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Top 20 Research Studies of 2012 for Primary Care Physicians

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Sources include Muster Records, secondary sources, private letters and ship records. Naturalization of Immigrants On Rantoul Street: This paper discusses the ethnic neighborhoods of Beverly off of Rantoul St.

The assimilation process and the lives of these immigrants are also researched. This student researched census records. Contains sample police reports and pay rolls. Nurses and Nuisance Removers A comparison between nuisance removers and nurses. This students also compared the ethnicities of medical employees in Beverly to that of those working throughout the U. Sources include Census results from Beverly, Beverly City Directories and secondary sources including those written by Holmes and Rothman.

Sources include the Census, Municipal documents, maps of Beverly and several secondary sources. Architectural Guide This paper is a guide to classical architecture. The examples from all different periods are found on the streets of Beverly and can be related to the goings on of the larger society not only in America but in foreign nations as well. Documents were found at the Registry of Deeds. History Of 42 Central St In Beverly The paper traces the owners of this particular home, investigates them and connects their occupations to the larger historical context.

The students sources were mainly City Directories, the and Census and a few secondary sources. Through research of former owners he discovers aspects of the past, i. Newspaper articles, city directories and documents from the Registry of Deeds were used in this research. By using city Death Records and hospital documents as well as newspaper articles the student paints a picture of life in Beverly. Occupations they held and lives they lived is researched, laborer in industry was common.

Sources include population schedules and maps. Native and Foreign Born Between Yrs: School or Working This paper investigates the working conditions of child labor in Beverly circa It researches which children work, from what socioeconomic group and age, and where they were employed using documents from the city of Beverly offices including that of census records.

Working Females This research paper investigates and researches the occupations and responsibilities of female employees. It mainly touches upon employment in the industrial areas such as the USMC. Census and USMC documents were used in the research.

Their Meaning To Themselves and Us This paper is about the movement of women to the role of educator. The student was able to link teacher lists from city directories with census records.

It also unearths some facts about how beaches were used as a means for climbing the socio-economic ladder and segregation. Sources include petitions regarding the issue and secondary sources. The student used such sources as shipping papers from local schooners, account books, census records and numerous secondary sources. Sources include records from the club researched, census records and secondary sources. It studies, with the aide of books by Katz and Vinovskis and Beverly City and School documents, those who were opposed and for a school in Beverly.

The student linked individuals who voted yes or no with the census. Sources include census and military records. The paper is part biography and analytical criticism of her work. Larcom was a Mill employee in Lowell who wrote for the companies newspaper, she went on to write famous works of poetry. Sources include newspaper articles, personal letters and works written by Lucy Larcom. Early Estates of Beverly: It focuses more, however, on the managers and workers of the estates.

Sources include census records, employment lists and newspapers. Owners, Those Whom Resided And Why Research regarding the connection of immigrant industrial workers to the cheap and efficient residence provided by boarding houses not only in Beverly put in all industrial communities. A study of the boarding house owners, typically women accustom to giving such services, cleaning cooking etc, whom rely on the house to make a living.

Census records from Beverly, scholarly journals and secondary sources by Zunz and Sennet were used in this students research. The attempts would leave prejudices of Farm summer residents and their now distant relationship with the rest of Beverly.

Sources include opinions and decisions on the issue written by local judges, Beverly Farms newspapers and a secondary source. The Farm topography was overseen by Olmstead, everything from the placement of the road and barn to the trees and shrubs planted on the facility. Sources include newspaper articles, many secondary sources, Conservative Commission maps and documents from the Registry of Deeds. It relates occurrences in Beverly to that of other nearby communities. The student used such sources as Census records, school documents and secondary sources including those written by Vinovskis and Ueda.

Lowell is a more industrialized community to the southwest of Beverly. Census records and company documents were used in the students research. Changing Roles of Women In the American Society This paper investigates the occupations, community contributions, and family roles that women played in American society. It reflects on how these roles have evolved or been replaced over the years, especially when women received more rights in the Twentieth Century.

Sources include secondary sources and census records. This paper goes into considerable depth regarding the changes and conservations of Moraine Farm and other Olmstead works. Sources include local newspaper articles and some secondary sources.

