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[4/5 Systemic therapies]. | nan | 15682726 | [
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Preoperative biliary stenting--a prequel to pancreatic resection in selected patients. | Biliary drainage is necessary to improve immediate survival in patients with profound co-morbidities associated with jaundice. We report on our experience with this category of patients in whom subsequent pancreaticoduodenectomy was performed.In the period January 2001-June 2002; 6 patients underwent biliary drainage to reverse potentially fatal complications or to optimise nutritional status. There were 2 female and 4 male patients (age range 50-70 years). The reasons for biliary drainage were suboptimal a | 15682731 | [
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Preoperative biliary stenting--a prequel to pancreatic resection in selected patients. | lbumin levels in all patients; cholangitis in 4 patients and renal impairment in 2 male patients and profound acute jaundice in 1.There was failure of stent placement at endoscopic retrograde cholangiopancreatography (ERCP) in 3 patients. Two had an ERCP performed before referral and had a metal stent deployed at percutaneous transhepatic cholangiography (PTC). In the other a plastic stent was placed at a combined PTC/ERCP session. The 3 others had stents placed by ERCP. None of the patients had complicatio | 15682731 | [
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Preoperative biliary stenting--a prequel to pancreatic resection in selected patients. | ns related to the stenting procedure. All the lesions were deemed resectable following imaging by ultrasound and computed tomography (CT) scan. Laparotomy with intent to resect was planned once the complications had resolved. The average duration of stenting before surgery was 46 days (range 12-100 days). All patients underwent pancreatoduodenectomy. One patient developed postoperative superficial wound sepsis; which resolved with topical management. There were no perioperative deaths. The postoperative hos | 15682731 | [
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Preoperative biliary stenting--a prequel to pancreatic resection in selected patients. | pital stay ranged from 10 to 21 days. Histological examination revealed pancreatic adenocarcinomas in 4 patients; an ampullary tumour in 1 patient and a non-functioning islet cell tumour in the other.Biliary drainage for complications should not be regarded as definitive treatment. It optimises co-morbidity factors and allows staging so that resection can be carried out successfully in selected patients. | 15682731 | [
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Cyclosporine treatment of anal furunculosis in 26 dogs. | To evaluate the effect of cyclosporine on anal furunculosis lesions in 26 dogs.Lesions were graded as mild in 11 dogs; moderate in eight and severe in seven. Each dog was treated with approximately 4 mg/kg cyclosporine orally every 12 hours until the lesions resolved or showed no further improvement. Residual lesions were resected surgically.Eighteen dogs (69 per cent) experienced complete resolution; seven (27 per cent) improved but had residual lesions and one (4 per cent) showed no improvement. The mean | 15682733 | [
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Cyclosporine treatment of anal furunculosis in 26 dogs. | duration of treatment until resolution or no further improvement was 8.8 weeks (range four to 24 weeks). Nine dogs (35 per cent) experienced recurrence. Six were from the group that had shown complete resolution and three were from the group that had surgery. Fifteen dogs (58 per cent) developed side effects to cyclosporine; although none required treatment to be discontinued. Mean duration of follow-up was 6.8 months (range one to 20 months).Cyclosporine was effective at resolving or reducing anal furuncul | 15682733 | [
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Cyclosporine treatment of anal furunculosis in 26 dogs. | osis lesions in 25 of 26 dogs (96 per cent). However; residual or recurrent lesions remain a potential problem; and surgical resection or long-term cyclosporine treatment may be necessary in some dogs. | 15682733 | [
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Primary hyperparathyroidism in 29 dogs: diagnosis, treatment, outcome and associated renal failure. | To review the records of 29 dogs diagnosed with primary hyperparathyroidism and see if any factors correlate with renal failure.Dogs were selected retrospectively from case files from the QVSH and the QMH.The majority of dogs were middle-aged and four were keeshonds. The primary presenting complaints were polyuria and polydipsia. All dogs had an elevated total and ionised plasma calcium concentration. Plasma phosphate concentrations were variable. Ultrasonography of the parathyroid gland revealed nodular en | 15682734 | [
