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Web-Based Patient Education

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53701. Community-based cancer screening for underserved women: design and baseline findings from the Breast and Cervical Cancer Intervention Study. (PubMed)

interventions in the San Francisco Bay Area from 1993 to 1996: (1) community-based lay health worker outreach; (2) clinic-based provider training and reminder system; and (3) patient navigator for follow-up of abnormal screening results. Study design and a description of the interventions are reported along with baseline results of a household survey conducted in four languages among 1599 women, aged 40-75.Seventy-six percent of women ages 40 and over had had at least one mammogram, and most had had (...) Community-based cancer screening for underserved women: design and baseline findings from the Breast and Cervical Cancer Intervention Study. Underutilization of breast and cervical cancer screening has been observed in many ethnic groups and underserved populations. Effective community-based interventions are needed to eliminate disparities in screening rates and thus to improve prospects for survival.The Breast and Cervical Cancer Intervention Study was a controlled trial of three

2001 Preventive Medicine Controlled trial quality: uncertain

53702. Panel-based pain management in primary care. a pilot study. (PubMed)

Panel-based pain management in primary care. a pilot study. Although pain is an extremely common symptom presenting to primary care physicians, it frequently is not optimally managed. The purpose of this feasibility study was to develop and pilot-test an efficient, rapid assessment and management approach for pain in busy community practices. The intervention utilized the Dartmouth COOP Clinical Improvement System (DCCIS) and a telephone-based, nurse-educator intervention. Patients from four (...) a nurse-educator who provided pain self-management strategies and a problem-solving approach for psychosocial problems. Post-treatment evaluation revealed that patients in the intervention group scored significantly better on the Pain, Physical, Emotional, and Social subscales of the SF-36 and on the total score of the Functional Interference Scale, as compared to a usual care control group. Feasibility and acceptability of the approach were demonstrated; however, the conclusions based on analyses

2001 Journal of pain and symptom management Controlled trial quality: uncertain

53703. High-soluble-fiber foods in conjunction with a telephone-based, personalized behavior change support service result in favorable changes in lipids and lifestyles after 7 weeks. (PubMed)

High-soluble-fiber foods in conjunction with a telephone-based, personalized behavior change support service result in favorable changes in lipids and lifestyles after 7 weeks. To evaluate whether an intervention of foods high in soluble fiber from psyllium and/or oats plus a telephone-based, personalized behavior change support service improves serum lipids and elicits cholesterol-managing lifestyle changes vs usual care.7-week randomized, controlled intervention.150 moderately (...) hypercholesterolemic men and women, age range 25 to 70 years.The intervention group consumed 4 servings/day of high-fiber foods and had weekly telephone conversations with a personal coach who offered support and guidance in making lifestyle changes consistent with the National Cholesterol Education Program's (NCEP) cholesterol-lowering guidelines. The usual care group received a handout describing the NCEP Step-1 diet.Serum lipids and lipoproteins and self-reported lifestyle changes.For physiologic and dietary

2002 Journal of the American Dietetic Association Controlled trial quality: uncertain

53704. Guideline-based early rehabilitation after myocardial infarction. A pragmatic randomised controlled trial. (PubMed)

Guideline-based early rehabilitation after myocardial infarction. A pragmatic randomised controlled trial. To determine the effectiveness of individualised educational behavioural treatment delivered by cardiac nurses in hospital compared to usual care for patients following acute myocardial infarction.One hundred and fourteen consecutive patients were randomised to receive the intervention or usual care. Outcome assessment was by self-report questionnaire (the Hospital Anxiety and Depression (...) patients had fewer further treatment needs.An individualised educational behavioural treatment delivered by cardiac nurses in hospital may have substantial benefits. A large-scale pragmatic RCT is needed.

2002 Journal of psychosomatic research Controlled trial quality: predicted high

53705. A new method for CHD prediction and prevention based on regional risk scores and randomized clinical trials; PRECARD and the Copenhagen Risk Score. (PubMed)

A new method for CHD prediction and prevention based on regional risk scores and randomized clinical trials; PRECARD and the Copenhagen Risk Score. There is a considerable gap between the recommended prevention of coronary heart disease (CHD) in the guidelines from the European Society of Cardiology and the actually conducted clinical practice in preventive cardiology. A new method for implementing the recommended clinical practice in preventive cardiology is described.To develop (...) a comprehensive and flexible health educational computer program (the PRECARD program) for individual coronary risk prediction and multifactorial prevention.The PRECARD program contains a new coronary risk score (the Copenhagen Risk Score) for myocardial infarction and a model for calculating the effect of intervention. Two Danish population studies (n = 11,765) with 10 years of follow up were used to establish the risk score. The included risk factors were: age, sex, cholesterol (incl. HDL), systolic blood

