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Find video protocols related to scientific articles indexed in Pubmed.
Cost-effectiveness of a peer and practice staff support intervention.
Am J Manag Care
PUBLISHED: 06-03-2014
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We examined the cost-effectiveness of an intervention to reduce coronary heart disease (CHD) risk and blood pressure in African Americans.
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Zinc and Vitamin Supplementation in an Under-5 Indigenous Population of Guatemala: Influence of Lay Health Promoters in Decreasing Incidence of Diarrhea.
J Transcult Nurs
PUBLISHED: 05-10-2014
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Malnutrition is an urgent problem in the developing world, especially for children under 5 years of age. The article describes the utilization of a standard of practice designed to prevent illness in a malnourished, under-5 indigenous population and reinforced by weekly basic health messages taught by lay community health promoters.
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Pain management and opioid risk mitigation in the military.
Mil Med
PUBLISHED: 05-09-2014
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Opioid analgesics misuse is a significant military health concern recognized as a priority issue by military leadership. Opioids are among those most commonly prescribed medications in the military for pain management. The military has implemented opioid risk mitigation strategies, including the Sole Provider Program and the Controlled Drug Management Analysis and Reporting Tool, which are used to identify and monitor for risk and misuse. However, there are substantial opportunities to build on these existing systems to better ensure safer opioid prescribing and monitor for misuse. Opioid risk mitigation strategies implemented by the civilian sector include establishing clinical guidelines for opioid prescribing and prescription monitoring programs. These strategies may help to inform opioid risk mitigation in the military health system. Reducing the risk of opioid misuse and improving quality of care for our Warfighters is necessary. This must be done through evidence-based approaches with an investment in research to improve patient care and prevent opioid misuse as well as its sequelae.
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A qualitative study of family healthy lifestyle behaviors of Mexican-American and Mexican immigrant fathers and mothers.
J Acad Nutr Diet
PUBLISHED: 02-12-2014
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This study qualitatively examines contrasting parental decision-making styles about family food choices and physical activities as well as willingness to change behaviors among Mexican-American and Mexican immigrant mothers and fathers of school-aged children. Twelve sex-specific focus groups were held in English or Spanish in 2012. Qualitative analysis informed by grounded theory examined parenting styles (ie, authoritative, authoritarian, or permissive), barriers to healthy lifestyle, and parents' stage of change about healthy lifestyles. One third of the 33 participating couples were born in Mexico. The majority of mothers and fathers described being permissive and allowing unhealthy food choices, and a minority of mothers reported more authoritarian approaches to promoting a healthier diet for their children. Mothers were more permissive than fathers about family physical activities and less engaged in these activities. Most mothers and fathers described only contemplating a healthier diet and more physical activity, while wanting their children to have a healthier lifestyle. These data suggest that clinicians need to assess and address differential parental roles when promoting a healthy lifestyle for children. Clinicians should also adopt culturally competent approaches to overcome barriers to parental engagement in diverse aspects of a healthy family lifestyle.
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Optimizing protein intake in premature infants: a neonatal quality improvement project.
Adv Neonatal Care
PUBLISHED: 12-05-2013
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This article examines a quality-improvement project to reduce clinical practice variation and measure growth outcomes by standardizing the process for the provision of protein intake for premature infants weighing 1250 g or less. Eighteen infants with a birth weight of 1250 g or less and gestational age of 32 weeks or less born between June and October 2010 were compared with 15 historical controls of the same birth weight and gestation born between January and May 2010 using a prospective cohort design. The prospective group followed a newly implemented standardized protein nutritional guideline. Independent t-tests and repeated measures of analyses of variance (between- and within-subjects) were performed on the difference between the intended and actual protein intakes between the 2 groups. A multivariate analysis of variance computed the difference between the birth and discharge gains. The prospective group showed statistically significant differences between the amount of intended and actual protein intakes (P = .023) when compared with historical controls. Growth outcomes were not significantly different (P = .67) between the 2 groups. Length of stay was not statistically significantly shorter (P = .06) in the prospective group. Reduction in clinical practice variation was associated with the implementation of a protein nutritional guideline. There was no statistical support for an improvement in the growth outcomes or reduction in length of stay.
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Dissemination and implementation of comparative effectiveness evidence: key informant interviews with Clinical and Translational Science Award institutions.
