- The document summarizes research exploring the utility of the PATH Type assessment tool with males over 40 in the UK's National Health Service Northeast region.
- Results found response patterns and associations with demographics and socioeconomic factors consistent with US studies, suggesting the tool could work in the UK system.
- Higher rates of some less health-involved PATH Types in the sample may correlate with lower healthcare demand compared to other NHS regions. Larger studies are recommended.
This document compares three regression methods - ordinary least squares (OLS), Poisson regression, and negative binomial regression - for analyzing count data from infrequently occurring health events. It uses data on adolescent pregnancies from the National Longitudinal Survey of Adolescent Health to illustrate the different approaches. OLS regression is found to be inappropriate for modeling count data that is highly skewed and clustered around low values. Poisson and negative binomial regression are identified as more suitable alternatives that do not assume a normal distribution of error terms or dependent variables. The strengths and limitations of each method are discussed to help researchers choose the most appropriate analysis.
The Relationship Between Sexual Abuse And AddictionAndrea Presnall
This document summarizes 10 studies that examine the relationship between childhood sexual abuse and later substance abuse. Across the studies, several common findings emerged: childhood sexual abuse was associated with earlier initiation and more frequent substance use, particularly of alcohol and drugs; substance use partially mediated the relationship between childhood sexual abuse and later health issues like HIV risk behaviors; and experiences of childhood sexual abuse along with other childhood trauma were correlated with higher rates of substance abuse disorders. The studies highlighted the need for larger and more diverse sample sizes in future research.
This document discusses Sir Richard Doll's landmark case-control studies from 1950 and 1990 that linked smoking to lung cancer. The 1950 study compared hospital patients with and without lung cancer and found heavy smokers were 50 times more likely to develop lung cancer. Subsequent national trends in the UK showed smoking rates halved between 1950-1990, while lung cancer rates fell more sharply, indicating risk declined for continuing smokers. However, those still smoking in 1990 had higher risks due to persistent smoking. The study concluded that stopping smoking, even in middle age, significantly reduces lung cancer risks, and stopping before middle age avoids over 90% of tobacco-related risk.
This study examined factors affecting adherence to Suboxone treatment among 50 African American patients through a retrospective chart review. The results showed significantly negative correlations between adherence and concurrent use of opioids, cocaine, and alcohol. Surprisingly, PTSD showed a positive correlation with adherence, contradicting other studies. No correlation was found between adherence and unemployment. The study concluded that while mental health issues and unemployment may impact adherence, the small sample size likely influenced the results. Larger studies are still needed to fully understand factors affecting Suboxone adherence in minority groups.
The document describes a study on the prevalence of overweight and obesity in Parkinson's disease (PD) patients in Mexico City. The study found:
1) 134 PD patients and 134 healthy controls were recruited and had their weight, height and BMI measured.
2) PD patients had a statistically significant lower mean BMI than controls, but there was no significant difference in overweight, obesity or underweight prevalence between the groups.
3) In PD patients, lower BMI correlated with higher Hoehn & Yahr stage (indicating more advanced disease) and worse motor function scores. BMI did not correlate with disease duration or levodopa dose.
4) 70% of PD patients were found to have overweight or
Correlation between Demographic, Socio-economic, and Cancer-Specific Factors with Quality of Life Scores among Newly-Diagnosed Cancer Patients of the Medical Oncology Clinics of the Philippine General Hospital Cancer Institute
https://www.actamedicaphilippina.org/issue/1102
cancer in the young, cancer in AYA, cancer in TYA, yeenage and adolescent cancer, adolescent and young adult cancer
Presentation date : 03-03-2012
CME - Head and Neck Oncology
This document provides guidance for medical providers on optimally caring for Black and Latino men who have sex with men (BLMSM) patients. It emphasizes the importance of taking comprehensive sexual histories, providing vaccinations and recommending regular STD/HIV testing. It also discusses how stigma can act as a barrier and provides suggestions for addressing stigma, such as emphasizing confidentiality and not making assumptions. The document recommends following CDC guidelines for screening and vaccination of MSM patients.
This document compares three regression methods - ordinary least squares (OLS), Poisson regression, and negative binomial regression - for analyzing count data from infrequently occurring health events. It uses data on adolescent pregnancies from the National Longitudinal Survey of Adolescent Health to illustrate the different approaches. OLS regression is found to be inappropriate for modeling count data that is highly skewed and clustered around low values. Poisson and negative binomial regression are identified as more suitable alternatives that do not assume a normal distribution of error terms or dependent variables. The strengths and limitations of each method are discussed to help researchers choose the most appropriate analysis.
The Relationship Between Sexual Abuse And AddictionAndrea Presnall
This document summarizes 10 studies that examine the relationship between childhood sexual abuse and later substance abuse. Across the studies, several common findings emerged: childhood sexual abuse was associated with earlier initiation and more frequent substance use, particularly of alcohol and drugs; substance use partially mediated the relationship between childhood sexual abuse and later health issues like HIV risk behaviors; and experiences of childhood sexual abuse along with other childhood trauma were correlated with higher rates of substance abuse disorders. The studies highlighted the need for larger and more diverse sample sizes in future research.
This document discusses Sir Richard Doll's landmark case-control studies from 1950 and 1990 that linked smoking to lung cancer. The 1950 study compared hospital patients with and without lung cancer and found heavy smokers were 50 times more likely to develop lung cancer. Subsequent national trends in the UK showed smoking rates halved between 1950-1990, while lung cancer rates fell more sharply, indicating risk declined for continuing smokers. However, those still smoking in 1990 had higher risks due to persistent smoking. The study concluded that stopping smoking, even in middle age, significantly reduces lung cancer risks, and stopping before middle age avoids over 90% of tobacco-related risk.
This study examined factors affecting adherence to Suboxone treatment among 50 African American patients through a retrospective chart review. The results showed significantly negative correlations between adherence and concurrent use of opioids, cocaine, and alcohol. Surprisingly, PTSD showed a positive correlation with adherence, contradicting other studies. No correlation was found between adherence and unemployment. The study concluded that while mental health issues and unemployment may impact adherence, the small sample size likely influenced the results. Larger studies are still needed to fully understand factors affecting Suboxone adherence in minority groups.
The document describes a study on the prevalence of overweight and obesity in Parkinson's disease (PD) patients in Mexico City. The study found:
1) 134 PD patients and 134 healthy controls were recruited and had their weight, height and BMI measured.
2) PD patients had a statistically significant lower mean BMI than controls, but there was no significant difference in overweight, obesity or underweight prevalence between the groups.
3) In PD patients, lower BMI correlated with higher Hoehn & Yahr stage (indicating more advanced disease) and worse motor function scores. BMI did not correlate with disease duration or levodopa dose.
4) 70% of PD patients were found to have overweight or
Correlation between Demographic, Socio-economic, and Cancer-Specific Factors with Quality of Life Scores among Newly-Diagnosed Cancer Patients of the Medical Oncology Clinics of the Philippine General Hospital Cancer Institute
https://www.actamedicaphilippina.org/issue/1102
cancer in the young, cancer in AYA, cancer in TYA, yeenage and adolescent cancer, adolescent and young adult cancer
Presentation date : 03-03-2012
CME - Head and Neck Oncology
This document provides guidance for medical providers on optimally caring for Black and Latino men who have sex with men (BLMSM) patients. It emphasizes the importance of taking comprehensive sexual histories, providing vaccinations and recommending regular STD/HIV testing. It also discusses how stigma can act as a barrier and provides suggestions for addressing stigma, such as emphasizing confidentiality and not making assumptions. The document recommends following CDC guidelines for screening and vaccination of MSM patients.
Medication Adherence in America reportcard full by National Community Pharmac...Fran Maciel
This document provides a summary of key findings from the National Report Card on Medication Adherence survey conducted by the National Community Pharmacists Association. Some key findings include:
- The average adherence score among those surveyed was 79 out of 100, equivalent to a C+ grade. Scores varied based on factors like affordability of medications, connection to healthcare providers, and side effects.
- The top reasons for non-adherence were simply forgetting to take medications (41% of respondents) and running out of medication (top reasons also included being away from home, cost, and side effects).