Primary sources came from the Registry of Deeds. It focuses on their occupations, places of employment and residence. Sources include city directories and census records.

It also connects this industry to the US and foreign counties industries. Sources include many captains logs, fishing journals, Census records and secondary sources. The sources the student used include newspapers from across the state, records of speeches given in the MA General Court and arguments given regarding the issue.

Swedish Immigrants and Swedish Evangelical Churches A study of Swedish immigrants and the religious institutions, which also served as social and educations centers, they established in Beverly. Lutheran, Baptist, Episcopal, Methodist, and Congregational. Church and municipal documents and city directories were used in the research. Relates this information to the Patria e Lavoro Society of Beverly to discover similarities and differences.

It analyzes the reasons assimilation and not naturalizing. Compares and contrasts immigrants in Beverly to immigrants residing in Boston and New York. Study 5 identified four studies on the treatment of mild hypertension in patients without known cardiovascular disease, and found no reduction in mortality or cardiovascular events.

These studies were of relatively short duration and were underpowered for mortality as an outcome. All studies involved drugs that are no longer prescribed in the United States.

They also included beta blockers, which are no longer considered a first-line medication for hypertension. These caveats are not important enough to negate the studies' overall findings—only enough to suggest that a small benefit to treating mild hypertension has not been ruled out, and more research is needed.

Many patients at low risk of cardiovascular disease are treated for hyperlipidemia in the United States, perhaps because the benefits are overestimated. It found that the number needed to treat was 80 to prevent one death from any cause over a year period for patients taking a statin compared with placebo. Can honey decrease nighttime cough and improve sleep in children with upper respiratory tract infection?

A teaspoonful of honey, given alone or with a noncaffeinated liquid before bed, decreases cough frequency and severity while improving the sleep of parents and the child with acute cough. Placebo also works, but not as well. Both honey and placebo give parents an active role in their child's well-being while not exposing the child to potentially harmful medicines.

The American Academy of Pediatrics recommends not giving honey to children younger than 12 months because of the rare risk of botulism. Two commonly used strep scores 15 , 16 are as effective as advertised for determining low likelihood of streptococcal pharyngitis in children and adults see an example at https: Their proper use, advocated in the United States by the Centers for Disease Control and Prevention, can decrease costs by avoiding unnecessary testing. Does use of azithromycin Zithromax increase the risk of cardiovascular death?

This is one more reason to avoid inappropriate use of antibiotics and to use amoxicillin instead of azithromycin when appropriate. Information from references 12 through The authors of study 7 Table 3 12 — 17 found that a little honey decreases the frequency of cough in children between one and five years of age, and helps parents and children sleep better. Additionally, it is safer than over-the-counter cold preparations.

For patients with sore throat, a strep score instructs physicians to assess for fever, adenopathy, exudates, and absence of cough. Study 8 indicates that using a score can help decrease costs without adversely affecting the quality of care. Macrolide antibiotics have long been known to increase the QT interval in some patients, rarely leading to arrhythmia and cardiac death. Study 9 used data from a large Medicaid database that linked information about prescriptions for azithromycin Zithromax with episodes of cardiovascular death, sudden cardiac death, and all-cause mortality.

Adults given azithromycin were matched with four patients who did not receive an antibiotic or who received an alternative antibiotic. Although there is only a small increase in the risk of death, many prescriptions for azithromycin are unnecessarily given for viral respiratory tract infections, making any serious adverse effects caused by this drug particularly unacceptable.

In patients with chronic illness complicated by depressive symptoms, is exercise effective for decreasing these symptoms? Getting patients with chronic illness on their feet and into exercise programs decreases their depressive symptoms. The response is greater in patients with higher depression scores and in patients who exercise regularly. These results apply to patients with depressive symptoms in general, not just to patients with major depressive disorder.

Can lifestyle intervention improve mobility and reduce the likelihood of disability among adults with obesity and type 2 diabetes? A fairly intensive lifestyle intervention had impressive results, with a significant reduction in disability and loss of mobility. The benefit was associated with the weight loss and the improved physical fitness. Mortality and morbidity data were not reported by the authors.

