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Biomedical subjects

J Bigby

Publications and source records attributed to J Bigby.

11 recordsLinked to original sources
PubMed1997

Women and alcohol abuse in primary care. Identification and intervention.

Female problem drinkers are less likely than men to be identified in the primary care setting. The authors studied 24 adult women attending a general, internal medicine clinic to assess the efficiency of self-reports of alcohol consumption when compared with physician identification and other measures and the impact of a brief intervention on alcohol consumption. Despite the high rate of lifetime (79%) and current (67%) alcohol diagnoses, no patient was in alcohol treatment. Physician identification of alcohol problems was least sensitive but most specific, when compared with other measures. Brief intervention, as offered in this study, did not appear to modify alcohol consumption.

Adult↗
PubMed1993

Substance abuse and AIDS: a faculty development program for primary care providers.

The authors implemented a three-day faculty development program on substance abuse and AIDS for primary care faculty. Objectives included: 1) increased knowledge concerning clinical issues; 2) skill development focusing on provider-patient interactions; and 3) the development of educational approaches for teaching about substance abuse and AIDS. Teaching formats included didactic (40%) and experimental (60%) sessions emphasizing role playing with patients affected by both substance abuse and HIV infection. Four courses have been given to 109 participants, who have rated the course highly in terms of its educational quality (4.4/5.0) and usefulness (4.2/5.0). At six-month follow-up, 75% of the participants reported enhanced teaching as a result of this faculty development program.

Acquired Immunodeficiency Syndrome↗
PubMed1993

Evaluation of a faculty development program in substance abuse education.

OBJECTIVE: To determine whether a faculty development program was effective in increasing clinical skills and the amount of substance abuse teaching of individual general medical faculty. DESIGN: Program participants were evaluated with a structured assessment before and several months after participating in a faculty development program in substance abuse education. PARTICIPANTS: Eighty percent were general internal medicine faculty, who on average devoted 25% of their time to teaching. The remainder of the participants were family medicine, psychiatry, or other internal medicine faculty and nonphysician teachers. INTERVENTION: The participants attended a learner-centered, largely experiential faculty development program in substance abuse education to improve their clinical and teaching skills relevant to substance abuse among patients in the general medical setting. MEASUREMENTS AND MAIN RESULTS: Eighty-six percent of the participants completed the evaluation. The participants reported increased confidence in their clinical skills in recognizing substance abuse, presenting the problem to the patient, and referring the patient for treatment. The participants also reported improved attitudes toward patients and increased teaching about the management of the primary problem of substance abuse, but not at the expense of teaching about medical complications. CONCLUSIONS: Clinically oriented, interactive faculty development courses in substance abuse education can contribute to increased confidence in clinical skills in substance abuse as well as teaching about substance abuse.

Alcoholism↗
PubMed1987

Assessing the preventability of emergency hospital admissions. A method for evaluating the quality of medical care in a primary care facility.

The quality of primary medical care was assessed by studying the events leading to 686 emergency admissions of patients from our hospital-based primary care practice. Independent physician reviewers determined that 59 (9 percent) of the admissions were potentially preventable; 40 were due to iatrogenic factors including inadequate follow-up and adverse drug reactions, 12 were due to lack of patient compliance, and seven were due to both iatrogenesis and noncompliance. Adverse drug reactions were the most common cause of iatrogenesis, and warfarin was the drug that most commonly caused an adverse reaction. Inadequate follow-up of abnormal physical findings, symptoms, and laboratory test results was also important. Patients with preventable admissions had more medical diagnoses (4.9 versus 4.1, p less than 0.01), were prescribed more medications (4.5 versus 3.7, p less than 0.01), and were older (66.5 years versus 60.2 years, p less than 0.01) than patients whose admissions were not preventable. It is concluded that a small percentage of emergency hospitalizations may be preventable and that systematic review of emergency hospitalizations may provide a means of measuring the quality of primary medical care.

Adult↗
PubMed1983

Appointment reminders to reduce no-show rates. A stratified analysis of their cost-effectiveness.

To determine whether reminders are cost-effective for an adult primary care internal medicine center, we randomized 590 scheduled, follow-up appointments to no reminder, computer-generated letter reminders, and telephoned reminders. The no-show rate was reduced from 24% in the control group to 14% in the reminder groups, and letter and telephoned reminders were equally effective. An economic analysis showed that about two thirds of the savings realized from reminders was generated in 23% of the patients whose prior predicted probability of a no-show appointment was above 20%. However, in our primary care center, computer-generated letter reminders were estimated to be cost-effective whenever the probability of a no-show was above 5%, and telephoned or manual letter reminders were estimated to be cost-effective whenever the probability of a no-show was above about 11%. Based on our sensitivity analysis, telephoned or manual letter reminders should be cost-effective in many other ambulatory settings as well, although in some settings, reminders may be restricted to patients at high risk for no-show behavior.

Aged↗
PubMedDate not supplied

Promoting the advancement of minority women faculty in academic medicine: the National Centers of Excellence in Women's Health.

Minority physicians provide care in a manner that promotes patient satisfaction and meets the needs of an increasingly diverse U.S. population. In addition, minority medical school faculty bring diverse perspectives to research and teach cross-cultural care. However, men and women of color remain underrepresented among medical school faculty, particularly in the higher ranks. National data show that although the numbers of women in medicine have increased, minority representation remains essentially static. Studying minority women faculty as a group may help to improve our understanding of barriers to diversification. Six National Centers of Excellence in Women's Health used a variety of approaches in addressing the needs of this group. Recommendations for other academic institutions include development of key diversity indicators with national benchmarks, creation of guidelines for mentoring and faculty development programs, and support for career development opportunities.

Career Mobility↗
PubMedDate not supplied

Women's health centers and minority women: addressing barriers to care. The National Centers of Excellence in Women's Health.

New models of care delivery have been developed to better coordinate and integrate healthcare for women. In the United States, one of the challenges is to incorporate the needs of racial and ethnic minority populations into these newer care paradigms. This paper begins with a brief historical review of the experience of racial and ethnic minorities in the American healthcare system to provide a context for discussing barriers and limitations of more traditional models of women's healthcare. Specific approaches used by National Centers of Excellence in Women's Health are presented as examples of strategies that may be implemented by other communities to address these barriers.

Community Health Centers↗