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Biomedical subjects

R Lorimor

Publications and source records attributed to R Lorimor.

14 recordsLinked to original sources
PubMed2000

Vaginal infections in human immunodeficiency virus-infected women.

OBJECTIVE: This study was undertaken to compare the frequencies of vaginal infections among human immunodeficiency virus-infected women with those among human immunodeficiency virus-seronegative women. STUDY DESIGN: Human immunodeficiency virus-seropositive women attending a comprehensive care center for human immunodeficiency virus disease at the outpatient department of an inner-city hospital in Houston underwent rigorous gynecologic evaluation for sexually transmitted diseases, including evidence of vaginal infections such as bacterial vaginosis, vulvovaginal candidiasis, and trichomonal vaginitis. Demographic information was collected, as was information regarding disease classification and degree of immunosuppression. Data regarding sexually transmitted diseases, data regarding vaginal infections, and demographic information were collected from a cohort of human immunodeficiency virus-seronegative women attending a sexually transmitted disease and family planning clinic at the same institution. The two groups were compared to determine whether there were any differences between them in the frequencies of sexually transmitted diseases and vaginal infection. Data analysis used the t test for parametric data and the Fisher exact test for nonparametric data where appropriate. P <.05 was considered significant. Statistical analysis was performed with the SAS (SAS Institute, Inc, Cary, NC) statistical software package. RESULTS: There was no difference in age between the 2 groups. The human immunodeficiency virus-infected group was predominantly African American (80.5%), whereas the human immunodeficiency virus-seronegative control group was more evenly divided between African American women (45.8%) and Latinos (41.7%; P <.0001). Although there was no significant association between HIV infection and sexually transmitted diseases in general, there were significant associations between human immunodeficiency virus infection and bacterial vaginosis (P =.02), vulvovaginal candidiasis (P =.001), and trichomonal vaginitis (P =. 003). CONCLUSION: Human immunodeficiency virus-infected women had increased frequencies of vaginal infections, including bacterial vaginosis, vulvovaginal candidiasis, and trichomonal vaginitis, with respect to human immunodeficiency virus-seronegative control subjects. No differences between the 2 groups were seen in the frequencies of sexually transmitted diseases.

Adult↗
PubMed1998

Caring for terminally ill persons: comparative analysis of attitudes (thanatophobia) of practicing physicians, student nurses, and medical students.

To investigate why some caregivers desire to avoid patients with terminal illnesses, a thanatophobia scale assessing caregivers' uncomfortable feelings and sense of helplessness was developed and evaluated among practicing physicians and student nurses and medical students. As a group, student nurses scored lower on the thanatophobia scale than practicing physicians and medical students. Higher scores on intolerance to clinical uncertainty were associated with higher thanatophobia scores in all groups. Scores for depressed mood, decreased sensitivity, and Machiavellianism were statistically significant predictors in some groups. Higher thanatophobia scores also predicted lower scores for ratings of self-esteem in caring for elderly patients. Among senior medical students, those with lower thanatophobia scores tended to enter primary care residencies. Health professional educators may find this scale helpful both in pinpointing sources of caregivers' angst and useful in counseling students in management of terminally ill persons.

Adult↗
PubMed1995

Is obstetrics-gynecology a primary care specialty?

Suddenly everyone wants more primary care physicians. For several years, we collected data from senior medical students to relate their attitudes and beliefs about several clinical problems common to primary care to their choices of residencies. Because the Texas Medical Association's Special Committee on Primary Care included obstetrics-gynecology as a primary care specialty, we reviewed our data to see if the personal traits and professional role characteristics of seniors choosing obstetrics-gynecology differed materially from those of seniors choosing family medicine, internal medicine, or pediatrics. Results of this analysis put obstetrics-gynecology about as firmly in the primary care group as if the experimental design had planned it that way.

Family Practice↗
PubMed1994

Uncertainties and ambiguities: measuring how medical students cope.

