A Description Of The Methods Of The Aspirin Supplementation For Pregnancy Indicated Risk Reduction In Nulliparas (Aspirin) Study, 2017 Christiana Care, Newark, DE USA
A Description Of The Methods Of The Aspirin Supplementation For Pregnancy Indicated Risk Reduction In Nulliparas (Aspirin) Study, Matthew K. Hoffman, Shivaprasad S. Goudar, Bhalachandra S. Kodkany, Norman Goco, Marion Koso-Thomas, Menachem Miodovnik, Elizabeth M. Mcclure, Dennis D. Wallace, Jennifer J. Emingway-Foday, Antoinette Tshefu, Adrien Lokangaka, Carl L. Bose, Elwyn Chomba, Musaku Mwenechanya, Waldemar A. Carlo, Ana Garces, Nancy F. Krebs, K. Michael Hambidge, Sarah Saleem, Robert L. Goldenberg, Archana Patel, Patricia L. Hibberd, Fabian Esamai, Edward A. Liechty, Robert Silver, Richard J. Derman
Community Health Sciences
Background: Preterm birth (PTB) remains the leading cause of neonatal mortality and long term disability throughout the world. Though complex in its origins, a growing body of evidence suggests that first trimester administration of low dose aspirin (LDA) may substantially reduce the rate of PTB.
Methods: Hypothesis: LDA initiated in the first trimester reduces the risk of preterm birth. Study Design Type: Prospective randomized, placebo-controlled, double-blinded multi-national clinical trial conducted in seven low and middle income countries. Trial will be individually randomized with one-to-one ratio (intervention/control) Population: Nulliparous women between the ages of 14 and 40, with a …
Did Contracting Effect The Use Of Primary Health Care Units In Pakistan?, 2017 Aga Khan University
Did Contracting Effect The Use Of Primary Health Care Units In Pakistan?, Ashar Muhammad Malik, Ellen Van De Poel, Eddy Van Doorslaer
Community Health Sciences
For many years, Pakistan has had a wide network of Basic Health Units spread across the country, but their utilization by the population in rural and peri-urban areas has remained low. As of 2004, in an attempt to improve the utilization and performance of these public primary healthcare facilities, the government has gradually started contracting-in intergovernmental organizations to manage these BHUs. Using five nationally representative household surveys conducted between 2001 and 2012, and exploiting the gradual roll-out of this reform to apply a difference-in-difference approach, we evaluate its impact on BHU utilization. We find that contracting of the BHU management …
Multimorbidity Among Adult Primary Health Care Patients In Canada: Examining Multiple Chronic Diseases Using An Electronic Medical Record Database, 2017 The University of Western Ontario
Multimorbidity Among Adult Primary Health Care Patients In Canada: Examining Multiple Chronic Diseases Using An Electronic Medical Record Database, Kathryn Nicholson
Electronic Thesis and Dissertation Repository
Introduction: The coexistence of multiple chronic diseases within an individual, also known as multimorbidity, is an ongoing challenge for patients, caregivers and primary health care (PHC) providers. An enhanced understanding of the burden of multimorbidity in Canada is needed.
Objectives: This research had two main objectives. Objective One aimed to understand the prevalence of multimorbidity among adult PHC patients, as well as the patterns of unordered and ordered clusters of multiple chronic diseases. Objective Two aimed to determine the natural progression of multimorbidity over time, as well as the patient-, provider- and practice-level predictors of progressing into more complex clinical …
Primary Care Transition Planning For Young Adults With Special Needs In Maine: A Preliminary Survey Of Pediatric Providers, 2017 University of Maine
Primary Care Transition Planning For Young Adults With Special Needs In Maine: A Preliminary Survey Of Pediatric Providers, Clelia Sigaud
Poster Presentations
Research suggests that less than half of young adults with special health care needs are prepared for the transition to an adult primary care provider at the age-appropriate time (McManus et al., 2013). Prior research also indicates that having a “usual source of care” and routinized medical services creates a higher likelihood of adult patients receiving preventative and screening health services (Blewett et al., 2008).
