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[PMID]:29181874
[Au] Autor:Neal AE; Lehto E; Miller KH; Ziegler C; Davis E
[Ad] Endereço:Department of Pediatrics, University of Louisville School of Medicine, Louisville, Kentucky, USA.
[Ti] Título:Using a statewide survey methodology to prioritize pediatric cardiology core content.
[So] Source:Congenit Heart Dis;13(1):147-153, 2018 Jan.
[Is] ISSN:1747-0803
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: Although pediatrician-reported relevance of Canadian cardiology-specific objectives has been studied, similar data are not available for the 2016 American Board of Pediatrics (ABP) cardiology-specific objectives. This study asked Kentucky trainees, pediatricians, and pediatric cardiologists to identify "most important" content within these objectives. DESIGN, METHODS, OUTCOME MEASURES: This cross-sectional study used an original, online survey instrument based on the 2016 ABP cardiology-specific objectives. We collected quantitative data (numerical indications of importance) and qualitative data (open-ended replies regarding missing content and difficulty in teaching and learning). Respondents indicated the top two choices of most important items within eight content areas. Descriptive statistics (frequencies and percentages) and chi-square analysis were calculated. Content within categories was organized using naturally occurring "clusters" and "gaps" in scores. Common themes among open-ended qualitative responses were identified using Pandit's version of Glaser and Strauss Grounded theory (constant comparison). RESULTS: Of the 136 respondents, 23 (17%) were residents, 15 (11%) fellows, 85 (62%) pediatricians, and 13 (10%) pediatric cardiologists. Of attendings, 80% reported faculty/gratis faculty status. Naturally occurring clusters in respondent-designated importance resulted in ≤3 "most selected" objectives per content area. Objectives in "most selected" content pertained to initial diagnosis (recognition of abnormality/disease) (n = 16), possible emergent/urgent intervention required (n = 14), building a differential (n = 8), and planning a workup (n = 4). Conversely, themes for "least selected" content included comanagement with subspecialist (n = 15), knowledge useful in patient-family communication (n = 9), knowledge that can be referenced (as needed) (n = 7), and longitudinal/follow-up concerns (n = 5). CONCLUSIONS: This study demonstrated the utility of an online survey methodology to identify pediatric cardiology content perceived most important. Learners and faculty generally provided concordant responses regarding most important content within the cardiology-specific ABP objectives. Medical educators could apply this methodology to inform curriculum revision.
[Mh] Termos MeSH primário: Cardiologia/educação
Currículo
Educação de Pós-Graduação em Medicina/organização & administração
Cardiopatias
Pediatria/educação
Inquéritos e Questionários/utilização
[Mh] Termos MeSH secundário: Adulto
Criança
Estudos Transversais
Feminino
Seres Humanos
Kentucky
Masculino
[Pt] Tipo de publicação:JOURNAL ARTICLE; MULTICENTER STUDY
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180219
[Lr] Data última revisão:
180219
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171129
[St] Status:MEDLINE
[do] DOI:10.1111/chd.12559


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[PMID]:29373780
[Au] Autor:Rodgers-Fischi P; Vyas KS; Davenport D; Saha SP
[Ti] Título:Trends in the Management of Spontaneous Pneumothorax: A Single Center Experience.
[So] Source:W V Med J;113(2):30-5, 2017 Mar-Apr.