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Primary hyperparathyroidism in 29 dogs: diagnosis, treatment, outcome and associated renal failure. | largement which was found to correlate well with surgical findings. The majority of dogs underwent surgical parathyroidectomy. Five cases were treated by ultrasound-guided chemical ablation of the parathyroid gland; of which only two cases showed a partial response. Three dogs were euthanased within a week of presentation. Seven other dogs had renal failure diagnosed either at presentation or up to six months after parathyroidectomy. The development of renal failure was correlated with total calcium concent | 15682734 | [
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Primary hyperparathyroidism in 29 dogs: diagnosis, treatment, outcome and associated renal failure. | ration but did not correlate with any other factor; including the calcium phosphate product. Thirteen treated dogs were known to be alive at the time of writing; which was six months to 3.5 years after parathyroidectomy.Primary hyperparathyroidism cases with high total calcium were more likely to develop renal failure in this group of dogs; however; the calcium phosphate product did not seem to be a useful predictor. Ultrasound-guided chemical ablation seemed to have limited advantage over surgery. | 15682734 | [
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Enhancement of bone healing using non-glycosylated rhBMP-2 released from a fibrin matrix in dogs and cats. | To test a non-glycosylated recombinant human bone morphogenetic protein-2 (ngly-rhBMP-2)/fibrin composite; which has been shown experimentally to enhance healing of bone defects in rodents; in a clinical case series of dogs and cats undergoing treatment for fracture non-unions and arthrodesis.A ngly-rhBMP-2/fibrin composite was applied in 41 sites in 38 dogs and cats for which a cancellous bone autograft was indicated; replacing the graft.Bridging of the bone defect with functional bone healing was achieved | 15682735 | [
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Enhancement of bone healing using non-glycosylated rhBMP-2 released from a fibrin matrix in dogs and cats. | in 90 per cent of the arthrodesis and fracture nonunions treated in this manner.This prospective clinical study demonstrates the beneficial effects of ngly-rhBMP-2 in a specially designed fibrin matrix on the treatment of bone defects; and validates the use of this composite as an alternative to bone autografts in dogs and cats. | 15682735 | [
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Carpal hyperflexion in a growing dog following neural injury to the distal brachium. | A three-month-old dobermann was presented with hyperfiexion of the right carpus. The abnormality had evolved over a three-week period; following circumferential soft tissue trauma to the distal brachium. The carpal joint angle measured at the limit of passive extension was 105 degrees compared with 175 degrees for the left carpus; and prevented placement of metacarpal and digital pads on the ground. Neurological examination revealed marked atrophy of the carpal extensors; an absent extensor carpi radialis r | 15682736 | [
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Carpal hyperflexion in a growing dog following neural injury to the distal brachium. | eflex and moderate atrophy of the carpal flexors. Spontaneous electromyographic activity consistent with denervation was recorded in the carpal extensor and flexor muscles. Surgical exploration of the distal radial nerve disclosed a region of fibrosis enmeshing the deep branch of the radial nerve. Following relief of the entrapped nerve; carpal hyperflexion; muscle atrophy and the extensor carpi radialis reflex deficit gradually resolved over four months. It is suggested that; In the rapidly growing limb; m | 15682736 | [
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Carpal hyperflexion in a growing dog following neural injury to the distal brachium. | yoneural dysfunction Induced by trauma was the underlying pathophysiological mechanism for carpal hyperflexion. | 15682736 | [
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Delayed recurrence of nasal aspergillosis in a dog. | A two-year-old; female spayed Australian cattle dog was diagnosed with nasal aspergillosis. The dog was treated topically with clotrimazole. Clinical signs recurred two months later and the clotrimazole treatment was repeated and 5 mg/kg itraconazole twice daily was added to it. The recommended dose of itraconazole for nasal aspergillosis is 5 mg/kg twice daily administered orally. The dog's symptoms completely resolved; but it developed an adverse febrile reaction to the Itraconazole. The Itraconazole was | 15682737 | [
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Delayed recurrence of nasal aspergillosis in a dog. | discontinued and the dog remained asymptomatic for four years. The dog then developed mucopurulent discharge from the right nostril and was diagnosed as having recurrent nasal aspergillosis. Itraconazole at 5 mg/kg twice daily was prescribed; which again induced a fever. When the itraconazole was decreased to 5 mg/kg once daily there were no fever episodes; but the nasal discharge was not completely resolved. The dog was then treated with topical clotrimazole Infusion; and maintained on 5 mg/kg itraconazole | 15682737 | [
