Indexed in MEDLINE, PubMed, and PubMed Central PRSRT STD US POSTAGE National Library of Medicine PAID 500 NE Multnomah St, Suite 100 PORTLAND OR PERMIT NO 1452 Portland, Oregon 97232 Volume Change Service Requested Fall 2014 Volume 18 No. 4 18 No. 4 — Fall 2014 A peer-reviewed journal of medical science, social science in medicine, and medical humanities Original Research & Contributions 4 Mindfulness-Based Stress Reduction in an Integrated Care Delivery System: One-Year Impacts on Patient-Centered Outcomes and Health Care Utilization 10 Improving Appropriate Use of Pulmonary Computed Tomography Angiography by Increasing the Serum D-Dimer Threshold and Assessing Clinical Probability 16 Testing for Meningitis in Children with THE Bronchiolitis PERMANENTE 21 Impact of Implementing Glycated Hemoglobin Testing for Identification of Dysglycemia in Youth 29 Most Common Dermatologic Topics Published in Five High-Impact General Medical Journals, JOURNAL 1970-2012: Melanoma, Psoriasis, Herpes Simplex, Herpes Zoster, and Acne 32 Prevalence of Hypovitaminosis D and Its Association with Comorbidities of Childhood Obesity 40 A Pilot Study Comparing Anatomic Failure after Sacrocolpopexy with Absorbable or Permanent Sutures for Vaginal Mesh Attachment 45 Differences in Perceived Difficulty in Print and Online Patient Education Materials Special Reports 52 Behavior Medicine Specialist 58 Mindful Mood Balance: A Case Report of Web-Based Treatment of Residual Depressive Symptoms 64 Thinking about Thinking and Emotion: The Metacognitive Approach to the Medical Humanities that Integrates the Humanities with the Basic and Clinical Sciences Editorial 89 Healthy Behavior Change in Practical Settings Follow @PermanenteJ Printed on acid free paper. The Permanente Journal Fall 2014 Volume 18 No. 4 See inside for additional content ISSN 1552-5767 as well as articles found only online www.thepermanentejournal.org Fall 2014/ Volume 18 No. 4 The ORIGINAL RESEARCH 21 Impact of Implementing Glycated Books published by & CONTRIBUTIONS Hemoglobin Testing for Identification PermanenteJournal Permanente authors: 4 Mindfulness-Based Stress Reduction of Dysglycemia in Youth. in an Integrated Care Delivery Vinutha Vijayadeva, PhD; Gregory A Mission: The Permanente Journal advances System: One-Year Impacts on Patient- Nichols, PhD knowledge in scientific research, clinical Centered Outcomes and Health Care At both, Kaiser Permanente Hawaii and medicine, and innovative health care delivery. Utilization. Tracy McCubbin, MD; Kaiser Permanente Northwest, fasting Sona Dimidjian, PhD; Karin Kempe, plasma glucose testing was significantly Is This Normal? MD, MPH; Melissa S Glassey; Colleen more common in 2009 and HbA1C testing The Essential Guide to Circulation: 25,000 print readers per Ross, MS; Arne Beck, PhD was more common in 2012, but the Middle Age and Beyond quarter, 6900 eTOC readers, and in Mindfulness-based stress reduction (MBSR) characteristics of the overall population John Whyte, MD, MPH did not change. At both sites, the 2013, TPJ content had 1 million page programs have demonstrated clinical ef- ISBN-10: 160961450X fectiveness for both mental and physical characteristics of youth at risk of diabetes views—660,000 of those on TPJ articles changed substantially with a much greater ISBN-13: 978-1609614508 on PubMed. Viewers visited from health conditions. Less research exists on health services utilization, self-efficacy, or proportion being female and children Emmaus, PA: Rodale Press; 2012 187 countries/territories. work productivity outcomes. A prospective younger than age 10 years. The size Paperback: 272 pages single cohort design evaluated an 8-week and composition of the population $15.99 MBSR program for 38 Kaiser Permanente of youth identified with diabetes was Colorado members with chronic pain, not affected. chronic illness, or stress-related problems. 29 Most Common Dermatologic Topics Repeated measures analyzed at 8 weeks Published in Five High-Impact and 1 year showed significant improve- General Medical Journals, 1970-2012: ments in self-reported mental and physical Melanoma, Psoriasis, Herpes Simplex, function, pain, psychological symptoms, Herpes Zoster, and Acne. and self-efficacy, but not in work produc- Handbook of Anesthesia, Backlit Aspens Young M Choi; Aram A Namavar, MS; 5th edition tivity. There were also significant decreases Jashin J Wu, MD Near Monitor Pass, at 1 year for visits to: primary care, spe- John J Nagelhout, Karen L Plaus California 2012 Internists frequently diagnose herpes cialty care, and the Emergency Depart- ISBN-10: 145571125X by Stuart Hahn, MD simplex, herpes zoster, and acne, which ment, and for hospital admissions. ISBN-13: 978-1455711253 This photograph of a are also common dermatologic topics