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Biomedical subjects

Walter L Larimore

Publications and source records attributed to Walter L Larimore.

10 recordsLinked to original sources
PubMed2005

Physician offered prayer and patient satisfaction.

OBJECTIVE: While there is ongoing debate about the role of physician-offered prayer during the physician-patient encounter, many physicians feel inclined to include prayer in their practices. This randomized-controlled trial evaluated patients' acceptance of physician-offered prayer in a family practice setting, and the impact of physician-offered prayer on patient satisfaction with the physician-patient encounter. METHOD: Subjects were 137 patients in an urban, largely African American, Southeastern family medicine practice who were randomized to receive usual care plus an offer of physician-led prayer or usual care alone. Satisfaction surveys were administered following the clinical encounter. The outcomes of interest were the rate of acceptance of physician-offered prayer and the impact of the prayer offer on patient satisfaction. Personal characteristics and satisfaction scores for patients accepting prayer were compared to those for patients declining prayer. RESULTS: Over 90% of patients accepted the offer of prayer. The offer of prayer had no significant impact on patient satisfaction scores. The number of patients declining prayer was too low to permit comparison of prayer decliners with acceptors. CONCLUSIONS: This small pilot trial demonstrated that patient responses to spiritual interventions by physicians can be evaluated using randomized study designs. A large majority of patients accepted an offer of physician-led prayer, but no significant short-term impact on patient satisfaction was detected. Future research with larger sample sizes and more diverse patient populations should evaluate the effects of physician-offered prayer on the physician-patient relationship. Difficulties in conducting such research are discussed.

Adult↗
PubMed2003

Quality assessment programs for dietary supplements.

BACKGROUND: In the US, consumers and healthcare professionals have been forced to depend on self-regulation by the dietary supplement industry for product quality, consistency, potency, and purity, a system that has yielded mixed results at best. OBJECTIVE: To characterize the current state of product quality verification in the dietary supplement industry and review recent developments and future plans to improve supplement safety and regulation. METHODS: Studies describing the quality of dietary supplements are reviewed, along with recent Food and Drug Administration (FDA) plans to improve supplement regulation. Several independent dietary supplement quality certification programs are described and evaluated. RESULTS: Quality control standards for dietary supplements run the gamut from good to nonexistent. Contamination, false labeling, and incomplete labeling are not uncommon problems--as are significant discrepancies in disintegration, dissolution, and in vitro release characteristics of various dietary supplements. The need for improved regulation has led to plans for increased FDA involvement through enforcement of good manufacturing practices and truths in labeling. Meanwhile, independent product certification companies have emerged and provide some reassurances; however, they possess several limitations as well. CONCLUSIONS: Until proposed FDA initiatives are finalized and implemented, certification programs can help provide assurances of safety and assist in product selection. Although they do not testify to effectiveness (and may even inadvertently mislead some consumers), certification programs may help curb what has been called "the Wild West nature of the dietary supplement industry."

Animals↗
PubMed2002

Rowe and Kahn's model of successful aging revisited: positive spirituality--the forgotten factor.

PURPOSE: We explain a new concept, positive spirituality, and offer evidence that links positive spirituality with health; describe effective partnerships between health professionals and religious communities; and summarize the information as a basis for strengthening the existing successful aging model proposed by Rowe and Kahn. DESIGN AND METHODS: A missing component to Rowe and Kahn's three-factor model of successful aging is identified, and we propose strengthening the model with a fourth factor, positive spirituality. RESULTS: We developed an enhanced model of successful aging based on Rowe and Kahn's theoretical framework. Evidence presented suggests that the addition of spirituality to interventions focused on health promotion has been received positively by older adults. IMPLICATIONS: Leaders in gerontology often fail to incorporate the growing body of scientific evidence regarding health, aging, and spirituality into their conceptual models to promote successful aging. The proposed enhancement of Rowe and Kahn's model will help health professionals, religious organizations, and governmental agencies work collaboratively to promote wellness among older adults.

Aged↗
PubMed2002

Should clinicians incorporate positive spirituality into their practices? What does the evidence say?

Most of the rhetoric decrying the incorporation of basic and positive spiritual care into clinical practice is not based on reliable evidence. We briefly review the current evidence, which demonstrates that (a) there is frequently a positive association between positive spirituality and mental and physical health and well being, (b) most patients desire to be offered basic spiritual care by their clinicians, (c) most patients censure our professions for ignoring their spiritual needs, (d) most clinicians believe that spiritual interventions would help their patients but have little training in providing basic spiritual assessment or care, (e) professional associations and educational institutions are beginning to provide learners and clinicians information on how to incorporate spirituality and practice, and (j) anecdotal evidence indicates that clinicians having received such training find it immediately helpful and do apply it to their practice. We point out the reasons that much more research is needed, especially outcome-based, clinical research on the effects of these spiritual interventions by clinicians. We conclude that the evidence to date demonstrates trained or experienced clinicians should encourage positive spirituality with their patients and that there is no evidence that such therapy is, in general, harmful. Further, unless or until there is evidence of harm from a clinician's provision of either basic spiritual care or a spiritually sensitive practice, interested clinicians and systems should learn to assess their patients' spiritual health and to provide indicated and desired spiritual intervention. Clinicians and health care systems should not, without compelling data to the contrary, deprive their patients of the spiritual support and comfort on which their hope, health, and well-being may hinge.

Cross-Sectional Studies↗
PubMed2002

Postfertilization effect of hormonal emergency contraception.

OBJECTIVE: To assess the possibility of a postfertilization effect in regard to the most common types of hormonal emergency contraception (EC) used in the US and to explore the ethical impact of this possibility. DATA SOURCES AND STUDY SELECTION: A MEDLINE search (1966-November 2001) was done to identify all pertinent English-language journal articles. A review of reference sections of the major review articles was performed to identify additional articles. Search terms included emergency contraception, postcoital contraception, postfertilization effect, Yuzpe regimen, levonorgestrel, mechanism of action, Plan B. DATA SYNTHESIS: The 2 most common types of hormonal EC used in the US are the Yuzpe regimen (high-dose ethinyl estradiol with high-dose levonorgestrel) and Plan B (high-dose levonorgestrel alone). Although both methods sometimes stop ovulation, they may also act by reducing the probability of implantation, due to their adverse effect on the endometrium (a postfertilization effect). The available evidence for a postfertilization effect is moderately strong, whether hormonal EC is used in the preovulatory, ovulatory, or postovulatory phase of the menstrual cycle. CONCLUSIONS: Based on the present theoretical and empirical evidence, both the Yuzpe regimen and Plan B likely act at times by causing a postfertilization effect, regardless of when in the menstrual cycle they are used. These findings have potential implications in such areas as informed consent, emergency department protocols, and conscience clauses.

Contraceptive Agents, Female↗