Comparison of blood pressure between Indiana AMA and NMA members. (49/397)

OBJECTIVE: 1) To determine whether African-American physicians, compared to caucasian physicians, were at increased risk to develop hypertension; and 2) to determine whether physicians' knowledge of cardiovascular risk factors influenced their pattern of exercise. DESIGN: A mailed survey of members of the American Medical Association (AMA) and the National Medical Association (NMA) was completed to assess health status and plans for retirement. RESULTS: High-normal blood pressure was defined as systolic blood pressure of 85-89 mmHg. Mild (stage-1) hypertension was defined as systolic blood pressure of 140-159 mmHg and diastolic blood pressure of 90-99 mmHg. Gender (male), age, and body mass index (BMI) were significantly correlated with elevated levels of selected blood pressure measures. Using regression analysis to control for gender, age, and BMI, ethnicity was identified as a fourth factor accounting for elevated blood pressure. NMA physicians had 3.25 times the risk of having systolic blood pressure in the mild (stage-1) hypertension range, 5.78 times the risk for blood pressure in the high-normal diastolic hypertension range, and 5.19 times the risk for blood pressure in the mild (stage-1) diastolic hypertension range. Medical specialty and type of psychological support were not significant predictors of elevated blood pressure. CONCLUSION: These data suggest that African-American physicians may be at an increased risk to develop abnormal blood pressure, compared to caucasian physicians, potentially affecting the number of physicians available to minority communities.  (+info)

From traditional reading rooms to a soft copy environment: radiologist satisfaction survey. (50/397)

Academic radiologists are experiencing increased clinical workloads. New technology such as picture archiving and communication systems (PACS) are often justified on the premise of increased efficiency. The authors believe that efficiency can be influenced by the image interpretation environment, and thus they set out to establish baseline satisfaction levels with this environment. The authors surveyed 90 Indiana University (IU) faculty radiologists, fellows, and residents. Their survey was implemented with a questionnaire sent via e-mail. Questions focused on satisfaction with the current soft-copy reading environments and preferences regarding improvements. Of the 90 radiologists surveyed, 55 (61%) responded. Several key findings emerged: (1) Overall satisfaction with the soft-copy environment is low, with nearly half (46%) of respondents rating themselves as "very dissatisfied" or "dissatisfied." (2) Faculty are least satisfied regarding work space ergonomics, room layout, and amount of work space. Appropriate lighting also emerged as an area with low satisfaction and high importance. (3) Ninety-eight percent of respondents indicated that an "ideal" soft-copy environment would have a positive effect on their efficiency. The dissatisfaction with the current soft-copy interpretation environments used by the IU radiologists indicates that this is an area that requires attention. Furthermore, there may be a direct relationship between radiologist efficiency and satisfaction with the image interpretation environment. Attention should be focused on this environment during a soft-copy technology implementation to ensure that planned efficiency gains are realized.  (+info)

A shared random effect parameter approach for longitudinal dementia data with non-ignorable missing data. (51/397)

A significant source of missing data in longitudinal epidemiologic studies on elderly individuals is death. It is generally believed that these missing data by death are non-ignorable to likelihood based inference. Inference based on data only from surviving participants in the study may lead to biased results. In this paper we model both the probability of disease and the probability of death using shared random effect parameters. We also propose to use the Laplace approximation for obtaining an approximate likelihood function so that high dimensional integration over the distributions of the random effect parameters is not necessary. Parameter estimates can be obtained by maximizing the approximate log-likelihood function. Data from a longitudinal dementia study will be used to illustrate the approach. A small simulation is conducted to compare parameter estimates from the proposed method to the 'naive' method where missing data is considered at random.  (+info)

Community clinical data exchange for emergency medicine patients. (52/397)

