Subject(s)
Clinical Clerkship , Family Practice/education , Physician-Patient Relations , Curriculum , Hawaii , Schools, Medical , TeachingABSTRACT
BACKGROUND AND OBJECTIVES: Management of upper respiratory infection (URI) was examined in a family practice clinic to determine evidence-based practices, specifically for medication choice. Scientific evidence supports the use of decongestants and perhaps decongestant/antihistamine combinations in adolescents and adults and antipyretics in all age groups. The use of cold preparations for children younger than age 5 is not evidence based. METHODS: Data on demographics, medications prescribed, and over-the-counter medications recommended were collected from patient charts for 293 URI visits over a 6-month period. The cost of evidence-based URI treatment was compared with the cost of nonevidence-based treatment. RESULTS: Thirty-three percent of patients younger than age 5 were given a prescription; 96% of the prescription cost in this age group was nonevidence based. Twenty-six percent of all patients seen were given unnecessary and potentially harmful medication. These unnecessary medications accounted for almost 60% of the total prescription cost. Various combinations of antihistamines, decongestants, and antitussives were most commonly prescribed. CONCLUSIONS: Few medications have been shown to effectively alleviate the symptoms of the generally self-limited, benign common cold. Medications are often overprescribed, escalating health care costs and, in some cases, exposing the patient to dangerous side effects. Family physicians and educators are encouraged to reexamine their treatment and teaching practices for the common cold.
Subject(s)
Evidence-Based Medicine , Respiratory Tract Infections/drug therapy , Adolescent , Adult , Aged , Aged, 80 and over , Child , Child, Preschool , Common Cold/drug therapy , Costs and Cost Analysis , Female , Humans , Infant , Male , Middle AgedABSTRACT
A survey of adolescents living in rural southwestern towns demonstrated their knowledge of the basic transmission routes of Acquired Immune Deficiency Syndrome (AIDS). Nevertheless, misconceptions and attitudes, which may interfere with adopting safe behaviors, persist. Significant differences in knowledge did exist between the ethnic groups surveyed. Further, American Indian and black adolescents were more likely to express attitudinal biases against people who have AIDS. We conclude that current media efforts have been successful in communicating basic information regarding transmission, but there may exist a need for ethnically specific programs that focus on the misconceptions and attitudes surrounding AIDS.
Subject(s)
Acquired Immunodeficiency Syndrome/psychology , Attitude to Health , Ethnicity/psychology , Health Education , Adolescent , Adolescent Behavior , Arizona , Child , Evaluation Studies as Topic , Health Knowledge, Attitudes, Practice , Humans , Rural Population , Statistics as Topic , Surveys and QuestionnairesABSTRACT
Saipan, one of many islands of the Pacific Trust Territory, depends on the United States for its medical care. The limited resources on the island have resulted in little medical attention for adolescents. This study surveyed 519 Saipan adolescents to determine their health practices, problems, and needs. Although these teenagers rarely saw physicians, they commonly reported health problems such as headaches, abdominal pain, and dental cavities. In the psychosocial arena, their problems involved parents, girlfriends/boyfriends, school, and suicidal thoughts. The health topics found to be of most interest included sex education, jobs, suicide prevention, drugs, and birth control. The most popular methods for learning about these subjects were books, movies, films, and school classes. There were high reported incidences of drug and alcohol problems among boys, and thoughts about suicide in all respondents.
Subject(s)
Health Surveys , Adolescent , Adult , Female , Gastrointestinal Diseases/epidemiology , Headache/epidemiology , Health Education , Health Services Needs and Demand , Humans , Male , Micronesia , Substance-Related Disorders/epidemiology , SuicideABSTRACT
Little attention is given in the medical school curriculum to providing care for the 5-10% of the population that is homosexual. An elective course was developed to promote more positive attitudes among doctors-in-training towards homosexual patients. The format was primarily small group discussion between students and articulate homosexual people around societal biases towards homosexuals and issues of health care delivery. Students from this seminar and a control group from another elective completed an attitude questionnaire before and after the course. The study group became more accepting towards homosexual lifestyles significantly in 12 of 15 measures while no difference was found in the control group. Students' reaction to this learning experience was highly positive: they appreciated the opportunity to learn about same-sex life-styles in a personal and nonthreatening way, thus enabling them to accept and better care for homosexual people.
