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Biomedical subjects

P M Butler

Publications and source records attributed to P M Butler.

At least 19 recordsLinked to original sources
PubMed2000

U.S. medical students choice of careers and its future impact on health care manpower.

During the last 10-15 years, the health care system of this country has faced major challenges, among them, spiraling increases of health care costs, physician manpower maldistribution, excessive production of subspecialists, shortages of primary care physicians (family practice, general internal medicine, and general pediatrics), and lack of access to health care, predominantly among the poor and disadvantaged populations. As a way of shedding light on some of these challenges, the authors conducted a study among junior medical students from the University of Texas Medical School at Houston which focused on some of the factors that might influence medical students' choice of careers. In this article, the authors review the most salient findings for some of the problems that currently plague the health care system of this nation. Certainly, the outcome of this study has important educational and health service delivery implications not only in the United States but abroad as well, particularly among developing nations.

Adult↗
PubMed1995

Patient empowerment. Results of a randomized controlled trial.

OBJECTIVE: The purpose of this study was to determine if participation in a patient empowerment program would result in improved psychosocial self-efficacy and attitudes toward diabetes, as well as a reduction in blood glucose levels. RESEARCH DESIGN AND METHODS: This study was conducted as a randomized, wait-listed control group trial. The intervention group received a six-session (one session per week) patient empowerment education program; the control group was assigned to a wait-list. At the end of 6 weeks, the control group completed the six-session empowerment program. Six weeks after the program, both groups provided follow-up data. RESULTS: The intervention group showed gains over the control group on four of the eight self-efficacy subscales and two of the five diabetes attitude subscales. Also, the intervention group showed a significant reduction in glycated hemoglobin levels. Within groups, analysis of data from all program participants showed sustained improvements in all of the self-efficacy areas and two of the five diabetes attitude subscales and a modest improvement in blood glucose levels. CONCLUSIONS: This study indicated that patient empowerment is an effective approach to developing educational interventions for addressing the psychosocial aspects of living with diabetes. Furthermore, patient empowerment is conducive to improving blood glucose control. In an ideal setting, patient education would address equally blood glucose management and the psychosocial challenges of living with diabetes.

Adaptation, Psychological↗
PubMed1995

Ontogenetic aspects of dental evolution.

The evolution of dental ontogeny in the vertebrates is reviewed. Teeth probably originated as dermal structures, which secondarily spread to the mouth, where they became associated with bones. Tooth formation is a repetitive process, resulting in spatially separate units, and primitively it continued throughout life. Development of conical teeth commences at the tip and extends basally; folding of the basal lamina of the inner dental epithelium results in complex shapes, as in mammalian molars. Heterodonty, the divergent development of the teeth in a dentition, has evolved in a number of vertebrates, particularly mammals. Experimental analysis of dental development is still at an early stage, and the explanation of evolutionary changes in developmental terms is largely speculative Mammals are atypical vertebrates in many ways, and more studies of lower vertebrates, especially fishes, are needed.

Animals↗
PubMed1993

College students' perception of vulnerability/susceptibility and desire for health information.

The specific aims of this study were to develop a questionnaire and conduct a survey of college students 18-22 years of age, in order to determine (1) their perception of being vulnerable and susceptible to health problems and (2) their interest in receiving help and information about health maintenance. Material from four 2-h focus groups provided the content for the initial questionnaire. Pilot testing of the early drafts consisted of several phases in which students completed the tool in both group situations and in face-to-face interviews. The final questionnaire was completed by 364 students on two campuses in the Midwest. Two scales were identified using factor analysis and analysis for internal consistency. The Vulnerability/Susceptibility Scale demonstrated a good reliability (Kuder-Richardson-20 = 0.8136) and five factors were identified through factor analysis. The Information Scale demonstrated a high reliability (Kuder-Richardson-20 = 0.8958) and two factors were identified through factor analysis. Based on analysis of variance (ANOVA) data, a model was developed using the variables of the Vulnerability/Susceptibility Scale, the Information Scale, gender and health rating. The model was then tested using multiple regression analysis. This study identified health related areas about which the students feel vulnerable/susceptible and are interested in receiving health help/information. This study suggests which population of college students might be most receptive to health information and future behavioral strategies.

Adolescent↗
PubMed1991

Munchausen syndrome by proxy: a review.