- Regression modeling identified the strongest independent predictors of adherence as personal connection to a pharmacist, ability to afford medications, continuity in
Factors Predicting Sexual Dysfunction in Thai Cancer Patients after TreatmentCrimsonpublishersTTEH
Aim: Purpose of this research was to study what factors that can predict sexual dysfunction in Thai patients with cancer after treatment.Methods: This study was a predictive correlational research. Participants were 110 Thai patients with cancer of breast, prostate, bladder, and colon who were completed treatments from 6 months - 2 years from a university hospital, and 2 cancer specialize hospitals in 2013. The instruments were (1) the personal information and disease related treatment questionnaires (2) Dyadic Adjustment Scale developed by Spanier [1] and were translated into Thai by Kasemkitawatana (1993); and (3) the Sexual Health Dysfunction questionnaires developed by Kumdaeng [2]. Alpha Cronbach’s coefficients were .89 both Dyadic Adjustment Scale and Sexual Health Dysfunction questionnaires. Data were analyzed by descriptive and multiple regression. Result: Results found that gender, dyadic consensus, and affectional expression in the dyadic adjustment could predict the sexual dysfunction at .05 level, whereas age, duration of marriage, and other two subscales of dyadic adjustment could not predict the sexual dysfunction in patients with cancer after treatment.Conclusion: Results confirmed that Thai cancer patients generally had to deal with sexual dysfunction. Female with low degree of dyadic consensus and less affectional expression predictively had more sexual dysfunction. These results can be used as evidence-based to provide and improve sexual health in patients with cancer after treatment.
Addressing the needs of fertility patientsLauri Pasch
This study examined the mental health of 352 women and 274 men undergoing fertility treatment. The researchers found high rates of depressive and anxiety symptoms among participants, with over half of women and a third of men experiencing clinical depression, and over 75% of women and 60% of men experiencing clinical anxiety. However, only 21% of women and 11.3% of men received mental health services, and about a quarter were provided information about such services by their fertility clinic. Those with the most severe or prolonged distress were no more likely to receive services or information. The researchers concluded that while psychological distress is common among fertility patients, most do not receive mental health support, and services are not targeted to those most in need.
How We Do Harm: A Webinar by SHARE with Dr. Otis Brawleybkling
Dr. Otis Brawley, author of How We Do Harm, pulls back the curtain on how health care is really practiced in American. Hosted by SHARE: Self-help for Women with Breast or Ovarian Cancer.. www.sharecancersupport.org. If you would like to watch the full webinar, visit www.sharecancersupport.org/brawley.
This document discusses epidemiological research methods and their application to health informatics. It covers the basic principles of epidemiology including different study designs like cross-sectional, case-control, cohort, and experimental studies. Examples are provided of how these designs have been used in health informatics research to study topics like use of health IT in physician offices and relationships between variables in electronic health record data. The document also explains how to calculate measures like prevalence rates, sensitivity, specificity, odds ratios, relative risk, and incidence rates for different epidemiological study designs.
Vitiligo and alopecia areata are both common, T cell-driven autoimmune diseases of the skin. Recognizing
similarities and differences between these diseases will promote a more complete understanding of their
pathogenesis as well as the development of new treatments.
This study examined variations in cost, mortality, and race among hospitalized patients with multiple chronic conditions (MCC) using a dataset of 788 patient cases from 2012. The results showed significantly higher average total charges for patients with 5+ chronic conditions compared to those with 1-4 conditions. There was no significant association found between the number of chronic conditions and mortality or between Hispanic and Black race among patients with 5+ conditions. The findings support the trend of higher healthcare costs for patients with MCC, though inconsistencies in mortality and race results highlight limitations of the small dataset size. Further exploration of factors related to rising MCC prevalence and healthcare costs is recommended.
The document discusses a study examining self-efficacy, body image, and sexual adjustment in women with breast cancer. Key findings include:
1) Women with breast cancer had low self-efficacy and their former sexual adjustment and body image negatively affected their post-diagnosis sexual functions.
2) Women who underwent mastectomy or lacked partner support/sexuality education had lower scores on measures of self-efficacy and sexual/body image adjustment.
3) There was a positive correlation between self-efficacy in self-care and better sexual adjustment, sexual function, and body image. Support from oncology professionals is important for women's physical, social and emotional needs after a breast cancer diagnosis.
1) The document describes a study examining infection-related health services available in substance abuse treatment programs and barriers to providing these services.
2) It found that programs with addiction services tailored for women or minorities were more likely to provide various infection-related services and non-medical services.
3) The most commonly cited barriers to providing infection services were funding, patient health insurance, and patient acceptance, especially for programs serving women and minority populations.
- Cohort studies examine the association between an exposure and an outcome by following groups over time and comparing their experience.
- This document discusses what a cohort study is, how it differs from other study designs in determining temporal relationships, and provides examples of cohort designs and their analysis.
- Key aspects reviewed include prospectively following groups based on exposure status and comparing disease incidence rates and relative risks between exposed and unexposed groups over time.
This curriculum vitae summarizes Jillian Murphy's education and qualifications. She is currently a candidate for a Doctor of Pharmacy degree at the University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences, and has a Bachelor of Science in Biomedical Science from SUNY Buffalo. Her experience includes internships at various pharmacies where she provided patient counseling and completed dispensing activities. She has also completed several advanced pharmacy practice experiences in different practice settings such as oncology, transplant, and community pharmacy.
This study examined the relationship between psychosocial factors (depression, anxiety, coping style, social support) and survival outcomes in 708 young women with early-stage breast cancer in Australia. Psychosocial factors were assessed via questionnaires administered about 11 months after diagnosis on average. Over a median follow-up of 8.2 years, 33% experienced distant cancer recurrence and 24% died. No statistically significant associations were found between any psychosocial factors and distant disease-free or overall survival after adjusting for known prognostic factors like tumor characteristics and treatment. Higher levels of anxious preoccupation were marginally associated with poorer survival in unadjusted analyses but not after adjustment, and anxious preoccupation was also associated with worse tumor features. The findings do
Genetic testing for breast cancer like HER2 and gene expression profiling (GEP) can impact healthcare disparities. While HER2 testing is widely used with trastuzumab treatment, there is still some underuse. GEP testing is only modestly used and is associated with less chemotherapy for low risk patients but more for high risk. Studies show black women may be less eligible for GEP and there is inadequate data on effectiveness in diverse groups. Ensuring validation in diverse populations, broad recruitment, and addressing social factors can help reduce disparities in precision medicine.
This study examined the relationship between gender and sexual risk behaviors among males and females. A mixed methods approach was used, including focus groups with 12 participants and an online/hard copy survey completed by 90 participants. The survey assessed demographics, sexual activity levels, and risk behaviors. Results found no statistically significant difference between males and females in terms of risk behaviors. However, qualitative findings suggested alcohol and drug use contribute to higher risk behaviors. In conclusion, gender alone did not predict risk, though other factors like substance use were implicated.
This document discusses sources of information bias in epidemiological studies. It describes different types of information bias including classification or measurement bias, differential versus non-differential bias, and direction of bias. Examples are provided of sources of error such as respondent bias from inability to recall or disclose accurately, data collector bias from unclear questions, and selection bias from only a portion of letters arriving in their destination in a classic study. Validation techniques and avoiding data collection errors are also discussed.
This document summarizes a study that used the Trauma Symptom Checklist for Children - Alternate Version (TSCC-A) to assess trauma symptoms in children ages 8-16 who were part of the LONGSCAN studies. The TSCC-A is a shortened version of the Trauma Symptom Checklist for Children (TSCC) that excludes questions about sexual issues. Results showed that LONGSCAN children scored higher than norms on clinical scales like anxiety, depression and dissociation. They were also more likely to underreport or overreport symptoms. Hispanic children and those from certain sites tended to score highest clinically. Reliability of the scales was generally good, suggesting the TSCC-A can validly assess trauma symptoms in
This study examined how numerical skills related to asthma self-management contribute to asthma-related quality of life. The study found that poorer numerical skills, as measured by an Asthma Numeracy Questionnaire, were associated with lower asthma-related quality of life. This relationship was largely mediated by household income and partially by self-efficacy. The findings suggest that improving numerical skills could help asthma patients better manage their condition and improve their quality of life, in part by increasing income and self-efficacy.
