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941.
Malcolm P. Cutchin MA James C. Norton PhD Mae Marie Quan MSEd David Bolt MA Sarah Hughes BSN Barry Lindeman MBA 《The Journal of rural health》1994,10(4):273-278
An important aspect of primary care physician availability is the retention of physicians once they have located. While retention has been under-researched compared to recruitment, it is especially important in rural areas where physician shortages already exist. This study reports the results of a retention survey completed by 132 primary care physicians in rural eastern Kentucky. The survey sets up an objective, hypothetical retention scenario and asks physicians to respond to structured questions and to an open-ended question about factors not appearing in the survey. In response to the structured portion of the survey, physicians indicate that relief coverage is the most important factor in rural physician retention. A content analysis of 75 open-ended responses reveals that besides the other factors in the survey, "sociocultural integration" is the pre-eminent retention issue for rural practitioners. This article concludes that the role of the local rural community may be more important in retention than in recruitment. Finally, it is suggested that additional in-depth qualitative research be conducted within the local contexts to enhance the understanding of rural physician retention processes. 相似文献
942.
目的:探讨体外模型评价神经生长因子(nerve growth factor,NGF)抗体在膝骨关节炎(knee osteoarthritis,KOA)疼痛模型中的作用。方法:选取30只8周龄雄性SPF大鼠,分为空白组10只;其余20只行右膝关节单碘乙酸 (monoiodoacetate,MIA) 注射,制备骨性关节炎疼痛模型。造模成功后,再根据干预方法不同分为对照组(生理盐水腹腔注射)、治疗组(抗NGF 腹腔注射),每组10只。所有动物右膝关节进行荧光金 (fluorogold,FG) 逆行神经示踪剂注射。分别在治疗前,治疗后1、2周使用猫道步态分析系统评估步态。治疗后3周,从L3-L5水平切除右背根神经节(dorsal root ganglia,DRG),进行降钙素基因相关肽 (calcitonin gene-related peptide,CGRP) 免疫染色,并计算DRG数量。结果:在使用猫道系统的步态分析中,与空白组相比,对照组、治疗组占空比、摆动速度和触地面积比率明显降低(P<0.05);与对照组相比,治疗组占空比、摆动速度明显改善(P<0.05),触地面积比率与空白组比较,差异无统计学意义(P>0.05)。对照组中FG标记的DRG神经元数量高于治疗组和空白组(P<0.05);对照组CGRP表达上调,与治疗组比较,差异有统计学意义(P<0.05)。结论:腹腔注射抗 NGF抗体抑制了步态损伤和 DRG 神经元中CGRP 的上调。这些发现提示抗神经生长因子治疗可能对治疗膝关节疼痛有价值。NGF可能是治疗KOA疼痛的重要靶点。 相似文献
943.
944.
945.
Usha Sambamoorthi PhD Stephen Crystal PhD Rizie Kumar MA Jeff Harman PhD 《Women's health issues》1999,9(6):286-294
Research Objectives: To develop population-based estimates of estrogen replacement therapy use rates in 1995 among women over age 65 living in the community; to estimate the impact of socioeconomic and health characteristics on estrogen use. Method: Estimates are based on a large, nationally representative sample of Medicare beneficiaries; detailed self-report data were merged with Medicare claims. Results: Overall, 13.1% of women reported use of estrogen replacement therapy in 1995. Estrogen users were more likely to be white, age 65–74, with private insurance, high income, history of osteoporosis and heart problems, no history of breast cancer, and a patient of gynecologists. Conclusions: Estrogen use was substantially lower among the socioeconomically disadvantaged, controlling for medical history variables, suggesting considerable inequity in access to estrogen replacement therapy treatment. 相似文献
946.
947.
Tracy Roberts BSc MPhil RGN Stirling Bryan BSc MSc Chris Heginbotham BSc MSc MA & Alison McCallum MB ChB MSc FFPHM 《Health expectations》1999,2(4):235-244
Background Public involvement in health care decision making and priority setting in the UK is being promoted by recent policy initiatives. In 1993, the British Medical Association called for public consultation where rationing of services was to be undertaken. The approach to priority setting advocated by many health economists is the maximization of quality adjusted life years (QALYs). Typically, for a particular health care programme, the QALY calculation takes account of four features: (1) the number of patients receiving the programme, (2) the survival gain, (3) the gain in quality of life and, (4) the probability of treatment success. Only one feature, that relating to quality of life, is based upon public preferences. If the QALY is to be used as a tool for health care resource allocation at a societal level then it should incorporate broader societal preferences.
Methods This study used an interview-based survey of 91 members of the general public to explore whether the traditional QALY maximization model is a good predictor of public responses to health care priority setting choices.
Results and conclusions Many respondents did not choose consistently in line with a QALY maximization objective and were most influenced by quality of life concerns. There was little support for health care programmes that provided a prognostic improvement but left patients in relatively poor states of health. The level of respondent engagement in the survey exercise was not sensitive to the provision of supporting clinical information. 相似文献
Methods This study used an interview-based survey of 91 members of the general public to explore whether the traditional QALY maximization model is a good predictor of public responses to health care priority setting choices.
Results and conclusions Many respondents did not choose consistently in line with a QALY maximization objective and were most influenced by quality of life concerns. There was little support for health care programmes that provided a prognostic improvement but left patients in relatively poor states of health. The level of respondent engagement in the survey exercise was not sensitive to the provision of supporting clinical information. 相似文献
948.
获得纯化的由大肠杆菌表达的小鼠 Fas配体(Fas ligand,FasL)。方法:以质粒 pET-15b为载体,在大肠杆菌BL21(DE3)中表达小鼠的FasL,用金属螫合亲和层析法纯化。结果:转化菌中,重组质粒是稳定的,异丙基-β-D硫代半乳糖苷可诱导小鼠FasL的表达 ,金属螫合亲和层析法可以初步纯化此蛋白。结论:在大肠杆菌中表达出小鼠的FasL,并得到初步纯化。 相似文献
949.
目的 比较常规疗法伍用增免灵与单用常规疗法对活动性肺结核的疗效及外周血T 淋巴细胞亚群的影响。方法 抽取常规化疗组(61 例)、常规化疗加增免灵组(72 例) 及健康对照组(35 例) 患者外周血,用APAAP法测定外周血淋巴细胞亚群。结果 活动性肺结核患者外周血CD+3 及CD+4 百分率及CD+4 /CD+8 比值显著低于健康对照组( P< 0.05) ,CD+8 高于健康对照组。结论 短程化疗伍用增免灵可显著改善活动性肺结核的疗效及细胞免疫状况。 相似文献
950.
尾部悬吊及恢复过程中大鼠动脉血管收缩反应的变化 总被引:2,自引:2,他引:0
目的 探讨模拟失重下动脉收缩反应变化的时程特征及其可逆性。方法 采用尾部悬吊大鼠模型模拟失重,利用离休动脉环测定血管收缩反应的变化。结果 尾部悬吊2wk后,大鼠的腹主动脉、肠系膜动脉和股动脉收缩反应明显降低,而颈总动脉无明显改变;悬吊4wk后,肠系膜动脉和股动脉的收缩反应与悬吊2wk相比有进一步的降低;悬吊8wk大鼠的动脉血管收缩反应性与悬吊4wk相比无明显差异;4wk尾部悬吊大鼠解除悬吊后5wk 相似文献