Global Health in Family Medicine Residency Programs: A Nationwide Survey of US Residency Directors: A CERA Study.

Background And Objectives: Interest in global health (GH) has increased significantly among medical trainees in the past 3 decades. Despite the potential for family medicine to be a major contributor to GH, there are no recent, large-scale studies of GH education and experiences in family medicine training. This study was designed to assess current opportunities, educational activities, resident interest, perceived program benefits, and barriers to international and domestic GH training in US family medicine residencies.

Telemedicine in education: bridging the gap.

Background: The increasing cost and inequitable access to quality healthcare, coupled with the merger of the information technology and health service sectors, has given rise to the modern field of telemedicine. Telemedicine, meaning medicine at a distance, allows us to transcend geographic and socioeconomic boundaries to deliver high quality care to remote and/or in-need patients. As technology becomes more affordable and a physician shortage looms, telemedicine is gaining attention as a possible solution to healthcare delivery.

Toward a common framework for rural background.

Background And Objectives: To develop a standardized framework to discuss rural background, a review of the literature to identify studies regarding the association of rural background with primary care and/or rural health practice was conducted. The various definitions of rural background were collated and from this data a framework for the conceptualization of rural background is proposed.

Methods: The Medline database from 1966-2009 was searched to find citations that included a rural background definition as a variable for rural intent to practice, rural career choice, or rural practice.

Braces and splints for musculoskeletal conditions.

Braces and splints can be useful for acute injuries, chronic conditions, and the prevention of injury. There is good evidence to support the use of some braces and splints; others are used because of subjective reports from patients, relatively low cost, and few adverse effects, despite limited data on their effectiveness. The unloader (valgus) knee brace is recommended for pain reduction in patients with osteoarthritis of the medial compartment of the knee.

Examining the adoption of electronic health records and personal digital assistants by family physicians in Florida.

Purpose: The purpose of this paper is to comprehensively characterise the current use of electronic health records (EHRs) and personal digital assistants (PDAs) among family physicians in Florida; and to compare family physicians with other doctors with respect to the functions commonly used on their EHR and PDA systems.

Methods: A postal survey was sent to family physicians (n=2076) and other doctors with a clear and active licence in Florida (total n=14 921). To examine factors among family physicians related to EHR and PDA use, binary logistic regression modelling techniques were utilised.

Heat illness in athletes: the dangerous combination of heat, humidity and exercise.

In 1980, 1700 people died during a prolonged heat wave in a region under-prepared for heat illness prevention. Dramatically underreported, heat-related pathology contributes to significant morbidity as well as occasional mortality in athletic, elderly, paediatric and disabled populations. Among US high school athletes, heat illness is the third leading cause of death.

Sun protection of children at the beach.

Background: We wanted to determine the frequency with which sun protection measures are used by children at the beach.

Methods: A cross-sectional study was undertaken that combined a brief, structured interview with direct observation of the sun protection methods (sunscreen, clothing, hats, shade) used for children at a public beach in Florida.

Results: Of the 139 children observed, 97 (69.

Primary care physician supply and colorectal cancer.

Objectives: Our goal was to determine if increasing primary care physician supply was associated with lower incidence and mortality rates for colorectal cancer.

Study Design: We performed an ecologic study of Florida's 67 counties, using data from the state tumor registry and the American Medical Association physician masterfile.

Population: Florida residents were included.

Comorbid illness and the early detection of cancer.

Background: Comorbidity may be associated with later detection of cancer.

Methods: Incident cases of colorectal, breast, and prostate cancer and melanoma were determined from the 1994 Florida state tumor registry (N = 32,074). The relationship between comorbidity and late stage at diagnosis was examined using multiple logistic regression.

Effects of health insurance and race on breast carcinoma treatments and outcomes.

Background: The authors hypothesized that insurance payer and race would influence the care and outcomes for patients with breast carcinoma.

