A Pilot Study Ludington-Hoe, Susan M.; Gittner, Lisaann S.; Haller, Harold S.
Clinical pediatrics,
06/2013, Letnik:
52, Številka:
6
Journal Article
Recenzirano
Aim. To determine if growth patterns in healthy infants can identify associations with obesity at age 5 years. Method. Body mass index growth patterns from birth to 1 year were described for cohorts ...of children who were classified at 5 years as normal weight (n = 61), overweight (n = 47), obese (n = 41), and morbidly obese (n = 72). A longitudinal analysis of body mass index means based on the age postbirth was conducted and graphed. Results. Distinctions in growth patterns were evident before 1 year postbirth. Children who were normal weight at 5 years demonstrated a growth pattern in the first year that differed from children who were overweight, obese, or morbidly obese at 5 years. Conclusions. Obesity growth patterns were seen in infancy and are clinically important because identification of infants who do not fit a normal weight pattern can occur and thus guide individualized interventions in the first year postbirth while precursors of later health are still forming.
Delivery of primary care preventative services can be significantly increased utilizing Six Sigma methods. Missed preventative service opportunities were compared in the study clinic with the ...community clinic in the same practice. The study clinic had 100% preventative services, compared with only 16.3% in the community clinic. Preventative services can be enhanced to Six Sigma quality when the nurse executive and medical staff agree on a single standard of nursing care executed via standing orders.
The purpose of this paper is to report the patients' perspective of effective healthcare encounter communication strategies and to propose a structured communication tool to enhance communication ...with their healthcare providers. The Chronic Care Model, a framework that has guided research to improve patient outcomes for the last 20 years, is a shift in the approach to care that moves from a reactive acute-illness focus to a systems approach in which patients are active in managing their care supported by the healthcare team. Integral to the Chronic Care Model is the concept of self-management. The literature on communication skills to enhance the patient and provider relationship has focused primarily on the enhancement of the provider skill set. Consequently, empowerment of patients to improve communication with healthcare providers is an important component in ensuing self-management of chronic conditions.
Celotno besedilo
Dostopno za:
BFBNIB, CEKLJ, DOBA, IZUM, KILJ, NMLJ, NUK, PILJ, PNG, SAZU, UILJ, UKNU, UL, UM, UPUK, VSZLJ
Background. Breast cancer is the most common cancer in women. Disparities in some characteristics of breast cancer patients and their survival data for six randomly selected states in the US were ...examined. Materials and Methods. A probability random sampling method was used to select the records of 2,000 patients from each of six randomly selected states. Demographic and disease characteristics were extracted from the Surveillance Epidemiology and End Results (SEER) database. To evaluate relationships between variables, we employed a Cox Proportional Regression to compare survival times in the different states. Results. Iowa had the highest mean age of diagnosis at 64.14 years (SE=0.324) and Georgia had the lowest at 57.97 years (SE=0.313). New Mexico had the longest mean survival time of 189.09 months (SE=20.414) and Hawaii the shortest at 119.01 (SE=5.394) months, a 70.08-month difference (5.84 years). Analysis of stage of diagnosis showed that the highest survival times for Whites and American Indians/Alaska Natives were for stage I cancers. The highest survival times for Blacks varied. Stage IV cancer consistently showed the lowest survival times. Conclusions. Differences in breast cancer characteristics across states highlight the need to understand differences between the states that result in variances in breast cancer survival.
Nearly one in five Americans are from medically or socially disenfranchised communities and are at risk of not having their basic health needs met. For these individuals, full engagement in their ...healthcare decisions is difficult at best and at worst. Communication difficulties arise frequently and have been the focus of many efforts seeking to 'fix' it rather than to explore why patients lose their Voice. Voice is the patient's ability to express themselves and feel heard and understood in the healthcare arena. As the authors re-read the themes that emerged in the primary analysis of the transcripts from our focus groups, it became clear that participants' perception of being heard, of having Voice, was very important to them. Perhaps they identified two major themes: Barriers to Voice and Traits -- system, provider and patient. From this work, they found that they needed a way to teach patients to re-gain their Voice in interactions with healthcare providers.
Celotno besedilo
Dostopno za:
BFBNIB, CEKLJ, DOBA, IZUM, KILJ, NMLJ, NUK, PILJ, PNG, SAZU, UILJ, UKNU, UL, UM, UPUK, VSZLJ
Objectives. We explored barriers to healthcare as perceived by members of medically and socially disenfranchised communities. Methods. We conducted focus groups with 28 women and 32 men from ...Northeast Ohio who identified themselves as African-American, Hispanic/Latino, lesbian/gay/bisexual/transgendered, and/or Russian immigrant. Results. Participants described their experiences of waiting, things they won't tolerate, when they won't participate, and what they want from providers. They described behaviors, actions and relationship characteristics that they want from their providers and characteristics that they prefer in health systems. Conclusions. The themes of Wait, Won't, and Want have healthcare practice and policy implications. Patient-provider interactions are known to be significant determinants of healthcare outcomes and these exploratory findings suggest that they might also affect patient self-management strategies. Future efforts should focus on developing and testing patient-centered strategies that address the themes identified to increase engagement to increase self-management of health.
Celotno besedilo
Dostopno za:
BFBNIB, CEKLJ, DOBA, IZUM, KILJ, NMLJ, NUK, PILJ, PNG, SAZU, UILJ, UKNU, UL, UM, UPUK, VSZLJ
This paper presents a new procedure that uses spatial statistics to identify clusters of counties having either a high or low incidence of a disease (dependent variable). These counties provide a ...spatial snapshot that describes the disease in the study area. Using this spatial snapshot as a reference, the procedure evaluates potential factors (independent variables) sorted out by the degree of similarity with the disease when comparing spatial snapshots. The greater the similarity, the greater the likelihood for a causal relationship. Similarity also can facilitate the selection of variables to be considered rather than relying only on the researcher's expertise. In particular, the procedure is used to analyze Cardiovascular Disease at the county level for the contiguous 48 states using the Public Health Exposome, a data repository of environmental factors to which a given group of people may be exposed over the course of their lifetime and that may impact their health. The proposed procedure enables the analysis of a study area with a large number of regions, such as entire countries, but is able to go to the level of detail of a smaller area, such as a county. In contrast, researchers may limit their work to a small number of regions due to computational and analytical limitations. In addition, the procedure yields a ranking of independent variables according to their effect on the dependent variable. In the past Public Health researchers reported that analytical approaches required days of extremely complex statistics and computational time that restricted their analysis to 60 variables. The proposed procedure is run at the Texas Tech High Performance Computing Center taking 12 minutes for 168 variables and a study area with 3,028 regions.
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