2001 Journal of cardiovascular risk Controlled trial quality: uncertain

53706. The effect of a home based exercise intervention package on outcome in ankylosing spondylitis: a randomized controlled trial. (PubMed)

). The intervention consisted of an exercise/information video, exercise progress chart, patient education booklet, and AS exercise reminder stickers. The outcome measures were function (BASFI), disease activity (BASDAI), global well being (BAS-G), exercise self-efficacy (ESE), arthritis self-efficacy (SES), and quantity of AS mobility/aerobic exercise assessed at baseline and 6 months.Of the 200 subjects, 155 completed the study (75 IG and 80 CG). Baseline analysis showed no differences between the CG and the IG (...) The effect of a home based exercise intervention package on outcome in ankylosing spondylitis: a randomized controlled trial. Home based self-care is essential for successful management of ankylosing spondylitis (AS). We designed an intervention package aimed at promoting self-care and regular longterm exercise and evaluated its effect on outcome.Members of our database (n = 4569) were randomly selected and randomized to an intervention group (IG) or a followup control group (CG

2002 The Journal of rheumatology Controlled trial quality: uncertain

53707. Secondary prevention of cardiovascular disease: a randomised trial of training in information management, evidence-based medicine, both or neither: the PIER trial. (PubMed)

Secondary prevention of cardiovascular disease: a randomised trial of training in information management, evidence-based medicine, both or neither: the PIER trial. Sub-optimal management of cardiovascular disease (CVD) patients is widespread in primary and secondary care, with risk factors frequently unrecorded or untreated.To investigate the effectiveness of educational interventions developed in primary care, on recording, prescribing and control of risk factors among all patients recorded (...) -up assessment of recording, treatment, and control of risk factors in the same CVD patients.Adequate recording of all three risk factors, found inapproximately a third of patients at baseline, increased non-significantly by 10.5% (95% confidence interval [CI] = 3.9 to 24.9) in the information (versus not information) group and by 6.6% (95% [CI] = 8.9 to 22.0) in the evidence (versus not evidence) group. Factorial improvements in prescribing and control of risk factors tended not to be significant

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2002 British Journal of General Practice Controlled trial quality: uncertain

53708. Evidence-Based Approach to the Medical Literature (PubMed)

Evidence-Based Approach to the Medical Literature 9127238 1997 07 01 2018 11 13 0884-8734 12 Suppl 2 1997 Apr Journal of general internal medicine J Gen Intern Med Evidence-based approach to the medical literature. S5-14 Fletcher R H RH Department of Ambulatory Care and Prevention. Harvard Medical School/Harvard Pilgrim Health Care, Boston, MA 02115, USA. Fletcher S W SW eng Journal Article Review United States J Gen Intern Med 8605834 0884-8734 IM Computer Communication Networks Education (...) , Medical, Continuing Evidence-Based Medicine Guidelines as Topic Humans Information Services Information Storage and Retrieval Information Systems Journalism, Medical MEDLINE Medical Informatics Applications Medical Informatics Computing Physician-Patient Relations United States 22 1997 4 1 1997 4 1 0 1 1997 4 1 0 0 ppublish 9127238 PMC1497222 Ann Intern Med. 1993 May 1;118(9):731-7 8460861 N Engl J Med. 1992 Jul 23;327(4):248-54 1614465 N Engl J Med. 1993 Sep 9;329(11):745-52 8350883 Ann Intern Med

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1997 Journal of General Internal Medicine

53709. A statewide, population-based time-series analysis of the outcome of ruptured abdominal aortic aneurysm. (PubMed)

A statewide, population-based time-series analysis of the outcome of ruptured abdominal aortic aneurysm. The purpose of this study was to perform the first statewide, population-based, time-series analysis of the frequency of ruptured abdominal aortic aneurysm (RAAA), to determine the outcomes of RAAA, and to assess the association of patient, physician, and hospital factors with survival after RAAA. The hypotheses of the study were as follows: 1) the rate of RAAA would increase over time and 2 (...) demonstrated that survival after RAAA was related most strongly to patient age at the time of the RAAA. The physician's and the hospital's experience with RAAA, the physician's background as measured by board certification, and the type of hospital at which the operation was performed (small vs. large) also may be associated with survival. These findings may have important implications for the regionalization of care and the education and credentialling of physicians. Given the lack of recent progress

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1996 Annals of Surgery

53710. Commentary: evidence based information for women is important. (PubMed)

Commentary: evidence based information for women is important. 8939121 1997 07 03 2018 11 13 0959-8138 313 7067 1996 Nov 16 BMJ (Clinical research ed.) BMJ Commentary: evidence based information for women is important. 1253-4 Newburn M M National Childbirth Trust, Alexandra House, London. Gready M M eng Journal Article England BMJ 8900488 0959-8138 AIM IM BMJ. 1999 Mar 20;318(7186):805-6 10215387 Attitude to Health Choice Behavior Evidence-Based Medicine Female Humans Patient Education as Topic

