Geriatric training needs of family physicians.

Family physicians provide the majority of medical care to the elderly population throughout the country. These physicians require accessible Continuing Medical Education (CME) programs that meet their specific educational needs. This study provides information on the perceived training needs and preferred training modalities reported by a sample of community based family medicine faculty preceptors in a Southeastern state. Respondents preffered short courses focusing on organ system diseases common in the elderly population but also wanted more training in managing some of the more complex nonmedical problems that can adversely affect the delivery of medical care. Findings have implications for CME planners who want to provide family physicians training in geriatrics and gerontology that will positively impact their care of the elderly.

Use of comprehensive geriatric assessment techniques by community physicians.

BACKGROUND: Research has shown that comprehensive assessment techniques have several clinical benefits for geriatric patients. The purpose of this study was to determine how frequently community practitioners used comprehensive geriatric assessment techniques to identify factors related to use of those techniques. METHODS: The study group included 54% of the 100 community-based family physician preceptors who participate in the University of Mississippi's family medicine training programs. On-site interviews were conducted in each physician's office to measure the percentage of physicians who performed comprehensive geriatric assessment. RESULTS: The majority of physicians employed some selected age-related assessment techniques, but less than 25% performed functional assessment techniques considered unique to the geriatric patient, such as mental status assessment and evaluation of activities of daily living. Most physicians' personal and practice characteristics were unrelated to the use of assessment techniques. CONCLUSIONS: Although many physicians use some techniques of geriatric assessment, most practicing physicians do not perform comprehensive assessment of geriatric patients.

Use of a problem-oriented dental record in undergraduate dental education.

This paper describes how the concepts and methods of problem-orientation have been applied in the clinical education of dental students. It makes the point that the problem-oriented dental record is only one part of a complete system which has five interrelated components. The problem-oriented dental record is discussed in detail, and the paper includes examples of all four sections of the record. All sections of the record are interrelated, and the steps in identifying and resolving problems follow a logical sequence: (1) collect the data base, (2) write the cue list, (3) write the problem list, (4) write the initial plan, (5) write the final plan, and (6) record progress. The problem-oriented dental record is seen as a tool for patient care, audit, and education. The main advantage lies in the way information is organized and recorded. The record is highly communicative and permits everyone involved an opportunity to relate the data collected to the problem list and to the decisions made regarding how problems will be resolved. The record and the systems were borrowed from Weed and are being adapted for use in dentistry. Although still in the trial stages, this system has proven to have many more advantages than other record-keeping systems and is invaluable as a tool for education. In the future we plan to use computers to help store and retrieve data from these records. We anticipate that a dental education built on this record will have a lasting impact on the graduates' approach to patient care. This should result in a graduate who is conversant with medical colleagues and systematic in the collection of data, listing of problems, and resolution of patient problems. Finally, we believe that the problem-oriented dental record is also a good tool to help the dental graduate become more empathetic with patients and more aware of their total health needs. The record provides a mechanism for recording physical and emotional information as well as the oral status.

Platyzoma: a new look at an old link in ferns.

Record of a chromosome number of 2n = 76, unusual for pteridophytes, in Platyzoma microphyllum R. Br. emphasizes other unique features of this monotypic Queensland fern and provides new evidence of its possible relationships. Other characteristics of this plant, which are not known among terrestrial ferns, are incipient heterospory-having two sizes of spores and a dioecious condition of the gametophytes. These and other morphological features show relationships of Platyzoma to members of the Schizaeaceae and Marsileaceae and relationships of these families to the Polypodiaceae, in which it is treated under the subfamily Platyzomatoideae.