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1.
《The Journal for Nurse Practitioners》2020,16(1):69-73
Adolescent substance use is a national public health crisis. The most commonly used substances among adolescents are nicotine, alcohol, and marijuana. Use of these substances during adolescence has serious adverse effects on brain development, with impairments that can endure into adulthood. Advanced practice nurses in primary care can address substance use in the adolescent population with the use of evidence-based interventions, such as Screening, Brief Intervention, and Referral to Treatment (SBIRT). This article describes trends in adolescent substance use and use of the SBIRT intervention for low, medium, and high-risk use in this population. 相似文献
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Rebecca M. Schwartz PhD Edmond S. Malka Michael Augenbraun Steven Rubin Matthew Hogben Nicole Liddon William M. McCormack Tracey E. Wilson 《Journal of urban health》2006,83(6):1095-1104
Efforts to control chlamydial and gonococcal infections include notifying eligible sexual partners of possible infection,
primarily by asking the diagnosed patient to notify their partners. This approach, known as patient referral, is widely used
but poorly understood. The current study examined psychosocial and cognitive factors associated with patient referral among
an urban, minority sample of 168 participants recently diagnosed with Chlamydia trachomatis or Neisseria gonorrhoeae. At a follow-up interview 1-month from diagnosis, participants were more likely to have notified all eligible partners if
they had greater intention to notify at baseline (OR = 3.72; 95% CI = 1.34, 10.30) and if they had only one partner at baseline
(OR = 4.08; 95% CI = 1.61, 10.31). There were also gender differences as well as differences based on type of partner (i.e.,
regular, casual, one-time). The implications of these findings for the design of programs to promote patient referral for
sexually transmitted infections are discussed.
Schwartz, Malka, Augenbraun, McCormack, and Wilson are with the State University of New York, Downstate Medical Center, Brooklyn,
NY, USA; Rubin is with the New York City Department of Health, Bureau of STD Control, New York, NY, USA; Rubin, Hogben, and
Liddon are with the Centers for Disease Control and Prevention, Atlanta, GA, USA; Schwartz is with the Department of Preventive
Medicine and Community Health, SUNY Downstate Medical Center, Box 1240, 450 Clarkson Avenue, Brooklyn, NY 11203, USA. 相似文献
4.
Andreas Jovanovic Engelbert A.J.M. Schulten Isaäc van der Waal 《Community dentistry and oral epidemiology》1992,20(2):94-96
The referral pattern of 140 Dutch patients with oral mucosal lesions, who had been referred to a Department of Oral & Maxillofacial Surgery and Oral Pathology, shows that patients with oral mucosal lesions consult the dentist as often as the family doctor as the first source of help or information. Furthermore, family doctors were much more used to refer patients with oral mucosal disease to medical specialists rather than to the dentist or the oral and maxillofacial surgeon. 相似文献
5.
Michael Rossdale Terry Kemple Sarah Payne Michael Calnan Rosemary Greenwood 《The British journal of general practice》2007,57(535):152-154
Out-of-hours organisations are responsible for the care of patients 70% of the time, and their GPs act as gatekeepers to secondary care services. This observational study identifies the variations in GPs' out-of-hours referral rates to secondary care and factors that could explain these variations. One hundred and forty-nine GPs who worked in one UK general practice out-of-hours cooperative which served 19 practices with 167 000 registered patients. Data on patients who accessed the out-of-hours service over 3 years (2001-2004) were examined. Factors thought to be predictors of variation in referral rates were investigated using logistic regression analysis. There was a fivefold difference in referral rates between the lowest and highest referring quartiles of GPs (OR [odds ratio] = 4.56, CI [confidence interval] = 3.86 to 5.38). The sex (female) of the clinician, the time of the consultation (11 pm to 7 am), and the place of the consultation (home visit) accounted for some, but not all, of the increased referral rates. A doctor working out-of-hours disproportionately influences the fate of the patient, the number of hospital admissions, and extra costs to the health service. There is a need for follow-up studies to investigate the factors associated with referral behaviour, and how the variation relates to patient factors and the resources available. These findings could be used when planning the staffing of out-of-hours services to optimise appropriate care and minimise patients' exposure to unnecessary intrusive and expensive hospital care. 相似文献
6.
