Nelia M. Afonso

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PURPOSE To assess the level of residents' competence in delivering bad news to patients. METHOD In June 1995, 25 residents (of 116) in the Wayne State University general internal medicine residency program volunteered to participate in the study, which consisted of videotaped interviews of a simulated patient whose profile had been developed to highlight(More)
This study notes the differences between trust and distrust perceptions by the elderly as compared with younger populations. Given the importance of trust and distrust in compliance, changing behaviors, and forming partnerships for both health and disease management, it is necessary to be able to measure patient-doctor trust and distrust (PDTD). Following(More)
Until recently, the assessment made by the primary care provider regarding screening for breast cancer was generally limited to decisions about when to initiate mammography. Early diagnosis was stressed as the best protection against breast cancer morbidity. However, there have been recent developments in the ability to predict and modify breast cancer(More)
INTRODUCTION Vaccination of health care workers (HCW) reduces transmission of influenza among patients, yet uptake of vaccination remains low. If vaccination education is integrated into the early medical school curriculum, will student attitudes toward the vaccine change? The objectives of the study were to: (1) Determine influenza vaccination rates among(More)
Ultrasound, a versatile diagnostic modality that permits real-time visualization at the patient’s bedside, can be used as an adjunct in teaching physical diagnosis (PD). Aims: (1) to study the feasibility of incorporating ultrasound into PD courses and (2) determine whether learners can demonstrate image recognition and acquisition skills. Three hundred(More)
BACKGROUND Physicians are aware of the National Cholesterol Education Program guidelines; however, most patients fail to attain cholesterol goals. OBJECTIVE To determine whether a combined program of patient education and provider awareness could improve the National Cholesterol Education Program goal attainment among patients at high risk for(More)
OBJECTIVE We compared teaching performance of medical school faculty using anonymous evaluations and open evaluations (in which the evaluator was not anonymous) and examined barriers to open evaluation. METHODS Residents and medical students evaluated faculty using an open evaluation instrument in which their identity was indicated in the evaluation.(More)
Polymerase chain reaction (PCR) tests that detect herpes simplex virus (HSV) DNA in cerebrospinal fluid (CSF) are increasingly used to diagnose central nervous system (CNS) infections caused by HSV. To determine proper utilization of this test at an inner-city hospital, we performed a case-control study of adult patients, with HSV detected in CSF by PCR.(More)
The quality of the papers published in the Journal depends on both the authors and the external reviewers who help the editors select the best papers and improve their presentation. We are very grateful for the efforts of our reviewers who have helped us to achieve and maintain exceptionally high standards. Names of those who have reviewed for us from(More)
The study analyzes medical residents (MRs) attitudes on the ethics of information disclosure in two case scenarios--HIV disease and cancer. A purposeful sample of 120 MRs took part in a self-completion questionnaire administered. Responses were factor analyzed and three factors (17 statements) protecting rights of (1) spouse/family, (2) patient and (3)(More)