Primary Care Commons^™

Men Provide Care To Relatives Also: Primary Care Practice Sheet #6, Eastern Agency On Aging, University Of Maine Center On Aging, Aroostook Area Agency On Aging, Senior Spectrum, Rosscare, Norumbega Medical, Horizons Health Services, Indian Township Tribal Health Center, Bucksport Regional Health Center

Maine Center on Aging Service and Consultation

Male caregivers in modern society often are overlooked or face discrimination. Due to the belief systems in our society, many men fell as though they should not seek outside help with their caregiving, and often experience health problems. Thus, it is important for healthcare professionals to ask questions to ensure that the male caregivers are maintaining their wellbeing. Encouraging discussions can assist in this as well as identifying if they need help from outside resources.

Elder Abuse, Neglect, And Exploitation: Primary Care Practice Fact Sheet #5, Eastern Agency On Aging, University Of Maine Center On Aging, Aroostook Area Agency On Aging, Senior Spectrum, Rosscare, Norumbega Medical, Horizons Health Services, Indian Township Tribal Health Center, Bucksport Regional Health Center

Maine Center on Aging Service and Consultation

Elder abuse often occurs in the home by family members, and often goes unreported due to isolation and dependency on these individuals. The term elder abuse encompasses physical abuse, sexual abuse, emotional abuse or psychological abuse, or neglect. It is important for healthcare professionals to ask older individuals questions in regard to safety and fears. By knowing the signs of abuse, physicians will be able to discuss and document potential dangers.

Stroke Mortality In Sao Paulo (1997-2003). A Description Using The Tenth Revision Of The International Classification Of Diseases, Paulo A. Lotufo

Paulo A Lotufo

Stroke mortality rates are higher in Brazil when compared to other countries. The city of Sao Paulo has a good system of mortality surveillance that allow us to describe the epidemiology of the stroke in the city. Our aim was to describe the stroke mortality pattern by gender and age characterizing the ischemic/hemorrhagic ratio. We categorized mortality data by gender and a 10-year age-strata from 30-39 years-old to 70-79 years-old. To avoid random variations, we calculated the mean of all deaths occurred during the period of 1997 to 2003. Mortality rates were calculated using the population from the Brazilian National …

A Comunicação Médica: Alguns Comentários E Observações, Paulo A. Lotufo

Paulo A Lotufo

No abstract provided.

Brazil Is Getting Older: Some Lessons From The Bambuí Health And Aging Study, Paulo A. Lotufo

Paulo A Lotufo

No abstract provided.

The Healthcare Team Includes The Caregiver: Primary Care Practice Fact Sheet #3, Eastern Agency On Aging, University Of Maine Center On Aging, Aroostook Area Agency On Aging, Senior Spectrum, Rosscare, Norumbega Medical, Horizons Health Services, Indian Township Tribal Health Center, Bucksport Regional Health Center

Maine Center on Aging Service and Consultation

Whether or not an older individual is able to remain living in their home or not often depends on the availability of a family caregiver. These informal caregivers are crucial for activities of daily living, monitoring medications, and monitoring the patient’s condition. The primary care physician should ensure that all members of the caregiving team fully communicates with each other.

Intimacy: Primary Care Practice Fact Sheet #4, Eastern Agency On Aging, University Of Maine Center On Aging, Aroostook Area Agency On Aging, Senior Spectrum, Rosscare, Norumbega Medical, Horizons Health Services, Indian Township Tribal Health Center, Bucksport Regional Health Center

Maine Center on Aging Service and Consultation

It is crucial for healthcare professionals to pay close attention to the caregiving experiences of their patients. If changes in roles, self-esteem, or loss of intimacy occurs, primary care physicians should encourage open discussion. The MPPC Care Specialist is available to address emotional challenges, and health care professionals can remember this to ensure the proper care of patients.

Impact Of Clinical Experience On Quantification Of Clinical Signs At Physical Examination, Luciano F. Drager, Paulo A. Lotufo, Isabela M. Bensenor

Paulo A Lotufo

Purpose. Although physical examination is a fundamental component of medical decision making, relatively few studies have evaluated how physicians quantify clinical signs and whether different methods of assessment have different effects on clinical practice. Objectives. To evaluate a possible impact of clinical experience when attending physicians, medical residents and medical students quantify qualitative signs of physical examination in a teaching hospital. Setting. Hospital das Clı´nicas, University of Sa˜o Paulo, Brazil. Subjects. A total of 244 randomly selected physicians and medical students completed a reliable and consistent eight-item questionnaire. Main outcome measures. To compare how they quantified clinical signs of cyanosis, …

Screening At Worksite Applying The Framingham Heart Study Score., Paulo A. Lotufo

