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Special Populations (special + population)
Selected AbstractsMeasurement in Veterans Affairs Health Services Research: Veterans as a Special PopulationHEALTH SERVICES RESEARCH, Issue 5p2 2005Robert O. Morgan Objective. To introduce this supplemental issue on measurement within health services research by using the population of U.S. veterans as an illustrative example of population and system influences on measurement quality. Principal Findings. Measurement quality may be affected by differences in demographic characteristics, illness burden, psychological health, cultural identity, or health care setting. The U.S. veteran population and the VA health system represent a microcosm in which a broad range of measurement issues can be assessed. Conclusions. Measurement is the foundation on which health decisions are made. Poor measurement quality can affect both the quality of health care decisions and decisions about health care policy. The accompanying articles in this issue highlight a subset of measurement issues that have applicability to the broad community of health services research. It is our hope that they stimulate a broad discussion of the measurement challenges posed by conducting "state-of-the-art" health services research. [source] Attention Problems in Very Low Birth Weight Preschoolers: Are New Screening Measures Needed for This Special Population?JOURNAL OF CHILD AND ADOLESCENT PSYCHIATRIC NURSING, Issue 2 2007Deborah Winders Davis DNS PROBLEM:,Children born prematurely have been shown to have a range of problems that often result in delayed academic achievement. METHODS:,The current study assessed both attention problem scores (Child Behavior Checklist) and actual performance on tasks tapping three attention networks in a sample of children (n = 94) born with very low birth weights (VLBW; , 1500 grams). FINDINGS:,Attention problem scores were extremely low and did not predict children's actual attention performance. CONCLUSIONS:,A body of research is developing that suggests VLBW children may have specific, yet subtle, attention problems that may differ from those of other children. [source] Cardiovascular Risk in Special Populations: OverviewPREVENTIVE CARDIOLOGY, Issue 3 2009Philip R. Liebson MD First page of article [source] Management of Bone Loss After Organ Transplantation,JOURNAL OF BONE AND MINERAL RESEARCH, Issue 12 2004Adi Cohen Organ transplant recipients experience rapid bone loss and high fracture rates, particularly during the early post-transplant period. Early rapid bone loss occurs in the setting of uncoupled bone turnover with increased bone resorption and decreased bone formation. Because there are no clinical factors that reliably predict post-transplant bone loss and fractures in the individual patient, all transplant recipients should be considered candidates for early preventive therapy for osteoporosis. Long-term transplant recipients with densitometric osteoporosis and/or fractures should also receive treatment. Although active metabolites of vitamin D and bisphosphonates have both shown efficacy, data from clinical trials suggest that bisphosphonates are the safest and most consistently effective agents for the prevention and treatment of post-transplantation osteoporosis in adults. Kidney transplant recipients represent a special population, and more research is needed to delineate the risks and benefits of treating bone disease in these patients. [source] A Support Group Intervention for Children Bereaved by Parental SuicideJOURNAL OF CHILD AND ADOLESCENT PSYCHIATRIC NURSING, Issue 1 2007Ann M. Mitchell PhD TOPIC:,Bereavement is considered by many to be among the most stressful of life events, and it becomes particularly distressing when it concerns the suicide death of a parent. Such an event is especially traumatic for children. PURPOSE AND SOURCES:,The purpose of this paper is to present a case for support group interventions designed specifically for child survivors of parental suicide. The authors provide a theoretical framework for supportive group interventions with these children and describe the structure of an 8-week bereavement support group for this special population of suicide survivors. CONCLUSIONS:,A case is made for designing and implementing group interventions to meet the mental health needs of this important group of individuals. [source] Developing Health Promotion Interventions: A Multisource Method Applied to Weight Loss Among Low-Income Postpartum WomenPUBLIC HEALTH NURSING, Issue 2 2010Lorraine O. Walker ABSTRACT Developing focused and relevant health promotion interventions is critical for behavioral change in a low-resource or special population. Evidence-based interventions, however, may not match the specific population or health concern of interest. This article describes the Multisource Method (MSM), which, in combination with a workshop format, may be used by health professionals and researchers in health promotion program development. The MSM draws on positive deviance practices and processes, focus groups, community advisors, behavioral change theory, and evidence-based strategies. Use of the MSM is illustrated in the development of ethnic-specific weight loss interventions for low-income postpartum women. The MSM may be useful in designing future health programs designed for other special populations for whom existing interventions are unavailable or lack relevance. [source] A Portrait: Magdalena's DreamPUBLIC HEALTH NURSING, Issue 3 2002B.S.N., Jennifer B. Averill R.N., M.S.N., Ph.D. A recent critical ethnographic study