No abstract

Echinacea from retail stores often does not contain the labeled species. A claim of "standardization" does not mean the preparation is accurately labeled, nor does it indicate less variability in concentration of constituents of the herb.

Homeless youths (N = 684) in eight cities participated in this study to understand the rates and correlates of substance use. Rates of lifetime and recent substance use ranged from 66% to 90%. Variability in lifetime and recent substance use was partially explained by being white (ages 14-17); ever attempting suicide (ages 14-17); not being African American (lifetime substance use) or Hispanic (ages 18-24); being male (ages 18-24); identifying as lesbian, gay, or bisexual (ages 18-24); using substances with a parent; beginning substance use at a young age; and having a family history of a substance problem.

PURPOSE Direct-to-consumer advertising (DTCA) has increased tremendously during the past decade. Recent changes in the DTCA environment may have affected its impact on clinical encounters. Our objective was to determine the rate of patient medication inquiries and their infl uence on clinical encounters in primary care. METHODSOur methods consisted of a cross-sectional survey in the State Networks of Colorado Ambulatory Practices and Partners, a collaboration of 3 practice-based research networks. Clinicians completed a short patient encounter form after consecutive patient encounter for one-half or 1 full day. The main outcomes were the rate of inquiries, independent predictors of inquiries, and overall impact on clinical encounters. RESULTSOne hundred sixty-eight clinicians in 22 practices completed forms after 1,647 patient encounters. In 58 encounters (3.5%), the patient inquired about a specifi c new prescription medication. Community health center patients made fewer inquiries than private practice patients (1.7% vs 7.2%, P <.001). Predictors of inquiries included taking 3 or more chronic medications and the clinician being female. Most clinicians reported the requested medication was not their fi rst choice for treatment (62%), but it was prescribed in 53% of the cases. Physicians interpreted the overall impact on the visit as positive in 24% of visits, neutral in 66%, and negative in 10%.CONCLUSIONS Patient requests for prescription medication were uncommon overall, and even more so among patients in lower income groups. These requests were rarely perceived by clinicians as having a negative impact on the encounter. Future mixed methods studies should explore specifi c socioeconomic groups and reasons for clinicians' willingness to prescribe these medications.

Most physicians have negative views of DTC pharmaceutical advertising and see several potential effects of these advertisements on the physician-patient relationship. Many public respondents have similarly negative views, and only a few agree that they change their expectations of or interactions with physicians. While these advertisements may be influencing only a few consumers, it seems that the impact on physicians and their interactions with patients may be significant.

The purpose of this study was to investigate homeless youth mobile phone and social media use, to plan health promotion efforts. Nearly half (46.7%) of runaway/homeless youth in this sample (n = 181) owned a mobile phone and a majority of those devices were smart phones. Ownership did not vary significantly by shelter location, though regular use of Facebook was more prevalent among those in housing programs or camping, than those living on the streets. Over 90% of youth in the sample reported using Facebook. Such media use might facilitate parent, family, and health provider communications with homeless youth.

Rates of completely accessible LNG-EC are low in Colorado despite high rates of availability. Behind-the-counter status and proof-of-age requirements are identified as the main sources of access restriction in Colorado.

testosterone and Male to Female (MTF) patients on estrogen with or without testosterone blockers (ie. spironolactone). Patients with endocrine disorders that would predispose patients to altered metabolic profiles, including CAH and PCOS, were excluded. Previously recorded measurements of testosterone, estradiol, prolactin, and lipids were reviewed, as well as blood pressure, BMI, electrolytes, liver function tests, hemoglobin/ hematocrit, and hemoglobin A1c. Values reviewed were obtained from prior to the beginning of therapy (baseline), at 1-3 months after the initiation of therapy, at 4-6 months, and at 6 months and beyond. Repeated measures ANOVA models were used to evaluate the change in lab values and other metabolic markers over time.Results: A total of 116 adolescents were included in the study, including 72 FTM patients on testosterone and 44 MTF patients on estrogen. Of the 72 subjects on testosterone therapy, hemoglobin and hematocrit significantly increased at each subsequent visit. There was also a significant increase in BMI and lowering of HDL levels found at each visit. There was an increase in blood pressure, total cholesterol and LDL noted at the 3 month visit; however, these were not statistically significant and were noted to plateau after three months. Changes in AST/ALT, BUN/Cr, Estradiol, Prolactin, Triglycerides and HgbA1c were also not found to be statistically significant. Of note, testosterone doses above 50mg weekly were associated with a greater increase in hematocrit, systolic blood pressure and HDL compared to those receiving only 25mg every week.Of the 44 subjects on estrogen therapy, no statistically significant changes were noted to measured metabolic parameters over time. There was also no statistically significant difference in measured metabolic parameters among the different Methods of administration of estradiol (patch, oral or parenteral). There was also no significant change in potassium levels over time among the 38 subjects on concurrent spironolactone therapy.Conclusions: Testosterone use was associated with increased hematocrit levels; otherwise, cross-gender hormone administration in adolescents was not associated with significant differences in the selected metabolic parameters over time.Acknowledgement: Funding for statistical analysis is from the Medstar