PubMed Health⌕ Search

Biomedical subjects

Cynthia Clark

Publications and source records attributed to Cynthia Clark.

6 recordsLinked to original sources
PubMed2004

Moving diabetes care from science to practice: the evolution of the National Diabetes Prevention and Control Program.

The National Diabetes Prevention and Control Program has a dynamic and evolving scientific foundation. This article describes this program and how seminal research studies provide an impetus for its public health policy and programs. The charge and challenges of integrating science into past, current, and future program designs are detailed, as are the program's accomplishments. Areas requiring new science are explored, including better research to translate new findings into clinical and public health practice and models to evaluate the effect of public health on improved outcomes. The epidemic of diabetes and its increasing burden on public health demands a better understanding of existing science and its limitations and informed public dialogue and policy responses.

Diabetes Mellitus↗
PubMed2004

Bringing buprenorphine-naloxone detoxification to community treatment providers: the NIDA Clinical Trials Network field experience.

In October 2002, the U.S. Food and Drug Administration approved buprenorphine-naloxone (Suboxone) sublingual tablets as an opioid dependence treatment available for use outside traditionally licensed opioid treatment programs. The NIDA Center for Clinical Trials Network (CTN) sponsored two clinical trials assessing buprenorphine-naloxone for short-term opioid detoxification. These trials provided an unprecedented field test of its use in twelve diverse community-based treatment programs. Opioid-dependent men and women were randomized to a thirteen-day buprenorphine-naloxone taper regimen for short-term opioid detoxification. The 234 buprenorphine-naloxone patients averaged 37 years old and used mostly intravenous heroin. Direct and rapid induction onto buprenorphine-naloxone was safe and well tolerated. Most patients (83%) received 8 mg buprenorphine-2 mg naloxone on the first day and 90% successfully completed induction and reached a target dose of 16 mg buprenorphine-4 mg naloxone in three days. Medication compliance and treatment engagement was high. An average of 81% of available doses was ingested, and 68% of patients completed the detoxification. Most (80.3%) patients received some ancillary medications with an average of 2.3 withdrawal symptoms treated. The safety profile of buprenorphine-naloxone was excellent. Of eighteen serious adverse events reported, only one was possibly related to buprenorphine-naloxone. All providers successfully integrated buprenorphine-naloxone into their existing treatment milieus. Overall, data from the CTN field experience suggest that buprenorphine-naloxone is practical and safe for use in diverse community treatment settings, including those with minimal experience providing opioid-based pharmacotherapy and/or medical detoxification for opioid dependence.

Administration, Sublingual↗
PubMed2003

Improving diabetes care and outcomes: the secondary benefits of a public health-managed care research collaboration.

The project improving Diabetes Care through Empowerment, Active Collaboration and Leadership (IDEAL) is a collaborative translational research project of the Minnesota Diabetes Program (MDP) at the Minnesota Department of Health and HealthPartners (HP), a large managed care organization. The research was designed to test a quality improvement model to improve diabetes care delivery and outcomes in primary care clinics, but the collaboration was structured from the beginning to maximize potential secondary effects. The MDP and HP participated jointly in every aspect of the project. Personnel from other health care systems and academic and quality improvement organizations also participated in IDEAL. Secondary effects included heightened priority for diabetes care improvement at HP and within its medical group, along with an increased emphasis on a population approach for both of these organizations. Simultaneously, the MDP developed a better understanding of the issues and potential for improving care in primary care clinics, medical groups, and managed care organizations. These benefits resulted in further collaboration between the MDP, HP, and other managed care, health care, and quality improvement organizations in Minnesota. Thus, Project IDEAL has been a successful collaboration of public health and managed care whose contribution to improved diabetes care in Minnesota health systems extends far beyond the original scope of the project.

Community Health Planning↗
PubMed2002

Staff beliefs about drug abuse clinical trials.

Staff from 10 community-based addiction treatment organizations in the National Drug Abuse Clinical Trials Network participated in an educational session about addiction research practices and human subject protections. This 1.5-hour presentation addressed "informed consent," "confidentiality of research information," "inclusion and exclusion criteria," "random assignment," "patient protections," and "patient payments." Pre- and postsession surveys were administered to 115 staff members measuring their beliefs about clinical trials. At baseline, 52% of staff believed patients could transfer out of a study even if they were doing poorly, and 55% believed staff had this right; 44% agreed that patients could participate in a clinical trial without understanding what would take place in the study. After the educational session, staff beliefs about patient protections were significantly increased in five of the seven items. A fourth of staff continued to believe patient payments were harmful, and 37% did not believe participation in a clinical trial would increase a patient's chances at recovery.

Attitude of Health Personnel↗