examined the effects of the health care system, historical exploitation, socioeconomic factors, and cultural values on retired migrant farm workers in northeastern Colorado. Combining ethnographic interviews, participant observation, photography, and critical analysis, study findings indicated a need to increase the cultural knowledge and collaborative efforts of health care providers. Emerging from the study, this article presents a creative composite vignette of retired migrant farm workers. The narrative and photograph offer testimony to the lived experience of these rural older Hispanic persons. The intent of the story is to provide the readers with deepened understanding of the hardships, social ostracism, economic challenges, personal hardiness, and cultural values that are characteristic of this special population. [source] Medical and psychiatric problems among men and women in a community corrections residential settingBEHAVIORAL SCIENCES & THE LAW, Issue 5 2009Tracy D. Gunter M.D. Though the medical and mental health morbidity of incarcerated offenders has been discussed in a number of recent reports, very few data have been published concerning medical and mental health problems facing those on community corrections supervision. In this study of community corrections offenders utilizing residential facilities, we found that frequencies of substance use disorders, other mental health disorders, and medical problems exceeded frequencies found in the community and, in some cases, were higher than frequencies found in incarcerated individuals. Of particular concern were the high frequencies of substance use disorders, traumatic brain injury, anxiety states, suicidal ideation, and prior self-harm. While the level of self-reported medical and mental health service utilization was higher than expected, it appeared low relative to the disease burden reported by this special population. We conclude that concurrent evaluation and treatment of medical and psychiatric problems during the process of community supervision is indicated in this population. Copyright © 2009 John Wiley & Sons, Ltd. [source] Primary prevention of neural tube defects with folate in Western Australia: the value of the Western Australian Birth Defects RegistryCONGENITAL ANOMALIES, Issue 2 2006Carol Bower ABSTRACT This paper reviews the role of the Western Australian Birth Defects Registry in the primary prevention of neural tube defects. The Registry provides complete and up-to-date information on all neural tube defects (NTD), including terminations of pregnancy. These data have been used to determine a baseline rate of NTD and to monitor trends in NTD over time, when health promotion of folic acid supplement use and voluntary fortification of food with folate were introduced. The register has also been used to investigate NTD in special populations (Indigenous infants in Australia) and as a sampling frame for case control studies. The data derived from these studies have been used to assist in assessing whether mandatory food fortification in Australia is indicated to prevent NTD. [source] Rural mental health and psychological treatment: a review for practitionersJOURNAL OF CLINICAL PSYCHOLOGY, Issue 5 2010K. Bryant Smalley Abstract Practitioners in rural areas face particular challenges in providing psychological services, ranging from disparate rates of mental disorders to unique circumstances in treating special populations. In this article, we discuss the burden of mental disorders in rural areas, current trends in integration of mental health care and primary care, and unique concerns practitioners face in treating two special populations in rural areas (children and families, and older adults and their caregivers). Implications for practice are also discussed. © 2010 Wiley Periodicals, Inc. J Clin Psychol: In Session 66:1,11, 2010. [source] Online Communication as a Potential Travel Medicine Research Tool: Analysis of Messages Posted on the TravelMed ListservJOURNAL OF TRAVEL MEDICINE, Issue 1 2009Liane Macdonald MD Background Access to the Internet and electronic mail has created opportunities for online discussion that can facilitate medical education and clinical problem solving. Research into the use of these information technologies is increasing and the analysis of these tools can support and guide the activities of professional organizations, including educational endeavors. Objective The initial objective was to analyze patterns of information exchange on the International Society of Travel Medicine's (ISTM) travel health electronic mailing list related to a specific area of society interest. Secondary objectives included the analysis of listserv use in relation to subscriber demographics and rates of participation to support travel health educational activities. Methods This study examined the use of the ISTM TravelMed listserv over an 8-month period from January 1, 2006, to July 31, 2006. Descriptive data analysis included TravelMed user demographics, the type of posting, the topic and frequency of postings, and the source of information provided. Results During the study period, 911 (47%) of the eligible ISTM members subscribed to the TravelMed listserv. About 369 of these subscribers posted 1,710 individual messages. About 1,506 (88%) postings were educational; 207 (12%) postings were administrative. A total of 389 (26%) of the educational postings were primary queries and 1,120 (74%) were responses, with a mean string length of 2.9 responses per query (range: 1,51). Twenty participants contributed 40% of the educational postings. The topics with the most frequent