[Is] ISSN:0043-3284
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Objectives: Management of patients with primary spontaneous pneumothorax is controversial. We sought to review our experience in the treatment of primary spontaneous pneumothorax (PSP) by comparing outcomes from video-assisted thoracoscopic surgery (VATS) with thoracotomy.A retrospective review of electronic and paper medical charts identified 104 consecutive operations performed at University of Kentucky Chandler Medical Center for spontaneous pneumothorax management between the dates of January 2000 and January 2013. Follow-up phone calls were made to ensure absence of re-ocurrences outside of our hospital system.Eighty-eight patients (85%) underwent VATS repair with unilateral and contralateral recurrence rates of 7% and 11% respectively. Mean operative time was 97 minutes; mean postoperative hospital stay was 6 days. Mechanical pleurodesis/pleurectomy was performed in 94% of cases. Comparatively 16 patients (16%) underwent thoracotomy repair with unilateral and contralateral recurrence rates of 0.00% and 6% respectively. Mean operative time for the thoracotomy group was 188 minutes; mean postoperative hospital stay was 5 days. Mechanical pleurodesis was performed 12 times (75%).In our study, the VATS group had a significant reduction in operating room time (P = .001), a non-significant increase in unilateral recurrence (p = .587), and no reduction in postoperative length of stay. Contralateral recurrence rate did not vary between groups.
[Mh] Termos MeSH primário: Tempo de Internação/tendências
Pneumotórax/cirurgia
[Mh] Termos MeSH secundário: Adolescente
Adulto
Idoso
Feminino
Seres Humanos
Kentucky
Masculino
Meia-Idade
Duração da Cirurgia
Pneumonectomia/tendências
Pneumotórax/epidemiologia
Estudos Retrospectivos
Toracotomia/tendências
Resultado do Tratamento
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180215
[Lr] Data última revisão:
180215
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180127
[St] Status:MEDLINE


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[PMID]:27776680
[Au] Autor:Hall MT; Wilfong J; Huebner RA; Posze L; Willauer T
[Ad] Endereço:Kent School of Social Work, University of Louisville, Louisville, KY. Electronic address: martin.hall@louisville.edu.
[Ti] Título:Medication-Assisted Treatment Improves Child Permanency Outcomes for Opioid-Using Families in the Child Welfare System.
[So] Source:J Subst Abuse Treat;71:63-67, 2016 12.
[Is] ISSN:1873-6483
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Parents who use opioids and are involved in the child welfare system are less likely to retain custody of their children than parents who use other drugs. No previous studies have described medication-assisted treatment (MAT) utilization and child permanency outcomes for this population. The Sobriety Treatment and Recovery Team (START) model is a child welfare-based intervention focused on families with co-occurring substance use and child abuse / neglect issues. This study examined the prevalence and correlates of MAT utilization among parents in the START program with a history of opioid use, and compared child outcomes for families who received MAT services to those who did not. Of the 596 individuals with a history of opioid use in the START program, 55 (9.2%) received MAT. Receipt of MAT services did not differ by gender, age, county of residence, or drug use, though individuals who identified as White were more likely to participate in MAT. In a multiple logistic regression model, additional months of MAT increased the odds of parents retaining custody of their children. To address barriers to MAT, results-focused educational interventions may be needed for the child welfare workforce, as well as programs to improve collaboration and decision-making between the child welfare workforce, court personnel, and drug addiction treatment providers.
[Mh] Termos MeSH primário: Maus-Tratos Infantis/estatística & dados numéricos
Bem-Estar da Criança/estatística & dados numéricos
Filho de Pais Incapacitados/estatística & dados numéricos
Tratamento de Substituição de Opiáceos/estatística & dados numéricos
Transtornos Relacionados ao Uso de Opioides/tratamento farmacológico
Avaliação de Resultados (Cuidados de Saúde)/estatística & dados numéricos
[Mh] Termos MeSH secundário: Adolescente
Adulto
Criança
Custódia da Criança/estatística & dados numéricos
Pré-Escolar
Feminino
Seres Humanos
Lactente
Kentucky
Masculino
Tratamento de Substituição de Opiáceos/utilização
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T; RESEARCH SUPPORT, U.S. GOV'T, P.H.S.
[Em] Mês de entrada:1712
[Cu] Atualização por classe:180215
[Lr] Data última revisão:
180215
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161026
[St] Status:MEDLINE


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[PMID]:29304035
[Au] Autor:Frost K; Bertocci G; Smalley C
[Ad] Endereço:Department of Bioengineering, J.B. Speed School of Engineering, University of Louisville, Louisville, Kentucky, United States of America.