Case control studies are retrospective studies that identify risk factors for diseases like cancer. They compare exposed and unexposed groups among people who are diseased (cases) and not diseased (controls). Cases and controls are matched based on factors like age and gender to make the groups comparable. Exposure is then measured and odds ratios are calculated to determine if cases were more likely to be exposed compared to controls. While quick and cost effective, case control studies are subject to biases due to recall and temporality issues.
This abstract summarizes a secondary analysis that compared oral anti-cancer agent (OA) dosages prescribed to 155 cancer patients to dosages recommended by the FDA. The analysis found that 55.5% of patients received the FDA-recommended daily dosage, while 19.4% received more and 25.2% received less. The most common drug prescribed was capecitabine, and for that drug only 5.5% of patients received the FDA dosage, with 54.5% receiving more and 40% receiving less. The abstract concludes that nurses should be aware of FDA dosing guidelines for oral chemotherapy agents prescribed to their patients.
A cohort study involves observing a group of individuals over time to examine exposure-outcome relationships. Key characteristics include prospectively following exposed and unexposed groups to compare disease outcomes. Major biases include loss to follow up and misclassification of exposure status. Cohort studies are well-suited for rare exposures and allow examination of multiple outcomes, but require large sample sizes and are time-consuming.
The author expresses fear for their safety and the safety of their associates as they have discovered corruption within the court system. They believe that those who uncover such corruption often meet mysterious and fatal ends. However, the author and their people will continue their work, even at the risk of their lives, as Anonymous is now the only source of true justice. They pledge their loyalty and friendship to Anonymous as long as they continue pursuing justice for the people.
Gestión de la Calidad. Caso Intendencia Lima - Curso de formación sobre Gesti...EUROsociAL II
La Unión Europea ha propuesto un nuevo paquete de sanciones contra Rusia que incluye un embargo al petróleo. El embargo prohibiría la importación de petróleo ruso a la UE y también prohibiría a los buques europeos transportar petróleo ruso a otros lugares. Sin embargo, Hungría se opone al embargo al petróleo, lo que podría retrasar la aprobación del paquete de sanciones de la UE.
Medication Adherence in America reportcard full by National Community Pharmac...Fran Maciel
This document provides a summary of key findings from the National Report Card on Medication Adherence survey conducted by the National Community Pharmacists Association. Some key findings include:
- The average adherence score among those surveyed was 79 out of 100, equivalent to a C+ grade. Scores varied based on factors like affordability of medications, connection to healthcare providers, and side effects.
- The top reasons for non-adherence were simply forgetting to take medications (41% of respondents) and running out of medication (top reasons also included being away from home, cost, and side effects).
- Regression modeling identified the strongest independent predictors of adherence as personal connection to a pharmacist, ability to afford medications, continuity in
Factors Predicting Sexual Dysfunction in Thai Cancer Patients after TreatmentCrimsonpublishersTTEH
Aim: Purpose of this research was to study what factors that can predict sexual dysfunction in Thai patients with cancer after treatment.Methods: This study was a predictive correlational research. Participants were 110 Thai patients with cancer of breast, prostate, bladder, and colon who were completed treatments from 6 months - 2 years from a university hospital, and 2 cancer specialize hospitals in 2013. The instruments were (1) the personal information and disease related treatment questionnaires (2) Dyadic Adjustment Scale developed by Spanier [1] and were translated into Thai by Kasemkitawatana (1993); and (3) the Sexual Health Dysfunction questionnaires developed by Kumdaeng [2]. Alpha Cronbach’s coefficients were .89 both Dyadic Adjustment Scale and Sexual Health Dysfunction questionnaires. Data were analyzed by descriptive and multiple regression. Result: Results found that gender, dyadic consensus, and affectional expression in the dyadic adjustment could predict the sexual dysfunction at .05 level, whereas age, duration of marriage, and other two subscales of dyadic adjustment could not predict the sexual dysfunction in patients with cancer after treatment.Conclusion: Results confirmed that Thai cancer patients generally had to deal with sexual dysfunction. Female with low degree of dyadic consensus and less affectional expression predictively had more sexual dysfunction. These results can be used as evidence-based to provide and improve sexual health in patients with cancer after treatment.
Addressing the needs of fertility patientsLauri Pasch
This study examined the mental health of 352 women and 274 men undergoing fertility treatment. The researchers found high rates of depressive and anxiety symptoms among participants, with over half of women and a third of men experiencing clinical depression, and over 75% of women and 60% of men experiencing clinical anxiety. However, only 21% of women and 11.3% of men received mental health services, and about a quarter were provided information about such services by their fertility clinic. Those with the most severe or prolonged distress were no more likely to receive services or information. The researchers concluded that while psychological distress is common among fertility patients, most do not receive mental health support, and services are not targeted to those most in need.
How We Do Harm: A Webinar by SHARE with Dr. Otis Brawleybkling
Dr. Otis Brawley, author of How We Do Harm, pulls back the curtain on how health care is really practiced in American. Hosted by SHARE: Self-help for Women with Breast or Ovarian Cancer.. www.sharecancersupport.org. If you would like to watch the full webinar, visit www.sharecancersupport.org/brawley.
This document discusses epidemiological research methods and their application to health informatics. It covers the basic principles of epidemiology including different study designs like cross-sectional, case-control, cohort, and experimental studies. Examples are provided of how these designs have been used in health informatics research to study topics like use of health IT in physician offices and relationships between variables in electronic health record data. The document also explains how to calculate measures like prevalence rates, sensitivity, specificity, odds ratios, relative risk, and incidence rates for different epidemiological study designs.
Vitiligo and alopecia areata are both common, T cell-driven autoimmune diseases of the skin. Recognizing
similarities and differences between these diseases will promote a more complete understanding of their
pathogenesis as well as the development of new treatments.
This study examined variations in cost, mortality, and race among hospitalized patients with multiple chronic conditions (MCC) using a dataset of 788 patient cases from 2012. The results showed significantly higher average total charges for patients with 5+ chronic conditions compared to those with 1-4 conditions. There was no significant association found between the number of chronic conditions and mortality or between Hispanic and Black race among patients with 5+ conditions. The findings support the trend of higher healthcare costs for patients with MCC, though inconsistencies in mortality and race results highlight limitations of the small dataset size. Further exploration of factors related to rising MCC prevalence and healthcare costs is recommended.
The document discusses a study examining self-efficacy, body image, and sexual adjustment in women with breast cancer. Key findings include:
1) Women with breast cancer had low self-efficacy and their former sexual adjustment and body image negatively affected their post-diagnosis sexual functions.
2) Women who underwent mastectomy or lacked partner support/sexuality education had lower scores on measures of self-efficacy and sexual/body image adjustment.
3) There was a positive correlation between self-efficacy in self-care and better sexual adjustment, sexual function, and body image. Support from oncology professionals is important for women's physical, social and emotional needs after a breast cancer diagnosis.
1) The document describes a study examining infection-related health services available in substance abuse treatment programs and barriers to providing these services.
2) It found that programs with addiction services tailored for women or minorities were more likely to provide various infection-related services and non-medical services.
3) The most commonly cited barriers to providing infection services were funding, patient health insurance, and patient acceptance, especially for programs serving women and minority populations.
- Cohort studies examine the association between an exposure and an outcome by following groups over time and comparing their experience.
- This document discusses what a cohort study is, how it differs from other study designs in determining temporal relationships, and provides examples of cohort designs and their analysis.
- Key aspects reviewed include prospectively following groups based on exposure status and comparing disease incidence rates and relative risks between exposed and unexposed groups over time.
This curriculum vitae summarizes Jillian Murphy's education and qualifications. She is currently a candidate for a Doctor of Pharmacy degree at the University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences, and has a Bachelor of Science in Biomedical Science from SUNY Buffalo. Her experience includes internships at various pharmacies where she provided patient counseling and completed dispensing activities. She has also completed several advanced pharmacy practice experiences in different practice settings such as oncology, transplant, and community pharmacy.
