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Biomedical subjects

Iman Sharif

Publications and source records attributed to Iman Sharif.

At least 19 recordsLinked to original sources
PubMed2006

Inner-city adults' knowledge about the effects of cigarette smoking on child health.

We sought to determine what adults in an inner-city setting know about the specific effects of adult cigarette smoking on child health. A cross-sectional survey was conducted at an inner-city community health center in the Bronx, New York; 684 subjects participated. Overall, 21% were current smokers, 19% had quit, and 60% had never smoked. While the majority of subjects knew about the effects of smoking on adult health, they were unaware of the extent to which smoking was harmful to child health. Notably, 72% did not know that cigarette smoking increased the risk for ear infections in children, 68% did not know that smoking increased the risk of colds in children, and 61% did not know that smoking increased the risk of sudden infant death syndrome. The findings suggest a need for public health education about the effects of adult smoking on child health.

Adolescent↗
PubMed2006

Availability of Spanish prescription labels.

The research team conducted a cross-sectional telephone survey of all pharmacies in the Bronx, New York (99.4% participation rate) to determine availability of Spanish prescription labels. One hundred twenty five pharmacies (78%) were small independent pharmacies; 36 (22%) were large-chain pharmacies. Overall, 111 (69%) stated that they could provide prescription labels in Spanish. Overall, for all the pharmacy ZIP codes, the mean proportion of the population that was Spanish-speaking was 46.8% (range 11% to 71.6%). Seventy-eight (48%) pharmacies were located in areas where more than 50% of the population were Spanish-speaking, 48 (30%) were located in areas with 25.1-50% Spanish-speakers, and 35 (22%) were in areas with up to 25% Spanish-speakers. Small independent pharmacies were more likely than large chain pharmacies to provide prescription labels in Spanish (71% vs. 61%, p=0.25). All the pharmacists commented that a patient must specifically request a Spanish prescription label in order to receive one. Pharmacies located in areas with the highest proportion of Spanish speakers were more likely to provide prescription labels in Spanish (82% vs. 62% vs. 49%; p=.001). Of the 111 pharmacies that could provide Spanish labels, 95 (86%) used a computer program to perform the translation and 16(14%) used a lay employee. Of pharmacies using a computer program, only one had a Spanish-speaking pharmacist who could check and correct the computer translations.

Communication Barriers↗
PubMed2006

Health literacy among English-speaking parents in a poor urban setting.

We surveyed English-speaking parents attending an inner-city health center. Subjects read the label on a bottle of liquid medicine and 1) demonstrated how much medicine they should give, 2) stated how many times a day they should give the medicine, and 3) stated when they should give the next dose. We calculated adjusted odds ratios to test for the likelihood of incorrect medication dosing for subjects with and without demographic risk factors. Three hundred twenty six subjects participated. Overall, 252 (77%) demonstrated incorrect medication dosing. Medication dosing was more likely to be incorrect among young parents (AOR 2.45; CI 1.14, 5.26), immigrants (AOR 2.27; CI 1.04, 4.96), subjects without a high school degree (AOR 2.05; CI 1.04,4.05), and those who did not recall ever having been shown how to use a medicine dropper (AOR 1.79; CI 1.01,3.19). Implications for practice are discussed.

Adult↗
PubMed2006

Association between television, movie, and video game exposure and school performance.

BACKGROUND: The relationship between media exposure and school performance has not been studied extensively in adolescents. OBJECTIVE: The purpose of this work was to test the relative effects of television, movie, and video game screen time and content on adolescent school performance. METHODS: We conducted a population-based cross-sectional survey of middle school students (grades 5-8) in the Northeastern United States. We looked at weekday television and video game screen time, weekend television and video game screen time, cable movie channel availability, parental R-rated movie restriction, and television content restriction. The main outcome was self-report of school performance (excellent, good, average, or below average). We used ordinal logistic-regression analysis to test the independent effects of each variable, adjusting for demographics, child personality, and parenting style. RESULTS: There were 4508 students who participated in the study; gender was equally represented, and 95% were white. In multivariate analyses, after adjusting for other covariates, the odds of poorer school performance increased with increasing weekday television screen time and cable movie channel availability and decreased with parental restriction of television content restriction. As compared with children whose parents never allowed them to watch R-rated movies, children who watched R-rated movies once in a while, sometimes, or all of the time had significantly increased cumulative odds of poorer school performance. Weekend screen time and video game use were not associated with school performance. CONCLUSIONS: We found that both content exposure and screen time had independent detrimental associations with school performance. These findings support parental enforcement of American Academy of Pediatrics guidelines for media time (particularly weekdays) and content limits to enhance school success.

