B N Doebbeling

..This environment facilitated rapid implementation, critique by scientific and public advisors, a high participation rate, and rapid publication...

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..The goal of this project was to develop procedures to link tumor registry and insurance claims databases on women younger than 65 years old with breast cancer and to assess the accuracy and validity of the linked dataset...

..We evaluated the associations between putative occupational and epidemiologic determinants and influenza vaccine acceptance among health care workers during two consecutive seasons...

..Occupational groups should be considered independently when strategies are developed to increase compliance. Interventions based on modifiable factors identified by this study may reduce bloodborne pathogen exposure among HCWs...

..Healthcare workers clearly remain at risk for injury. Further effective interventions are needed for employee training, improving adherence, and providing needlestick prevention devices...

..To assess the association between military service in a combat zone and subsequent traumatic injury requiring medical consultation, the authors analyzed veterans' interview responses...

..This study identified physician characteristics and attitudes related to self-reported compliance with adult prevention guidelines...

..Using the Aday-Andersen model, we evaluated the impact of predisposing, need, and enabling factors on tertiary prevention, hypothesizing that urban-rural geographic differences in delivery would be detected...

..2, p - 0.007). Students are frequently exposed to blood and body fluid during clinical training. Higher levels of retained knowledge about universal precautions are associated with a decreased risk of mucous membrane exposure...

..CONCLUSIONS: Excellent HBV vaccine acceptance rates may be achieved among preclinical medical and PA students. Recommendations of authority figures are important motivators for HBV vaccine acceptance among students...

..Little data are available to identify specific risk factors for colonisation or infection of burn wounds by MRSA...

..62 and 0.38, respectively. None of the signs or symptoms was a necessary indicator of infection, but increasing pain and wound breakdown were both sufficient indicators with specificity of 100%...

..The study assessed baseline knowledge and attitudes about clinical preventive medical services among psychiatric faculty and psychiatric residents at a tertiary care medical center...

..Additionally, molecular typing of all isolates obtained from the nares and hands found identical strains at both sites in the majority of subjects, implicating the nares as the primary reservoir of S. aureus colonisation...

..The use of CAM for arthritis was most common among those with poorer self-assessed health and higher use of traditional health care resources...

..Antimicrobial resistance is a growing clinical and public health crisis. Experts have recommended measures to monitor antimicrobial resistance; however, little is known regarding their use...

..We discuss potential implications regarding the similarities and differences in study findings for factors to consider in planning interventions to improve clinical reminder use...

..The aim of the current analyses is to describe current adherence rates and the organizational factors related to provider adherence to the COPD guideline...

..A history of incarceration may be a behavioral marker for substance abuse, antisocial behavior, and mental illness. Importantly, GW deployment carried no increased risk of subsequent incarceration overall...

..However, little is known about the implementation of these strategies...

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..It remains for future research to show whether negative temperament is a vulnerability factor for hypochondriasis or hypochondriasis is itself a personality disorder...

..However, VA hospitals should consider selective combinations of approaches to ensure the use of the most effective implementation methods...

..To identify patterns of use of computerized clinical reminders (CCRs) across an integrated healthcare system and describe institutional factors associated with their implementation...

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..Implementation plans should specifically incorporate actions to address these barriers and enhance the facilitative aspects of information technologies in clinical practice guideline use...

..While patient-centered care (PCC) is desirable for many reasons, its relationship to treatment outcomes is controversial. We evaluated the relationship between PCC and the provision of preventive services...

..To examine the patterns of coexisting (comorbid) mental disorders and whether comorbidity influences quality of life ratings in a sample of U.S. veterans...

..We also examine structural, financial, policy-related, cultural, and organizational barriers to IT implementation for evidence-based practice and strategies to overcome them...

..24; 95% confidence interval [CI] = 1.06, 1.51]). Among these groups, the National Guard and Reserve personnel were more likely to have been hospitalized than were the regular military personnel (OR= 1.65; 95% CI=1.21, 2.26)...

..The risk of poor health outcomes suggests that veterans returning from the present conflict should be screened for CWP on their return...