J Comp Eff Res
PUBLISHED: 11-19-2013
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To identify ongoing practices and opportunities for improving national comparative effectiveness research (CER) translation through dissemination and implementation (D&I) via NIH-funded Clinical and Translational Science Award (CTSA) institutions.
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Improving stroke education performance measures scores: the impact of a stroke nurse coordinator.
J Neurosci Nurs
PUBLISHED: 11-13-2013
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Stroke is a leading cause of death and adult disability worldwide. North Carolina is considered to be a part of an area of the United States called the "stroke belt." Education coupled with implementation of a program that promotes primary and secondary stroke prevention is paramount to support the reduction of stroke and improvement of stroke care across the continuum. The groundwork for stroke care at Onslow Memorial Hospital began in 2006 with participation in the North Carolina Stroke Care Collaborative (NCSCC), which allowed for benchmarking of data.
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Improving the adoption of evidence-based practice among nurses in Army outpatient medical treatment facilities.
Mil Med
PUBLISHED: 09-06-2013
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This quality improvement project implemented and evaluated an evidence-based practice (EBP) program at two Army outpatient health care facilities. The EBP program consisted of five implementation strategies that aimed to inculcate EBP into organizational culture as well as nursing practice and culture. A conceptual model of the "Diffusion of Innovations" theory was adapted to explain the application of the program. The Institutional Review Boards at Walter Reed National Military Medical Center and Duke University School of Medicine reviewed and exempted this quality improvement project. A pretest-posttest design was used with four instruments at each facility. The EBP program was successful in enhancing organizational culture and readiness for EBP (p < 0.01) and nursing staffs belief about the value of EBP and their ability to implement it (p < 0.05). Another indicator that the EBP program achieved its goals was the significant difference (p = 0.002) in the movement of the outpatient health care facilities toward an EBP culture. These results suggest that this EBP program may be an effective method for empowering outpatient nursing staff with the knowledge and tools necessary to use evidence-based nursing practice.
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Analyses of amplified fragment length polymorphisms (AFLP) indicate rapid radiation of Diospyros species (Ebenaceae) endemic to New Caledonia.
BMC Evol. Biol.
PUBLISHED: 08-14-2013
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Radiation in some plant groups has occurred on islands and due to the characteristic rapid pace of phenotypic evolution, standard molecular markers often provide insufficient variation for phylogenetic reconstruction. To resolve relationships within a clade of 21 closely related New Caledonian Diospyros species and evaluate species boundaries we analysed genome-wide DNA variation via amplified fragment length polymorphisms (AFLP).
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Molecular phylogenetics of New Caledonian Diospyros (Ebenaceae) using plastid and nuclear markers.
Mol. Phylogenet. Evol.
PUBLISHED: 01-25-2013
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To clarify phylogenetic relationships among New Caledonian species of Diospyros, sequences of four plastid markers (atpB, rbcL, trnK-matK and trnS-trnG) and two low-copy nuclear markers (ncpGS and PHYA) were analysed. New Caledonian Diospyros species fall into three clades, two of which have only a few members (1 or 5 species); the third has 21 closely related species for which relationships among species have been mostly unresolved in a previous study. Although species of the third group (NC clade III) are morphologically distinct and largely occupy different habitats, they exhibit little molecular variability. Diospyros vieillardii is sister to the rest of the NC clade III, followed by D. umbrosa and D. flavocarpa, which are sister to the rest of this clade. Species from coastal habitats of western Grande Terre (D. cherrieri and D. veillonii) and some found on coralline substrates (D. calciphila and D. inexplorata) form two well-supported subgroups. The species of NC clade III have significantly larger genomes than found in diploid species of Diospyros from other parts of the world, but they all appear to be diploids. By applying a molecular clock, we infer that the ancestor of the NC clade III arrived in New Caledonia around 9 million years ago. The oldest species are around 7 million years old and the youngest ones probably much less than 1 million years.
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Clinician suspicion of an alcohol problem: an observational study from the AAFP National Research Network.
Ann Fam Med
PUBLISHED: 01-16-2013
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In clinical practice, detection of alcohol problems often relies on clinician suspicion instead of using a screening instrument. We assessed the sensitivity, specificity, and predictive values of clinician suspicion compared with screening-detected alcohol problems in patients.
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Utilizing a diabetic registry to manage diabetes in a low-income Asian American population.
