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Medicine Clinic (medicine + clinic)

Distribution by Scientific Domains

Medical Sciences	94%

Distribution within Medical Sciences

Allergy & Clinical Immunology	22%
Nursing General	15%

Selected Abstracts

Socio-psychological stressors as risk factors for low back pain in Chinese middle-aged women

JOURNAL OF ADVANCED NURSING, Issue 3 2001
Yin-bing Yip BAppSc MPH PhD GDipEd RN
Socio-psychological stressors as risk factors for low back pain in Chinese middle-aged women Aim(s) of the study.,This study aims to explore the relationship between socio-psychological stress and low back pain (LBP) prevalence among Chinese middle-aged women. Background.,Women in mid-life experience increasing socio-psychological stress because of midlife transitions, stressful life events and housework or work factors. Encountering socio-psychological stress itself may result in the manifestation of LBP. Design.,A case,control study of Hong Kong community-based middle-aged women was conducted. The study subjects were either from the University Family Medicine Clinic or from a previous population-based cross-sectional study of middle-aged women conducted by Department of Community and Family Medicine. Among the 928 potential eligible subjects from both sources, a total of 182 cases and 235 controls participated in this study. Data were collected from face-to-face interviews and included demographic factors, menopausal status, socio-psychological stress and occurrence of LBP. Socio-psychological stress covered social factors, self-reported nature of housework/work, housework/work stress and stressful life events. Results.,Among the 182 cases who entered this study, 83 women (45·6%) had experienced 1,<14 days of LBP, and 99 women (54·4%) had at least 14 days of LBP in the previous 12 months. Those who reported that ,their family members, relatives or friends were very sick, died, needed her to take care of them or who they worried about in the past 12 months' had an increased risk of LBP of 67% (95% confidence interval (CI) 1·09,2·55). In addition women with a bad or ordinary relationship with cohabitants had an increased risk of LBP of 70% (95% CI 1·00,3·04). Lastly, women with a high housework or work stress had an increased risk of suffering both types of LBP of nearly two- and half-fold (95% CI 1·61,3·85). Conclusions.,The results indicate that an association exists between high socio-psychological stress and LBP prevalence. Alleviating the impact of housework or work related factors would, however, involve improving both the work and home environment. [source]

Widespread pain symptoms and psychological distress in southern Chinese with orofacial pain

JOURNAL OF ORAL REHABILITATION, Issue 1 2010
A. S. MCMILLAN
Summary, The study investigated the experience of widespread pain (WP) symptoms and psychological distress in southern Chinese with orofacial pain (OFP). A community-based, cross-sectional case,control study involving people aged 35,70 registered with the Hospital Authority/University of Hong Kong Family Medicine Clinic served as the sampling frame. People with recent OFP symptoms and a group without OFP took part. Standard questions were asked about OFP conditions in the previous month. Psychological status was evaluated through depression, and non-specific physical symptoms (NPS) scores were measured with depression and somatization sub-scales of the Symptom Checklist-90. Widespread pain was determined using body outline drawings to identify painful sites prior to a standard clinical examination. Two hundred people with OFP and 200 without OFP participated. Compared with 5·0% in the comparison group (P = 0·005), 13·5% of participants with OFP had WP (OFP/WP). Multiple OFP symptoms were more common in the OFP/WP sub-group than the OFP sub-group without WP (OFP/No WP) (P < 0·002). Sixty-three percent of the OFP/WP sub-group had moderate/severe depression scores compared with 26·0% in the OFP/No WP sub-group (P < 0·001). When pain items were included and excluded, 92·6% and 88·9% of the OFP/WP sub-group had moderate/severe NPS scores, respectively compared with 68·5% and 65·0% in the OFP/No WP sub-group (P = 0·004). Co-morbid WP occurred relatively often in southern Chinese with OFP. Psychological distress was common in OFP sufferers, particularly those with WP. A multidisciplinary approach to treatment including cognitive/behavioural therapy should be considered in Chinese people with OFP as part of a WP pattern. [source]

Medical Problems of Internationally Adopted Children Presenting to a Travel Medicine Clinic in Nepal

JOURNAL OF TRAVEL MEDICINE, Issue 6 2006
DTM&H, Johnnie A. Yates MD
Dermatologic, respiratory, and gastrointestinal infections were the most commonly diagnosed conditions among adopted Nepali children presenting to a travel medicine clinic in Kathmandu. Surveillance and early treatment of infections in international adoptees in their birth country may help prevent the importation of infectious diseases. [source]

