New Patient Telephonic Visits

PMG Oregon currently schedules approximately 60,000 New Patient visits each year. New patients are often seen at their first visit, with very little, and/or, without most up-to-date medical information transferred to their new clinical care team. The delay or lack of information results in challenges to our clinic teams to provide the best care for our new patients. It also results in providers/care teams spending additional time entering clinical data either during the new patient appointment, after the appointment, and often additional appointments are needed to address patient problems that could be completed in the initial visit

Proceedings of the 3rd Biennial Conference of the Society for Implementation Research Collaboration (SIRC) 2015: advancing efficient methodologies through community partnerships and team science

It is well documented that the majority of adults, children and families in need of evidence-based behavioral health interventionsi do not receive them [1, 2] and that few robust empirically supported methods for implementing evidence-based practices (EBPs) exist. The Society for Implementation Research Collaboration (SIRC) represents a burgeoning effort to advance the innovation and rigor of implementation research and is uniquely focused on bringing together researchers and stakeholders committed to evaluating the implementation of complex evidence-based behavioral health interventions. Through its diverse activities and membership, SIRC aims to foster the promise of implementation research to better serve the behavioral health needs of the population by identifying rigorous, relevant, and efficient strategies that successfully transfer scientific evidence to clinical knowledge for use in real world settings [3]. SIRC began as a National Institute of Mental Health (NIMH)-funded conference series in 2010 (previously titled the “Seattle Implementation Research Conference”; $150,000 USD for 3 conferences in 2011, 2013, and 2015) with the recognition that there were multiple researchers and stakeholdersi working in parallel on innovative implementation science projects in behavioral health, but that formal channels for communicating and collaborating with one another were relatively unavailable. There was a significant need for a forum within which implementation researchers and stakeholders could learn from one another, refine approaches to science and practice, and develop an implementation research agenda using common measures, methods, and research principles to improve both the frequency and quality with which behavioral health treatment implementation is evaluated. SIRC’s membership growth is a testament to this identified need with more than 1000 members from 2011 to the present.ii SIRC’s primary objectives are to: (1) foster communication and collaboration across diverse groups, including implementation researchers, intermediariesi, as well as community stakeholders (SIRC uses the term “EBP champions” for these groups) – and to do so across multiple career levels (e.g., students, early career faculty, established investigators); and (2) enhance and disseminate rigorous measures and methodologies for implementing EBPs and evaluating EBP implementation efforts. These objectives are well aligned with Glasgow and colleagues’ [4] five core tenets deemed critical for advancing implementation science: collaboration, efficiency and speed, rigor and relevance, improved capacity, and cumulative knowledge. SIRC advances these objectives and tenets through in-person conferences, which bring together multidisciplinary implementation researchers and those implementing evidence-based behavioral health interventions in the community to share their work and create professional connections and collaborations

Age-Related Cone Abnormalities in Zebrafish with Genetic Lesions in Sonic Hedgehog

PURPOSE. Sonic hedgehog (Shh) signaling is essential for photoreceptor differentiation and retinal cell survival in embryonic zebrafish. The study was conducted to determine whether adult heterozygous carriers of mutant alleles for the shh gene display retinal abnormalities. METHODS. Retinal cryosections from young, middle-aged, and senescent wild-type and sonic-you ϩ/Ϫ (syu ϩ/Ϫ ) zebrafish were probed with retinal cell type-specific markers. Contralateral retinal flatmounts from these fish, and from adult albino zebrafish subjected to light-induced photoreceptor damage followed by regeneration, were hybridized with blue cone opsin cRNA for quantitative analysis of the blue cone pattern. Retinal expression of shh mRNA was measured by quantitative RT-PCR. RESULTS. Regions of cone loss and abnormal cone morphology were observed in the oldest syu ϩ/Ϫ zebrafish, although no other retinal cell type was affected. This phenotype was agerelated and genotype-specific. Cone distribution in the oldest syu ϩ/Ϫ zebrafish was predominantly random, as assessed by measuring the short-range pattern, whereas that of wild-type fish and the younger syu ϩ/Ϫ zebrafish was statistically regular. A measure of long-range pattern revealed atypical cone aggregation in the oldest syu ϩ/Ϫ zebrafish. The light-treated albino zebrafish displayed random cone patterns immediately after light toxicity, but showed cone aggregation on regeneration. Retinas from the syu ϩ/Ϫ fish showed reduced expression of shh mRNA compared with those of wild-type siblings. 9 In addition, Shh stimulates proliferation of rat Müller glia and the generation of rhodopsin-expressing cells in vitro, and in vivo subsequent to retinal damage. CONCLUSIONS. The The use of anamniote vertebrate models has uncovered important roles for Hedgehog signaling in the development of rod and cone photoreceptors and the RPE. In zebrafish embryos, reduction in Shh signaling through molecular, pharmacologic, or genetic techniques results in multiple retinal abnormalities including reduced rod and cone photoreceptor differentiation. Many inherited retinal degenerative diseases, including those related to age, are characterized by rod and/or cone photoreceptor death. 18 As a complement to the mouse models, zebrafish offer several advantages for studying retinal disorders. For example, zebrafish have a duplex retina with a substantial number of cone photoreceptors arranged in a precise mosaic that can be quantitatively assessed. 23 Zebrafish are also a model for aging and age-related disease

Reducing diabetes risk in American Indian women

BACKGROUND: American Indians experience high rates of type 2 diabetes. The impact of low-intensity interventions on diabetes risk among young American Indian women is unknown. DESIGN: Randomized controlled trial SETTING/PARTICIPANTS: Community-based; participants were 200 young urban American Indian women who were block-randomized on fasting blood glucose (FBG) into intervention and control groups. Inclusion criteria included self-reported identity, aged 18–40 years, not pregnant, willingness to stay in urban area for 2 years, and not having type 2 diabetes. Measures were taken at baseline, 6, 12, and 18 months. Data were gathered 2002–2006 and analyzed 2006–2007. INTERVENTION: Five discussion group sessions (one meeting per month for five months) were held focusing on healthful eating, physical activity, goal-setting, and social support.. MAIN OUTCOME MEASURES: Primary outcomes included dietary fat and vegetable consumption and self-reported physical activity. Secondary outcomes included cardiorespiratory fitness, insulin sensitivity, blood pressure, lipid profiles, percent body fat, BMI, intake of fruit, total sugar and sweetened beverages, FBG, and television viewing. RESULTS: Mean vegetable and fruit intake increased significantly more in the intervention group than in the control group over time (group by visit interaction, p=0.02 and p=0.002, respectively). Both groups had significant increases in percent body fat and decreases in waist circumference, insulin sensitivity, blood cholesterol, LDL, television viewing, and total intakes of energy, saturated fat, sugar, and sweetened beverages. CONCLUSIONS: A culturally influenced, low-intensity lifestyle intervention can improve self-reported intakes of vegetables and fruit over 18 months in young, urban American Indian women