Popul Health Manag
PUBLISHED: 12-22-2011
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Racial and income disparities persist in diabetes management in America. One third of African and Hispanic Americans with diabetes receive the recommended diabetes services (hemoglobin A1c [A1c] testing, retinal and foot examinations) shown to reduce diabetes complications and mortality, compared to half of whites with diabetes. National data for Asian Americans are limited, but studies suggest that those with language and cultural barriers have difficulty accessing health services. A diabetic registry has been shown to improve process and clinical outcomes in a population with diabetes. This study examined whether a community center that serves primarily low-income Asian American immigrants in Santa Clara County, California, could improve diabetes care and outcomes by implementing a diabetic registry. The registry was built using the Access 2007 software program. A total of 580 patients with diabetes were identified by reviewing charts, the appointment database, and reimbursement records from Medicaid, Medicare, and private insurance companies. Utilizing the registry, medical assistants contacted patients for follow-up appointments, and medical providers checked and tracked the patients A1c results. Among the 431 patients who returned for treatment, the mean A1c was reduced from 7.27% to 6.97% over 8 months (P<0.001). Although 10.8% of the patients changed from controlled to uncontrolled diabetes post intervention, 32.6% of patients with uncontrolled diabetes converted to controlled diabetes (P<0.001). The diabetes control rate improved from 47% to 59% at the end of the study. This study demonstrated that a diabetic registry is an effective tool to manage an underserved population with diabetes, thereby reducing disparities in diabetes management.
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Central line "attention" is their best prevention.
Adv Neonatal Care
PUBLISHED: 11-30-2011
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Central line associated blood stream infections (CLABIs) are associated with an increase in length of stay, morbidity, hospital costs, and mortality. In 2009, CLABIs were on the increase at Covenant Healthcares 55 bed Level III neonatal intensive care unit (NICU). Prior to this practice initiative, there were no standardized central line management practices in the NICU. We retrospectively reviewed the incidence CLABIs for the six months prior to the initiation of the standardization of central line management and then 3 months following the implementation of the new practice policy. Specific outcomes measured were the number of CLABIs, length of stay related to CLABIs, and adherence to the policies and procedures. The project was implemented in four phases: 1) hand hygiene, 2) "scrub the hub", 3) central line tubing changes, 4) central line insertion, removal, and dressing changes. Although there were no statistically significant changes in the outcome measures, there were clinically significant differences between length of stay and risk for central line infection, incidence of CLABIs, and an increase in adherence to the central line practice change policies. The study showed for every week that is added to the patient stay, the patient was 7 times more likely to have a CLABIs. The rate of central line infection was decreased from 15.6 percent per 1000 line days to zero in 2010.
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Emotional responses of mothers of late-preterm and term infants.
J Obstet Gynecol Neonatal Nurs
PUBLISHED: 11-03-2011
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To compare the emotional responses of mothers of late-preterm infants (34 0/7 to 36 6/7 weeks gestation) with those of mothers of full-term infants.
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A retrospective cohort study of the potency of lipid-lowering therapy and race-gender differences in LDL cholesterol control.
BMC Cardiovasc Disord
PUBLISHED: 09-30-2011
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Reasons for race and gender differences in controlling elevated low density lipoprotein (LDL) cholesterol may be related to variations in prescribed lipid-lowering therapy. We examined the effect of lipid-lowering drug treatment and potency on time until LDL control for black and white women and men with a baseline elevated LDL.
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The promiscuous and the chaste: frequent allopolyploid speciation and its genomic consequences in American daisies (Melampodium sect. Melampodium; Asteraceae).
Evolution
PUBLISHED: 09-06-2011
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Polyploidy, an important factor in eukaryotic evolution, is especially abundant in angiosperms, where it often acts in concert with hybridization to produce allopolyploids. The application of molecular phylogenetic techniques has identified the origins of numerous allopolyploids, but little is known on genomic and chromosomal consequences of allopolyploidization, despite their important role in conferring divergence of allopolyploids from their parental species. Here, using several plastid and nuclear sequence markers, we clarify the origin of tetra- and hexaploids in a group of American daisies, allowing characterization of genome dynamics in polyploids compared to their diploid ancestors. All polyploid species are allopolyploids. Among the four diploid gene pools, the propensity for allopolyploidization is unevenly distributed phylogenetically with a few species apparently more prone to participate, but the underlying causes remain unclear. Polyploid genomes are characterized by differential loss of ribosomal DNA loci (5S and 35S rDNA), known hotspots of chromosomal evolution, but show genome size additivity, suggesting limited changes beyond those affecting rDNA loci or the presence of processes counterbalancing genome reduction. Patterns of rDNA sequence conversion and provenance of the lost loci are highly idiosyncratic and differ even between allopolyploids of identical parentage, indicating that allopolyploids deriving from the same lower-ploid parental species can follow different evolutionary trajectories.
