Home About us Contact
|
Home About us Contact | ||
|
|
||
Health Care Clinics (health + care_clinic)
Selected AbstractsFasting capillary glucose as a screening test for gestational diabetes mellitusBJOG : AN INTERNATIONAL JOURNAL OF OBSTETRICS & GYNAECOLOGY, Issue 9 2006H Fadl Objective, To evaluate fasting capillary glucose as a screening test for gestational diabetes mellitus (GDM) compared with traditional risk factors and repeated random capillary glucose measurements. Design, Cross-sectional, population-based study. Setting, Maternal Health Care Clinics in Örebro County, Sweden. Population, An unselected population of women without diabetes. Methods, Fasting capillary glucose levels were measured at gestational weeks 28,32. Random capillary glucose levels were measured four to six times during pregnancy. Traditional risk factors for GDM were registered. GDM was diagnosed using a 75-g oral glucose tolerance test. Main outcome measures, Sensitivity, specificity, likelihood ratios. Results, In 55 of 3616 women participating in the study, GDM was diagnosed before 34 weeks of gestation. For fasting capillary glucose cutoff values between 4.0 and 5.0 mmol/l, sensitivity was in the range between 87 and 47% and specificity between 51 and 96%. Using a combined screening model of traditional risk factors with fasting capillary glucose at various cutoff values increased the sensitivity only slightly compared with using fasting capillary glucose alone. Conclusion, In this Swedish, unselected, low-risk population, fasting capillary glucose measurements were found to be an acceptable and useful screening test for GDM. [source] A Comparison of Perspectives on Breastfeeding Between Two Generations of Black American WomenJOURNAL OF THE AMERICAN ACADEMY OF NURSE PRACTITIONERS, Issue 1 2001Marjaneh M. Fooladi MSN, PhDArticle first published online: 24 MAY 200 PURPOSE To determine differences in breastfeeding perspectives between two generations of black American women with and without access to governmental food assistance programs (i.e., WIC). DATA SOURCES Descriptive, comparative study of a convenience sample of 118 black American women in their childbearing years and beyond conducted in a primary rural health care clinic serving an indigent population. CONCLUSIONS A significant difference was found between breastfeeding perceptions and rate among younger black American women on WIC program and their mothers without access to these programs. The availability of free formula through WIC programs has partially influ-enced the rate of breastfeeding among the young black American women. The other sig-nificant influencing factor was public embarrassment at breastfeeding. IMPLICATIONS FOR PRACTICE An extensive educational campaign is needed in order to influence the public's perceptions of breastfeeding as an embarrassment. The success of programs such as WIC must be measured beyond the first six months of an infant's life. [source] Retinal photography for diabetic retinopathy screening in Indigenous primary health care: the Inala experienceAUSTRALIAN AND NEW ZEALAND JOURNAL OF PUBLIC HEALTH, Issue 2010Geoffrey K. P. Spurling Abstract Objective: We aimed to determine the impact of clinic based retinal photography on access to appropriate screening for diabetic retinopathy (DR). Design, setting and participants: We opportunistically recruited patients undergoing their annual diabetic cycle of care over a two year period in the urban Indigenous primary health care clinic. Data were collected on retinal outcomes, health variables and referral patterns. Main outcome measures: Access to appropriate screening and ophthalmic follow up, prevalence of DR, acceptability and feasibility of clinic-based retinal photography were the main outcome measures of this study. Results: One hundred and thirty-two of a possible 147 patients consented to participate. 30% of participants had DR. Appropriate screening and ophthalmic follow up increased six fold, from 20 to 124 participants, following the introduction of the retinal camera. Most participants felt very positive about DR screening. Conclusions: Primary care DR screening using retinal photography can improve access to DR screening for indigenous patients, reduce the burden on busy outpatient departments and should reduce visual loss. Policy-makers could contribute to screening sustainability by funding a medicare item-number for primary care based DR screening associated with the annual diabetic cycle of care. An upfront Practice Incentive Program (PIP) payment could offset set up costs. [source] The influence of education on the interpretation of pharmaceutical pictograms for communicating medicine instructionsINTERNATIONAL JOURNAL OF PHARMACY PRACTICE, Issue 1 2003Ros Dowse senior