Paulo A Lotufo

The first evaluation of class of occupation and cardiovascular risk factors in a Brazilian sample of civil servants. 1) context: Cardiovascular diseases are the main causes of death in Brazil. The high-risk approach to cardiovascular risk factors by screening test at worksite is one possible strategy of prevention. 2) objective: to verify the impact of a risk factors screening according to occupational levels. 3) type of study: cross-sectional 4) setting: occupational division of University of Sao Paulo 5) participants: 6,587 employees aged 20 to 69 years-old classified according three occupational grades (non-skilled, both manual and non-manual jobs; technical; faculty). 6) …

Depression In The Elderly: Primary Care Practice Fact Sheet #2, Eastern Agency On Aging, University Of Maine Center On Aging, Aroostook Area Agency On Aging, Senior Spectrum, Rosscare, Norumbega Medical, Horizons Health Services, Indian Township Tribal Health Center, Bucksport Regional Health Center

Maine Center on Aging Service and Consultation

Depression is the most common psychiatric disorder that is seen in individuals over the age of 65. The National Institute of Health Consensus Statement concluded that only ten percent of older individuals needing psychiatric treatment actually receive this service. Suicide is common in these individuals, and when recognized and treated, clinical depression can be manages in over 80 percent of cases. The primary care practitioner should ensure that the family caregivers regularly see and speak to their older relatives in order to check in on well-being and recognize possible symptoms of depression.

Who Cares For The Caregiver: Primary Care Practice Fact Sheet #1, Eastern Agency On Aging, University Of Maine Center On Aging, Aroostook Area Agency On Aging, Senior Spectrum, Rosscare, Norumbega Medical, Horizons Health Services, Indian Township Tribal Health Center, Bucksport Regional Health Center

Maine Center on Aging Service and Consultation

Informal caregivers are crucial to society, yet often sacrifice their own health in order to maintain the proper care of others. The economic value of informal caregivers’ services is projected to be $196 billion, and approximately 15 to 25 million adults in the United States fit this profile. The health of caregivers is often overlooked, so primary care practices should focus on checking in with them and being an advocate for them. This will allow for an improvement in the health of both the caregiver and the care recipient.

Migraine And Coronary Heart Disease In Women And Men, Paulo A. Lotufo

Paulo A Lotufo

Objective.—We evaluated migraine as an independent risk factor for subsequent coronary heart disease (CHD) events among women in the Women’s Health Study (WHS) and men in the Physicians’ Health Study (PHS). Background.—Although several studies have suggested that migraine is associated with increased risk of stroke, there are few and conflicting data on whether migraine predicts risk of future CHD events. Methods.—The WHS is an ongoing randomized, double-blind, placebo-controlled trial of low-dose aspirin and vitamin E in the primary prevention of cardiovascular disease and cancer in 39,876 women health professionals aged 45 years in 1993, and the PHS is a completed …

Epidemologia Das Doenças Cardiovasculares No Brasil [Portuguese], Paulo A. Lotufo

Paulo A Lotufo

No abstract provided.

Barrier To Utilization Of Primary Healthcare Resources In Children Two Years Of Age And Under, Ruth A. Waibel

Health Services Research Dissertations

This is a retrospective longitudinal study of health service utilization using the Immunization Practice Data Set obtained from the Center for Pediatric Research, Norfolk, Virginia. Cluster sampling was used to identify a cohort of children (n = 271), aged 0 to 24 months, from the city of Norfolk, Virginia. A two-year abstraction of medical records was used to determine utilization practice patterns for three categories of health: well-baby, acute and chronic care. The purpose of this study was to identify socio-demographic, need, and health system factors associated with under-utilization of primary care services using Aday's model. The proportion of children …

Diabetes And All-Cause And Coronary Heart Disease Mortality Among Us Male Physicians, Paulo A. Lotufo, Joann E. Manson

Paulo A Lotufo

Background: While diabetes has long been associated

with increased risk of coronary heart disease (CHD), the

magnitude of risk of diabetes-related CHD is uncertain.

Objective: To evaluate the impact of diabetes and prior

CHD on all-cause and CHD mortality.

Methods: In a prospective cohort study of 91 285 US

male physicians aged 40 to 84 years, participants were

divided into 4 groups: (1) a reference group of 82 247

men free of both diabetes and CHD (previous myocardial

infarction and/or angina) at baseline, (2) 2317 men

with a history of diabetes but not CHD, (3) 5906 men

with a history …

Coffee, Samba, Football And Social Inequalities: Some Lessons From Mortality In Brazil, Paulo A. Lotufo

Paulo A Lotufo

No abstract provided.

O Nosso Amigo Esfigmomanômetro [Portuguese], Paulo A. Lotufo

Paulo A Lotufo

No abstract provided.

O Exame Físico Com Finalidade De Prevenção: Estudos De Base Populacional. [Portuguese], Paulo A. Lotufo

Paulo A Lotufo

No abstract provided.

Increasing Obesity In Brazil: Predicting A New Peak Of Cardiovascular Diseases, Paulo A. Lotufo

Paulo A Lotufo

No abstract provided.

