The burden of childhood atopic dermatitis in the primary care setting: a report from the Meta-LARC Consortium

Background: Little is known about the burden of AD encountered in U.S. primary care practices and the frequency and type of skin care practices routinely used in children. Objectives: To estimate the prevalence of AD and allergic comorbidities in children 0-5 years attending primary care practices in the U.S. and to describe routine skin care practices used in this population. Design: A cross-sectional survey study of a convenience sample of children under the age of 5 attending primary care practices for any reason. Setting: Ten primary care practices in five U.S. states.Results: Amongst 652 children attending primary care practices, the estimated prevalence of ever having AD was 24 % (95% CI= 21-28) ranging from 15% among those under the age of one to 38% among those aged 4- 5 years. The prevalence of comorbid asthma was higher among AD participants compared to those with no AD, 12% and 4%, respectively (p less than 0.001). Moisturizers with high water:oil ratios were most commonly used (i.e., lotions) in the non-AD population, whereas moisturizers with low water:oil content (i.e. ointments) most common when AD was present. Conclusions: Our study found a large burden of AD in the primary care practice setting in the U.S. The majority of households reported skin care practices in children without AD that may be detrimental to the skin barrier such as frequent bathing and the routine use of moisturizers with high water: oil ratios. Clinical trials are needed to identify which skin care practices are optimal for reducing the significant risk of AD in the community

Enhancing Online Training in an Evidence-Based Treatment for Adolescent Panic Disorder: A Randomized Controlled Trial

This randomized controlled trial compared 3 modes of training clinicians in a youth-focused evidence-based treatment for panic disorder, using an additive design. Community practitioners (N = 140) were randomly assigned to one of three conditions: a standard text-alone training condition (TXT); an interactive, online training program plus the TXT (TXT + OLT); or the TXT + OLT enhanced by a learning community adjunct leveraging Twitter (TXT + OLT + LC). Mastery of Anxiety and Panic for Adolescents (MAP-A), an efficacious cognitive-behavioral therapy for adolescents with panic disorder, was taught in all three training conditions. Analyses revealed that participants were more satisfied with the TXT + OLT and TXT + OLT + LC training, compared to the TXT condition. Although all conditions demonstrated equivalent increases in knowledge of MAP-A, participants in the TXT + OLT + LC demonstrated greater proficiency using MAP-A skills in a simulated clinical scenario, compared to those in both the TXT + OLT and TXT conditions. However, this effect was no longer statistically significant at a 90-day follow-up. Results indicate initial promise for enhancing online training dissemination efforts with a novel learning community and Twitter adjunct in training clinicians in a youth-focused, efficacious cognitive-behavioral therapy. Directions for future research and dissemination efforts are discussed

Implementing patient navigation programs: Considerations and lessons learned from the Alliance to Advance Patient-Centered Cancer Care

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/173011/1/cncr34251_am.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/173011/2/cncr34251.pd