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Biomedical subjects

J L Temte

Publications and source records attributed to J L Temte.

16 recordsLinked to original sources
PubMed2001

Patient attitudes toward issues of environmental health.

OBJECTIVE: Although the place of environmental health in medical education has been cautiously explored, patient attitudes toward environmental issues have been largely ignored in the medical literature. The purpose of this study was to evaluate the baseline level of family practice patient concerns about a variety of environmental issues, including their major sources of information and their level of trust in each source. Patient desire for more environmental education was also assessed. METHODS: This cross-sectional, descriptive study was based on a confidential, 14 question survey administered to a convenience sample of 373 adult family medicine patients at 4 University of Wisconsin-Madison Department of Family Medicine affiliated clinics, including 2 urban, 1 suburban, and 1 rural site. Of 496 patients approached, 415 accepted, and 373 returned complete and acceptable questionnaires. The level of patient concern for each environmental issue, patient trust in each source of information, and the amount of education patients felt they had received from their physician were measured. RESULTS: A high level of concern for environmental issues existed among the study sample patients. Although only 18% of patients reported utilizing their physician as a major source of environmental information, physicians were considered the most trustworthy source. In general, patients felt that they had received an inadequate amount of environmental education from their physician regarding all environmental issues presented. CONCLUSIONS: Patients desire and would be receptive to more environmental education from their physicians.

Adolescent↗
PubMed2001

Surveillance porn.

Explore the source record for details and available documents.

Delivery of Health Care↗
PubMed2001

Rate of case reporting, physician compliance, and practice volume in a practice-based research network study.

OBJECTIVE: Practice-based research is one method for answering questions about common problems that are seen infrequently in referral centers. We explored the potential limitations of this method. STUDY DESIGN: This was a prospective observational cohort study of participants in a practice-based research network who submitted data on 231 patients with dyspepsia from a total of 45,337 patient encounters over a 53-week period. Reporting of individual cases involved use of a relatively high-burden data instrument. Outcome measures were compared using rank correlation. POPULATION: We included 18 physicians in a Wisconsin research network study on initial management of dyspepsia in primary care settings. OUTCOMES MEASURED: The outcomes we measured were the rate of dyspepsia visits, average weekly patient volume, and self-reported compliance to the study protocol for each physician. RESULTS: A significant negative correlation existed between physician patient volume and the reported rate of dyspepsia visits. Self?reported compliance with the protocol was negatively correlated to patient volume and positively correlated to the reported rate of dyspepsia visits. CONCLUSIONS: Practice volume may influence the results in practice-based research. Investigators using practice-base research networks need to consider the complexity of their protocols and should be cognizant of compliance-sensitive measures.

Attitude of Health Personnel↗
PubMed2000

Proteinuria in adults: a diagnostic approach.

Proteinuria is a common finding in adults in primary care practice. An algorithmic approach can be used to differentiate benign causes of proteinuria from rarer, more serious disorders. Benign causes include fever, intense activity or exercise, dehydration, emotional stress and acute illness. More serious causes include glomerulonephritis and multiple myeloma. Alkaline, dilute or concentrated urine; gross hematuria; and the presence of mucus, semen or white blood cells can cause a dipstick urinalysis to be falsely positive for protein. Of the three pathophysiologic mechanisms (glomerular, tubular and overflow) that produce proteinuria, glomerular malfunction is the most common and usually corresponds to a urinary protein excretion of more than 2 g per 24 hours. When a quantitative measurement of urinary protein is needed, most physicians prefer a 24-hour urine specimen. However, the urine protein-to-creatinine ratio performed on a random specimen has many advantages over the 24-hour collection, primarily convenience and possibly accuracy. Most patients evaluated for proteinuria have a benign cause. Patients with proteinuria greater than 2 g per day or in whom the underlying etiology remains unclear after a thorough medical evaluation should be referred to a nephrologist.

Adult↗
PubMed1999

Prevention and control of influenza by Wisconsin family physicians: a WReN supported study.

PROBLEM: Although patients infected with influenza commonly present to family physicians, little is known about the usual clinical practices utilized by these physicians regarding influenza. METHODS: A 1-page questionnaire was mailed to a random sample of Wisconsin family physicians. Responses were used to describe current management style and evaluate for possible relationships between management style and demographic and practice variables. RESULTS: Completed questionnaires were obtained from 89 (29%) physicians. Influenza was perceived as a moderately important and frequent illness. Physicians estimated that 66% of their high-risk patients received immunization. Antiviral medications were infrequently used, mostly for older patients and those with comorbid conditions. The news media, other physicians and public health officials were the most common sources of information on influenza. CONCLUSIONS: Family physicians utilize current guidelines for prevention and control of influenza. Improvements can be made in mechanisms to identify high-risk patients and improved access to surveillance reports.

Adolescent↗
PubMed1999

Effects of viral respiratory disease education and surveillance on antibiotic prescribing.

