American journal of preventive medicine
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During the early 1990s, the American College of Preventive Medicine (ACPM), with support from the Health Resources and Services Administration (HRSA), identified core competencies and performance indicators (measures to assess their achievement) for all preventive medicine residents. After the competencies were approved, distributed by the ACPM and HRSA, and published in the American Journal of Preventive Medicine, they were integrated in various ways into the operation of individual residency programs. ⋯ HRSA funded an effort to produce Version 2.0 of the preventive medicine competencies based on review and refinement of the original competencies through a consensus process. This article includes these revised core competencies and performance indicators.
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Comparative Study
A comparison of driver- and passenger-based estimates of alcohol-impaired driving.
Persons who drive after drinking or ride with drinking drivers are at increased risk of motor vehicle crash. Although alcohol is involved in 40% of fatal motor vehicle crashes yearly, there exist few systems to monitor alcohol-impaired driving. In this study we compare driver- and passenger-based estimates of the prevalence of alcohol-impaired driving. ⋯ Passengers who report riding with a drinking driver may provide an important estimate of the prevalence of drinking driving. Passengers of drinking drivers represent a high-risk group that is not considered in most prevention efforts. Because being a passenger of a drinking driver is not illegal, it may be an easier topic for clinicians to broach than drinking and driving.
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Comparative Study
How does managed care manage the frail elderly? The case of hospital readmissions in fee-for-service versus HMO systems.
This study examined whether hospital readmissions varied among the frail elderly in managed care versus fee-for-service (FFS) systems. ⋯ In this group of frail elderly Medicare beneficiaries, those enrolled in an HMO were more likely to have a preventable hospital readmission than those receiving care under FFS. These results suggest that policies promoting stringent approaches to utilization control (e.g., early hospital discharge, reduced levels of post-acute care, and restricted use of home health services) may be problematic for the frail elderly.
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Cigars have been heavily promoted in recent years. The nature and extent of the resultant increase in cigar smoking needs to be understood before the public health implications can be assessed. ⋯ If more people begin to smoke cigars daily, or if cigar use leads young people to initiate cigarette smoking or leads former cigarette smokers to relapse to cigarette smoking, the recent trends in cigar use may have public health implications.