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991.
Buck J Kang MS van der Straten A Khumalo-Sakutukwa G Posner S Padian N 《AIDS and behavior》2005,9(4):415-422
In Zimbabwe, adult HIV prevalence is over 25% and acceptable prevention methods are urgently needed. Sixty-eight Zimbabwean
women who had completed a barrier-methods study and 34 of their male partners participated in focus group discussions and
in-depth interviews to qualitatively explore acceptability of male condoms, female condoms and diaphragms. Most men and about
half of women preferred diaphragms because they are female-controlled and do not detract from sexual pleasure or carry stigma.
Unknown efficacy and reuse were concerns and some women reported feeling unclean when leaving the diaphragm in for six hours
following sex. Nearly half of women and some men preferred male condoms because they are effective and limit women's exposure
to semen, although they reportedly detract from sexual pleasure and carry social stigma. Female condoms were least preferred
because of obviousness and partial coverage of outer-genitalia that interfered with sexual pleasure. 相似文献
992.
Lafata JE Baker AM Divine GW McCarthy BD Xi H 《Journal of general internal medicine》2002,17(7):521-530
BACKGROUND: Although mailed reminders have been used for prevention among general populations, few studies have evaluated their effectiveness among chronically ill populations. OBJECTIVE: We evaluated the effectiveness of mailed reminders for improving diabetes management. The reminder included a letter from the individual's primary care physician (PCP), a self-care handbook, a preventive care checklist, and specific recommendations regarding receipt of routine monitoring and screening. METHODS: Of 195 PCPs practicing with a large group practice, 111 agreed to have their adult patients with diabetes randomized to receive the reminder (n = 1,641) or usual care (n = 1,668). Using data from automated databases, we fit generalized estimating equations to evaluate the effect of reminder receipt on fasting lipid profile and glycated hemoglobin testing, dilated retinal exam receipt, and visit frequency during the 6 and 12 months following randomization, and glycated hemoglobin and cholesterol levels in the year following randomization. RESULTS: Reminder and usual care recipients did not differ in sociodemographic, clinical, or prior testing characteristics. In the 6 months following randomization, reminder recipients were more likely to receive a retinal exam (odds ratio [OR], 1.29; 95% confidence interval [95% CI], 1.12 to 1.49) and diabetes visit (OR, 1.28; 95% CI, 1.12 to 1.47). In the 12 months following randomization, reminder recipients were more likely to receive a glycated hemoglobin test (OR, 1.21; 95% CI, 1.03 to 1.43), retinal exam (OR, 1.23; 95% CI, 1.07 to 1.41), and diabetes visit (OR, 1.25; 95% CI, 1.09 to 1.29). In the follow-up year, reminder recipients also tended to have a glycated hemoglobin test that did not reflect poor control (<9.5%). CONCLUSIONS: We found small but significant improvements in the management of patients with diabetes receiving a computerized mailed reminder. 相似文献
993.
Brief report: Quality of ambulatory care for women and men in the veterans affairs health care system 下载免费PDF全文
Jha AK Perlin JB Steinman MA Peabody JW Ayanian JZ 《Journal of general internal medicine》2005,20(8):762-765
BACKGROUND: Gender differences in inpatient quality of care are well known. However, whether men and women receive equivalent ambulatory care is less well understood. OBJECTIVE: To study gender differences in quality of care for patients receiving primary care in the Veterans Affairs (VA) Health Care System. DESIGN: Cross-sectional samples of VA enrollees during fiscal years 1999 to 2000. PARTICIPANTS: Samples of 6,442 to 86,405 men and women treated at VA facilities for whom at least 1 of 9 quality measures was available. MEASUREMENTS: Appropriate general preventive services (pneumococcal vaccination, influenza vaccination, colorectal cancer screening), and specific services for diabetes (annual hemoglobin A1c [HbA1c] testing, good glycemic control, annual diabetic eye exam), hypertension (good blood pressure control), or prior myocardial infarction (use of beta-blockers or aspirin). RESULTS: In adjusted analyses, there were no substantial gender differences in rates of appropriate care. For women compared with men, the adjusted relative risk for appropriate care ranged from 0.96 for blood pressure control (95% confidence interval: 0.93 to 0.99; P=.02) to 1.05 for HbA1c< or =8.0% (95% confidence interval: 1.03 to 1.07; P<.01). Analyses stratified by age demonstrated equivalent care between men and women in 9 of the 14 subgroups evaluated. CONCLUSIONS: In this large national health care system that predominantly serves men, the quality of ambulatory care is equivalent for women and men on numerous measures. 相似文献
994.
