The Experts below are selected from a list of 360 Experts worldwide ranked by ideXlab platform
Elizabeth A Bukusi - One of the best experts on this subject based on the ideXlab platform.
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cervical cancer Prevention and treatment research in africa a systematic review from a public health perspective
BMC Women's Health, 2016Co-Authors: Sarah Finocchariokessler, Catherine Wexler, May Maloba, Natabhona Mabachi, Florence Ndikummoffor, Elizabeth A BukusiAbstract:Women living in Africa experience the highest burden of cervical cancer. Research and investment to improve vaccination, screening, and treatment efforts are critically needed. We systematically reviewed and characterized recent research within a broader public health framework to organize and assess the range of cervical cancer research in Africa. We searched online databases and the Internet for published articles and cervical cancer reports in African countries. Inclusion criteria included publication between 2004 and 2014, cervical cancer-related content pertinent to one of the four public health categories (primary, secondary, Tertiary Prevention or quality of life), and conducted in or specifically relevant to countries or regions within the African continent. The study design, geographic region/country, focus of research, and key findings were documented for each eligible article and summarized to illustrate the weight and research coverage in each area. Publications with more than one focus (e.g. secondary and Tertiary Prevention) were categorized by the primary emphasis of the paper. Research specific to HIV-infected women or focused on feasibility issues was delineated within each of the four public health categories. A total of 380 research articles/reports were included. The majority (54.6 %) of cervical cancer research in Africa focused on secondary Prevention (i.e., screening). The number of publication focusing on primary Prevention (23.4 %), particularly HPV vaccination, increased significantly in the past decade. Research regarding the treatment of precancerous lesions and invasive cervical cancer is emerging (17.6 %), but infrastructure and feasibility challenges in many countries have impeded efforts to provide and evaluate treatment. Studies assessing aspects of quality of life among women living with cervical cancer are severely limited (4.1 %). Across all categories, 11.3 % of publications focused on cervical cancer among HIV-infected women, while 17.1 % focused on aspects of feasibility for cervical cancer control efforts. Cervical cancer research in African countries has increased steadily over the past decade, but more is needed. Tertiary Prevention (i.e. treatment of disease with effective medicine) and quality of life of cervical cancer survivors are two severely under-researched areas. Similarly, there are several countries in Africa with little to no research ever conducted on cervical cancer.
Larry B Goldstein - One of the best experts on this subject based on the ideXlab platform.
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primary care physician reported secondary and Tertiary stroke Prevention practices a comparison between the united states and the united kingdom
Stroke, 1997Co-Authors: Larry B Goldstein, Andrew Farmer, David B MatcharAbstract:Background and Purpose Stroke is a major healthcare problem in both the United States (US) and the United Kingdom (UK). Little comparative data are available concerning how generalist physicians in the two countries approach the management of patients at high risk of stroke. Methods Contemporaneous surveys of random samples of primary care physician–reported stroke Prevention practices were performed in the US and UK from 1993 to 1994. The US National Survey of Physician Practices for the Secondary and Tertiary Prevention of Ischemic Stroke included 254 noninternist primary care physicians. The UK Survey of the Care of Patients With Stroke in General Practice obtained responses from 661 general practitioners. The two surveys used many of the same questions, allowing for direct comparisons of reported stroke Prevention practices between American and British physicians. Results More than 80% of American physicians reported a variety of services (24-hour electrocardiography, echocardiography, brain CT scan, ...
