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Biomedical subjects

William H Replogle

Publications and source records attributed to William H Replogle.

7 recordsLinked to original sources
PubMed2004

Assessing the predictive value of the American Board of Family Practice In-training Examination.

BACKGROUND AND OBJECTIVES: The American Board of Family Practice In-training Examination (ABFP ITE) is a cognitive examination similar in content to the ABFP Certification Examination (CE). The ABFP ITE is widely used in family medicine residency programs. It was originally developed and intended to be used for assessment of groups of residents. Despite lack of empirical support, however, some residency programs are using ABFP ITE scores as individual resident performance indicators. This study's objective was to estimate the positive predictive value of the ABFP ITE for identifying residents at risk for poor performance on the ABFP CE or a subsequent ABFP ITE. METHODS: We used a normal distribution model for correlated test scores and Monte Carlo simulation to investigate the effect of test reliability (measurement errors) on the positive predictive value of the ABFP ITE. RESULTS: The positive predictive value of the composite score was .72. The positive predictive value of the eight specialty subscales ranged from .26 to .57. CONCLUSIONS: Only the composite score of the ABFP ITE has acceptable positive predictive value to be used as part of a comprehension resident evaluation system. The ABFP ITE specialty subscales do not have sufficient positive predictive value or reliability to warrant use as performance indicators.

Certification↗
PubMed2003

Personal breast-feeding behaviors of female physicians in Mississippi.

BACKGROUND: In this study, we examined the personal breast-feeding behaviors of female physicians in Mississippi. METHOD: Two hundred fifteen of 350 female physicians responded to a survey inquiring of their personal breast-feeding behaviors. RESULTS: One hundred fifty-five mothers (74%) reported having biologic children, and 146 (94.2%) breast-fed at least 1 child. Approximately 21% of the responding mothers breast-fed their first-born children for at least 6 months. There was a positive relationship between the duration of breast-feeding of older children and the breast-feeding duration for younger children. The major reasons for weaning were return to work, diminishing milk supply, and lack of time to pump breast milk. CONCLUSION: The breast-feeding initiation rates among female physicians surpassed those of women in the general population, yet duration rates were comparable. Their own breast-feeding success might enhance the potential of female physicians as advocates and sources of credible information regarding breast-feeding; however, physicians need to be better educated regarding the management of breast-feeding.

Adult↗
PubMed2003

Breastfeeding education, treatment, and referrals by female physicians.

The female membership of the Mississippi State Medical Association and female physician employees of the Mississippi State Department of Health were surveyed (N = 350) to examine their practice-related decisions relative to breastfeeding; 215 (61%) responded to the survey. Discussion was commonly used for educating patients, with face-to-face demonstrations used by less than half of respondents. Female physicians with breastfeeding experience were more comfortable than others in treating sore nipples, plugged ducts, infected nipples, and inadequate infant weight gain. There was no difference in the proportion of physicians with and without breastfeeding experience who treated mastitis, low milk supply, and poor latch. The largest percentages of referrals to other providers were in response to infants' poor weight gain and poor latch; the fewest were for nipple infections. Seventy percent of the respondents were not taught lactation management in medical school or residency. Better education for physicians regarding lactation management is needed.

Adult↗
PubMed2003

Prenatal smoking and birth outcomes among Mississippi residents.

In this study we examined trends within Mississippi in prenatal smoking and in the effects of such smoking on birthweight, preterm delivery, and infant mortality. The study was a retrospective cohort analysis of 120,429 singleton births in 1995-1997. We found that even though prenatal smoking is decreasing overall, it is increasing among young pregnant women aged 15-19 years. The primary effect of prenatal smoking was to lower birthweight; correspondingly, the principal effect of smoking on infant death appeared to be this decreasing of birthweight. In addition, infants of mothers who smoked during pregnancy were two and one-half times as likely to die from SIDS as were infants whose mothers did not smoke. These data demonstrate the importance of strategies such as training in smoking cessation for providers of prenatal care in Mississippi and provide a foundation for future evaluations of current aggressive anti-tobacco campaigns in the state.

Female↗
PubMed2003

The employment-related breastfeeding decisions of physician mothers.

One hundred and forty-six physician mothers responded to a survey of their personal decisions regarding employment and breastfeeding. The mean duration of breastfeeding was 18.8 weeks with a range of 1 week to 128 weeks. The three major factors contributed to the physician mother' decisions to completely wean their children were return to work (45%), diminishing milk supply (31%), and lack of time to pump (18%). Return to part-time work was positively associated with greater duration of maternity leave and breastfeeding. The relationship between breastfeeding and weeks of maternity leave was positive for first- and second-born children. It was not significant for subsequent children. Upon returning to work, space and time for milk expression were obstacles for the majority of the physician mothers. Without time, space, and workplace support, mothers who attempt to combine full time employment and breastfeeding are likely to delay or skip milk expression. This may cause them to experience breastfeeding problems, resulting in premature weaning. Flexible employment arrangements may increase duration among physician mothers and provide an atmosphere of greater acceptance. Protected time and a space for milk expression could contribute to greater frequency of pumping and fewer problems associated with incomplete emptying of the breast.

Adult↗