..Findings supported the validity of noncredibility judgments and suggested that noncredible examinations are not a significant problem in neuropsychological investigations of GWVs...

..Expert panels, identifying strategies for optimizing antibiotic use and preventing AMR spread, have recommended hospitals undertake efforts to implement specific evidence-based practices...

..However, the organizational factors and implementation approaches that influence adherence to national guidelines are poorly understood...

..The objective of this study was to examine relationships between antimicrobial use control strategies and AMR rates in a national sample of US hospitals...

..Our results add to a growing body of evidence suggesting that GAD and PTSD have more in common with major depression than with their anxiety disorder counterparts...

..To examine the presence of borderline personality disorder (BPD) traits in Gulf War veterans, and to assess psychiatric comorbidity, health status, healthcare utilization, and quality of life (QOL) along a continuum of BPD trait severity...

..The differential health effects associated with severe violence supports the public health importance of sexual violence screening, treatment, and prevention...

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..The overall objective of this article was to review the theoretical and conceptual dimensions of how the implementation of clinical practice guidelines (CPGs) is likely to affect treatment costs...

..For this to happen, medical professionals and managers need to understand and appreciate the power that systems engineering concepts and tools can bring to redesigning and improving health care environments and practices...

..The objective of this research is to determine whether people with mental disorders are at increased risk for the subsequent development of malignancies compared with people without mental disorders...

..However, the effectiveness of this guideline has not been reported. The goal of this project was to evaluate the effect of the AHCPR smoking cessation guideline on provider practices with smokers and on patient smoking rates...

..Health hazards specific to women workers have not been adequately documented. This study assessed military environmental factors associated with rape occurring during military service, while controlling for pre-military trauma experiences...

..We examined the relationship between organizational and patient population characteristics and adherence to three screening CPGs implemented throughout the Veterans Health Administration (VHA)...

..Results are discussed in the context of hierarchical models of anxiety and depression...

..In contrast, there was no association between the modeled exposure and any of the outcomes. These findings do not support speculation that exposures to oil-fire smoke caused respiratory symptoms among veterans...

..There are numerous opportunities for health care organizations to overcome the barriers to physician adoption of clinical practice guidelines in their day-to-day practice...

..Only 6 percent of all patients reported having been screened for gun ownership, despite the high risk of suicide among gun owners...

..These health effects may manifest themselves in both psychological and physical outcomes. Health care providers must be attentive to recognize and evaluate both of these dimensions...

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..Further investigation of factors influencing postdeployment HRQL is needed. Routine collection of health information by using standardized instruments pre- and perideployment should be implemented...

..Guideline implementation efforts that target multiple organizational levels may increase provider knowledge...

..To identify, categorize, and assess critical incidents of nonadherence to standard precautions...

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..Optimal diabetes management relies on providers adhering to evidence-based practice guidelines in the processes of care delivery and patients adhering to self-management recommendations to maximize patient outcomes...

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..0031). Adherence to guidelines for preparation and dissemination of antibiograms could be improved. Institutional commitment to high quality, on-site microbiology laboratory services will improve adherence to these guidelines...

..Veterans of the first Gulf War have higher rates of medical and psychiatric symptoms than nondeployed military personnel...

..The most common resistant pathogen in US hospitals is ORSA, which accounts for many recognized outbreaks and is increasing in frequency in most facilities. Current practices to prevent and control antimicrobial resistance are inadequate...

..New strategies for preventing exposures, training, and monitoring adherence are needed...

..Prior research suggesting a relationship between pancreatic cancer and depression conducted on clinical populations has been subject to recall bias. We reexamined this association using longitudinal population-based data...

..If these important differences in exposures and health care use are confirmed in other studies, optimal training and deployment preparedness strategies should be reconsidered...

..Differences in utilization and health status were also examined while controlling for life span violence exposures and important patient characteristic confounders...

..System-level and patient-level characteristics influence both early and overall hospital mortality rates. These variables should be considered when risk stratifying medical intensive care unit patients and in studying outcomes of care...

..Thus, the RC scales demonstrated several psychometric strengths while utilizing 60% fewer items, but the 2 sets of scales cannot be used interchangeably. Interpretive considerations are discussed...