Family Medicine Commons^™

An Update On The Diagnosis And Treatment Of Early Lyme Disease: "Focusing On The Bull's Eye, You May Miss The Mark", Amber Stonehouse, James S. Studdiford, C. Amber Henry

Department of Family & Community Medicine Faculty Papers

To confidently diagnose and treat Lyme disease, the clinician must first understand the natural history of this disease, especially its protean early manifestations. Emergency physicians, primary care physicians, and other providers need to be vigilant in terms of the timely recognition of erythema migrans (EM), the unique marker of early localized stage 1 disease. The classic EM, originally described as a slowly expanding bull's eye lesion, is now recognized to be present in only the minority of cases (9%); the dominant morphologic lesion of EM is now recognized to be the diffusely homogenous red plaque or patch, which occurs in …

Relationships Between Scores On The Jefferson Scale Of Physician Empathy, Patient Perceptions Of Physician Empathy, And Humanistic Approaches To Patient Care: A Validity Study., Karen M. Glaser, Fred W. Markham, Herbert M. Adler, Patrick R. Mcmanus, Mohammadreza Hojat

Department of Psychiatry and Human Behavior Faculty Papers

BACKGROUND: Empathy is the backbone of a positive physician-patient relationship. Physician empathy and the patient's awareness of the physician's empathic concern can lead to a more positive clinical outcome.

MATERIAL/METHODS: The Jefferson Scale of Physician Empathy (JSPE) was completed by 36 physicians in the Family Medicine residency program at Thomas Jefferson University Hospital, and 90 patients evaluated these physicians by completing the Jefferson Scale of Patient Perceptions of Physician Empathy (JSPPPE), and a survey about physicians' humanistic approaches to patient care.

RESULTS: A statistically significant correlation was found between scores of the JSPE and JSPPPE (r=0.48, p

CONCLUSIONS: These findings …

Allergic Contact Dermatitis From Tea Tree Oil

Department of Family & Community Medicine Faculty Papers

The sudden appearance of a pruritic confluent erythematous rash on the anterior neck and upper back prompted a 30-year-old woman to seek medical attention. She had recently started applying 5% tea tree oil to the area to treat chronic, recurrent tinea versicolor. An herbal specialist had recommended this therapy.

Predoctoral Directors: Who Are They And What Do They Do In These Trying Times?, John Gazewood, Katherine Margo, Christine Jerpbak, Sandra Burge, Thea Ballinger, Richard Usatine

Department of Family & Community Medicine Faculty Papers

BACKGROUND AND OBJECTIVES: Family medicine faces declining student interest and funding. Predoctoral directors will help lead efforts to overcome these challenges. Academic success will be important for predoctoral directors to be effective leaders in academic health centers. We therefore sought to describe predoctoral directors and factors associated with their academic success.

METHODS: We carried out a cross-sectional survey of all family medicine predoctoral directors at US allopathic medical schools using a Web-based questionnaire. The response rate was 82%. We measured academic success using a variable combining rank and tenure status. We used bivariate analysis and multiple linear regression …

Development Of A Reliable And Construct Valid Measure Of Nutritional Literacy In Adults, James J. Diamond

Department of Family & Community Medicine Faculty Papers

NOTE: The Nutritional Literacy Scale can be found here: http://jdc.jefferson.edu/nls/1/

Background: Research into the relation of literacy to health status has not included measures of nutritional literacy. This may be a critical area in the study of chronic conditions such as hypertension and diabetes, which can both relate to obesity and nutrition. This paper details the development and psychometric characteristics of the Nutritional Literacy Scale (NLS), offered as a measure of adults' ability to comprehend nutritional information.

Methods: In order to assess the internal consistency and construct validity of the NLS, demographic data, readability statistics, NLS scores and …

Toward A Biopsychosocial Understanding Of The Patient-Physician Relationship: An Emerging Dialogue, Herbert M. Adler

Department of Family & Community Medicine Faculty Papers

Complexity theory has been used to view the patient-physician relationship as constituted by complex responsive processes of relating. It describes an emergent, psychosocial relational process through which patients and physicians continually and reciprocally influence each other's behavior and experience. As psychosocial responses are necessarily biopsychosocial responses, patients and physicians must likewise be influencing each other's psychobiology. This mutual influence may be subjectively experienced as empathy, and may be skillfully employed by the clinician to directly improve the patient's psychobiology.