Hajime Orimo 《Geriatrics & Gerontology International》2004,4(S1):S3-S5
The aging of society is increasing very rapidly in most of the Asian countries. In Japan, the population of elderly aged 65 years and over is estimated to increase to 17.0% in 2000 – and to 25.0% of the entire population by 2020. The primary aim of geriatric medicine is to promote the health and quality-of-life of the elderly, leading them towards successful and active aging. In this plenary lecture, I would like to cover the following issues. (1) major diseases that cause disability in the elderly; (2) prevention of lifestyle and age-related disease; (3) medical care of the elderly in 21st century; and (4) future perspectives. 相似文献
995.
Eugeni García‐Grau Adela Fust Anna Mir Carmina Saldaa Arturo Bados 《European eating disorders review》2004,12(1):61-67
The main goal of this study was to analyse the relationship between coping styles and the predisposition to eating disorders in a sample of adolescent boys. The sample comprised 171 males (mean age 15.74 years) and the questionnaires used were the Eating Disorders Inventory‐2 (EDI‐2) and the Adolescent Coping Scale (ACS). The results indicated that self‐blame, a scale of the dimension intropunitive avoidance, characterized by self‐blaming excessively in the face of problems, was the strategy most closely linked to the predisposition to eating disorders. This scale accounted for 18 per cent of the variance of the total score of the EDI‐2, 11 per cent of the drive for thinness and 10 per cent of the body dissatisfaction. Several hypotheses are presented in an attempt to account for the differences between the results of this study and those obtained by studies carried out with adolescent girls. Finally, the need for prevention programmes for adolescents, in particular in groups at risk, is emphasized. Copyright © 2004 John Wiley & Sons, Ltd and Eating Disorders Association. 相似文献
996.
997.
998.
Lara A. Harvey Rebecca J. Mitchell Stephen R. Lord Jacqueline C.T. Close 《Australian and New Zealand journal of public health》2014,38(6):585-590
Objective: To examine the age‐specific population prevalence and predictors of uptake of home modifications and exercise to prevent falls in the NSW older population. Methods: A total of 5,681 respondents were asked questions on fall prevention activities as part of the 2009 NSW Falls Prevention Survey. Results were weighted to represent the NSW population. Regression analysis was used to determine factors associated with uptake of interventions. Results: Overall, 28.9% of the older population have modified their home, and 35.1% increased exercise to prevent falls. Main predictors of home modification were being aged 85+ (RR 2.04, 95% CI 1.76–2.35) and physiotherapy/occupational therapy intervention (RR 1.57, 95% CI 1.22–2.01). Main predictors of increasing exercise were physiotherapy/OT intervention (RR 2.12, 95% CI 1.86–2.42) and medical advice (RR 1.45, 95% CI1.32–1.60). Older respondents (RR 0.68, 95% CI 0.57–0.81) and those with fair/poor health (RR 0.86, 95% CI 0.77–0.96) were less likely to report increased exercise. Conclusion: More than one‐quarter of the older population of NSW report having made modifications to their home and one‐third increased exercise to prevent falls. There was a clear gradient of increased uptake of home modifications with increasing age, with the reverse trend for increased exercise. Implication: Although fall prevention initiatives are having an impact at the population level, targeted strategies for high‐risk groups are still required. 相似文献
999.
Cédric Rat Gaelle Quereux Christelle Riviere Sophie Clouet Rémy Senand Christelle Volteau Brigitte Dreno Jean-Michel Nguyen 《Annals of family medicine》2014,12(1):21-28
PURPOSE
Targeted interventions to reduce the risk and increase the early detection of melanoma have the potential to save lives. We aimed to assess the effect of such an intervention on patient prevention behavior.METHODS
We conducted a pilot clustered randomized controlled trial, comparing a targeted screening and education intervention with a conventional information-based campaign in 20 private surgeries in western France. In the intervention group, 10 general practitioners identified patients at elevated risk for melanoma with a validated assessment tool, the Self-Assessment Melanoma Risk Score (SAMScore), examined their skin, and counseled them using information leaflets. In the control group, 10 general practitioners displayed a poster and the leaflets in their waiting room and examined patients’ skin at their own discretion. The main outcome measures were sunbathing and skin self-examinations among patients at elevated risk, assessed 5 months later with a questionnaire.RESULTS
Analyses were based on 173 patients. Compared with control patients, intervention patients were more likely to remember the campaign (81.4% vs 50.0%, P = .0001) and to correctly identify their elevated risk of melanoma (71.1% vs 42.1%, P = .001). Furthermore, intervention patients had higher levels of prevention behaviors: they were less likely to sunbathe in the summer (24.7% vs 40.8%, P = .048) and more likely to have performed skin self-examinations in the past year (52.6% vs 36.8%, P = .029). The intervention was not associated with any clear adverse effects, although there were trends whereby intervention patients were more likely to worry about melanoma and to consult their general practitioner again about the disease.CONCLUSIONS
The combination of use of the SAMScore and general practitioner examination and counseling during consultations is an efficient way to promote patient behaviors that may reduce melanoma risk. Extending the duration of follow-up and demonstrating an impact on morbidity and mortality remain major issues for further research. 相似文献1000.