What is the usual course of acute low back pain and of persistent low back pain? Most patients with acute low back pain have significant improvement at six weeks, although some still have significant pain at one year after presentation. Information from references 18 through The value of exercise and lifestyle interventions is often underestimated.

Studies 10 and 11 Table 4 18 — 20 demonstrate that even modest exercise can reduce morbidity and mortality, and improve symptoms of depression.

Study 10 is a systematic review of 90 studies comparing exercise with nonexercise treatment in patients with chronic disease and depression. Benefit was greatest in patients with higher depression scores, but occurred in any patient with depressive symptoms. The researchers found that the number needed to treat to achieve good mobility was 18, and to avoid severe disability was Study 12 systematically reviewed the literature, identifying high-quality cohort studies of patients with back pain.

For patients with acute or subacute back pain duration of less than 12 weeks , the pain score decreased from 69 at baseline to 28 at six weeks and to 4 at one year. Disability scores decreased from 57 at baseline to 28 at six weeks and to 11 at one year. For patients with persistent back pain duration of 12 weeks to 12 months , disability scores were 51 at baseline, 28 at six weeks, and 15 at one year. What are the acceptability and cancer yield of colonoscopy and fecal occult blood testing?

Fecal occult blood testing every two years is more acceptable to patients than colonoscopy, and results in a similar cancer yield but a lower yield of advanced adenomas. Although at this point the weight of observational evidence and limited clinical trial evidence supports endoscopic screening every 10 years, for patients who are unwilling to undergo colonoscopy or who cannot afford it, fecal occult blood testing with semiquantitative fecal immunochemical testing is a good option.

Does screening for prostate cancer in asymptomatic men improve mortality? After more than a decade of follow-up from the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial, there appears to be no mortality benefit to screening asymptomatic men for prostate cancer.

Does screening for prostate cancer with PSA testing decrease prostate cancer—specific mortality? The authors of this evidence review concluded that PSA testing provides a small reduction or no reduction in prostate cancer—specific mortality and increases the risk of harm. If there is a benefit to PSA screening, it is very small.

One in eight men has a false-positive result with regular testing, leading to more testing and treatment, which is likely to be harmful. Information from references 21 through Study 13 Table 5 21 — 23 is the initial report of a large randomized trial of colorectal cancer screening comparing a fecal immunochemical test for blood in the stool every two years as opposed to the guaiac test with colonoscopy.

Testing the stool for blood and not using a rectal examination remains an important option for colorectal cancer screening. Articles about prostate cancer screening remain of great interest to primary care physicians.

There is an attendant harm of more than men who are diagnosed with and treated for prostate cancer, and several dozen men who experience incontinence, erectile dysfunction, or both.

Preventive Services Task Force recommend against the use of prostate-specific antigen testing for screening in men of any age. What is the best interval for repeat bone mineral density testing in older women? This study suggests that if the results of the initial screening test are normal or reveal only mild osteopenia in the femoral neck, the patient can wait 15 years before having a second examination. Women with moderate osteopenia should be retested five years after the initial screening, and those with severe osteopenia should consider annual testing until they are given a bisphosphonate.

What is the optimal dosage of vitamin D for fracture prevention? A dosage of IU per day is associated with a lower risk of hip and vertebral fracture among persons older than 65 years.

A higher baseline vitamin D level is also associated with lower risk of fracture, but this may be because higher levels are a marker of better health and good health habits. How do the failure rates of long-acting reversible contraception methods compare with the pill, patch, and ring? The contraceptive failure rate with intrauterine devices and implants is much lower than failure rates with contraceptive pills, patches, and rings.

The failure rate was similar to that of depot medroxyprogesterone acetate. The absolute difference in this study was approximately four pregnancies per women-years of use. Information from references 26 through Preventive Services Task Force recommends that women 65 years or older, and women who have a risk of fracture similar to or greater than that of a year-old woman, should be screened for osteoporosis.

However, an interval for subsequent screening is not specified. Women with a normal examination result or only mild osteopenia can wait 15 years between screenings, whereas those with moderate osteopenia should be retested in five years, and those with severe osteopenia should be tested annually.

