WMJ : official publication of the State Medical Society of Wisconsin
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Asthma management should follow evidence-based national guidelines. We compared patient self-reports of usual care to clinical practice guidelines. ⋯ Care of Wisconsin children with asthma inconsistently follows national guidelines. They and their families require improved education, written care plans, appropriate medications, and psychosocial support.
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Domestic violence is a prevalent problem with significant health consequences. Early recognition and appropriate intervention with referral to local domestic violence agencies can be life-saving. Little is known, however, about the current level of training, knowledge base and attitudes of physicians in this area. ⋯ Significant numbers of physicians, in Milwaukee County, practicing certain specialties that potentially have a high rate of contact with domestic violence victims have had insufficient training in domestic violence assessment and intervention. Physicians should be familiar with the domestic violence hotlines and shelters in their communities and need to incorporate screen questions for domestic violence into their regular practice.
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The prevalence of childhood lead poisoning has substantially decreased in Milwaukee, Wisconsin over the past decade. Nevertheless, by the mid 1990s, 30% of children were still found to have elevated blood levels. ⋯ We conclude that the Sixteenth Street Community Health Center Childhood Lead Outreach Project has successfully accessed populations of children with high rates of lead poisoning who had escaped more traditional screening venues and effectively intervened to reduce their BLLs to < 10 micrograms/dL. Moreover, CLOP produced impressive and unanticipated primary prevention benefits in the community at large. The demonstrated ability of community outreach workers to access high-risk populations and reduce exposure to lead hazards suggests the potential of this strategy for extension to other geographic areas, to the patients of private physicians and to address other prevalent, urban health problems like asthma, injuries and violence.
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Our previous publications on the epidemiology of blastomycosis suggested that the etiologic organism, Blastomyces dermatitidis, may be acquired at home, however this view was challenged in an editorial. ⋯ There appears to be growing evidence that blastomycosis may be acquired at home, and that B. dermatitidis may be relatively persistent on certain properties.