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排序方式: 共有339条查询结果,搜索用时 31 毫秒
31.
Kevin L. Kraemer MD MSc Michael F. Mayo‐Smith MD MPH David R. Calkins MD MPP 《Substance Abuse》2013,34(4):197-209
This retrospective cohort study sought to identify clinical variables that independently correlate with severe alcohol withdrawal and to quantify risk in a clinically useful manner. The records of 284 inpatients admitted to an acute detoxification unit at a Veterans Affairs teaching hospital were reviewed. Clinical data were recorded on standardized forms at the time of admission and abstracted by a physician reviewer. Alcohol withdrawal severity was prospectively measured with the revised Clinical Institute Withdrawal Assessment for Alcohol (CIWA‐Ar) scale. Seventy‐one patients (25% of cohort) had severe withdrawal. We identified six independent correlates of severe withdrawal: use of a morning eye‐opener (adjusted odds ratio [OR], 5.6; 95% confidence interval [CI], 1.2–25.9), an initial CIWA‐Ar score ≥ 10 (OR, 5.1; 95% CI, 2.4–10.6), a serum aspartate aminotransferase ≥ 80 U/L (OR, 4.2; 95% CI, 2.0–8.8), past benzo‐diazepine use (OR, 3.6; 95% CI, 1.3–9.9), self‐reported history of “delirium tremens”; (OR, 2.9; 95% CI, 1.3–6.2), and prior participation in two or more alcohol treatment programs (OR, 2.6; 95% CI, 1.3–5.6). Significantly higher risk was observed in subjects with three or more independent correlates. In conclusion, several readily available clinical variables correlate with the occurrence of severe alcohol withdrawal. Ascertainment of these variables early in the course of alcohol withdrawal has the potential to improve triage and treatment decisions. 相似文献
32.
ABSTRACT The present analyses were undertaken to understand the role of workplace characteristics in the breastfeeding practices of working women. The effects of the perception of the availability of employer-sponsored child care, the perception of the availability of a flexible schedule, hours worked at home, and worked a fixed schedule on breastfeeding outcomes were estimated using a sample of 1,506 births from the National Longitudinal Survey of Youth 1979 and the Children of the National Longitudinal Survey of Youth 1979. The availability of employer-sponsored child care increased the likelihood of breastfeeding six months after birth by 47 percent. In addition, working an additional eight hours at home per week, at the mean, increased the probability of breastfeeding initiation by 8 percent and breastfeeding six months after birth by 16.8 percent. Workplace characteristics show promise as an effective way to increase breastfeeding rates among working women. 相似文献
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Dr. Lawrence K. Gottlieb MD MPP Halsted R. Holman MD 《Journal of general internal medicine》1992,7(6):630-635
OBJECTIVE: To determine the views of leaders in academic medicine concerning the need for programs in preventive medicine (PM) and the prevailing barriers to program development. DESIGN: Structured interviews. SETTING: Medical schools of the United States. PATIENTS/PARTICIPANTS: 90% of deans and chairpersons of departments of medicine and preventive medicine. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: 91% considered academic PM underdeveloped and 100% considered their own programs average or worse. Identified barriers to development included funding constraints, academic partiality to biomedicine, inadequate quality of preventive medicine research and faculty, public preferences for technologic care, and organization of academic medical centers (AMCs). While 80% perceived a shortage of able PM faculty and 60% considered PM research quality to be inadequate, only 12% of PM units gave research training high priority. While 95% of respondents held that AMCs should develop community programs and 75% identified social problems as a cause of chronic diseases, 65% agreed that community programs are not considered scholarly. Only 23% of PM units gave community service high priority. CONCLUSIONS: A policy contradiction exists: academic leadership agreed on the problems and needed changes in PM, yet the problems were often attributed to nonacademic sources, particularly finding and public preferences, and current academic practices commonly fail to address recognized developmental barriers within academic institutions. A chain of barriers is apparent. Breaking the chain may require a change in our understanding of the role of prevention. 相似文献
35.
Impacts of a School‐Wide,Peer‐Led Approach to Sexuality Education: A Matched Comparison Group Design 下载免费PDF全文
Dana Rotz PhD Brian Goesling PhD Jennifer Manlove PhD Kate Welti MPP Christopher Trenholm PhD 《The Journal of school health》2018,88(8):549-559
BACKGROUND
Teen Prevention Education Program (PEP) is a school‐wide, peer‐led comprehensive sexuality education program currently implemented in more than 50 schools across 2 states. Many teen pregnancy prevention researchers and practitioners view peer‐led programs as a promising approach for reducing teen pregnancy and associated sexual risk behaviors. However, prior research on the effectiveness of these programs indicates mixed results.METHODS
We randomly assigned schools to implement Teen PEP immediately (intervention group) or on a delayed schedule (comparison group) and used propensity score matching to improve the comparability of the study groups. We surveyed students at baseline and about 6 months after the program ended.RESULTS
Teen PEP did not significantly impact rates of sexual activity or unprotected sex; however, the program led to improvements in exposure to information about sexual health topics and knowledge of preventing pregnancy and transmission of sexually transmitted infections.CONCLUSIONS
Teen PEP succeeded in accomplishing some of its most proximal goals, increasing students' access to information and knowledge. However, we found little evidence that the program affects sexual risk‐taking within 6 months of its conclusion. Future research will examine the program's longer‐term impacts on sexual risk behaviors.36.
37.
Bret A. Nicks MD MHA Manish N. Shah MD MPH David H. Adler MD MPH Aveh Bastani MD FACEP Christopher W. Baugh MD MBA Jeffrey M. Caterino MD MPH Carol L. Clark MD MBA Deborah B. Diercks MD MPH Judd E. Hollander MD Susan E. Malveau MSBME Daniel K. Nishijima MD MAS Kirk A. Stiffler MD Alan B. Storrow MD Scott T. Wilber MD Annick N. Yagapen MPH CCR Benjamin C. Sun MD MPP 《Academic emergency medicine》2017,24(4):458-466
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39.
Impact of Hospital “Best Practice” Mandates on Prescription Opioid Dispensing After an Emergency Department Visit 下载免费PDF全文
40.
Cancer survivors' disclosure of complementary health approaches to physicians: The role of patient‐centered communication 下载免费PDF全文