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Delayed recurrence of nasal aspergillosis in a dog. | daily. To the authors' knowledge; this case is unique because of the delayed recurrence of nasal aspergillosis. Additionally; the idiosyncratic febrile reaction to the itraconazole has not previously been reported in the veterinary literature; but is similar to reports of drug-induced fever in humans. | 15682737 | [
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Eyelid eosinophilic granuloma in a Siberian husky. | Canine eosinophilic granuloma (CEG) is a rare skin disease of unknown origin. It has been reported in Siberian huskies; Cavalier King Charles spaniels and occasionally in other breeds. The lesions comprise nodules or plaques; mostly localised in the oral cavity. A case of a single cutaneous nodular lesion of CEG on the eyelid of a Siberian husky is described. Complete remission was achieved with oral glucocorticoid treatment. | 15682738 | [
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Myelopathy caused by a histiocytic sarcoma in a cat. | An eight-year-old; female spayed; domestic shorthair cat presented with a three-week history of progressive general proprioceptive ataxia and upper motor neuron paresis of the hindlimbs. Computed tomography revealed a mediastinal mass invading the vertebral canal with the T1 spinal nerve and roots; causing extramedullary compression of the cranial thoracic spinal cord. Histopathological and immunohistochemical studies of the mass during postmortem examination disclosed a neoplasm; later determined to be a p | 15682739 | [
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Myelopathy caused by a histiocytic sarcoma in a cat. | oorly differentiated histiocytic sarcoma. Feline histiocytic tumours are rare; with only two prior reports existing in the veterinary literature. This report details a case work-up and reviews the literature on feline histiocytic diseases and tumours affecting the feline spinal | 15682739 | [
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Pyometra in a bitch following unusual sterilisation. | A female; stray crossbreed dog; approximately four years old; was presented for routine spaying during a charity neutering programme in Romania. On clinical examination the bitch was lethargic and pyrexic (40.6 degrees C); but no other signs of illness were detected. Laparotomy revealed an enlarged uterus; severed at the cervix; with no communication to the vagina. Abdominal inspection showed an apparently normal; ligated vaginal stump. An ovariohysterectomy was performed and the dog was treated with a seve | 15682740 | [
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Pyometra in a bitch following unusual sterilisation. | n-day course of netilmicine. It subsequently made a full recovery. | 15682740 | [
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What is your diagnosis? Stenosing tenosynovitis of the tendon of the abductor pollicis longus muscle. | nan | 15682741 | [
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Honorary treasurer: it's not all about money. | nan | 15682742 | [
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Listening: defusing the angry employee. | nan | 15682744 | [
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Morbid obesity: considerations for the EMS provider. | Emergency responders cannot pick and choose their patients; who come in all shapes and sizes. As lifestyles continue to change; EMS can expect the number of obese and morbidly obese patients to increase. Now is the time to plan. Innovate; initiate and implement engineering controls and safe work practices for providers to use when the everyday call is anything but everyday. Until next time...be safe! | 15682747 | [
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Motivation for documentation. | The quality improvement plan relies on controlling quality of care through improving the process or system as a whole. Your ongoing data collection is paramount to the process of system-wide improvement and performance; enhancement of financial performance; operational performance and overall service performance and satisfaction. The threat of litigation and having to defend yourself from a claim of wrongdoing still looms every time your wheels turn. Your runsheet must serve and protect you. Look at the NFP | 15682748 | [
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Motivation for documentation. | A 1710 standard; which was enacted to serve and protect firefighters. This standard was enacted with their personal safety and well-being as the principle behind staffing requirements. At what stage of draft do you suppose the NFPA 1710 standard would be today if the relative data were collected sporadically or were not tracked for each service-related death? It may have taken many more service-related deaths to effect change for a system-wide improvement in operational performance. Every call merits docume | 15682748 | [
