B. Krishna Singh

Primary Care Physicians and Complementary-Alternative Medicine: Training, Attitudes, and Practice Patterns

Background: Physician interest in complementary medicine is widely documented in many Western countries. The extent of level of training, attitudes toward legitimacy, and use of complementary therapies by US primary care physicians has not been extensively surveyed. We conducted a national mail survey of primary care physicians to explore these issues. Methods: Primary care specialties represented were family and general practice, internal medicine, and pediatrics. A total of 783 physicians responded to the survey. For the multivariate analysis, sample weights were assigned based on specialty. Assessments were done for training, attitudes, and usage for complementary medicine. Additional data collected included years in practice, specialty, and type of medical degree. Results: Biofeedback and relaxation, counseling and psychotherapy, behavioral medicine, and diet and exercise were the therapies in which physicians most frequently indicated training, regarded as legitimate medical practice, and have used or would use in practice. Traditional Oriental medicine, Native American medicine, and electromagnetic applications were least accepted and used by physicians. Conclusions: Many psychobehavioral and lifestyle therapies appear to have become accepted as part of mainstream medicine, with physicians in this study having training in and using them. Such therapies as chiropractic and acupuncture appear to be gaining in acceptance despite low training levels among physicians. Those in practice more than 22 years had the least positive attitudes toward and use of complementary therapies. Osteopathic physicians were more open than medical physicians to therapies that required administering medication or a procedural technique. In the multivariate analysis, attitude and training were the best predictors of use.

Childlessness and Family Satisfaction

This study examines the effects of childlessness on family satisfaction among older persons. Respondents 65 years of age and older from four national surveys are selected for the analysis. The results indicate that childlessness has significant negative effects on family satisfaction, especially among those who are 70 years of age and older, and more so among older women than men. This effect is above and beyond sociodemographic characteristics and interaction patterns with relatives, neighbors, and friends. Implications of childlessness and roles of formal and informal support systems for the older persons are discussed.

Abstinence from Alcohol: Some Implications for Epidemiology of Alcohol Problems

This study examines the utility of abstinence from alcohol use for epidemiological estimations of alcohol problems and characteristics of those who report total abstinence. The data are derived from a national probability sample of adults (18 years of age and older). The results indicate that proportionate abstinence at the regional level shows very strong negative relationships with estimated alcoholism rates and per capita alcohol consumption. Although all the attributes of respondents examined are found to be statistically significant, the three most significant predictors of abstinence are religious attendance, family income, and geographic region. The epidemiological implications for estimating alcohol problems from abstinence data are discussed.

The Impact of Mass Media on Fertility Rates: An Exploration.

Data were gathered from the United Nations Statistical yearbooks 1955-1972 in the effort to investigate the impact of the mass media on fertility rates. Only those years and countries or territories which included information on fertility rates number of daily newspapers per 1000 population number of radio receivers/1000 population number of television receivers/1000 number of cinema seats/1000 and per capita income in dollars were used. Examination of the relationships among the 4 types of mass media - televisions newspapers radios and cinema seats - reveals that they all are substantially associated with the reduction of fertility rates. This finding is inconsistent with the works that indicate printed matter to be more detailed and tended to be considered as a more credible source than other forms of mass media. The entertainment media of television is the strongest media variable associated wth fertility rates; newspapers radios and cinema seats in this order are also substantively related to fertility.