Little is known about the opportunities for a community clinical data exchange network to influence patient care. Rates of patient "cross-over" among different institutions can provide one estimate of the additional value such systems have over unconnected, independent institutional electronic medical records. The Indiana Network for Patient Care (INPC) represents such a system, involving a collaboration of central Indiana hospitals to improve patient care. During a one year study period, 288,696 patients made 471,640 Emergency Department (ED) visits within the INPC collaboration -- accounting for 92% of all Indianapolis ED visits. Overall 25% of the patients with more than one visit also visited one of the other five hospital systems, accounting for 19% of all visits. Our results help clarify the expected frequency within one large metropolitan area that ED patients could obtain direct benefit from a community clinical data exchange network.  (+info)

Creating a virtual community of learning predicated on medical student learning styles. (53/397)

To create a virtual community of learning within the Indiana University School of Medicine, learning tools were developed within ANGEL to meet the learning needs and habits of the medical students. METHODS: Determined by student feedback, the integration of digital audio recordings of class lectures into the course management content with several possible outputs was paramount. The other components included electronic enhancement of old exams and providing case-based tutorials within the ANGEL framework. RESULTS: Students are using the curriculum management system more. Faculty feel more secure about their intellectual property because of the authentication and security offered through the ANGEL system. The technology applications were comparatively easy to create and manage. The return on investment, particularly for the digital audio recording component, has been substantial. CONCLUSION: By considering student learning styles, extant curriculum management systems can be enhanced to facilitate student learning within an electronic environment.  (+info)

Implementing wireless evaluation in a hospital-based OSCE center. (54/397)

To provide an effective and efficient means to gather assessment data during Objective Structured Clinical Examinations [OSCEs] and integrate the data into ANGEL, the Indiana University School of Medicine's [IUSM] curriculum management system, a wireless approach using PDAs was selected, configured and evaluated. Following a systems architecture and human-computer interface analysis of the project, a system with less functionality but greater reliability was designed and implemented.  (+info)

Computerized reminders for syphilis screening in an urban emergency department. (55/397)

Point of care reminders have been shown to be effective in changing ordering behavior in primary care settings, but electronic reminders in the emergency department have not been studied. We retrospectively evaluated a computerized system designed to prompt syphilis testing in an emergency department during an outbreak. Most individual reminders were not followed by a test. However, there was a marked general increase in syphilis testing.  (+info)

Vaginal yeast colonisation, prevalence of vaginitis, and associated local immunity in adolescents. (56/397)

OBJECTIVES: To evaluate point prevalence vaginal yeast colonisation and symptomatic vaginitis in middle adolescents and to identify relation of these yeast conditions with reproductive hormones, sexual activity, sexual behaviours, and associated local immunity. METHODS: Middle adolescent females (n = 153) were evaluated for sexually transmitted infections (STIs), asymptomatic yeast colonisation, and symptomatic vulvovaginal candidiasis (VVC) by standard criteria. Also evaluated were local parameters, including vaginal associated cytokines, chemokines, and antibodies, vaginal epithelial cell antifungal activity, and Candida specific peripheral blood lymphocyte responses. Correlations between yeast colonisation/vaginitis and local immunomodulators, reproductive hormones, douching, sexual activity, condom use, and STIs were identified. RESULTS: Rates of point prevalence asymptomatic yeast colonisation (22%) were similar to adults and similarly dominated by Candida albicans, but with uncharacteristically high vaginal yeast burden. In contrast with the high rate of STIs (18%), incidence of symptomatic VVC was low (<2%). Immunological properties included high rates of Candida specific systemic immune sensitisation, a Th2 type vaginal cytokine profile, total and Candida specific vaginal antibodies dominated by IgA, and moderate vaginal epithelial cell anti-Candida activity. Endogenous reproductive hormones were in low concentration. Sexual activity positively correlated with vaginal yeast colonisation, whereas vaginal cytokines (Th1, Th2, proinflammatory), chemokines, antibodies, contraception, douching, or condom use did not. CONCLUSION: Asymptomatic vaginal yeast colonisation in adolescents is distinct in some ways with adults, and positively correlates with sexual activity, but not with local immunomodulators or sexual behaviours. Despite several factors predictive for VVC, symptomatic VVC was low compared to STIs.  (+info)