Didriksendalby4953
This study examined the effects of the Great Recession (GR) on type 2 diabetes management using individual-level data in a historically underserved, high-risk patient population at a federally qualified health center (FQHC). Comparing three time periods (pre-recession [2004-2006], recession [2007-2009], and recession recovery [2010-2012]), we found that patients had significant increases in blood pressure and body mass index as they entered the GR. Conversely, we found a significant decrease in HbA1c across the study period likely influenced by interventions to improve HbA1c during this time at this FQHC. While previous studies on the impact of the GR have focused primarily on the middle class, our findings suggest that high-risk patients who are already struggling to maintain their health may be further hurt by economic downturns. click here Intensive programs to serve these patients can act as a safety net to buffer the potential health impacts of these downturns.In Montana, American Indians with chronic illnesses (CIs) die 20 years earlier than their White counterparts highlighting an urgent need to develop culturally consonant CI self-management programs. Historical and current trauma places Indigenous peoples at increased health risk relative to others, and negatively influences CI self-management. The Apsáalooke Nation and Montana State University worked together to develop and implement a trauma-informed CI self-management program to improve the Apsáalooke community's health. This paper describes the origins and development of the trauma-informed components of the program. Using community stories and a literature review of trauma-informed interventions, partners co-developed culturally consonant trauma materials and activities grounded in community values and spirituality. Trauma-informed content was woven throughout three intervention gatherings and was the central focus of the gathering, Daasachchuchik ('Strong Heart'). Apsáalooke ancestors survived because of their cultural strengths and resilience; these cultural roots continue to be essential to healing from historical and current trauma.Low-dose computed tomography (LDCT), an accepted U.S. screening tool for early lung cancer detection, is not widely-used in Puerto Rico. We investigated knowledge and attitudes about LDCT in focus groups of primary care physicians (PCP) and individuals at high risk for lung cancer (HRI) in Puerto Rico. Transcribed/translated audio-recorded discussions were analyzed with the constant comparison method. Both groups had limited knowledge about LDCT and concerns regarding insurance coverage. Most HRIs had never had a provider recommend LDCT and believed that having symptoms was necessary to obtain LDCT screening. Perceived barriers included fears about results and the procedure; a perceived benefit was having early detection and possibly being cured. Few PCPs had ever recommended LDCT to a patient, with those who had basing their decision on symptoms/smoking history but having challenges with insurance. More education on LDCT is needed among HRIs, and U.S. Preventive Services Task Force guidelines should be widely distributed to encourage physician recommendations.
About 22,000 refugee women are resettled in the U.S. annually. Women's health screenings for breast and cervical cancer and reproductive health should be examined within the context of the built environment where refugees are resettled.
1) Analyze the proportion of resettled refugees who had women's health screenings and 2) map the available refugee, health, and social services organizations compared with the ZIP codes where refugees were resettled.
Two clinical sites in Philadelphia conducted a retrospective chart review (N = 914). Community organizations were mapped.
Within age guidelines, 460 (59%) women had a cervical cancer screening, 95 (63%) had a breast cancer screening, 296 (51%) were currently using contraception, and 118 (13%) became pregnant. Most community organizations were not located within ZIP codes where refugees resettled.
There is a need for increased resources-which could increase women's screening rates-within a broader area of Philadelphia.
There is a need for increased resources-which could increase women's screening rates-within a broader area of Philadelphia.
Women of color and people of low socioeconomic status continue to have poorer health outcomes than their counterparts. This study explored patientsatisfaction and perceptions of low-income African American women regarding access to care.
The study took a mixed-methods approach. Ninety-five women were surveyed using the Short-form Patient Satisfaction Questionnaire (PSQ-18). Two sub-scales assessed satisfaction with access to care. Qualitative data were collected using one-on-one interviews (n=22) and two focus groups of community leaders. A thematic analysis was then conducted.
On a 5-point scale, patient-satisfaction with access was moderate (accessibility and convenience -2.99; financial aspects -3.35). Emerging themes included obtaining insurance, dynamics of insurance eligibility, adequacy and scope of insurance coverage, scheduling appointments, and transportation.
Providing insurance coverage for people with low incomes is not sufficient to close the racial/ethnic disparities gap in access to care. Understanding the challenges from patients' perspectives can help to make health care resources and services more accessible.
Providing insurance coverage for people with low incomes is not sufficient to close the racial/ethnic disparities gap in access to care. Understanding the challenges from patients' perspectives can help to make health care resources and services more accessible.This study assessed dependent personality, marital satisfaction, and mindful awareness and their association with postpartum depression and anxiety. It was a cross-sectional study of nursing mothers, within 6-14 weeks postpartum, at the postnatal and children's welfare clinics of two tertiary hospitals in Enugu, southeastern Nigeria. The nursing mothers responded to different questionnaires that measure each of these variables. Correlations and multiple regression analyses were used to measure the strength of association between the variables in the study and to identify predictors for the outcome variables of interest, respectively. Low mindful attention awareness, poor marital satisfaction, and low dependency predicted an increased risk of postpartum depression and anxiety, with low mindful attention awareness as the strongest predictor. The findings from the study carry significant implications for the roles of dependent personality, marital satisfaction, and mindful awareness in the etiology of postpartum depression and anxiety in Southeast Nigeria.
