B P Yawn

..This survey explores the attitudes, beliefs, and knowledge related to COPD recognition, diagnosis, and treatment from family physicians and nurse practitioners (NPs) and physician assistants (PAs) working in primary care...

..The objectives of this study are to evaluate the effect of VFC on physician reported referral of children to public health clinics and on doses administered in the public sector...

..Rural health care workforce forecasting has not included adjustments for predictable changes in practice patterns, such as the introduction of practice guidelines...

..To determine the health care follow-up and treatment associated with physician-diagnosed hepatitis C (HCV) in a community-based population...

..To identify the healthcare utilization and evaluation in a community-based population with an incident diagnosis of irritable bowel syndrome (IBS)...

..To assess temporal trends in carpal tunnel syndrome (CTS) incidence, surgical treatment, and work-related lost time...

..We report the incidence and prevalence of this condition in the general population. We also examined the validity of the Mayo natural history model for PBC among these unselected patients from the community...

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..Although school-based screening programs for adolescent idiopathic scoliosis are mandated in 26 states in the United States, few program outcomes data exist regarding the effectiveness of such programs...

..This study was designed to compare expert opinion guidelines with the actual primary care provided and to assess outcomes in the 3 years following the IBS diagnosis...

..CONCLUSIONS: IBS is perceived as a chronic condition resulting in frustration and social isolation, and physicians are perceived to be providing inadequate medical information or support to patients with IBS...

..Although dyspepsia is common, management patterns in the United States are unknown...

..These teams identified factors associated with potentially preventable deaths and gaps in services for women, infants, and families. A regional team then grouped and prioritized the factors...

..Since these criteria are met by more than one method, the choice of method should be governed by the goals of the research as well as more practical concerns...

..Such studies may exclude patients who are not candidates for treatment and may not account for costs incurred during diagnosis or primary treatment...

..We sought to compare change in diagnosis among orthopedists and non-orthopedists caring for a community based cohort of individuals with incident acute knee injuries...

..12 percent, P = 0.04). If given inhaled anti-inflammatory medication, rural children were more likely to receive inhaled steroids while urban children were more likely to receive cromoglycates...

..CONCLUSION: Induction of term labor has almost doubled in prevalence during the past 15 years. The most common indications are elective induction and postdate pregnancy, often applied to gestations of 40 to 41 weeks' duration...

..The incidence of irritable bowel syndrome is uncertain. We aimed to determine the incidence of clinically diagnosed irritable bowel syndrome in the community...

..25 per child with a curve of 20 degrees or more (n = 16) and $10, 836.00 per child treated for scoliosis (n = 5). CONCLUSION: School scoliosis screening is significantly more costly than has previously been reported...

..Stroke is associated with a large increase in the risk for death after MI...

..The US experienced a shortage of varicella vaccine in 2002, leading to the concerns about its impact...

..Many people with hepatitis C receive all or most of their care from primary care physicians, yet little information exists about the practice patterns, knowledge, and beliefs and attitudes of family physicians related to hepatitis C...

..The disparity in student and parent symptom reporting did not vary by age of the student. Students appear to provide the most sensitive measure of asthma-related problems...

..And to compare the temporal trends in varicella vaccinations to trends of an older, more widely accepted vaccine, the MMR...

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..It uses a symptom-based approach, and includes original questionnaires and diagnostic guides to help the primary care clinician proceed systematically through the diagnostic process...

..001). CONCLUSION: More than 1 in 5 people with chronic pain did not seek physician care for their pain. This group is unknown to physicians and therefore represents an unreported patient group with an unmet need for pain care...

..Despite the apparent protective effect of farm residence, asthma remains a significant public health issue among rural Minnesota adolescents...

..In 2005, school-based asthma work focused on two areas: identification of unrecognized asthma and management of under-treated asthma...

..The consequences of this variance from guideline recommendations are not well described...

..B recommendation) Current evidence is insufficient to assess the balance of benefits and harms of routine screening in asymptomatic adults with blood pressure of 135/80 mm Hg or lower. (I statement)...

..Pain is poorly understood on a population level. This study provides updated estimates of the prevalence, location, severity, and impact of pain in a U.S. community and discusses current definitions of "chronic" pain...

..To assess bias in parent reports of asthma status of children and detection bias of medical records-based asthma ascertainment and to examine effects of such bias on the association between asthma status and infections...

..4; 95% confidence interval, 0.1-1.0; P = .044). The data highlight the problems working parents have in accessing health care during usual working hours and the potential value of convenient health care programs...

..To establish accurate, up-to-date, baseline epidemiological data for herpes zoster (HZ) before the introduction of the recently licensed HZ vaccine...

..While many patients with asthma and COPD are cared for by primary care practices, limited data are available on the use and results associated with spirometry in primary care...

