scholarly journals Students Adding Value: Improving Patient Care Measures While Learning Valuable Population Health Skills

2019 ◽  
Vol 35 (1) ◽  
pp. 70-78 ◽  
Author(s):  
Amy W. Shaheen ◽  
Kelly Bossenbroek Fedoriw ◽  
Susanna Khachaturyan ◽  
Beat Steiner ◽  
Julie Golding ◽  
...  
Keyword(s):  
Student Involvement ◽  
Odds Ratio ◽  
Mixed Effects ◽  
Mixed Effects Models ◽  
Learning Goals ◽  
Collaborative Practices ◽  
Private Practices ◽  
Care Practices ◽  
Primary Care Practices ◽  
Improving Patient Care

Medical students are potential resources for ambulatory primary care practices if learning goals can align with clinical needs. The authors introduced a quality improvement (QI) curriculum in the ambulatory clinical rotation that matched student learning expectations with practice needs. In 2016-2017, 128 students were assigned to academic, university affiliated, community health, and private practices. Student project measures were matched with appropriate outcome measures on monthly practice dashboards. Binomial mixed effects models were used to model QI measures. For university collaborative practices with student involvement, the estimated odds of a patient being screened for breast cancer in March 2017 was approximately 2 times greater than in 2016. This odds ratio was 36.2% greater than the comparable odds ratio for collaborative practices without student involvement (95% confidence interval = 22.7% to 51.2% greater). When student curriculum and assignments align with practice needs, practice metrics improve and students contribute to improvements in real-world settings.

scholarly journals Using a daily diary approach to examine the early effects of COVID-19 on daily physical activity bouts and contexts among residents of Colorado and California

2021 ◽  
Author(s):  
Jimikaye Courtney ◽  
Kayla Nuss ◽  
Shirlene Wang ◽  
Bridgette Do ◽  
Genevieve Dunton
Keyword(s):  
Physical Activity ◽  
Odds Ratio ◽  
Daily Diary ◽  
Mixed Effects ◽  
Mixed Effects Models ◽  
Disease Spread ◽  
Negative Effects ◽  
Hispanic Latinos ◽  
Early Effects ◽  
Streaming Videos

Abstract COVID-19 restrictions may prevent adults from achieving sufficient physical activity (PA) and may affect PA context. This study examined the early effects of COVID-19 on daily PA bouts and contexts during April–June 2020 using a daily diary approach. Adults (N = 390) completed daily diary surveys for 28 days assessing number of PA bouts and social (e.g., alone), locational (i.e., home, neighborhood, recreational space), and technology (e.g., using streaming videos) contexts of PA. Mixed-effects models examined the effects of days since the pandemic started (on 3/13/2020), state residence, and demographics on number of daily PA bouts. Models examined demographic and temporal effects on PA context. Participants were 18–77 years, 15% Hispanic/Latino, and 80% female. PA bouts per day decreased significantly over time among Californians versus Coloradans (bsimple = −0.01, p < .001) and Hispanics/Latinos (vs. non-Hispanic Latinos) did fewer PA bouts per day (b = −0.17, p = .04). Most PA bouts occurred while alone (56.7%), at home (43.4%), or in any neighborhood (40.5%). Older (60+ years) versus younger (<40 years) adults were less likely to do PA with others (odds ratio [OR] = 0.40, 95% confidence interval [CI]: 0.18–0.90). PA bouts in recreational spaces were more common on weekends versus weekdays (OR = 1.59, 95% CI: 1.32–1.92) and were less common among California versus Colorado residents (OR = 0.23, 95% CI: 0.12–0.42). PA bouts decreased from April to June 2020, and these changes disparately affected subgroups. Resources are needed to counteract the negative effects of COVID-19 restrictions intended to slow disease spread on PA.

scholarly journals Effect of tofogliflozin on arterial stiffness in patients with type 2 diabetes: prespecified sub-analysis of the prospective, randomized, open-label, parallel-group comparative UTOPIA trial

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Naoto Katakami ◽  
◽  
Tomoya Mita ◽  
Hidenori Yoshii ◽  
Toshihiko Shiraiwa ◽  
...  
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Type 2 Diabetes ◽  
Conventional Treatment ◽  
Mixed Effects ◽  
Mixed Effects Models ◽  
Open Label ◽  
Parallel Group ◽  
History Of

Abstract Background Tofogliflozin, an SGLT2 inhibitor, is associated with favorable metabolic effects, including improved glycemic control and serum lipid profile and decreased body weight, visceral adipose tissue, and blood pressure (BP). This study evaluated the effects of tofogliflozin on the brachial-ankle pulse wave velocity (baPWV) in patients with type 2 diabetes (T2DM) without a history of apparent cardiovascular disease. Methods The using tofogliflozin for possible better intervention against atherosclerosis for type 2 diabetes patients (UTOPIA) trial is a prospective, randomized, open-label, multicenter, parallel-group, comparative study. As one of the prespecified secondary outcomes, changes in baPWV over 104 weeks were evaluated in 154 individuals (80 in the tofogliflozin group and 74 in the conventional treatment group) who completed baPWV measurement at baseline. Results In a mixed-effects model, the progression in the right, left, and mean baPWV over 104 weeks was significantly attenuated with tofogliflozin compared to that with conventional treatment (– 109.3 [– 184.3, – 34.3] (mean change [95% CI] cm/s, p = 0.005; – 98.3 [– 172.6, – 24.1] cm/s, p = 0.010; – 104.7 [– 177.0, – 32.4] cm/s, p = 0.005, respectively). Similar findings were obtained even after adjusting the mixed-effects models for traditional cardiovascular risk factors, including body mass index (BMI), glycated hemoglobin (HbA1c), total cholesterol, high-density lipoprotein (HDL)-cholesterol, triglyceride, systolic blood pressure (SBP), hypertension, smoking, and/or administration of drugs, including hypoglycemic agents, antihypertensive agents, statins, and anti-platelets, at baseline. The findings of the analysis of covariance (ANCOVA) models, which included the treatment group, baseline baPWV, and traditional cardiovascular risk factors, resembled those generated by the mixed-effects models. Conclusions Tofogliflozin significantly inhibited the increased baPWV in patients with T2DM without a history of apparent cardiovascular disease, suggesting that tofogliflozin suppressed the progression of arterial stiffness. Trial Registration UMIN000017607. Registered 18 May 2015. (https://www.umin.ac.jp/icdr/index.html)

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