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Biomedical subjects

B Rubin

Publications and source records attributed to B Rubin.

At least 217 records · Page 12Linked to original sources

Clinician compliance with primary prevention of tobacco use: the impact of social contingencies.

BACKGROUND: This study evaluated clinicians' compliance with delivering written advice and information against tobacco use (prevention prescriptions) to adolescent patients. METHODS: Clinicians in 77 orthodontic offices were trained (and asked) to provide anti-tobacco counseling and prescriptions to 10- to 18-year-olds for 2 years. Each of eight prescriptions was provided for distribution to adolescent patients. Information concerning prescription-tracking methods and operant learning theory variables such as modeling and feedback was obtained using a cross-sectional interview of clinical staff. The proportion of prescriptions written was regressed on possible "determinants." Analyses were replicated for two time periods. RESULTS: Mean anti-tobacco prescription compliance was 66 and 73% for two separate time periods. Multiple regression analyses were computed for the first (R = 0.45, F(7,63) = 2.29, P < 0.001) and second (R = 0.48, F(7,63) = 2.76, P < 0.001) time periods. Prescription tracking and praise from patients were significant correlates for the first time period; praise and modeling were significant for the second time period. Twenty and twenty-three percent, respectively, of the variance in office prescription rate was explained. CONCLUSIONS: Results suggest that compliance with primary prevention procedures may be influenced by feedback from patients, staff modeling, and formal office tracking information.

Adolescent↗

Comparison of the efficacy and safety of oxaprozin and nabumetone in the treatment of patients with osteoarthritis of the knee.

This multicenter, 6-week, double-blind, placebo-controlled, parallel-group study compared the efficacy and safety of oxaprozin 1200 mg once daily with that of nabumetone 1000 mg once daily in patients with moderate-to-severe osteoarthritis (OA) of the knee. To be eligible, patients had to experience a flare of OA within 2 weeks of discontinuing their usual OA medication (nonsteroidal anti-inflammatory drug or analgesic). Eligible patients were assessed at baseline and then randomized to receive oxaprozin (n = 109), nabumetone (n = 110), or placebo (n = 109). Efficacy assessments were performed at weeks 1, 2, 4, and 6. Primary efficacy variables included knee pain on weight bearing, knee pain on motion, and patient's and physician's global assessments of OA. Secondary efficacy variables included pain intensity, time to walk 50 feet, and duration of morning stiffness. Safety was evaluated by use of routine laboratory analyses; physical examination at screening, baseline, and week 6 (or study termination); assessment of symptoms at baseline and at each visit; and testing stools for occult blood at screening and between week 4 and the final visit. Adverse events were monitored throughout the study. Between-group differences in efficacy variables were evident by week 1. The mean change in improvement from baseline with oxaprozin compared with placebo was statistically significant in favor of oxaprozin at weeks 1, 2, 4, and 6 for all primary efficacy variables. The mean change in improvement from baseline with nabumetone compared with placebo, however, was statistically significant only at week 1 for knee pain on motion, patient's global assessment, and physician's global assessment. The mean change in improvement from baseline was statistically significant (P < or = 0.035) in favor of oxaprozin versus nabumetone at weeks 2 and 6 for all four primary efficacy variables and also at week 4 for knee pain on motion. The incidence of adverse clinical events between treatment groups was not statistically significant. However, nine oxaprozin-treated patients had asymptomatic liver enzyme elevations reported as adverse events. Four of these patients had reversible elevations of aspartate aminotransferase and alanine aminotransferase greater than three times the upper limit of normal range (P < 0.05); two of these patients were taking other medications known to induce liver enzyme abnormalities. The study showed that oxaprozin 1200 mg once daily was statistically significantly more efficacious than nabumetone 1000 mg once daily for the treatment of patients with moderate-to-severe OA of the knee. Both drugs were clinically well tolerated.

Aged↗