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Blood pressure screenings through community nursing health fairs: motivating individuals to seek health care follow-up.
J Community Health Nurs
PUBLISHED: 08-04-2011
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To evaluate the effectiveness of blood pressure [BP] screenings through community-based health fairs. Effectiveness was measured by those with high BP readings who either made an appointment with or actually followed up with their primary care provider [PCP] in person following post-screening referral.
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Raising achievement: educating physicians to address effects of at-risk drinking on common diseases.
Qual Prim Care
PUBLISHED: 06-28-2011
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Despite a high prevalence, internists rarely screen for at-risk drinking. A contributing factor is likely to be physicians limited understanding of the negative effects that at-risk drinking can have on common clinical conditions managed on a daily basis.
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Acute coronary syndromes in deployed military personnel.
J Am Acad Nurse Pract
PUBLISHED: 06-09-2011
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The purpose of this study was to describe the cardiovascular (CV) risk profile of deployed military men who experience acute coronary syndrome (ACS).
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A meta-analysis of the efficacy of nonphysician brief interventions for unhealthy alcohol use: implications for the patient-centered medical home.
Am J Addict
PUBLISHED: 05-31-2011
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Brief physician interventions can reduce alcohol consumption. Physicians may not have the time to provide brief interventions, and it is unclear whether nonphysicians can do so effectively. We conducted a systematic review and meta-analysis to examine the efficacy of brief interventions by nonphysician clinicians for unhealthy alcohol use. We searched the English-language literature in MEDLINE and other databases covering the domains of alcohol problems, primary care, nonphysician, and brief interventions. Studies of brief interventions delivered at least in part by nonphysicians in primary care and examining drinking outcomes were included. Sensitivity analyses examined the effect of excluding studies that contributed disproportionately to the heterogeneity of results. Thirteen studies, conducted 1996-2008, met our criteria. Seven studies with a total of 2,633 patients were included in the meta-analysis. Nonphysician interventions were associated with 1.7 (95% confidence interval [CI]=-.03 to -3.5) fewer standard drinks per week than control conditions (p = .054). Excluding the one study that increased heterogeneity, the effect was smaller but reached statistical significance; nonphysician counseling was associated with 1.4 (95% CI = .3- 2.4) fewer standard drinks per week compared to control (p = .012). Nonphysician brief interventions are modestly effective at reducing drinking in primary care patients with unhealthy alcohol use.
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Racial differences in primary care opioid risk reduction strategies.
Ann Fam Med
PUBLISHED: 05-11-2011
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Racial disparities in treating pain with opioids are widely reported; however, differences in use of recommended strategies to reduce the risk of opioid misuse by race/ethnicity have not been evaluated.
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Association of black race with follow-up of an abnormal prostate-specific antigen test.
J Natl Med Assoc
PUBLISHED: 03-30-2011
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Delayed evaluation after a clearly abnormal prostate-specific antigen (PSA) result may contribute to more advanced prostate cancer at diagnosis in black men. In 46 primary care practices over a period of 4.5 years, we studied men aged more than 50 years without known prostate cancer who had a PSA of at least 10.0 ng/mL for the first time. PSA follow-up included: a urology appointment, a new prostate diagnosis, or repeat PSA test. Cox proportional hazards models assessed time to follow-up, adjusting for demographic, clinical, and health care factors with censoring at a time that represents excessive delay (200 days). Among all 724 study men (27% black), delay until PSA follow-up averaged 115.2 days (+/- 79.7 d) and the unadjusted hazard ratio (HR) for follow-up was shorter for black men than nonblack men (HR, 1.23; 95% CI, 1.00-1.51). However, black men were more likely to have had prior urology care and had higher index PSA levels than other men; both factors were associated with shorter follow-up. After adjustment, delay did not differ for black vs nonblack race (HR, 1.05; 95% Cl, 0.78-1.43) but men aged at least 75 years had a longer delay than men aged 74 years or less (HR, 0.72; 95% CI, 0.59-0.89). Despite black men having greater risk of advanced prostate disease at diagnosis and better linkage to urologic care, follow-up was delayed, on average, by more than 3 months and did not differ by race. These results reveal a potentially important, remediable factor to improve prostate cancer prevention and care for black men.
