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Physical Medicine

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139181. Item response theory analyses of physical functioning items in the medical outcomes study. (Abstract)

Item response theory analyses of physical functioning items in the medical outcomes study. Constructing and evaluating item pools that measure a single domain of health-related quality of life (HRQOL) is one of the fundamental objectives of the Patient Reported Outcome Measurement and Information System (PROMIS) project. The initial focus of PROMIS is on 5 HRQOL domains: physical function, fatigue, pain, emotional distress, and social/role participation. Analysis of related, available data can (...) inform construction of these new banks.We sought to inform the building of the PROMIS physical function item bank by evaluating physical functioning items administered to participants in the Medical Outcomes Study.Secondary analyses of physical functioning items administered at baseline (Fall, 1986) to 3223 individuals in the Medical Outcomes Study.The mean age of participants was 54 years old; 15% had less than a high school education, 30% had a high school education, 27% had some but <4 years

2007 Medical Care

139182. Self-confidence in and perceived utility of the physical examination: a comparison of medical students, residents, and faculty internists. Full Text available with Trip Pro

Self-confidence in and perceived utility of the physical examination: a comparison of medical students, residents, and faculty internists. Little is known about the differences in attitudes of medical students, Internal Medicine residents, and faculty Internists toward the physical examination. We sought to investigate these groups' self-confidence in and perceived utility of physical examination skills.Cross-sectional survey of third- and fourth-year medical students, Internal Medicine (...) residents, and faculty Internists at an academic teaching hospital.Using a 5-point Likert-type scale, respondents indicated their self-confidence in overall physical examination skill, as well as their ability to perform 14 individual skills, and how useful they felt the overall physical examination, and each skill, to be for yielding clinically important information.The response rate was 80% (302/376). The skills with overall mean self-confidence ratings less than "neutral" were interpreting

2007 Journal of General Internal Medicine

139183. The somatising effect of clinical consultation: what patients and doctors say and do not say when patients present medically unexplained physical symptoms. (Abstract)

The somatising effect of clinical consultation: what patients and doctors say and do not say when patients present medically unexplained physical symptoms. Patients with symptoms that doctors cannot explain by physical disease are common in primary care. That they receive disproportionate amounts of physical intervention, which is largely ineffective and sometimes iatrogenic, is usually attributed to patients' belief that they are physically diseased, their denial of psychological difficulties (...) by British GPs as presenting medically unexplained symptoms (MUS) were audio-recorded, transcribed and coded, utterance-by-utterance, using a specially developed coding scheme based on the previous qualitative analyses of these kinds of consultation. Physical intervention was, as predicted, proposed more often by GPs than patients. Also as predicted, almost all patients provided cues concerning psychosocial difficulties or their need for explanation. Although, contrary to prediction, most GPs did provide

2005 Social Science & Medicine

139184. Multiple medically unexplained physical symptoms and health care utilization: outcome of psychological intervention and patient-related predictors of change. (Abstract)

Multiple medically unexplained physical symptoms and health care utilization: outcome of psychological intervention and patient-related predictors of change. To test the effect of psychological intervention on multiple medically unexplained physical symptoms, psychological symptoms, and health care utilization in addition to medical care as usual. To identify patient-related predictors of change in symptoms and care utilization.In a randomized controlled trial, subjects were assigned to one (...) of two conditions: psychological intervention by a qualified therapist plus care as usual by a general practitioner (GP) or care as usual only. Participants (N=98) were administered a standardized interview and several outcome measures at intake and after 6 months and 12 months after intake. GPs rated medically unexplained and explained symptoms and consultations over a period of 1 1/2 years.ANOVAs for repeated measures showed that self-reported and GP-registered unexplained physical symptoms

2004 Journal of psychosomatic research Controlled trial quality: uncertain

139185. Comparing the effects of physical practice and mental imagery rehearsal on learning basic surgical skills by medical students. (Abstract)

Comparing the effects of physical practice and mental imagery rehearsal on learning basic surgical skills by medical students. The purpose of this study was to test the effects of varying the amount of physical practice and mental imagery rehearsal on learning basic surgical procedures.Using a sample of 65 second-year medical students, 3 randomized groups received either: (1) 3 sessions of physical practice on suturing a pig's foot; (2) 2 sessions of physical practice and 1 session of mental (...) imagery rehearsal; or (3) 1 session of physical practice and 2 sessions of imagery rehearsal. All participants then performed a surgery on a live rabbit in the operating theater of a veterinary college under approved conditions. Analysis of variance was applied to pre- and post-treatment ratings of surgical performance.Physical practice followed by mental imagery rehearsal was statistically equal to additional physical practice.Initial physical practice followed by mental imagery rehearsal may