The Effectiveness of Intradermal Pre-exposure Rabies Vaccination in an Australian Travel Medicine Clinic

JOURNAL OF TRAVEL MEDICINE, Issue 6 2002
Colleen Lau
Background: The objective of the study was to assess the effectiveness of intradermal (ID) rabies vaccination and to determine whether any difference in response with age or gender exists. No published Australian data on the subject is available and controversy continues to surround the use of ID rabies vaccination for pre-exposure prophylaxis. Vaccinated travelers requiring postexposure treatment are sometimes considered unvaccinated. By confirming their immunity prior to travel, this problem may be avoided. Methods: The data was collected by retrospective analysis over 2 years at a specialized travel medicine clinic in Perth, Western Australia. The standard protocol is three ID injections of 0.1 mL, given on days 0, 7, and 28 with a booster after 12 months. The vaccine used was the Pasteur Merieux human diploid cell vaccine. Serology was performed 3 weeks after completion of the primary course or after a booster. Antibody levels were measured using the rapid fluorescent focus inhibition test, and levels of > 0.5 IU/mL were considered protective. Results: A total of 164 travelers were included in the study, of which 144 had completed the three primary ID doses, and 20 had received an ID booster after a previous primary ID course. The mean age was 34.75 years, and gender distribution was equal. The median time between vaccination and serology was 23 days. The antibody levels ranged from 0 to 50 IU/mL with a mean of 8.42 IU/mL. Three travelers had no detectable antibodies giving a seroconversion rate of 98.2%. No statistically significant correlation between age or gender and antibody levels was present. Conclusion: We have found that ID rabies vaccination is effective in a travel clinic with nurses experienced in the technique. The lower cost of ID rabies vaccination makes it accessible to a larger number of travelers. Further studies will be required to determine the duration of protection after ID vaccination and antibody response after postexposure boosters. We will continue to recommend ID rabies vaccination if there is sufficient time for serology to be performed and for results to be available prior to departure. [source]

The Knowledge and Attitudes about Mammography in a Group of Turkish Women Who Attended a Family Medicine Clinic

THE BREAST JOURNAL, Issue 6 2008
Ganime Sadikoglu MD
No abstract is available for this article. [source]

Hand hygiene among nurses in Turkey: opinions and practices

JOURNAL OF CLINICAL NURSING, Issue 3 2007
Asiye D. Akyol RN
Aims and objectives., This study aims to identify nurses' practices and opinions of handwashing during routine patient care. Background., Transmission of microorganisms from the hands of healthcare workers is the main source of cross-infection in hospitals and can be prevented by handwashing. Design and methods., A questionnaire survey was used for this study. A total of 129 clinical nurses at University of Ege Faculty of Medicine Application and Investigation Hospital at Internal Medicine Clinics was surveyed with a response rate of 100%. Data analysis was carried out using SPSS version 10. Results., The study revealed that nurses have a poor level of knowledge concerning quality of hand washing. All nursing actions related to ,clean' and ,dirty' activities were evaluated using the Fulkerson scale. The majority of nurses reported that they always wash hands after contact with contaminated and non-contaminated patients, equipment and environment. It was found that they did need to wash their hands often but that they were not able to do this because of dense working conditions, insufficiency of necessary materials and drying and sore of hands after frequent washing. Conclusion., To improve hand hygiene and quality of handwashing compliance, additional factors must be considered. These factors include improving healthcare workers , especially nurses', skin conditions, hand hygiene techniques and disinfections substantially. Relevance to clinical practice., Hospitals need to develop and implement innovative educational and motivational programmes tailored to specific groups of health personnel. [source]

A National Survey of Travel Medicine Clinics in Canada

JOURNAL OF TRAVEL MEDICINE, Issue 4 2003
Jay S. Keystone
No abstract is available for this article. [source]

Modest Impact of a Brief Curricular Intervention on Poor Documentation of Sexual History in University-Based Resident Internal Medicine Clinics

