JAMA : the journal of the American Medical Association
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Randomized Controlled Trial Clinical Trial
High-dose nicotine patch therapy. Percentage of replacement and smoking cessation.
To assess the level of nicotine replacement, evidence of nicotine toxicity, and withdrawal symptom relief with placebo and 11-, 22-, and 44-mg/d doses of transdermal nicotine. A secondary objective was to assess short- and long-term smoking cessation rates. ⋯ A 44-mg/d dose of nicotine patch therapy appears to be safe for use in heavy smokers. Cigarette smoking rates can be used to estimate the initial nicotine patch dose. Monitoring blood cotinine levels at baseline and steady state can be used for assessing the adequacy of nicotine replacement. Withdrawal symptom relief can be improved with more complete nicotine replacement. Achieving a greater percentage of nicotine replacement may increase the efficacy of nicotine patch therapy.
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Our on-site counseling for medical students at UCD School of Medicine has provided easily accessible services by psychologists who understand the rules, values, and traditions of the medical training experience. We also have had the benefit of a close working relationship with the faculty, staff, and administration of the School of Medicine. Counseling can facilitate exploration of personal issues that have been exposed during medical training, and it offers medical students an opportunity to learn new coping skills and enhance their understanding of themselves and their training environment, which in turn contributes to their professional growth. ⋯ We encourage students who are experiencing the stress of their arduous training experience to seek counseling when their usual coping strategies are exhausted. We encourage other medical schools to provide effective, accessible counseling services to their students. These services will assist in the development of a training atmosphere in which students can learn that medical education involves their whole person.