This study examined the relationship between psychosocial factors (depression, anxiety, coping style, social support) and survival outcomes in 708 young women with early-stage breast cancer in Australia. Psychosocial factors were assessed via questionnaires administered about 11 months after diagnosis on average. Over a median follow-up of 8.2 years, 33% experienced distant cancer recurrence and 24% died. No statistically significant associations were found between any psychosocial factors and distant disease-free or overall survival after adjusting for known prognostic factors like tumor characteristics and treatment. Higher levels of anxious preoccupation were marginally associated with poorer survival in unadjusted analyses but not after adjustment, and anxious preoccupation was also associated with worse tumor features. The findings do
Genetic testing for breast cancer like HER2 and gene expression profiling (GEP) can impact healthcare disparities. While HER2 testing is widely used with trastuzumab treatment, there is still some underuse. GEP testing is only modestly used and is associated with less chemotherapy for low risk patients but more for high risk. Studies show black women may be less eligible for GEP and there is inadequate data on effectiveness in diverse groups. Ensuring validation in diverse populations, broad recruitment, and addressing social factors can help reduce disparities in precision medicine.
This study examined the relationship between gender and sexual risk behaviors among males and females. A mixed methods approach was used, including focus groups with 12 participants and an online/hard copy survey completed by 90 participants. The survey assessed demographics, sexual activity levels, and risk behaviors. Results found no statistically significant difference between males and females in terms of risk behaviors. However, qualitative findings suggested alcohol and drug use contribute to higher risk behaviors. In conclusion, gender alone did not predict risk, though other factors like substance use were implicated.
This document discusses sources of information bias in epidemiological studies. It describes different types of information bias including classification or measurement bias, differential versus non-differential bias, and direction of bias. Examples are provided of sources of error such as respondent bias from inability to recall or disclose accurately, data collector bias from unclear questions, and selection bias from only a portion of letters arriving in their destination in a classic study. Validation techniques and avoiding data collection errors are also discussed.
This document summarizes a study that used the Trauma Symptom Checklist for Children - Alternate Version (TSCC-A) to assess trauma symptoms in children ages 8-16 who were part of the LONGSCAN studies. The TSCC-A is a shortened version of the Trauma Symptom Checklist for Children (TSCC) that excludes questions about sexual issues. Results showed that LONGSCAN children scored higher than norms on clinical scales like anxiety, depression and dissociation. They were also more likely to underreport or overreport symptoms. Hispanic children and those from certain sites tended to score highest clinically. Reliability of the scales was generally good, suggesting the TSCC-A can validly assess trauma symptoms in
This study examined how numerical skills related to asthma self-management contribute to asthma-related quality of life. The study found that poorer numerical skills, as measured by an Asthma Numeracy Questionnaire, were associated with lower asthma-related quality of life. This relationship was largely mediated by household income and partially by self-efficacy. The findings suggest that improving numerical skills could help asthma patients better manage their condition and improve their quality of life, in part by increasing income and self-efficacy.
Case control studies are retrospective studies that identify risk factors for diseases like cancer. They compare exposed and unexposed groups among people who are diseased (cases) and not diseased (controls). Cases and controls are matched based on factors like age and gender to make the groups comparable. Exposure is then measured and odds ratios are calculated to determine if cases were more likely to be exposed compared to controls. While quick and cost effective, case control studies are subject to biases due to recall and temporality issues.
This abstract summarizes a secondary analysis that compared oral anti-cancer agent (OA) dosages prescribed to 155 cancer patients to dosages recommended by the FDA. The analysis found that 55.5% of patients received the FDA-recommended daily dosage, while 19.4% received more and 25.2% received less. The most common drug prescribed was capecitabine, and for that drug only 5.5% of patients received the FDA dosage, with 54.5% receiving more and 40% receiving less. The abstract concludes that nurses should be aware of FDA dosing guidelines for oral chemotherapy agents prescribed to their patients.
A cohort study involves observing a group of individuals over time to examine exposure-outcome relationships. Key characteristics include prospectively following exposed and unexposed groups to compare disease outcomes. Major biases include loss to follow up and misclassification of exposure status. Cohort studies are well-suited for rare exposures and allow examination of multiple outcomes, but require large sample sizes and are time-consuming.
The author expresses fear for their safety and the safety of their associates as they have discovered corruption within the court system. They believe that those who uncover such corruption often meet mysterious and fatal ends. However, the author and their people will continue their work, even at the risk of their lives, as Anonymous is now the only source of true justice. They pledge their loyalty and friendship to Anonymous as long as they continue pursuing justice for the people.
Gestión de la Calidad. Caso Intendencia Lima - Curso de formación sobre Gesti...EUROsociAL II
La Unión Europea ha propuesto un nuevo paquete de sanciones contra Rusia que incluye un embargo al petróleo. El embargo prohibiría la importación de petróleo ruso a la UE y también prohibiría a los buques europeos transportar petróleo ruso a otros lugares. Sin embargo, Hungría se opone al embargo al petróleo, lo que podría retrasar la aprobación del paquete de sanciones de la UE.
Dokumen tersebut memberikan informasi tentang persyaratan untuk mendapatkan NIK Bea Cukai termasuk dokumen pendirian perusahaan, perubahan terakhir, domisili, NPWP, Siup/IUI, TDP, Api, NPPPJK, KTP dan NPWP direksi, serta proses 5 hari kerja dan biaya jasa konsultasi hukum dari PT. Jeklindo Consulting.
Este documento enumera cinco funciones básicas de un reproductor de audio o video: reproducir sonido, utilizar la pantalla, avanzar, retroceder y acelerar. Las funciones se presentan en una secuencia lógica.
El documento describe la situación de Colombia en 2002, cuando Álvaro Uribe asumió la presidencia, incluyendo altos niveles de violencia, bajo crecimiento económico y pobreza. Explica cómo Uribe implementó una estrategia de "Seguridad Democrática" enfocada en fortalecer las fuerzas militares, combatir grupos armados ilegales y mejorar la economía y cobertura social. Resalta los resultados positivos logrados para 2010 en seguridad, economía y bienestar social.
La aviación es un tema amplio que abarca muchos aspectos como la historia, las aeronaves, los aeropuertos y la seguridad aérea. Se trata de un sector importante que ha evolucionado mucho a lo largo del tiempo gracias a los avances tecnológicos. La aviación permite el transporte de personas y mercancías de forma rápida a nivel global.
El documento describe los conceptos clave de la administración, incluyendo tribus familiares, evolución social, sistemas administrativos, control, planificación, organización y dirección. Explica que la planificación implica elegir tareas para alcanzar metas y esquematizar cómo se lograrán, y que la toma de decisiones involucra objetivos, planes y programación de actividades. También define misión como el objetivo de una empresa y visión como ver hacia el futuro para establecer metas.
Dubái es uno de los destinos turísticos más lujosos del mundo, ubicado en los Emiratos Árabes Unidos. Alberga algunos de los hoteles, centros comerciales y rascacielos más exclusivos, como el hotel Burj Al Arab, situado en una isla artificial frente a la costa, el Dubai Mall, que tiene un acuario de 10 millones de litros, y el Burj Khalifa, el edificio más alto del mundo con 828 metros de altura.
La carta está fechada el 24 de mayo en Alovera. Brevemente describe los planes de viaje de la persona para visitar a familiares y amigos en varias ciudades durante una semana y espera poder verse con el destinatario durante ese tiempo.
El documento describe los principales símbolos patrios del Perú, incluyendo la bandera, el escudo, el himno nacional y la escarapela. La bandera peruana consta de tres franjas verticales de color rojo, blanco y rojo. El escudo muestra tres campos con una vicuña, un árbol de quina y una cornucopia derramando monedas de oro. El himno nacional fue seleccionado en un concurso público en 1821 y fue estrenado oficialmente en el Teatro de Lima. La escarapela peruana tiene
Este documento presenta un plan para establecer centros de formación laboral. Explica la necesidad de estos centros debido a problemas cotidianos y falta de recursos, y que su objetivo será satisfacer estas necesidades mediante el mantenimiento e implementación de materiales. También introduce conceptos básicos de economía como familias, empresas, mercados y el estado, y define la microeconomía y macroeconomía. Por último, define términos clave de administración como eficiencia, eficacia, organización, planificación, control y dirección.