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1996 BMJ : British Medical Journal

53711. Commentary: evidence based practice and antenatal ultrasonography--the need for more studies. (PubMed)

Attitude to Health Choice Behavior Communication Evidence-Based Medicine Female Humans Patient Education as Topic Pregnancy Ultrasonography, Prenatal United Kingdom 1996 11 16 1996 11 16 0 1 1996 11 16 0 0 ppublish 8939122 PMC2352579 Obstet Gynecol Surv. 1982 Aug;37(8):499-506 7050797 Lancet. 1990 Aug 18;336(8712):387-91 1974940 BMJ. 1992 Jun 6;304(6840):1474-8 1611369 N Engl J Med. 1993 Sep 16;329(12):821-7 8355740 Br J Obstet Gynaecol. 1994 May;101(5):392-7 8018609 BMJ. 1996 Aug 24;313(7055):478-80 (...) Commentary: evidence based practice and antenatal ultrasonography--the need for more studies. 8939122 1997 07 03 2018 11 13 0959-8138 313 7067 1996 Nov 16 BMJ (Clinical research ed.) BMJ Commentary: evidence based practice and antenatal ultrasonography--the need for more studies. 1254-5 Chamberlain P P Oxford Prenatal, Diagnosis Service, Radcliffe Hospital. Boyd P A PA eng Journal Article England BMJ 8900488 0959-8138 AIM IM BMJ. 1999 Mar 20;318(7186):805-6 10215387 Attitude of Health Personnel

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1996 BMJ : British Medical Journal

53712. Ophthalmology in Luanda (Angola): a hospital based report. (PubMed)

Ophthalmology in Luanda (Angola): a hospital based report. As part of a 4 year Spanish development aid programme, an ophthalmic hospital was set up in Luanda in 1991 for the in situ training of local ophthalmologists. Presented here are the data obtained from 4201 patients treated during the first 2 years of the project.Patients were referred to the institute from the emergency ward at the Luanda General Hospital, selected mainly according to the severity of their disease. The following data (...) resources in Angola are generally inadequate, and ophthalmic care is no exception to this. Owing to the high percentage of preventable or treatable blinding diseases in this environment, a campaign of social education should always be held along with any medical programme, in order to optimise the available resources.

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1995 The British journal of ophthalmology

53713. A population based case-control study of agricultural injuries in children. (PubMed)

A population based case-control study of agricultural injuries in children. To identify preventable risk factors related to agricultural injuries occurring to children on family farms.A geographically defined central region of Wisconsin, USA with nearly 1800 family dairy farms.A two year, population based incidence study of occupational injuries among farm residents was conducted. For cases, trained staff abstracted information on the nature, severity, and treatment of the injury from (...) the patient's medical record. Staff also administered a telephone questionnaire to cases and controls, usually answered by parents.There were 60 cases of farm residents younger than 18 years who sought care for acute agriculture related injuries. Farms on which uninjured children lived served as controls (n = 102). Multivariate analyses of 16 different variables revealed three significantly related to injuries to children: hours worked per week (odds ratio (OR) = 1.05; 95% confidence interval (CI) = 1.01

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1996 Injury Prevention

53714. Obtaining useful information from expert based sources. (PubMed)

Obtaining useful information from expert based sources. Clinicians rely heavily on expert based systems-consultation with colleagues, journal reviews and textbooks, and continuing education activities-to obtain new information. The usefulness of sources such as these depends on the relevance and validity of the information and the work it takes to obtain it. Useful information can be distinguished from the useless by asking three questions: Does the information focus on an outcome that my (...) patients care about? Is the issue common to my practice, and is the intervention feasible? If the information is true, will it require me to change my practice? If the answer to all three questions is yes, then the information is a common POEM (patient oriented evidence that matters), capable of improving the lives of your patients and must be evaluated for validity. Conclusions based on results of well designed clinical trials are more likely to be valid than those drawn from observations based

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1997 BMJ : British Medical Journal