Male Pattern Baldness And Coronary Heart Disease: The Physicians' Health Study, Paulo A. Lotufo

Paulo A Lotufo

Is baldness a risk factor for heart attack? Aim: To examine the association between male pattern baldness and the risk of coronary heart disease (CHD) events. Desing, setting and participants:Retrospective cohort study among 22,071 US male physicians aged 40 to 84 years enrolled in the Physicians' Health Study. Of these, 19,112 were free of CHD at baseline and completed a questionnaire at the 11-year follow-up concerning their pattern of hair loss at age 45 years. Response options included no hair loss, frontal baldness only, or frontal baldness with mild, moderate, or severe vertex baldness. Main outcome measures: Coronary heart disease …

Moratoria Para A Crise Hipertensiva [Portuguese], Paulo A. Lotufo

Paulo A Lotufo

No abstract provided.

Increasing Readiness To Change Among Smokers In A Primary Care Setting, Sheila F. Collicott

Psychology Theses & Dissertations

This study compared the effectiveness of two brief interventions, direct advice and motivational interviewing, for increasing motivation to quit among male smokers in the pre-contemplation and contemplation stages of change who were primary care patients at an Eastern urban VA medical center. Contrary to expectations, participants receiving motivational interviews did not increase more in readiness to change, motivation, and actions to quit, than those receiving direct advice or a control conversation, nor did they smoke fewer cigarettes per day. As expected, contemplators reported more cutting down and quit attempts than pre-contemplators. Factors that may have limited the effectiveness of interventions …

Alcohol Consumption And Risk Of Coronary Heart Disease By Diabetes Status, Paulo A. Lotufo

Paulo A Lotufo

Background—An inverse association between moderate alcohol consumption and coronary heart disease (CHD) has been observed in several epidemiological studies. To assess whether a similar association exists among diabetics, we examined the relation between light to moderate alcohol consumption and CHD in men with and without diabetes mellitus in a prospective cohort study. Methods and Results—A total of 87 938 US physicians (2790 with diagnosed diabetes mellitus) who were invited to participate in the Physicians’ Health Study and were free of myocardial infarction, stroke, cancer, or liver disease at baseline were followed for an average of 5.5 years for death with …

Ervilhas, Gado E Gente [Portuguese], Paulo A. Lotufo

Paulo A Lotufo

No abstract provided.

Winter And Cardiovascular Mortality, Paulo A. Lotufo

Paulo A Lotufo

Winter time and mortality due to heart failure in Sao Paulo, Brazil during the 1930's.

Poor Performance Of Health And Population Welfare Programmes In Sindh: Case Studies In Governance Failure, Mehtab S. Karim, Shehla Zaidi

Community Health Sciences

Over the past few years, the issue of what is meant by “good governance” has generated increasing attention and debate both at the national and international level [Streeten (1997)]. The role of state and how that role is to be exercised is appearing high on the agenda of politicians, policy-makers and academicians in the developing world. Governance has been defined by the World Bank as “the manner in which power is exercised in the management of the country’s economic and social resources” [World Bank (1994)]. The somewhat narrow scope of this definition has been broadened in recent years to “the …

Tropicalizando A Medicina [Portuguese], Paulo A. Lotufo

Paulo A Lotufo

No abstract provided.

A Odisseia Do Paje, Paulo A. Lotufo

Paulo A Lotufo

No abstract provided.

Premature Mortality From Heart Diseases In Brazil. A Comparison With Other Countries[Portuguese], Paulo A. Lotufo

Paulo A Lotufo

Chronic diseases have been the main cause of mortality in the Brazilian metropolitan areas since 1960. Circulatory diseases are the main causes of chronic diseases. The aim was to compare the heart disease related premature deaths in Brazil with other countries in 1984-87. Methods: We studied the deaths from the official mortality statistics from eight metropolitan areas with good assurance of information: Belém, Recife, Salvador, Belo Horizonte, Rio de Janeiro, São Paulo, Curitiba, Porto Alegre. Death causes analyzed were coronary heart disease (410-414); and heart diseases [ischemic heart disease (410-414) plus heart failure (428) plus, hypertension (401-404)]. The population was …

Tratamento Anti-Hipertensivo. Prescrição E Custo De Medicamentos. Pesquisa Em Hospital Terciário, Paulo A. Lotufo

Paulo A Lotufo

To study the most prescribed anti-hypertensive drugs, evaluating their agreement with established guidelines and drug cost. Methods - One hundred and forty one (101 women, mean age = 53.3 years) hypertensive patients who searched spontaneous attention were interviewed in a tertiary-care hospital. The inclusion criteria were previous diagnosis of hypertension and non cardiovascular complaints. Results - The majority of the 107 (75.9%) patients were on medical treatment. In those receiving monotherapy, thiazides were the most utilized drugs, followed by methyldopa, ACE inhibitors, calcium channel-blockers, a n d b e t a - b l o c k e r s …