Arch Intern Med
-
Multicenter Study Comparative Study
Variation in the tendency of primary care physicians to intervene.
Research has documented dramatic variation in health care spending across the United States that has little relationship to health outcomes. Although high-spending areas have more physicians per capita, it is not known whether this disparity fully explains the differences in spending or whether individual physicians in high-spending regions have a greater tendency to intervene for their patients. We sought to measure the tendency of primary care physicians to intervene across regions that differ in their levels of local health care spending. ⋯ Varying rates of health care spending across the United States reflect the underlying tendency of local physicians to recommend interventions for their patients.
-
Multicenter Study Comparative Study
Justice at work and reduced risk of coronary heart disease among employees: the Whitehall II Study.
Justice is a fundamental value in human societies, but its effect on health is poorly described. We examined justice at work as a predictor of coronary heart disease (CHD). ⋯ Justice at work may have benefits for heart health among employees.
-
Randomized Controlled Trial Clinical Trial
Efficacy of bupropion and nortriptyline for smoking cessation among people at risk for or with chronic obstructive pulmonary disease.
The observations that smokers with chronic obstructive pulmonary disease (COPD) are at increased risk of depression and that nicotine may have antidepressant effects and regulate mood provide a rationale for the use of antidepressant drugs for smoking cessation in patients with COPD. No clinical trial has studied the efficacy of bupropion hydrochloride and nortriptyline hydrochloride for smoking cessation in this patient population, to our knowledge. ⋯ Bupropion SR treatment is an efficacious aid to smoking cessation in patients with COPD. Nortriptyline treatment seems to be a useful alternative.