The Journal of the American Board of Family Practice / American Board of Family Practice
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J Am Board Fam Pract · Sep 2001
Individual and contextual factors related to family practice residents' assessment and counseling for tobacco cessation.
Tobacco use is the chief avoidable cause of death in the United States. Physicians, however, are not routinely assessing this risk and providing counseling for risk reduction. This study examines tobacco cessation counseling practices among family practice residents and explores the determinants of residents' smoking-counseling behaviors and counseling duration. ⋯ Faculty physicians should assist residents to implement the Public Health Service-sponsored clinical practice guideline for tobacco control. There is a need to increase behavioral skills and perceived effectiveness for assessing and counseling smokers among first-year residents.
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Restless legs syndrome is a common but not well-recognized central nervous system disorder that leads to insomnia and daytime distress. ⋯ Restless legs syndrome occurs in about 6% of the adult population, more so in the elderly. Affected patients experience uncomfortable sensations in the legs with inactivity, more pronounced late in the day and at bedtime, which are temporarily relieved by moving the limbs. Affected patients can suffer from insomnia, disrupted sleep, daytime fatigue, and difficulty with sedentary activities. Most cases are idiopathic, although secondary causes, such as iron deficiency, should be excluded. Dopaminergic agents are highly effective in treating restless legs syndrome, but side effects can be problematic. Alternative medications include benzodiazepines, opioids, gabapentin, and clonidine.