PHYSICIANS WHO read selected articles in this issue of Archives of Family Medicine, answer the Self-assessment Quiz, complete the CME Evaluation, and mail in the Answer Card are eligible for category 1 credit toward the American Medical Association (AMA) Physician's Recognition Award (PRA). There is no charge to subscribers or nonsubscribers.
The AMA is accredited by the Accreditation Council for Continuing Medical Education to sponsor continuing medical education for physicians. The AMA designates this education activity for up to 3 hours of category 1 credit per issue toward the AMA PRA. Each physician should claim only those hours of credit that he or she actually spent in the educational activity.
In addition, Archives of Family Medicine has been approved by the American Academy of Family Physicians (AAFP) as having educational content acceptable for Prescribed credit hours. This issue has been approved for up to 3 Prescribed credit hours. Credit may be claimed for 1 year from date of individual issue.
EARNING CREDIT
To earn credit, read the articles designated for CME credit carefully and take the following Self-assessment Quiz. Mark your responses on the accompanying Answer Card and complete the CME Evaluation. Then fax your Answer Card to the Blackstone Group at (312)269-1636 or mail it to the address on the back of the card. Answers are provided in Figure 1 so that you can immediately assess your performance.
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Answers to This Issue's Self-assessment Quiz
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Answer Cards must be submitted within 1 year of the issue date. The AMA maintains no permanent record of individual quiz scores. A certificate specifying the total amount of credit received for this educational activity will be returned to you by mail or fax. Please allow up to 4 weeks for your certificate to arrive. Questions about CME processing should be directed to the Blackstone Group; fax: (312) 269-1636.
CME EVALUATION
Our goal is to continually assess the educational needs of our readership for the purpose of enhancing the educational effectiveness of the Archives of Family Medicine. To achieve this goal, we need your help. You must complete the CME Evaluation on the Answer Card to receive credit. Participants are encouraged to reply within 2 months of the issue date, to facilitate the assessment of its educational value.
STATEMENT OF EDUCATIONAL PURPOSE
The Archives of Family Medicine is devoted to strengthening the science, practice, and art of family medicine. Its emphasis is on original research that is clinically practical and academically sound. A flexible curriculum of article topics is developed annually by the journal's editorial board and is then supplemented throughout the year with information gained from readers, authors, reviewers, and editors.
Readers of the Archives of Family Medicine should be able to attain the following educational objectives: (1) use the latest information on diagnosis and treatment of diseases commonly seen in clinical practice to maximize patient health; (2) recognize uncommon illnesses that present with common symptoms to the family physician and treat or refer as appropriate; (3) use practical tools for health promotion and disease prevention; and (4) learn the clinical indications and adverse effects of pertinent new drugs or new uses for available drugs.
Self-assessment Quiz
Questions for March/April 1999
Use of Restraints for Patients in Nursing Homes (SEE ARTICLE)
Q1. What is the general rate of restraint use that can be achieved with proper care in a running home?
A. 30%-35%.
B. 20%-25%.
C. 10%-15%.
D. 5%-10%.
E. 0%-5%.
Q2. Which of the following is true concerning the use of restraints in nursing homes?
A. The restraint should enable the patient rather than merely restrain.
B. A fall from a bed without bed rails is associated with more injury than a fall from a bed with bed rails.
C. The use of restraints does not require consent from the nursing home resident or their appropriate surrogate.
D. Restraints can be legitimately used when a patient is being verbally abusive.
E. Psychoactive drugs, used as "chemical restraints," are preferable to physical restraints.
Q3. Known adverse effects of restraints in nursing home patients include:
A. Incontinence.
B. Decreased range of motion.
C. Decreased ability to ambulate.
D. Symptoms of depression.
E. All of the above.
Family Dysfunction and Prenatal Care (SEE ARTICLE)
Q4. Women with no prenatal care:
A. Usually get prenatal care during the following pregnancy.
B. Have similar initial parenting practices to women who obtain prenatal care.
C. Have lower fertility rates than women who obtain prenatal care.
D. Are more likely to have significant family dysfunction than women who obtain prenatal care.
E. Have much higher rates of medical risk factors for low birth weight than women who obtain prenatal care.
Factors Associated With Premenstrual Syndrome (SEE ARTICLE)
Q5. In a population-based study of premenstrual syndrome, symptoms were higher in:
A. Women with higher caffeine intake.
B. Physically active women.
C. Older women.
D. White women.
E. Women with lower body mass indexes.
Follow-up of Abnormal Papanicolaou Smears (SEE ARTICLE)
Q6. In a recent study of receipt of recommended colposcopy in a high-risk clinical population, which of the following predicted lower rates of colposcopy completion?
A. Difficulty arranging child care.
B. Difficulty arranging transportation.
C. Inadequate insurance.
D. Lack of understanding of Papanicolaou smear results.
E. Fear of cancer.
Physician Awareness of Mental Disorders (SEE ARTICLE)
Q7. The presence of a mental disorder in a patient:
A. Decreases the likelihood of a patient visiting a physician.
B. Is unrelated to physicians reporting patients as "difficult."
C. Increases the likelihood of unexplained physical complaints.
D. Is identified because the patient usually presents with mental health symptoms to the primary care physician.
Effects of Ankle Sprain (SEE ARTICLE)
Q8. Six months following the common ankle sprain, about what percentage of patients will have remaining symptoms?
A. 10%.
B. 25%.
C. 50%.
D. 75%.
E. 90%.
Reducing Physician Financial Risk Under Capitation (SEE ARTICLE)
Q9. Which of the following represents the type of capitation plan least financially risky to the physician?
A. Partial capitation with age/sex adjustment, reinsurance, and pharmacy carve-out.
B. Full capitation with health risk adjustment.
C. Partial capitation with mental health and pharmacy carve-out, no reinsurance, no risk adjustment.
D. Modest volume of patients with partial capitation.
E. Large panel of patients, unadjusted, with full capitation.
Treating the Obese Patient (SEE ARTICLE)
Q10. Genetics controls about what percentage of the body mass index?
A. 10%.
B. 25%.
C. 33%.
D. 50%.
E. 75%.
Q11. Concerning obesity:
A. Lower-body fat is more important than abdominal fat in predicting negative health outcomes.
B. Loss of 5% to 10% of body weight can improve hypertension and diabetes.
C. Obesity is primarily caused by a leptin deficiency.
D. Use of food intake records does not increase weight loss.
E. Group behavior modification programs have better outcomes for obesity than frequent brief office visits with a physician.