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Association of alcohol consumption with selected cardiovascular disease outcomes: a systematic review and meta-analysis.
BMJ
PUBLISHED: 02-24-2011
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To conduct a comprehensive systematic review and meta-analysis of studies assessing the effect of alcohol consumption on multiple cardiovascular outcomes.
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Effect of alcohol consumption on biological markers associated with risk of coronary heart disease: systematic review and meta-analysis of interventional studies.
BMJ
PUBLISHED: 02-24-2011
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To systematically review interventional studies of the effects of alcohol consumption on 21 biological markers associated with risk of coronary heart disease in adults without known cardiovascular disease.
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Primary care providers perspective on prescribing opioids to older adults with chronic non-cancer pain: a qualitative study.
BMC Geriatr
PUBLISHED: 02-03-2011
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The use of opioid medications as treatment for chronic non-cancer pain remains controversial. Little information is currently available regarding healthcare providers attitudes and beliefs about this practice among older adults. This study aimed to describe primary care providers experiences and attitudes towards, as well as perceived barriers and facilitators to prescribing opioids as a treatment for chronic pain among older adults.
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Qualitative analysis of peer coaches experiences with counseling African Americans about reducing heart disease risk.
J Gen Intern Med
PUBLISHED: 01-26-2011
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Despite mounting evidence that peer coaches can make significant contributions to patient health, little is known about factors that must be addressed to engage and retain them in their role.
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Low use of opioid risk reduction strategies in primary care even for high risk patients with chronic pain.
J Gen Intern Med
PUBLISHED: 01-06-2011
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Experts recommend close oversight of patients receiving opioid analgesics for chronic non-cancer pain (CNCP), especially those at increased risk of misuse. We hypothesized that physicians employ opioid risk reduction strategies more frequently in higher risk patients.
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Risk based HIV retesting: back to the same old challenges.
Virulence
PUBLISHED: 12-24-2010
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An estimated 230,000 Americans are unaware that they have HIV infection. As a result, these individuals have not benefited from treatment for HIV infection and they may continue to spread the disease. In 2006, the Centers for Disease Control and Prevention (CDC) reported that 40% of adults aged 18-64 had been tested for HIV but only 10% had been tested within the last 12 months. A national survey conducted by the CDC in 2000 found that only about one-quarter of primary care providers and emergency physicians reported routinely testing their patients for HIV. To improve the performance of HIV testing, in 2006 the CDC issued recommendations that patients in all health care settings be offered universal, opt-out HIV testing. Since that time, several studies have demonstrated the feasibility of opt-out testing but barriers to implementation persist. Many states still require signed consent and counseling and other logistical challenges include: insufficient time, competing priorities, and inadequate reimbursement. Therefore, universal HIV testing remains an unrealized goal.
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Alcohol and sleep problems in primary care patients: a report from the AAFP National Research Network.
Ann Fam Med
PUBLISHED: 11-10-2010
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Hazardous and harmful drinking and sleep problems are common, but their associations among patients seen in primary care have not been examined. We hypothesized that greater levels of alcohol consumption would be associated with several self-reported sleep problems.
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Characteristics of older adults receiving opioids in primary care: treatment duration and outcomes.
Pain Med
PUBLISHED: 07-21-2010
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To describe characteristics of older adults who received opioids for chronic non-cancer pain (CP), ascertain types of opioid treatments received, and examine associations between patient characteristics and treatment outcomes.
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Systematic review: treatment agreements and urine drug testing to reduce opioid misuse in patients with chronic pain.
Ann. Intern. Med.
PUBLISHED: 06-02-2010
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Experts recommend opioid treatment agreements and urine drug testing to reduce opioid analgesia misuse, but evidence of their effectiveness has not been systematically reviewed.
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Outcomes associated with opioid use in the treatment of chronic noncancer pain in older adults: a systematic review and meta-analysis.
