Health and school performance of teenagers born before 29 weeks gestation. (73/1094)

OBJECTIVE: To ascertain the health and school performance of teenagers born before 29 weeks gestation (extremely low gestational age (ELGA)) and to compare those in mainstream school with classroom controls. METHODS: Three geographically defined cohorts of babies born in 1983 and 1984 were traced at the age of 15-16 years. Their health, abilities, and educational performance were ascertained using postal questionnaires to the teenagers themselves, their parents, their general practitioners, and the teachers of those in mainstream school. Identical questionnaires were sent to classroom controls. RESULTS: Of the 218 teenagers surviving to the age of 16 years, information was obtained on 179. Of these, 29 were in special schools and 150 in mainstream school, 10 of whom had severe motor or sensory impairment. Using the Child Health Questionnaire, parents of teenagers in mainstream school reported a higher incidence of problems than controls in physical functioning (difference in mean scores 9.0 (95% confidence interval (CI) 4.9 to 13.1)) and family life (difference in mean scores for family cohesion 7.0 (95% CI 1.6 to 12.4)). In all areas of learning, teachers rated the ability of the ELGA teenagers in mainstream school lower than the control group. Parents of teenagers in special schools reported a higher rate of problems in most areas. CONCLUSIONS: One in six ELGA survivors at age 16 years have severe disabilities and are in special schools. Most ELGA survivors are in mainstream school and are coping well as they enter adult life, although some will continue to need additional health, educational, and social services.  (+info)

Preregistration house officers in general practice: review of evidence. (74/1094)

OBJECTIVES: To examine the strengths and weaknesses of the national and local schemes for preregistration house officers to spend four months in general practice, to identify any added value from such placements, and to examine the impact on career choices. DESIGN: Review of all studies that reported on placements of preregistration house officers in general practice. SETTING: 19 accounts of preregistration house officers' experience in general practice, ranging from single case reports to a national evaluation study, in a variety of locations in Scotland and England. PARTICIPANTS: Views of 180 preregistration house officers, 45 general practitioner trainers, and 105 consultant trainers. MAIN OUTCOME MEASURES: Main findings or themes weighted according to number of studies reporting them and weighted for sample size. RESULTS: The studies were unanimous about the educational benefits of the placements. The additional learning included communication skills, social and psychological factors in illness, patient centred consultations, broadening of knowledge base, and dealing with uncertainty about diagnosis and referral. CONCLUSIONS: Despite the reported benefits and recommendations of the scheme, it is not expanding. General practitioner trainers reported additional supervision that was unremunerated. The reforms of the senior house officer grade may resolve this problem by offering the placements to senior house officers, who require less supervision.  (+info)

Harlem health care, a look back. An interview with Edward A. Nichols, MD/pediatrician. Interview by George A. Dawson. (75/1094)

Our goal in this series of interviews is to provide a historical record, of sorts, and to highlight persons of African American ancestry who are health care professionals in Harlem, New York. Today, Harlem is undergoing a second cultural renaissance, and in this milieu, doctors are active contributors as providers of health care and, therefore, must be reckoned with as the proverbial backbone to any community change, be it positive or negative. In this instance, we judge the changes occurring in Harlem, for the most part, to be positive. Our inaugural interview is with Dr. Nichols, a longtime member of the National Medical Association and a pediatrician who has practiced in Harlem for well over 25 years.  (+info)

A physician's guide to working as a locum tenens. (76/1094)

BACKGROUND: The number of physicians working as a locum tenens is increasing. Although most physicians who provide locum tenens coverage are often older and semiretired, an increasing number of physicians are taking this route for limited periods early in their careers. METHODS: The medical literature was searched through MEDLINE using the key words "career choice," "contract services," and "locum tenens." Information about locum tenens was gained by the author through research and a personal experience working as a locum tenens. RESULTS AND CONCLUSION: Working as a locum tenens can be an opportunity to meet interesting patients, learn about local culture, see how practices are organized, learn adaptability, and broaden clinical skills. Opportunities are available through for-profit agencies, academic health centers, state agencies, federal sites such as the Indian Health Service, individual hospitals, and physicians or international staffing companies. Because the physician working as a locum tenens is an independent contractor, exercising some caution when choosing where to work by carefully checking workload and available resources is advised.  (+info)

