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Biomedical subjects

J D Hain

Publications and source records attributed to J D Hain.

4 recordsLinked to original sources
PubMed1990

A randomized, double-blind trial of nystatin therapy for the candidiasis hypersensitivity syndrome.

BACKGROUND: Candida albicans infection has been proposed to cause a chronic hypersensitivity syndrome characterized by fatigue, premenstrual tension, gastrointestinal symptoms, and depression. Long-term antifungal therapy has been advocated as treatment for the syndrome, which is most often diagnosed in women with persistent or recurrent candida vaginitis. METHODS: To determine the efficacy of nystatin therapy for presumed candidiasis hypersensitivity syndrome, we conducted a 32-week randomized, double-blind, cross-over study using four different combinations of nystatin or placebo given orally or vaginally in 42 premenopausal women who met present criteria for the syndrome and had a history of candida vaginitis. The outcomes studied were the changes from base line in scores for vaginal, systemic, and overall symptoms and in the results of standardized psychological tests. RESULTS: The three active-treatment regimens (oral and vaginal nystatin, oral nystatin and vaginal placebo, and oral placebo and vaginal nystatin) and the all-placebo regimen significantly reduced both vaginal and systemic symptoms (P less than 0.001), but nystatin did not reduce the systemic symptoms significantly more than placebo. On average, the scores for systemic symptoms improved 25 percent with the three active-treatment regimens and 23 percent with the all-placebo regimen, a difference of only 2 percent (95 percent confidence interval, -3 to 7 percent). As expected, the three active-treatment regimens were more effective than placebo in relieving vaginal symptoms (P less than 0.001). All four regimens reduced psychological symptoms and global indexes of distress; there were no significant differences among the treatment regimens. CONCLUSIONS: In women with presumed candidiasis hypersensitivity syndrome, nystatin does not reduce systemic or psychological symptoms significantly more than placebo. Consequently, the empirical recommendation of long-term nystatin therapy for such women appears to be unwarranted.

Administration, Oral↗
PubMed1979

Evaluation of extramural programs.

Extramural programs may be evaluated in terms of effectiveness in achieving their particular goals. The components of structure, process, and outcome are examined as related sets of program elements. Goals influence appropriate structure in organization, facilities, and manpower. Structure in turn influences process or activities which result in outcome. Outcome is considered in terms of goals. Each set of elements is examined by institutional faculty and administration, extramural faculty, and students. Where all agree that desired outcome variables are relevant to the goal(s) and are achieved, the program is "effective." Where outcome and goal are not compatible, process and then structure must be examined for appropriateness of each. When there is disagreement between groups about any element, a problem area in the program is specifically identified. The procedure for cyclic assessment may be used by a school or program for self-study or for periodic internal monitoring of problem areas. Use of this method has shown some characteristics common to different types of extramural programs.

Education, Medical↗
PubMed1975

Clinical teaching reexamined.

In an effort to determine the most effective clinical teaching behaviors of clinical teachers or preceptors in individual or small group settings, investigators at the University of North Carolina and the University of Alabama developed an instrument to survey all clinical medical students at the two institutions. This process resulted in a compilation of the specific behaviors found to be most helpful to the responding students in facilitating their clinical learning. All items were then factor analyzed, resulting in six more general teaching dimensions or factors being identified. There were active student participation, preceptor attitude toward teaching, emphasis on applied problem-solving, a student-centered instructional strategy, humanistic orientation, and emphasis on content and research. The more specific behaviors which loaded on each factor were also examined.

Alabama↗