J Am Geriatr Soc
PUBLISHED: 06-01-2010
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This systematic review summarizes existing evidence regarding the efficacy, safety, and abuse and misuse potential of opioids as treatment for chronic noncancer pain in older adults. Multiple databases were searched to identify relevant studies published in English (1/1/80-7/1/09) with a mean study population age of 60 and older. Forty-three articles were identified and retained for review (40 reported safety and efficacy data, the remaining 3 reported misuse or abuse outcome data). The weighted mean subject age was 64.1 (mean age range 60-73). Studies enrolled patients with osteoarthritis (70%), neuropathic pain (13%), and other pain-producing disorders (17%). The mean duration of treatment studies was 4 weeks (range 1.5-156 weeks), and only five (12%) lasted longer than 12 weeks. In meta-analyses, effect sizes were -0.557 (P<.001) for pain reduction, -0.432 (P<.001) for physical disability reduction, and 0.859 (P=.31) for improved sleep. The effect size for the Medical Outcomes Study 36-item Health Survey was 0.191 (P=.17) for the physical component score and -0.220 (P=.04) for the mental component score. Adults aged 65 and older were as likely as those younger than 65 to benefit from treatment. Common adverse events included constipation (median frequency of occurrence 30%), nausea (28%), and dizziness (22%) and prompted opioid discontinuation in 25% of cases. Abuse and misuse behaviors were negatively associated with older age. In older adults with chronic pain and no significant comorbidity, short-term use of opioids is associated with reduction in pain intensity and better physical functioning but poorer mental health functioning. The long-term safety, efficacy, and abuse potential of this treatment practice in diverse populations of older persons remain to be determined.
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Racial disparities in hypertension control, but not treatment intensification.
Am. J. Hypertens.
PUBLISHED: 11-05-2009
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Racial disparities in hypertension control are well documented, yet the contribution of providers to these disparities remains unclear. The objective of this study was to examine whether provider management of uncontrolled hypertension differed by patient race.
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Gaps in addressing problem drinking: overcoming primary care and alcohol treatment deficiencies.
Curr Psychiatry Rep
PUBLISHED: 09-30-2009
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Despite the high prevalence of problem drinking among Americans, primary care physicians often fail to address this major health threat. In addition, once alcohol use disorders are identified, patients often fail to receive coordinated medical and substance abuse treatment. This article reviews four types of barriers as well as potential facilitators to improving the prevention and management of problem drinking. First, primary care physicians are poorly trained about the clinical relevance of addressing alcohol problems in their daily patient care. Second, primary care physicians are concerned about the stigma and health insurance problems encountered by patients diagnosed with alcohol use disorders. Third, primary care practices have limited organizational and financial support to identify and address alcohol problems. Fourth, primary care and alcohol treatment settings communicate and collaborate poorly in delivering patient care. Opportunities to overcome these challenges are discussed and must be initiated to reduce the myriad of adverse outcomes resulting from problem drinking.
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Methodological challenges and limitations of research on alcohol consumption and effect on common clinical conditions: evidence from six systematic reviews.
J Gen Intern Med
PUBLISHED: 06-30-2009
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Despite the high prevalence of alcohol consumption in the US, mainstream physicians generally consider it to be peripheral to most patient care. This may be due in part to a dearth of rigorous research on alcohols effect on common diseases.
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Barriers to adherence and hypertension control in a racially diverse representative sample of elderly primary care patients.
Pharmacoepidemiol Drug Saf
PUBLISHED: 05-30-2009
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To examine the effect of antihypertensive adherence on blood pressure and barriers to adherence in racially diverse elderly patients.
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Adapting a multifaceted U.S. HIV prevention education program for girls in Ghana.
AIDS Educ Prev
PUBLISHED: 02-27-2009
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We adapted a U.S. HIV prevention program to address knowledge gaps and cultural pressures that increase the risk of infection in adolescent Ghanaian girls. The theory-based nine-module HIV prevention program combines didactics and games, an interactive computer program about sugar daddies, and tie-and-dye training to demonstrate an economic alternative to transactional sex. The abstinence-based study was conducted in a church-affiliated junior secondary school in Nsawam, Ghana. Of 61 subjects aged 10-14 in the prevention program, over two thirds were very worried about becoming HIV infected. A pre-post evaluation of the intervention showed significant gains in three domains: HIV knowledge (p = .001) and self efficacy to discuss HIV and sex with men (p < .001) and with boys (p < .001). Responses to items about social norms of HIV risk behavior were also somewhat improved (p = .09). Subjects rated most program features highly. Although short-term knowledge and self-efficacy to address HIV improved significantly, longer term research is needed to address cultural and economic factors placing young women at risk of HIV infection.