To develop psychometric measures specific to the ambiguities encountered in medicine and determine their value in predicting medical students' attitudes towards patients and their choice of residency, we administered to senior and first-year medical students a 25-item Likert-type questionnaire to assess their intolerance of ambiguity (ITA). Factor analysis yielded two dimensions that were converted to scales: 'Aversion to uncertainties in clinical medicine' (ITA1) and 'Preference for highly structured training environs' (ITA2). First-year students scored higher on ITA1 and lower on ITA2 than seniors. An excessive reliance on high-technology medicine, a negative orientation toward psychological problems, and Machiavellianism predicted ITA1. ITA1 was the best predictor of senior medical students' negative attributional style toward hypochondriac, geriatric and chronic pain patients. The following rank order of seniors' career choice was predicted by ITA1 scores: internal medicine, psychiatry and family medicine (lowest); radiology, surgery and anaesthesiology (highest). And by ITA2 scores: surgery, obstetrics and gynaecology, and surgical subspecialties (lowest); radiology, psychiatry and anaesthesiology (highest). We concluded that personality traits and role characteristics which predict 'Aversion to uncertainties in clinical medicine' are maladaptive to managing many primary care patients, and this mismatch is reflected in seniors' residency choice.

Adaptation, Psychological↗
PubMed1984

Estimates of the demand for health: males in the pre-retirement years.

The demand for health is estimated for black and white males in the pre-retirement years using data from the first wave of 1966 National Longitudinal Survey of men aged 45-59. This survey includes direct measures of the wage rate and family assets. Findings for whites generally corroborate Grossman's initial estimates of the demand for health. In contrast to whites, blacks show a much stronger wage effect and a significant positive effect of wife's education, with no other factors being significant. The issue of reverse causality between the wage and health is addressed via a simultaneous equations health-wage model. Contrary to expected, but consistent with previous findings, the structural model yielded an even larger wage effect.

Black or African American↗
PubMed1980

A multi-tiered screening system for the least restrictive setting.

The authors evaluated the placement process in a large psychiatric facility with both inpatient and outpatient services. They examined 71 inpatient and 90 outpatient new admissions using standardized tests of psychopathology and sociodemographic status. After correcting for response bias, the authors found, in contrast to other studies, that the level of morbidity in the inpatient service was significantly different from that in the outpatient unit. The measures of sociodemographic data indicate that inpatients were more dependent on social support systems and that this finding was not influenced by response bias.

Commitment of Persons with Psychiatric Disorders↗
PubMed1979

The effects of response bias on sex differences in a psychiatric population.

A sample of 58 male and 84 female new admissions to a psychiatric facility was interviewed to identify sex differences in personal and social functioning. Female subjects were found to score significantly higher on intrapsychic distress scales while male subjects scored higher on scales measuring antisocial behavior. Using analysis of covariance, keeping the L- or Lie scale of the MMPI constant, all measures which had previously shown significant sex differences now became nonsignificant. This finding suggests that reported sex differences may be accounted for by response bias.

Adult↗
PubMed1978

Stress levels of ambulance paramedics and fire fighters.

Responses to Rahe and job stress questionnaires and urinary concentrations of cortisols and catecholamines served to indicate work related stress in 56 fire fighters and 67 paramedics. Although the average Rahe test scores, indicative of stress arising from life events, were comparable, those of the job stress test were statistically significantly higher for the paramedics. The paramedics felt their jobs more exhausting, less satisfying and requiring too much responsibility. For the paramedics, statistically significant higher levels of epinephrine and elevated levels of norepinephrine were found for the work as compared to the off day. For fire fighters, higher levels of cortisol and norepinephrine evident on the off day rather than the work day apparently reflect the relatively light work load experienced during the span of urine collections.

Adult↗
PubMedDate not supplied

Initiation of prenatal care by low-income Hispanic women in Houston.

OBJECTIVE: To understand why many Hispanic women begin prenatal care in the later stages of pregnancy. METHODS: The authors compared the demographic profile, insurance status, and health beliefs--including the perceived benefits of and barriers to initiating prenatal care--of low-income Hispanic women who initiated prenatal care at different times during pregnancy or received no prenatal care. RESULTS: A perception of many barriers to care was associated with later initiation of care and non-use of care. Perceiving more benefits of care for the baby was associated with earlier initiation of care, as was having an eligibility card for hospital district services. Several barriers to care were mentioned by women on open-ended questioning, including long waiting times, embarrassment the physical examination, and lack of transportation. CONCLUSIONS: Recommendations for practice included decreasing the number of visits for women at low risk for poor pregnancy outcomes while increasing the time spent with the provider at each visit, decreasing the number of vaginal examinations for low risk women, increasing the use of midwives, training lay workers to do risk assessment, emphasizing specific messages about benefits to the baby, and increasing general health motivation to seek preventive care through community interventions.

Adolescent↗