Gout Knowledge, Beliefs and Treatment Practices in a National Sample of US Primary Care Providers

Objectives: We sought to examine primary care providers’ gout knowledge and reported treatment patterns in comparison to current treatment recommendations. Methods: We conducted a national survey of a random sample of primary care physicians (internists and family practitioners) to assess their treatment of acute, intercritical, and tophaceous gout in comparison to published European and American gout treatment recommendations and guidelines. Results: There were 838 respondents (response rate of 41%) most of whom worked in private practice (63%) with \u3e16 years experience (52%). For acute podagra, 16% reported care consistent with the recommendations including avoidance of anti-inflammatory drugs in the setting of renal insufficiency, use of colchicine at a dose of ≤ 1.8mg a day, and no initiation of a urate-lowering drug (ULD) during an acute attack (internists 21% vs. family practitioners 11%, p Conclusion: While internists were more likely than family practitioners to suggest recommended care, the majority of physicians did not report optimal treatment practices, suggesting further education is needed

Patients\u27 knowledge and beliefs concerning gout and its treatment: a population based study

BACKGROUND: For patients to effectively manage gout, they need to be aware of the impact of diet, alcohol use, and medications on their condition. We sought to examine patients\u27 knowledge and beliefs concerning gout and its treatment in order to identify barriers to optimal patient self-management. METHODS: We identified patients (\u3e/=18 years of age) cared for in the setting of a multispecialty group practice with documentation of at least one health care encounter associated with a gout diagnosis during the period 2008-2009 (n = 1346). Patients were sent a questionnaire assessing knowledge with regard to gout, beliefs about prescription medications used to treat gout, and trust in the physician. Administrative electronic health records were used to identify prescription drug use and health care utilization. RESULTS: Two hundred and forty patients returned surveys out of the 500 contacted for participation. Most were male (80%), white (94%), and aged 65 and older (66%). Only 14 (6%) patients were treated by a rheumatologist. Only a minority of patients were aware of common foods known to trigger gout (e.g., seafood [23%], beef [22%], pork [7%], and beer [43%]). Of those receiving a urate-lowering medication, only 12% were aware of the short-term risks of worsening gout with initiation. These deficits were more common in those with active as compared to inactive gout. CONCLUSION: Knowledge deficits about dietary triggers and chronic medications were common, but worse in those with active gout. More attention is needed on patient education on gout and self-management training

Pilots for Space Tourism

This article sheds light on the key player needed for any space tourism adventure: the pilot who flies the spacecraft. The paper addresses the potential benefits of including a pilot at the controls when designing a space tourism spacecraft. It examines the basic qualifications and advanced skills required of space tourism pilots and discusses key training requirements for selected pilots and space pilots’ pay and benefits. In addition, the research concludes that, just as the pioneers of passenger transport in aviation entertained and captured the interest of their passengers, the space pilot should have the skills of a tour guide

Two Multiâ Center Studies Evaluating Locally Delivered Doxycycline Hyclate, Placebo Control, Oral Hygiene, and Scaling and Root Planing in the Treatment of Periodontitis

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/142011/1/jper0490.pd

Feeding Barley to Swine and Poultry

EB-7

Feeding Barley to Swine and Poultry

EB-7

Water-Resources Investigations Report 83-4213

From abstract: Suspended-sediment and bedload-transport rates for the Tanana River near Fairbanks can be related to water discharge and annual sediment loads can be computed using these relations. For a site at Fairbanks the annual loads in 1982 were 26.1 million tons of suspended sediment and 227,000 metric tons of bedload. Data collected at five other sites within a 40-kilometer reach of the river indicate very similar suspended-sediment-transport relations but bedload-transport relations varied from site to site. For all sites bedload is on the order of 1 percent of suspended-sediment load

Water-Resources Investigations Report 83-4064

From abstract: Suspended-sediment and bedload-transport rates for the Tanana River near Fairbanks, Alaska, can be related to water discharge, and annual sediment loads can be computed using these relations