Lead Exposure Assessment Among Pregnant Women, Newborns, And Children: Case Study From Karachi, Pakistan., 2017 Aga Khan University
Lead Exposure Assessment Among Pregnant Women, Newborns, And Children: Case Study From Karachi, Pakistan., Zafar Fatmi, Ambreen Sahito, Akihiko Ikegami, Atsuko Mizuno, Xiaoyi Cui, Nathan Mise, Mai Takagi, Yayoi Kobayashi, Fujio Kayama
Community Health Sciences
Lead (Pb) in petrol has been banned in developed countries. Despite the control of Pb in petrol since 2001, high levels were reported in the blood of pregnant women and children in Pakistan. However, the identification of sources of Pb has been elusive due to its pervasiveness. In this study, we assessed the lead intake of pregnant women and one- to three-year-old children from food, water, house dust, respirable dust, and soil. In addition, we completed the fingerprinting of the Pb isotopic ratios (LIR) of petrol and secondary sources (food, house-dust, respirable dust, soil, surma (eye cosmetics)) of exposure within …
The Disappearance Of Nyoman And Ketut, 2017 SIT Study Abroad
The Disappearance Of Nyoman And Ketut, Laura Michelle Garvie
Independent Study Project (ISP) Collection
No abstract provided.
Identificando Los Limites Del Acceso A La Salud Reproductiva: Un Análisis Sobre Las Experiencias Vividas Por Las Mujeres Guaraníes Con Los Servicios De La Salud Reproductiva En La Villa 31 De Buenos Aires, 2017 SIT Study Abroad
Identificando Los Limites Del Acceso A La Salud Reproductiva: Un Análisis Sobre Las Experiencias Vividas Por Las Mujeres Guaraníes Con Los Servicios De La Salud Reproductiva En La Villa 31 De Buenos Aires, Amelia Mitchell
Independent Study Project (ISP) Collection
In order to serve the ‘public’, public health services must be accessible to everyone, without discrimination based on race, gender, social class, or geographic location, among other facets of identity. Reproductive health services, in particular, are a key service that must be adequately supplied in order to guarantee the health and wellbeing of a population. Reproductive healthcare not only allows individuals to decide if and when they wish to have a child, it also contributes to cancer prevention and the detrimental effects of sexually transmitted diseases. This investigation examines the experiences of Guaraní women that live within “Villa 31” of …
Comparison Of Multiple Obesity Indices For Cardiovascular Disease Risk Classification In South Asian Adults: The Carrs Study., 2017 Emory University, Atlanta, Georgia, United States of America
Comparison Of Multiple Obesity Indices For Cardiovascular Disease Risk Classification In South Asian Adults: The Carrs Study., Shivani A. Patel, Mohan Deepa, Roopa Shivashankar, Mohammed K. Ali, Deksha Kapoor, Ruby Gupta, Dorothy Lall, Nikhil Tandon, Viswanathan Mohan, Muhammad Masood Kadir, Zafar Fatmi, Dorairaj Prabhakaran, K. M. Venkat Narayan
Community Health Sciences
BACKGROUND:
We comparatively assessed the performance of six simple obesity indices to identify adults with cardiovascular disease (CVD) risk factors in a diverse and contemporary South Asian population.
METHODS:
8,892 participants aged 20-60 years in 2010-2011 were analyzed. Six obesity indices were examined: body mass index (BMI), waist circumference (WC), waist-height ratio (WHtR), waist-hip ratio (WHR), log of the sum of triceps and subscapular skin fold thickness (LTS), and percent body fat derived from bioelectric impedance analysis (BIA). We estimated models with obesity indices specified as deciles and as continuous linear variables to predict prevalent hypertension, diabetes, and high cholesterol …
Repeat 24-Hour Recalls And Locally Developed Food Composition Databases: A Feasible Method To Estimate Dietary Adequacy In A Multi-Site Preconception Maternal Nutrition Rct., 2017 University of Colorado School of Medicine, Aurora, CO, USA.
Repeat 24-Hour Recalls And Locally Developed Food Composition Databases: A Feasible Method To Estimate Dietary Adequacy In A Multi-Site Preconception Maternal Nutrition Rct., Rebecca L. Lander, K. Michael Hambidge, Nancy F. Krebs, Jamie E. Westcott, Ana Garces, Lester Figueroa, Gabriela Tejeda, Adrien Lokangaka, Tshilenge S. Diba, Manjunath S. Somannavar, Ranjitha Honnayya, Sumera Aziz Ali, Umber S. Khan, Elizabeth M. Mcclure, Vanessa R. Thorsten, Kristen B. Stolka, For The Women First Preconception Nutrition Trial Group
Community Health Sciences
Background:
Our aim was to utilize a feasible quantitative methodology to estimate the dietary adequacy of >900 first-trimester pregnant women in poor rural areas of the Democratic Republic of the Congo, Guatemala, India and Pakistan. This paper outlines the dietary methods used.
