The Journal of family practice
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Randomized Controlled Trial Clinical Trial
The impact of patient-centered care on outcomes.
We designed this observational cohort study to assess the association between patient-centered communication in primary care visits and subsequent health and medical care utilization. ⋯ Patient-centered communication influences patients' health through perceptions that their visit was patient centered, and especially through perceptions that common ground was achieved with the physician. Patient-centered practice improved health status and increased the efficiency of care by reducing diagnostic tests and referrals.
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Despite the success of the national childhood vaccination program in the United States in decreasing mortality due to vaccine-preventable diseases, vaccination rates remain suboptimal. Contributing factors include the failure to appreciate the hazards of vaccine-preventable diseases, concerns about adverse reactions associated with vaccine administration, and missed opportunities to administer vaccines. The 2 major types of indications for vaccinating children are age and presence of a medical condition that increases the risk of a vaccine-preventable disease. ⋯ IPV should eliminate vaccine-associated paralytic poliomyelitis. Pneumococcal conjugate vaccine was licensed in 2000 for routine use on a schedule of 2, 4, 6, and 12 to 15 months. The first dose of measles-mumps-rubella vaccine is now recommended at age 12 to 15 months, simultaneous with varicella vaccine administration.
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Randomized Controlled Trial Clinical Trial
Training in back care to improve outcome and patient satisfaction. Teaching old docs new tricks.
We examined clinical outcomes and patient perceptions of back care given by physicians before and after an intensive course of training in back care and limited manual therapy techniques. ⋯ A structured clinical approach to low back care may bring modestly improved clinical outcomes and patient satisfaction.
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Standard obstetrical practice has included iron therapy for patients with anemia without requiring the determination of iron deficiency. However, the proportion of pregnant women with anemia who have such a deficiency may be relatively modest. We instituted a practice protocol using serum ferritin levels to determine the proportion of women undergoing prenatal care who had both anemia and iron deficiency. ⋯ In our population of prenatal patients with anemia, only approximately half had an iron deficiency. Diagnostic and therapeutic approaches to screening for anemia in pregnancy should be reconsidered and further evaluated.