Journal of epidemiology and community health
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J Epidemiol Community Health · Sep 2002
Randomized Controlled Trial Multicenter Study Clinical TrialEvidence based educational outreach visits: effects on prescriptions of non-steroidal anti-inflammatory drugs.
To evaluate the effectiveness of an evidence based group educational outreach visit on prescription patterns of non-steroidal anti-inflammatory drugs (NSAIDs) in primary care. ⋯ Evidence based educational outreach visits are more effective than no intervention at all. Results suggest that evidence based educational outreach visits are incrementally more effective than conventional educational sessions, which in turn are more effective than no intervention at all.
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J Epidemiol Community Health · Sep 2002
Short-term mortality of myocardial infarction patients with diabetes or hyperglycaemia during admission.
The hypothesis that patients with hyperglycaemia during admission, regardless of previous diagnosis of diabetes, have worse prognosis than those with normal glucose values is controversial. The objective was to assess the role of hyperglycaemia on short-term mortality after myocardial infarction (MI). ⋯ Higher 28 day mortality was observed among MI patients with glycaemia on admission >6.67 mmol/l compared with patients with lower levels, independently of major confounding variables and, particularly, previous diagnosis of diabetes. This early, simple, and inexpensive marker of bad prognosis after MI should prompt the application of more aggressive treatment of MI and risk factors and, probably, of glycaemia during admission.
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J Epidemiol Community Health · Jul 2002
Outreach and improved access to specialist services for indigenous people in remote Australia: the requirements for sustainability.
To examine the role of specialist outreach in supporting primary health care and overcoming the barriers to health care faced by the indigenous population in remote areas of Australia, and to examine issues affecting its sustainability. ⋯ In a setting where there is a disadvantaged population with inadequate access to medical care, specialist outreach from a regional centre can provide a more equitable means of service delivery than hospital based services alone. A sustainable outreach service that is organised appropriately, responsive to local community needs, and has an adequate regional specialist base can effectively integrate with and support primary health care processes. Poorly planned and conducted outreach, however, can draw resources away and detract from primary health care.
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J Epidemiol Community Health · Jun 2002
Comparative StudyInfluence of patient gender on admission to intensive care.
To compare the case mix and outcomes of male and female patients admitted to intensive care units for a wide range of conditions. ⋯ This study demonstrated, for the first time, possible inequitable use of intensive care for patients with certain conditions. This may be secondary to gender bias and can result in either over-treatment in the favoured group, or under-treatment in the neglected group. It would therefore be pertinent to re-examine these findings using other databases, and to further investigate the causative factors, including gender bias.
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J Epidemiol Community Health · Jun 2002
Multicenter StudyBunk versus conventional beds: a comparative assessment of fall injury risk.
To depict the magnitude and spectrum of childhood injuries attributable to falls from bunk beds in comparison with conventional beds and to outline sociodemographic risk factors and injury characteristics. ⋯ Falls from bunk beds represent a non-negligible childhood injury risk. A sizeable fraction can be avoided with simple design modifications of the product, such as use of side rails in the upper bed or removal of the bed ladder when not in use.