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Biomedical subjects

David R Garr

Publications and source records attributed to David R Garr.

8 recordsLinked to original sources
PubMed2004

Clinical prevention and population health: curriculum framework for health professions.

The Clinical Prevention and Population Health Curriculum Framework is the initial product of the Healthy People Curriculum Task Force convened by the Association of Teachers of Preventive Medicine and the Association of Academic Health Centers. The Task Force includes representatives of allopathic and osteopathic medicine, nursing and nurse practitioners, dentistry, pharmacy, and physician assistants. The Task Force aims to accomplish the Healthy People 2010 goal of increasing the prevention content of clinical health professional education. The Curriculum Framework provides a structure for organizing curriculum, monitoring curriculum, and communicating within and among professions. The Framework contains four components: evidence base for practice, clinical preventive services-health promotion, health systems and health policy, and community aspects of practice. The full Framework includes 19 domains. The title "Clinical Prevention and Population Health" has been carefully chosen to include both individual- and population-oriented prevention efforts. It is recommended that all participating clinical health professions use this title when referring to this area of curriculum. The Task Force recommends that each profession systematically determine whether appropriate items in the Curriculum Framework are included in its standardized examinations for licensure and certification and for program accreditation.

Advisory Committees↗
PubMed2004

Wellness and prevention.

BACKGROUND AND OBJECTIVES: The importance of wellness and prevention in medical education is well documented. This report discusses the educational innovations in wellness and prevention that were implemented as part of the Undergraduate Medical Education for the 21st Century (UME-21) project. METHODS: Eight partner schools and four of the 10 associate partner schools provided specific information about learning objectives, content, and methods used in incorporating wellness and prevention into the curriculum. Based on these reports, common learning objectives and core content were identified. RESULTS: Many schools emphasized that integration of content across courses and throughout the preclinical and clinical years was important in incorporating wellness and prevention content into existing curricula. A variety of instructional methods were used, including didactic lectures, workshops, smallgroup sessions, case studies, computer-based instructional modules, patient simulators, and standardized patient encounters. Based on partner reports, after completing the UME-21 project, students demonstrated gains in knowledge, clinical skills, and positive attitudes toward preventive care and wellness. The project outcome data indicated that student instruction in and exposure to preventive care was increased during the project. However, these increases were not significant when compared to their peers from non-UME-21 schools. CONCLUSIONS: Although partner schools used different methods to incorporate wellness and prevention, the UME-21 project was an effective project in improving the educational experience in this content area for students from institutions that included this area in their educational innovations.

Clinical Competence↗
PubMed2004

Medical students' perceptions of rural practice following a rural clerkship.

BACKGROUND AND OBJECTIVES: Evidence suggests that rural experiences can positively influence students' preferences for rural practice. This study examined changes in students' perceptions toward rural primary care following a required rural clerkship. METHODS: Third-year students completed pre- and post-clerkship questionnaire items assessing their beliefs about primary care physicians who practice in rural communities in comparison with their urban/suburban counterparts. A factor analysis was performed, and pre- and post-clerkship scale means were calculated to determine differences. RESULTS: A total of 428 (88%) students completed these questionnaires. There was a significant increase in students' perceptions of rural primary care physicians' primary care service features and medical expertise. Students perceived the physicians' work demands more positively, and there was no change in students' perceptions of the physicians' income potential. CONCLUSIONS: Results suggest that the rural primary care clerkship positively influenced students' perceptions toward rural primary care.

Attitude↗
PubMed2002

Is an elevated serum transferrin saturation associated with the development of diabetes?

OBJECTIVES: Diabetes mellitus is a common comorbid condition of hemochromatosis and is often identified as a complication of untreated hemochromatosis. However, there are few primary data examining the development of diabetes secondary to hemochromatosis. Our objective was to determine the likelihood of developing diabetes in a nationally representative cohort of patients who have an elevated serum transferrin saturation rate but no current diagnosis of diabetes. STUDY DESIGN: This is a retrospective cohort study based on merging the National Health and Nutrition Examination Survey I (1971-1974; NHANES I) with the NHANES I Epidemiologic Followup Study (1992). POPULATION: Individuals aged 25 to 74 years at the time of the NHANES I without diabetes (n = 9274). OUTCOMES MEASURED: The outcome was development of diabetes according to patient report, proxy report, or death certificate by the time of the follow-up interview. RESULTS: The incidence of diagnosed diabetes in the cohort was 10.2%. Among individuals with serum transferrin saturation levels above 55%, 7.5% developed diagnosed diabetes compared with 10.2% with a serum transferrin saturation of no more than 45% (P =.38). The relation remained nonsignificant in models adjusted for risk factors of diabetes and in analyses that assumed 10% of patients had received treatment for hemochromatosis. CONCLUSIONS: In this nationally representative cohort of adults, elevated serum transferrin saturation was not significantly associated with the development of diabetes.

Adult↗
PubMedDate not supplied

Race, rural residence, and control of diabetes and hypertension.

PURPOSE: African Americans are at increased risk for diabetes mellitus and hypertension, and rural residents have historically had decreased access to care. It is unclear whether living in a rural area and being African American confers added risks for diagnosis and control of diabetes and hypertension. The purpose of this study was to examine the prevalence of diagnosed diabetes and hypertension, as well as control of both conditions, among rural and urban African Americans and whites. METHODS: We conducted an analysis of the Third National Health and Nutrition Examination Survey (1988-1994). Non-Hispanic African Americans and non-Hispanic white adults 20 years and older were classified according to rural or urban residence (n = 11,755). Investigated outcomes were previously diagnosed diabetes mellitus and hypertension and control of diabetes and hypertension. RESULTS: The prevalence of diagnosed diabetes was 4.5% for urban whites, 6.5% for rural whites, 6.0% for urban African Americans, and 9.5% for rural African Americans. Among patients with diagnosed diabetes, 33% of rural whites, 43% of urban whites, 45% of urban African American, and 61% of rural African Americans had glycosylated hemoglobin (HbA(1c)) levels of 8% or higher (P < .01). Among patients with diagnosed hypertension, 11% of rural whites, 13% of urban whites, 20% of urban African Americans, and 23% of rural African Americans had diastolic blood pressure greater than 90 mmHg (P < .01). In regression models controlling for relevant variables, including body mass index, health status, access to care, education, income, and insurance, compared with rural African Americans, rural and urban whites were significantly more likely to have better glycemic control and diastolic blood pressure control. Urban African Americans also had better diabetes control than rural African Americans. CONCLUSIONS: In this nationally representative sample, rural African Americans are at increased risk for a lack of control of diabetes and hypertension.

Adult↗