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Biomedical subjects

D D Schmidt

Publications and source records attributed to D D Schmidt.

At least 19 recordsLinked to original sources
PubMed1990

The individual over time: time series applications in health care research.

This paper presents a summary and a brief theoretical introduction to time series ARIMA modeling of single subject data. Time series, a statistical technique that may be appropriate when data are measured repeatedly and at nearly equal intervals of time, has potential research applications in the study of chronic diseases such as diabetes, hypertension, and herpes simplex. Both intervention models and multivariate models are covered, with examples illustrating the utility of time series techniques in chronic disease research. Time series modeling of a subject with diabetes before and after being placed on a regimen of chlorpropamide is used to demonstrate the potential of intervention analysis. Multivariate time series techniques are illustrated by modeling the relationship between exercise and blood glucose, and by modelling the relationship between psychosocial distress and lymphocyte subsets of the cellular immune system.

Blood Glucose↗
PubMed1985

Stress as a precipitating factor in subjects with recurrent herpes labialis.

The model of recurrent herpes labialis was selected to evaluate the role played by stress in increasing susceptibility to illness. Initially, 35 paid volunteers with recurrent herpes were enrolled in the project. Compared with 35 age- and sex-matched controls, this group demonstrated a familial predisposition for recurrent herpes labialis. Eighteen subjects without confounding variables known to precipitate recurrent herpes infections completed a pretested "stress" questionnaire during a dormant and again during an active stage of infection. In the week prior to the appearance of a recurrence, this group experienced increased daily hassles, increased stressful life events, and higher state anxiety. These findings are discussed in the broader context of stress-associated disease with some speculations concerning a possible biologic mechanism, which involves modulations of T-lymphocyte function.

Adult↗
PubMed1983

When is it helpful to convene the family?

There are three factors supporting current efforts to bring the family into the mainstream of American medicine: (1) research capabilities of the discipline of epidemiology, (2) the intervention skills developed by family therapy, and (3) pressures to provide cost-effective care as economic resources diminish. The fundamental question addressed in this paper is, when can it be helpful for the family physician to convene the family in the consultation room? Physicians in the field and residents in training are often reluctant to take this step because of time constraints, awkwardness in talking to two or more members of the family, and unfamiliarity with what to do with the information that is gathered. From currently available research data, a list of 14 medical conditions is presented in which it can be predicted that family functioning or nonfunctioning is contributing to the cause of disease, or that the family will experience a major reaction to the illness. These medical conditions offer an ideal opportunity to begin working with families. A specific case history illustrating this approach is presented to demonstrate that convening the family can be an important dimension of family medicine.

Adenocarcinoma↗
PubMed1983

Troubled marriages and divorce: a prospective suburban study.

A longitudinal survey of adjustment to divorce in Cleveland, Ohio, suburbs was conducted with a matched sample of married persons in order to identify some of the common complaints, feelings, concerns, and health hazards among separated and divorced persons. The study findings show that substantial numbers of divorced and married people turn to their physicians for help with personal problems, suggesting that physicians need to be prepared to help them appropriately. Based upon these findings, opportunities are described that are open to the family physician for detecting distress in the troubled marriage and in divorce, as well as for therapeutic intervention. Types of interventions include anticipatory guidance, counseling, and referral for more intensive therapy. In the troubled marriage there is often an extended period of unhappiness and indecision. A physician alerted to the frequency with which marital distress is exhibited in physical or psychological symptoms may be able to provide assistance in sorting out priorities and options. Following a crisis model of adjustment, the heightened physical and psychological distress experienced during the early stages of the divorce process decreases with time. Many divorced parents are not aware of the im pact of marital turmoil and divorce on their children. The family physician plays an important part in helping parents recognize their continuing role in the lives of their children even if the marital relationship ends.

Counseling↗
PubMed1978

The family as the unit of medical care.

This review of the literature on the family and medical care involves an expedition into the sister disciplines of epidemiology, sociology, and psychology. There is a considerable volume of evidence that documents how important to the individual's health is his family. This material has been organized into four categories: (1) the family's contribution to the "cause" of disease, (2) the family's contribution to the "cure" of disease, (3) the family's response to serious or chronic disease, and (4) the family's desire and/or need for family-oriented care. In the conclusion, some implications for the future of the discipline of family medicine are discussed in relation to the material presented.

Chronic Disease↗
PubMed1977

The female hysterical personality disorder.

It is not uncommon in family practice for the family physician to encounter the female patient with a hysterical personality disorder. A case presentation and interview are provided to help the family physician recognize the problem. A formulation of this case stresses psychosexual development, which will provide the reader with insight that can be generalized to other patients. Major emphasis is given to practical guidelines for the clinician for management of this frequently difficult problem in a medical setting.

Adult↗
PubMed1977

Patient compliance: the effect of the doctor as a therapeutic agent.

This paper is a review of the available literature on patient complicance with medical regimens. An effort is made to focus on those features or characteristics associated with compliance or noncompliance that are clinically relevant for the practicing physician. These include the intelligence of the patient, the patient's knowledge of his disease, the complexity of the medical regimen, the influence of the family, the health belief model, and the doctor-patient relationship. From this review of research data, 12 concrete suggestions are presented for the purpose of enhancing patient compliance and enabling the doctor himself to be more effective as a therapeutic agent.

Attitude to Health↗
PubMed1977

The clinical recognition of congestive heart failure.

The recognition of early or mild congestive heart failure in the ambulatory patient is a common clinical challenge in everyday practice. Early diagnosis requires attention to symptoms, signs, and radiographic changes which may be minimal. This paper reviews basic pathophysiological principles involved in congestive heart failure and summarizes etiological factors which may cause or precipitate congestive heart failure. The symptoms, signs, and subtle radiological findings of early congestive heart failure are also described in some detail.

Cough↗
PubMed1977

Referral patterns in an individual family practice.

This retrospective study of referral patterns in an individual private practice demonstrates that the family physician provides a definitive care for the large majority of patient problems in everyday practice and does not function primarily as a triage officer. Ninety-seven percent of all patient contacts, both ambulatory and in-hospital, were managed by the individual physician and his staff. Two-and-one-half percent of patient contacts required consultation with local specialists, and only .5 percent required referral to a tertiary care center. These results are compared with other large-scale population studies of the "ecology" of medical care and with other recent studies of referral patterns in family practice.

Age Factors↗