THE JOURNAL OF SEXUAL MEDICINE, Issue 10 2010
Danielle F. Loeb MD
ABSTRACT Introduction., Providers need an accurate sexual history for appropriate screening and counseling. While curricula on sexual history taking have been described, the impact of such interventions on resident physician performance of the sexual history remains unknown. Aims., Our aims were to assess the rates of documentation of sexual histories, the rates of documentation of specific components of the sexual history, and the impact of a teaching intervention on this documentation by Internal Medicine residents. Methods., The study design was a teaching intervention with a pre- and postintervention chart review. Participants included postgraduate years two (PGY-2) and three (PGY-3) Internal Medicine residents (N = 25) at two university-based outpatient continuity clinics. Residents received an educational intervention consisting of three 30-minute, case-based sessions in the fall of 2007. Main Outcome Measures., We reviewed charts from health-care maintenance visits pre- and postintervention. We analyzed within resident pre- and postrates of sexual history taking and the number of sexual history components documented using paired t -tests. Results., In total, we reviewed 369 pre- and 260 postintervention charts. The mean number of charts per resident was 14.8 (range 8,29) pre-intervention and 10.4 (range 3,25) postintervention. The mean documentation rate per resident for one or more components of sexual history pre- and postintervention were 22.5% (standard deviation [SD] = 18.1%) and 31.7% (SD = 20.4%), respectively, P < 0.01. The most frequently documented components of sexual history were current sexual activity, number of current sexual partners, and gender of current sexual partner. The least documented components were history of specific sexually transmitted infections, gender of sexual partners over lifetime, and sexual behaviors. Conclusion., An educational intervention modestly improved documentation of sexual histories by Internal Medicine residents. Future studies should examine the effects of more comprehensive educational interventions and the impact of such interventions on physician behavior or patient care outcomes. Loeb DF, Aagaard EM, Cali SR, and Lee RS. Modest impact of a brief curricular intervention on poor documentation of sexual history in university-based resident internal medicine clinics. J Sex Med 2010;7:3315,3321. [source]

Effect of betel chewing, tobacco smoking and alcohol consumption on oral submucous fibrosis: a case,control study in Sri Lanka

JOURNAL OF ORAL PATHOLOGY & MEDICINE, Issue 4 2006
A. Ariyawardana
Background:, Oral submucous fibrosis (OSMF) is a chronic, insidious, disabling potentially malignant condition of the oral mucosa seen predominantly in south and Southeast Asia. No reports are hitherto available on the aetiological factors of OSMF based on Sri Lankan patients. Methods:, A total of 74 patients with OSMF and 74 controls who consecutively attended the Oral Medicine clinic at the Dental Hospital (Teaching) Faculty of Dental Sciences, University of Peradeniya, Sri Lanka were included in the study. Binary logistic regression analyses were performed to model the influence of betel chewing, smoking and alcohol use and to determine the effects of different combinations of chewing habits on OSMF. Results:, Betel chewing was the only significantly associated factor in the aetiology of OSMF (OR = 171.83, 95% CI: 36.35,812.25). There were no interaction effects of chewing, smoking and alcohol consumption in the causation of OSMF. Conclusion:, The present study has shown a strong association of betel quid chewing (including tobacco as an ingredient) with the causation of OSMF. [source]

The impact of stomatological disease on oral health-related quality of life

EUROPEAN JOURNAL OF ORAL SCIENCES, Issue 4 2003
Carrie Diane Llewellyn
The clinical diagnosis of stomatological disease may indicate its cause and prognosis; however, it says little about the resulting level of impairment from the patient's perspective. The primary objective of this study was to test whether patients attending an outpatient oral medicine clinic would have worse oral health related quality of life (OHR-QoL) compared with the general population. In addition, we aimed to assess whether anxiety or depression could be predicted by OHR-QoL and to explore the relationship between clinical diagnoses, OHR-QoL and anxiety/depression. Data were collected from patients (n = 97) through face-to-face interviews using the Oral Health Impact Profile Short form (OHIP-14) to measure OHR-QoL, the Hospital Anxiety and Depression Scale (HADS) for psychiatric morbidity, and a visual analogue scale for self-rated general health. Age- and sex-matched controls (n = 388) were provided from a normative data set collected in a UK national survey in 1998. Participants had significantly lower OHR-QoL scores than the general population on all domains and overall OHR-QoL scores. Of the variance in anxiety, 55% was predicted by general health ratings and OHR-QoL domains of ,psychological discomfort' and ,psychological disability'. Of the variance in depression, 54% was predicted by general health ratings and OHR-QoL domains of ,functional limitation' and ,social disability'. Patient centred, routine assessment of OHR-QoL provides an additional dimension that may help to improve awareness of the impact of disease on the individual's life and enhance the clinical decision-making process. [source]

The role of doctor's opinion in shared decision making: what does shared decision making really mean when considering invasive medical procedures?,

