Monika M Safford

..To confirm past reports of the clinical importance of microsize MIs, we also contrasted in-hospital, 28-day and 1-year mortality among those with microsize and nonmicrosize MI...

..It is unknown whether long-standing disparities in incidence of coronary heart disease (CHD) among US blacks and whites persist...

..Our understanding of social disparities in diabetes-related health behaviors is incomplete. The purpose of this study was to determine if having less education is associated with poorer diabetes-related health behaviors...

..The conceptualization of patient complexity is just beginning in clinical medicine...

..Intensity of hypertension treatment may play a role. We examined whether AA with treated hypertension received less-intense medication regimens than EA, as reflected in the number of antihypertensive medication classes...

..Some have proposed that it accounts for up to 80% of cardiovascular events, potentially an important quality problem. However, reasons for so-called clinical inertia are poorly understood...

..Current performance measures of glycemic control may not be reliably identifying quality problems, and tying reimbursements to such measures may compromise the care of complex patients...

..Little is reported about how much time patients spend on self-management, a cornerstone of diabetes care...

..Between the ages 45 and 65 years, incident stroke is 2 to 3 times more common in blacks than in whites, a difference not explained by traditional stroke risk factors...

..Black/white disparities in stroke incidence are well documented, but few studies have assessed the contributions to the disparity. Here we assess the contribution of "traditional" risk factors...

..The primary objective of this study was to assess the relationship between trust in physicians and blood pressure control among Blacks and Whites being treated for hypertension...

..Geographic variation in risk factors may underlie geographic disparities in coronary heart disease (CHD) and stroke mortality...

..Health Professional Shortage Areas (HPSA) receive extra federal resources, but recent reports suggest that HPSA may not consistently identify areas of need...

..Less medication use for CVD prevention was not associated with HPSA status, but less statin use was associated with lack of insurance...

..Stroke symptoms are common among people without a history of stroke or transient ischemic attack; however, it is unknown if particular attention should be focused on specific symptoms for subgroups of patients...

..To determine the effectiveness of a provider-based education and implementation intervention for improving diabetes control...

..20 (1.04-1.39), 1.23 (0.94-1.60), and 1.59 (1.08-2.33), respectively (P<.001). Worse adherence was also associated with higher multivariable adjusted hazard ratios for each of the 6 stroke symptoms...

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..The objective of this study was to examine the joint associations of estimated glomerular filtration rate (eGFR) and urinary albumin excretion with incident stroke in a large national cohort study...

..Few studies have assessed whether individuals with diabetes or prediabetes, but no physician diagnosis of stroke, have an increased prevalence of stroke symptoms...

..Future studies should include social factors, such as income and education, and consider additional characteristics that may modify or confound associations between alcohol and blood pressure...

..It is not known whether geographic differences in the prevalence of chronic kidney disease exist and are associated with end-stage renal disease (ESRD) incidence rates across the United States...

..Potential disparities in health care utilization were examined using overnight hospitalization data from the University of Alabama at Birmingham Study of Aging, a longitudinal investigation of a stratified sample of Medicare beneficiaries...

..We examined variation in awareness, treatment, and control of hypertension, diabetes, and hyperlipidemia according to both geographic and financial access to care...

..In many settings, proxy reports may represent a better strategy for determining cause of death than reliance on death certificates...

..We sought to obtain qualitative insight into beliefs about generic medication use among African Americans in the rural South...

..We propose that evaluation of change in A1c levels over time can be used as a new measure to reflect quality of care provided to populations of individuals with chronic disease...

..In this study, we describe the associations of discrimination with income and education in elderly African Americans (AA) and European Americans (EA)...

..We provide national estimates of stroke incidence by race and region, contrasting these to publicly available stroke mortality data...

..Assessment tools to identify high risk individuals may improve the harm versus benefit profile of screening ECGs. In particular, people with unrecognized myocardial infarction (UMI) have elevated risk for cardiovascular events and death...

..Therefore, we adopted a quality-oriented approach in reviewing those factors which could influence whether it will be embraced by the dental profession...

..We sought to examine regional and black-white differences in mean age at self-reported menopause among community-dwelling women in the United States...

..To investigate the association between physician participants' levels of engagement in a Web-based educational intervention and their patients' baseline diabetes measures...

..004) were more likely to receive narcotic analgesics. Students prescribed more narcotics than residents (p = .001). No differences were found by race in prescribing analgesics...

..Observational studies can avoid biases by blinding medical records to characteristics of interest before outcome adjudication. However, blinding is costly. We assessed the effect of blinding race and geography on outcome ascertainment...

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..To explore the relationship between degree of rurality and glucose (hemoglobin A1c), blood pressure (BP), and lipid (LDL) control among patients with diabetes...

..The International Diabetes Federation (IDF) and Adult Treatment Panel (ATP) III define metabolic syndrome (MetSyn) differently, with unclear implications for cardiovascular disease (CVD) risk...

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..We sought to examine the relationship between comorbidity and commonly assessed services for diabetic patients in a managed care organization...

..Providing diabetes education to all participants, including intervention and control, helped ensure that everyone stood to benefit and likely enhanced overall participation...

..The prevalence of cardioprotective medication use and blood pressure and low-density lipoprotein cholesterol control among individuals with UMI is unknown...

..For adults in general population community settings, data regarding long-term course and outcomes of illicit drug use are sparse, limiting the formulation of evidence-based recommendations for drug use screening of adults in primary care...