Running Head FINDINGS USED TO MAKE PUBLIC HEALTH PLANNING AND POL.docxcowinhelen
Running Head: FINDINGS USED TO MAKE PUBLIC HEALTH PLANNING AND POLICY DECISIONS 5
Findings Used to Make Public Health Planning and Policy Decisions
Unit 4 - HA560
March 28, 2016
There has been increased concern among policy makers, scientists and communities that health is greatly affected by a number of factors that occur in a person’s lifetime and in multi levels. Prevention is sententious to curb occurrence of any disease within the population, and it has to come first even if access to quality healthcare services is provided. To adequately promote health and prevent diseases, certain policies and factors need to be addressed mostly factors that are related to health behaviors.
Social psychology is all about understanding individuals’ behavior specifically in a social setting. Basically, social psychology focuses on factors that influence people to behave in certain ways in presence of others. The two greatest contributors in the field of social psychology were Allport (1920) and Bandura (1963). To begin with, according to Allport; he argued that the interaction of individuals with others or the presence of social groups can encourage the development of certain behaviors (Kassin, 2014). This is what Allport referred to as social facilitation, in his research he identified that an audience will facilitate the performance of an actor in a well learnt and understood task; however the performance of the same actor will decrease in performance on difficult tasks which are newly learnt, and this is contributed by social inhibition. The second contributor in the field of social psychology is Bandura (1963), in his work he developed a notion that behavior in the social world could be possibly modeled, and this is what he referred to as social learning theory. He gave his explanation with three groups of children who were watching a video where in the video an adult showed aggressiveness towards a “bobo doll” and the adults who displayed such behavior were awarded by another adult or were just punished. Therefore Bandura found that children who saw the adult being rewarded were found to be more likely to imitate that adult’s behavior.
Certain theories plays important roles in health assessment, and a theory is defined as a collection of concepts in specific area of concern or interest in the world that need explanations, intervening and prediction. Theories need to be backed up with evidence that tend to explain why things will happen in relation to current situations, and followed with some actions to turn situations in certain desirable ways. Health assessment can be defined as a plan of care that recognizes specific person’s health needs and how such needs will be addressed by healthcare system or any other health institutions (Jarvis, 2008). Generally, health assessment is the evaluation of health status through examination of physical and psychological concerns after looking at the health history of the victim assess ...
RunningHead: PICOT Question 1
RunningHead: PICOT Question 7
PICOT Question
Avery Bryan
NRS-433V
Professor Christine Vannelli
May 19, 2019
Clinical Problem
A report from the Center for Disease Control and Prevention in 2015 revealed that (9.4%) 30.3 million Americans are diabetic and 84.1 million have prediabetes. This is a total population of over 100 million is at risk of developing type 2 diabetes which is a growing health problem being the seventh leading cause of death in the U.S. An estimated 1.5 million new cases were among 18-year old bracket and the rates of diagnosed diabetes increased proportionally to age. Below 44 years accounted for 4%, below 64 years at 17 % and 25% for those above 65 years across both genders. One-third of adults in America has prediabetes but sadly, they are unaware despite reports released by The National Diabetes Statistics Report every year. These reports elaborate on prevalence and incidence, prediabetes, long-term complications, risk factors, mortality, and cost. Diabetes poses the risk of serious complications like death, blindness, stroke, kidney disorders, cardiac diseases and health problems that lead to amputation of legs. However, the risks can be mitigated through physical body activities, proper dieting and prescribed use of insulin and other related measures to control the blood sugar levels. Diabetes Prevention Program was funded by NIH to research a yearly evidence-based program to improve healthy weight loss through diet and physical activities. There also efforts to determine the effectiveness of public service campaigns in improving the real-life experience in the diagnosis and treatment of diabetes.
PICOT Question.
The population affected by diabetes cuts across all ages, gender, race, and ethnicity. The prevalence is significantly high from 18 years and it increases with age to about 25% above 65 years. In terms of gender, men are at higher risk accounting for 37% while women are at 30% across races and educational levels. On races, the rates were higher among Indians/Alaska natives at 15%, non-Hispanic blacks at 12.7% and Hispanics at 12%. Among Asians, the rates were lower at 8% and 7.4% for non-Hispanic whites.
Intervention indicator for diabetes shows that individuals who do not observe a healthy diet are more exposed to the disease. Some risk behaviors include lack of exercise and excessive intake of junk foods that lead to obesity and increased blood sugar levels. Diabetes prevalence varied according to education levels were those with less than high school education at 12.6% and 7.2% for those higher than high school education.
Comparison and use of a control group from the popularity of Complementary and Alternative Medicine and Traditional Chinese Medicine showed distinct knowledge of diabetes, blood sugar control, and self-care. The experimental group received education through interactive multimedia for three months while the control group received.
Background: The Food and Drug Administration relies on adverse event reports linked with health risks to remove potentially harmful dietary supplements from the market. Many emergency medicine physicians encounter suspected adverse events related to
dietary supplement use but we do not know what proportion of those adverse events are reported to the Food and Drug Administration. The objective of the study was to determine emergency medicine physicians’ practices regarding adverse event reporting and knowledge of dietary supplements.
Methods: A prospective, cross-sectional study was conducted across five medical centers around the U.S: three military and two civilian. A web-based survey was distributed to emergency medicine attending physicians and emergency medicine residents. The questionnaire was created and administered using Lime Survey software. An administrator at each site communicated study details to emergency medicine physicians and residents via email. The survey was kept open for fi ve months. To preserve participant anonymity,
neither email domains, email addresses, Internet Protocol addresses, nor any other personally identifi able or demographic information were collected.
The document discusses providing fair health to African Americans through community health fairs. It notes that African Americans have higher rates of chronic diseases than Caucasians due to factors like lack of access to healthcare. The purpose is to plan a health fair in East Tampa, where 59% of residents are African American with low income and high poverty/unemployment. A survey found that only 30% had been screened for diabetes, 64% for hypertension, and 27% or less for other diseases. Respondents said they lacked time, insurance, or screening opportunities. The health fair aims to provide free screenings and education to address disparities.
This review summarizes evidence from 54 existing systematic reviews on behavioral counseling and pharmacotherapy interventions for tobacco cessation among adults and pregnant women. The reviews found that behavioral interventions and pharmacotherapy alone or combined are effective for reducing smoking rates in adults, with behavioral interventions particularly helpful for pregnant women. Nicotine replacement therapy, bupropion, and varenicline were found to increase quit rates compared to placebo, with no major adverse events. Behavioral interventions like counseling also increased quit rates compared to various controls. Limited evidence suggested no benefit of e-cigarettes for smoking cessation. Future research should focus on direct drug comparisons, serious adverse events, e-cigarette effectiveness and safety, and interventions for pregnant women and those with
Behavioral Counseling and Pharmacotherapy Interventions for Tobacco Cessation in Adults, Including Pregnant Women: A Systematic Review for the U.S. Preventive Services Task Force
This document discusses predicting medication adherence through predictive modeling. It begins by outlining the problem of medication non-adherence and its impacts. It then describes the methodology used, which involved blending data from Medicare, drug information databases, and census data to derive predictors and classify patients based on adherence. Regression and decision tree models with 45 predictors were able to predict medication adherence days and classify patients as adherent or non-adherent. The inferences from the models supported the hypothesis that public health, personal, and medication factors influence non-adherence. The document concludes by discussing interventions like behavioral, financial, and clinical approaches that can be tailored to individuals to improve adherence.
This document provides a summary of a systematic review on screening for and managing obesity and overweight in adults. The review assessed behavioral interventions, pharmacotherapy with orlistat or metformin, and combinations for weight loss or maintenance. Behavioral treatment resulted in average weight loss of 3.0 kg more than control, with greater loss of 4-7 kg with more treatment sessions. Orlistat added to behavioral counseling led to 6-9 kg total weight loss. One metformin trial showed 2.3 kg more loss in intervention. Weight loss treatments did not improve health outcomes but reduced diabetes incidence in two behavioral trials. Behavioral treatment showed small positive effects on blood pressure. Orlistat improved lipids and blood pressure. Metformin reduced diabetes incidence but
The document discusses the role of statistics and mathematicians in public health practice and HIV/AIDS surveillance. It provides examples of how HIV/AIDS data is collected through disease reporting and used by statisticians to analyze trends, identify at-risk groups, and inform prevention strategies. Specific projects highlighted include using population attributable risk to quantify how social determinants influence racial disparities in HIV incidence among women and analyzing mediators of behavioral interventions.
