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991.
Job stress, absenteeism and coronary heart disease European cooperative study (the JACE study): Design of a multicentre prospective study 总被引:1,自引:0,他引:1
HOUTMAN IRENE; KORNITZER MARCEL; SMET PATRICK DE; KOYUNCU RAMAZAN; BACKER GUY DE; PELFRENE EDWIN; ROMON MONIQUE; BOULENGUEZ CHARLES; FERRARIO MARCO; ORIGGI GIANNI; SANS SUSANA; PEREZ INAKI; WILHELMSEN LARS; ROSENGREN ANNIKA; OLOFISACSSON SVEN; OSTERGREN PER-OLOF 《European journal of public health》1999,9(1):52-57
Background: The motives, objectives and design of a multicentreprospective study on job stress, absenteeism and coronary heartdisease in Europe (the JACE study) is presented in this paper.Some specific gaps in the reviewed literature are explicitlytapped into by the JACE study. Its objectives are i) to comparethe distributions of the Karasek job stress scales for the samebroad categories of occupations in different European countries(in males and females), ii) to study the predictive power ofthe job stress scales and the job strain model for one yearof sickness absence (in males and females) and iii) to studythe predictive power of the job stress scales and the job strainmodel for a three year incidence of coronary heart disease (Inmales only). Methods: In answering these questions, relationsare studied controlling for gender, age, level of education,company size, physical work risks and shift work, as well astraditional risk factors for CHD (i.e serum cholesterol, serumHDL cholesterol, smoking habits and blood pressure). The JACEstudy is a Biomed 1 concerted action. The JACE group consistsof eight participating centres from six countries, i.e. fromBelgium and Sweden (two centres), France, Italy, Spain, Swedenand The Netherlands (each one centre). The coordination of thegroup is in Brussels. The participating centres brought in over15, 000 European workers to test the hypotheses. 相似文献
992.
The tax exemption for not-for-profit hospitals has been subject to many recent challenges, in part related to concerns over whether these hospitals provide sufficient levels of community benefits to merit tax exemption. Computing the value of community benefits for California hospitals as the sum of uncompensated care, education and research, net income, money-losing services, and price discounts from for-profit hospitals reveals that 20 to 80 percent of hospitals would have met various recommended community benefits standards. There is a clear need for hospitals and their communities to establish dialogues on what levels of community benefits are appropriate. 相似文献
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Krista K. Wheeler Junxin Shi Henry Xiang Rajan K. Thakkar Jonathan I. Groner 《Journal of pediatric surgery》2018,53(4):765-770
Purpose
We sought to determine readmission rates and risk factors for acutely injured pediatric trauma patients.Methods
We produced 30-day unplanned readmission rates for pediatric trauma patients using the 2013 National Readmission Database (NRD).Results
In US pediatric trauma patients, 1.7% had unplanned readmissions within 30 days. The readmission rate for patients with index operating room procedures was no higher at 1.8%. Higher readmission rates were seen in patients with injury severity scores (ISS) = 16–24 (3.4%) and ISS ≥ 25 (4.9%). Higher rates were also seen in patients with LOS beyond a week, severe abdominal and pelvic region injuries (3.0%), crushing (2.8%) and firearm injuries (4.5%), and in patients with fluid and electrolyte disorders (3.9%). The most common readmission principal diagnoses were injury, musculoskeletal/integumentary diagnoses and infection. Nearly 39% of readmitted patients required readmission operative procedures. Most common were operations on the musculoskeletal system (23.9% of all readmitted patients), the integumentary system (8.6%), the nervous system (6.6%), and digestive system (2.5%).Conclusions
Overall, the readmission rate for pediatric trauma patients was low. Measures of injury severity, specifically length of stay, were most useful in identifying those who would benefit from targeted care coordination resources.Level of evidence
This is a Level III retrospective comparative study. 相似文献995.
