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991.
Adverse Events in Mobility‐Limited and Chronically Ill Elderly Adults Participating in an Exercise Intervention Study Supported by General Practitioner Practices 下载免费PDF全文
992.
We assessed the 15‐year trends in the distribution of body mass index (BMI) and the prevalence of overweight in the Seychelles (Indian Ocean, African Region) and the relationship with socio‐economic status (SES). Three population‐based examination surveys were conducted in 1989, 1994 and 2004. Occupation was categorized as ‘labourer’, ‘intermediate’ or ‘professional’. Education was also assessed in 1994 and 2004. Between 1989 and 2004, mean BMI increased markedly in all sex and age categories (overall: 0.16 kg m?2 per calendar year, which corresponds to 0.46 kg per calendar year). The prevalence of overweight (including obesity, BMI ≥ 25 kg m?2) increased from 29% to 52% in men and from 50% to 67% in women. The prevalence of obesity (BMI ≥ 30 kg m?2) increased from 4% to 15% in men and from 23% to 34% in women. Overweight was associated inversely with occupation in women and directly in men in all surveys. In multivariate analysis, overweight was associated similarly (direction and magnitude) to occupation and education. In conclusion, the increasing prevalence of overweight and obesity over time in all age, sex and SES categories suggests large‐scale changes in societal obesogenic factors. The sex‐specific association of SES with overweight suggests that prevention measures should be tailored accordingly. 相似文献
993.
Geraldine M. Leydon Beth Stuart Rachael H. Summers Paul Little Stuart Ekberg Fiona Stevenson Carolyn A. Chew-Graham Lucy Brindle John Heritage Paul Drew Michael V. Moore 《Patient education and counseling》2018,101(8):1394-1402
Objectives
To establish: a) feasibility of training GPs in a communication intervention to solicit additional patient concerns early in the consultation, using specific lexical formulations (“do you have ‘any’ vs. ‘some’ other concerns?”) noting the impact on consultation length, and b) whether patients attend with multiple concerns and whether they voiced them in the consultation.Methods
A mixed-methods three arm RCT feasibility study to assess the feasibility of the communication intervention.Results
Intervention fidelity was high. GPs can be trained to solicit additional concerns early in the consultation (once patients have presented their first concern). Whilst feasible the particular lexical variation of ‘any’ vs ‘some’ seemed to have no bearing on the number of patient concerns elicited, on consultation length or on patient satisfaction. The level of missing questionnaire data was low, suggesting patients found completion of questionnaires acceptable.Conclusion
GPs can solicit for additional concerns without increasing consultation length, but the particular wording, specifically ‘any’ vs. ‘some’ may not be as important as the placement of the GP solicitation.Practice implications
GPs can solicit early for additional concerns and GPs can establish patients’ additional concerns in the opening of the consultation, which can help to plan and prioritise patients multiple concerns. 相似文献994.
995.
《Patient education and counseling》2020,103(12):2532-2539
ObjectiveTo explore the views of primary care teams about the provision of self-management support to patients with common health problems.MethodsSemi-structured interviews were conducted with twenty-one members of the primary care team from thirteen general practices. Interviews were transcribed verbatim, and analysed using the ‘Framework’ approach.ResultsThree categories and six sub-categories illustrating different self-management support activities across common health problems were identified from the analysis of interviews, and contributed to one major theme and one cross-cutting theme. Referral and signposting were frequently used to facilitate patient engagement with external services and resources. Practitioners faced some challenges in balancing medical management and psychosocial support and motivating patients to engage with self-management.ConclusionsPrimary care teams described providing a wide range of self-management support activities, but the pattern of use varied for different types of health problem. These patterns may have been influenced, in part, by general practices focusing upon achieving financially incentivised quality improvement goals.Practice implicationsTo improve self-management support, practitioners need a digital repository of services/resources, motivational interviewing skills, an understanding of the optimum duration and pattern of consultations, and incentivised targets that match a biopsychosocial model of care. 相似文献
996.
《Journal de Mycologie Médicale》2020,30(2):100970
A survey of mycology laboratories for antifungal susceptibility testing (AFST) was undertaken in France in 2018, to better understand the difference in practices between the participating centers and to identify the difficulties they may encounter as well as eventual gaps with published standards and guidelines. The survey captured information from 45 mycology laboratories in France on how they perform AFST (number of strains tested, preferred method, technical and quality aspects, interpretation of the MIC values, reading and interpretation difficulties). Results indicated that 86% of respondents used Etest as AFST method, with a combination of one to seven antifungal agents tested. Most of the participating laboratories used similar technical parameters to perform their AFST method and a large majority used, as recommended, internal and external quality assessments. Almost all the participating mycology laboratories (98%) reported difficulties to interpret the MIC values, especially when no clinical breakpoints are available. The survey highlighted that the current AFST practices in France need homogenization, particularly for MIC reading and interpretation. 相似文献
997.
通过阐述研究与实践合作促进模式、健康服务领域研究成果应用的行动促进框架和医疗机构与高等院校合作的促进方式,分析国外成功的循证实践组织管理促进模式,探讨如何在我国医院护理管理中多方面、多角度促进循证护理实践发展. 相似文献
998.
Nurses deliver most of Israel's healthcare services, yet its nurse per population ratio is only 5.9 per 1000, one of the lowest in the developed world. For several years, the managers of the profession have been pushing to upgrade nursing and to move it into the academic sphere. The semiskilled qualification of the practical nurse has been eliminated and training programs for registered nurses are being transformed from diploma training to academic degree programs. A midwifery license is accessible only to registered nurses who take a further 1 year of advanced training and sit the State Midwifery Licensing Examination. Most deliveries in Israel are carried out by midwives. Alongside the Western-standard hospital system there operates both a well-developed community nursing network and a strong mother-and-child clinic system. The acute shortage of nurses in Israel is now coinciding with a rising number of academic job-seekers, which has encouraged the Ministry of Health to offer university graduates a career-change program. Special scholarships are on offer in return for a 4 year commitment to work in nursing after completing an accelerated training curriculum (2.5 years instead of the usual 3 years), plus a starting monthly wage that is higher than the national average wage. 相似文献
999.
Ivan Ranković Vladimir Milivojević Aleksandra PavlovićMarković Mihailo Bezmarević 《World journal of gastroenterology : WJG》2022,28(4):497-499
Elaboration of carotid atherosclerosis in the setting of hepatitis B virus(HBV)infection should emphasize the significance of extrahepatic manifestations of the infection pathogenesis.Diverse processes comprise the pathoevolution of HBV infection,rendering it a multi-systemic disease in its essence.Our work not only exemplified atherosclerosis as an often-underestimated contributor to the severity of HBV infection but has also highlighted the bidirectional relationship between the two.Therefore,it is suggested that HBV-induced inflammation is one of the root causes of atherosclerosis,which in turn has a consequent effect on the severity of the chronic infection disease state,creating a vicious cycle.Additionally,we coupled prior data with the current concepts of HBV infection to postulate intriguing perspectives and theories. 相似文献
1000.
Christopher M. Bond Dennis DjogovicCristina Villa-Roel MD MSc Michael J. BullardDavid P. Meurer BSCN Brian H. Rowe 《The Journal of emergency medicine》2013