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Crush syndrome: estimating skeletal muscle damage by the rule of thirds. | Since the early 1900s; CI and CS have been observed and reported. However; there has not been a method to rapidly determine the severity of CS based on the amount of SM damaged as the result of high-pressure forces exerted on the tissue. The amount of SM involved in the CI is directly proportional to the severity of the resulting CS. The severity of the CS dictates the level and complexity of care needed to best ensure patient survivability. Unlike surface burn injuries; where the "rule of nines" or the "ru | 15682753 | [
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Crush syndrome: estimating skeletal muscle damage by the rule of thirds. | le of palm" are used to estimate the percentage of surface area involved; no such method has ever been presented for use in CS. In fact; there has been an attempt to use the "rule of nines" in CS patients. In developing a method to estimate percentage of SM involved in CS; it is hoped that retrospective studies can be performed to generate a workable model for treatment of CS patients. | 15682753 | [
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Improvise and overcome: bringing EMS to Kenya, part 2. | nan | 15682754 | [
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Health status among REACH 2010 communities, 2001-2002. | The REACH 2010 Risk Factor Survey was conducted in 21 minority communities in the United States during June 2001-August 2002. The survey included 10;953 Blacks/African Americans; 4;257 Hispanics/Latinos; 4;204 Asians; and 1;791 American Indians. Data demonstrate that residents in the minority communities bear a greater socioeconomic; risk factor; and disease burden than do members of the general US population. However; substantial variations in the prevalence of risk factors and chronic conditions also indi | 15682766 | [
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Health status among REACH 2010 communities, 2001-2002. | cated that public health priorities should vary among different racial/ethnic groups; and even among communities within each group; and that culturally sensitive primary and secondary prevention strategies should be tailored to meet community-specific needs. | 15682766 | [
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Exploring access to cancer control services for Asian-American and Pacific Islander communities in Southern California. | During the last 25 years; numerous studies have been conducted to promote breast cancer and cervical cancer screening. Most of these studies focused on individual-level factors predicting screening; but we are unaware of any that directly examined community and ecological influences. The goal of this project; Promoting Access to Health for Pacific Islander and Southeast Asian Women (PATH for Women); was to increase community capacity for breast and cervical cancer screening and follow up in Los Angeles and | 15682767 | [
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Exploring access to cancer control services for Asian-American and Pacific Islander communities in Southern California. | Orange counties. We focused on Southeast Asian and Pacific Islander women because; although they have the lowest rates for cancer; compared to all other ethnic groups; relatively few programs have specifically targeted Asian-American and Pacific Islander (AAPI) women to promote and sustain screening practices. The PATH for Women project involved a partnership between 5 community-based organizations and 2 universities; and included 7 Asian-American and Pacific Islander communities: Cambodians; Chamorros; Lao | 15682767 | [
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Exploring access to cancer control services for Asian-American and Pacific Islander communities in Southern California. | tians; Thais; Tongans; Samoans; and Vietnamese. In this paper; we share our experiences in developing a Geographic Information System (GIS)-mapping evaluation component that was used to explore availability and accessibility to culturally responsive breast and cervical cancer screening services for Southeast Asian and Pacific Islander women in all 7 communities. We describe the methods used to develop the maps; and present the preliminary findings that demonstrate significant geographic and language barrier | 15682767 | [
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Exploring access to cancer control services for Asian-American and Pacific Islander communities in Southern California. | s to accessing healthcare providers; services for breast and cervical cancer screening; and follow up; in each of the communities. Finally; we discuss implications for programs designed to promote breast and cervical screening and policy education. | 15682767 | [