Martina C. Cornel Anthonie J. van Essen Leo P. ten Kate 《American journal of medical genetics. Part A》1992,42(3):387-392
After the birth of a child with a congenital anomaly, parents have many questions about cause, prognosis, and recurrence risk. An important means of transmitting such information is referral to a genetic clinic. We were interested in knowing what determines whether or not parents are referred for genetic counseling. Data from the local registration of congenital anomalies in the northeastern Netherlands (birth years 1981–1986; 1,217 children/fetuses) and data of the local genetic clinic were compared. The parents of 204 cases (16.8%) had been referred for genetic counseling. Of the couples referred, 76% were referred within one year after birth, usually by a pediatrician (48%). Parents of children with a single anomaly, recognized syndrome, or multiple anomalies not recognized as a syndrome were referred in 5%, 43%, and 26% of cases, respectively. Parents of liveborn children who died were referred in 38% of cases, parents of liveborn/still-alive and stillborn children in 13% and 22%, respectively. Previous affected sibs and absence of previous livebirths increased the likelihood of referral. 相似文献
7.
The dose-dependent effect of acute zimeldine and alaproclate treatment upon the acquisition of two-way and one-way active avoidance in the rat was studied in a single-session and in a repeated-sessions design. Zimeldine (5–20 mg/kg, IP), but not alaproclate, caused disruptions of two-way avoidance acquisition. Acquisition deficits were also caused by citalopram and fluoxetine but not the other antidepressant drugs tested. Zimeldine, but not alaproclate or desipramine, caused a slight but non-significant impairment of one-way active avoidance; neither zimeldine nor alaproclate produced any effects upon fear conditioning and retention testing. The long-term action of p-chloroamphetamine (2×10 mg/kg) antagonised the acute zimeldine effect totally, and chronic treatment with zimeldine (15 days, 1×50 mol/kg) and chlorimipramine (15 days, 2×10 mol/kg) also caused some partial blockade of the two-way avoidance deficit. These data seem to suggest some involvement of serotonin (5-HT) in the observed disruptions of two-way active avoidance caused by acute zimeldine treatment. 相似文献
8.
Wayne M. Tsuang Susana Arrigain Rocio Lopez Marie Budev Jesse D. Schold 《American journal of transplantation》2021,21(1):272-280
There is a broad range of patient travel distances to reach a lung transplant hospital in the United States. Whether patient travel distance is associated with waitlist outcomes is unknown. We present a cohort study of patients listed between January 1, 2006 and May 31, 2017 using the Scientific Registry of Transplant Recipients. Travel distance was measured from the patient's permanent zip code to the transplant hospital using shared access signature URL access to Google Maps, and assessed using multivariable competing risk regression models. There were 22 958 patients who met inclusion criteria. Median travel distance was 69.7 miles. Among patients who traveled > 60 miles, 41.2% bypassed a closer hospital and sought listing at a more distant hospital. In the adjusted models, when compared to patients who traveled ≤60 miles, patients who traveled >360 miles had a 27% lower subhazard ratio (SHR) for waitlist removal (SHR 0.73, 95% confidence interval [CI]: 0.60, 0.89, P = .002), 16% lower subhazard for waitlist death (SHR 0.84; 95% CI 0.73-0.95, P = .07), and 13% increased likelihood for transplant (SHR 1.13, 95% CI: 1.07, 1.20, P < .001). Many patients bypassed the nearest transplant hospital, and longer patient travel distance was associated with favorable waitlist outcomes. 相似文献
9.
Sudeshna Paul Taylor Melanson Sumit Mohan Katherine Ross-Driscoll Laura McPherson Raymond Lynch Denise Lo Stephen O. Pastan Rachel E. Patzer 《American journal of transplantation》2021,21(1):314-321
Kidney transplant program performance in the United States is commonly measured by posttransplant outcomes. Inclusion of pretransplant measures could provide a more comprehensive assessment of transplant program performance and necessary information for patient decision-making. In this study, we propose a new metric, the waitlisting rate, defined as the ratio of patients who are waitlisted in a center relative to the person-years referred for evaluation to a program. Furthermore, we standardize the waitlisting rate relative to the state average in Georgia, North Carolina, and South Carolina. The new metric was used as a proof-of-concept to assess transplant-program access compared to the existing transplant rate metric. The study cohorts were defined by linking 2017 United States Renal Data System (USRDS) data with transplant-program referral data from the Southeastern United States between January 1, 2012 and December 31, 2016. Waitlisting rate varied across the 9 Southeastern transplant programs, ranging from 10 to 22 events per 100 patient-years, whereas the program-specific waitlisting rate ratio ranged between 0.76 and 1.33. Program-specific waitlisting rate ratio was uncorrelated with the transplant rate ratio (r = −.15, 95% CI, −0.83 to 0.57). Findings warrant collection of national data on early transplant steps, such as referral, for a more comprehensive assessment of transplant program performance and pretransplant access. 相似文献
10.