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Biomedical subjects

P W Robie

Publications and source records attributed to P W Robie.

9 recordsLinked to original sources
PubMed1992

Residents' use of humanistic skills and content of resident discussions in a support group.

In a 1983 position paper, the American Board of Internal Medicine stressed the importance of teaching humanistic skills to residents; however, how to teach or measure these skills is not well defined. In this study, the content of discussion (personal and professional problems) and processing of four humanistic skills (empathy, level of regard, unconditionality, and congruence) by Bowman Gray School of Medicine first year general medicine residents was observed. Fourteen videotapes of support group meetings from 1986 to 1988 were reviewed for humanistic relationship behaviors using the Barrett-Lennard Relationship Inventory and for the types of personal and professional problems discussed using a content inventory. Barrett-Lennard Relationship Inventory scores for empathy and regard paralleled increases in the number of professional problems raised at midyear, a time of maximum stress for residents. Congruence scores became flat after an initial peak while unconditionality scores remained low. Interventions designed to improve residents' use of humanistic skills could take into account residents' need for support and education, as well as the natural flow of humanistic behaviors within residency programs.

Attitude of Health Personnel↗
PubMed1989

Cancer screening in the elderly.

Cancer screening in the elderly presents several unique challenges. There are no prospective trials of any cancer screening exam that have conclusively demonstrated efficacy in this age group. Any assessment of cancer screening in the elderly must include measuring an improvement in quality of life and functional status as well as decreased mortality from early cancer detection. Older patients usually prefer improved quality over quantity of life; they may be less interested in a trade-off of months or years of life in exchange for the side effects of cancer treatment. The elderly may need more home assistance during the treatment of the detected cancers; physicians should arrange for this. All of these variables must be included in studies of cancer screening in the elderly; the need for these studies is great. The following recommendations are probably the most reasonable in view of the currently inadequate knowledge base. Screening for breast cancer has demonstrated efficacy, with growing evidence for a cumulative effect from monthly breast self-examination, yearly breast examination by a physician, and yearly or biennial mammography. There may be no need to screen for cervical cancer in women after age 65 who have had regular Pap smear screening; however, older women who have never had Pap smears should have regular Pap smears for several years. Finally, because of the high frequency of colorectal and prostate cancers in the elderly, physicians should probably perform yearly rectal examinations with stool guaiac and regular sigmoidoscopy in this age group until definitive data support continuing or discontinuing these screening examinations. Physicians should educate their elderly patients to the importance of regular cancer screening and cancer risk-factor modification and should offer cancer screening examinations and counseling to elderly patients on a regularly scheduled basis.

Aged↗
PubMed1988

Improving and sustaining outpatient cancer screening by medicine residents.

The sustained effectiveness in improving resident performance of breast, cervical, and colorectal cancer screening examinations in the medicine outpatient department (OPD) was studied. Residents were divided into two groups: an intervention group, which received lectures presenting cancer screening rationale and recommendations, followed by chart reminders for three months, and a control group with no intervention. Charts were reviewed for cancer screening performance before, and one and six months after the intervention. Results showed increased performance of Pap smears (50% vs 22%, P less than .04 at one month and 46% vs 23%, P less than .08 at six months) and rectal examinations (73% vs 58%, P less than 0.2 at six months) by the intervention group. There was no improvement in breast examination performance over baseline (39%). Other screening examinations were rarely done. Future outpatient practice will include preventive health care, and greater emphasis must be devoted to increasing and sustaining residents' cancer screening performance to improve these results.

Ambulatory Care Facilities↗
PubMed1975

The effects of methadone on maternal-fetal interactions in the rat.

Female Sprague-Dawley rats received methadone (25 mg/kg/day) by gavage throughout gestation. Water-gavaged rats served as controls. Fetuses were delivered by cesarean section when parturition was imminent. Our results indicate that methadone may interfere with fetal development and maternal-fetal interactions to some degree. The observed alterations were as follows: fetal growth retardation, an interference with the triggering of parturition once normal delivery size is attained and possible positional malformations.

Abnormalities, Drug-Induced↗
PubMedDate not supplied

The service and educational contributions of a general medicine consultation service.

General medicine consultation services (GMCS) are perceived as providing routine services in perioperative patient management for referring surgeons. Their potential contributions to improving patient care and resident education have not been well defined. Review of the first year of GMCS in a university teaching hospital showed that only 57% of the consultations were for routine perioperative management of surgical patients. The consultations presented a broad range of medical problems, especially cardiovascular disease (35% of all consultations). Consulting physicians made 2.2 new diagnoses per consult, and 16% of patients required transfer to other services. A GMCS may improve patient care by uncovering new diagnoses, and, by offering them exposure to a variety of medical problems, can improve the consultation skills of students and residents.

Diagnosis↗