Family Medicine Predoctoral Education: 30-Something, Howard K. Rabinowitz

Department of Family & Community Medicine Faculty Papers

From the introduction:

The specialty of family medicine is now more than 30 years old. Fitting for its stage of life, family medicine predoctoral education has achieved appropriate maturity and parity with other core clinical departments and has assumed its role and responsibility in medical education within the academic health center. Of course, this wasn’t always true.

The Interplay Of Obesity And Asthma, James Plumb, Rickie Brawer, Nancy Brisbon

Department of Family & Community Medicine Faculty Papers

The relationships, interactions, and association between obesity and asthma are complex, and are active sources of hypotheses and research. An association between obesity and asthma has been reported in many studies, although considerable debate about the existence of the association and its meaning still exists. Potential associative relationships may result from genetics, immune system modifications, and mechanical mechanisms. The rising prevalence of asthma and obesity in children and adults, and the significant morbidity from both, makes it imperative that clinicians recognize the importance of weight management in patients with and without asthma.

Awareness About Reproductive Health And Rights Among Students Of A Public University In Karachi, Pakistan: A Cross Sectional Study, Naheed Nabi, Waris Qidwai, Farhat Batool,, Iqbal Azam

Department of Family Medicine

Objective: To determine the knowledge, attitude and practices of Karachi University students about reproductive health and rights.
Design: Cross sectional study Methods: A survey was conducted from February to May 2005 to determine the understanding and knowledge related to reproductive health and rights among the students of the department of Biochemistry, University of Karachi, Pakistan. A pre-coded questionnaire was developed and pre-tested. The questionnaire was introduced to those students, who agreed to participate in the study. Data collected was double entered and analyzed on SPSS and Epi-info latest version.
Results: Fifty five percent (55%) of participants believed …

Metabolic Syndrome: Frequency And Gender Differences At An Out - Patient Clinic, Firdous Jahan, Riaz Qureshi, Tasneem Borhany, Hasan Bin Hamza

Department of Family Medicine

Objective: To determine the frequency of metabolic syndrome among patients attending an out-patient clinic of a teaching hospital and to compare the clinical features regarding metabolic syndrome among males and females.
Study Design: Cross-sectional study.
Place and Duration: Aga Khan University Hospital (AKUH), Executive and Family Medicine Clinics, from December 2004 to April 2005.
Patients and Methods: All adults, above 25 years, attending the clinics for an executive check-up and giving informed consent were included in the study. Data was collected through a structured questionnaire administered to those eligible to participate. Metabolic syndrome was defined according to ATP-III guidelines. …

Knowledge, Attitude And Practice Regarding Immunization Among Family Practice Patients, Waris Qidwai, Syed Sohail Ali, Semi Ayub, Salma Ayub

Department of Family Medicine

Objective: To determine the knowledge, attitude and practices about immunization among family practice patients.
Design: A questionnaire based survey.
Patients and Method: A questionnaire was developed in line with the study objectives. It was administered to patients visiting family physicians, after they were administered, informed consent and assurance with regards to confidentiality was provided. Epi-info and SPSS software was used for data management.
Results: A total of 97 patients were surveyed. The majority were men (59.8%) with a mean age of 29.69 years. Majority was unmarried (51.5%), with graduate and post-graduate education (73%), and in government and …

Primary Care Research: Opportunities And Challenges, Waris Qidwai

Department of Family Medicine

No abstract provided.

Prevalence And Predictors Of Smokeless Tobacco Use Among High-School Males In Karachi, Pakistan, S Rozi, S Akhtar

Community Health Sciences

A cross-sectional study was conducted in 3 towns in Karachi, Pakistan to investigate the prevalence of and factors associated with the use of smokeless tobacco among 772 high-school adolescent males. A structured questionnaire collected data on sociodemographic factors and history of cigarette and smokeless tobacco use. Prevalence of smokeless tobacco use (gutka, snuff, niswar) was 16.1% (95% CI: 13.5%-18.9%). On multiple logistic regression analysis, the factors significantly related to smokeless tobacco use among the sample were: attending government school [adjusted odds ratio (OR) 6.3], smoking cigarettes (OR 3.2), not seeing anti-tobacco advertisements (OR 1.5), family history of tobacco use (OR …