North East Medical Services

Stockton, CA, United States

North East Medical Services

Stockton, CA, United States
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Chen J.-L.,University of California at San Francisco | Kwan M.,North East Medical Services | Liu K.,North East Medical Services | Yu F.,San Francisco State University
Journal of Pediatric Nursing | Year: 2015

Childhood obesity is one of the most prevalent public health concerns. Method: A pre and post study design was used to explore the efficacy of an obesity prevention program.Children had weight, height, blood pressure, and waist circumference measured, and completed self-reported questionnaires on food intake, knowledge, self-efficacy, and health-related quality of life. Parents completed demographic and acculturation surveys. Results: Seventy children participated in the study. Results demonstrated significant reduction of BMI, systolic blood pressure, and fast food consumption and improvement of self-efficacy, knowledge, and quality of life. Discussion: Childhood obesity intervention is feasible and has short-term efficacy. © 2015 Elsevier Inc.


Chen J.-L.,University of California at San Francisco | Kwan M.,North East Medical Services
Clinical Pediatrics | Year: 2015

A pretest and posttest study design was used to test a healthy weight management intervention with overweight and/or obese Chinese American children. Children attended 8-weekly small group sessions while parents attended a single 2-hour parent workshop. Children had their weight, height, blood pressure, waist and hip circumference, and fast lipids data assessed and completed several questions questionnaires regarding food choices, self-efficacy, and knowledge at baseline, 2 months, and 6 months. Parents completed questionnaires regarding demographic, acculturation level and family environment. We found significant reduction of body mass index, waist/hip ratio, systolic blood pressure and improvement of child's eating style, physical activity knowledge, self-efficacy, and children's quality of life at 6-month follow-up. In addition, significant improvement of high-density lipoprotein cholesterol and decrease in triglyceride were found at 6-month follow-up. Improvement of nutrition self-efficacy and decreased stimulus environment were associated with decreased body mass index in overweight and obese Chinese American children. © SAGE Publications.


Kwan C.M.L.,University of California at San Francisco | Mullan J.T.,University of California at San Francisco | Chun K.M.,University of San Francisco | Kwong Y.,Donaldina Cameron House | And 2 more authors.
Clinical Gerontologist | Year: 2014

This study examined whether social relationships were linked to health among Chinese Americans with diabetes, and whether age moderated these links given the norm of respect for the elderly. Chinese American immigrants with type 2 diabetes (n= 163) provided questionnaire and laboratory data. Relationships were assessed with diabetes family instrumental support, emotional support, and conflicts, as well as general support. Health was assessed with subjective health, depressive symptoms, and glucose regulation. When relationship predictors were examined simultaneously, more conflicts and less general support were associated with more depressive symptoms, after adjusting for covariates. More emotional support was associated with better glucose regulation only for midlife, not older, participants. Findings underscore cultural and life-stage considerations in studying social determinants of health. Copyright © Taylor & Francis Group, LLC.


Chen J.-L.,University of California at San Francisco | Kwan M.,North East Medical Services | Mac A.,University of California at San Francisco | Chin N.-C.,University of California at San Francisco | Liu K.,North East Medical Services
Journal of Immigrant and Minority Health | Year: 2013

Children who are ethnic minorities, low income and live in urban neighborhoods are at higher risk for obesity. This study examined the feasibility and efficacy of a primary care-based and community partnered obesity intervention in Chinese American children. An experimental design with a historical comparison group was used to explore the feasibility of an obesity intervention for overweight Chinese American children, ages 7-12. Data were collected on weight, height, blood pressure, waist circumference, physical activity, food intake, knowledge, and self-efficacy about diet and physical activity at baseline, 2 months, and 6 months post-baseline. Significant improvements in BMI, blood pressure, and nutrition knowledge and self-efficacy were found in the intervention group. Intervention group reduced their BMI compared to the comparison group (F = 8.65, p =.004). An obesity intervention in primary care setting is feasible and demonstrates a short-term effect on weight loss in Chinese American children. © 2013 Springer Science+Business Media New York.


Burman B.E.,University of California at San Francisco | Mukhtar N.A.,University of California at San Francisco | Toy B.C.,University of California at San Francisco | Nguyen T.T.,University of California at San Francisco | And 8 more authors.
Digestive Diseases and Sciences | Year: 2014

Background: Hepatitis B (HBV) is prevalent in certain US populations and regular HBV disease monitoring is critical to reducing associated morbidity and mortality. Adherence to established HBV monitoring guidelines among primary care providers is unknown. Aims: The purpose of this study was to evaluate HBV disease monitoring patterns and factors associated with adherence to HBV management guidelines in the primary care setting. Methods: Primary providers within the San Francisco safety net healthcare system were surveyed for HBV management practices, knowledge, attitudes, and barriers to HBV care. Medical records from 1,727 HBV-infected patients were also reviewed retrospectively. Results: Of 148 (45 %) responding providers, 79 % reported ALT and 44 % reported HBV viral load testing every 6-12 months. Most providers were knowledgeable about HBV but 43 % were unfamiliar with HBV management guidelines. Patient characteristics included: mean age 51 years, 54 % male and 67 % Asian. Within the past year, 75 % had ALT, 24 % viral load, 21 % HBeAg tested, and 40 % of at-risk patients had abdominal imaging for HCC. Provider familiarity with guidelines (OR 1.02, 95 % CI 1.00-1.03), Asian patient race (OR 4.18, 95 % CI 2.40-7.27), and patient age were associated with recommended HBV monitoring. Provider HBV knowledge and attitudes were positively associated, while provider age and perceived barriers were negatively associated with HCC surveillance. Conclusions: Comprehensive HBV disease monitoring including HCC screening with imaging were suboptimal. While familiarity with AASLD guidelines and patient factors were associated with HBV monitoring, only provider and practice factors were associated with HCC surveillance. These findings highlight the importance of targeted provider education to improve HBV care. © 2013 Springer Science+Business Media New York.