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The Boston Haitian HIV Prevention Coalition formative evaluation: a participatory approach to community self-assessment. | This article describes the application of participatory evaluation principles and methods to designing and conducting a community survey of the metropolitan Boston Haitian population. The findings of the evaluation baseline community survey of 2;719 Haitians are described; including an overview of the population characteristics and the prevailing HIV prevention knowledge; attitudes; and practices. The participatory evaluation approach was effective in building evaluation capacity; and provided a reliable da | 15682768 | [
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Reducing disparities in diabetes among African-American and Latino residents of Detroit: the essential role of community planning focus groups. | Diabetes is prevalent among African-American and Latino Detroit residents; with profound consequences to individuals; families; and communities. The REACH Detroit Partnership engaged eastside and southwest Detroit families in focus groups organized by community; age; gender; and language; to plan community-based participatory interventions to reduce the prevalence and impact of diabetes and its risk factors. Community residents participated in planning; implementing; and analyzing data from the focus groups | 15682769 | [
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Reducing disparities in diabetes among African-American and Latino residents of Detroit: the essential role of community planning focus groups. | and subsequent planning meetings. Major themes included: 1) diabetes is widespread and risk begins in childhood; with severe consequences for African Americans and Latinos; 2) denial and inadequate health care contribute to lack of public awareness about pre-symptomatic diabetes; 3) diabetes risks include heredity; high sugar; fat and alcohol intake; overweight; lack of exercise; and stress; and 4) cultural traditions; lack of motivation; and lack of affordable; accessible stores; restaurants; and recreati | 15682769 | [
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Reducing disparities in diabetes among African-American and Latino residents of Detroit: the essential role of community planning focus groups. | on facilities and programs; are barriers to adopting preventive lifestyles. Participants identified community assets and made recommendations that resulted in REACH Detroit's multi-level intervention design and programs. They included development of: 1) family-oriented interventions to support lifestyle change at all ages; 2) culturally relevant community and health provider education and materials; 3) social support group activities promoting diabetes self-management; exercise; and healthy eating; and 4) c | 15682769 | [
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Reducing disparities in diabetes among African-American and Latino residents of Detroit: the essential role of community planning focus groups. | ommunity resource development and advocacy. | 15682769 | [
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Exploring ethnic disparities in diabetes, diabetes care, and lifestyle behaviors: the Nashville REACH 2010 community baseline survey. | In order to gain a better understanding of diabetes-related health disparities; Nashville REACH 2010 conducted a community baseline survey on health status. A total of 3204 randomly selected African-American (AA) and Caucasian (C) residents of North Nashville; and a comparison sample of residents living in Nashville/Davidson County were interviewed using a computer-assisted telephone interviewing system. Diabetes prevalence was determined; and similarities/differences relative to access to health care; co-m | 15682770 | [
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Exploring ethnic disparities in diabetes, diabetes care, and lifestyle behaviors: the Nashville REACH 2010 community baseline survey. | orbid conditions; diabetes care; and lifestyle behaviors; were examined. Age-adjusted prevalence of diabetes was 1.7 times higher among AAs. Increasing age (P<.0001) and being AA (P<.01) were predictive of diabetes status in a regression model. African Americans were more likely to be uninsured (P<.01); while Cs had to travel farther to get medical care (P<.0002). Compared to Caucasians; African Americans were 1.6 times more likely to have co-morbid hypertension (P<.004). Reported insulin use was higher (P< | 15682770 | [
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Exploring ethnic disparities in diabetes, diabetes care, and lifestyle behaviors: the Nashville REACH 2010 community baseline survey. | .0001) in AAs; and more Cs (25.5% vs 9.1%; respectively) reported taking no medications. African Americans were more likely to report (P<.0001) daily glucose self-monitoring; while more Cs (P<.04) reported having had an eye exam in the last 1 to 2 years. Caucasians reported more (P<.05) active lifestyle behaviors; while AA reported more (P<.001) fat-increasing behaviors. In conclusion; interventions addressing diabetes disparities in the target population should focus on insuring equitable awareness of; and | 15682770 | [