The First session in the Epidemiology Lecture Series
Defining Epidemiology. Keywords in the definition. Aims of Epidemiology, Epidemiological Approach & Reasoning
Chapter 3Public Health Data and Communications.docxwalterl4
Chapter 3
Public Health Data and Communications
Learning Objectives
Identify six basic types of public health data
Explain the meaning, use, and limitations of the infant mortality rate and life expectancy measurements
Explain the meanings and uses of HALEs and DALYs
Identify criteria for evaluating the quality of information presented on a website
Explain ways that perceptions affect how people interpret information
Learning Objectives
Explain the roles of probabilities, utilities, and the timing of events in combining public health data
Explain the basic principles for the construction of decision trees and their uses
Explain how attitudes, such as risk-taking attitudes, may affect decision making
Identify three different approaches to clinical decision making and their advantages and disadvantages
Vignette 1
You read that the rate of use of cocaine among teenagers has fallen by 50% in the last decade.
You wonder where that information might come from.
Vignette 2
You hear that life expectancy in the United States is now approximately 80 years.
You wonder what that implies about how long you will live and what that means for your grandmother, who is 82 and in good health.
Vignette 3
You hear on the news the gruesome description of a shark attack on a young boy from another state and decide to keep your son away from the beach.
While playing at a friend’s house, your son nearly drowns after falling into the backyard pool.
You ask why so many people think that drowning in a backyard pool is unusual when it is far more common than shark attacks.
Vignette 4
“Balancing the harms and benefits is essential to making decisions,” your clinician says.
The treatment you are considering has an 80% chance of working, but there is also a 20% chance of side effects.
“What do I need to consider when balancing the harms and the benefits?” you ask.
Vignette 5
You are faced with a decision to have a medical procedure.
One physician tells you there’s no other choice and you must undergo the procedure, another tells you about the harms and benefits and advises you to go ahead and the third lays out the options and tells you it’s your decision.
Why are there such different approaches to making decisions these days?
Questions-to-Ask (1)
What is the scope of health communications?
Where does public health data come from?
How is public health information compiled to measure the health of a population?
How can we evaluate the quality of the presentation of health information?
What factors affect how we perceive public health information?
Questions-to-Ask (2)
What type of information needs to be combined to make health decisions?
What other data needs to be included in decision making?
How do we utilize information to make health decisions?
How can we use health information to make healthcare decisions?
Table 3-1 The 6 Ss of Quantitative Sources of Public Health Data (1/3)Type
ExamplesUsesAdvantages/
DisadvantagesSingle case or small seriesC.
Gender Difference in Response to Preventative Health Careiowafoodandfitness
Luther College Students prepared the following community assessments as part of their Psychology of Health and Illness class in the Fall Semester 2008.
LuciousDavis1-Research Methods for Health Sciences-01-Unit9_AssignmentLucious Davis
This document discusses health disparities faced by minority groups in the United States. It focuses on disparities experienced by African Americans, such as higher rates of homicide, heart disease, and cancer. These disparities are linked to socioeconomic factors like low income and lack of access to quality healthcare. The author proposes investigating connections between race, economic status, access to healthcare and treatment. A quantitative and qualitative research approach will be used to understand disparities and how socioeconomic status impacts health outcomes in minority communities.
This paper discusses obesity in Florida. Obesity rates are high, with 36% of Florida adults overweight and 26.2% obese. Obesity increases risks for diseases like diabetes and heart disease. As a future nurse practitioner, the author plans to screen patients for obesity, discuss weight management, and work with communities to increase access to healthy foods and physical activity.
1Running head OBESITY 4Running head OBESITY.docxvickeryr87
1
Running head: OBESITY
4
Running head: OBESITY
Obesity
NR503 Population Health, Epidemiology, & Statistical Principles
January 2018
Obesity
Obesity is a chronic medical condition and a significant health concern in the United States that is increasing worldwide. More than one third of the adults in the U.S. are obese. It is a leading cause of preventable illness and death (Centers for Disease Control and Prevention [CDC], 2016). This global epidemic is a leading concern for adults and for children who are predisposed to becoming obese as adults. This paper will discuss the significance of obesity in Florida, provide a background of the disease, review current surveillance and reporting methods, conduct a descriptive epidemiological analysis, discuss diagnosis and screening for prevention tools, develop an evidence based plan along with measureable outcomes to address obesity as an advanced practice nurse, and conclude with an overview of the main points presented.
Background and Significance
According to the CDC (2016), obesity is defined as “weight that is higher than what is considered as a healthy weight for a given height.” It involves excessive weight gain and accumulation of fat. In order to determine obesity, Body Mass Index or BMI is used to indirectly calculate a person’s body fat and health risk based on weight in relation to height. A BMI of 25.0 or above is considered overweight and 30.0 or greater is considered obese. Athletes with a greater amount of muscle mass may have a higher BMI even though they do not have excess body fat. Waist circumference is also used as a tool to diagnose obesity.
There are many causes that contribute to obesity, including behavioral, genetic, hormonal, environmental, and social factors. Increase in caloric intake, unhealthy eating habits, decrease in physical activity, certain medications, age, lack of sleep, quitting smoking, pregnancy, and certain medical disorders can contribute to weight gain (Mayo Clinic, 2018). Driving cars has replaced walking and riding bikes, technology has replaced engaging in physical activity, and easy access to cheaper foods has replaced nutritional importance. Most people are aware when weight is gained. Obvious signs and symptoms are tighter clothes, excess fat, and increased weight on a scale. Being overweight or obese increases the risk for many health diseases. Obesity may cause low endurance, breathing issues, excessive sweating, and joint discomfort. It can also lead to diabetes, gastroesophageal reflux disease, coronary heart disease, hypertension, high cholesterol, stroke, depression, and even certain types of cancer such as bowel, breast, and prostate cancer (Mayo Clinic, 2018).
Below is a map that highlights the obesity prevalence across the U.S. in 2016 according to the CDC. There is no significant difference in overall prevalence between men and women. The prevalence of women with a BMI > 35 is 18.3% compared to 12.5% of men. The.
This document provides an overview of biostatistics. It defines biostatistics as the application of statistical principles and methods to biological and health data. Biostatistics is used in various fields including public health, epidemiology, medicine, anatomy, physiology, pharmacology, and preventive medicine. It involves collecting, presenting, analyzing and interpreting numerical data to evaluate public health programs, compare medical treatments, define normal health ranges, and study associations between biological factors. The document also discusses limitations of statistics and the various steps involved in biostatistical analysis including collecting and presenting data, descriptive and inferential analysis, and interpretation.
This document provides an introduction to biostatistics. It discusses key concepts including descriptive statistics, inferential statistics, hypothesis testing, and sampling techniques. It outlines the role of biostatistics in various areas like clinical medicine, preventive medicine, health planning and evaluation, and medical research. Biostatistics helps manage uncertainties in medicine by providing statistical methods to analyze data, evaluate treatments and programs, and make inferences about populations. It is important for designing valid research studies and interpreting medical literature.
1ANNOTATED BIBLIOGRAPHY FOR SEDENTARY LIFESTYLESTHESE ARE.docxhyacinthshackley2629
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ANNOTATED BIBLIOGRAPHY FOR SEDENTARY LIFESTYLES
THESE ARE THE INSTRUCTORS REMARKS AFTER GRADING AND GIVING ME A ZERO/100. PLEASE CORRECT THIS DOCUMENT FOR ME. THANKS.
I HAVE ALSO ATTACHED A Turnitin Report in pdf format.
Hi, Jude. Your Turnitin report showed that 74% of your draft matches sources that were not cited properly. Please review the plagiarism tutorial in the syllabus, and review the APA materials on how to cite sources. Paraphrase your sources whenever possible; this shows you understand the material and can restate it in your own words. This also enables you to claim ownership of the language while still giving credit for the ideas. When you use source material verbatim, make sure to place it in quotation marks. Avoid copying and pasting large chunks of text. Even if you include proper citations, your essay will lack originality. Please review the attached Turnitin report so you can see which sections need attention. I will review your draft and update your score once you've rewritten it in your own words and cited sources properly. Please note the late policy in the syllabus. Let me know if you have any questions. Thanks.
