Antibiotic prescribing and respiratory tract infections.
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Anti-Bacterial Agents↗
Biomedical subjects
L B Jacques
Publications and source records attributed to L B Jacques.
Have our recruiting efforts distracted us from our teaching mission?
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Clinical Competence↗
Variation of bicycle helmet use rates with route distance.
The relationship between bicycle helmet use and demographic measures has been studied extensively. To date, however, there have been very few studies of helmet use by amateur cyclists in organized, noncompetitive, long distance events. Seven hundred eleven riders were observed during three organized events offering route distances ranging from 16 to 161 kilometres. Helmet use ranged from 59% in the shorter distance groups to one hundred percent in the longest distance group. This information can assist organizers of bicycling events by permitting estimation of helmet use rates for planned routes of varying distance.
Adult↗
Personal protective equipment use by in-line roller skaters.
BACKGROUND: In-line roller skating is a growing recreational fitness activity, but little is known about the use of personal protective equipment, such as helmets, wrist guards, elbow and knee pads, by participants. METHODS: An unobtrusive observational study was performed on a stratified random sample of adult and child in-line skaters in Oakland County, Michigan. A follow-up observational study was performed on locations identified as having high rates of in-line skating activity. RESULTS: The prevalence of personal protective equipment use varied greatly with the type of equipment. Helmet use was less than 10% in both phases of the study; wrist guard use ranged from 46% to 65%; and intermediate values were noted for the use of elbow and knee pads. CONCLUSIONS: Recreational in-line skating is concentrated in paved public areas and is largely a young adult activity. The use of some items of personal protective equipment is common, although few skaters wear all recommended items. Efforts to prevent or reduce accidental injury should include consideration of all these factors.
Adult↗
Solving the shortage of primary care physicians.
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Education, Medical↗
Cardiac arrhythmias during arousal from hibernation in three species of rodents.
Cardiac activity was monitored during arousal from deep hibernation in three species of hibernators (Citellus tridecemlineatus, Marmota monax, and Mesocricetus auratus). Individuals of each species showed marked arrhythmias, and these were confined to a body temperature range of between 11 and 20 degrees C, measured orally or rectally. The arrhythmias consisted of intermittent periods of asystole and bradycardia and were sometimes marked by the appearance of premature ventricular contractions and elevated or depressed S-T segments. Surgical manipulation of euthermic M. monax, under pentobarbital sodium anesthesia, indicated that none of the arrhythmias observed was inducible by injections of cold saline into the vena cava.
Animals↗
Heparin: an old drug with a new paradigm.
Recent studies have shown that heparin is a biochemical representative of a distinct class of compounds known as linear anionic polyelectrolytes. Members of this class are mixtures of individual highly negatively charged chains that show a wide spectrum of specific reactions with biologically active proteins. Upon administration, heparin chains enter a cellular pool and effectively prevent thrombosis by increasing the electronegative potential of the vessel wall. Anticoagulant activity is an unusual feature of a few heparin chains and appears to play a minor role in many clinical uses and in physiological and pathological responses.
Antithrombin III↗
Letter: Standardisation of heparin for clinical use.
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Heparin↗
Rates of bicycle helmet use in an affluent Michigan County.
Bicycle helmet use in the United States has remained low despite clear demonstration of its beneficial effect on reducing the incidence of serious head injury. Several interventions have been reported, with variable results and costs. Much of the recent literature has focused on child cyclists and on demographic factors associated with helmet use. This paper reports on helmet use by children and adults in a sample of 652 riders in an affluent southeast Michigan region, chosen to minimize the effect of previously recognized socioeconomic negative predictors that are not readily changed by intervention. Subjects were classified by age, sex, location, riding surface, type of bicycle, child bicycle seat use, child bicycle trailer use, and helmet use by companions. Overall helmet use was 24 percent; infants and toddlers had the highest rate of helmet use at 61 percent, followed by adults at 26 percent and school-aged children at 17 percent. The strongest predictor of helmet use in all age categories was the presence of a helmeted companion. Adult helmet use was also positively predicted by riding in the street and by riding a racing-type bicycle. The use of a city-type bicycle negatively predicted helmet use. For non-adults, female sex and the use of a child seat or trailer were positive predictors. Fostering peer pressure to increase helmet use may be an effective yet relatively inexpensive way to achieve the goal of widespread use of bicycle helmets.
Adult↗
Incremental change in student knowledge during a third-year family medicine clerkship.
BACKGROUND AND OBJECTIVES: Family medicine clerkships compete with other clinical experiences for a limited amount of available curricular time. The overlap of clinical material covered by other departments raises the possibility that students will realize increased or diminished added value from a family practice rotation if they take it later in the third-year schedule. METHODS: All students (n = 420) in a required third-year clerkship in two geographically distant medical schools completed pre- and post-clerkship multiple choice examinations on the clinical content of family practice. School A has a lock-step schedule; all the clinical rotations are taken in a specific order by all students. School B has a random schedule. These examinations were random samples, stratified by clinical subject area, from the Exam. Kit database, based on the text Essentials of Family Medicine, Second Edition. The difference between the pre- and post-clerkship scores determined the incremental performance. RESULTS: There was no significant change in incremental performance over the course of the year at either school. CONCLUSIONS: The increased fund of knowledge acquired during a family medicine clerkship, as measured by a multiple choice examination, is not diminished by prior clinical clerkships in other specialties.
Adult↗