Band 117, Heft 5

Context Previous studies of the Complete Health Improvement Program (CHIP) have demonstrated short-term improvements in select metabolic and cardiovascular biomarkers in community-based programs. However, less is known about the benefits of an employer-funded lifestyle intervention program. Objectives To determine if participation in employer-provided CHIP would result in improvements in short-term metabolic and cardiovascular biomarkers, and to compare the results of the current study to a larger national study. Methods This observational study evaluated metabolic and cardiovascular biomarker changes in employer health insurance beneficiaries enrolled in CHIP between August 2012 and November 2014. Body mass index; blood pressure (systolic and diastolic); total cholesterol, low-density lipoprotein, high-density lipoprotein, fasting plasma glucose, and triglyceride levels; and weight were measured at baseline and after CHIP. Results Of 160 employees enrolled in CHIP, 115 women and 45 men agreed to participate in the study. Overall, the participants demonstrated significant reductions in body mass index, from a baseline average of 31.5 to a post-CHIP average of 30.5 ( P <.001), systolic blood pressure from 124.5 to 119.4 mm Hg ( P =.017), diastolic blood pressure from 77.3 to 74.5 mm Hg ( P =.046), total cholesterol from 186.0 to 168.8 mg/dL ( P <.001), low-density lipoprotein from 112.9 to 99.3 mg/dL ( P <.001), high-density lipoprotein from 48.8 to 46.4 mg/dL ( P <.001), and fasting plasma glucose from 100.8 to 96.5 mg/dL ( P <.001). Conclusion When funded by an employer, CHIP demonstrated short-term improvements in select metabolic and cardiovascular biomarkers. Future studies will analyze these data to determine whether these findings translate into subsequent decreased employee absenteeism and reduced beneficiary health claims.

Vitamin D deficiency has been identified as a common metabolic/endocrine abnormality. Despite known dietary sources of vitamin D and the role of sunlight in its production, much of the US population may have inadequate levels of serum 25-hydroxyvitamin D. Deficiency of vitamin D can be caused by a variety of health conditions, but studies on the effects of vitamin D supplements have had mixed results. This evidence-based clinical review discusses what is currently known about vitamin D and what areas need further research to clarify its role in health and disease.

Chronic pain reduces quality of life and productivity, costing billions in health care dollars and lost revenue. Physicians routinely prescribe opioids, which has led to opioid addiction and overdose. The US surgeon general recommends nonpharmacologic treatment for patients with chronic pain. A paradigm shift is necessary for patients to partner with physicians to take control of their own health. This article outlines the cognitive behavioral approaches, nonopioid therapies, and nonpharmacologic therapies that osteopathic physicians can integrate in their treatment of patients with chronic pain.

The physician shortage in Oklahoma coupled with geographic maldistribution of primary care physicians limits access to care in rural and underserved areas. One of the most effective strategies to recruit and retain physicians in rural areas is to create undergraduate and graduate medical education training sites in these locations. Oklahoma State University Center for Health Sciences College of Osteopathic Medicine has implemented a rural training program that begins with early recruitment of rural high school students, introduces medical students to rural practice options through rural clinical training opportunities, and provides opportunities to remain in rural Oklahoma for residency training through ongoing graduate medical education development. The purpose of this article is to provide a case study of the development of the college's Rural Medical Track. Preliminary findings indicate that rural-based clinical training for third- and fourth-year students strengthens performance on standardized tests.

An aging population and expansion of health care coverage under the Patient Protection and Affordable Care Act have led to a predicted deficit of primary care physicians by 2025. In response, medical schools must develop new strategies to identify students early in their educational pathways to encourage exploration of careers in science, technology, engineering, and mathematics (STEM) fields, especially medicine. Oklahoma State University Center for Health Sciences developed 2 internship programs, Oklahoma Science Training and Research Students (OKStars) and Native OKStars, to introduce high school students to osteopathic medicine. Native OKStars was designed to encourage Native American students, who are underrepresented in STEM fields, to pursue osteopathic medicine. These programs provided students with a 6-week immersion in biomedical research, along with weekly discussion groups with mentors. Participant questionnaire responses suggested that these programs were effective in introducing them to careers in osteopathic medicine as well as other STEM fields.