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Biomedical subjects

Margaret R H Nusbaum

Publications and source records attributed to Margaret R H Nusbaum.

10 recordsLinked to original sources
PubMed2005

Mini-immersion in medical Spanish for family practice residents.

BACKGROUND: Residency programs vary widely in types of training to increase cultural competency and sensitivity. Moreover, few empirical studies exist regarding effectiveness of these experiences. The purpose of our study was to offer and evaluate a linguistic mini-immersion, !Español Rápido!, required of 8 new family practice interns during their orientation month at the University of North Carolina. DESCRIPTION: The curriculum was based on accelerative learning, a pedagogy that considers all parts of the brain, the paraconscious, and the role of the emotions. EVALUATION: Pretests and posttests and a postimmersion and 6-month follow-up evaluation indicated that the mini-immersion was successful. A simple t test for paired samples showed a significant improvement in interns' comprehension after the 6-day immersion, t(7)=11.399, p<.000. CONCLUSION: This brief experience should be viewed only as a first step in a long-term plan for a comprehensive curriculum to prepare family practice residents as culturally competent practitioners.

Family Practice↗
PubMed2004

The changing nature of women's sexual health concerns through the midlife years.

OBJECTIVE: Information about the sexual health care needs for midlife women is limited. This study compares and contrasts the nature and prevalence of sexual concerns for women as they progress through life and into menopause and the interest and experience these women have in discussing sexual concerns with their physicians. METHODS: Questionnaires were mailed to 2073 eligible women at military medical clinics in the early 1990s. Main outcome measures are self-reported sexual concerns and interest and experience in discussing these concerns with their physicians. RESULTS: Over 98% of women reported one or more sexual concerns. Type and intensity of sexual concerns changed as women aged. Most women had not had the topic of sexual health ever raised by their physicians. CONCLUSIONS: The sexual health concerns of women change as they age. Women desire to address their sexual health care needs with their physicians. Physicians should be aware of the common sexual concerns of women, and be comfortable in initiating discussion to address them.

Adult↗
PubMed2004

Sexual healthcare needs of women aged 65 and older.

OBJECTIVES: To compare prevalence and type of sexual concerns and interest in and experience with discussing these concerns with physicians for women younger than 65 and 65 and older. DESIGN: Cross-sectional survey. SETTING: Departments of Family Practice and Obstetrics and Gynecology at Madigan Army Medical Center, Tacoma, Washington. PARTICIPANTS: Of 1,480 women seeking routine gynecological care, 964 (65%) responded; 163 (17%) were aged 65 and older. MEASUREMENTS: Self-reported sexual concerns and interest in and experience with discussing these concerns with their physicians. RESULTS: Older women had a similar number of sexual concerns as younger women and were more likely to be concerned about their partner's sexual difficulties. Older women were less likely to have ever had the topic of sexual health raised during healthcare visits. Even though these women were more likely to report youthful-appearing physicians as hindering the topic of sexual health, the majority indicated that they would have discussed their concerns had the physician raised the topic and were interested in a follow-up appointment to do so. CONCLUSION: Although the types of sexual concerns vary in frequency, women aged 65 and older have a similar number of sexual concerns as younger women. Older women want physicians to inquire about their sexual health. This discussion should include inquiries about their partner's sexual functioning. To overcome age as a barrier to this discussion, younger physicians should be particularly attentive to initiating the topic of sexual health.

Adolescent↗
PubMed2004

Therapeutic options for patients returning to sexual activity.

No head-to-head studies have been conducted with the phosphodiesterase type 5 (PDE5) inhibitors to date. Results of noncomparative studies, however, suggest that tadalafil and vardenafil hydrochloride are at least as effective as sildenafil citrate in improving erections and increasing the number of successful intercourse attempts in men with erectile dysfunction (ED) at all levels of severity. By facilitating a sexual response, PDE5 inhibitors lend naturalness to sexual activity and may permit couples to return to their previous sexual lifestyle. By providing a broader window of opportunity, a longer-acting PDE5 inhibitor such as tadalafil adds to the variety of options currently available in managing ED with PDE5 inhibitors. This option offers increased flexibility by minimizing the need to plan sexual activity; allowing more time for intimacy or romance before sexual intercourse; and reducing the pressure on the patient to perform.