Study 17 is a systematic review of patient-level data with more than 30, persons taking vitamin D. The only statistically significant reduction in the risk of hip or nonvertebral fracture was among patients taking IU or more of vitamin D per day. Study 18 is a prospective cohort study that examined unplanned pregnancy rates in women using contraception. Does the concurrent use of probiotics decrease the risk of antibiotic-associated diarrhea in adults and children? Probiotics, live organisms thought to reestablish gastrointestinal flora, are effective in decreasing the likelihood of antibiotic-associated diarrhea in adults and children.

This approach is also effective when using multiple antibiotics to eradicate Helicobacter pylori. It is not clear from this analysis whether one type of probiotic bacterium is better than another. Does watching a painful procedure increase patients' perceptions of the pain and unpleasantness?

Physicians should ask patients to look away or close their eyes before getting an injection or having blood drawn. In this experimental study, patients who received a mild electric shock experienced greater pain scores while simultaneously watching a video of a needle pricking a finger, even though they were fully aware that the video was not of their own hand. Information from references 30 and These two POEMs do not fit well into the other categories.

Study 19 Table 7 30 , 31 is a meta-analysis of 34 randomized trials with more than 3, patients that compared probiotics with placebo for the prevention of antibiotic-associated diarrhea. The study found a similar benefit from probiotics for adults and children, with a number needed to treat of about 8.

Does it hurt more to watch an injection? This clinical trial found that the pain patients experienced from an electric shock was higher when they watched a video of a needle pricking a finger. Physicians should tell patients to just look away. A few themes emerge from these 20 research studies. One is that there is value and efficiency in taking a patient-centered approach to care.

Treating low-risk patients as aggressively as high-risk patients is inappropriate, and may be harmful. Whether we are talking about control of blood glucose levels, 5 — 7 cardiovascular prevention, 8 — 10 or the interval for osteoporosis screening, 26 sometimes less testing or less treatment can be better for our patients. It is worth examining the Choosing Wisely campaign, which provides a long list of evidence-based recommendations for more efficient care, with contributions from the American Academy of Family Physicians and other specialty societies http: An editorial about the Choosing Wisely campaign, including a table of primary care—relevant recommendations, is available in American Family Physician at https: Already a member or subscriber?

Address correspondence to Mark H. Reprints are not available from the authors. This article was cowritten by Dr. Mark Ebell who is a member of the U. Ebell's dual roles and ties to Essential Evidence Plus, the concept for this article was independently reviewed and approved by a group of AFP 's medical editors.

In addition, the article underwent peer review and editing by four of AFP 's medical editors. Ebell was not involved in the editorial decision-making process.

Ebell MH, Grad R. Top 20 research studies of for primary care physicians. Finding POEMs in the medical literature. Becoming an information master: Evaluation of email alerts in practice:

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62 rows · Jan 29,  · Census records and secondary sources were used in this research project. Sarah De Cruz. 1/18/ Metal Hydrides Company’s Involvement In The Atom Bomb This paper touches upon the Metal Hydrides Company’s involvement in the Atom Bomb. Their actual contributions, labor, research,materials etc is investigated.

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Finding a Research Topic Assigned Topics. In many instances, your professor will give you a list of topics to choose from for your research paper. Since all of these topics are bound to offer plenty of sources for research, your best option in this case is to choose the topic most familiar to you.

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This is the second annual summary of top research studies in primary care. In , through regular surveillance of more than English-language clinical research journals, seven clinicians identified studies with the potential to change primary care practice, called POEMs, or . The topics are specifically organized to help you find one that will work for your project. Broad topics are headed, and then below them are narrowed topics, all to help you find an area to focus on. The way we have organized the topics for research papers can save .

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All of these results are generally primary research articles, but keep in mind that while all case studies are primary research, not all primary research is in the form of a case study, so you may be missing some primary research articles on your topic by searching this way. Management of spontaneous primary ovarian insufficiency (premature ovarian failure) The use of bisphosphonates in postmenopausal women with osteoporosis Iodine deficiency disorders.