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Biomedical subjects

K J Kallail

Publications and source records attributed to K J Kallail.

At least 19 recordsLinked to original sources
PubMed2001

Maximizing the use of a Web-based teaching skills curriculum for community-based volunteer faculty.

BACKGROUND: The University of Kansas School of Medicine in Wichita created an Internet-based faculty development curriculum for community-based faculty. Because relatively few physicians use Internet-based continuing medical education (CME), the most cost-effective methods of encouraging use need to be identified. METHOD: Five interventions intended to increase use of the curriculum were assessed. The number of times the CME curriculum Webpages were accessed was correlated with the interventions. RESULTS: Demonstrating the Website to faculty at a semiannual meeting elicited the most Website "hits." Electronic mail and flyers also appeared to be effective in stimulating interest in the Website. Only four community-based faculty applied for CME credit for completing the curricular modules. FINDINGS: Multiple modalities should be used in advertising and stimulating interest in an Internet-based faculty development curriculum. Demonstrating the Website to faculty at a meeting appeared to achieve the greatest return. Offering CME credit was not helpful in stimulating interest.

Curriculum↗
PubMed2000

Medical student interest in alternative medicine.

BACKGROUND OBJECTIVES: An increasing sector of the American population is seeking health services from alternative practitioners and using alternative therapies. This study investigated whether medical students perceived that information on alternative therapies would be useful to them as future practicing physicians. METHODS: A one-page anonymous questionnaire was distributed to the entire first-year medical class of a large, public, Midwestern medical school during their first semester. They responded to a series of five statements concerning alternative medicine and medical school coverage of this topic. RESULTS: The majority (84%) of students reported that knowledge about alternative medical therapies would be important to them as future physicians. The respondents wanted to learn about alternative therapies while in medical school (72%), but very few thought they would receive adequate exposure to this topic (6%). The majority also reported that direct observation of alternative practitioners would be the best method of instruction in this area (58%). CONCLUSIONS: The results suggest that medical students are interested in learning about alternative medical therapies and they perceive this knowledge will be important to them as physicians. As medical schools undertake various curriculum reforms they should be aware of rising student interest in alternative medical therapies.

Adult↗
PubMed1996

The provision of labor and delivery services by graduates of four Kansas family practice residencies.

The provision of labor and delivery services by family physicians is especially important in largely rural states such as Kansas. The decline in the number of family physicians offering labor and delivery services threatens those who depend on access to primary health care in rural areas. A survey was mailed to all 370 of the University of Kansas School of Medicine-Wichita (UKSM-W) family practice residency graduates. Two hundred sixty-five (72%) graduates responded, of whom 206 are in private practice. Eighty percent of responding graduates practice in communities of less than 100,000, and 72% of those physicians provide labor and delivery services. Although 48 of 206 graduates have ceased delivering babies, 131 still do so, averaging 41 deliveries per year. Sixty-five graduates perform C-sections, averaging 12 per year. CONCLUSIONS. UKSM-W graduates afford rural patients considerable access to care. Income, work hours, and practice satisfaction were similar in all three groups (no delivery, delivery without cesarean section, and cesarean section). Policy makers are justified in expanding educational programs in family practice that emphasize complete care of the pregnant woman.

Cesarean Section↗
PubMed1995

Attention-deficit hyperactivity disorder. Management by family physicians.

OBJECTIVE: To assess the evaluation and treatment practices of family physicians in regard to attention-deficit hyperactivity disorder (ADHD). DESIGN, SETTING, AND PARTICIPANTS: A 20-item survey was developed and mailed to all 940 family and general physicians in Kansas. MAIN OUTCOME MEASURES: Physician practices regarding ADHD. RESULTS: The 471 respondents (50.1%) included 386 physicians in private clinical practice, who constituted the study group. Ninety-eight percent of these physicians regularly saw children and over half suspected four or more cases of ADHD in the past year. When suspecting ADHD, 43% of the physicians referred for diagnosis and treatment; 30% evaluated and treated by themselves; and 27% referred for evaluation but did follow-up treatment themselves. There was no significant difference in these ratios between rural and urban physicians. Family physicians referred to a pediatric psychiatrist most often, with no apparent difference in referral pattern by community size; 75% indicated they were comfortable with their current referral support. Of the physicians who diagnosed and treated ADHD themselves, only 30.6% routinely ordered laboratory work or other tests, only 28.7% used teacher questionnaires, and only 20.4% used parent questionnaires. CONCLUSIONS: An important amount of patient care for ADHD is managed by family physicians, without significant differences between rural and urban practices. Most family physicians are satisfied with their current level of referral support. Physicians who treat ADHD themselves usually rely on clinical evaluation rather than special tests or standardized questionnaires.

