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Aging is associated with progressive losses in function across multiple systems, including sensation, cognition, memory, motor control, and affect. The traditional view has been that functional decline in aging is unavoidable because it is a direct consequence of brain machinery wearing down over time. In recent years, an alternative perspective has(More)
BACKGROUND In the United States, venous leg ulcers (VLUs) are commonly associated with substantial disability, impaired quality of life, and high economic costs. Compression therapy, which has remained the standard care for VLUs over several decades, is often insufficient to heal VLUs in a timely manner. VLU-related treatment costs are directly related to(More)
Agitation among psychiatric inpatients (particularly those diagnosed with schizophrenia or bipolar disorder) is common and, unless recognized early and managed effectively, can rapidly escalate to potentially dangerous behaviors, including physical violence. Inpatient aggression and violence have substantial adverse psychological and physical consequences(More)
OBJECTIVE To develop and test a brief, reliable, and valid HIV-risk screening instrument for use in primary health care settings. DESIGN A two-phase study: (1) developing a self-administered HIV-risk screening instrument, and (2) testing it with a primary care population, including testing the effect of confidentiality on disclosure of HIV-risk behaviors.(More)
BACKGROUND AND DESIGN This study determines (1) the readiness of primary care physicians (PCPs) to triage optimally lesions suspicious for skin cancer, (2) the difference in their abilities from those of dermatologists, and (3) whether accurate diagnosis after viewing slide images transfers to accurate diagnosis after viewing lesions on patients.(More)
This qualitative study aimed to describe, from the perspective of domestic violence survivors, what helped victims in health care encounters improve their situation and thus their health, and how disclosure to and identification by health care providers were related to these helpful experiences. Semi-structured, open-ended interviews were conducted with a(More)
BACKGROUND Although research demonstrates that allergy immunotherapy (IT) improves allergic rhinitis (AR) outcomes, little is known about IT patterns of care and associated resource use and costs among US children with diagnoses of AR. OBJECTIVE We sought to examine characteristics associated with receiving IT, patterns of IT care, and health care use and(More)
BACKGROUND Physicians have been called upon to identify victims of domestic violence, but few studies provide insight into how physicians can navigate around the barriers to identification. OBJECTIVE To describe how physicians who are committed to helping battered patients identify victims of domestic violence in health care encounters. DESIGN Six focus(More)
BACKGROUND Children with allergic rhinitis (AR) often experience significant impairment in quality of life and health, which increases health care utilization. OBJECTIVE To determine whether allergen immunotherapy reduces health care utilization and costs in children newly diagnosed as having AR using a retrospective matched cohort design. METHODS Among(More)
OBJECTIVE To determine the efficacy of an Internet-based skin cancer triage intervention for physicians. METHODS Physicians were randomly assigned to an intervention group or a control group. The 14 outcome measures included diagnosis and evaluation planning for malignant melanoma, basal cell carcinoma, and squamous cell carcinoma. RESULTS Forty-six(More)