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Effect of patient comorbidities on filling of antihypertensive prescriptions.
Am J Manag Care
PUBLISHED: 01-17-2009
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To evaluate the extent of patient failure to fill antihypertensive prescriptions and to test the hypothesis that the presence of noncardiovascular disease is negatively associated with filling an antihypertensive prescription, and, conversely, that the presence of cardiovascular disease is positively associated with filling an antihypertensive prescription.
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Reasons patients with a positive fecal occult blood test result do not undergo complete diagnostic evaluation.
Ann Fam Med
PUBLISHED: 01-14-2009
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Screening for fecal occult blood reduces colorectal cancer mortality by identifying patients with positive results for complete diagnostic evaluation (CDE). CDE rates are suboptimal, however. We sought to determine common reasons for nonperformance of a CDE as recorded by the primary care physician.
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Undiagnosed hepatitis C on the general medicine and trauma services of two urban hospitals.
J. Infect.
PUBLISHED: 01-08-2009
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The inpatient medical service may be an important location to identify undiagnosed hepatitis C virus (HCV) infection. We conducted a cross-sectional HCV prevalence study in consecutive patients aged 18-65 admitted in a three-month period to two urban hospitals general internal medicine and trauma services. Patient sera were anonymously screened for anti-HCV antibody with an enzyme-linked immunoassay and, when anti-HCV positive (+), for HIV. Health system records were examined for prior HCV testing or diagnosis or an HIV diagnosis then linked anonymously to test results. Multivariate logistic regression was used to examine associations of patient and health care factors with unknown HCV+ status. Of 786 unique patients tested (60.3% of all admitted patients), 62 (7.9%) were HCV+ without a prior HCV+ test or diagnosis while 61 patients (7.8%) tested HCV+ but had prior HCV+ test or diagnosis. Of 62 patients with unknown HCV+, 6 (9.7%) were HIV+ but only 3 had a prior HIV diagnosis; of 61 patients with known HCV+, all 9 (14.8%) HIV+ had been diagnosed. Among the 640 patients with prior unknown HCV status, an HCV+ test was strongly associated with age: 50-65 (adjusted odds ratio [AOR] 5.44, CI 2.20-13.48) and age 36-49 (AOR 4.65, CI 1.91-11.32) versus. 18-35. In this anonymous study, we could not obtain HCV risk factor data but the positive and negative predictive values of HCV testing all inpatients with an unknown HCV status were 99.3% and 99.0%, respectively. In similar urban general medicine and trauma services, broader efforts to test for HCV in inpatients aged 36-65 may be warranted.
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Behavioral Support Intervention for Uncontrolled Hypertension: A Complier Average Causal Effect (CACE) Analysis.
Med Care
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BACKGROUND:: The complier average causal effect (CACE) analysis addresses noncompliance with intervention and missing end-point measures in randomized controlled trials. OBJECTIVES:: To conduct a CACE analysis for the Peer Coach and Office Staff Support Trial examining the interventions effect among "compliers," defined as subjects who would have received an effective dose of the intervention had it been offered, and to compare with an intention-to-treat analysis. RESEARCH DESIGN AND SUBJECTS:: A randomized controlled trial of 280 African American patients aged 40-75 with sustained uncontrolled hypertension from 2 general internal medicine practices. MEASURES:: Change in 4-year coronary heart disease (CHD) risk (primary) and in systolic blood pressure (SBP) (secondary) from the baseline to the end of the 6-month intervention. RESULTS:: Of 136 intervention subjects, 68% were compliers who had significantly more end points measured (86% vs. 34% for CHD risk; 99% vs. 57% for SBP) and lower baseline CHD risk (5% vs. 7.5%) and SBP (139 vs. 144 mm Hg) compared with noncompliers. In the intention-to-treat analysis, the effect of offering the intervention was nonsignificant for 4-year CHD risk (P=0.08) but significant for SBP (P=0.003). CACE analyses showed that receipt of an effective dose of the intervention resulted in a 1% greater reduction in 4-year CHD risk (P<0.05) and at least 8.1 mm Hg greater reduction in SBP compared with compliers in the control group (P<0.05). CONCLUSIONS:: Among compliers, an effective dose of peer coach and office-based support resulted in significant reductions in 4-year CHD risk and SBP. More intensive interventions are likely to be required for noncompliers.