HEALTH EXPECTATIONS, Issue 2 2005
Dennis J. Mazur MD
Abstract Objective, The goal of this study was to gain understanding about patients' perspectives on decision making in the context of invasive medical interventions and whether patients' decision-making preferences influenced the type of information they desired to be provided by physicians. Design, Questionnaire study of consecutive patients in a university-based general medicine clinic. Interventions, Patients were presented with a randomized list of three types of information that physicians could provide (risk, benefit and physician's opinion on whether they should undergo the procedure). Patients were asked whether they preferred patient-based, physician-based, or shared decision making and then were asked to select which one or combination of these three information types was most important to them in their own decision making. Patients were also asked to self-report on how many invasive procedures they had undergone in their own lives. Participants, A total of 202 consecutive patients (mean age = 65.1 years, SD = 12.3, range 28,88; mean education 13.3 years, SD 2.9, range 2,23). Main outcome measures, Patient reports. Results, Of the 202 patients, two patients reported no decision-making preference. These two patients were excluded from the analysis. Of the 200 remaining patients, 62.5% (125/200) preferred shared, 22.5%(45/200) preferred physician-based, and 15.5% (31/200) preferred patient-based decision making. More than half of all subjects chose physician opinion as the most important type of information for decision making. Older patients (odds ratio 1.028; confidence interval 1.003,1.053) were more likely to have ranked the doctor's opinion as the most important in their decision making for invasive medical interventions. Conclusions, Although most patients want to share decision making with their physicians regarding invasive procedures, the majority of these patients report relying on the doctor's opinion on whether to undergo the procedure as the most important information in their own decision making. [source]

Older Women and HIV: How Much Do They Know and Where Are They Getting Their Information?

JOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 9 2004
Susan J. Henderson MD
Objectives: To assess older urban women's knowledge about sexual transmission of human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS) and to evaluate the relationship between their HIV/AIDS knowledge level and sources of information. Design: Cross-sectional survey conducted between June 2001 and July 2002. Trained research assistants administered a questionnaire in a face-to-face interview. Setting: General medicine clinic in a large public hospital in a high HIV/AIDS incidence area. Participants: Five hundred fourteen women aged 50 and older. Measurements: Nine questions assessing knowledge of risk of HIV sexual transmission with potential scores ranging from 0 to 9 correct answers. Participants identified all sources of HIV information. Results: The mean knowledge score was 3.7 out of a possible 9 correct responses (range 0 (3%) to 8 (1%)). Younger age, employment, and higher educational level were associated with higher knowledge scores, whereas marital status was unrelated. No respondent correctly answered all of the nine questions. The most commonly identified sources of HIV/AIDS information were television (85%), friends (54%), and newspapers (51%). Only 38% of respondents identified health professionals as a source of information about HIV/AIDS. Health professionals, newspapers, and family members were each independently associated with higher knowledge scores (P<.05). Conclusion: Older women in a general medicine clinic had limited knowledge of sexual transmission of HIV. HIV/AIDS education specifically targeted to this subpopulation is warranted, and health professionals may have an important role in disseminating such messages. [source]

Medical Problems of Internationally Adopted Children Presenting to a Travel Medicine Clinic in Nepal

The Effectiveness of Intradermal Pre-exposure Rabies Vaccination in an Australian Travel Medicine Clinic

On-site mental health care: a route to improving access to mental health services in an inner-city, adolescent medicine clinic

CHILD: CARE, HEALTH AND DEVELOPMENT, Issue 4 2006
A. Lieberman
First page of article [source]

Fertility needs and funding in couples with blood-borne viral infection

HIV MEDICINE, Issue 1 2010
E Kalu
Background Couples infected with HIV, hepatitis B virus (HBV) and hepatitis C virus (HCV) are increasingly seeking assisted conception. These couples avoid unprotected intercourse and use condoms at all times in order to minimize the risk of infecting their partner. As this practice inhibits pregnancy, assisted procreation is generally required for safe conception. For many couples, access to such services is restricted on ethical, geographical and financial grounds. Objective The aim of the study was to assess the fertility needs, geographical origin and state funding of patients with blood-borne viral infection. Methods A retrospective review of the medical records of couples referred for fertility treatment between January 1999 and December 2006, where one or both partners were infected with HIV, HBV and/or HCV, was carried out. Results Of the 205 couples included in the study, 44% lived in London, 51% came from elsewhere in the United Kingdom and 5% travelled from outside the United Kingdom to seek treatment. Genitourinary medicine clinics were the main source of referral. 85.8% of couples had HIV infection, 15.1% were infected with HBV and 13.6% had HCV infection. Fertility screening identified a high incidence of male factor infertility (33.3%) in HIV-infected men and tubal disease (40.8%) in HIV-infected women. Only 23.6% of HIV-infected couples, 20% of HBV-infected couples and 12.5% of HCV-infected couples obtained state funding for assisted conception. Conclusion Fertility screening identified a high incidence of male and tubal factor subfertility among couples living with HIV, HBV and HCV. Limited access to specialist clinics equipped to cater for these couples and restricted funding may impact negatively on couples obtaining risk-reducing assisted reproduction treatment. This may have long-term public health implications as individuals attempt to conceive through unprotected intercourse. [source]