Will the nation need more cardiologists in the future than are being trained now? (77/1094)

This article supports the view that in the future our nation will need more general cardiologists who perform no high-tech procedures than we are currently training. It also addresses the reason graduates of American medical schools, especially women who make up 40% to 50% of the graduating class, are not choosing cardiology fellowship programs as they were previously. A remedy for this serious problem is offered.  (+info)

Overrepresentation of women veterans among homeless women. (78/1094)

OBJECTIVES: This study estimated the proportion of veterans among homeless women and their risk of homelessness relative to that of nonveterans. METHODS: Data came from 2 surveys of homeless women (1 clinical and 1 nonclinical) and 1 survey of domiciled women. RESULTS: The proportion of veterans (4.4%, 3.1%) among homeless women was greater than the proportion among domiciled women (1.3%, 1.2%). When we computed odds ratios for being a veteran among homeless women compared with nonhomeless women, homeless women were significantly more likely than nonhomeless women to be veterans. CONCLUSIONS: Women veterans are at greater risk for homelessness than are nonveterans. Further study is needed to determine whether increased risks for veterans are a product of military service or reflect volunteers' self-selection into the armed forces.  (+info)

Declining interest in family medicine: perspectives of department heads and faculty. (79/1094)

BACKGROUND AND OBJECTIVES: In 2003, US seniors filled 42% of family practice residency positions, the lowest percentage in the specialty's recent history. We hypothesized that institutional support, contact with family medicine faculty, and faculty satisfaction would be positively related to choice of family practice and that faculty satisfaction would be negatively affected by increasing pressure for clinical productivity. METHODS: We surveyed department heads and faculty at 24 US allopathic medical schools, selected by their rate of family medicine graduates from 1997 to 1999 and the size of the school. Twelve of these schools had an increase in rates of graduates selecting family practice, and 12 showed decreases. RESULTS: Department heads and faculty from schools with an increase in student entry into family practice residencies were significantly more likely to report financial and philosophical support from their state legislature or medical school administration. Faculty ranked patient care as most valued at their institutions, followed by teaching, research, and service. A common theme emerging from both the faculty and department head surveys was an inverse relationship between research activity and graduates choosing family practice. CONCLUSIONS: This study demonstrates the importance of upper-level institutional support on family practice specialty choice. It also highlights a need for further examination of the specialty's relationship to research.  (+info)

Sociodemographic and career characteristics in female and male faculty members of Swiss medical schools. (80/1094)

OBJECTIVES: Women are still underrepresented in the senior ranks of medical school faculties. Thus far information has been lacking on gendersensitive career paths for professorial and nonprofessorial staff of Swiss medical schools. The aim of this study was to survey faculty members of all Swiss medical schools on sociodemographic aspects, career paths and current career position. METHODS: 342 senior and junior faculty members (SFMs/JFMs) participated in a postal questionnaire survey. They represent 61.9% of female SFMs, 41.8% of male SFMs, 35.2% of female JFMs and 40.3% of male JFMs. RESULTS: There was no age difference between the men and women in the two groups (SFMs/JFMs). There were, however, significant gender-typical differences in terms of living arrangements, whether or not they had children of their own, who the children's primary caregiver was, and whether or not the spouse was a researcher as well. Females were significantly lesslikely to be married or have children, and relied on childminders or nurseries for childcare. Their spouses were more often involved in research. The career paths of physicians in academic medicine showed that fewer female JFMs advanced to tenure; they obtained fewer academic awards and had a lower scientific publication rate. CONCLUSIONS: The data show that Swiss medical faculties reflect the same underrepresentation of women in the higher echelons of medicine as most other Western countries. Gender-sensitive mentoring is needed in medical faculties to support women, especially in advancing to tenure and increasing their publication activities.  (+info)