[Ti] Título:Wheelchair tiedown and occupant restraint practices in paratransit vehicles.
[So] Source:PLoS One;13(1):e0186829, 2018.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:The purpose of this study was to characterize wheelchair tiedown and occupant restraint system (WTORS) usage in paratransit vehicles based on observations of wheelchair and scooter (wheeled mobility devices, collectively, "WhMD") passenger trips. A retrospective review of on-board video monitoring recordings of WhMD trips was conducted. Four hundred seventy-five video recordings were collected for review and analysis. The use of all four tiedowns to secure the WhMD was observed more frequently for power WhMDs (82%) and manual WhMDs (80%) compared to scooters (39%), and this difference was significant (p< 0.01). Nonuse or misuse of the occupant restraint system occurred during 88% of WhMD trips, and was most frequently due to vehicle operator neglect in applying the shoulder belt. Despite the absence of incidents or injuries in this study, misuse and nonuse of WTORS potentially place WhMD seated passengers at higher risk of injury during transit. These findings support the need for improved vehicle operator training and passenger education on the proper use of WTORS and development of WTORS with improved usability and/or alternative technologies that can be automated or used independently.
[Mh] Termos MeSH primário: Veículos Automotores
Equipamentos de Proteção/utilização
Cintos de Segurança
Cadeiras de Rodas
[Mh] Termos MeSH secundário: Acidentes de Trânsito/prevenção & controle
Pessoas com Deficiência
Seres Humanos
Kentucky
Estudos Retrospectivos
Segurança
Cintos de Segurança/utilização
Equipamentos de Autoajuda/utilização
Gravação em Vídeo
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180210
[Lr] Data última revisão:
180210
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180106
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0186829


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[PMID]:28463083
[Au] Autor:Moe AZ; Paulsen P; Pichpol D; Fries R; Irsigler H; Baumann MPO; Oo KN
[Ad] Endereço:1 Joint Master Course in Veterinary Public Health, Freie Universität, Berlin, Germany and Chiang Mai University, Chiang Mai, Thailand.
[Ti] Título:Prevalence and Antimicrobial Resistance of Salmonella Isolates from Chicken Carcasses in Retail Markets in Yangon, Myanmar.
[So] Source:J Food Prot;80(6):947-951, 2017 06.
[Is] ISSN:1944-9097
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:A cross-sectional investigation was conducted concerning prevalence, antimicrobial resistance, multidrug resistance patterns, and serovar diversity of Salmonella in chicken meat sold at retail in Yangon, Myanmar. The 141 chicken meat samples were collected at 141 retail markets in the Yangon Region, Myanmar, 1 November 2014 to 31 March 2015. Information on hygienic practices (potential risk factors) was retrieved via checklists. Salmonella was isolated and identified according to International Organization for Standardization methods (ISO 6579:2002) with minor modifications. Twelve antimicrobial agents belonging to eight pharmacological groups were used for antimicrobial susceptibility testing (disk diffusion method). Salmonella was recovered from 138 (97.9%) of the 141 samples. The isolates were most frequently resistant to trimethoprim-sulfamethoxazole (70.3% of isolates), tetracycline (54.3%), streptomycin (49.3%), and ampicillin (47.1%). Resistance was also found to chloramphenicol (29.7%), amoxicillin-clavulanic acid (17.4%), ciprofloxacin (9.4%), tobramycin (8.7%), gentamicin (8%), cefazolin (7.2%), lincomycin-spectinomycin (5.8%), and norfloxacin (0.7%). Among the 138 Salmonella isolates, 72 (52.2%) were resistant to three or more antimicrobial agents. Twenty-four serovars were identified among the 138 Salmonella-positive samples; serovars Albany, Kentucky, Braenderup, and Indiana were found in 38, 11, 10, and 8% of samples, respectively. None of the potential risk factors were significantly related to Salmonella contamination of chicken carcasses. This study provides new information regarding prevalence and antimicrobial resistance and Salmonella serovar diversity in retail markets in Yangon, Myanmar.
