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OBJECTIVE To assess racial differences in diabetes processes and intermediate outcomes of care in an internal medicine, patient-centered medical home (PCMH) group practice. RESEARCH DESIGN AND METHODS We conducted a retrospective cohort study of 1,457 adults with diabetes receiving care from 89 medical providers within a PCMH-designated academic practice between 1 July 2009 and 31 July 2010. We used mixed models to assess independent associations between patient race (non-Hispanic white or black) and 1) receipt of processes of care (A1C and LDL testing, foot and retinal examination, and influenza and pneumococcal vaccination) and 2) achievement of intermediate outcomes (LDL <100 mg/dL, blood pressure [BP] <140/90 mmHg, A1C <7.0% [<53 mmol/mol], and A1C >9.0% [>75 mmol/mol]), controlling for sociodemographic factors, health status, treatment intensity, and clinical continuity. RESULTS Compared with non-Hispanic white patients, black patients were younger, were more often single, had lower educational attainment, and were less likely to have commercial insurance. In unadjusted analyses, fewer black patients received a retinal examination and influenza vaccination during the study period or any lifetime pneumococcal vaccination (P < 0.05 [all comparisons]). Fewer black patients achieved an LDL <100 mg/dL, BP <140/90 mmHg, or A1C <7.0% (<53 mmol/mol), while more black patients had an A1C >9.0% (>75 mmol/mol) (P < 0.05 [all comparisons]). In multivariable models, black patients were less likely to receive A1C testing (odds ratio [OR] 0.57 [95% CI 0.34-0.95]) or influenza vaccination (OR 0.75 [95% CI 0.57-0.99]) or to achieve an LDL <100 mg/dL (OR 0.74 [95% CI 0.55-0.99]) or BP <140/90 mmHg (OR 0.64 [95% CI 0.49-0.84]). CONCLUSIONS Racial differences in processes and intermediate outcomes of diabetes care were present within this PCMH-designated practice, controlling for differences in sociodemographic, clinical, and treatment factors. [ABSTRACT FROM AUTHOR]

The article reports on a study related to the incidence of adenocarcinoma of the lung (ADL) in the U.S. It has been reported in the study that a continuous decline of ADL began in the U.S. in 1999. It has been found that declining incidence rate of ADL was 14% in men and 8% in women from 1999 through 2003. The study has also found that rates declined progressively among persons born after 1934 for both genders.

The synoptic patterns and boundary layer conditions over a range of antecedent periods associated with the summertime hot events for the years 1951–93 are examined. A hot event is defined as a single day with the highest average daily temperature within a surrounding 5-day window. Among these events, four event subtypes were determined on the basis of extreme values of temperature and/or dewpoint. Composite synoptic maps and vertical profiles of atmospheric variables are produced to distinguish the hottest and moistest events. The hot events, including the extreme categories, are influenced by similar large-scale circulation features. The region is under the control of the Bermuda high, which is centered off the coast of Florida and in the Atlantic Ocean. An upstream 500-hPa ridge produces subsidence and adiabatic warming in the midlevels of the troposphere. Composite patterns of the hottest and moistest events indicate stronger upstream 500-hPa ridging and upper-level subsidence, which suggest greater suppression of local convection and reduction in the upward turbulence transfer of surface sensible heat and water vapor. The moistest events are tied to considerably greater antecedent precipitation, which suggests increased evapotranspiration and accumulation of water vapor near the ground. The extreme hot and humid events are also associated with greater accumulated precipitation hours in the antecedent periods, especially on a 30-day scale. The hottest events also have less sky cover in the 30-day antecedent period, allowing more insolation and surface heating. The extreme events also have greater atmospheric thickness, lighter winds, and greater westerly component in the winds. Synoptic analysis shows that low-level thermal and moisture advection are not significant contributors to the heat and moisture in the extreme events of the Piedmont region. [ABSTRACT FROM AUTHOR]