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61.
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OBJECTIVES: This study investigated racial differences in mammography use and their association with physicians' recommendations and other factors. METHODS: The study used 1988 survey data for 948 women 50 years of age and older from the New Hanover Breast Cancer Screening Program. Racial differences in terms of physician recommendation, personal characteristics, health characteristics, and attitudes toward breast cancer and mammography were examined. Factors at least minimally associated with race and use were included in multivariate logistic regression analyses to examine the effect of race while controlling for other factors. RESULTS: In comparison with White women. Black women were half as likely to report ever having had a mammogram (27% vs 52%) and having a mammogram in the past year (17% vs 36%). Black women also significantly less often reported physician recommendation (25% vs 52%). Although Black and White women differed significantly in other characteristics, multivariate logistic regression analyses indicated that physician recommendation accounted for 60% to 75% of the initial racial differences in mammography use. CONCLUSIONS: Understanding physicians' recommendations for breast cancer screening is a critical first step to increasing mammography use in disadvantaged populations. 相似文献
64.
Cognitive models of depression propose that negative schemas contribute to depressive symptoms. Early experiences, particularly parenting, have been proposed to influence cognitive schemas and have also been shown to correlate with depression. This study explores the concurrent relationship between retrospective reports of parenting, Early Maladaptive Schemas (EMSs) described by J. E. Young (1994), and symptoms of depression in a sample of undergraduate students (N = 194). The EMSs of defectiveness/shame, insufficient self-control, vulnerability, and incompetence/inferiority were associated with perceptions of parenting and depressive symptomatology. There was evidence that these four EMSs partially mediate the relationship between parental perceptions and depressive symptomatology. Results are discussed in relation to previous findings, theory, and the measurement of EMSs. 相似文献
65.
A report of a patient with an azygos lobe and an associated anomalous azygos vein covering the upper thoracic sympathetic chain. This anomaly poses a significant risk during the procedure of endoscopic thoracic sympathectomy. A chest X-ray is useful in detecting this anomaly and alerting the surgeon to potential problems. 相似文献
66.
Pseudomembranous tracheobronchitis caused by Aspergillus 总被引:1,自引:0,他引:1
D W Hines M H Haber L Yaremko C Britton R W McLawhon A A Harris 《The American review of respiratory disease》1991,143(6):1408-1411
Four immunosuppressed patients with a rapidly evolving, febrile, respiratory distress syndrome were found at autopsy to have Aspergillus pseudomembranes of their lower tracheobronchial tree. Steroids, neutropenia, broad spectrum antibiotic use, and alcoholism appear to be predisposing risk factors. Bronchoscopy may reveal the pathology but antemortem diagnosis is difficult because of the low yield of sputum cultures and fulminant nature of the disease. 相似文献
67.
J. Keith Smith M.D. Ph.D. Gordon C. Carson III M.D. Jay D. Johnson B.S. John H. Harris Jr. M.D. D.Sc. F.A.C.R. 《Emergency radiology》1994,1(2):78-80
Purpose: To describe an educational computer aided instruction program dealing with diagnosis and classification of facial
fractures.
Methods: A program was created for use on Macintosh computers using a graphic presentation package. This program allows for
the display of high resolution digitized radiographic images and illustrations, along with integrated voice and text information.
Users can interact with the program to review complex concepts or study additional cases. Case material was obtained from
selected high quality plain radiographs and computed tomography (CT) scans obtained in the trauma center of one institution,
and was scanned on a high resolution digital scanner with image parameters optimized for viewing on the Macintosh high resolution
color monitor.
Results: The program has been installed in the computer aided instructional laboratories or trauma centers at The University
of Texas Health Science Center, Houston; The University of Alabama, Birmingham; Emory University School of Medicine, Atlanta,
Georgia; and The University of North Carolina, Chapel Hill. The program is available to radiology residents and medical students
rotating on the trauma radiology services at these institutions. Completion of the program requires 30–45 minutes.
Conclusion: Based on our initial experience, the program has been used by residents in the training programs of all institutions
with favorable results. 相似文献
68.
Zhenfeng Xu Dajoie R Croslan Adalynn E Harris Gregory D Ford Byron D Ford 《Journal of cerebral blood flow and metabolism》2006,26(4):527-535
We have previously shown that neuregulin-1 (NRG-1) protects neurons from ischemic brain injury if administered before focal stroke. Here, we examined the therapeutic window and functional recovery after NRG-1 treatment in rats subjected to 90 mins of middle cerebral artery occlusion (MCAO) and 24 h of reperfusion. Neuregulin-1 (2.5 ng/kg bolus, 1.25 ng/kg/min infusion) reduced infarct volume by 89.2%+/-41.9% (mean+/-s.d.; n=8; P<0.01) if administered immediately after the onset of reperfusion. Neuroprotection was also evident if NRG-1 was administered 4 h (66.4%+/-52.6%; n=7; P<0.01) and 12 h (57.0%+/-20.8%; n=8; P<0.01) after reperfusion. Neuregulin-1 administration also resulted in a significant improvement of functional neurologic outcome compared with vehicle-treated animals (32.1%+/-5.7%; n=9; P<0.01). The neuroprotective effect of the single administration of NRG-1 was seen as long as 2 weeks after treatment. Neurons labeled with the neurodegeneration marker dye Fluoro-JadeB were observed after MCAO in the cortex, but the numbers were significantly reduced after NRG-1 treatment. These results indicate that NRG-1 is a potent neuroprotective compound with an extended therapeutic window that has practical therapeutic potential in treating individuals after ischemic brain injury. 相似文献
69.
70.
QALYfying the value of life. 总被引:10,自引:0,他引:10
J Harris 《Journal of medical ethics》1987,13(3):117-123
This paper argues that the Quality Adjusted Life Year or QALY is fatally flawed as a way of priority setting in health care and of dealing with the problem of scarce resources. In addition to showing why this is so the paper sets out a view of the moral constraints that govern the allocation of health resources and suggests reasons for a new attitude to the health budget. 相似文献