Biomedical subjects

L Candib

Publications and source records attributed to L Candib.

5 recordsLinked to original sources

PubMed1990

Accuracy of Chlamydia trachomatis antigen detection methods in a low-prevalence population in a primary care setting.

We compared a direct fluorescent-antibody stain (DFA) and an enzyme immunoassay (EIA) with a standard cell culture technique for the detection of Chlamydia trachomatis infection in women in an urban family practice setting. We also evaluated a DFA sample in a commercial laboratory to determine the interlaboratory reliability of this test. There were 268 women in the study; the EIA provided a higher sensitivity (83 versus 50%) and a higher positive predictive value (83 versus 69%) than the DFA test and comparably high specificity (99 versus 98%). Concordance between the two laboratories on the DFA test was not high when data were adjusted for chance agreement (kappa coefficient = 0.64). DFA validity was optimal with an elementary body cutoff of greater than 5, while EIA validity was optimal at the recommended cutoff of 0.1 optical density unit. None of 11 women with negative cultures after treatment had false-positive antigen tests. False-negative results with both tests were associated with low culture inclusion counts but were not strongly associated with the presence or absence of symptoms, menses, pregnancy, or recent antibiotic use. False-positive results with EIA were seen only for three women who had a chief complaint of vaginal discharge. Although the positive predictive value of DFA could be increased in high-prevalence subpopulations, EIA was still more valid in two such groups: teenagers and prenatal patients. These results indicate that EIA might be preferable for low- or moderate-prevalence populations in primary care settings and that a falloff in DFA sensitivity could be explained by lower infection burdens in low-prevalence groups.

Adult↗

PubMed1983

Family medicine and family therapy: comparative development, methods, and roles.

Family medicine and family therapy have evolved separately, but the fields are now increasingly in contact with each other. Today's family physician needs a deeper grasp of their similarities and differences. This paper compares the two disciplines in terms of their (1) membership criteria for treatment, (2) considered appropriateness for treatment, (3) contractual process, and (4) evolution of membership over time. Also explored are the disciplines' notions of illness and change; their differing attitudes toward technique are analyzed as well. Family therapists and family physicians appear likely to have increased exposure to one another. As they do, common approaches may develop, and conceptual differences may present a mutual stimulus for growth and change.

Behavior Therapy↗

PubMed1980

Case oriented group discussions for family physicians.

Curriculum in family medicine and primary care includes various areas of concern for educators in the behavioral sciences. Most of this concerns the physician-patient relationship as the focus for teaching and learning. This paper outlines the work of a longitudinal, case oriented group of family physicians as it reflects the correlation between the actualities of practice and the curriculum in behavioral science for family practice residents. Also discussed is the issue of potential "typologies" as elaborated in the family physicians' reasons for case presentations. Such groups assist faculty and practitioners in their own awareness of educational and patient care issues in the physician-patient relationship as well as serve as a foundation for building a relevant behavioral science curriculum for residents and students.

Behavioral Sciences↗

PubMed1976

Obstetrics in family practice: a personal and political perspective.

A heated debate is currently taking place concerning the style, methods and location of future obstetrical and neonatal care. On the one hand, there is a trend toward increasing technology of obstetrical and neonatal care with some professional groups favoring regionalization of these services to large regional centers. On the other hand, there are counterforces to such regionalization including community hospitals, many practicing obstetricians, nurse midwives, the women's liberation movement, the "alternative lifestyle movement," the Leboyer concept of delivery, the family-centered maternity care movement, and the family practice movement. This paper explores these issues and presents important reasons for family-oriented obstetric and neonatal care involving the family physician in community settings readily accessible to patients. The inclusion of obstetrical care as an integral part of family practice is important to the growth and development of the specialty.

Delivery, Obstetric↗

PubMedDate not supplied

Part-time doctors: reduced working hours for primary care physicians.

Women are entering the professional workforce in increasing numbers, and male professionals are more likely than ever to be involved in dual-career families. For primary care physicians the traditional 50-70-hour work week increasingly creates conflict between professional and other personal goals. Many believe that unless physicians work these long hours they will be unable to successfully provide personal, high-quality continuing care to their patients. Long-term career development for physicians who choose nontraditional arrangements has also presented problems. The authors review the literature on part-time work for physicians, then discuss their experiences as part-time family physicians at an academic health center. Various specific strategies are recommended for physicians and institutions considering part-time employment.

Adult↗