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91.
Determination of a Testing Threshold for Lumbar Puncture in the Diagnosis of Subarachnoid Hemorrhage after a Negative Head Computed Tomography: A Decision Analysis 下载免费PDF全文
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Adherence to an Accelerated Diagnostic Protocol for Chest Pain: Secondary Analysis of the HEART Pathway Randomized Trial 下载免费PDF全文
Simon A. Mahler MD MS Robert F. Riley MD Gregory B. Russell MS Brian C. Hiestand MD MPH James W. Hoekstra MD Cedric W. Lefebvre MD Bret A. Nicks MD David M. Cline MD Kim L. Askew MD John Bringolf MD Stephanie B. Elliott David M. Herrington MD MHS Gregory L. Burke MD MSc Chadwick D. Miller MD MS 《Academic emergency medicine》2016,23(1):70-77
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Lisa Kane Low PhD CNM FAAN Beverly Rosa Williams PhD Deepa R. Camenga MD MHS Jeni Hebert‐Beirne PhD MPH Sonya S. Brady PhD Diane K. Newman DNP ANP‐BC FAAN Aimee S. James PhD MPH Cecilia T. Hardacker MSN RN CNL Jesse Nodora DrPH Sarah E. Linke PhD MPH Kathryn L. Burgio PhD 《Journal of advanced nursing》2019,75(11):3111-3125
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Gregory M. Pontone MD James R. Williams MHS Karen E. Anderson MD Gary Chase PhD Susanne A. Goldstein MD Stephen Grill MD PhD Elaina S. Hirsch BS Susan Lehmann MD John T. Little MD Russell L. Margolis MD Peter V. Rabins MD Howard D. Weiss MD Laura Marsh MD 《Movement disorders》2009,24(9):1333-1338
Anxiety disorders are common in Parkinson's disease (PD), but are not well characterized. This study determined the prevalence and clinical correlates of all DSM‐IV‐TR anxiety disorder diagnoses in a sample of 127 subjects with idiopathic PD who underwent comprehensive assessments administered by a psychiatrist and neurologist. A panel of six psychiatrists with expertise in geriatric psychiatry and/or movement disorders established by consensus all psychiatric diagnoses. Current and lifetime prevalence of at least one anxiety disorder diagnosis was 43% (n = 55) and 49% (n = 63), respectively. Anxiety disorder not otherwise specified, a DSM diagnosis used for anxiety disturbances not meeting criteria for defined subtypes, was the most common diagnosis (30% lifetime prevalence, n = 38). Compared with nonanxious subjects, panic disorder (n = 13) was associated with earlier age of PD onset [50.3 (12.2) vs. 61.0 (13.7) years, P < 0.01], higher rates of motor fluctuations [77% (10/13) vs. 39% (25/64), P = 0.01] and morning dystonia [38% (5/13) vs. 13% (8/62), P < 0.03]. This high prevalence of anxiety disorders, including disturbances often not meeting conventional diagnostic criteria, suggests that anxiety in PD is likely underdiagnosed and undertreated and refined characterization of anxiety disorders in PD is needed. In addition, certain anxiety subtypes may be clinically useful markers associated with disease impact in PD. © 2009 Movement Disorder Society 相似文献
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BACKGROUND Previous studies suggest that patients who are more involved in their medical care have better outcomes.
OBJECTIVES We sought to compare health care processes and outcomes for patients with HIV based on their preferred level of involvement
in health decisions.
DESIGN Cross-sectional analysis of audio computer-assisted interviews with patients at an urban HIV clinic.
PATIENTS One thousand and twenty-seven patients awaiting an appointment with their primary care provider.
MEASURES Patients were asked how they preferred to be involved in decisions (doctor makes most or all decisions, doctor and patient
share decisions, patient makes all decisions). We also asked patients to rate the quality of communication with their HIV
provider, and their self-reported receipt of and adherence to HAART.
RESULTS Overall, 23% patients preferred that their doctor make all or most decisions, 63% preferred to share decisions with their
doctor, and 13% preferred to make all final decisions alone. Compared to patients who prefer to share decisions with their
HIV provider, patients who prefer that their provider make all/most decisions were significantly less likely to adhere to
HAART (OR [odds ratio] 0.57, 95% CI 0.38–0.86) and patients who preferred to make decisions alone were significantly less
likely to receive HAART or to have undetectable HIV RNA in unadjusted analyses (OR 0.52, 95% CI 0.31–0.87 for receipt of HAART;
OR 0.64, 95% CI 0.44–0.95 for undetectable HIV RNA). After controlling for potentially confounding patient characteristics
and differences in patient ratings of communication quality, patients who preferred that their provider make all/most decisions
remained significantly less likely to adhere to HAART (OR 0.58, 95% CI 0.38–0.89); however, the associations with receipt
of HAART and undetectable HIV RNA were no longer significant (OR 0.60, 95% CI 0.34–1.05 for receipt of HAART; OR 0.80, 95%
C.I 0.53–1.20 for undetectable HIV RNA).
CONCLUSIONS Although previous research suggests that more patient involvement in health care decisions is better, this benefit may be
reduced when the patient wants to make decisions alone. Future research should explore the extent to which this preference
is modifiable so as to improve outcomes. 相似文献