[Mh] Termos MeSH primário: Anti-Infecciosos/farmacologia
Galinhas/microbiologia
[Mh] Termos MeSH secundário: Animais
Antibacterianos/farmacologia
Estudos Transversais
Farmacorresistência Bacteriana/efeitos dos fármacos
Farmacorresistência Bacteriana Múltipla/efeitos dos fármacos
Kentucky
Carne
Testes de Sensibilidade Microbiana
Mianmar
Prevalência
Salmonella/isolamento & purificação
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Nm] Nome de substância:
0 (Anti-Bacterial Agents); 0 (Anti-Infective Agents)
[Em] Mês de entrada:1706
[Cu] Atualização por classe:180202
[Lr] Data última revisão:
180202
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170503
[St] Status:MEDLINE
[do] DOI:10.4315/0362-028X.JFP-16-407


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[PMID]:27779308
[Au] Autor:Flunker JC; Clouser JM; Mannino D; Swanberg J
[Ad] Endereço:Department of Epidemiology, College of Public Health, University of Kentucky, Lexington, Kentucky.
[Ti] Título:Pulmonary function among Latino thoroughbred horse farmworkers.
[So] Source:Am J Ind Med;60(1):35-44, 2017 Jan.
[Is] ISSN:1097-0274
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Latino thoroughbred workers may be at risk for developing abnormal pulmonary function related to occupational exposures. METHODS: Eighty worker participants were recruited via community-based purposive sampling. Questionnaires and spirometry tests were administered by trained lay health promoters. Demographic and occupational factors were assessed for associations with respiratory outcomes via multivariable logistic regression. RESULTS: Twenty-seven percent of participants exhibited abnormal pulmonary function (primarily restrictive), 79% reported any respiratory symptoms, and 94% infrequently used dust masks. Shorter duration of both current horse farm employment (≤5 years) and time living in the United States (≤10 years) increased the odds of abnormal pulmonary function. Shorter time living in the United States increased the odds of upper respiratory symptoms and shorter duration of current horse farm employment increased the odds of lower respiratory symptoms. CONCLUSIONS: Abnormal pulmonary function was high among this vulnerable worker group, suggesting the need for increased dust mask usage and further exposure assessment. Am. J. Ind. Med. 60:35-44, 2017. © 2016 Wiley Periodicals, Inc.
[Mh] Termos MeSH primário: Doenças dos Trabalhadores Agrícolas/epidemiologia
Poluição do Ar em Ambientes Fechados/efeitos adversos
Criação de Animais Domésticos
Hispano-Americanos
Exposição por Inalação/efeitos adversos
Doenças Respiratórias/epidemiologia
[Mh] Termos MeSH secundário: Adolescente
Adulto
Idoso
Doenças dos Trabalhadores Agrícolas/etiologia
Doenças dos Trabalhadores Agrícolas/fisiopatologia
Animais
Tosse/epidemiologia
Tosse/etiologia
Estudos Transversais
Poeira
Dispneia/epidemiologia
Dispneia/etiologia
Feminino
Volume Expiratório Forçado
Inquéritos Epidemiológicos
Cavalos
Seres Humanos
Kentucky/epidemiologia
Pulmão/fisiopatologia
Masculino
Meia-Idade
Projetos Piloto
Sons Respiratórios/etiologia
Doenças Respiratórias/etiologia
Doenças Respiratórias/fisiopatologia
Autorrelato
Espirometria
Capacidade Vital
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Dust)
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180109
[Lr] Data última revisão:
180109
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161026
[St] Status:MEDLINE
[do] DOI:10.1002/ajim.22667


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[PMID]:29197312
[Au] Autor:Pravosud V; Huang B; Tucker T; Vanderford NL
[Ad] Endereço:From the Departments of Epidemiology, Cancer Biostatistics, Toxicology, and Cancer Biology, Rural Cancer Prevention Center, College of Medicine, University of Kentucky, Lexington.