postings were vaccines and vaccine-preventable diseases (473/31%) and malaria (258/17%). Postings focused on special populations, including pregnant women or immigrants, comprised a total of 14 postings (<1%). Conclusions During the study period, a limited number of ISTM members (19%) authored postings on the listserv. Regular discussion centered on a limited number of recurring topics. The analysis provides several opportunities for the support of educational initiatives, clinical problem solving, and program evaluation. [source] Sibling socialization: The effects of stressful life events and experiencesNEW DIRECTIONS FOR CHILD & ADOLESCENT DEVELOPMENT, Issue 126 2009Katherine J. Conger Stressful life events and experiences may disrupt the typical day-to-day interactions between sisters and brothers that provide the foundation of sibling socialization. This chapter examines four experiences that may affect patterns of sibling interaction: parental marital conflict, parental divorce and remarriage, foster care placement, and a sibling's developmental disability. We propose a model to guide future research on sibling socialization in distressed families and special populations in which qualities of the sibling relationship moderate the effects of stressful life experiences on child and family adjustment. [source] Understanding the ergonomic risk for musculoskeletal disorders in the United States agricultural sectorAMERICAN JOURNAL OF INDUSTRIAL MEDICINE, Issue 7 2007Kermit G. Davis PhD Abstract Introduction Farming is a very large industry in the United States. Understanding the risks for injuries and more specifically musculoskeletal disorders in this industry poses a challenge for health officials. Methods A review was conducted of the existing peer-reviewed publications prior to December 2006 about injuries and musculoskeletal disorders for farmers and farm workers. The aim was to review existing knowledge concerning: (1) the prevalence, types, and causes of farm-related injuries, paying particular attention to musculoskeletal disorders and the special populations within the agricultural sector, and (2) interventions that have been developed to reduce risk factors associated with farm-related injuries. Results Farmers and farm workers experience high rates of low back, shoulder, and upper extremity disorders. Musculoskeletal disorders may disproportionately affect farm youth and migrant workers due to the types of farm tasks performed. There is an urgent need for improved and validated interventions to reduce exposures and to improve the health of farmers and farm workers. Discussion Future farm-related musculoskeletal disorder research should emphasize: (1) better identification of exposures for special populations, (2) development of interventions for diverse farm populations, and (3) identification of additional exposures for musculoskeletal disorders. Inadequate understanding of musculoskeletal disorders in farming impedes efforts to prevent this common and important type of occupational injuries on farms. Am. J. Ind. Med. 50:501,511, 2007. © 2007 Wiley-Liss, Inc. [source] Developing Health Promotion Interventions: A Multisource Method Applied to Weight Loss Among Low-Income Postpartum WomenPUBLIC HEALTH NURSING, Issue 2 2010Lorraine O. Walker ABSTRACT Developing focused and relevant health promotion interventions is critical for behavioral change in a low-resource or special population. Evidence-based interventions, however, may not match the specific population or health concern of interest. This article describes the Multisource Method (MSM), which, in combination with a workshop format, may be used by health professionals and researchers in health promotion program development. The MSM draws on positive deviance practices and processes, focus groups, community advisors, behavioral change theory, and evidence-based strategies. Use of the MSM is illustrated in the development of ethnic-specific weight loss interventions for low-income postpartum women. The MSM may be useful in designing future health programs designed for other special populations for whom existing interventions are unavailable or lack relevance. [source] Studies in Otitis Media: Children's Hospital Of Pittsburgh,University of Pittsburgh Progress Report,2004THE LARYNGOSCOPE, Issue S105 2004Charles D. Bluestone MD Abstract Objectives/Hypothesis: The present Progress Report has summarized the key otitis media clinical trials and laboratory studies conducted since 1969 by investigators at the Children's Hospital of Pittsburgh,University of Pittsburgh (Pittsburgh, PA). Study Design: Review. Methods: Included in the discussion are the following: 1) studies of the epidemiology and risk factors; 2) anatomy and pathology of the eustachian tube,middle ear from human temporal bone histopathological specimens; 3) physiology and pathophysiology of the eustachian tube,middle ear in humans and animal models; 4) pathogenesis; 5) otitis media in special populations (e.g., patients with cleft palate, Native Americans, patients with Down syndrome); 6) microbiology; 7) diagnosis; 8) outcomes of randomized clinical trials that evaluated efficacy of nonsurgical and surgical methods of treatment and prevention; 9) studies of certain complications and sequelae (e.g., effect of middle-ear effusion on hearing, early child development, and the vestibular system; chronic suppurative otitis media). Also included are relevant summary tables and 256 references. [source] Alcohol, Tobacco, and Other Drugs: Future Directions for Screening and Intervention in the Emergency DepartmentACADEMIC EMERGENCY MEDICINE, Issue 