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Systematic review: effect of alcohol intake on adherence to outpatient medication regimens for chronic diseases.
J Stud Alcohol Drugs
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Nonadherence to medications can lead to adverse health outcomes. Alcohol consumption has been shown to be associated with nonadherence to antiretroviral medications, but this relationship has not been examined at different drinking levels or with other chronic disease medications. We conducted a narrative synthesis of the association of alcohol consumption with nonadherence to medications for four chronic diseases.
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Limited PSA testing in indigent men in South Texas: an appropriate care or missing a prevention opportunity?
Cancer Epidemiol. Biomarkers Prev.
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No previous study has examined racial ethnic differences in prostate-specific antigen (PSA) testing and followup in primary care practices serving an indigent population.
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The evolutionary history of the white-rayed species of Melampodium (Asteraceae) involved multiple cycles of hybridization and polyploidization.
Am. J. Bot.
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Polyploidy plays an important role in race differentiation and eventually speciation. Underlying mechanisms include chromosomal and genomic changes facilitating reproductive isolation and/or stabilization of hybrids. A prerequisite for studying these processes is a sound knowledge on the origin of polyploids. A well-suited group for studying polyploid evolution consists of the three species of Melampodium ser. Leucantha (Asteraceae): M. argophyllum, M. cinereum, and M. leucanthum.
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A randomized trial of peer coach and office staff support to reduce coronary heart disease risk in African-Americans with uncontrolled hypertension.
J Gen Intern Med
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Adopting features of the Chronic Care Model may reduce coronary heart disease risk and blood pressure in vulnerable populations. We evaluated a peer and practice team intervention on reduction in 4-year coronary heart disease risk and systolic blood pressure.
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The next phase of Title VII funding for training primary care physicians for Americas health care needs.
Ann Fam Med
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Health care reform will add millions of Americans to the ranks of the insured; however, their access to health care is threatened by a deep decline in the production of primary care physicians. Poorer access to primary care risks poorer health outcomes and higher costs. Meeting this increased demand requires a major investment in primary care training. Title VII, Section 747 of the Public Health Service Act previously supported the growth of the health care workforce but has been severely cut over the past 2 decades. New and expanded Title VII initiatives are required to increase the production of primary care physicians; establish high-functioning academic, community-based training practices; increase the supply of well-trained primary care faculty; foster innovation and rigorous evaluation of these programs; and ultimately to improve the responsiveness of teaching hospitals to community needs. To accomplish these goals, Congress should act on the Council on Graduate Medical Educations recommendation to increase funding for Title VII, Section 747 roughly 14-fold to $560 million annually. This amount represents a small investment in light of the billions that Medicare currently spends to support graduate medical education, and both should be held to account for meeting physician workforce needs. Expansion of Title VII, Section 747 with the goal of improving access to primary care would be an important part of a needed, broader effort to counter the decline of primary care. Failure to launch such a national primary care workforce revitalization program will put the health and economic viability of our nation at risk.
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High Risk of Obesity and Weight Gain for HIV-Infected Uninsured Minorities.
J. Acquir. Immune Defic. Syndr.
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Obesity and HIV disproportionately affect minorities and have significant health risks, but few studies have examined disparities in weight change in HIV-seropositive (HIV+) cohorts.
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What is Visualize?

JoVE Visualize is a tool created to match the last 5 years of PubMed publications to methods in JoVE's video library.

How does it work?

We use abstracts found on PubMed and match them to JoVE videos to create a list of 10 to 30 related methods videos.

Video X seems to be unrelated to Abstract Y...

In developing our video relationships, we compare around 5 million PubMed articles to our library of over 4,500 methods videos. In some cases the language used in the PubMed abstracts makes matching that content to a JoVE video difficult. In other cases, there happens not to be any content in our video library that is relevant to the topic of a given abstract. In these cases, our algorithms are trying their best to display videos with relevant content, which can sometimes result in matched videos with only a slight relation.