Adult↗
PubMed2004

Sexually transmitted infections and increased risk of co-infection with human immunodeficiency virus.

The incidence of trichomoniasis (Trichomonas vaginalis) in the United States is estimated at 5 million cases annually; chlamydia (Chlamydia trachomatis) at 3 million; gonorrhea (Neisseria gonorrhoeae), 650,000; and syphilis (Treponema pallidum), 70,000. However, most sexually transmitted infections (STIs) are asymptomatic-contributing to underdiagnosis estimated at 50% or more. Diagnosis of an STI signals sexual health risk because an STI facilitates the transmission and acquisition of other STIs, including human immunodeficiency virus (HIV). In fact, comorbid STIs increase patients' susceptibility of acquiring and transmitting HIV by two- to fivefold. Several studies have shown that aggressive STI prevention, testing, and treatment reduces the transmission of HIV. The authors discuss common clinical presentations, screening, diagnosis, and treatment for trichomoniasis, chlamydia, gonorrhea, syphilis, and herpes simplex virus.

Comorbidity↗
PubMed2003

Chronic illness and sexual functioning.

Chronic illness and its treatments can have a negative impact on sexual functioning. The mechanism of interference may be neurologic, vascular, endocrinologic, musculoskeletal, or psychologic. Patients may mistakenly perceive a medical prohibition to the resumption of sexual activity, or they may need advice on changes in sexual activity to allow satisfactory sexual functioning. Family physicians must be proactive in diagnosing and managing the alterations in sexual functioning that can occur with chronic illness. Patient education and reassurance are essential. Before sexual activity is resumed, patients with cardiovascular disease should be stratified according to risk. Patients with musculoskeletal disease should be educated about positional changes that may improve comfort during sexual activity. Psychosocial concerns should be addressed in patients with human immunodeficiency virus infection or acquired immunodeficiency syndrome. In patients with cancer, it is important to discuss sexual problems that may arise because of negative body image and the effects of chemotherapy. Patients who have disabilities can benefit from the use of muscle relaxants, technical adaptations, and expansion of their sexual repertoire.

Cardiovascular Diseases↗
PubMed2002

The proactive sexual health history.

Family physicians must proactively address the sexual health of their patients. Effective sexual health care should address wellness considerations in addition to infections, contraception, and sexual dysfunction. However, physicians consistently underestimate the prevalence of sexual concerns in their patients. By allocating time to discuss sexual health during office visits, high-risk sexual behaviors that can cause sexually transmitted diseases, unintended pregnancies, and unhealthy sexual decisions may be reduced. Developing a routine way to elicit the patient's sexual history that avoids judgmental attitudes and asks the patient for permission to discuss sexual function will make it easier to gather the necessary information. Successful integration of sexual health care into family practice can decrease morbidity and mortality, and enhance well-being and longevity in the patient.

Family Practice↗
PubMed2002

A birth crisis.

Explore the source record for details and available documents.

Anecdotes as Topic↗
PubMed2002

Erectile dysfunction: prevalence, etiology, and major risk factors.

Erectile dysfunction is a multifactorial condition that may include psychological, neurologic, hormonal, vascular, or cavemosal impairment, or a combination of these factors. Major risk factors include aging, depression, and lifestyle. The diagnosis of erectile dysfunction can be an indicator for undiagnosed diseases, including coronary artery disease, hypertension, and diabetes mellitus. Erectile dysfunction is highly prevalent in the United States, affecting approximately 30 million men. Erectile dysfunction in the majority of men remains undiagnosed, and many men who receive treatment discontinue it because of general dissatisfaction with real-life issues that can have an impact on therapeutic success. Early identification, behavior modification, and increased therapeutic options may improve patient outcomes.

Aging↗