automated rep-PCR were examined by performing DNA typing and replicate testing with multiple laboratories, personnel, instruments, DNA template concentrations, and culture conditions prior to DNA isolation. Finally, we demonstrated the use of automated rep-PCR for clinical laboratory applications by using isolates from an outbreak of Neisseria meningitidis infections. N. meningitidis outbreak-related strains were distinguished from other isolates. The DiversiLab system is a highly integrated, convenient, and rapid testing platform that may allow clinical laboratories to realize the potential of microbial DNA typing.

Automation↗

PubMed2003

Imaging multispectral polarimetric sensor: single-pixel design, fabrication, and characterization.

A discrete-component approach was taken to establish the operational feasibility of a novel, imaging, midinfrared, multispectral, polarimetric sensor for remote-sensing application. The sensor is designed to exploit the spectral and polarimetric characteristics of the scene as discriminants. Pixelated multispectral filters and polarization filters were designed and fabricated on sapphire and Si substrates, respectively, and both were characterized. A single-pixel spectropolarimetric composite filter was characterized by use of a Fourier transform infrared spectrometer and a Pt-Si thermal-imaging camera. The experimental results show excellent agreement with theoretical predictions.

Journal Article↗

PubMed2002

Trends in interventions to reduce perinatal human immunodeficiency virus type 1 transmission in North Carolina.

BACKGROUND: Mother-to-child transmission of HIV has decreased in industrialized countries because of widespread use of antiretroviral therapy (ART) by HIV-infected pregnant women and perhaps to increased use of elective cesarean section. We evaluated changes in the use of ART and mode of delivery among HIV positive pregnant women in North Carolina. METHODS: We reviewed the medical records of HIV-exposed infants born in North Carolina between January 1, 1998, and December 31, 1999, who were tested for HIV DNA. These results were compared with data collected on HIV-exposed infants born from 1993 through 1997. RESULTS: The use of combination ART increased from 1.5% in 1996 to 73% in 1999. The most common ART was zidovudine/lamivudine (39%) followed by zidovudine-lamivudine-nelfinavir (34%), although 34 combinations were used. Elective cesarean sections in the state increased significantly from 16.5% in the first half of 1998 to 49.4% in the second half of 1999. Overall transmission rates declined from 24.5% in 1993 to an average of 10.6% in 1994 to 1996 (41 of 385) and to 3.5% in 1997 to 1999 (15 of 428). CONCLUSIONS: Increased use of combination ART and elective cesarean section was accompanied by consistently low rates of perinatal transmission. However, because perinatal transmission rates were also low among women who used combination therapy and had vaginal deliveries, it is difficult to determine how much additional benefit cesarean section affords. Most HIV transmission occurred among women who lacked prenatal care and did not receive or adhere to ART.

Anti-HIV Agents↗

PubMedDate not supplied

Cranberry use among pediatric nephrology patients.

INTRODUCTION: Recurrent urinary tract infections are common in children, and the use of complementary therapies is common in other children with recurrent illnesses. However, little is known about the use of cranberry products by children with renal disease. We hypothesized that, because cranberry is often used to prevent urinary tract infections (UTI) in adult women, many parents would give it to their children, particularly to children prone to recurrent UTI (rUTI). METHODS: Anonymous, cross-sectional, self-administered survey of parents of children seen in the pediatric nephrology clinic at Brenner Children's Hospital between June 1, 2004, and August 13, 2004. RESULTS: Of the 117 parents surveyed, the patients' average age was 10.3 years, and 15% reported rUTI as a problem. Overall, 29% of surveyed parents gave cranberry products therapeutically; as expected, use was higher among those with rUTI (65%) than among those with other renal conditions (23%); odds ratio = 6.1 (2.0, 18.4, P < .001); many parents gave cranberry to treat as well as prevent diverse renal problems. Most felt it was beneficial and only 1 parent reported a side effect (nausea). Only 23% of those who used it had discussed cranberry use with their physician. CONCLUSION: Cranberry is commonly used therapeutically among patients seen in a pediatric nephrology clinic and is perceived as useful by parents, though uncommonly discussed with physicians. Randomized controlled trials are needed to determine the effectiveness of cranberry juice therapy for rUTI in children.

Beverages↗

PubMedDate not supplied

Attitudes and expectations about music therapy for premature infants among staff in a neonatal intensive care unit.

BACKGROUND: Music appears to reduce stress in premature infants, but little is known about the attitudes and expectations about music among clinicians caring for these infants. The study questions were: a) would staff like to have music played in the Neonatal Intensive Care Unit (NICU), b) would they prefer live to recorded music, and c) how would their attitudes be affected by their profession and experience? DESIGN: Cross sectional survey of NICU staff in the winter of 2003. METHODS: Eligible subjects were 37 physicians and 150 nurses and other clinical staff in the NICU. After pilot testing and revision, the self-administered questionnaires contained 57 Likert type or multiple choice items. They were distributed by e-mail and in staff mailboxes with two reminders. Data were analyzed using simple descriptive statistics, Chi-square, and logistic regression. RESULTS: The response rate was 75%. Most were nurses and 27 were MD's. Most (84%) were female and most (70%) reported some previous musical training. The majority (68%) agreed that they would like to have music played in the NICU. Most agreed that music could reduce stress (86%) and crying (79%) and improve sleep (79%) in premature infants. Recorded was preferred to live music by more than 2:1. Attitudes were significantly associated with prior musical training, experience, and profession. CONCLUSIONS: NICU staff holds favorable attitudes toward music for premature infants. Music's effects on caregiver attitudes, mood and behavior may contribute to its impact on infants. Evaluation of the effects of music on infants needs to account for caregiver's expectations and behavior as well as direct effects on infants' physiology.

Adult↗