Achievement↗
PubMed2004

Rubbing ointments and asthma morbidity in adolescents.

OBJECTIVE: To determine the relationship between the use of rubbing ointments and asthma morbidity in adolescents. DESIGN: Cross-sectional study. SETTINGS/LOCATION: Inner-city high school in the Bronx, New York. SUBJECTS: 165 adolescents with asthma. OUTCOME MEASURES: Asthma morbidity, defined as emergency department (ED) use for asthma in the past year and over the lifetime. RESULTS: While 127 (77%) of subjects used albuterol as the first treatment for their last asthma attack, 18 (11%) used rubbing ointments. The rubs and albuterol groups were similar in asthma severity, mean age, gender, and ethnicity. However, subjects in the the rubs group were less likely than subjects in the albuterol group to have made an ED visit over the past 12 months or over their lifetime. Regression analysis revealed that, after controlling for asthma severity, use of rubs independently predicted less lifetime ED use. CONCLUSIONS: After controlling for asthma severity, use of rubs by adolescents with asthma was associated with lower asthma morbidity as measured by ED use.

Adolescent↗
PubMed2004

Inner-city availability of preservative-containing albuterol.

Benzalkonium chloride (BAC) added to nebulized albuterol may induce bronchospasm. The objective of this study was to determine the availability of BAC-containing nebulized albuterol in the Bronx, New York pharmacies. A cross-sectional telephone survey of pharmacies was conducted. Overall, 158 (80%) pharmacies participated in the survey; 133 (84%) carried BAC-containing albuterol; 25 (16%) dispensed BAC-containing albuterol solution when presented with a prescription written for generic albuterol. Only 14 (9%) pharmacists had seen a prescription for nebulized albuterol where a physician specified "without BAC." Despite availability of BAC-free albuterol, pharmacies in the Bronx still carried and dispensed BAC-containing product.

Albuterol↗
PubMed2004

Use of interactive videoconferencing to deliver asthma education to inner-city immigrants.

Videoconferencing to deliver asthma health education to patients or their parents has not been widely used in the USA. We used two 90 min interactive videoconferences to deliver an asthma education programme to a convenience sample of mainly Latino immigrant parents in the Bronx, New York. In these sessions short presentations were given on asthma triggers, medications and the prevention of asthma exacerbations. To test gains in knowledge, we administered a self-completion questionnaire consisting of true/false statements before and after the videoconferences. Sixty subjects participated in the first videoconference and 56 in the second. Asthma knowledge improved significantly after both. Three months later, knowledge retention from the first videoconference was good. The majority of subjects asked questions and commented on their personal experiences of asthma. Interactive videoconferencing allowed asthma education to be delivered to a large immigrant population, elicited concerns from the audience and was effective in improving knowledge.

Asthma↗
PubMed2003

Documenting asthma severity: do we get it right?

BACKGROUND: The 1997 National Asthma Education and Prevention Program (NAEPP) recommends a severity classification scheme to optimize the use of anti-inflammatory therapy for persistent asthma. Physician documentation of asthma severity is often used as a quality assurance measure. OBJECTIVE: To test the hypothesis that physician documentation of asthma severity is associated with appropriate use of anti-inflammatory therapy. DESIGN/METHODS SETTING: inner-city academic health center. First, we reviewed a consecutive sample of charts of scheduled pediatric patients. Then, we administered a structured parent survey regarding the child's asthma symptoms and current asthma therapy. We used NAEPP guidelines to classify patients' severity of asthma. The main outcome measure was appropriate use of anti-inflammatory therapy. Appropriate therapy was defined as: (1) mild persistent asthmatics using anti-inflammatory therapy, and (2) moderate-severe persistent asthmatics using inhaled steroids. Chart classification of asthma severity was compared with the NAEPP-applied classification. RESULTS: Of 784 charts, 214 (27%) were asthmatic. Of these, 176 (82%) were surveyed. The mean age was 7.4 years; 61% were males. Severity classification was documented in 77% of charts. Chart documentation differed significantly from survey classification for the same patients: (mild intermittent 54% vs. 40%, mild persistent 21% vs. 14%, moderate persistent 24% vs. 36%, severe persistent 1% vs. 10%; all p < .001). Correctly classified patients were more likely to be on appropriate therapy. CONCLUSIONS: Physicians underestimated the severity classification of asthmatic patients. Incorrect classification was associated with inappropriate asthma therapy. These findings have implications for the institution of asthma quality improvement programs.

