Archives of family medicine
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Multicenter Study
Reported bicycle helmet use among adults in the United States.
This study estimates bicycle helmet use among adults in the United States, examines factors associated with helmet use among adult bicyclists in 1994, and examines other safety-related practices. A telephone survey of 5238 randomly dialed households in the United States was conducted. The participants were randomly selected adult (aged > or = 18 years) respondents, and the main outcome measure was bicycle riding and helmet use in the last 30 days. ⋯ Further efforts to increase the wearing of bicycle helmets by adults are necessary to meet the year 2000 objective of 50% helmet use. Adults should be targeted for increased helmet promotion efforts, especially those between the ages of 18 and 24 years. Increasing consistent use of helmets among adults may also help increase consistent use of helmets among children through role modeling.
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To evaluate the effectiveness of continuing medical education seminars in changing physician attitudes and practice approaches to the provision of home health care and use of community resources, to increase physician awareness of the needs of homebound older adults, and to teach physicians appropriate medical management in the home. ⋯ The seminars achieved the intended outcomes of bridging the gap in the awareness and provision of geriatric home health care and of producing physician attitude and behavior change.
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To examine the way patients with serious, progressive illnesses communicate their care preferences to their physician. ⋯ Most persons with symptomatic human immunodeficiency virus infection have not discussed their preferred treatment approach with a physician. This disparity is greater for blacks, who were less likely to want a palliative treatment approach.
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The poorly reactive and dilated pupil observed in a comatose patient is often thought to represent an acute third nerve palsy owing to brain herniation or aneurysm. In the well patient, however, the isolated dilated pupil is unlikely to be owing to a third nerve palsy. It is more commonly owing to other benign causes such as local iris sphincter abnormalities, pharmacologic dilation, tonic pupil syndrome, or sympathetic irritation. This article presents a diagnostic flowchart to help the primary care physician analyze this problem and prevent costly and unnecessary imaging of these patients.