53715. Community-based home-care program for the management of pre-eclampsia: an alternative. (PubMed)

Community-based home-care program for the management of pre-eclampsia: an alternative. To evaluate the safety, acceptability and cost of a community-based home-care program for the management of mild pre-eclampsia.A descriptive study of outcomes between Apr. 1, 1985, and Dec. 31, 1989.St. Boniface General Hospital, Winnipeg.Urban Winnipeg residents between 27 and 40 weeks' gestation with mild pre-eclampsia who demonstrated acceptance and compliance with home-care management; 321 patients (...) of 1330 were enrolled in the program.Bed rest at home with daily biochemical and biophysical follow-up protocol and weekly clinic visits; patient education; hospital admission for labour, induction, worsening pre-eclampsia or noncompliance with rest at home.Patterns of referral to the program; clinical, biochemical and biophysical profiles; incidence of severe complications; reduction in total hospital stay and cost analysis.As many women were referred from physicians' offices as were referred from

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1993 CMAJ: Canadian Medical Association Journal

53716. The academic base for general practice: the case for change. (PubMed)

development, allow human and other resources to be used more flexibly and effectively, and provide a strong base for undergraduate education, vocational training, higher professional training, and continuing education. It could encourage collaborative ventures with other disciplines and also lead to higher standards of patient care. (...) The academic base for general practice: the case for change. University departments of general practice and the postgraduate education system for general practice have developed separately over the past 30 years. This separation is now impeding the academic development of the discipline and causes difficulties with recruitment and career progression. These problems could be eased by the creation of integrated departments. This would establish a critical mass for research and educational

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1993 BMJ : British Medical Journal

53717. Support for hospital-based HIV testing and counseling: a national survey of hospital marketing executives. (PubMed)

. These include hospital support for voluntary HIV testing and AIDS education and the impact that treating AIDS patients has on the hospital's image. Also tested is the hypothesis that certain hospitals, such as for-profit institutions and those outside the AIDS epicenters, would be less supportive of hospital-based AIDS intervention strategies. To assess these issues, a national random sample of 193 executives in charge of hospital marketing and public relations were surveyed between December 1992 (...) Support for hospital-based HIV testing and counseling: a national survey of hospital marketing executives. Today, hospitals are involved extensively in social marketing and promotional activities. Recently, investigators from the Centers for Disease Control and Prevention (CDC) estimated that routine testing of hospital patients for human immunodeficiency virus (HIV) could identify more than 100,000 patients with previously unrecognized HIV infections. Several issues are assessed in this paper

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1995 Public Health Reports

53718. Toward a Multidimensional Model for Psychotherapy Supervision Based on Developmental Stages (PubMed)

Toward a Multidimensional Model for Psychotherapy Supervision Based on Developmental Stages The need for a systematic approach to psychotherapy training in psychiatric education is greater than ever. Most models of psychotherapy supervision focus on supervisee development and ignore developmental issues concerning the other participants in the supervisory triangle. The author reviews theories of psychotherapy supervision and identifies factors that contribute to the dynamic interrelationships (...) among psychiatrists who are supervising psychotherapy, the psychiatry resident supervisees, and their patients as each party progresses through stages of development. A dynamic formulation of psychotherapy supervision based on developmental stages can result in a better understanding of the instructional process, its greater effectiveness, and associated changes in program structure. Further development of a comprehensive dynamic model depends on additional research.

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1994 The Journal of psychotherapy practice and research

53719. Identification of design features to enhance utilization and acceptance of systems for Internet-based decision support at the point of care. (PubMed)

Identification of design features to enhance utilization and acceptance of systems for Internet-based decision support at the point of care. Extensive utilization of point-of-care decision support systems will be largely dependent on the development of user interaction capabilities that make them effective clinical tools in patient care settings. This research identified critical design features of point-of-care decision support systems that are preferred by physicians, through a multi-method (...) . Users also preferred features that enhance usefulness and motivate use, such as an encounter documentation tool and the availability of physician instruction and patient education materials. In addition to identifying design features that are relevant to efforts to develop clinical systems for point-of-care decision support, this study demonstrates the value of combining quantitative and qualitative methods of formative evaluation with an iterative system development strategy to implement new

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1998 Proceedings of the AMIA Symposium

53720. General practitioner's perceptions of the route to evidence based medicine: a questionnaire survey. (PubMed)

General practitioner's perceptions of the route to evidence based medicine: a questionnaire survey. To determine the attitude of general practitioners towards evidence based medicine and their related educational needs.A questionnaire study of general practitioners.General practice in the former Wessex region, England.Randomly selected sample of 25% of all general practitioners (452), of whom 302 replied.Respondents' attitude towards evidence based medicine, ability to access and interpret (...) evidence, perceived barriers to practising evidence based medicine, and best method of moving from opinion based to evidence based medicine.Respondents mainly welcomed evidence based medicine and agreed that its practice improves patient care. They had a low level of awareness of extracting journals, review publications, and databases (only 40% knew of the Cochrane Database of Systematic Reviews), and, even if aware, many did not use them. In their surgeries 20% had access to bibliographic databases

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1998 BMJ : British Medical Journal

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