Administration, Inhalation↗
PubMed2003

The use of complementary therapies in inner-city asthmatic children.

Use of complementary/alternative medicine (CAM) has been increasing, especially among patients with a chronic illness. Although asthma is the most common chronic illness affecting children in the United States, very little is known about the use of CAM in children with asthma. Our objective was to determine the prevalence and correlates of CAM use among inner-city children with asthma. A cross-sectional survey of parents of children with asthma attending an urban health center was performed. Parents were surveyed regarding CAM use over the past year, perceived efficacy of CAM, severity of child's asthma symptoms and demographic information. Differences in proportions were tested by chi-square or Fisher's exact test as appropriate. Three hundred ten parents participated, of whom 61% were Hispanic and 37% were African American. Parental mean age was 33 years and the mean age of the child was 7.2 years; 89% of parents had treated their child in the past year with some form of CAM. However, only 18% had informed a physician of doing so. The most common forms of CAM used were as follows: prayers (53%), rubs (53%), and massage (45%). Of those who used CAM, 59% perceived it to be at least as effective as pharmacotherapy, and 44% used CAM as first treatment of an asthma attack. Mild and moderate persistent asthmatics had significantly higher rates of CAM use than did mild intermittent and severe persistent asthmatics. We found a very high rate of CAM use among children with asthma in this inner-city population. Most importantly, a very high proportion of parents perceived the therapies to be effective, used them as first treatment of an acute exacerbation, and did not inform a physician of doing so. These findings have implications for the care of asthmatic children by pediatricians practicing in urban settings.

Adult↗
PubMed2002

Ambulatory rounds: a venue for evidence-based medicine.

OBJECTIVE: The format of inpatient morning reports and ward rounds is infrequently applied in ambulatory medical education. Published reports, however, suggest that this format provides for learner-centered, case-based discussions rather than topic-based lectures in the ambulatory setting.(1) We developed an ambulatory morning report with the specific objective of enhancing evidence-based medical inquiry among our pediatrics housestaff. DESCRIPTION: We developed a pediatric encounter form (PEF) by adapting and modifying an instrument described by Paccione et al.(2) The PEF was to be used by residents to document pertinent information and unanswered questions about patients seen during each ambulatory clinic session. Prompts were provided for documenting the patient's primary complaints, the patient's disposition, and questions that the resident needed answered. The PEF was piloted among a group of residents and faculty. The final version incorporated both resident and faculty input. Each resident was asked to complete a PEF for a maximum of two patients per clinic session. We did not direct residents as to what types of questions to formulate. All completed forms were maintained in a central folder. Next, we instituted a one-hour "Ambulatory Rounds" seminar once a week at lunch-time. During these seminars, faculty selected PEF cases from the previous week for discussion. Residents presented the cases and discussed the reasons behind the formulation of their questions. Faculty facilitated and guided residents toward resources for answering their questions. Faculty also helped residents to reformulate their questions to reflect an evidence-based medicine approach. At the end of each seminar, residents elected to research specific questions and present brief reports at the next seminar. To test the hypothesis that residents will formulate a higher proportion of evidence-based medicine (EBM) questions over time, we collected and analyzed 445 questions asked by 12 residents between July 2000 and August 2001. We categorized questions into EBM and non-EBM questions based on faculty assessment. We performed a trend analysis using chi-square to compare questions from July 2000 (as reference value) with the six-month periods of August 2000 to January 2001 and February to August 2001. By the end of the observation period, the proportion of EBM questions had significantly increased from 13% in July 2000 to 28% in the first six-month period and 59% in the second six-month period (p < 0.001). DISCUSSION: We describe a new application of outpatient morning reports. This format has been very well received. Housestaff gave the ambulatory rounds an average rating of 4.3 (out of 5) on a Likert scale. Our experience suggests that this format not only provides a forum for case-based learning but can be successfully used to enhance the principles of evidence-based medicine among residents.

Ambulatory Care↗