Academic Health Centers and Humanitarian Crises: One Health System's Response to Unaccompanied Children at the Border.

University of California Health (UCH) provided a system-wide, rapid response to the humanitarian crisis of unaccompanied children crossing the southern U.S. border in the midst of the COVID-19 pandemic in 2021.

Creating a standard inpatient opioid withdrawal protocol.

Despite safety and efficacy of medications for opioid use disorder, United States (US) hospitals face high health care costs when hospitalized patients with opioid use disorder (OUD) leave due to untreated opioid withdrawal.  Recent studies have concluded that evidence-based interventions for OUD like buprenorphine are underutilized by hospital services. We developed a practical opioid withdrawal protocol utilizing buprenorphine and the Clinical Opiate Withdrawal Scale to address opioid withdrawal during inpatient treatment of a primary medical condition.

Using Virtual Visits to Care for Primary Care Patients With COVID-19 Symptoms.

Purpose: Examine use of office resources by primary care patients who were initially evaluated through telehealth, telephone, or in-person encounters.

Methods: Retrospective electronic health record review on patients seen in March 2020 for evaluation of potential COVID-19 symptoms, to assess the total number of interactions with physicians and office staff.

Results: Of 202 patients, 89 (44%) had initial telehealth, 55 (27%) telephone, and 52 (26%) in-person encounters.

Effectiveness of a smartphone application for weight loss compared with usual care in overweight primary care patients: a randomized, controlled trial.

Background: Many smartphone applications (apps) for weight loss are available, but little is known about their effectiveness.

Objective: To evaluate the effect of introducing primary care patients to a free smartphone app for weight loss.

Design: Randomized, controlled trial.

Utilizing international medical graduates in health care delivery: brain drain, brain gain, or brain waste? A win-win approach at University of California, Los Angeles.

After identifying many unlicensed Hispanic international medical graduates (IMGs) legally residing in southern California, University of California, Los Angeles developed an innovative program to prepare these sidelined physicians to enter family medicine residency programs and become licensed physicians. On completion of a 3-year family medicine residency-training program, these IMGs have an obligation to practice in a federally designated underserved community in the state for 2 to 3 years. As the US health care system moves from physician-centered practices to patient-focused teams, with primary care serving as the foundation for building patient-centered medical homes, attention to educating IMGs in these concepts is crucial.

Health information technology: medical record documentation issues in the electronic era.

This article outlines the regulatory movement propelling physicians into the electronic health record environment and the subsequent emergence of quality issues in the medical record. There are benefits and downside risks for implementing electronic health records as part of the desire of a practice or institution to build patient-centered medical homes. The intersection of how a practice or institution collects and reports quality metrics using health information technology and subsequently submits claims for services rendered has created unforeseen challenges for which leadership must be aware and address proactively.

Opportunities to improve clinical outcomes and challenges to implementing clinical pharmacists into health care teams.

Improving patient care outcomes is achieved through communication, collaboration, and coordination of care between various health care professionals in all health care practice settings. The foundation of this patient-centered model approach includes the recognition of pharmacists as drug therapy experts and, therefore, as members of the health care team who provide a unique set of knowledge and skills. This article focuses on improving clinical outcomes by integrating clinical pharmacists into health care teams, and addresses the obstacles and solutions to achieving this goal.

Integration of behavioral medicine in primary care.

The health care system in the United States is inefficient and there are many incentives for sustainable changes in the delivery of care. Incorporating behavioral medicine offers a wide range of opportunities. Within primary care settings, pain disorders, addiction, depression, and anxiety disorders are highly prevalent.

Double-blind placebo-controlled evaluation of the PROMETA™ protocol for methamphetamine dependence.

Aims: To evaluate the efficacy and safety of the PROMETA™ Protocol for treating methamphetamine dependence.

Design: A double-blind, placebo-controlled 108-day study with random assignment to one of two study conditions: active medication with flumazenil (2 mg infusions on days 1, 2, 3, 22, 23), gabapentin (1200 mg to day 40) and hydroxazine (50 mg to day 10) versus placebo medication (with active hydroxazine only).

Setting: Three substance abuse treatment clinics: two in-patient, one out-patient.

Eight years of building community partnerships and trust: the UCLA family medicine community-based participatory research experience.

Acknowledging the growing disparities in health and health care that exist among immigrant families and minority populations in large urban communities, the UCLA Department of Family Medicine (DFM) sought a leadership role in the development of family medicine training and community-based participatory research (CBPR). Performing CBPR requires that academic medicine departments build sustainable and long-term community partnerships. The authors describe the eight-year (2000-2008) process of building sustainable community partnerships and trust between the UCLA DFM and the Sun Valley community, located in Los Angeles County.

Bupropion hydrochloride versus placebo, in combination with cognitive behavioral therapy, for the treatment of cocaine abuse/dependence.

Bupropion hydrochloride is a dopamine and norepinephrine reuptake inhibitor which may be an effective treatment for cocaine dependence due to its ability to reverse deficits in dopaminergic functioning that occur in chronic cocaine users. We performed a randomized, double-blind, placebo controlled trial comparing outpatient treatment with bupropion (N = 37) and placebo (N = 33) in combination with standard cognitive behavioral therapy. There were no statistically significant differences between bupropion and placebo in treatment outcomes, including aggregate measures of urine drug screen results (Joint Probability Index at 16 weeks: 0.