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Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

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PubMed1995

Awakening the sleeping giant: mainstreaming efforts to decrease tobacco use in an HMO.

Group Health Cooperative (GHC) of Puget Sound is developing, within a framework of quality improvement, a comprehensive population-based approach to decreasing the prevalence of tobacco use. Broad organizational support has been obtained, centralized support is being integrated with clinic-level activity, local ownership of outcomes is encouraged with empowerment of health care teams, and support for community and policy-based activities is being provided. GHC's smoking prevalence has decreased from 25% to 15.5% over the past decade, while the state of Washington's prevalence declined from 23.7% to 21.8%.

Community Health Planning↗
PubMedDate not supplied

Mainstream assistance teams: a scientific basis for the art of consultation.

The purpose of this investigation was to determine whether a consultant-driven prereferral intervention may be shortened in duration, thereby improving its efficiency, without reducing its effectiveness. Subjects were 60 general educators; their 60 most difficult-to-teach pupils without disabilities; and 22 consultants, representing 17 elementary schools in a large metropolitan school system. The teachers were assigned randomly to a short (n = 24) and long version (n = 24) of the prereferral intervention and to a control group (n = 12). Analyses indicated that the two variants of the prereferral intervention improved teacher perceptions of their difficult-to-teach students and decreased referrals for testing and possible special education placement. Moreover, results suggested that the short and long versions were equally effective. Implications for consultation-related activity are discussed.

Child↗
PubMed1998

A review of the incorporation of complementary and alternative medicine by mainstream physicians.

BACKGROUND: Studies suggest that between 30% and 50% of the adult population in industrialized nations use some form of complementary and/or alternative medicine (CAM) to prevent or treat a variety of health-related problems. METHOD: A comprehensive literature search identified 25 surveys conducted between 1982 and 1995 that examined the practices and beliefs of conventional physicians with regard to 5 of the more prominent CAM therapies: acupuncture, chiropractic, homeopathy, herbal medicine, and massage. Six studies were excluded owing to their methodological limitations. RESULTS: Across surveys, acupuncture had the highest rate of physician referral (43%) among the 5 CAM therapies, followed by chiropractic (40%) and massage (21%). Rates of CAM practice by conventional physicians varied from a low of 9% for homeopathy to a high of 19% for chiropractic and massage therapy. Approximately half of the surveyed physicians believed in the efficacy of acupuncture (51%), chiropractic (53%), and massage (48%), while fewer believed in the value of homeopathy (26%) and herbal approaches (13%). CONCLUSIONS: This review suggests that large numbers of physicians are either referring to or practicing some of the more prominent and well-known forms of CAM and that many physicians believe that these therapies are useful or efficacious. These data vary considerably across surveys, most likely because of regional differences and sampling methods, suggesting the need for more rigorous surveys using national, representative samples. Finally, outcomes studies are needed so that physicians can make decisions about the use of CAM based on scientific evidence of efficacy rather than on regional economics and cultural norms.

Acupuncture Therapy↗
PubMedDate not supplied

Articles on complementary medicine in the mainstream medical literature: an investigation of MEDLINE, 1966 through 1996.

OBJECTIVE: To investigate the growth of interest, if any, in complementary or alternative medicine by the professional scientific community from the number of MEDLINE-listed and clinical trial-type articles for January 1, 1966, through December 31, 1996. METHODS: Systematic literature searches of the MEDLINE database, using the expanded terms "alternative medicine," "traditional medicine," "acupuncture," "homeopathy," and "chiropractic," were conducted in January 1998 to evaluate the number of all articles. The number of clinical trial-type articles on the above was obtained by conducting searches for those indexed as 1 or more of the following publication types: clinical trial; clinical trial phase 1, 2, 3, or 4; controlled clinical trial; metaanalysis; randomized controlled trial; and limited to "human" trials only. RESULTS: Articles indexed as alternative medicine formed a small proportion (0.4%) of the total number of MEDLINE-listed articles throughout the period studied. From 1966 through 1996, the total number of articles listed in MEDLINE rose significantly to a peak of 400000 additions per annum in 1996 (r = 0.97; P<.001). By contrast, the number of articles indexed under alternative medicine rose progressively only from 1972 through 1986 and since then has been relatively stable at around 1500 additions per annum. For this period, the proportion of clinical trial-type alternative medicine articles was low (mean, 2.1% per annum) but increased significantly from 1987 through 1996, reaching around 10% of the total in 1996 (r = 0.79; P<.001). Patterns of growth in the number of publications for individual therapies have varied during the period studied, and clinical trial-type articles form only a small part of any increase. CONCLUSIONS: Interest in and awareness of complementary medicine among orthodox health care professionals has increased in the past 30 years. The increase in the number and proportion of reports of clinical trials indicates an increasing level of original research activity in complementary medicine and suggests a trend toward an evidence-based approach in this discipline. The cumulative number of clinical trial-type articles is small, however, and more high-quality original research in complementary medicine is required.

Complementary Therapies↗