Dementia Care Management in an Underserved Community: The Comparative Effectiveness of Two Different Approaches.

Objectives: To compare the effectiveness and costs of telephone-only approach to in-person plus telephone for delivering an evidence-based, coordinated care management program for dementia.

Methods: We randomized 151 patient-caregiver dyads from an underserved predominantly Latino community to two arms that shared a care management protocol but implemented in different formats: in-person visits at home and/or in the community plus telephone and mail, versus telephone and mail only. We compared between-arm caregiver burden and care-recipient problem behaviors (primary outcomes) and patient-caregiver dyad retention, care quality, health care utilization, and costs (secondary outcomes) at 6- and 12-months follow-up.

What to wear today? Effect of doctor's attire on the trust and confidence of patients.

Purpose: There are very few studies about the impact of physicians' attire on patients' confidence and trust. The objective of this study was to determine whether the way a doctor dresses is an important factor in the degree of trust and confidence among respondents.

Methods: A cross-sectional descriptive study using survey methodology was conducted of patients and visitors in the waiting room of an internal medicine outpatient clinic.

Thyroid disorders in elderly patients.

Thyroid disorders are common in the elderly and are associated with significant morbidity if left untreated. Typical symptoms may be absent and may be erroneously attributed to normal aging or coexisting disease. Physical examination of the thyroid gland may not be helpful, as the gland is often shrunken and difficult to palpate.

Evaluating concordance to American Diabetes Association standards of care for type 2 diabetes through group visits in an uninsured or inadequately insured patient population.

Objective: To evaluate the effectiveness of a managed care approach to health care delivery, group visits, in the management of uninsured or inadequately insured patients with type 2 diabetes.

Research Design And Methods: A total of 120 patients with uncontrolled type 2 diabetes were randomly assigned to receive their care in group visits or usual care for 6 months. After 6 months, concordance with 10 process-of-care indicators recommended by the American Diabetes Association (ADA) standards of care was evaluated through chart abstraction.

Evaluating group visits in an uninsured or inadequately insured patient population with uncontrolled type 2 diabetes.

Purpose: This study was conducted to evaluate the feasibility and acceptability of a managed-care approach (group visits) on delivering care to uninsured or inadequately insured patients with type 2 diabetes.

Methods: One hundred twenty patients with uncontrolled type 2 diabetes were randomly assigned to receive care in group visits or usual care for 6 months. At baseline, 3 months, and 6 months, the feasibility and acceptability of this model of healthcare delivery were assessed through the patients' responses to the Primary Care Assessment Tool and the Trust in Physician Scale.

Metastatic gastroesophageal adenocarcinoma to skeletal muscle: a unique event.

Skeletal muscle is rarely the site of metastatic cancer, though a few such cases have been reported. Esophageal adenocarcinoma metastasic to skeletal muscle has not previously been reported in the literature. We describe the case of 71-year-old African American male with stage IV adenocarcinoma of the gastroesophageal junction.