Biomedical subjects

M F Fleming

Publications and source records attributed to M F Fleming.

58 records · Page 4Linked to original sources

PubMedDate not supplied

Widowhood: a review of the social and medical implications.

Widowed women in America are a rapidly growing and expanding proportion of the population. This article reviews important research on the social changes, family relationships, and health risks associated with widowhood from the perspective of providing background for teachers of family medicine and suggesting research directions in this area. Since research indicates widowed women utilize outpatient and inpatient services more often than married individuals of either sex, family physicians have the opportunity to assist women who are facing the changes associated with the death of a life partner.

Adaptation, Psychological↗

PubMedDate not supplied

A technique for measuring family physician priorities for patient care.

Family physicians frequently choose which elements of patient care to emphasize in order to balance the idealized principles of medical care with the real constraints of medical practice. Colleagues at several residency programs agreed to help us to find out if these choices can be quantified and whether personal characteristics of respondents or the acuteness or chronicity of the patient's illness influence these priorities. Two sets of 15 forced-choice item pairs, one set in reference to chronic illness and one set in reference to acute illness, were used in the study. Responses from 346 family physicians and non-physician colleagues ranked six hypothetical elements of patient care for acute and chronic illness: continuity, comprehensiveness, family orientation, community orientation, coordination and prevention. The data were analyzed using the psychometric scaling technique of paired comparisons. The analysis yielded a set of rankings which showed that these choices were quantifiable and made with a high degree of individual consistency and greater intragroup agreement than would result from chance. Patterns of choice differed for acute and chronic illness in a manner consistent with observed clinical practice.

Attitude of Health Personnel↗

PubMedDate not supplied

Faculty orientation within departments of family medicine.

As new faculty members in a large university-based department of family medicine, the authors were struck by the absence of a structured orientation program to help new faculty enter the world of academic family medicine. In response to a perceived need for such a program, a national survey of family medicine was conducted. In addition, 50 departments of a local university and ten local businesses were surveyed. The results of this survey, as well as a conceptual framework for an orientation program, are presented.

Faculty, Medical↗

PubMedDate not supplied

Chronic opioid analgesic therapy for chronic low back pain.

BACKGROUND: Eleven percent of American adults have chronic low back pain- and many of these individuals have severe, disabling, refractory pain. Many texts recommend against using opioids for these patients without citing original research. METHODS: A MEDLINE literature search was conducted for original research on the use of opioids for chronic noncancer pain. Additional references were also sought from review articles and book chapters. Based on this research and the authors' clinical experience, recommendations were formulated for implementing chronic opioid analgesic therapy (COAT) for patients with chronic low back pain. RESULTS: No controlled studies were found. Case series reports on a total of 566 patients suggest that COAT is safe and effective for many patients with recalcitrant chronic low back pain. Preexisting substance use disorders, personality disorders, certain medical conditions, and certain occupational factors are relative contraindications to COAT. Methods to prevent and monitor for drug problems among COAT recipients include contracts, family interviews, and drug testing. Pain and overall function are the key monitoring parameters. Once patients attain some relief, an exercise regimen should be initiated. Other nonpharmacologic treatments and nonopioids are also recommended. CONCLUSION: Physicians are encouraged to consider COAT for selected patients with severe chronic low back pain who respond inadequately to other treatments.

Adult↗