Michelle Milner

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The patient-centered medical home (PCMH) is a primary care model that aims to provide quality care that is coordinated, comprehensive, and cost-effective. PCMH is hinged upon building a strong patient-provider relationship and using a team-based approach to care to increase continuity and access. It is anticipated that PCMH can curb the growth of health(More)
OBJECTIVE To assess the distribution of cord blood insulin in an unselected population, and examine its relation to birthweight centiles. SETTING District General Hospital in Nottinghamshire. SUBJECTS 209 unselected singleton births. MEAN OUTCOME MEASURE Cord blood insulin; cord blood C-peptide; birthweight centiles. RESULTS Hyperinsulinaemic babies(More)
PURPOSE The purpose of this study was to evaluate brief physician advice regarding seatbelt and bicycle helmet use in adolescents and young adults. METHODS We recruited 200 patients ages 11-24 years presenting for all visits to a primary care clinic in the Southwestern United States from January 2000 to March 2001. Patients were randomized to control or a(More)
Current diagnosis of Clostridium difficile infection (CDI) relies upon detection of toxins A/B in stool by enzyme immunoassay [EIA(A/B)]. This strategy is unsatisfactory because it has a low sensitivity resulting in significant false negatives. We investigated the performance of a two-step algorithm for diagnosis of CDI using detection of glutamate(More)
Human papillomaviruses (HPVs) are obligate epithelial pathogens and typically cause localized mucosal infections. We therefore hypothesized that T-cell responses to HPV antigens would be greater at sites of pathology than in the blood. Focusing on HPV-16 because of its association with cervical cancer, the magnitude of HPV-specific T-cell responses at the(More)
AIMS To provide an overview of the literature relating to the principles, policy and practice of extended nursing roles in UK intensive care settings to date; to review and critically assess evidence of impact, outcomes and effect on practice and provide suggestions for future research. BACKGROUND It is known that career development opportunities, new(More)
During the past ten years, two-dimensional echocardiography has become a major tool in the assessment of cardiovascular diseases. With the advent of pulsed, continuous wave, and color flow Doppler, the field of echocardiography is now accepted as the ideal noninvasive technique for assessing left and right ventricular function; determining valvular stenosis(More)
Oncogenic human papillomaviruses (HPVs) are obligate mucosal pathogens and typically cause localized infections. The mucosal surface of the genital tract also provides the first line of defense against genital HPV infection. Although local antibody production following HPV-infection has been demonstrated, their role in protection from cervical disease is(More)
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