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Biomedical subjects

J Willms

Publications and source records attributed to J Willms.

13 recordsLinked to original sources
PubMed1998

The rise and fall of students' skill in obtaining a medical history.

A gradual shift towards a more humanistic conception of medicine has occurred in recent years. Along with this shift have come attempts by medical educators to include interviewing and communication skills as part of the medical curriculum. The current study evaluates the effectiveness of a clinical medicine curriculum which emphasizes interviewing skills. Between 1992 and 1994 and 292 graduates of the University of Connecticut School of Medicine participated in five clinical skills teaching and assessment programmes during the four years of medical school. During each of these five programmes, the students' interviewing skills were rated using the Arizona Clinical Interview Rating Scale (ACIR). The raters were standardized patients with whom they had just completed a medical encounter. Results show that students' development of skills differed, with closure items showing the greatest increase and social history items showing the greatest decline, with an overall initial increase and then a decline in interviewing skills over the four years. Explanations for these findings include the de-emphasis of communication skills during the clinical years and the culture of medicine to which students are exposed during these years.

Clinical Competence↗
PubMed1994

Correlates of psychopathology and intelligence in children with fetal alcohol syndrome.

After documenting the wide range of psychopathology and impairment of intellectual functioning in earlier contributions, the present report from long-term observations of an extended cohort of children with Fetal Alcohol Syndrome (FAS) deals with correlates of psychopathology and intelligence in these children. At preschool age, severity of morphological damage, the type of milieu, sex and IQ were significant predictors of psychopathology. In another subgroup of school-aged children, these associations were less strong; only severity of morphological damage and IQ still correlated to some extent significantly with psychopathology. Intelligence was significantly impaired in those children with severe morphological damage who were raised in institutions.

Child↗
PubMed1994

The fetal alcohol syndrome in adolescence.

At present, alcohol is recognized as the leading teratogenic agent in long-lasting CNS dysfunction. Little is known about the long-term development and outcome of children with fetal alcohol syndrome (FAS). Forty-four FAS patients who were diagnosed in early childhood were followed up for 10-14 years. This study documents the developmental changes of the manifestations of FAS from childhood to adolescence and describes a characteristic "juvenile" pattern of FAS, which may help to identify this syndrome even in adolescence. This is especially relevant for patients who were not diagnosed earlier.

Adolescent↗
PubMed1993

Prenatal alcohol exposure and long-term developmental consequences.

Fetal alcohol syndrome (FAS) is a leading cause of congenital mental retardation but little is known about the long-term development and adolescent outcome of children with FAS. In a 10-year follow-up study of 60 patients diagnosed as having FAS in infancy and childhood, we investigated the long-term sequelae of intrauterine alcohol exposure. We found that the characteristic craniofacial malformations of FAS diminish with time, but microcephaly and, to a lesser degree, short stature and underweight (in boys) persist; in female adolescents body weight normalises. Persistent mental retardation is the major sequela of intrauterine alcohol exposure in many cases, and environmental and educational factors do not have strong compensatory effects on the intellectual development of affected children.

Adolescent↗
PubMed1993

Long-term psychopathological and cognitive outcome of children with fetal alcohol syndrome.

OBJECTIVE: The long-term outcome of a large cohort of children suffering from fetal alcohol syndrome was studied. METHOD: Structured psychiatric interviews, behavior checklists for parents and teachers, and intelligence tests were used. Assessments took place during preschool age, early school age (6 to 12 years), and late school age (> or = 13 years). RESULTS: There was an excess of psychopathology with a wide variety of psychiatric syndromes in this cohort. Hyperkinetic disorders, emotional disorders, sleep disorders, and abnormal habits and stereotypes persisted over time. Interview findings were largely in accordance with parents' and teachers' questionnaire findings. Intelligence test findings included a large proportion of mentally retarded children and displayed high stability at follow-up. CONCLUSIONS: The development of children suffering from fetal alcohol syndrome is jeopardized by a high rate of persistent psychiatric and cognitive impairments.

Adaptation, Psychological↗
PubMed1992

[Alcohol drinking and intrauterine dystrophia. Effects and significance in infancy].

In a prospective study intrauterine growth retardation (IUGR) (less than 10. growth percentile at birth) was used as a predictor to diagnose intrauterine alcohol exposure. An interview about maternal alcohol consumption was performed prenatally--when IUGR was diagnosed by ultrasound--or postnatally. The children were followed up to 18 months of age. In 6/47 children we diagnosed various degrees of the Fetal Alcohol Syndrome FAS, with only one patient showing a full blown syndrome at birth. 5 patients could not be identified until the pediatric reexamination at the age of 8-18 months. IUGR and a maternal history of even moderate drinking during pregnancy should emphasize the possibility of an intrauterine alcohol damage, even in a normal child at birth.

Alcohol Drinking↗
PubMed1990

An assessment of the clinical skills of fourth-year students at four New England medical schools.

This paper describes a collaborative effort among five New England medical schools to assess important clinical skills of fourth-year medical students graduating in the class of 1988; results are presented from the four schools that provided sufficient data. Faculty from each school developed 36 patient cases representing a variety of common ambulatory-care problems. Over the course of a day, each student, on average, interacted with 16 different standardized patients, who were nonphysicians trained to accurately and consistently portray a patient in a simulated clinical setting. The students obtained focused histories, performed relevant physical examinations, and provided the patients with education and counseling. At each school, the performance of a small number of the students fell below standards set by the faculty. These deficiencies were not detected with the evaluation strategies currently being used. Although the use of standardized patients should not substitute for the process of faculty observing students as they interact with real patients, it appears that standardized patients can provide faculty with important information, not readily available from other sources, about students' performances of essential clinical activities and the levels of their clinical skills.

Ambulatory Care↗
PubMed1989

The family physician's role following a neonatal death.

The process of grieving for the death of a neonate is different from other grief processes. The family physician is in the unique position of playing a significant role in assisting families who are living through this tragedy. Even if the family physician has not been part of the prenatal care and delivery, he or she will continue to see the parents for weeks, months, and even years, long after most other support is gone. This paper outlines seven possible specified times when a family physician can intervene in aiding the couple through the evolving grief process.

Anger↗
PubMed1984

Detection of cytogenetic regions influencing RNA polymerase activity in Drosophila melanogaster by segmental aneuploid mapping.

In a search for loci with RNA polymerase related function, we have screened the Drosophila melanogaster genome for regions effective in eliciting a dosage response for total RNA polymerase activity using segmental aneuploids generated by the use of Y-autosome translocations. From this screen we have identified a total of six cytogenetically defined regions which elicit significant dosage response: a single X-chromosome region, 9C-11A, within which resides a known RNA polymerase locus and five noncontiguous regions on chromosome 3 with no previously identified RNA polymerase related function.

Age Factors↗
PubMed1982

Alpha-amanitin resistance in three wild strains of Drosophila melanogaster.

Three wild strains of D. melanogaster have been identified which are resistant to normally lethal levels of the fungal toxin, alpha-amanitin. Dietary LD50S for Oregon-R, the reference strain, and Ama-KTT, Ama-MI and Ama-KLM, the resistant strains, are 1.2, 35, 30 and 10 micrograms alpha-amanitin/vial, respectively. Resistance in all three strains is a digenic trait, being determined by two independently acting dominant genes, Ama-1, Ama-2, either of which is sufficient to confer resistance and which are located at approximately 18.8 and 100.7, respectively, on chromosome 3. Resistance to alpha-amanitin in all three strains is apparently not mediated by modification of RNA polymerase form II nor by failure of toxin transport or by toxin inactivation.

Amanitins↗