BACKGROUND AND OBJECTIVES: We describe a partnership between family practice residency clinics and a state public health virology laboratory that has produced comprehensive viral respiratory disease education and surveillance. Family practice residents have been provided with education on respiratory viruses and the results of ongoing viral surveillance. The preliminary effects of this program on antibiotic prescribing by senior residents are evaluated in this paper. METHODS: We used a questionnaire to assess the acceptance by family practice residents of the educational component and the utility of ongoing viral surveillance. We used chart review to evaluate rates of antibiotic prescribing and the number of patients diagnosed per year with acute upper respiratory infection and acute bronchitis by senior residents in 1992 (preexposure) and 1996 (postexposure). RESULTS: By the third year of training, most residents (79%) reported receiving adequate training regarding common viral respiratory diseases. Moreover, residents reported that they were less likely to prescribe antibiotics to patients presenting with respiratory infections when provided with specific information on circulating viral pathogens. Antibiotic prescribing in the postexposure group was 68% lower for upper respiratory infection (URI) and 45% lower for a composite of URI and bronchitis. CONCLUSIONS: Education and monitoring of circulating respiratory viruses can result in familiarity with common disorders in primary care and reduce unnecessary antibiotic use.

Anti-Bacterial Agents↗
PubMed1996

Elevation of serum cholesterol at high altitude and its relationship to hematocrit.

The positive relationship between hematocrit and serum cholesterol may be due to dilution. Accordingly, high hematocrits would yield reduced serum pools for dilution of cholesterol, thus producing higher levels. To test this effect, the relationships between hematocrit and cholesterol were evaluated at low-altitude and high-altitude clinics. Retrospective chart reviews were conducted at Madison, WI (264 m) and Leadville, CO (3105 m) to identify family practice patients who underwent hematocrit and serum cholesterol determinations on the same day. We excluded patients with medical conditions or on medications that affect cholesterol, patients with high glucose and triglyceride levels, and patients with extreme cholesterol levels. Remaining patients (153 in each altitude group) were matched by age and sex. The mean hematocrits and cholesterol levels were compared using analysis of variance. The linear relationships between hematocrit and cholesterol were compared using analysis of covariance. The mean hematocrit was significantly higher at high altitude (47.5% versus 41.3%; p < 0.0005) as were the mean serum cholesterol (190 mg/dL versus 177 mg/dL; p < 0.002) and the low-density lipoprotein:high-density lipoprotein ratio (2.80 versus 2.27; p < 0.05). Whereas a significant, positive relationship existed between hematocrit and cholesterol at low altitude (2.15 mg/dL per %; p < 0.002), no such relationship was found at high altitude. Hematocrit and serum cholesterol were elevated for family practice patients living at high altitudes. Differences exist between altitudes in the relationship between hematocrit and cholesterol. Acclimatization to high altitude and its resultant erythropoiesis may increase serum cholesterol levels. Consequently, relocation to a high altitude may increase the risk of arteriosclerotic cardiovascular disease.

Acclimatization↗
PubMed1994

Factors associated with research interest and activity during family practice residency.

BACKGROUND: Family medicine lacks a tradition of research training during residency. Previous studies of research during residency have surveyed faculty to assess residents' research interests. In contrast, we directly assessed research interest and activity during residency by surveying all 203 Wisconsin family practice residents. METHODS: The survey instrument was a questionnaire that included questions about the appropriateness of research experience, interest in pursuing research during residency, involvement in research, and perceptions regarding program research support. The importance of factors that encourage research were evaluated. We then used stepwise discriminant analysis to assess whether residents with different levels of interest in research had different perceptions about program support and environmental factors that promote research. RESULTS: Of 143 respondents, most (85%) felt research experience was desirable, and 48% were interested in pursuing research during residency. Only 8% were active in research. Although faculty were perceived as having sufficient research skills and encouraging resident research, few residents responded that dedicated time, seminars on goals and methods of family practice research, or funding were available. Residents with research interests were more likely to respond that their faculty had sufficient research skills and knowledge. Active researchers rated time availability and access to resource personnel as highly important. Those interested, but not active, rated basic information, assistance in identifying topics, and a forum for presentation as highly important. CONCLUSION: Exposure to skilled and knowledgeable faculty researchers may stimulate interest in research. Teaching research goals and methods, assisting in identifying topics, and providing research forums, especially early in residency, may promote research activity. Dedicated time for research and availability of resource personnel will enhance this activity.

Attitude of Health Personnel↗
PubMed1989

Exploring environmental cycles in psychiatric patients.

The daily psychiatric inpatient population at a large medical center recorded over a two-year period and consisting of 11,864 inpatient days was analyzed for circannual (365-day) and synodic (29.53-day) cycles. A highly significant circannual cycle, in which the population peaks in early February, was found. This cycle was compared to seasonal cycles of photoperiod, sunlight, and temperature and was found to be highly correlated with each. The best correlation was between patient population and photoperiod during the previous month. A significant synodic (lunar) cycle, with a peak in patient census occurring at the last quarter moon, was also found.

Environment↗
PubMed1985

Photoperiod and delayed implantation in the northern fur seal (Callorhinus ursinus).

An equation for determination of the photoperiod at any given latitude for any given date is presented and used in an analysis of reproductive timing in the northern fur seal in which there is an obligatory delay of implantation. Fur seals breeding on San Miguel Island, California (33 degrees N) displayed a mean date of parturition that was 14 days earlier (P less than 0.001) than that of the parent stock on the Pribilof Islands, Alaska (57 degrees N). Previous studies have shown that changes occur in the corpus luteum, in follicles in the ovary containing the corpus luteum, in concentrations of plasma progesterone and oestradiol-17 beta, and in the uterine lining when there is a mean photoperiod of 12.5 h/day. This photoperiod occurs at both locations at 62 days after the mean dates of parturition, and may act as a cue for the initiation of implantation in these seals.

Animals↗