Strategies for implementing implementation science: a methodological overview

A key reason for the consistent gaps between evidence and practice across all areas of medicine is that there has been little attempt to identify or target factors critical for successful implementation of an evidence-based intervention. There is either no explicit implementation strategy or the strategy is based on a best guess rather than on a systematic assessment of crucial barriers and enablers. A different approach is needed to close the evidence-practice gap and thereby achieve the triple aim of improved health, improved patient experience and reduced healthcare costs. We present three fundamental principles of implementation science, which is a methodology that offers a systematic and comprehensive approach to improving healthcare practice and a series of 'how to' steps to conduct implementation science research. In an accompanying article, a scoping review of the types of implementation science research conducted in emergency medicine is reviewed, and several of the principles related to this review are discussed

Comparison of Propranolol versus Amitriptyline as monotherapy for migraine prophylaxis

Introduction: Several drugs like Beta Blockers, SSRIs etc., are used for migraine prophylaxis. Objectives: The purpose of the present study was to compare the efficacy of propranolol and amitriptyline as monotherapy for the prophylaxis of migraine. Materials and Methods: This was a comparative, double-blinded, Prospective, randomized controlled study conducted at Department of General Medicine at Surabhi Institute of Medical Sciences. A total of 140 patients were enrolled in the study, diagnosed cases of migraine were randomly allocated using random number table to either Group 1 (Period 1: To receive tablet Propranolol 4–16 weeks and Period 2: Amitriptyline 20–32 weeks) or Group 2 (Period 1: To receive tablet Amitriptyline 4–16 weeks and Period 2: Propranolol 20–32 weeks). During the first 4 weeks, the run-in period, the patients do not receive prophylactic treatment and have to record in a headache diary the number of migraine attacks, the duration of attacks in hours and the severity.  Similarly during 16 to 20 weeks patient didn’t receive any prophylactic treatment to wear of the drug effects

Adolescents' attitudes towards e-cigarette ingredients, safety, addictive properties, social norms, and regulation.

E-cigarette use has dramatically increased. While studies have examined adolescents' attitudes towards smoking, few have extended this research to adolescents' attitudes towards e-cigarettes. The goal of this study was to examine adolescents' attitudes regarding e-cigarette ingredients, safety, addictive properties, social norms, accessibility, price, and regulation; and determine whether attitudes differ by past cigarette/e-cigarette use. Participants were 786 9th and 12th graders from California (63.21% females; mean age=16.10years [SD=1.6]; 26.61% White, 21.98% Asian/Pacific Islander, 29.82% Hispanic, and 21.59% other). Results indicated that 19.05% of participants believed smoke from e-cigarettes is water; 23.03% believed e-cigarettes aren't a tobacco product; 40.36% considered e-cigarettes to be for cessation, and 43.13% felt they were safer than cigarettes. Participants felt it was more acceptable to use e-cigarettes indoors and outdoors compared to cigarettes (p<0.0001), 23.13% felt raising e-cigarette taxes is a bad idea, 63.95% thought e-cigarettes were easier to get than cigarettes, 54.42% felt e-cigarettes cost too much, 64.33% felt the age for buying e-cigarettes should be raised, and 64.37% favored e-cigarette regulation. Adolescents who used e-cigarettes and/or cigarettes had significantly more favorable e-cigarette attitudes than non-users. This study indicates that adolescents are aware of some of the risks of e-cigarettes, although many harbor misperceptions and hold more favorable attitudes towards e-cigarettes than cigarettes. Of concern is the relationship between favorable e-cigarette attitudes and use. Findings suggest the need to provide adolescents with correct information about e-cigarette ingredients, risks, and the insufficient evidence of their role in cigarette cessation

The Health Literacy of U.S. Immigrant Adolescents: A Neglected Research Priority in a Changing World