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us national survey of physician practices for the secondary and Tertiary Prevention of ischemic stroke medical therapy in patients with carotid artery stenosis
Stroke, 1996Co-Authors: Larry B Goldstein, Arthur J Bonito, David B Matchar, Pamela W Duncan, Gregory P SamsaAbstract:Background and Purpose Aspirin or other platelet antiaggregants and anticoagulants are commonly used in many types of patients at elevated stroke risk. However, relatively little is known concerning how practicing physicians use these medications in their patients with extracranial carotid artery stenosis. The identification of variations in practice may help to both direct specific educational efforts and guide further research. Methods Between August 1993 and February 1994, we surveyed the stroke Prevention practices of a stratified random sample of 2000 US physicians. The survey included clinical scenarios that probed the use of aspirin or other platelet antiaggregants and anticoagulants in symptomatic and asymptomatic patients with carotid artery stenoses of 50% to 70% or more than 70%, with and without known surgical contraindications. Results Sixty-seven percent of those eligible completed the survey (n=1006). More than 85% of physicians responded that they always or often prescribe aspirin or other platelet antiaggregants regardless of degree of carotid artery stenosis, symptom status, or presence of surgical contraindications. However, the reported frequency of use of these medications varied independently according to physician specialty ( P =.044). In contrast, in addition to physician specialty, the reported frequency of anticoagulant use varied independently with degree of carotid artery stenosis, symptom status, and presence of surgical contraindications ( P P P Conclusions These data show the following: (1) Aspirin or other platelet antiaggregants are used by most physicians regardless of degree of carotid artery stenosis, symptom status, or presence of surgical contraindications; (2) anticoagulants are prescribed selectively, with each of these variables influencing their use; and (3) the use of both classes of agents varies with physician specialty training.
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us national survey of physician practices for the secondary and Tertiary Prevention of ischemic stroke carotid endarterectomy
Stroke, 1996Co-Authors: Larry B Goldstein, Arthur J Bonito, David B Matchar, Pamela W Duncan, Gregory P SamsaAbstract:Background and Purpose Stroke is largely a preventable disease. However, there are little data available concerning the use of stroke Prevention diagnostic and treatment modalities by practicing physicians. These data are critical for the rational allocation of resources and targeting of educational efforts. The purposes of this national survey were to gather information about physicians’ stroke Prevention practice patterns and their attitudes and beliefs regarding secondary and Tertiary stroke Prevention strategies. Methods We conducted a national survey of stroke Prevention practices among a stratified random sample of 2000 physicians drawn from the American Medical Association’s Physician Masterfile. The survey focused on the availability of services and the use of diagnostic and preventive strategies for patients at elevated risk of stroke. Results Sixty-seven percent (n=1006) of eligible physicians completed the survey. Diagnostic studies considered readily available by at least 90% of physicians inc...
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us national survey of physician practices for the secondary and Tertiary Prevention of ischemic stroke design service availability and common practices
Stroke, 1995Co-Authors: Larry B Goldstein, Arthur J Bonito, David B Matchar, Pamela W DuncanAbstract:Background and Purpose Stroke is largely a preventable disease. However, there are little data available concerning the use of stroke Prevention diagnostic and treatment modalities by practicing physicians. These data are critical for the rational allocation of resources and targeting of educational efforts. The purposes of this national survey were to gather information about physicians’ stroke Prevention practice patterns and their attitudes and beliefs regarding secondary and Tertiary stroke Prevention strategies. Methods We conducted a national survey of stroke Prevention practices among a stratified random sample of 2000 physicians drawn from the American Medical Association’s Physician Masterfile. The survey focused on the availability of services and the use of diagnostic and preventive strategies for patients at elevated risk of stroke. Results Sixty-seven percent (n=1006) of eligible physicians completed the survey. Diagnostic studies considered readily available by at least 90% of physicians included carotid ultrasonography, transthoracic echocardiography, Holter monitoring, and brain CT and MRI scans. MR angiography was perceived as being readily available by 68% and transesophageal echocardiography by 74% of respondents. Twelve percent of physicians reported cerebral arteriography and 10% reported carotid endarterectomy as not being readily available. Multiple logistic regression analyses showed that the availability of services varied with physician specialty (noninternist primary care, internal medicine, neurology, surgery), practice setting (nonmetropolitan versus small metropolitan or large metropolitan areas), and for carotid endarterectomy, region of the country (South, Central, Northeast, and West). The odds of carotid endarterectomy being reported as readily available were approximately 2.5 to 3.5 times greater for physicians practicing in the central, northeastern, and western regions compared with those practicing in the South, independent of practice setting and specialty. With regard to stroke Prevention practices, 61% of physicians reported prescribing 325 mg of aspirin for stroke Prevention, while 33% recommend less than 325 mg and 4% use doses of 650 mg or more. Seventy-one percent of physicians using warfarin reported monitoring anticoagulation with international normalized ratios, and 78% reported monitoring anticoagulated patients at least once a month. Fewer than 20% of physicians reported knowing the perioperative carotid endarterectomy complication rates at the hospital where they perform the operation themselves or refer patients to have the procedure done. Conclusions Although all routine and most specialized services for secondary and Tertiary stroke Prevention are readily available to most physicians, variation in availability exists. The use of international normalized ratios for monitoring warfarin therapy has not yet become universal. Physician knowledge of carotid endarterectomy complication rates is generally lacking. Depending on their causes, these problems may be addressed through targeted physician education efforts and systematic changes in the way in which services are provided.