PubMed | University of California at San Francisco, North East Medical Services and San Francisco State University
Type: Journal Article | Journal: Journal of pediatric nursing | Year: 2015

Childhood obesity is one of the most prevalent public health concerns.A pre and post study design was used to explore the efficacy of an obesity prevention program. Children had weight, height, blood pressure, and waist circumference measured, and completed self-reported questionnaires on food intake, knowledge, self-efficacy, and health-related quality of life. Parents completed demographic and acculturation surveys.Seventy children participated in the study. Results demonstrated significant reduction of BMI, systolic blood pressure, and fast food consumption and improvement of self-efficacy, knowledge, and quality of life.Childhood obesity intervention is feasible and has short-term efficacy.


This study examines the relationship between the anatomical location of traditional acupuncture points and their clinical indications as stated in two textbooks of traditional Chinese medicine (TCM). The following relationships are noted: (1) The acupuncture points in the trunk and their stated effects on the internal organs in the trunk have a segmental relationship-that is, acupuncture points within certain spinal segments in the trunk affect the functioning of the organs that receive autonomic innervation from the same spinal segments. This is consistent with the concept of segmental acupuncture and the idea that acupuncture may act via the somatic sympathetic refl ex with a spinal pathway to affect the trunk organs. (2) The acupuncture points in the trunk and extremities have a musculoskeletal effect that is local or regional, but not distal. This is consistent with some of the models of acupuncture mechanisms on musculoskeletal effects in the Western medical acupuncture approach. (3) The acupuncture points on the head and neck preferentially affect the nearest organ. This presumably refl ects the belief in TCM that acupuncture can somehow regulate the functioning of the proximal organ. No clear relationship can be identifi ed between the myotome level of the acupuncture points in the extremities and their non-musculoskeletal clinical indications.


Cheng K.J.,North East Medical Services
JAMS Journal of Acupuncture and Meridian Studies | Year: 2014

This paper presents some previously proposed neurobiological mechanisms on how acupuncture may work in some clinical applications from a clinician's perspective. For the treatment of musculoskeletal conditions, the proposed mechanisms included microinjury, increased local blood flow, facilitated healing, and analgesia. Acupuncture may trigger a somatic autonomic reflex, thereby affecting the gastric and cardiovascular functions. Acupuncture may also change the levels of neurotransmitters such as serotonin and dopamine, thereby affecting the emotional state and craving. This mechanism may form the basis for the treatment of smoking cessation. By affecting other pain-modulating neurotransmitters such as met-enkephalin and substance P along the nociceptive pathway, acupuncture may relieve headache. Acupuncture may affect the hypothalamus pituitary axis and reduce the release of the luteinizing hormone in the treatment of polycystic ovary syndrome. In addition, two other approaches to the acupuncture mechanism, the fascia connective tissue network and the primo vascular system, are briefly reviewed. Finally, the idea of true versus sham acupuncture points, which are commonly used in clinical trials, is examined because the difference between true and sham points does not exist in the neurobiological model. © 2013 .


PubMed | North East Medical Services
Type: Journal Article | Journal: Acupuncture in medicine : journal of the British Medical Acupuncture Society | Year: 2011

This study examines the relationship between the anatomical location of traditional acupuncture points and their clinical indications as stated in two textbooks of traditional Chinese medicine (TCM). The following relationships are noted: (1) The acupuncture points in the trunk and their stated effects on the internal organs in the trunk have a segmental relationship--that is, acupuncture points within certain spinal segments in the trunk affect the functioning of the organs that receive autonomic innervation from the same spinal segments. This is consistent with the concept of segmental acupuncture and the idea that acupuncture may act via the somatic sympathetic reflex with a spinal pathway to affect the trunk organs. (2) The acupuncture points in the trunk and extremities have a musculoskeletal effect that is local or regional, but not distal. This is consistent with some of the models of acupuncture mechanisms on musculoskeletal effects in the Western medical acupuncture approach. (3) The acupuncture points on the head and neck preferentially affect the nearest organ. This presumably reflects the belief in TCM that acupuncture can somehow regulate the functioning of the proximal organ. No clear relationship can be identified between the myotome level of the acupuncture points in the extremities and their non-musculoskeletal clinical indications.


PubMed | North East Medical Services
Type: Journal Article | Journal: Journal of acupuncture and meridian studies | Year: 2014

This paper presents some previously proposed neurobiological mechanisms on how acupuncture may work in some clinical applications from a clinicians perspective. For the treatment of musculoskeletal conditions, the proposed mechanisms included microinjury, increased local blood flow, facilitated healing, and analgesia. Acupuncture may trigger a somatic autonomic reflex, thereby affecting the gastric and cardiovascular functions. Acupuncture may also change the levels of neurotransmitters such as serotonin and dopamine, thereby affecting the emotional state and craving. This mechanism may form the basis for the treatment of smoking cessation. By affecting other pain-modulating neurotransmitters such as met-enkephalin and substance P along the nociceptive pathway, acupuncture may relieve headache. Acupuncture may affect the hypothalamus pituitary axis and reduce the release of the luteinizing hormone in the treatment of polycystic ovary syndrome. In addition, two other approaches to the acupuncture mechanism, the fascia connective tissue network and the primo vascular system, are briefly reviewed. Finally, the idea of true versus sham acupuncture points, which are commonly used in clinical trials, is examined because the difference between true and sham points does not exist in the neurobiological model.

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