beautifully lit aspen 10 Improving Appropriate Use of published. The authors conducted an Philadelphia, PA: Saunders; 2013 grove in autumn was Pulmonary Computed Tomography independent search of the Thomson Paperback: 864 pages taken in the Sierra Angiography by Increasing the Serum Reuters’ Science Citation Index for $70.95 Nevada Mountains near D-Dimer Threshold and Assessing common dermatologic topics, limited to the border of California Clinical Probability. Sydney Char; the period 1970 to 2012. The five most and Nevada. Hyo-Chun Yoon, MD, PhD common dermatologic topics published in five high-impact general medical journals Dr Hahn retired from The Permanente A retrospective review was conducted of all patients undergoing pulmonary com- were melanoma, psoriasis, herpes simplex, Medical Group in 2010. He has been seri- herpes zoster, and acne. ously exploring photography since 2000 puted tomography angiogram during 2 and has an interest in both wildlife and separate 12-month intervals: 1 before the 32 Prevalence of Hypovitaminosis D and landscape photography. For further infor- implementation of an increased D-dimer Its Association with Comorbidities of mation about his artwork, Dr Hahn can threshold and recommendation for formal Childhood Obesity. Ronald Williams, Luck Just Happens clinical probability assessment, and the be contacted at: [email protected]. MD, FAAP, FACP; Marsha Novick, MD; Paul Crane ANNOUNCEMENT: other after regional implementation. The Erik Lehman, MS prevalence of pulmonary embolism de- ISBN-10: 1479798290 ISBN-13: 978-1479798292 tected by computed tomography angiog- We conducted a retrospective chart CME Credits Now Available for Reviewers raphy increased from 4.7% to 11.7%, but review from 155 obese children aged Bloomington, IN: XLibris; 2013 only 4% of patients had a formal clinical 5 to 19 years who attended the Penn Paperback; 182 pages probability assessment recorded in their State Children’s Hospital Pediatric $19.99 electronic medical record. Multidisciplinary Weight Loss Program from November 2009 through November The Permanente Journal is happy to announce 16 Testing for Meningitis in Children with 2010. Under the latest Institute the availability of Continuing Medical Education Bronchiolitis. Michael Stefanski, MD, of Medicine definitions, vitamin D credits for completing manuscript reviews for 93 LETTERS TO THE EDITOR MPH; Ronald Williams, MD, FAAP, deficiency (< 20 ng/mL) and insufficiency FACP; George McSherry, MD; Joseph (20-29 ng/mL) was present in 40% The Permanente Journal. Physicians are now eligible 95 BOOK REVIEWS Geskey, DO, MBA and 38% of children, respectively. African-American race, winter/spring to receive up to 15 AMA PRA Category 1 Credits 96 CME EVALUATION FORM The authors present a retrospective, case-control study of hospitalized infants season, hyperinsulinemia, elevated Crush Step 1: The Ultimate per year (3 AMA PRA Category 1 Credits per systolic blood pressure, urban location, USMLE Step 1 Review younger than age one year diagnosed manuscript). With this change, we have launched with viral bronchiolitis who underwent and total numbers of comorbidities were significantly associated with Theodore X O’Connell, lumbar puncture as part of an evaluation Ryan A Pedigo, Thomas E Blair our new For Reviewers home page on our Web site: for meningitis. The presence of apnea, hypovitaminosis D (< 30 ng/mL). Obese ISBN-10: 1455756210 cyanosis, meningeal signs, positive urine children should be considered for routine www.thepermanentejournal.org/reviewers.html. ISBN-13: 978-1455756216 culture results, and young age were fac- vitamin D screening. tors found to be preliminarily associated Philadelphia, PA: Saunders; 2013 Paperback: 680 pages The Permanente Journal with the performance of a lumbar punc- ture in the setting of bronchiolitis. Young $37.75 500 NE Multnomah St, Suite 100 age was the only significant clinical factor The Portland, Oregon 97232 found after multivariable regression; no www.thepermanentejournal.org other demographic, clinical, laboratory, PermanenteJournal or radiologic variables were found to be ISSN 1552-5767 significant. Follow @PermanenteJ If you are a Permanente author and would like your book cited here, send an e-mail to [email protected]. For information and/or rates for placing an The Permanente Journal/ Fall 2014/ Volume 18 No. 4 announcement here, please contact [email protected]. CME credits are available online at www.thepermanentejournal.org. The mail-in CME form can be found on page 96. 40 A Pilot Study Comparing Anatomic edge and experience used to treat mental system was associated with cost savings, Failure after Sacrocolpopexy with illness into the medical home to help the shorter lengths of stay, and decreased mor- Absorbable