Immigrant adolescents are the fastest-growing sector among U.S. youth, but they receive little attention in health literacy research. Immigrant adolescents are a diverse population tasked with mastering new literacies while also navigating new social systems. Many immigrant adolescents serve as important linguistic and cultural resources in their families and local communities, and yet their contributions (and struggles) as new navigators of our health care system remain invisible. In this commentary article, we argue that health literacy researchers need to devote more attention to immigrant adolescents and the pathways by which they learn new language and literacy skills while also developing their own health habits and behaviors. We contend that the study of immigrant adolescents provides a critical window into health literacy as a socially and historically situated practice, specifically how immigrant adolescents’ transnational experiences shape their learning of new health literacy practices. With a coordinated interdisciplinary research agenda on immigrant adolescents, the health literacy field will expand its empirical base for what becoming “health literate” looks like in today’s globalizing world

Correlation between Glycosylated Haemoglobin and serum lipid profile in patients with type 2 diabetes

Introduction: Dyslipidaemia is one of the major risk factor for cardiovascular disease in Type 2 Diabetes mellitus, characterized by elevated Total cholesterol (TC), Triglycerides (TG), Low density lipoprotein (LDL) and decreased High density lipoprotein (HDL). Haemoglobin A1c (HbA1c) is widely used as an index of mean glycaemia, a measure of risk for the development of diabetes complications and a measure of the quality of diabetes care. The aim of this study was to determine the impact of glycaemic control on lipid profile and to know utility of HbA1c as an indirect indicator of dyslipidaemia. Objectives:  To assess the relationship between glycemic control (HbA1c) and serum lipid profile as well as to evaluate the importance of HbA1c as an indicator of dyslipidemia in patients with T2DM. Materials and Methods: The present study is a prospective, observational study which is conducted in the Department of General Medicine at Surabhi Institute of Medical Sciences over a period of 6 months.  A total of 65 T2DM patients with dyslipidemia who had visited the hospital. Inclusion criteria: Adults aged above 30 years and having Type 2 Diabetes Mellitus with dyslipidaemia

Correlation Between Glycosylated Haemoglobin and Serum Lipid Profile in Patients with Type 2 Diabetes

Introduction: Dyslipidaemia is one of the major risk factor for cardiovascular disease in Type 2 Diabetes mellitus, characterized by elevated Total cholesterol (TC), Triglycerides (TG), Low density lipoprotein (LDL) and decreased High density lipoprotein (HDL). Haemoglobin A1c (HbA1c) is widely used as an index of mean glycaemia, a measure of risk for the development of diabetes complications and a measure of the quality of diabetes care. The aim of this study was to determine the impact of glycaemic control on lipid profile and to know utility of HbA1c as an indirect indicator of dyslipidaemia. Objectives:  To assess the relationship between glycemic control (HbA1c) and serum lipid profile as well as to evaluate the importance of HbA1c as an indicator of dyslipidemia in patients with T2DM. Materials and Methods: The present study is a prospective, observational study which is conducted in the Department of General Medicine at Surabhi Institute of Medical Sciences over a period of 6 months.  A total of 65 T2DM patients with dyslipidemia who had visited the hospital. Inclusion criteria: Adults aged above 30 years and having Type 2 Diabetes Mellitus with dyslipidaemia

Examining Lead Exposures in California through State-Issued Health Alerts for Food Contamination and an Exposure-Based Candy Testing Program.

In California, the annual number of children under age 6 y of age with blood lead levels (BLL) ≥10μg/dL is estimated at over 1,000 cases, and up to 10,000 cases when BLL between 4.5 and 9.5 μg/dL are included. State-issued health alerts for food contamination provide one strategy for tracking sources of food-related lead exposures. As well, California passed legislation in 2006 for the Food and Drug Branch (FDB) of the state health department to test and identify lead in candy. This report presents health alert data from California over a 14-y period, compares data before and after the candy testing program began, and examines country of origin, ZIP code data, and time from candy testing to release of health alerts for lead-contaminated candies for 2011-2012. After 2007, health alerts issued for lead in candy and food increased significantly. Analysis of candy-testing data indicated that multiple counties and ZIP codes were affected. Seventeen candies with high lead concentrations were identified, resulting in rapid dissemination (<2wk) of health alerts to local health departments and community clinicians and to the public. Surveillance of lead exposures from state-based food and candy testing programs provides an opportunity to identify and immediately act to remove nonpaint sources of lead affecting children. https://doi.org/10.1289/EHP2582