Annotated Bibliography for Sedentary Lifestyles
Jude Kum
DeVry University
Sedentary lifestyle is predominant in our everyday life be it in workplace, school, social or homes and the fact is we have got accustomed to sitting down and doing many things forgetting the impact this is causing to our health. People fail to realize how valuable exercise is in their life and especially in improving their health and well-being. Sitting down on the computer with all focused attention and forgetting that we need to get up and even eat cause problems to many people.
Guedes, N.G., Lopes, M.V., Leite de Araujo, T. Moreira, R.P. and Martins, L.C. G. (2010). Predictive Factors of the Nursing Diagnosis Sedentary Lifestyle in People with High Blood Pressure. Public Health Nursing. Vol. 28 No. 2, p. 193-200. Wiley Periodicals, Inc.
The research question for the study conducted by Guesdes, et al (2010) is based on the following: 1.what is the result of the defining characteristics and related factors of sedentary lifestyle diagnosis in patients with high blood pressure? 2. What are the predictive value and possible predictors of the nursing diagnosis sedentary lifestyle in patients with high blood pressure? The study looked at the validation of diagnostic groupings of the population being studied including aspects of their clinical situations. The study looked at diagnosis resulting from insufficient physical activity, intolerance of activity, fatigue, impaired physical mobility, self-care deficit.
My assessment: Using this article, I will bring out the important indicators and useful predictors for identification of sedentary lifestyle; demonstrated the benefits of physical fitness, verbalized preferences for activities that are to accomplish real training or exercises. I will point out appr.
Critical Appraisal Of Research Essay Example Paper.docxstudywriters
1) Four peer-reviewed articles on racism and health were critically appraised using an evaluation table.
2) Based on the appraisal, the best practice that emerged was reducing racism in healthcare settings to improve health outcomes and promote equal access to quality care.
3) Stronger measures are needed to eliminate racism through increasing cultural competency training and ensuring non-discriminatory, equitable treatment for all patients.
Critical Appraisal Of Research Essay Example Paper.docxstudywriters
1) Four peer-reviewed articles on racism and health were critically appraised using an evaluation table.
2) Based on the appraisal, the best practice that emerged was reducing racism in healthcare settings to improve health outcomes and promote equal access to quality care.
3) Stronger measures are needed to eliminate racism through improving cultural competency and ensuring all patients receive equitable treatment.
Critical Appraisal Of Research Essay Example Paper.docx
PATH Report Northeast_NHS_UK
1. PATH TYPE® TEST APPLICATION
Supplemental report exploring utility of PATH Type assessment with
males, 40+ years in the U.K., Northeast, NHS
Prepared by
Frederick H. Navarro
President, PATH Institute Corporation
11321 Jacaranda Circle, Suite A
Fontana, CA 92337-1401, USA
Phone: 909-350-0400
Fax: 909-854-6800
Mobile: 909-835-5292
Toll Free: 800-501-7284 (PATH)
fnavarro@pathinstitute.com
www.pathinstitute.com
Directing health practice to
serve health priorities
PATH Institute Corporation
11321 Jacaranda Circle, Suite A
Fontana, CA 92337-1401 USA
Phone: (909-350-0400
Fax: (909) 854-6800
E-mail: info@pathinstitute.com
2. PATH Type® Test Application
Exploring utility of PATH Type assessment with males, 40+ years in
the U.K., Northeast, NHS
INTRODUCTION
This report provides a brief summary of the PATH Type results found for the 30 males, 40+ years
old in the U.K. Northeast NHS, interviewed in May of 2008.
PURPOSE
This research was carried out to evaluate the feasibility of using the PATH Type® methodology,
developed and validated in the U.S. and in the context of the U.S. health care market, within the
U.K. national health care system.
INITIAL FINDINGS
Results suggest that the PATH Type® methodology should be applicable in the U.K. Northeast, NHS,
and would likely function well throughout the U.K.’s various NHS regions. Even with a small, limited
sample like response patterns are identified along with the same demographic and socioeconomic
associations with the PATH Types as found in the U.S. If the PATH Type mix of subjects in this
sample were in fact representative of the men in the Northeast NHS area, these men, while likely
having higher rates of disease and health risk, would not demand for medical services resulting in
lower demand compared to other NHS areas. Suggested next steps are offered at the end of this
report.
KEY CONSIDERATIONS
It is critical to keep in mind that the dramatic variances in health risk prevalence, disease, and
health care demand linked to the PATH Type® model in the U.S. are found just by identifying the
consistent cognitive patterns that shape how people think about and prioritize health issues. It
suggests that working to change and promote the prevalence of various cognitive patterns of health
care thinking in a population could be a viable tactic to improving health with minimal medical
intervention.
PATH TYPE® RESULTS
Table 1 shows the distribution of participants within the patterns of health-behavior identified by the
PATH Type Model identified among the subjects interviewed with comparative distributions of males
found in larger studies within the U.S. General findings are:
o Three out of 30 subjects (10%) registered a secondary PATH Type. This is the same rate
found in the U.S.
REPORT
3. 2
o Consistent with the makeup of the sample, the PATH Types that appeared tend to be male
dominated in the U.S., with the exception of the one Naturalist
o An unassignment rate (P1=10) as high as 25% is consistent with other male-only studies
conducted in the U.S. (see Table 1)
o With the exception of the two PATH Type 8 (Independently Healthy) subjects and one the
PATH Type 9 (Naturalist), all other types represent subjects who are fairly uninvolved with
personal health issues and avoid seeking care. (All but five of the 30 males interviewed
somewhat or strongly agreed with the statement, “When it comes to my health, I rarely
plan ahead and just take things as whey come.” And nearly all of them either somewhat or
strongly agreed with the statement, “I only go to the doctor if I’m really sick or injured.”)
o The lower socioeconomic status of residents of the Northeast, NHS is consistent with the
higher rates of Types 2 (Traditionalist), 3 (Generic) and 10 (unassigned). All three types
are likewise associated with lower economic status in the U.S.
o While the initial assessment of subject health status did not follow expected trends (i.e.,
subjects initially rated their health good or very good), later self-disclosure by the subjects
revealed that more often than not subjects reported having many ailments or disease
issues suggesting that health status was actually lower than reported. Higher rates of
health risk factors or disease are commonly found among PATH Types 2 and 9.
Table 1: PATH Type Assessment Results with U.S. Comparisons
NESHA - Males Only PATH Type Breakdown
May-June 2008
PATH Types P1 Count % Count % Count % Count %
Clinic Cynic 1 3 10% 1 1% 1,086 2% 64 2%
Avoider 2 9 30% 8 8% 4,952 9% 94 3%
Generic 3 6 20% 19 19% 9,101 17% 582 16%
Traditionalist n 0 0% 2 2% 3,142 6% 71 2%
Family Centered 5 1 3% 10 10% 5,514 10% 567 15%
Loyalist n 0 0% 6 6% 4,411 8% 355 10%
Ready User n 0 0% 7 7% 5,478 10% 462 12%
Independently Healthy 8 2 7% 8 8% 3,122 6% 628 17%
Naturalist 9 1 3% 6 6% 4,394 8% 374 10%
Unassigned 10 8 27% 35 34% 13,785 25% 502 14%
Total 30 100% 102 100% 54,985 100% 3,699 100%
Test sample results
(A) On-line data
collection
Male Only PATH Type Distribution Examples
(B) National
tele+mail (C) Health plan-mail
.
PATH TYPE® ASSESSMENT RESPONSE PATTERNS
The response patterns to the PATH Type® assessment among the Northeast, NHS sample were
examined in an attempt to detect variance from the response patterns found in the U.S. Such
variances might signify lack of applicability, cultural differences in understanding, or other factors
related to the differences between the U.K. and U.S. health care systems. The responses for all
subjects in the Northeast, NHS sample are shown in Table 3 below. Overall, the response patterns
to the PATH Type® assessment do not appear to vary in any significant way from those in the U.S.,
with the exception of the cost/price related questions.
4. 3
PRICE/QUALITY CONCERN
Contrary to early expectations, subjects in the U.K. offered pretty much the full range of responses
to assessment measures related to price/cost/quality issues. While most responses did cluster in the
neutral response category, never more than half did; this means that many subjects still think
about price/quality issues even in a nationalized health care system.