[Ti] Título:Development of Multiple Primary Cancers in Lung Cancer Patients: Appalachian Versus Non-Appalachian Populations of Kentucky.
[So] Source:South Med J;110(12):775-781, 2017 Dec.
[Is] ISSN:1541-8243
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVES: The aim of this study was to investigate whether patients with lung cancer in Appalachian Kentucky are more likely to develop multiple primary cancers than patients in non-Appalachian Kentucky. Additional analyses were conducted to identify other factors that may be associated with an increased hazard of developing multiple primary cancers in patients with lung cancer. METHODS: The data for this retrospective, population-based cohort study of 26,456 primary lung cancer patients were drawn from the Kentucky Cancer Registry. For inclusion in the study, patients must have been diagnosed between January 1, 2000 and December 31, 2013 and they must either have continually resided in Appalachian Kentucky or continually resided in non-Appalachian Kentucky. Cases were excluded if the patient was diagnosed as having additional primary cancers within 3 months of the initial diagnosis of primary lung cancer. The medical records for each case were examined to determine whether the patient was subsequently diagnosed as having additional primary cancers. The Cox proportional hazards model was then used to assess whether there was an association between the region in which the patients live and the likelihood of developing multiple primary cancers. Time to event was considered as the time from diagnosis to either death or development of a second primary cancer. RESULTS: The results presented here indicate that the risk of developing multiple primary cancers is the same for patients with lung cancer throughout Kentucky (hazard ratio [HR] 1.002, = 0.9713). We found no evidence for a greater hazard in patients from Appalachia; however, additional analyses revealed several high-risk groups. Male patients and older patients had a significantly greater hazard of developing multiple primary cancers (HR 1.169, = 0.012 and 1.015, = 0.0001, respectively). In addition, patients who underwent surgery and those who were diagnosed initially as having an earlier stage of cancer also were more likely to develop multiple primary cancers (HR 1.446, = 0.0003 and 0.684, = 0.0015, respectively). CONCLUSIONS: This is a negative study. Patients with primary lung cancer living in Appalachian Kentucky are not at a greater risk of developing multiple primary cancers than those residing in non-Appalachian Kentucky. High-risk groups identified in this study are male patients and older patients. The increased hazard seen in patients who underwent surgery or those who were diagnosed as having earlier stages of lung cancer are likely an artifact of these patients living longer and, therefore, having more time to develop additional primary cancers.
[Mh] Termos MeSH primário: Neoplasias Pulmonares/etnologia
Neoplasias Primárias Múltiplas/etnologia
Neoplasias Primárias Múltiplas/etiologia
[Mh] Termos MeSH secundário: Adulto
Fatores Etários
Idoso
Região dos Apalaches/epidemiologia
Região dos Apalaches/etnologia
Feminino
Seres Humanos
Kentucky/epidemiologia
Kentucky/etnologia
Neoplasias Pulmonares/epidemiologia
Neoplasias Pulmonares/etiologia
Masculino
Meia-Idade
Neoplasias Primárias Múltiplas/epidemiologia
Modelos de Riscos Proporcionais
Sistema de Registros
Estudos Retrospectivos
Fatores de Risco
Fatores Sexuais
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1712
[Cu] Atualização por classe:171207
[Lr] Data última revisão:
171207
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171203
[St] Status:MEDLINE
[do] DOI:10.14423/SMJ.0000000000000742


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[PMID]:29016511
[Au] Autor:Clark NM; Schembri M; Jacoby VL
[Ad] Endereço:University of California, San Francisco School of Medicine, and the Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Francisco, San Francisco, California.
[Ti] Título:Change in Surgical Practice for Women With Leiomyomas After the U.S. Food and Drug Administration Morcellator Safety Communication.
[So] Source:Obstet Gynecol;130(5):1057-1063, 2017 Nov.
