Research Partnerships with Healthcare Providers in Rural Community Health Centers: Needs and Challenges in Diabetes Research.

Kentucky has among the highest rates of diabetes and obesity in the United States. The Kentucky Diabetes and Obesity Collaborative (KDOC) was designed to develop a novel research infrastructure that can be used by researchers focusing on obesity and diabetes among patients cared for by Federally Qualified Health Centers (FQHC) serving rural Kentucky. Focus groups were carried out to develop an understanding of the needs and interests of FQHC practitioners and staff regarding participation in KDOC.

Increased resting energy expenditure is associated with failure to thrive in infants with severe combined immunodeficiency.

Objectives: To measure resting energy expenditure (REE) and determine whether increased REE (hypermetabolism) is associated with failure to thrive (FTT) in patients with severe combined immunodeficiency (SCID) at diagnosis.

Study Design: REE was measured in 26 patients with SCID in a single transplant center. Predicted REE was determined with World Health Organization standards.

Cancer risk assessment by rural and Appalachian family medicine physicians.

Context: Challenges to the identification of hereditary cancer in primary care may be more pronounced in rural Appalachia, a medically underserved region.

Purpose: To examine primary care physicians' identification of hereditary cancers.

Methods: A cross-sectional survey was mailed to family physicians in the midwestern and southeastern United States, stratified by rural/non-rural and Appalachian/non-Appalachian practice location (n = 176).

Cardiovascular risk education and social support (CaRESS): report of a randomized controlled trial from the Kentucky Ambulatory Network (KAN).

Purpose: Test a practice-based intervention to foster involvement of a relative or friend for the reduction of cardiovascular risk in patients with type 2 diabetes.

Methods: We enrolled in a randomized controlled trial 199 patients and 108 support persons (SPs) from 18 practices within a practice-based research network. All patient participants had type 2 diabetes with suboptimal blood pressure control and were prepared to designate a SP.

Nutritional issues in infants with cancer.

Cancer and cancer therapy may have adverse effects on food intake, absorption and metabolism resulting in malnutrition. Malnutrition can adversely affect tolerance of therapy and hence overall survival. Malnutrition is of particular concern in infants and young children due to limited reserves and the effect undernutrition can play on a patient's weight gain, growth, immune function and overall well-being.

Patients, practices, and relationships: challenges and lessons learned from the Kentucky Ambulatory Network (KAN) CaRESS clinical trial.

The Cardiovascular Risk Education and Social Support (CaRESS) study is a randomized controlled trial that evaluates a social support intervention toward reducing cardiovascular risk in type 2 diabetic patients. It involves multiple community-based practice sites from the Kentucky Ambulatory Network (KAN), which is a regional primary care practice-based research network (PBRN). CaRESS also implements multiple modes of data collection.

How and why to study the practice content of a practice-based research network.

Background: We describe the rationale, methods, and important lessons learned from doing a practice content study in a new practice-based research network (PBRN).

Methods: We performed a modified replication of the National Ambulatory Medical Care Survey (NAMCS) in the Kentucky Ambulatory Network (KAN). Network clinicians had input into focused modifications of the NAMCS protocol, including addition of data fields of special interest to them.