Methods:
Local nutritionists were trained at the sites by the lead study nutritionist and received ongoing mentoring throughout the study. Training topics focused on the standardized conduct of repeat multiple-pass 24-hr dietary recalls, including interview techniques, estimation of portion sizes, and construction of a unique site-specific food composition database (FCDB). Each FCDB was based on 13 …
Navigating Long-Term Care, 2017 East Tennessee State University
Navigating Long-Term Care, Jim Holt
ETSU Faculty Works
Americans over age 65 constitute a larger percentage of the population each year: from 14% in 2010 (40 million elderly) to possibly 20% in 2030 (70 million elderly). In 2015, an estimated 66 million people provided care to the ill, disabled, and elderly in the United States. In 2000, according to the Centers for Disease Control and Prevention (CDC), 15 million Americans used some form of long-term care: adult day care, home health, nursing home, or hospice. In all, 13% of people over 85 years old, compared with 1% of those ages 65 to 74, live in nursing homes in …
Quality Improvement Of Procedural Services In Family Medicine Residency Clinics, 2017 Department of Family Medicine, Aurora Health Care
Quality Improvement Of Procedural Services In Family Medicine Residency Clinics, Keisha Rogers, Nora Guschwan, Lisa Sullivan Vedder
Lisa Sullivan Vedder, MD
Background: Performing common procedures in our family medicine residency clinics is often a difficult and inefficient process. A 2008 Society of Teachers of Family Medicine consensus statement on procedural training found higher job satisfaction and better financial compensation for family practitioners who performed procedures. Patient satisfaction is likely increased when minor procedures are able to be performed by their primary clinician. This would suggest a disconnect between the known benefits of providing procedural services and the ability of our residency clinics to provide those services in an efficient manner. Purpose: To assess clinician and staff comfort with performance of common …
Motivating And Demotivating Factors For Community Health Workers Engaged In Maternal, Newborn And Child Health Programs In Low And Middle-Income Countries: A Systematic Review., 2017 Aga Khan University
Motivating And Demotivating Factors For Community Health Workers Engaged In Maternal, Newborn And Child Health Programs In Low And Middle-Income Countries: A Systematic Review., Leah Shipton, Aysha Zahidie, F. Rabbani
Community Health Sciences
This systematic review aimed to synthesize primary research on motivating factors of community health workers (CHWs) for maternal, neonatal, and child health (MNCH) in low and middle-income countries (LMICs). Peer-reviewed literatures were systematically searched in five databases. Identified studies were then screened and selected for inclusion. The eligibility criteria were reported primary qualitative, quantitative, or mixed methods research, with participants being CHWs in LMICs who address MNCH, which investigated motivation or related concepts of retention, attrition, and performance. A thematic synthesis process was used to analyze findings of motivating factors, reported by included studies. Seventeen qualitative, quantitative, or mixed methods …
A Review Of Echocardiograms In Hypertensive Patients Greater Than 60 Years In A Community Based Family Medicine Program, 2017 New York Medical College
A Review Of Echocardiograms In Hypertensive Patients Greater Than 60 Years In A Community Based Family Medicine Program, Shideh Doroudi, Michael Delisi, Vincent Debari
NYMC Faculty Publications
Background: Heart disease as a result of Hypertension is known to occur. Anatomical and functional changes of the heart can easily be detected by echocardiography, which is a safe and readily available study. Objectives: The aims of this study were to evaluate the prevalence of common echocardiographic changes in chronic hypertensive patients and to compare these changes in male and female populations. Design/methods: The study was a community-based cross-sectional study, on 227 hypertensive patients, 60 years and older, seen in St. Joseph's Family Medicine at Clifton, with integrated clinical and echocardiographic data. Results: Study population consisted of 227 hypertensive patients, …