11 2009Rebecca M. Cunningham MD Abstract This article is a product of a breakout session on injury prevention from the 2009 Academic Emergency Medicine consensus conference on "Public Health in the ED: Screening, Surveillance, and Intervention." The emergency department (ED) is an important entry portal into the medical care system. Given the epidemiology of substance use among ED patients, the delivery of effective brief interventions (BIs) for alcohol, drug, and tobacco use in the ED has the potential to have a large public health impact. To date, the results of randomized controlled trials of interventional studies in the ED setting for substance use have been mixed in regard to alcohol and understudied in the area of tobacco and other drugs. As a result, there are more questions remaining than answered. The work group developed the following research recommendations that are essential for the field of screening and BI for alcohol, tobacco, and other drugs in the ED. 1) Screening,develop and validate brief and practical screening instruments for ED patients and determine the optimal method for the administration of screening instruments. 2) Key components and delivery methods for intervention,conduct research on the effectiveness of screening, brief intervention, and referral to treatment (SBIRT) in the ED on outcomes (e.g., consumption, associated risk behaviors, and medical psychosocial consequences) including minimum dose needed, key components, optimal delivery method, interventions focused on multiple risk behaviors and tailored based on assessment, and strategies for addressing polysubstance use. 3) Effectiveness among patient subgroups,conduct research to determine which patients are most likely to benefit from a BI for substance use, including research on moderators and mediators of intervention effectiveness, and examine special populations using culturally and developmentally appropriate interventions. 4) Referral strategies,a) promote prospective effectiveness trials to test best strategies to facilitate referrals and access from the ED to preventive services, community resources, and substance abuse and mental health treatment; b) examine impact of available community services; c) examine the role of stigma of referral and follow-up; and d) examine alternatives to specialized treatment referral. 5) Translation,conduct translational and cost-effectiveness research of proven efficacious interventions, with attention to fidelity, to move ED SBIRT from research to practice. [source] Five year research update (1996,2000): evaluations for competence to stand trial (adjudicative competence)BEHAVIORAL SCIENCES & THE LAW, Issue 3 2003Denise L. Mumley Ph.D This article reviews and evaluates publications during 1996,2000 with relevance for assessments of competence to stand trial (also known as adjudicative competence). The review focuses specifically on articles that provide new concepts or data supported by research or case analyses. The studies are reviewed under the following headings: (i) the systemic context of evaluations of adjudicative competence (AC); (ii) conceptual guidelines for AC evaluations; (iii) research on AC assessment methods; (iv) empirical correlates of AC judgments and psycholegal abilities; (v) quality of AC evaluations and reports; (vi) interpretation of AC evaluation data; (vii) issues in AC assessment of special populations (e.g., juveniles, persons with mental retardation, and women); and (viii) treatment to restore competence. Suggestions are offered for further research to advance the quality of clinical evaluations of adjudicative competence. Copyright © 2003 John Wiley & Sons, Ltd. [source] Frequency of renal impairment, advanced age, obesity and cancer in venous thromboembolism patients in clinical practiceJOURNAL OF THROMBOSIS AND HAEMOSTASIS, Issue 5 2007L. M. COOK Summary.,Background:,Low-molecular-weight heparin (LMWH) dosed by weight is recommended as first-line therapy for the initial treatment of venous thromboembolism (VTE) and as monotherapy for long-term treatment of cancer-related VTE. In ,special populations' such as those with renal impairment or the elderly, weight-based dosing may be excessive, and capping the dose in obese patients may lead to inadequate dosing. Objectives:,We determined the frequency of ,special population' characteristics (renal impairment, advanced age, obesity) and cancer among VTE patients in clinical practice, and assessed whether these characteristics appeared to influence the type and dose of anticoagulants prescribed. Methods:,During 2004,2005, among consecutive patients with VTE at two large Canadian hospitals, the proportions with the above characteristics were calculated and treatments prescribed were determined. Results:,Of 524 VTE patients, 31% were aged > 75 years. Moderate renal impairment [creatinine clearance (CrCl) 30,59 mL min,1] was present in 20% of patients, and severe renal impairment (CrCl < 30 mL min,1) in 5% of patients. LMWH was prescribed to 67% of patients with severe renal impairment and to 83% of patients with moderate renal impairment. Body weight was > 100 kg in 15% of patients. Underdosing of LMWH by > 10% was documented in 36% of such patients compared with 8% of patients < 100 kg (P < 0.001). Among 26% of patients with active cancer, only one-third were prescribed LMWH monotherapy. Conclusions:,In clinical practice, renal impairment, advanced age, obesity and cancer are frequently present in patients with VTE. A considerable proportion of these patients may not receive the optimal type or dose of medication to treat VTE. [source] | |||||||||||||