Teresa Manygoats - One of the best experts on this subject based on the ideXlab platform.
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impact evaluation of a four year academic community partnership in provision of medication management and Tertiary Prevention services for rural patients with diabetes and or hypertension
Preventive medicine reports, 2020Co-Authors: Elizabeth J Anderson, David Rhys Axon, Ann M Taylor, Victoria Towers, Terri L Warholak, Melissa Johnson, Stephanie Forbes, Teresa ManygoatsAbstract:Abstract Medication therapy management (MTM) services, including targeted, pharmacist-delivered, Tertiary Prevention interventions, were provided to rural patients with chronic diseases via an academic-community partnership. The purpose of this investigation was to evaluate the overall program and pre/post patient outcomes from this four-year, multi-site collaboration. Five community health sites collaborated with a university-based MTM provider to deliver services in Arizona (2012–16). Eligible patients: were 18 or older (median 65 years); had a diagnosis of diabetes and/or hypertension; and resided in a rural community. Participants received an initial telephone consultation with the MTM pharmacist; follow-up consultations were conducted after 30 or 90 days for high- and low-risk patients, respectively. Community partner staff collected clinical data and addressed pharmacists’ recommendations. Descriptive analysis and bivariate analyses of pre- and post-intervention results were conducted. Most (n = 410, 70%) of the 577 participants receiving an initial and follow-up consultation with the MTM pharmacist had both diabetes and hypertension. These individuals showed statistically significant improvements in fasting blood glucose (p
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impact evaluation of a four year academic community partnership in provision of medication management and Tertiary Prevention services for rural patients with diabetes and or hypertension
Preventive medicine reports, 2020Co-Authors: Elizabeth Anderson, David Rhys Axon, Ann M Taylor, Victoria Towers, Terri L Warholak, Melissa Johnson, Stephanie Forbes, Teresa ManygoatsAbstract:Abstract Medication therapy management (MTM) services, including targeted, pharmacist-delivered, Tertiary Prevention interventions, were provided to rural patients with chronic diseases via an academic-community partnership. The purpose of this investigation was to evaluate the overall program and pre/post patient outcomes from this four-year, multi-site collaboration. Five community health sites collaborated with a university-based MTM provider to deliver services in Arizona (2012–16). Eligible patients: were 18 or older (median 65 years); had a diagnosis of diabetes and/or hypertension; and resided in a rural community. Participants received an initial telephone consultation with the MTM pharmacist; follow-up consultations were conducted after 30 or 90 days for high- and low-risk patients, respectively. Community partner staff collected clinical data and addressed pharmacists’ recommendations. Descriptive analysis and bivariate analyses of pre- and post-intervention results were conducted. Most (n = 410, 70%) of the 577 participants receiving an initial and follow-up consultation with the MTM pharmacist had both diabetes and hypertension. These individuals showed statistically significant improvements in fasting blood glucose (p
David B Matchar - One of the best experts on this subject based on the ideXlab platform.
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primary care physician reported secondary and Tertiary stroke Prevention practices a comparison between the united states and the united kingdom
Stroke, 1997Co-Authors: Larry B Goldstein, Andrew Farmer, David B MatcharAbstract:Background and Purpose Stroke is a major healthcare problem in both the United States (US) and the United Kingdom (UK). Little comparative data are available concerning how generalist physicians in the two countries approach the management of patients at high risk of stroke. Methods Contemporaneous surveys of random samples of primary care physician–reported stroke Prevention practices were performed in the US and UK from 1993 to 1994. The US National Survey of Physician Practices for the Secondary and Tertiary Prevention of Ischemic Stroke included 254 noninternist primary care physicians. The UK Survey of the Care of Patients With Stroke in General Practice obtained responses from 661 general practitioners. The two surveys used many of the same questions, allowing for direct comparisons of reported stroke Prevention practices between American and British physicians. Results More than 80% of American physicians reported a variety of services (24-hour electrocardiography, echocardiography, brain CT scan, ...