..Low adherence to antihypertensive medication is an important barrier to achieving blood pressure control. Few data are available for medication adherence in adults with chronic kidney disease (CKD)...

..46 days, p = 0.048). Medical records retrieval in prospective research studies is still feasible under HIPAA regulation...

..Instances of patients' not having received a diagnosis have been reported widely, as have instances of poor control of DM or prediabetes among patient's who have the disease. These facts indicate that blood glucose screening is needed...

..These claims algorithms will be useful in future population-based observational studies to evaluate associations between osteoporosis medications and subtrochanteric and diaphyseal femoral fractures...

..We conclude that large-scale implementation of P4P for dentistry may not be a realistic option before significant progress is achieved in quality of dental care indicators...

..We hypothesized that multiple uncontrolled cardiovascular risk factors would decrease blood pressure (BP) medication intensification among uncontrolled hypertensive patients...

..Stroke symptoms in the absence of recognized stroke are common, but potential associated dysfunctions have not been described...

..The growing number of dental patients with diabetes warrants strengthening the evidence base to guide their dental care and prevent possible morbid complications...

..Nonrandomized studies of interventions designed to maintain or improve bone density and/or hip fracture may need to consider medication compliance as a confounder to better estimate true intervention effects...

..Our purpose was to determine factors independently associated with cardiac rehabilitation referral, which are currently not well described at a national level...

..We defined sepsis deaths as deaths attributed to an infection, classified according to the International Classification of Diseases, Version 10. We calculated national and state age-adjusted sepsis-attributed mortality rates...

..Among US Medicare beneficiaries, we evaluated the risk for second fracture versus death in the 5 years following a hip, clinical vertebral, and wrist/forearm fracture...

..Its six symptom-related questions could potentially be used to screen for undiagnosed stroke or transient ischemic attack (TIA), but the sensitivity and specificity of just the six symptom-related questions are unknown...

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..We sought to determine whether greater implementation of clinical care strategies in managed care is associated with attenuation of known racial/ethnic disparities in diabetes care...

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..Although disease management programs are widely implemented, little is known about their effectiveness...

..We assessed educational disparities in smoking rates among adults with diabetes in managed care settings...

..Despite consensus about the importance of measuring quality of diabetes care and the widespread use of self-reports and medical records to assess quality, little is known about the degree of agreement between these data sources...

..To examine racial/ethnic and socioeconomic variation in diabetes care in managed-care settings...

..The characteristics associated with meeting goals for glycemia, blood pressure (BP), and low-density lipoprotein (LDL) cholesterol for participants with diabetes were examined...

..Metabolic decompensations (MD) are hospitalizations considered preventable with appropriate ambulatory care. We tested for associations between diabetes care and MD...

..This study investigated the effect of out-of-pocket expenditures on the utilization of recommended diabetes preventive services...

..We evaluated the effect of chlorhexidine (CHX) 0.12% rinses on the clinical and microbiologic manifestations of oral candidiasis in HIV-infected children...

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..No studies have compared care in the Department of Veterans Affairs (VA) with that delivered in commercial managed care organizations, nor have studies focused in depth on care comparisons for chronic, outpatient conditions...

..To examine the effect of referral management on diabetes care...

..It is difficult to treat these disorders when they co-occur. We discuss such a case in the context of relevant literature and make recommendations for assessment, management, and documentation...

..To examine the association between the organizational model and diabetes processes of care...

..To optimize methods for identifying patients with diabetes based on computerized records and to obtain best estimates of diabetes prevalence in Department of Veterans Affairs (VA) patients...

..0434) and strongly in black women (P =.0095). Components of the IR syndrome appear to be associated with CVD in postmenopausal women, although the magnitude of these relationships differed by ethnicity...

..To estimate all-cause hospitalizations, nursing home admissions, and deaths attributable to diabetes using a new methodology based on longitudinal data for a representative sample of older U.S. adults...

..Reporting of diabetes on death certificates has been stable over time. Death certificates underestimate the prevalence of diabetes among decedents and present a biased picture of the causes of death among people with diabetes...

..Therefore, we studied whether self-report of prevalent and incident diabetes in Women's Health Initiative (WHI) participants was concordant with other diagnostic evidence of diabetes...

..Heart failure (HF) and cognitive impairment are both common in older adults. However, the association between the two has not been well studied...

..Recent data suggest that residential environment may influence health behaviors and outcomes. We assessed whether perception of neighborhood problems was associated with diabetes behaviors and outcomes...

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..This article reviews relevant evidence and discusses concerns for the dental practitioner...

..The purpose of this article was to evaluate the impact of self-reported patient factors on quality assessment of Veterans Health Administration medical centers in achieving glycemic control...

..CONCLUSIONS: Lifestyle factors are important contributors to the long-term risk of nursing home admission. Modifying lifestyle, especially in middle age, may reduce the risk of admission...

..This study was undertaken to assess the effects of a low-fat dietary pattern on incidence of treated diabetes among generally healthy postmenopausal women...

..Our results will contribute significantly to the knowledge base essential for attaining the Healthy People 2010 goal of reducing health disparities. ..

..Our results will contribute significantlyto the knowledge base essential for attaining the Healthy People 2010 goal of reducing health disparities. ..

..Our results will contribute significantlyto the knowledge base essential for attaining the Healthy People 2010 goal of reducing health disparities. ..

..Our results will contribute significantlyto the knowledge base essential for attaining the Healthy People 2010 goal of reducing health disparities. ..