Tobacco Control Environment: Cross-Sectional Survey Of Policy Implementation, Social Unacceptability, Knowledge Of Tobacco Health Harms And Relationship To Quit Ratio In 17 Low-Income, Middle-Income And High-Income Countries., 2017 University of Sydney, Camperdown, New South Wales, Australia
Tobacco Control Environment: Cross-Sectional Survey Of Policy Implementation, Social Unacceptability, Knowledge Of Tobacco Health Harms And Relationship To Quit Ratio In 17 Low-Income, Middle-Income And High-Income Countries., Clara K. Chow, Daniel J. Corsi, Anna B. Gilmore, Annamarie Kruger, Ehimario Igumbor, Jephat Chifamba, Wang Yang, Li Wei, Romaina Iqbal, Prem Mony, Rajeev Gupta, Krishnapillai Vijayakumar, V Mohan, Rajesh Kumar, Omar Rahman, Khalid Yusoff, Noorhassim Ismail, Katarzyna Zatonska, Yuksel Altuntas, Annika Rosengren, Ahmad Bahonar, Afzal Hussein Yusufali, Gilles Dagenais, Scott Lear, Rafael Diaz, Alvaro Avezum, Patricio Lopez-Jaramillo, Fernando Lanas, Sumathy Rangarajan, Koon Teo, Martin Mckee, Salim Yusuf
Community Health Sciences
OBJECTIVES:
This study examines in a cross-sectional study 'the tobacco control environment' including tobacco policy implementation and its association with quit ratio.
SETTING:
545 communities from 17 high-income, upper-middle, low-middle and low-income countries (HIC, UMIC, LMIC, LIC) involved in the Environmental Profile of a Community's Health (EPOCH) study from 2009 to 2014.
PARTICIPANTS:
Community audits and surveys of adults (35-70 years, n=12 953).
PRIMARY AND SECONDARY OUTCOME MEASURES:
Summary scores of tobacco policy implementation (cost and availability of cigarettes, tobacco advertising, antismoking signage), social unacceptability and knowledge were associated with quit ratios (former vs ever smokers) using multilevel logistic regression …
Multilevel Modeling Of Binary Outcomes With Three-Level Complex Health Survey Data., 2017 Aga Khan University
Multilevel Modeling Of Binary Outcomes With Three-Level Complex Health Survey Data., Shafquat Rozi, Sadia Mahmud, Gillian Lancaster, Wilbur Hadden, Gregory Pappas
Community Health Sciences
Complex survey designs often involve unequal selection probabilities of clus-ters or units within clusters. When estimating models for complex survey data, scaled weights are incorporated into the likelihood, producing a pseudo likeli-hood. In a 3-level weighted analysis for a binary outcome, we implemented two methods for scaling the sampling weights in the National Health Survey of Pa-kistan (NHSP). For NHSP with health care utilization as a binary outcome we found age, gender, household (HH) goods, urban/rural status, community de-velopment index, province and marital status as significant predictors of health care utilization (p-value < 0.05). The variance of the random intercepts using scaling method 1 is estimated as 0.0961 (standard error 0.0339) for PSU level, and 0.2726 (standard error 0.0995) for household level respectively. Both esti-mates are significantly different from zero (p-value < 0.05) and indicate consid-erable heterogeneity in health care utilization with respect to households and PSUs. The results of the NHSP data analysis showed that all three analyses, weighted (two scaling methods) and un-weighted, converged to almost identical results with few exceptions. This may have occurred because of the large num-ber of 3rd and 2nd level clusters and relatively small ICC. We performed a sim-ulation study to assess the effect of varying prevalence and intra-class correla-tion coefficients (ICCs) on bias of fixed effect parameters and variance components of a multilevel pseudo maximum likelihood (weighted) analysis. The simulation results showed that the performance of the scaled weighted estimators is satisfactory for both scaling methods. Incorporating simulation into the analysis of complex multilevel surveys allows the integrity of the results to be tested and is recommended as good practice.
Childhood And Adolescent Obesity: Primary Health Care Physicians’ Perspectives From Riyadh, Saudi Arabia, 2017 College of Medicine, King Saud University, Riyadh, Saudi Arabia
Childhood And Adolescent Obesity: Primary Health Care Physicians’ Perspectives From Riyadh, Saudi Arabia, Faiza Nasser Alotaibi, Majeedah Alotaibi, Shiakhah Alanazi, Hanan Al-Gethami, Deemah Alateeq, Rowaydah Mishiddi, Amna Rehana Siddiqui
Community Health Sciences
BACKGROUND & OBJECTIVES:
Primary health care (PHC) physicians are foremost to confront childhood and adolescent obesity. Our objective was to evaluate PHC Physicians perspectives for managing overweight/obesity in children and adolescents.