Adolescent↗
PubMed1994

Staffing in small rural hospital emergency rooms: dependence on community family physicians.

OBJECTIVE: This study describes the characteristics of emergency room staffing at rural hospitals in Kansas. METHODS: Administrators at 84 rural hospitals in communities of less than 5,000 were surveyed by telephone using a scripted interview. RESULTS: Seventy-seven hospitals provided physician-staffed emergency room services. Their average daily emergency room census was 4.4. The average hospital medical staff consisted of 2.9 physicians. Eighty-six percent of all hospital staff physicians were family physicians. Ninety-six percent of all hospital emergency room staffing was provided by the local medical staff. Fee-for-service was the only method of reimbursement to physicians in 44 hospitals. Alternatives to emergency room staffing by local physicians included contracted part-time emergency room physicians, locum tenens physicians, mid-level practitioners, or emergency room closure. CONCLUSIONS: Rural family physicians have considerable responsibility for providing emergency care. Physicians must have adequate training in emergency medical care to practice in communities such as these.

Emergency Service, Hospital↗
PubMed1993

Physicians' strategies for safeguarding confidentiality: the influence of community and practice characteristics.

BACKGROUND: Confidentiality is an issue of particular importance in rural communities where it seems everyone knows everyone else. Privacy may be compromised when professional relationships are interwoven with personal ones. We conducted a study to determine the influence of practice characteristics on safeguarding confidentiality. METHODS: A survey was mailed to all family and general practice physicians in Kansas. Differences in confidentiality strategies were studied to determine if they were related to characteristics of the respondents and their practice environments. RESULTS: A total of 510 physicians (55%) responded to the survey. Only in practices in which more than 5% of the patients were personal acquaintances was a strategy for preserving confidentiality affected: of seven specific strategies, only one, speaking with office personnel about confidentiality, was statistically associated with this practice characteristic. CONCLUSIONS: Physicians practicing in smaller communities and areas with more extensive social interconnectedness may need to address the issue of privileged communication to a greater extent. If other options are exhausted, physicians may need to send patients with particular needs for confidentiality outside their communities to obtain care.

Adult↗
PubMed1993

Chlamydia trachomatis screening in a family planning clinic.

OBJECTIVE: The purpose of this study was to determine the prevalence of chlamydia in women attending a family planning clinic and to explore the feasibility of making chlamydia screening part of the routine procedure for all women. This study also investigated clinical and demographic parameters that may be associated with chlamydial infections. METHODS: Subjects were 239 female patients who attended the Planned Parenthood Clinic in Wichita, Kansas, during July 1990. Subjects included all patients receiving pelvic examinations regardless of indication. Each subject was screened for C. trachomatis using Testpack Chlamydia (Abbott Labs). RESULTS: Of the 239 women screened, 11 (4.6%) had positive Testpack Chlamydia tests. Young age (< 24 years), self-reported bleeding, and inflammation found on Papanicolaou exams were positively associated with chlamydial infection. CONCLUSION: These parameters provide additional information for the clinician deciding who should be screened for chlamydia infections.

Adult↗
PubMed1992

Cervical conization: cold knife and laser excision in residency training.

During a 2-year period, 293 consecutive conizations performed by residents in obstetrics and gynecology were reviewed. One hundred sixty-one patients underwent laser excision and 132 women were treated by cold knife conization. Average operating times for laser excision and knife conization were 31 and 33 minutes, respectively. Combined minor and major complication rates for laser and knife cones were 19 and 30%, respectively. Major complications including cervical stenosis and heavy bleeding were seen in 20% of knife conizations and 6% of laser excisions. Average blood loss for knife conization was 65 mL, and average blood loss for laser conization was 34 mL. Among those examined in follow-up with cervical cytology and colposcopy, no patient in the laser excision group showed evidence of persistent dysplasia, compared with one patient (3%) in the knife conization group. The reported data suggest no difference in operating time, length of anesthesia, or success of treatment between laser excision and knife conization performed by residents in training. Fewer complications were seen in the laser excision group.

Anesthesia, Obstetrical↗
PubMed1991

Abortion attitudes and practices of family and general practice physicians.