Table 2: Response Patterns Related To Health Cost/Quality Issues
PATH Type assessment questions Strongly
agree
Somewhat
agree
Neutral Somewhat
disagree
Strongly
disagree
2. If doctors and hospitals advertised their
prices, I would certainly shop more by price
7 10 4 3 6
4. I have tried to save money by shopping
around for health
3 3 13 2 9
8. I only seek health from doctors or
therapists when I am really sick because
it is too expensive.
6 0 15 3 6
18. If doctors in my area charged different fees
I would never go to the lowest priced doctor.
6 6 10 7 1
5. 4
Table 3: Response patterns and PATH Type assignment
ID P1 P2 PRscores
1 1 11414 11135 15411 43444
2 1 41333 31311 45414 11445
3 1 10 44511 44334 45355 43555
4 2 23531 14354 25114 44325
5 2 34231 33344 25115 11525
6 2 15552 42542 15414 12345
7 2 23511 13155 45112 31255
8 2 21511 42345 14111 24535
9 2 31131 13535 14114 31515
10 2 32531 14355 35432 42345
11 2 31531 13555 34223 13335
12 2 33511 13151 15511 12234
13 3 45245 24554 25125 54255
14 3 10 45422 14542 45343 45535
15 3 2 44511 13345 25212 54345
16 3 54544 13552 55411 55535
17 3 44514 12343 25324 41345
18 3 44333 35243 14111 41135
19 5 42431 24325 44224 23434
20 8 44155 14242 55111 51215
21 8 21134 14355 35132 31355
22 9 44422 13234 44423 44445
23 10 24435 53354 45254 44224
24 10 45554 45145 52222 44445
25 10 23215 14343 25334 43324
26 10 45441 53145 25152 51223
27 10 55532 42134 34324 33244
28 10 25515 23325 25154 21434
29 10 34535 33333 55234 51334
30 10 32434 43343 45234 53345
PRscores = PATH Type response scores (1=strongly disagree, 5=strongly agree)
P1=primary PATH Type
P2=secondary PATH Type
A key indicator of attentiveness
to the PATH Type assessment
questions is “somewhat” or
“strong” agreement with the last
statement of I make my own
health care decisions. Ninety
percent of U.S. residents, both
males and females, strongly or
somewhat agree with this
statement. The fact that U.K.
males precisely mirrored this
trend is another strong
confirmation of the applicability
of the methodology in the U.K.
6. 5
IMPORTANT PATH TYPE® TRENDS IN U.S.
A wider application of the PATH Type® methodology in the U.K. should reveal that several PATH
Type® cognitive patterns pull along higher rates of health risk (Chart 2) or disease (Chart 3), while
other cognitive patterns pull along lower rates. Note that this increased or decreased prevalence is
identified by the cognitive patterns themselves and not some other demographic or physical health
assessment measure. This insight into the power of cognitive drivers is not identified by any
database driven methodology, financial records system or health risk assessment focused
assessments available today. The PATH Type® methodology is the only tool that reveals this ever
present, yet unseen influence shaping health outcomes.
Chart 1: National Mix of PATH Types in the U.S.
Chart 2: Prevalence of Health Risk Factors by PATH Type®
Health Risk Conditions and PATH Types
Sach/Scarborough HealthPlus, 2001, N=93,400
0.0%
50.0%
100.0%
150.0%
200.0%
250.0%
300.0%
350.0%
Avoiders
Traditionalist
N
aturalist
R
eady
User
C
linic
Cynics
Fam
ily
CenteredG
enericLoyalist
Independently
Healthy
%exceed100duetomultipleresponse
Poor attention to nutrition
Low physical activity
Migraines
Weight Problem
Chronic back pain
Depression
Smoking (4+ days per week
Sleeping Problems
High Cholesterol
Hypertension
Avoider
6%
Generic
15%
Traditionalist
6%
Family
Centered
14%
Loyalist
8%
Ready User
15%
Independently
Healthy
12%
Naturalist
9%
Unassigned
11%
Clinic Cynic
4%
7. 6
Chart 3: Disease Prevalence and PATH Type®
Reported Disease Conditions
by PATH Type
Sachs/Scarborough HealthPlus USA Survey, 2000, N=61,000
0.0%
20.0%
40.0%
60.0%
80.0%
100.0%
120.0%
140.0%
R
eady
User
TraditionalistN
aturalistG
enericLoyalist
C
linic
Cynics
Fam
ily
CenteredAvoider
Independently
Healthy
%exceed100duetomultipleresponses
Dermatitis
Osteoporosis
Respiratory conditions
Arthritis/ rhematism
Alzheimer's
Chronic Allergies
Heart Disease
All Cancers
Skin Cancer
Breast Cancer
Kidney Disease
The impact of the cognitive patterns and disease prevalence in the U.S. becomes evident in Chart 4
below. Identified only by revealing the patterns of health care thinking detected by the PATH Type®
methodology, the cognitive patterns of health related thinking explain a variance in both disease
and demand of $238 billion dollars a year.
Chart 4: Estimated Rate of National Health Care Spending by PATH Type®
$50
$81
$110 $115
$139 $143 $145
$184
$219
$288
$0
$50
$100
$150
$200
$250
$300
SpendPerYear(inbillions)
Clinic Cynic
Avoider
Traditionalist
Loyalist
Naturalist
Unassigned
Independently Healthy
Family Centered
Generic
Ready User
Medical Spending (in billions) Per U.S. Adult
Population
8. 7
In the above chart, it is important to note that both the Generic and Ready User types represent the
same number of people (see Chart 1), yet the Ready User types generates $68 billion more in
medical spending per year. Also, the Avoider and Traditionalist types represent the same number of
people, yet Traditionalist type adults generate $29 billion more per year. It is critical to keep in
mind that these dramatic variances in health care demand are identified just by assessing how
people think about and prioritize health issues in the PATH Type® model framework. It also
suggests that working to change the cognitive patterns of health care thinking could be both a
viable tactic to improve health and reduce medical care consumption. For example, it’s estimated
that a one percent (1%) drop in the PATH Type 7 (Ready User) prevalence in favor of a one percent
(1%) increase in the prevalence of PATH Type 8 (Independently Healthy) would improve health
along with an expected reduction in health care spending of about $5 billion per year.
NEXT STEPS: SUGGESTIONS FOR FURTHER RESEARCH
Given the research outcomes, there is every indication the PATH Type® methodology can be
effectively used in the U.K. While similar small studies like the current one can be applied in other
NHS areas to further validate the applicability, if necessary, the PATH Institute Corporation suggests
more substantive quantitative research as the next phase if and when the Northeast and/or other
NHS areas decide to further PATH Type® research.
Step 1: Quantitative Study and Baseline
o Conduct a larger, quantitative study of 10,000 adults throughout the U.K. NHS areas using
the PATH Type® assessment as the first measure.
o All adults completing the PATH Type® assessment should have their data linked to their
medical record information (i.e., use of prescription medications, hospitalizations,
outpatient procedures, visits to MDs, visits to specialists, plus monetary outlay in each
category). This data will be analyzed using various multivariate procedures to explore and
validate the demand and diagnostic trends for PATH Types as found in the U.S. and confirm
or not that they can be extended to the U.K.
o Supplement the PATH Type® assessment with standard health risk assessment variables
and other measures to assess disease state prevalence (e.g., heart disease, diabetes,
cancer) across the PATH Types.
Step 2: Intervention Study 1
o Select a subsample of the 2,000 subjects from the PATH Type identified patterns associated
with the highest health risk or disease.
o Train four health coach/nurse/physician counselors in the PATH Voice Clinical Interventions
(12 hours of training per clinician).
o Assign these four counselors to interact with half of the 2,000 subsample (i.e., case load of
250:1) for 6 months with the goal of improving their engagement in desirable health
behaviors
o Assign two non-PATH trained counselors to intervene with the other half of the subsample
using standard interventions and without the benefit of PATH Type® insights
o After six months, evaluate impact
SPECIAL THANKS
The PATH Institute Corporation wishes to thank Claire Riley, Strategic Head of Communications,
Northeast Strategic Health Authority, U.K., for supporting this research. Special thanks goes to
Lorna Johnson, Lindum Research, U.K., for organizing and managing this research effort, the
9. 8
Northeast data collection, subsequent analysis, and very cordial dealings with the PATH Institute
Corporation “across the pond”.