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us national survey of physician practices for the secondary and Tertiary Prevention of ischemic stroke medical therapy in patients with carotid artery stenosis
Stroke, 1996Co-Authors: Larry B Goldstein, Arthur J Bonito, David B Matchar, Pamela W Duncan, Gregory P SamsaAbstract:Background and Purpose Aspirin or other platelet antiaggregants and anticoagulants are commonly used in many types of patients at elevated stroke risk. However, relatively little is known concerning how practicing physicians use these medications in their patients with extracranial carotid artery stenosis. The identification of variations in practice may help to both direct specific educational efforts and guide further research. Methods Between August 1993 and February 1994, we surveyed the stroke Prevention practices of a stratified random sample of 2000 US physicians. The survey included clinical scenarios that probed the use of aspirin or other platelet antiaggregants and anticoagulants in symptomatic and asymptomatic patients with carotid artery stenoses of 50% to 70% or more than 70%, with and without known surgical contraindications. Results Sixty-seven percent of those eligible completed the survey (n=1006). More than 85% of physicians responded that they always or often prescribe aspirin or other platelet antiaggregants regardless of degree of carotid artery stenosis, symptom status, or presence of surgical contraindications. However, the reported frequency of use of these medications varied independently according to physician specialty ( P =.044). In contrast, in addition to physician specialty, the reported frequency of anticoagulant use varied independently with degree of carotid artery stenosis, symptom status, and presence of surgical contraindications ( P P P Conclusions These data show the following: (1) Aspirin or other platelet antiaggregants are used by most physicians regardless of degree of carotid artery stenosis, symptom status, or presence of surgical contraindications; (2) anticoagulants are prescribed selectively, with each of these variables influencing their use; and (3) the use of both classes of agents varies with physician specialty training.
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us national survey of physician practices for the secondary and Tertiary Prevention of ischemic stroke carotid endarterectomy
Stroke, 1996Co-Authors: Larry B Goldstein, Arthur J Bonito, David B Matchar, Pamela W Duncan, Gregory P SamsaAbstract:Background and Purpose Stroke is largely a preventable disease. However, there are little data available concerning the use of stroke Prevention diagnostic and treatment modalities by practicing physicians. These data are critical for the rational allocation of resources and targeting of educational efforts. The purposes of this national survey were to gather information about physicians’ stroke Prevention practice patterns and their attitudes and beliefs regarding secondary and Tertiary stroke Prevention strategies. Methods We conducted a national survey of stroke Prevention practices among a stratified random sample of 2000 physicians drawn from the American Medical Association’s Physician Masterfile. The survey focused on the availability of services and the use of diagnostic and preventive strategies for patients at elevated risk of stroke. Results Sixty-seven percent (n=1006) of eligible physicians completed the survey. Diagnostic studies considered readily available by at least 90% of physicians inc...
