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Biomedical subjects

E G Baxley

Publications and source records attributed to E G Baxley.

16 recordsLinked to original sources
PubMed2001

A collaborative clerkship with a focus on rural community health.

The Deans' Rural Primary Care Clerkship was developed through the collaborative efforts of South Carolina's two medical schools. The clerkship provides students an innovative learning experience in rural community medicine through the unique combination of learning opportunities with community-oriented primary care, continuous quality improvement, interdisciplinary health care teams, and cultural competency. Much of students' learning addresses current directives for population health training. The positive experience students are having in these rural, underserved South Carolina communities will help them better understand the rewards and challenges of rural, community-responsive health care.

Clinical Clerkship↗
PubMed1998

Organizational environment and perceptions of teaching quality in seven South Carolina family medicine residency programs.

PURPOSE: To explore the relationship between organizational environment and teaching quality in seven family medicine residency programs. METHOD: In 1995, a questionnaire on organizational environment was administered to the faculties at all seven family medicine residency programs in South Carolina. Eighty-seven percent of the faculty members participated, as did convenience samples of residents, nurses, and administrative staff. The questionnaire measured seven variables: teaching quality, job satisfaction, organizational climate, employees' autonomy, goal attainment, organizational commitment, and job-related stress. RESULTS: Residents, nurses, and administrative staff who were connected to programs at which faculty expressed high levels of job satisfaction assessed teaching quality as higher than did those at other programs. The residents' perceptions of teaching quality were positively correlated with high ratings of organizational climate and job-related stress. The staffs' ratings of goal attainment were also associated with teaching quality. Faculty satisfaction was associated with their reported employee autonomy and goal attainment. CONCLUSION: The organizational characteristics of family medicine residency programs significantly influence the perceptions of teaching quality: specifically, there perceptions are correlated with the degree to which faculty are satisfied with their work environments. In addition, residents' and staffs' perceptions of teaching quality are associated with their attitudes toward their organizations' environments.

Attitude of Health Personnel↗
PubMed1997

Leadership and organizational skills in academic medicine.

BACKGROUND AND OBJECTIVES: The complex and unique challenge of academic medicine requires that faculty possess both organizational and leadership skills. This article presents a framework of leadership and organizational skills in family medicine. METHODS: We conducted a focused review of the literature, of presentations at national primary care meetings, and of the curricula of several national faculty development fellowship programs to identify the current emphases, strategies, and outcomes regarding organizational and leadership development activities for academic physicians. RESULTS: We identified three types of organizational and leadership development strategies and programs, including isolated faculty development workshops at national meetings, longitudinal faculty development fellowship programs, and organizational change efforts within an academic department or residency training program. Indicators that these efforts are successful have primarily been reported in the context of career satisfaction, retention in academic medicine, and attainment of administrative roles or higher academic rank among faculty who have participated. CONCLUSIONS: Organizational and leadership development is occurring in the context of both individual and organizational initiatives. We propose a cycle-of-learning framework that provides one model for development of these essential skills.

Curriculum↗
PubMed1994

Postpartum fatigue.

Postpartum fatigue may be a symptom of significant medical or psychiatric illness and must be distinguished from tiredness, which is a common adaptive response after delivery. Anemia, infections, thyroid disorders, mood disorders and cardiomyopathy are important causes of fatigue in the postpartum period. Recognition and treatment of these conditions improves the medical care of women following delivery.

Anemia↗
PubMed1994

Scapholunate dissociation.

Scapholunate dissociation is the most frequent serious ligamentous injury of the wrist. Untreated, this injury can lead to disabling wrist pain, reduced wrist mobility and chronic degenerative arthritis. Early recognition of the injury by careful clinical and radiographic examination results in the most favorable prognosis. Standard posteroanterior and lateral radiographs of the wrist may be inadequate. Instead, radiographs obtained with the wrist in radial and ulnar deviation or with the hand gripping forcefully may be needed to reveal the instability of this joint. Magnetic resonance imaging may be required in special cases, as it is the only imaging modality that can directly depict abnormalities of the ligaments. Surgical intervention is recommended for optimal results. Chronic injuries require specialized operative and rehabilitative management.

Athletic Injuries↗
PubMed1993

Cryotherapy precision. Clinician's estimate of cryosurgical iceball lateral spread of freeze.

