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S.L. Hendrix DO S.D. Piereson MD S.G. McNeeley MD 《American journal of obstetrics and gynecology》1995,172(6):1719-1725
Objective: Our purpose was to determine whether primary and preventive care is practiced by a university obstetrician-gynecologist group practice.Study design: A retrospective chart review spanning 2 years of four academic physicians' private practices was performed. A total of 335 patients were reviewed with 739 patient encounters and 1032 patient problems identified. The definition of a primary care physician according to The American College of Obstetricians and Gynecologists was used to standardize data collection and evaluation.Results: Obstetric complaints accounted for 27.7% of all visits, whereas 65.4% were for gynecologic problems. Almost 7% of all complaints were neither obstetric nor gynecologic, and of those 74.6% were primary care problems completely managed by the obstetrician-gynecologist. Only 19.7% of these were referred for management. More than 89% of all encounters () involved some element of primary care.Conclusion: This study provides evidence that the majority of health care provided by the obstetrician-gynecologists is primary care. 相似文献
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RHONDA NAY 《Journal of clinical nursing》1995,4(5):319-325
Summary
- ? The lived experience of relocating to a nursing home is explored from the perspective of 19 residents of Australian nursing homes.
- ? The interpretative research methodology is informed by hermeneutic phenomenology.
- ? In-depth interviews were conducted with 19 nursing home residents living in nursing homes in NSW. Interviews were audiotaped, transcribed and analysed to identify emergent themes.
- ? The themes are described and interpreted to provide an understanding of the relocation experience.
995.
- ? A pilot study of catheterized women was designed to investigate their perceptions of pain and discomfort during the procedure.
- ? The study aimed to test the feasibility of conducting a larger randomized controlled trial.
- ? Problems were encountered during the execution of the study, due to the need to conform to established principles in clinical research.
- ? Restrictions on access to patients impinged upon the opportunity to ‘cast the net wide’ in order to generate meaningful data.
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Braithwaite J Lazarus L Vining RF Soar J 《The International journal of health planning and management》1995,10(2):87-98
Hospitals are changing. Throughout the OECD the hospital, that enduring and pervasive organization which has delivered the vast majority of acute care services for decades, is being reconceptualized. We briefly analyse trends which clearly indicate that the existing concept of the hospital is rapidly coming to an end. The emerging model consists of a core facility comprising only the most acute services, intensive care, operating theatres and an accident and emergency unit, with all other services and units linked by information technology to each other and to the core facility. We explore some of the management challenges confronting those who will be responsible for taking their organization through the transition to the boundaryless hospital arrangement, discuss a number of the existing problems with today's hospitals which the new model has the propensity to resolve, and deal with some of the emerging issues which it brings with it. 相似文献
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FITCH KATHRYN M.; ALVAREZ LUCIA PEREZ; ANDRES MEDINA RAFAEL DE; MORRONDO RAFAEL NAJERA 《European journal of public health》1995,5(3):175-186
Health care workers have a small but real risk of acquiringHIV infection as a result of occupational exposure. In thispaper, we review all reports in the scientific literature from1984 through to December 1993 of confirmed and probable casesof HIV seroconversion after a specific occupational exposure.A total of 64 confirmed cases have been reported, 24 in Europe,36 in the USA and 4 in other countries. Most seroconversionshave resulted from percutaneous exposure (91%) to AIDS patients(62%), usually caused by hollow bore needlestick injuries inflictedduring blood drawing procedures. Almost all seroconversionshave been detected within 6 months of exposure (94%) and haveusually been preceded by an episode of acute illness (73%).Ten seroconversions have occurred in spite of partial or completecourses of zidovudine prophylaxis. An additional 113 probablecases have been reported, 75 in the USA, 35 in Europe and 3in other countries. Aggregating the results of the prospectivestudies carried out, it is calculated that the risk of seroconversionfollowing percutaneous exposure is 0.33% or 3 in 1000 exposures(95% Cl: 0.210.52%), while the risk following mucocutaneousexposure is much lower (0.04%, 95% Cl: 0.0060.31%). Thedocumented failure of zidovudine prophylaxis following occupationalexposure in a number of instances indicate its effect is, atbest, only partial; furthermore, exposure to source patientswho have been receiving the drug may lead to transmission ofzidovudine-resistant strains of HIV. Risk factors for occupationalexposure to HIV and for transmission, given that an exposurehas occurred, are discussed. 相似文献
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目的评价几种铅中毒指标筛选不同水平职业性铅接触的准确性。方法连续性收集157名铅接触工人的血标本,同时测定血铅、红细胞游离原卟啉(FEP)、锌原卟啉(ZPP)、尿铅、尿δ氨基酮戊酸(δALA),以血铅≥40、≥60μg/dl的铅接触水平为金标准,用ReceiverOperatingCharacteristic(ROC受试者工作特征)曲线分析软件评价所测定指标筛选血铅≥40、≥60μg/dl职业性铅接触的价值,在ROC曲线上制定各测定指标筛选上述2个铅接触水平的最佳临界点,用EPINFOR统计软件比较筛选血铅≥40、≥60μg/dl的平行试验的敏感度。结果筛选血铅≥40、≥60μg/dl的铅接触水平,ROC曲线下的面积(AUCROC)最大的是ZPP,其他依次为FEP、尿铅、尿δALA;联合ZPP与FEP的平行试验的敏感度高于联合尿铅与尿δALA的平行试验。结论筛选血铅≥40、≥60μg/dl水平的职业性铅接触,ZPP的准确性最高,并且联合ZPP与FEP的平行试验的敏感度高于联合尿铅与尿δALA的平行试验。 相似文献