Hare WA WoldeMussie E Weinreb RN Ton H Ruiz G Wijono M Feldmann B Zangwill L Wheeler L 《Investigative ophthalmology & visual science》2004,45(8):2640-2651
PURPOSE: To determine, using anatomic measurements, whether daily oral dosing with memantine is both safe and effective to reduce the injury associated with experimental glaucoma in primates. METHODS: Argon laser treatment of the anterior chamber angle was used to induce chronic ocular hypertension (COHT) in the right eyes of 18 macaque monkeys. Nine animals were daily orally dosed with 4 mg/kg memantine while the other nine animals received vehicle only. Measurements of intraocular pressure (IOP) from both eyes of all animals were made at regular intervals. Appearance of the optic nerve head, retinal vessels, and surrounding retina was documented with stereo fundus photographs obtained at multiple time points throughout the study. Measurements of optic nerve head topography were obtained from confocal laser scans made from animals with the highest IOPs at approximately 3, 5, and 10 months after elevation of IOP. At approximately 16 months after IOP elevation, animals were killed and histologic counts of cells in the retinal ganglion cell (RGC) layer were made. RESULTS: Histologic measurements showed that, for animals with moderate elevation of IOP, memantine treatment was associated with an enhanced survival of RGCs in the inferior retina. Measurements of optic nerve head topography showed less IOP-induced change in memantine-treated animals. This effect was seen in measurements of both the cup and the neuroretinal rim. A comparison of these same histologic and morphologic measurements in normotensive eyes from the two treatment groups showed that memantine treatment was not associated with any significant effects on these eyes. CONCLUSIONS: Histologic measurements of RGC survival as well as tomographic measurements of nerve head topography show that systemic treatment with memantine, a compound which does not lower intraocular pressure, is both safe and effective to reduce changes associated with experimental glaucoma. 相似文献
996.
997.
998.
Ben Caplin Kristin Veighey Arundathi Mahenderan Miriam Manook Joanne Henry Dorothea Nitsch Mark Harber Peter Dupont David C. Wheeler Gareth Jones Bimbi Fernando Alexander J. Howie Peter Veitch 《Clinical transplantation》2013,27(6):E669-E678
The amount of irreversible injury on renal allograft biopsy predicts function, but little is known about the early evolution of this damage. In a single‐center cohort, we examined the relationship between donor‐, recipient‐, and transplantation‐associated factors and change in a morphometric index of chronic damage (ICD) between protocol biopsies performed at implantation and at 2–3 months. We then investigated whether early delta ICD predicted subsequent biochemical outcomes. We found little evidence to support differences between the study group, who had undergone serial biopsies, and a contemporaneous control group, who had not. In allografts with serial biopsies (n = 162), there was an increase in ICD between implantation (median: 2%, IQR:0–8) and 2–3 months post‐transplant (median 8% IQR:4–15; p < 0.0001). Donation from younger or live donors was independently associated with smaller early post‐transplant increases in ICD. There was no evidence for a difference in delta ICD between donation after cardiac death vs. donation after brain death, nor association with length of cold ischemia. After adjustment for GFR at the time of the second biopsy, delta ICD after three months did not predict allograft function at one yr. These findings suggest that graft damage develops shortly after transplantation and reflects donor factors, but does not predict future biochemical outcomes. 相似文献
999.
Patel MI DeConcini DT Lopez-Corona E Ohori M Wheeler T Scardino PT 《The Journal of urology》2004,171(4):1520-1524
PURPOSE: We evaluated expectant management of prostate cancer with definitive treatment deferred until evidence of cancer progression in men with low risk, localized cancers. MATERIALS AND METHODS: We retrospectively reviewed prospectively entered data base records. Patients with low risk cancer who were eligible for definitive therapy but chose deferred management between 1984 and 2001 composed the cohort. Followup included regular evaluations to detect progression by prostate specific antigen (PSA), digital rectal examination, transrectal ultrasound and prostate biopsy. Objective progression was defined by a point scale of changes in prognostic factors. Definitive treatment was recommended in patients with objective progression. RESULTS: The cohort comprised 88 patients with clinical stages T1-2, NX0, M0 prostate cancer, a mean age of 65.3 years and a mean initial PSA of 5.9 ng/ml. Systematic biopsy, which was repeated after the initial diagnostic biopsy, showed no cancer in 61% of cases. During a median followup of 44 months 22 patients had progression. Factors that predicted progression were repeat biopsy showing cancer (p = 0.004) and initial PSA (p = 0.014). Actuarial 5 and 10-year progression-free probabilities were 67% and 55%, respectively. Of the 31 patients treated 17 underwent radical prostatectomy, 13 received radiation therapy and 1 received androgen ablation. Seven men who did not show objective progression were treated because of anxiety. Only 1 patient, who was treated with radiation therapy, had biochemical recurrence. CONCLUSIONS: Deferred therapy may be a feasible alternative to curative treatment in select patients with favorable, localized prostate cancer. About half of these patients remain free of progression at 10 years and definitive treatment appeared effective in those with progression. Absent cancer on repeat needle biopsy identified cases highly unlikely to progress. 相似文献
1000.
Royal K. Law Josh Schier Jay Schauben Katherine Wheeler Prakash Mulay 《Online Journal of Public Health Informatics》2013,5(1)