[Is] ISSN:1873-233X
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: To evaluate the association between the U.S. Food and Drug Administration (FDA) communication discouraging use of power morcellators on changes in surgical practice for women with uterine leiomyomas. METHODS: This is a cross-sectional study using data from 2013 to 2014 in the Healthcare Cost and Utilization Project State Inpatient and State Ambulatory Surgical Databases from Arizona, Florida, Kentucky, and New Jersey. Women with a diagnosis of leiomyomas who underwent hysterectomy or myomectomy were included in the analysis. Multivariable models were used to assess changes in the proportion of hysterectomies performed laparoscopically, vaginally, or by laparotomy in the 15 months before the FDA safety communication in April 2013 (January 2013 to March 2014) to the 9 months after the FDA communication (April to December 2014). Changes in the proportion of women who underwent myomectomy compared with hysterectomy were also evaluated during this time period. RESULTS: There were 77,637 hysterectomy and myomectomy cases analyzed from states with both inpatient and ambulatory surgery data; 59% of patients were outpatients. Overall, there was a 4% (95% CI 3.2-4.8%) decrease in the use of laparoscopic hysterectomy for treatment of uterine leiomyomas from 62% of all hysterectomies before the FDA communication on morcellation to 58% afterward. Changes in surgical practice were more pronounced in the inpatient compared with outpatient setting; inpatient laparoscopic hysterectomy decreased by 7% (95% CI 6.1-7.9%) from 24% to 17% of all hysterectomies with an accompanying increase in abdominal hysterectomy of 8% (95% CI 6.7-8.6%) from 71% to 79%. There were no significant changes in the proportion of women with leiomyomas who underwent myomectomy compared with hysterectomy. CONCLUSION: The FDA communication discouraging the use of power morcellators was associated with a decline in laparoscopy to perform hysterectomy, particularly in the inpatient setting. There was no change in the selection of myomectomy compared with hysterectomy for leiomyoma treatment after the FDA communication.
[Mh] Termos MeSH primário: Histerectomia/tendências
Laparoscopia/tendências
Leiomioma/cirurgia
Morcelação/instrumentação
Retirada de Dispositivo Médico Baseada em Segurança
Miomectomia Uterina/tendências
Neoplasias Uterinas/cirurgia
[Mh] Termos MeSH secundário: Adulto
Arizona
Estudos Transversais
Bases de Dados Factuais
Feminino
Florida
Seres Humanos
Histerectomia/instrumentação
Histerectomia/métodos
Kentucky
Laparoscopia/métodos
Meia-Idade
Análise Multivariada
New Jersey
Estados Unidos
United States Food and Drug Administration
Miomectomia Uterina/instrumentação
Miomectomia Uterina/métodos
[Pt] Tipo de publicação:EVALUATION STUDIES; JOURNAL ARTICLE
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171102
[Lr] Data última revisão:
171102
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171011
[St] Status:MEDLINE
[do] DOI:10.1097/AOG.0000000000002309


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[PMID]:28834806
[Au] Autor:Heath J; Swartz C
[Ad] Endereço:Author Affiliations: Dean and Warwick Professor of Nursing (Dr Heath), College of Nursing, University of Kentucky; Chief Nurse Executive/Chief Administrative Officer (Dr Swartz), University of Kentucky HealthCare, Lexington.
[Ti] Título:Building a Culture of Authentic Partnership: One Academic Health Center Model for Nursing Leadership.
[So] Source:J Nurs Adm;47(9):458-464, 2017 Sep.
[Is] ISSN:1539-0721
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Senior nursing leaders from the University of Kentucky (UK) College of Nursing and UK HealthCare have explored the meaning of an authentic partnership. This article quantifies the tangible benefits and outcomes from this maturing academic nursing and clinical practice partnership. Benefits include inaugural academic nursing participation in health system governance, expanded integration of nursing research programs both in the college and in the health science center, and the development of collaborative strategies to address nursing workforce needs.