BACKGROUND: Approximately 1.5 million abortions are performed each year in the United States. Little information has been published on the abortion attitudes and practices of family physicians. The object of this investigation was to assess the abortion attitudes and practices of family and general practice physicians in Kansas. METHODS: A 19-item self-administered survey questionnaire was designed and mailed to 856 family and general practice physicians in Kansas. RESULTS: A 63% survey response rate was obtained. Seventy-eight percent of the physicians reported that abortion should be legal, but only 56% of the respondents classified themselves as pro-choice. Conversely, only 8% reported that legal abortion should not be available, even though 33% classified themselves as pro-life. The majority of physicians reported that abortion is an appropriate option to save the life of the mother, in cases of rape or incest, and when a fetal anomaly is diagnosed. Only three respondents (0.5%) had performed abortions during the previous year. In general, female physicians and physicians over the age of 40 years (regardless of sex) were more likely to be pro-choice and to view a woman's personal decision as a circumstance in which abortion may be appropriate. CONCLUSIONS: Physician's views about abortion and their practice patterns are important components of health care for thousands of women each day.

Abortion, Induced↗
PubMed1991

Attitudes of family practice residents about speech-language-hearing referrals.

The "family doctor" has been identified as the professional most likely to be contacted by the general public with concerns about communication disorders; yet the family practice physician is unlikely to refer patients with communicative disorders to speech-language pathologists or audiologists for nonmedical evaluation and treatment. The purpose of this study was to determine attitudes of family practice residents about referral patterns for communication disorders using a survey format. Thirty-nine residents estimated that they had referred an average of 1.5 patients to a speech-language pathologist and 2.2 patients to an audiologist during a six-month interval. The findings indicated that these residents did not routinely refer patients to speech-language pathologists. When they did refer, a limited view of communication problems was used.

Attitude to Health↗
PubMed1990

Multifactorial causes of adolescent driver accidents: investigation of time as a major variable.

This study examined all reported motor vehicle accidents with adolescent drivers, aged 18 and under, in Wichita, Kansas, during 1987. The analysis focused on several time variables that may influence the cause of an accident, including time of day, day of week, and school versus nonschool day. Data analysis from 1903 accident reports showed a predominance of accidents among male drivers, a higher accident prevalence on school days, and a cluster of accidents on school days before school, during lunch hours, and immediately after school. Accidents on weekends and nonschool days clustered later in the day, with alcohol-related and injury accidents occurring more frequently than on school days. These results have potential implications for health care professionals working with youths on health promotion/disease prevention, for policymakers who schedule school activities, and for those involved in driver safety and education.

Accidents, Traffic↗
PubMed1990

The incidence of Haemophilus influenzae meningitis in a midwestern metropolitan county.

The incidence of H. influenzae meningitis in children under five years of age was monitored during the years 1983-87 by a retrospective study of records from all hospitals serving a metropolitan county in Kansas. The mean annual incidence rate for the five years studied was 26.0 per 100,000. This compares with a mean of 56.0 per 100,000 measured in the same county during 1979-82.

Child, Preschool↗
PubMed1989

An investigation of the counseling needs of male and female laryngectomees.

A 25-item survey was developed to investigate the distinct counseling needs of male and female laryngectomees. Data were obtained from 120 subjects from across the country. The subjects were surveyed regarding their lifestyle changes, informational needs, and feelings about the surgery and its consequences. The results indicated that more and better pre- and postoperative counseling of laryngectomees was needed. Further, male laryngectomees differed from females in their feelings about the surgery, their emotional support systems, and their perceived usefulness of information presented by various counselors. Health-care professionals who counsel laryngectomees must make a concerted effort to meet the unique needs of each patient.

Counseling↗
PubMed1989

A multidisciplinary approach to the management of Huntington's disease.

Huntington's disease is an incurable, progressive, inherited neurological disorder resulting in involuntary choreic movements, dementia and behavorial changes. The Donald J. Allen Memorial Huntington's Disease Clinic is a free-standing multidisciplinary clinic in the midwest specifically devoted to the diagnosis and treatment of HD. In its first eighteen months of operation, the clinic staff examined 38 patients. Approximately 30% of those patients did not have HD or were originally misdiagnosed.

Adult↗
PubMed1988

Assessing and treating communication disorders.

Communication disorders are defined as difficulties involving speech, language or hearing. Speech problems may involve disorders of articulation, fluency or voice. Language disorders include problems of receptive, expressive and pragmatic language. The most common communication disorder is hearing loss. The role of the family physician is to recognize the problem, supervise the evaluation, coordinate the therapy, and support the patient and family.

Aged↗