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Biomedical subjects

Patricia K Kokotailo

Publications and source records attributed to Patricia K Kokotailo.

7 recordsLinked to original sources
PubMed2006

Caring for the underserved: blending service learning and a web-based curriculum.

BACKGROUND: Recognition of health disparities among underserved individuals, whose demographic, geographic, or economic characteristics impede access to health-related services, has led to calls for the development of medical school curricula that address care for the underserved, but reports of the development and evaluation of such curricula are limited. METHODS: Two formats of a curriculum addressing care for the underserved were developed and implemented during the 6-week pediatric clerkship for third-year medical students during the 2003-2004 academic year. One format was faculty-led; the other was web-based. Skills for providing care to underserved families were taught through didactic, experiential, and service-learning curriculum components. Novel core curriculum elements included a screening tool for recognizing underserved patients and an independent clinical project through which students linked underserved families with community health resources. Analyses from 2004-2005 compared pre- and post-curriculum knowledge and attitudes of web-based students (n = 29) to those receiving either the faculty-led (n = 36) or the established "readings-only" curriculum (n = 35). Qualitative data from service learning projects were analyzed to assess clinical skills. RESULTS: Compared to students in the established curriculum, both web-based and faculty-led students demonstrated improved knowledge (p < 0.001) and attitudes (p < 0.05) about caring for the underserved. Both web-based and faculty-led students were successful in recognizing and addressing underserved health issues in the clinical setting. CONCLUSIONS: Faculty-led and web-based curricula can equally improve student knowledge, attitudes, and skills about caring for the underserved.

Adult↗
PubMed2006

Abuse of proprietary (over-the-counter) drugs.

A predominantly overlooked type of substance abuse by adolescents and young adults in the United States and around the world is the abuse of medications and other products sold without a prescription, or over-the-counter (OTC), to the public. OTC substance abuse causes significant morbidity and mortality, and there are concerns that some types of OTC substance abuse are increasing. Regular office screening for inhalant abuse and other substance abuse and health risk behaviors must be part of standard pediatric care. This article discusses what is known about the extent and clinical impact of OTC substance abuse and reviews key points about recognition, detection, and management.

Humans↗
PubMed2004

Validity of the alcohol use disorders identification test in college students.

BACKGROUND: High-risk alcohol use among college students is associated with accidents, partner violence, unwanted sexual encounters, tobacco use, and performance issues. The identification and treatment of high-risk drinking students is a priority for many college campuses and college health centers. The goal of this study was to test the psychometric properties of the Alcohol Use Disorders Identification Test (AUDIT) in college students. METHODS: A convenience sample of students coming into a college health clinic was asked to complete the 10-question AUDIT and then participate in a research interview. The interview focused on assessing students for alcohol abuse and dependence by using the Composite International Diagnostic Interview Substance Abuse Module and timeline follow-back procedures to assess a 28-day drinking history. RESULTS: A total of 302 students met the eligibility criteria and agreed to participate in the study. The sample consisted of 185 females (61%) and 117 males (39%), with a mean age of 20.3 years. Forty students were abstinent, 88 were high-risk drinkers, and 103 met criteria for a 12-month history of dependence. Receiver operator curves demonstrated that the AUDIT had the highest area under the cure for detecting high-risk alcohol use (0.872) and the lowest for identifying persons with a lifetime history of alcohol abuse or dependence (0.775). An AUDIT cutoff score of 6 or greater demonstrated a sensitivity of 91.0% and a specificity of 60.0% in the detection of high-risk drinkers. CONCLUSIONS: The AUDIT has reasonable psychometric properties in sample of college students using student health services. This study supports the use of the AUDIT in this population.

Adolescent↗
PubMed2004

UME-21 and teaching ethics: a step in the right direction.

BACKGROUND AND OBJECTIVES: Ethics education for medical students has included a number of relatively vague descriptions of appropriate curricular objectives, but medical schools struggle with the general teaching of ethics, as well as with presenting the ethical dilemmas posed by managed care. This paper proposes some standards and uses them to analyze the general and managed care ethics content of the Undergraduate Medical Education for the 21st Century (UME-21) curricula. METHODS: We analyzed progress and final reports from each school to define their learning objectives, content, teaching methods, and evaluation strategies in ethics. Each was evaluated using principles of adult learning and Rest's Four Component Model of Moral Development. Good examples of curricular elements from participating schools are described. RESULTS: Ethics curricula varied widely among the schools. Goals and objectives were often stated in generalities. Teaching methods were diverse and innovative, and several new combinations of learning activities were created to highlight ethics topics. Content represented managed care and non-managed care topics in varying proportions. Student surveys of attitudes toward managed care and opinions of the ethics programs were the most commonly used as evaluation tools. Some schools were able to develop more direct means of evaluating student learning. The Four Component Model was not fully addressed in the programs developed by the participating schools. CONCLUSIONS: We make recommendations about the objectives, teaching methods, content, and evaluation methods of an ideal medical school curriculum in ethics.

Adult↗
PubMed2002

Male adolescent use of health care services: where are the boys?

PURPOSE: To describe patterns of health care use by adolescent males in the United States and clinical practice characteristics associated with their use of adolescent-specific programs. METHODS: Secondary analysis of three national data sets to determine health care use by male adolescents: the National Ambulatory Medical Care Survey [NAMCS (1994): pediatric, family physician, internal medicine, and obstetric/gynecologic outpatient visits]; National Hospital Ambulatory Medical Care Survey [NHAMCS (1994): outpatient department (OPD) and emergency department (ED) visits]; and Comprehensive Adolescent Health Services Survey [CAHSS (1995)]. Both NAMCS and NHAMCS are representative national probability samples. Total visit estimates by adolescents in 1994 to NAMCS sites were 387,076,630, to OPD sites were 6,511,244, and to ED sites were 13,161,824. For CAHSS, 468 programs (60% of eligible) participated. Data analyses were performed using two-tailed Student's t-tests and correlation testing. RESULTS: Older male adolescents, aged 16-20 years, account for a lower percentage of total visits to NAMCS sites combined compared to younger males, aged 11-15 years (15.8% vs. 25.1%, p <.001), mainly owing to a significant decline in visits to pediatricians (3.2% vs. 14.9%, p <.001), despite significant increases in female health care use during the same time period. Younger males were seen at similar rates compared to females at NAMCS, NHAMCS-OPD and NHAMCS-ED sites, but older males account for a significantly lower percentage of total visits than females to all NAMCS sites combined (15.8% vs. 34.7%, p <.001), the NHAMCS-ED (26.4% vs. 31.5%, p <.05), and the NHAMCS-OPD (15.0% vs. 41.2%, p =.001). Among specialized adolescent sites (CAHSS), 13-19-year-old males account for fewer visits than females to all programs types: schools (40% vs. 60%), hospitals (33% vs. 67%), and community/health departments (25% vs. 75%) (all p's < or =.001). Clinical practice characteristics correlated with having a greater proportion of male adolescent visit varied depending on the types of adolescent program examined. CONCLUSIONS: Younger male adolescents make health care visits in relatively equal proportions to females at all NAMCS and NHAMCS locations and visits by older males are significantly reduced. Male adolescent visits are lower than females at all adolescent-specific programs; school-based clinics see the highest proportion of males. Greater understanding of male adolescents' transition between providers from adolescence to adulthood is needed to improve care to male adolescents who under-use health services.

Adolescent↗