Methods: The authors examined treatments and adjusted risk of death (through 1997) for all incident cases of breast carcinoma occurring in Florida in 1994 (n = 11,113) by using state tumor registry data.

Results: Patients lacking health insurance were less likely to receive breast-conserving surgery (BCS) compared with patients who had private health insurance.

Effects of health insurance and race on colorectal cancer treatments and outcomes.

Objectives: We hypothesized that health insurance payer and race might influence the care and outcomes of patients with colorectal cancer.

Methods: We examined treatments received for all incident cases of colorectal cancer occurring in Florida in 1994 (n = 9551), using state tumor registry data. We also estimated the adjusted risk of death (through 1997), using proportional hazards regression analysis controlling for other predictors of mortality.

Demographic predictors of melanoma stage at diagnosis.

Objective: To examine sociodemographic characteristics as possible predictors of late-stage melanoma diagnosis. We hypothesized that late-stage diagnosis would be associated with the following: older age, male sex, unmarried status, lower educational attainment and income level, rural residence, and cigarette smoking.

Methods: We used data from the state tumor registry to study all incident cases of melanoma occurring in Florida during 1994 whose stage at diagnosis was available (N = 1884).

The effects of physician supply on the early detection of colorectal cancer.

Background: Policymakers question whether there is a relationship between the number and distribution of physicians and the outcomes for important health conditions. We hypothesized that increasing primary care physician supply would be related to earlier detection of colorectal cancer.

Methods: We identified incident cases of colorectal cancer occurring in Florida in 1994 (n = 8,933) from the state cancer registry.

Increasing supplies of dermatologists and family physicians are associated with earlier stage of melanoma detection.

Background: Physicians are important in the early detection of melanoma. We investigated whether primary care physician supply and the supply of dermatologists were related to stage at diagnosis for malignant melanoma.

Methods: From the state tumor registry in Florida in 1994, we identified incident cases of malignant melanoma for which stage at diagnosis was available (N = 1884).

The accuracy of community-based automated blood pressure machines.

Background: Despite widespread use, the accuracy of community-based automated blood pressure machines has been questioned. We sought to determine if these machines are as accurate and reliable as those obtained by a clinician with a mercury manometer.

Methods: We randomly selected 25 pharmacies and compared blood pressure readings obtained from their automated machines with from a mercury manometer.

Influence of longitudinal primary care training on medical students' specialty choices.

Background: At the University of South Florida College of Medicine, a program designed to give students four years of primary care training began in 1983. As of 1992, six classes that included program participants had graduated. The present study examined the effect of the program on the participants' choices of specialty by comparing their choices with those of other graduates.

Cancer screening. Knowledge, recommendations, and practices of physicians.

Background: Americans visit their primary care physicians several times a year. These visits provide physicians with many opportunities to reduce cancer risk in their patients by recommending periodic cancer screening. There is evidence of noncompliance among primary care physicians and their patients with regard to periodic cancer screening.

Validity of immunization documentation presented to a student health program.

Background: Unavoidable exposure to disease and to patients susceptible and vulnerable to disease warrants that students entering medical school be immunized against many of the illnesses for which vaccines are available. The validity of immunization records presented at the time of registration, however, is largely dependent on the provision of accurate and reliable documentation by the student.

Methods: We evaluated for authenticity the immunization and tuberculin testing records of 85 students entering medical school in 1990.

Barriers to screening among participants of a media-promoted breast cancer screening project.

Breast cancer detection and awareness projects have been implemented nationwide in an attempt to increase compliance with screening mammography. Previous studies, however, showed that the elderly, minorities, and women of lower socioeconomic status fail to respond in representative numbers. A cross-sectional analysis of 6640 participants of a Breast Cancer Detection and Awareness Project in Tampa, FL, was conducted to determine if barriers and motivations to screening differed among targeted (the elderly, minorities, women of lower socioeconomic status) and nontargeted groups.