Munchausen syndrome by proxy is a form of child abuse in which a parent or caretaker simulates or produces illness in a child. Case reports of Munchausen syndrome by proxy document a wide and confusing spectrum of symptoms. The children who are the victims of this syndrome suffer morbidity linked to numerous unnecessary hospital admissions and diagnostic procedures, severe psychological morbidity, and a significant risk of mortality. Because of these extreme consequences, all health-care professionals must be able to recognize its warning signals.

Child↗
PubMed1987

Diagnosing psychiatric disorders in adolescent females with abdominal pain.

Psychiatric diseases, recently renamed psychiatric disorders by the American Psychiatric Association, are commonly associated with abdominal pain in adolescents but may be difficult to diagnose. In a prospective study, we evaluated four psychiatric scales, including the Childhood Depression Inventory (CDI) and the Speilberger State-Trait Anxiety Inventory (STAI) as aids in the diagnosis of psychiatric disorders in 40 adolescent females with abdominal pain. Final diagnosis of organic-dysfunctional disease was made in 32 patients, and a psychiatric disorder was found in eight. Only the CDI (p = 0.001) and the State (p = 0.006) and Trait (p = 0.022) scales of the STAI had significantly different mean values between subjects with organic-dysfunctional disease and a psychiatric disorder. Almost all subjects with a psychiatric disorder had abnormally high scores, whereas the subjects with organic-dysfunctional disease did not. We conclude that three brief, self-administered psychiatric scales may be useful in differentiating between organic-dysfunctional disease and a psychiatric disorder in adolescent patients with abdominal pain.

Abdomen↗
PubMed1987

Two cases of benzodiazepine toxicity in children.

While benzodiazepines have been widely used in adult populations, their role in the treatment of anxiety disorders in children and adolescents has not been well established. The authors report on two cases in which benzodiazepine use resulted in psychotic symptoms. The importance of eliciting a careful history as well as being familiar with drugs' side effects and withdrawal effects is stressed.

Age Factors↗
PubMed1986

Identification of electrocardiographic criteria for diagnosis of right ventricular hypertrophy due to mitral stenosis.

Current electrocardiographic (ECG) criteria for diagnosing right ventricular hypertrophy (RVH) have low sensitivity. In this study maximally specific and sensitive ECG criteria for RVH due to mitral stenosis (MS) were developed that incorporated the principles derived from spatial changes in the QRS complex observed on the vectorcardiogram and any existent ECG criteria that supplement the diagnostic capability of the criteria derived from the vectorcardiogram. The standard 12-lead electrocardiograms of a control group of 500 consecutively selected subjects with 50 women and 50 men in each decade between ages 20 and 69 years were compared with the electrocardiograms of a study population of 50 patients with RVH due to MS. Inclusion criteria were a diagnosis of MS by catheterization, normal coronary arteriographic and left ventriculographic findings and no other valvular abnormalities. It was hypothesized that patients with RVH resulting from MS would have QRS forces that are maximally anterior (A) and rightward (R) and minimally posterolateral (PL); thus, the A + R - PL value in the study group would be greater than that in the control group. The subsequently derived formula criterion (A + R - PL greater than or equal to 0.7 mV) and 2 additional criteria, R less than or equal to 0.2 mV in lead I and P less than 0.25 mV in leads II, III, aVF, V1 or V2, were tested in both groups. The specificity and sensitivity of each individual criterion was determined; when combined, the criteria yielded 94% specificity and 64% sensitivity. Moderate to severe RVH due to MS was detected in two-thirds of the patients using the proposed criteria.

Adult↗
PubMed1983

Evolution and mammalian dental morphology.

Evidence for the action of natural selection on the mammalian dentition is reviewed. Dental variation largely reflects genetical differences, but environmental factors have a significant effect, especially on the later developing teeth. Reduction of dental variance with age provides direct evidence of selection, but most evidence consists of demonstrations of adaptiveness. Dental adaptation is partly external, mainly to the food, and partly internal, resulting in the functional integration of teeth with each other, as in occlusal relations, and with the neuromuscular system responsible for jaw movements. Ontogeny is also adapted to produce a functional end-product. Most interspecific differences have not yet been explained in terms of function, and many of them may be due to drift.

Adaptation, Physiological↗