2004 American journal of obstetrics and gynecology Controlled trial quality: uncertain

139186. An after-school physical activity program for obesity prevention in children: the Medical College of Georgia FitKid Project. (Abstract)

An after-school physical activity program for obesity prevention in children: the Medical College of Georgia FitKid Project. This article describes the process of setting up a 3-year, school-based after-school physical activity intervention in elementary schools. The primary aim of the study is to determine whether adiposity and fitness will improve in children who are exposed to a fitogenic versus an obesogenic environment. Eighteen schools were randomized to the control (obesogenic (...) ) or intervention (fitogenic) group. The study design, program components, and evaluation of the intervention are described in detail. The intervention consists of (a) academic enrichment, (b) a healthy snack, and (c) physical activity in a mastery-oriented environment. Successful implementation would show the feasibility of schools' being able to provide a fitogenic environment. Significant differences between the groups would provide evidence that a fitogenic environment after school has positive health

2005 Evaluation & the health professions Controlled trial quality: uncertain

139187. Integrating physical examination and trunk anatomy; a new course for second year medical students. (Abstract)

Integrating physical examination and trunk anatomy; a new course for second year medical students. The aim of this study was to determine the effect of an integrated course of physical examination and trunk anatomy on second year medical students' attitude and knowledge of anatomy. Thirty nine second year medical students attended a physical examination course (5 small group sessions) related to topics in trunk anatomy (2004/05). Students in control group attended routine anatomy lectures (...) and problem based learning discussions relevant to their physiology course. Routine final anatomy exam (65 multiple choices questions) was performed. Attitude toward course impacts in intervention group were assessed by a likert questionnaire (18 items). A T-test was performed to compare anatomy scores. The Intervention group had higher score exam anatomy (46.6 +/- 6.3) than others (41.4 +/- 6.0, p = 0.04). The mean score of attitude questionnaire was 3.48 (SD = 0.8). In conclusion teaching physical

2007 Medical teacher Controlled trial quality: uncertain

139188. Preliminary findings of the effect of a 3-year after-school physical activity intervention on fitness and body fat: the Medical College of Georgia Fitkid Project. (Abstract)

Preliminary findings of the effect of a 3-year after-school physical activity intervention on fitness and body fat: the Medical College of Georgia Fitkid Project. To evaluate the effect of a 3-year after-school physical activity (PA) intervention on aerobic fitness and percent body fat (%BF).In total, 18 schools were randomized into intervention or control arms. Measurements were made at the beginning and end of the third, fourth and fifth grades. Fitness was measured with heart rate response

2008 International journal of pediatric obesity : IJPO : an official journal of the International Association for the Study of Obesity Controlled trial quality: uncertain

139189. Fatal Abusive Head Trauma Cases: Consequence of Medical Staff Missing Milder Forms of Physical Abuse. Full Text available with Trip Pro

Fatal Abusive Head Trauma Cases: Consequence of Medical Staff Missing Milder Forms of Physical Abuse. Missed diagnosis of child abuse may lead to chronic abuse with potential for death. This paper reports 3 such cases.This is a retrospective chart review of 38 cases diagnosed as abusive head trauma between January 1, 2004 and December 31, 2006 at a university hospital. We sought to identify fatal cases with a past medical history of physical abuse that was missed by the medical staff.Three (...) cases (7.9%) had a past medical history of physical abuse that was missed by the medical staff. Infants were 2 males and 1 female. Their ages were 2.5, 3.5, and 6 months, respectively. Missed abuse episodes involved rib fractures, a metaphyseal tibial fracture, and a shaking episode, respectively. The intervals that had elapsed between the missed and the fatal abuse episodes were 24 hours, 12 days, and 6 weeks, respectively. Perpetrators of fatal head trauma were all biological fathers. One plead

2008 Pediatric Emergency Care

139190. The other children: a survey of child abuse physicians on the medical evaluation of children living with a physically abused child. Full Text available with Trip Pro

The other children: a survey of child abuse physicians on the medical evaluation of children living with a physically abused child. To explore the practice and attitudes of child abuse physicians regarding the evaluation of "contact children" identified in the home of a physically abused index child.A self-administered survey.E-mail and postal mailings from May 10 through September 30, 2005.Physicians in the United States recognized as experts in child abuse medicine based on membership (...) in the Helfer Society.Descriptive measures of recommended medical evaluations of contact children in 3 clinical settings, estimates of association between these recommendations, and respondent experiences.There was a 61% (93/153) response rate. Respondents uniformly endorsed medical evaluation for contact children, although there was substantial variability in the extent of evaluation recommended. Recommended diagnostic testing varied by age of contact child and by type of abuse in the index child

