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91.
Nelson KM 《Journal of general internal medicine》2006,21(9):915-919
BACKGROUND: Few national data exist about the prevalence of obesity and the resulting health burden among veterans. METHODS: We analyzed data from the 2003 Behavioral Risk Factor Surveillance System (n = 242,362) to compare rates of obesity among veterans who do and do not utilize the VA, compared with nonveterans. We used bivariate analyses to describe the association of obesity with lifestyle factors, disability, and comorbid disease, and multivariate analysis to assess the independent association of obesity with VA care. RESULTS: Veterans who use the VA for health care have the highest rates of obesity compared with veterans who do not use the VA and nonveterans (27.7% vs 23.9% vs 22.8%, P < .001). Only 27.8% of veterans who receive health care at the VA are of normal weight (vs 42.6% of the general population, P < .001), 44.5% are overweight, 19.9% have class I obesity, 6% have class II obesity, and 1.8% are morbidly obese (an estimated 82,950 individuals). Obese veterans who utilize the VA for services have higher rates of hypertension (65.8%) and diabetes (31.3%), are less likely to follow diet and exercise guidelines, and more likely to report poor health and disability than their normal-weight counterparts. CONCLUSIONS: Veterans who receive care at the VA have higher rates of overweight and obesity than the general population. At present, less than half of VA medical centers have weight management programs. As the largest integrated U.S. health system, the VA has a unique opportunity to respond to the epidemic of obesity. 相似文献
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Tyler G. Ketterl MD MS Karen L. Syrjala PhD Jacqueline Casillas MD MSHS Linda A. Jacobs PhD CRNP Steven C. Palmer PhD Mary S. McCabe RN MA Patricia A. Ganz MD Linda Overholser MD Ann Partridge MD MPH Emily Jo Rajotte MPH Abby R. Rosenberg MD MS MA Betsy Risendal PhD Donald L. Rosenstein MD Kevin Scott Baker MD MS 《Cancer》2019,125(11):1908-1917
93.
Studies of Physician‐Patient Communication with Older Patients: How Often is Hearing Loss Considered? A Systematic Literature Review 下载免费PDF全文
Jamie M. Cohen BS Jan Blustein MD PhD Barbara E. Weinstein PhD Hannah Dischinger BS Scott Sherman MD MPH Corita Grudzen MD MSHS Joshua Chodosh MD MSHS 《Journal of the American Geriatrics Society》2017,65(8):1642-1649
Hearing loss is remarkably prevalent in the geriatric population: one‐quarter of adults aged 60–69 and 80% of adults aged 80 years and older have bilateral disabling loss. Only about one in five adults with hearing loss wears a hearing aid, leaving many vulnerable to poor communication with healthcare providers. We quantified the extent to which hearing loss is mentioned in studies of physician‐patient communication with older patients, and the degree to which hearing loss is incorporated into analyses and findings. We conducted a structured literature search within PubMed for original studies of physician‐patient communication with older patients that were published since 2000, using the natural language phrase “older patient physician communication.” We identified 409 papers in the initial search, and included 67 in this systematic review. Of the 67 papers, only 16 studies (23.9%) included any mention of hearing loss. In six of the 16 studies, hearing loss was mentioned only; in four studies, hearing loss was used as an exclusion criterion; and in two studies, the extent of hearing loss was measured and reported for the sample, with no further analysis. Three studies examined or reported on an association between hearing loss and the quality of physician‐patient communication. One study included an intervention to temporarily mitigate hearing loss to improve communication. Less than one‐quarter of studies of physician‐elderly patient communication even mention that hearing loss may affect communication. Methodologically, this means that many studies may have omitted an important potential confounder. Perhaps more importantly, research in this field has largely overlooked a highly prevalent, important, and remediable influence on the quality of communication. 相似文献
94.
Preoperative Psoas Muscle Size Predicts Postoperative Delirium in Older Adults Undergoing Surgery: A Pilot Cohort Study 下载免费PDF全文
95.
Low‐Dose Intravenous Soybean Oil Emulsion for Prevention of Cholestasis in Preterm Neonates 下载免费PDF全文
Orly L. Levit MD Kara L. Calkins MD L. Caroline Gibson MD Lorraine Kelley‐Quon MD MSHS Daniel T. Robinson MD David A. Elashoff PhD Tristan R. Grogan MS Ning Li PhD Matthew J. Bizzarro MD Richard A. Ehrenkranz MD 《JPEN. Journal of parenteral and enteral nutrition》2016,40(3):374-382
Background: Premature infants depend on intravenous fat emulsions to supply essential fatty acids and calories. The dose of soybean‐based intravenous fat emulsions (S‐IFE) has been associated with parenteral nutrition (PN)–associated liver disease. This study's purpose was to determine if low‐dose S‐IFE is a safe and effective preventive strategy for cholestasis in preterm neonates. Materials and Methods: This is a multicenter randomized controlled trial in infants with a gestational age (GA) ≤29 weeks. Patients <48 hours of life were randomized to receive a low (1 g/kg/d) or control dose (approximately 3 g/kg/d) of S‐IFE. The primary outcome was cholestasis, defined as a direct bilirubin ≥15% of the total bilirubin at 28 days of life (DOL) or full enteral feeds, whichever was later, after 14 days of PN. Secondary outcomes included growth, length of hospital stay, death, and major neonatal morbidities. Results: In total, 136 neonates (67 and 69 in the low and control groups, respectively) were enrolled. Baseline characteristics were similar for the 2 groups. When the low group was compared with the control group, there was no difference in the primary outcome (69% vs 63%; 95% confidence interval, ?0.1 to 0.22; P = .45). While the low group received less S‐IFE and total calories over time compared with the control group (P < .001 and P = .03, respectively), weight, length, and head circumference at 28 DOL, discharge, and over time were not different (P > .2 for all). Conclusion: Compared with the control dose, low‐dose S‐IFE was not associated with a reduction in cholestasis or growth. 相似文献
96.
Disparities in the use of screening magnetic resonance imaging of the breast in community practice by race,ethnicity, and socioeconomic status 下载免费PDF全文
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