Preventive medicine
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Preventive medicine · May 2003
ReviewStatus of practice guidelines in the United States: CDC guidelines as an example.
Clinical practice guidelines have proliferated in the past several decades, starting with only a handful in the 1980s to over 1000 approved through The National Guideline Clearinghouse in 2002. ⋯ An immediate mandate is to ensure that when guidelines are promulgated, they include an evaluation plan, developed by the implementer of the guideline, which takes advantage of existing qualitative and quantitative data and programs (e.g., patient-centered care, quality assurance, risk management) not limited to expensive and sophisticated clinical trials.
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Preventive medicine · Apr 2003
Randomized Controlled Trial Clinical TrialThe D-Net diabetes self-management program: long-term implementation, outcomes, and generalization results.
A prerequisite to translating research findings into practice is information on consistency of implementation, maintenance of results, and generalization of effects. This follow-up report is one of the few experimental studies to provide such information on Internet-based health education. ⋯ The basic D-Net intervention was implemented well and improvements were observed across a variety of patients, interventionists, and clinics. There were, however, difficulties in maintaining usage over time and additions of tailored self-management and peer support components generally did not significantly improve results.
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Preventive medicine · Apr 2003
National trends in screening, prevalence, and treatment of cardiovascular risk factors.
Few studies have documented national trends in screening, awareness, and treatment of cardiovascular risk factors. We evaluated trends in screening, prevalence, and treatment of hypertension, hypercholesterolemia, and smoking. ⋯ Although screening for hypertension and hypercholesterolemia has increased, a substantial proportion of cases were not being prescribed medications. While the prevalence of smoking remains constant, quit attempts have fallen. Continuing challenges for cardiovascular disease prevention include identification of individuals with hypercholesterolemia, appropriate prescription (initiation and/or maintenance) of antihypertensive and lipid-lowering medications, and intensifying smoking cessation efforts.
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The United States has the highest prevalence of sexually transmitted diseases in the developed world. Control strategies should address the most frequent reasons why curable sexually transmitted diseases are not treated. ⋯ The primary reason that gonorrhea and chlamydial infections are untreated is that infected persons never have symptoms. The most effective method to control these sexually transmitted diseases is routine screening at high-volume sites.
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Preventive medicine · Apr 2003
Awareness of hypertension and dyslipidemia in a semirural population of young adults: the Bogalusa Heart Study.
To assess the awareness of hypertension and dyslipidemia in a semirural population of young adults. ⋯ These results underscore the need for cardiovascular health education efforts in this population group.