[Mh] Termos MeSH primário: Centros Médicos Acadêmicos
Prática do Docente de Enfermagem/organização & administração
Pesquisa em Enfermagem/organização & administração
Escolas de Enfermagem
[Mh] Termos MeSH secundário: Comportamento Cooperativo
Seres Humanos
Relações Interinstitucionais
Kentucky
Liderança
Modelos Organizacionais
Prática do Docente de Enfermagem/normas
Pesquisa em Enfermagem/normas
Desenvolvimento de Pessoal/métodos
Desenvolvimento de Pessoal/organização & administração
Desenvolvimento de Pessoal/normas
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170913
[Lr] Data última revisão:
170913
[Sb] Subgrupo de revista:AIM; IM; N
[Da] Data de entrada para processamento:170824
[St] Status:MEDLINE
[do] DOI:10.1097/NNA.0000000000000514


  10 / 5301 MEDLINE  
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[PMID]:28800246
[Au] Autor:Oscar TP
[Ad] Endereço:U.S. Department of Agriculture, Agricultural Research Service, Residue Chemistry and Predictive Microbiology Research Unit, Room 2111, Center for Food Science and Technology, University of Maryland Eastern Shore, Princess Anne, Maryland 21853, USA.
[Ti] Título:Risk of Salmonellosis from Chicken Parts Prepared from Whole Chickens Sold in Flow Pack Wrappers and Subjected to Temperature Abuse.
[So] Source:J Food Prot;80(9):1496-1505, 2017 Sep.
[Is] ISSN:1944-9097
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:The flow pack wrapper is a popular packaging choice for retail sale of whole chickens. However, it may provide a favorable environment for growth and spread of Salmonella within the package, leading to an outbreak of salmonellosis. To investigate this possibility, a process risk model was developed that predicted the risk of salmonellosis from chicken parts prepared from whole chickens sold in flow pack wrappers and subjected to proper storage (6 h at 4°C) or improper storage (72 h at 15°C) before preparation. The model had four unit operations (pathogen events): (i) preparation (contamination), (ii) cooking (death), (iii) serving (cross-contamination), and (iv) consumption (dose-response). Data for prevalence, number, and serotype of Salmonella on chicken parts were obtained by whole sample enrichment, real-time PCR. Improper storage increased (P < 0.05) prevalence of Salmonella on raw chicken parts from 10.6% (17 of 160) to 41.2% (66 of 160) and incidence of cross-contamination of cooked chicken from 10% (4 of 40) to 52.2% (24 of 46). Improper storage also increased (P < 0.05) the number (mean ± standard deviation) of Salmonella from 0.017 ± 0.030 to 3.51 ± 1.34 log per raw chicken part and from 0.048 ± 0.089 to 3.08 ± 1.50 log per cooked chicken part. The predominant serotypes isolated (n = 111) were Typhimurium (34.2%), Typhimurium var 5- (20.7%), Kentucky (12.6%), Enteritidis (11.7%), and Heidelberg (8.1%). When chicken was properly stored before preparation, the model predicted that risk of salmonellosis was low and sporadic with only six cases per 100 simulations of 10 chicken parts. However, when 0.1 to 1% of chickens were improperly stored before preparation, the model predicted that salmonellosis would increase (P < 0.05) linearly from a median of 7 (range, 1 to 15) to a median of 72 (range, 52 to 93) cases per 10 chicken parts. These results indicated that the flow pack wrapper provided a favorable environment for growth and spread of Salmonella within the package and that even when only a small percentage of packages were subjected to improper storage before preparation, the risk and size of an outbreak of salmonellosis from chicken parts increased significantly.
[Mh] Termos MeSH primário: Contaminação de Alimentos/análise
Embalagem de Alimentos/métodos
Carne/microbiologia
Salmonella/isolamento & purificação
Temperatura Ambiente
[Mh] Termos MeSH secundário: Animais
Galinhas
Microbiologia de Alimentos
Kentucky
Infecções por Salmonella
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171102
[Lr] Data última revisão:
171102
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170812
[St] Status:MEDLINE
[do] DOI:10.4315/0362-028X.JFP-17-097



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