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us national survey of physician practices for the secondary and Tertiary Prevention of ischemic stroke design service availability and common practices
Stroke, 1995Co-Authors: Larry B Goldstein, Arthur J Bonito, David B Matchar, Pamela W DuncanAbstract:Background and Purpose Stroke is largely a preventable disease. However, there are little data available concerning the use of stroke Prevention diagnostic and treatment modalities by practicing physicians. These data are critical for the rational allocation of resources and targeting of educational efforts. The purposes of this national survey were to gather information about physicians’ stroke Prevention practice patterns and their attitudes and beliefs regarding secondary and Tertiary stroke Prevention strategies. Methods We conducted a national survey of stroke Prevention practices among a stratified random sample of 2000 physicians drawn from the American Medical Association’s Physician Masterfile. The survey focused on the availability of services and the use of diagnostic and preventive strategies for patients at elevated risk of stroke. Results Sixty-seven percent (n=1006) of eligible physicians completed the survey. Diagnostic studies considered readily available by at least 90% of physicians included carotid ultrasonography, transthoracic echocardiography, Holter monitoring, and brain CT and MRI scans. MR angiography was perceived as being readily available by 68% and transesophageal echocardiography by 74% of respondents. Twelve percent of physicians reported cerebral arteriography and 10% reported carotid endarterectomy as not being readily available. Multiple logistic regression analyses showed that the availability of services varied with physician specialty (noninternist primary care, internal medicine, neurology, surgery), practice setting (nonmetropolitan versus small metropolitan or large metropolitan areas), and for carotid endarterectomy, region of the country (South, Central, Northeast, and West). The odds of carotid endarterectomy being reported as readily available were approximately 2.5 to 3.5 times greater for physicians practicing in the central, northeastern, and western regions compared with those practicing in the South, independent of practice setting and specialty. With regard to stroke Prevention practices, 61% of physicians reported prescribing 325 mg of aspirin for stroke Prevention, while 33% recommend less than 325 mg and 4% use doses of 650 mg or more. Seventy-one percent of physicians using warfarin reported monitoring anticoagulation with international normalized ratios, and 78% reported monitoring anticoagulated patients at least once a month. Fewer than 20% of physicians reported knowing the perioperative carotid endarterectomy complication rates at the hospital where they perform the operation themselves or refer patients to have the procedure done. Conclusions Although all routine and most specialized services for secondary and Tertiary stroke Prevention are readily available to most physicians, variation in availability exists. The use of international normalized ratios for monitoring warfarin therapy has not yet become universal. Physician knowledge of carotid endarterectomy complication rates is generally lacking. Depending on their causes, these problems may be addressed through targeted physician education efforts and systematic changes in the way in which services are provided.
Jennifer A Ligibel - One of the best experts on this subject based on the ideXlab platform.
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practical clinical interventions for diet physical activity and weight control in cancer survivors
CA: A Cancer Journal for Clinicians, 2015Co-Authors: Wendy Demarkwahnefried, Laura Q Rogers, Catherine M Alfano, Cynthia A Thomson, Kerry S Courneya, Jeffrey A Meyerhardt, Nicole L Stout, Elizabeth Kvale, Heidi Ganzer, Jennifer A LigibelAbstract:Answer questions and earn CME/CNE The importance of expanding cancer treatment to include the promotion of overall long-term health is emphasized in the Institute of Medicine report on delivering quality oncology care. Weight management, physical activity, and a healthy diet are key components of Tertiary Prevention but may be areas in which the oncologist and/or the oncology care team may be less familiar. This article reviews current diet and physical activity guidelines, the evidence supporting those recommendations, and provides an overview of practical interventions that have resulted in favorable improvements in lifestyle behavior change in cancer survivors. It also describes current lifestyle practices among cancer survivors and the role of the oncologist in helping cancer patients and survivors embark upon changes in lifestyle behaviors, and it calls for the development of partnerships between oncology providers, primary care providers, and experts in nutrition, exercise science, and behavior change to help positively orient cancer patients toward longer and healthier lives.
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practical clinical interventions for diet physical activity and weight control in cancer survivors
CA: A Cancer Journal for Clinicians, 2015Co-Authors: Wendy Demarkwahnefried, Laura Q Rogers, Catherine M Alfano, Cynthia A Thomson, Kerry S Courneya, Jeffrey A Meyerhardt, Nicole L Stout, Elizabeth Kvale, Heidi Ganzer, Jennifer A LigibelAbstract:Answer questions and earn CME/CNE The importance of expanding cancer treatment to include the promotion of overall long-term health is emphasized in the Institute of Medicine report on delivering quality oncology care. Weight management, physical activity, and a healthy diet are key components of Tertiary Prevention but may be areas in which the oncologist and/or the oncology care team may be less familiar. This article reviews current diet and physical activity guidelines, the evidence supporting those recommendations, and provides an overview of practical interventions that have resulted in favorable improvements in lifestyle behavior change in cancer survivors. It also describes current lifestyle practices among cancer survivors and the role of the oncologist in helping cancer patients and survivors embark upon changes in lifestyle behaviors, and it calls for the development of partnerships between oncology providers, primary care providers, and experts in nutrition, exercise science, and behavior change to help positively orient cancer patients toward longer and healthier lives. CA Cancer J Clin 2015;65: 167–189. © 2015 American Cancer Society.