..The purpose of this review is to discuss the potential benefit of mass screening for improving postpartum depression recognition and outcomes...

..To assess the frequency and types of visits related to modifications in the intensity of asthma medications...

..Earlier recognition of CHD may be associated with higher levels of recognition and treatment of CHD risk factors that may delay incident AMI. To assess timing of CHD and CHD risk factor diagnoses prior to incident AMI...

..This work lays the foundation for a quality improvement initiative that provides practice-specific feedback related directly to clinical activities completed for individual patients with asthma...

..We wanted to quantify how the location in which medical care is delivered in the United States varies with the sociodemographic characteristics and health care arrangements of the individual person...

..69) and age greater than 40 years (OR = 2.32 per decade). In conclusion, in this Midwestern community, chronic HBV infection was predominantly seen in immigrants from endemic parts of the world...

..This difference was constant over the time period. This twofold difference in brain metastases detected in women versus men with lung cancer deserves further evaluation and confirmation...

..To determine whether physicians' satisfaction in clinical encounters with ethnic immigrant patients differs from satisfaction in clinical encounters with white patients in the local community...

..This suggests that improved survival after MI is unlikely to be a major contributor to the heart failure epidemic...

..Guideline dissemination and clinician education have met with variable success. School-based identification of children with potentially undertreated asthma may provide an alternative strategy for improving asthma management in children...

..Without further study, spirometry cannot be recommended for school-based asthma screening...

..Asthma is the most common chronic condition of childhood and a common reason for school absenteeism and use of school health services. Unrecognized but symptomatic childhood asthma may be adding to this school burden...

..The combination of standardized methodology and of the longitudinal data via the record linkage system of the Rochester Epidemiology Project will allow reliable measures of CHD trends and help define preventive strategies...

..CONCLUSIONS: In this community, 1 in 3 children have had a physician-documented recurrent wheezing-type illness, and 1 in 6 were diagnosed with asthma. Diagnoses rates were directly related to socioeconomic status...

..181) from 1987 to 1994, while the incidence of diabetes increased (p = 0.033). Thus, the authors conclude that the increase in diabetes incidence accelerated over the last quinquennium and was not due to increased surveillance...

..To develop a model for community-population- or health system-based registries of all patients with diagnosed hepatitis C, to facilitate clinical care and epidemiologic studies...

..Although HRR has been tested in large populations, the short-term test-retest stability (reproducibility) of abnormal HRR for an individual has not been assessed...

..In addition, generalists' recognition and treatment of potentially reversible contraindications to hepatitis C therapy could greatly increase the number of treatment candidates...

..Evidence indicates that deaths from coronary disease are decreasing less in elderly persons and women. Understanding the determinants of these trends is important for prevention...

..The ecology of medical care model may provide a useful framework to describe the use of health services in people with asthma compared to those without asthma and identify subgroups with apparent gaps in care...

..IRR information should be required for all large medical records studies...

..To understand when women's coronary heart disease (CHD) and CHD risk factors are recognized prior to first myocardial infarction (MI)...

..A large nationally diverse sample of asthma patients' self-assessment of severity is available but has not been analyzed to look at asthma severity from the patients' perspective...

..This article gives one example of participatory research used to help translate asthma guidelines into primary care in rural Minnesota practices...

..To investigate presenting signs and symptoms of ovarian cancer and stage of tumor in a community cohort of women with the diagnosis of ovarian cancer...

..The epidemic of heart failure has yet to be fully investigated, and data on incidence, survival, and sex-specific temporal trends in community-based populations are limited...

..We examined whether widespread use of laparoscopy was accompanied by increased diagnosis of asymptomatic endometriosis, inflated rates of diagnosis, or changes in the clinical spectrum of disease...

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..B recommendation) Current evidence is insufficient to assess the balance of benefits and harms of behavioral counseling to prevent STIs in non-sexually active adolescents and in adults not at increased risk for STIs. (I statement)...

..D recommendation). The USPSTF concludes that the evidence is insufficient to assess the benefits and harms of computed tomographic colonography and fecal DNA testing as screening modalities for colorectal cancer. (I statement)...

..Grade A recommendation.) Do not screen for asymptomatic bacteriuria in men and nonpregnant women. (Grade D recommendation.)...

..The SQ, obtained by directly screening students, may provide a sensitive approach for detecting children with previously undiagnosed asthma and allergies...

..We sought to summarize the rationale behind the various UMI-ECG definitions and to suggest an approach to develop uniform criteria...

..Our data suggest that the prevalence of PSC in the United States, with its attendant medical burdens, is significantly greater than previously estimated...

..Although clinical practice guidelines have been developed for COPD, their influence on primary care practice is unclear...

..The relationship between electrocardiographic unrecognized myocardial infarction (UMI), abnormal functional status, echocardiographic abnormalities, and mortality has not been evaluated...