PubMed Health⌕ Search

Biomedical subjects

L Ginsburg

Publications and source records attributed to L Ginsburg.

6 recordsLinked to original sources
PubMed1998

Geriatric psychiatry outreach practices in the province of Ontario: the role of the psychiatrist.

OBJECTIVE: To determine the mode of practice of multidiscliplinary and interdisciplinary teams in the field of geriatric psychiatry in the province of Ontario with specific reference to the role of the psychiatrist on the teams. METHOD: Teams were identified, and a simple questionnaire was developed and submitted to every team at an annual conference. RESULTS: Responses were obtained from 38 out of 47 teams. The composition of the teams is variable as regards size and represented discliplines. Nine teams do not have psychiatrists directly affiliated with them. Eighteen teams, 4 of which are based in teaching hospitals, have fewer than 1 full-time equivalent (FTE) psychiatrist. Among these teams, 4 have fewer than 0.1 FTE psychiatrist and 10 have fewer than 0.5 FTE psychiatrist. Eleven teams include between 1 and 1.5 FTE psychiatrists on their staff. Four teams (10.5%) require that the initial assessment of all patients be undertaken by a psychiatrist. In 18 (47%) of the teams, assessment by a psychiatrist can be infrequent or nonexistent. Discussion of the referral with a psychiatrist occurs in the majority of teams, but in a significant minority (10 [27%]), this occurs quite infrequently or not at all. CONCLUSION: Geriatric psychiatry outreach practices in Ontario involve many different disciplines in the assessment and follow-up of geriatric psychiatry patients, often without the ready availability of psychiatric input. We applaud the expanding roles of different disciplines in this practice. We are concerned, however, at the paucity of psychiatrists working in this field.

Aged↗
PubMed1997

Do doctors know when their patients don't? A survey of doctor-patient communication in lung cancer.

OBJECTIVES: a) To determine how much patients with recently diagnosed lung cancer know about their illness and its treatment, and b) to find out if doctors know what their patients know and what they don't. PATIENTS AND METHODS: One hundred patients with recently diagnosed lung cancer, who were undergoing radiotherapy or chemotherapy, were interviewed to determine their view of their diagnosis, the extent of the cancer, the intent of treatment, and the risks and benefits of treatment. Their attending physicians' view were elicited contemporaneously, using a self-administered questionnaire. The principle outcome measure of the study was the level of agreement between the views of the patients and the doctors about the disease, the treatment, and the prognosis. Concordance between doctors' and patients' views was expressed in terms of percentage agreement, and Kappa (kappa). RESULTS: Ninety-nine percent of the patients knew that they had lung cancer. Sixty-four percent (64%) agreed with their doctor about the extent of the disease (kappa = 0.48). Most of those who disagreed underestimated the extent of their cancer. Seventy-two percent (72%) agreed with their doctor about the intent of treatment (kappa = 0.49). Thirty-six percent (36%) agreed with their doctors about their probability of cure, (kappa = 0.17): most of those who disagreed systematically overestimated it. Sixty-eight patients were receiving palliative treatment. Of these, 56% agreed with their doctor about the probability of symptomatic benefit (kappa = 0.42), but only 14% agreed with their doctor about the probability that the treatment would prolong life (kappa = 0.06). Doctors frequently failed to recognize their patients' misconceptions about the intent of treatment and the prognosis. CONCLUSION: Many patients did not understand their situation well enough to make a truly autonomous treatment decision, and their doctors often failed to recognize this.

Adult↗
PubMed1990

The macular photostress test in diabetic retinopathy and age-related macular degeneration.

We propose the macular photostress test for the evaluation of macular function in the office setting. Eighty eyes were tested and divided into four diagnostic categories: background diabetic retinopathy, diabetic macular edema, age-related macular degeneration, and normal. The recovery times for the eyes with age-related macular degeneration were longer than for eyes with macular edema (P = .03). Age-matched patients with age-related macular degeneration had longer recovery times than did those without age-related macular degeneration (P = .0001). A possible explanation is that the prolonged recovery time in the eyes with age-related macular degeneration reflects that the anatomic lesion is located in the retinal pigment epithelium-photoreceptor complex. In comparison, the eyes with macular edema, whose lesion is in the inner retina and not the retinal pigment epithelium, show a less-prolonged recovery time than the eyes with age-related macular degeneration.

Adolescent↗
PubMed1981

Part-time residency training.

The development of part-time training in the United States and Canada is described. The flexibility required for young women physicians who attempted to combine childbearing and career development, together with the increasing number of women entering medicine, underlines the importance of part-time training schedules. A variety of flexible training options have been defined and a set of guidelines has been produced by the Canadian Royal College of Physicians and Surgeons. The experiences of part-time psychiatry residents at Queen's University, Kingston is presented. Thus far this has involved a total of six residents over a four year period, including the authors of this paper. The advantages and disadvantages, viewed from both the resident and system viewpoint, are discussed.

Adult↗