2006 Archives of Pediatrics & Adolescent Medicine

139191. Physical and chemical properties of chlorhexidine and calcium hydroxide-containing medications. (Abstract)

Physical and chemical properties of chlorhexidine and calcium hydroxide-containing medications. This study was performed to evaluate the physicochemical properties (pH, contact angle, working time, radio-opacity, and viscosity) of chlorhexidine (CHX) and calcium hydroxide-containing medications in gel form in different concentrations. The pH value was assessed with a pH meter. The contact angle was measured with a goniometer. The radio-opacity and working time measurements were taken (...) in accordance with the standards of the International Organization for Standardization. The viscosity was evaluated using a Brookfield RVDV viscometer. The results showed that CHX did not affect the pH, radio-opacity, and working time of the calcium hydroxide-containing medications (p < 0.05). However, adding CHX lowered the contact angle and increased the viscosity of calcium hydroxide significantly. This research showed that CHX in different concentrations and in combination with calcium hydroxide has

2004 Journal of Endodontics

139192. Cardiovascular medication, physical activity and mortality: cross-sectional population study with ongoing mortality follow up. Full Text available with Trip Pro

samples of adults aged >or=35 living in households, respondents of the Scottish Health Survey and the Health Survey for England.Moderate to vigorous physical activity (MVPA) levels and CVD mortality.15% (n = 3116) of the 20 177 respondents (8791 men) were prescribed at least one cardiovascular drug. Medicated respondents were less likely than those unmedicated to meet the physical activity recommendations (OR = 0.89, 95% CI 0.81 to 0.99, p = 0.028). The mean (SD) follow-up was 6.6 (2.3) years (...) Cardiovascular medication, physical activity and mortality: cross-sectional population study with ongoing mortality follow up. To establish physical activity levels in relation to cardiovascular medication and to examine if physical activity is associated with benefit independently of medication among people with no diagnosis of cardiovascular disease (CVD).Cross-sectional surveys in 1998 and 2003 with continuing mortality follow-up.Household-based interviews in England and Scotland.Population

2008 Heart

139193. Monitoring the physical health of cancer survivors: a survivorship-focused medical history. (Abstract)

Monitoring the physical health of cancer survivors: a survivorship-focused medical history. Cancer survivors frequently visit their primary-care physicians, as well as oncology specialists, for follow-up care. There is a need to monitor these survivors for the late physical effects of cancer, yet few health care providers have received training in how to do this. This article provides guidance on how to take a cancer survivor-directed medical history to facilitate the elicitation of relevant (...) exposures, family history, and symptoms that may be related to the late effects of cancer therapy.

2006 Journal of Clinical Oncology

139194. Physical activity energy expenditure predicts progression toward the metabolic syndrome independently of aerobic fitness in middle-aged healthy Caucasians: the Medical Research Council Ely Study. (Abstract)

Physical activity energy expenditure predicts progression toward the metabolic syndrome independently of aerobic fitness in middle-aged healthy Caucasians: the Medical Research Council Ely Study. To examine over a period of 5.6 years the prospective associations between physical activity energy expenditure (PAEE), aerobic fitness (Vo(2max)), obesity, and the progression toward the metabolic syndrome in a population-based cohort of middle-aged men and women (n = 605) who were free (...) component from the metabolic syndrome (standardized beta = -0.0011, P = 0.035). Vo(2max) was not an independent predictor of the metabolic syndrome after adjusting for physical activity (standardized beta = 0.00011, P = 0.93).PAEE predicts progression toward the metabolic syndrome independent of aerobic fitness, obesity, and other confounding factors. This finding underscores the importance of physical activity for metabolic disease prevention even when an improvement in aerobic fitness is absent.

2005 Diabetes Care

139195. Left ventricular apical ballooning due to severe physical stress in patients admitted to the medical ICU. (Abstract)

Left ventricular apical ballooning due to severe physical stress in patients admitted to the medical ICU. We sought to assess the frequency and clinical implications of left ventricular apical ballooning (LVAB) in patients who had been admitted to the medical ICU for noncardiac physical illnesses.Ninety-two consecutive patients who were admitted to the medical ICU from March to May 2003 were prospectively enrolled. Patients underwent echocardiography on the day of ICU admission (...) kinase level was elevated in 12 of 26 patients (46%) with LVAB. The normalization of this condition occurred in 20 of 26 patients (77%) a mean duration of 7.4 +/- 5.6 days later (range, 2 to 25 days). The mean 2-month survival rate was lower in patients with LVAB than in those without (71 +/- 6% vs 52 +/- 10%, respectively; p = 0.047).LVAB develops in a considerable number of patients who are admitted to the medical ICU, and echocardiography is useful in detecting this phenomenon.