Perimenopausal knowledge of mid-life women in northern Taiwan

JOURNAL OF CLINICAL NURSING, Issue 5 2004
Lee-Ing Tsao DNSc
Background., This work has been carried out keeping in view that although knowledge related to perimenopause is an important health issue for women worldwide, little information is known about mid-life Taiwanese women's knowledge of perimenopause. Objective., The aim of this paper was to explore the level of perimenopausal knowledge of mid-life women in northern Taiwan, to describe the relationship between demographic factors and women's knowledge, and to identify what information health providers need to offer them. Design., A cross-sectional descriptive survey was conducted. Method., The Perimenopausal Knowledge Questionnaire was used to collect data. The study was carried out in August 2000 to September 2001. A convenience sample was recruited from traditional Chinese medicine clinics, gynecology clinics and communities in northern Taipei. Results., Our findings indicated that the overall mean correct answer weighted Perimenopausal Knowledge score of these mid-life women was 46.31. The rank of weighted scores from highest to lowest was: (1) self-care during perimenopause, (2) the perception of perimenopause, (3) knowledge related to hormone replacement therapy and (4) body changes associated with the declined oestrogen in perimenopause. Only educational level was significantly associated with Perimenopause Knowledge level (P < 0.01). Less than 20% (n = 353) of the women answered the items that measured self-management of symptoms related to perimenopause correctly. Less than 1.4% of the women knew that taking hormone replacement therapy required a physician's prescription and subsequent regular health check-ups. Conclusion., Participants lacked adequate knowledge about perimenopause. Relevance to clinical practices., Health providers need to provide factual information about the normal body changes of perimenopause, self-management of perimenopausal disturbances and appropriate use of hormone replacement therapy. [source]

Modest Impact of a Brief Curricular Intervention on Poor Documentation of Sexual History in University-Based Resident Internal Medicine Clinics

ORIGINAL RESEARCH,ERECTILE DYSFUNCTION: Journey into the Realm of Requests for Help Presented to Sexual Medicine Specialists: Introducing Male Sexual Distress

THE JOURNAL OF SEXUAL MEDICINE, Issue 3 2007
Edoardo S. Pescatori MD
ABSTRACT Introduction., The recent availability of noninvasive pharmacological remedies for male sexual function triggered an exponential increase in the number of men requesting help in the sexuality area. Aim., The Italian Society of Andrology explored requests for help, not included in formerly established clinical categories of sexual medicine. Methods., A central board of 67 andrologists identified new areas of requests for help, instrumental for a web-based questionnaire, forwarded to 912 members of the Italian Society of Andrology. Results were submitted to an independent consensus development panel. Main Outcome Measures., A questionnaire response rate of 30.8% was considered acceptable according to standard response rates of medical specialist samples. Results., The Central Board interaction identified two new domains of requests for help: sexual distress and unconventional requests for pro-erectile medications. Web-based questionnaire results suggested that such domains account for 29% and 9% respectively of all requests for help already presented by male patients at sexual medicine clinics. The Independent Consensus Development Panel issued a final consensus document; herewith, the statement defining male sexual distress: A non-transitory condition and/or feeling of inadequacy such as to impair "sexual health" (WHO working definition). Inadequacy can originate both from physiological modifications of male sexual functions, and from diseases, dysfunctions, dysfunctional symptoms and dysmorphisms, both of andrological and non-andrological origin, which do not relate to "erectile dysfunction" (NIH Consensus Development Panel definition), but that might also induce erectile dysfunction. Sexual Distress can lead to a request for help which needs to be acknowledged. Conclusion., The Italian Society of Andrology identified two new areas of requests for help concerning male sexual issues: sexual distress and unconventional requests for pro-erectile medications. These domains, which do not represent new diseases, nonetheless induce the sufferers to seek help and, accordingly, need to be acknowledged. Pescatori ES, Giammusso B, Piubello G, Gentile V, and Pirozzi Farina F. Journey into the realm of requests for help presented to sexual medicine specialists: Introducing male sexual distress. J Sex Med 2007;4:762,770. [source]