lecturer Objective To assess the influence of formal education on the interpretation of pharmaceutical pictograms. Method A total of 46 pictograms were used: 23 were extracted directly from the USP-DI, and 23 with corresponding meanings were designed in accordance with the local culture (local pictograms). One hundred and thirty Xhosa respondents, who ranged from having no formal education to tertiary level education, were interviewed with the aid of an interpreter. Demographic data were collected, a literacy test was conducted and respondents were tested for their interpretation of all 46 pictograms. Preference for either the USP-DI or the local pictogram was determined. Setting Respondents were interviewed in primary health care clinics, a variety of work settings or in their homes in Grahamstown, South Africa. Key findings Standard of education had a significant influence on the interpretation of 24 of the 46 pictograms. Generally, significant differences in interpretation were apparent between those with only primary school education and those who had completed at least some senior school education (P < 0.05). The group with tertiary education was significantly better than the other groups (P < 0.05). Only 15 of the 46 pictograms met the American National Standards Institute (ANSI) 85% correct criterion. Conclusion Interpretation was dependent on education and the development of visual literacy skills, but potential for misinterpretation in all educational groups was noted. These results suggest that pictograms should only be used as a communication aid in combination with text or verbal information from the health care provider. [source] Cooperative Dementia Care Clinics: A New Model for Managing Cognitively Impaired PatientsJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 12 2006Mary Lessig BS Cooperative health care clinics (CHCCs), or shared medical appointments, are a healthcare innovation that can improve access and expand physicians' capacity to manage common geriatric conditions. This report describes a pilot program and working model for extending CHCCs to patients with dementia. Three cooperative dementia care clinics (CDCCs) met monthly for up to 1 year, drawing participants from a dementia clinic roster of patients and caregivers who had required continued specialty care for at least 3 months. Twenty-six of 33 eligible patient,caregiver dyads expressed interest, and 21 enrolled; five whose clinical status changed during the year withdrew and were replaced with new members. Brief introductory socialization, individualized clinical management, and an educational focus selected from problems of patients and caregivers were common to all sessions. Most participants required several types of clinical intervention and educational support. One group ended after reaching a natural termination point, and two others are ongoing at the request of participants. CDCCs can be a viable approach to increasing dementia care capacity in health systems. Formal service intervention trials to evaluate the generalizability and comparative effectiveness and economic viability of this model versus usual care are an appropriate next step. [source] Psychosocial Well-Being and Quality of Life Among Women Newly Diagnosed With Genital HerpesJOURNAL OF OBSTETRIC, GYNECOLOGIC & NEONATAL NURSING, Issue 3 2009Hayley Mark ABSTRACT Objective: To assess the psychosocial well-being and quality of life among women with a new genital herpes simplex virus diagnosis. Design: Data were collected by a cross-sectional survey. Participants: Eighty-three women diagnosed with genital herpes simplex virus by culture, visual exam and/or a description of symptoms within the last 3 months were recruited from primary health care clinics by their provider. Measures: Participants completed the Hospital Anxiety and Depression Scale and the Recurrent Genital Herpes Quality of Life scale. Results: Thirty-four percent of the women qualified as "clinical cases" for depression, and 64% were designated as "anxiety cases" based on Hospital Anxiety and Depression Scale scoring methods. A majority of participants reported feeling ashamed about having herpes and worried about having an outbreak or giving herpes to someone else. Conclusions: Despite substantial progress toward understanding genital herpes simplex virus epidemiology and transmission, a diagnosis of genital herpes continues to cause considerable psychosocial morbidity and to impact quality of life. There is a dearth of good evidence on how best to intervene to minimize the psychological impact of a diagnosis. Experts recommend addressing both the medical and psychological aspects of infection by providing antiviral therapy, written material, and resources. [source] | ||||||||||