2005 Chest

139196. Campaign to revitalise academic medicine: Is the bubble due to burst for medical research funding? Full Text available with Trip Pro

Campaign to revitalise academic medicine: Is the bubble due to burst for medical research funding? 15284175 2004 09 10 2018 11 13 1756-1833 329 7460 2004 Jul 31 BMJ (Clinical research ed.) BMJ Campaign to revitalise academic medicine: is the bubble due to burst for medical research funding? 294 Charlton Bruce G BG Andras Peter P eng Comment Letter England BMJ 8900488 0959-8138 AIM IM BMJ. 2004 Jun 19;328(7454):1454 15205276 Biomedical Research standards trends Physics trends 2004 7 31 5 0 2004

2004 BMJ : British Medical Journal

139197. Use of prescription medications and complementary and alternative medicines to treat depressive and anxiety symptoms: results from a community sample. (Abstract)

Use of prescription medications and complementary and alternative medicines to treat depressive and anxiety symptoms: results from a community sample. Individuals prescribed antidepressants or anxiolytics may replace or augment such medications with complementary and alternative medicines (CAMs). Little is known about the extent to which individuals in the community use CAMs instead of, or in addition to, medications they have been prescribed, for anxiety and depressive symptoms.Information (...) on use of CAMs, antidepressants and anxiolytics was obtained from a community sample of 7485 survey participants from Canberra and environs, Australia. Participants aged 20-24, 40-44, or 60-64 were also provided information on sociodemographic attributes, physical and mental health.6.29% of participants used only prescription medications to treat their depression or anxiety. 2.28% used only CAMs for this purpose while a further 0.59% reported using both types of treatments. Those using CAMs and those

2004 Journal of Affective Disorders

139198. Medical Malpractice and the Sports Medicine Clinician. Full Text available with Trip Pro

Medical Malpractice and the Sports Medicine Clinician. More individuals are participating in athletics today than ever before. Physicians treating athletes confront unique diagnostic and treatment challenges and an increased risk of legal liability. The key areas regarding liability are preparticipation examinations, determination of eligibility, evaluation of significant on-field injuries, and information disclosure. The issues surrounding preparticipation physicals and determination (...) or their parents. All athletic programs should develop a plan that details roles and procedures to be followed in a medical emergency. Sports caregivers must take affirmative steps that better protect their patients from harm and physicians from legal liability.

2008 Clinical Orthopaedics and Related Research

139199. Design and implementation of a system-based course in musculoskeletal medicine for medical students. Full Text available with Trip Pro

Design and implementation of a system-based course in musculoskeletal medicine for medical students. The amount of time devoted to musculoskeletal medicine in the typical undergraduate curriculum is disproportionately low compared with the frequency of musculoskeletal complaints that occur in a general practice. Consequently, whether because of the quantity or quality of the education, the competence level of graduating physicians regarding musculoskeletal problems is inadequate. Our purposes (...) were to design a self-contained, system-based course in musculoskeletal medicine for medical students in the preclinical years and to measure the level of competence achieved by a class of first-year medical students who took the course.The course was formulated by faculty from the departments of orthopaedic surgery, anatomy, and rheumatology and included elements of both objectives-based and problem-centered curricular models. The clinical lectures were preceded by pertinent anatomy lectures

2008 The Journal of Bone and Joint Surgery. American Volume

139200. Integrative Medicine Research at an Academic Medical Center: Patient Characteristics and Health-Related Quality-of-Life Outcomes. Full Text available with Trip Pro

limitations. Controlled studies that measure HRQoL and additional outcomes related to whole person health--physical, mental, social, and spiritual--are needed to determine the full therapeutic potential of integrative medicine, and to determine efficacy and cost-effectiveness relative to conventional medical care. (...) Integrative Medicine Research at an Academic Medical Center: Patient Characteristics and Health-Related Quality-of-Life Outcomes. To characterize patients seeking care at a university-based integrative medicine practice, and to assess short-term changes in health-related quality of life (HRQoL) associated with integrative medical treatment.Prospective, observational study.This study was conducted at a large U.S. academic medical center affiliated with the Consortium of Academic Health Centers

2008 Journal of Alternative and Complementary Medicine

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