OBJECTIVE: To examine physicians' ability to estimate the lateral spread of freeze (LSF) of a cryosurgical iceball using three techniques. DESIGN: A nonrandomized control trial of in vitro nitrous oxide cryosurgical procedures. SETTING: Primary care residency training programs. PARTICIPANTS: A convenience sample of 80 resident and faculty physicians from four family practice residency programs and one obstetrics and gynecology residency program. INTERVENTIONS: After performing cryosurgery with standard naked-eye and colposcopic-assisted techniques, subjects used a new experimental cryosurgical iceball gauge (CIG) to estimate the LSF during cryotherapy. MAIN OUTCOME MEASURES: LSF estimations reported physicians were compared simultaneously with those measured by an observer. RESULTS: The mean (+/- SD) LSF estimation errors at the termination of freeze were as follows: 2.62 +/- 2.42 mm for the colposcopy technique, 2.00 +/- 2.16 mm for the naked-eye method, and 1.28 +/- 0.87 mm for the CIG technique. The range of maximum error was 6.5 to 11 mm for the colposcopic technique, 5.5 to 12.5 mm for the naked-eye method, and 3.0 to 4.0 mm for the CIG technique. CONCLUSIONS: Overestimation of the LSF, which increases the risk of undertreatment and residual disease, was more common than underestimation. The CIG minimized perceptual error and provided the best cryosurgical precision.

Calibration↗
PubMed1993

Correlates of plasma cortisol and DNA repair in human peripheral lymphocytes: suppression of repair in women taking estrogen.

We have examined the relationship between total plasma cortisol concentration and DNA repair capacity in human peripheral lymphocytes cultured in vitro; the data indicate that high concentrations of cortisol (> 20 micrograms/dl) inhibit DNA repair. The inhibitory effect can be abrogated by the addition of RU38486, a cortisol antagonist. In addition, we compared plasma cortisol concentration and in vitro DNA repair capacity in 52 healthy individuals. Females on therapeutic estrogen (oral contraceptive or estrogen replacement therapy) had significantly elevated plasma cortisol and suppression of DNA repair capacity.

Adult↗
PubMedDate not supplied

A primary care approach to the infertile couple.

BACKGROUND: Approximately 20% of reproductive age couples have difficulty conceiving or maintaining an established pregnancy. The family physician is in a unique position to provide patient education, begin initial evaluation, make appropriate referrals, and offer ongoing counseling and support to couples who experience problems with fertility. METHODS: And extensive clinical review was conducted based on a MEDLINE search, the Cochrane database of systematic reviews, and other supporting evidence. RESULTS: Major physiologic influences affecting live birth rates include age, coital frequency, and duration of infertility. Male factor is associated with approximately 40% of these cases and should be addressed early in the evaluation. CONCLUSION: Many conditions once considered untreatable can now be routinely corrected. As managed care programs expand coverage to include infertility services, primary care providers will be asked to participate in the initial phase of this care. This article offers a practical approach.

Abortion, Habitual↗
PubMedDate not supplied

Postpartum Pap smear.

Explore the source record for details and available documents.

False Negative Reactions↗
PubMedDate not supplied

Papanicolaou smear discrepancy: resolution by review.

BACKGROUND: Discrepancy between Papanicolaou smears and colposcopically directed biopsies often creates a treatment dilemma, especially when the cytologic specimen suggests a higher grade lesion than the histologic specimen. A method of side-by-side review using the Bethesda System was evaluated as a means of resolving this discrepancy between cytologic and histologic specimens. METHODS: By means of a retrospective chart review, we selected 150 patients undergoing colposcopic evaluation for abnormal cytologic findings. Thirty-eight patients had higher grade lesions on cytologic examination than on histologic examination. Twenty-four of these patients had both cytologic and histologic slides available, and these specimens were evaluated in a blinded review by a single pathologist using the Bethesda System of classification. RESULTS: Reevaluation yielded resolution of discrepancy in 19 of 24 cases, a 79.2 percent resolution. CONCLUSION: Review of cytologic and histologic specimens by an experienced pathologist using the Bethesda System can resolve many of the cases in which the cervical lesion is considered to be of a higher grade by cytologic examination than by histologic examination.

Biopsy↗