METHODS:
PHC services from eight public hospitals in Riyadh participated. A self-administered tool maintaining anonymity evaluated facilitators and barriers for managing overweight/obese children and adolescent patients. Physicians who 'always' recommended weight management for an overweight / obese patient during past year, by involving patient, parents, and others were classified as having positive and appropriate practice.
RESULTS:
Of the 58 respondents, 51.7% had appropriate practices. Lack of patient motivation (82.2%), …
Coping Styles And Depression Among Patients With Solid Organ Cancers Attending Two Tertiary Care Hospitals Of Karachi: A Cross Sectional Study., 2017 Aga Khan University
Coping Styles And Depression Among Patients With Solid Organ Cancers Attending Two Tertiary Care Hospitals Of Karachi: A Cross Sectional Study., Khadija Vadsaria, Adnan Jabbar, Iqbal Azam Syed, Sameera Rizvi, Ghulam Haider, Haider Naqvi
Community Health Sciences
Cancer undoubtedly affects patients in all aspects. Cancer diagnosis is a stressful event and coping is the primary mechanism used to adjust and counteract the stress. This study aims to assess the coping styles and prevalence of depression among solid organ cancer patients during treatment phase, attending two tertiary care hospitals of Karachi. A cross-sectional survey was conducted among solid organ cancer patients at Aga Khan University Hospital and Jinnah Post Graduate Medical Center. Coping and depression were assessed by Brief COPE and Self Reporting Questionnaire (SRQ) 20 respectively. Purposive sampling technique was used to recruit 488 patients. Coping styles …
Did You Hear What I Meant To Say?, 2017 Aurora UW Medical Group, Aurora Health Care
Did You Hear What I Meant To Say?, Dennis J. Baumgardner
Journal of Patient-Centered Research and Reviews
The author introduces Volume 4, Issue 1 of Journal of Patient-Centered Research and Reviews by acknowledging the importance of communication between patient and caregiver in the clinical setting. Failure to communicate effectively can have a negative impact on a patient's well-being, therefore efforts to improve communication skills among clinicians, researchers and health practice administrators should be undertaken with regularity.
Group Medical Visits To Provide Gynecologic Care For Women Affected By Breast Cancer, 2017 University of California, San Francisco
Group Medical Visits To Provide Gynecologic Care For Women Affected By Breast Cancer, Sally R. Greenwald, Sarah Watson, Mindy Goldman, Tami S. Rowen
Journal of Patient-Centered Research and Reviews
Purpose
Women with breast cancer have complex and unique gynecologic needs that are challenging to effectively and comprehensively meet in a traditional gynecology visit format. Group medical visits are an effective and well-received model of care in other disease settings and can provide comprehensive health education as an adjunct to one-on-one evaluation and treatment. There are limited data regarding the use of this type of health care delivery in providing gynecology-focused care to women affected by breast cancer.
Methods
A group medical visit model was created for gynecology providers to see new breast cancer patient consults. From May 2012 to …
What Can A Primary Care Physician Discuss With Older Patients To Improve Advance Directive Completion Rates? A Clin-Iq, 2017 Medical College of Wisconsin
What Can A Primary Care Physician Discuss With Older Patients To Improve Advance Directive Completion Rates? A Clin-Iq, Judith M. Myers, Edmund Duthie Jr., Kathryn Denson, Steven Denson, Deborah Simpson
Journal of Patient-Centered Research and Reviews
Advance directives (ADs) provide patients with the opportunity to indicate their preferences for medical care while they still maintain the capacity to express their wishes, thus retaining autonomy. ADs increase the likelihood that patients will receive the care they desire, as their family members and physicians will better understand the level of care desired. Despite this, the AD completion rate by elderly patients continues to be low, especially for patients not facing serious illnesses. Primary care physicians (PCPs) are uniquely positioned to engage patients in discussions about ADs before a health crisis arises yet often do not due to time …