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Exploring ethnic disparities in diabetes, diabetes care, and lifestyle behaviors: the Nashville REACH 2010 community baseline survey. | access to; insurance options; managing co-morbidities; improving provider adherence to standards of care; and establishing multi-level supports for lifestyle modifications. | 15682770 | [
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Overcoming historical and institutional distrust: key elements in developing and sustaining the community mobilization against HIV in the Boston Haitian community. | The Metro Boston REACH 2010 HIV Coalition needs to develop innovative processes aimed at overcoming a history of distrust that has led to limited cooperation from the Haitian community. Among the key elements being implemented are the development of a community vision through a community mobilization process; the development of an innovative working group process; in which coalition members worked together to develop and implement culturally and linguistically appropriate HIV prevention curricula; participa | 15682771 | [
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Overcoming historical and institutional distrust: key elements in developing and sustaining the community mobilization against HIV in the Boston Haitian community. | tory leadership and joint accountability processes; manifested in decision-making approaches; such as the fund allocation system; and in the provision of technical assistance workshops on team building; designed to engender cohesion; skills; and resources sharing among coalition members. The success of this venture is measured through the growing expectation that this coalition could serve as a community planning body for all HIV-related services aimed at reducing HIV infection in the Greater Boston Haitian | 15682771 | [
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The development of a community action plan to reduce breast and cervical cancer disparities between African-American and White women. | The purpose of this project was to establish a coalition of academic; state; and community-based organizations to develop a community action plan (CAP) to eliminate breast and cervical cancer morbidity and mortality disparities between African-American (AA) and Caucasian women. The project targeted rural and urban low-income AA women in Alabama. Based on the logic model; community capacity building was implemented; followed by the development of a community-driven CAP. For community capacity building; a coa | 15682772 | [
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The development of a community action plan to reduce breast and cervical cancer disparities between African-American and White women. | lition comprising 12 organizations was established; and a network of 84 community volunteers was formed. Community needs assessments identified 3 levels of barriers to breast and cervical cancer screening: 1) individual; 2) community systems; and 3) healthcare provider. Based on these findings; a community-driven CAP was developed. Our results indicate that a coalition of diverse organizations can partner and develop CAPs to improve the health of their communities. | 15682772 | [
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Intermediate outcomes of a tribal community public health infrastructure assessment. | The purpose of this collaborative participatory project was to assess the strengths and needs of a tribal community as part of a larger public health capacity building program. Key project partners included: the Ramah Band of Navajo Indians; the Albuquerque Area Indian Health Board; the University of New Mexico Masters in Public Health Program; and the University of Nevada; Las Vegas; American Indian Research and Education Center. Principal intervention steps entailed: 1) relationship-building activities am | 15682773 | [
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Intermediate outcomes of a tribal community public health infrastructure assessment. | ong tribal programs and between the Tribe and the scientific community; 2) an orientation to public health; 3) a comprehensive public health infrastructure assessment; utilizing a standardized CDC instrument; and 4) a prioritization of identified needs. The direct outcome was the development and beginning implementation of a community specific public health strategic action plan. Broader results included: 1) increased comprehension of public health within the Tribe; 2) the creation of a community public hea | 15682773 | [
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Intermediate outcomes of a tribal community public health infrastructure assessment. | lth task force; 3) the design of a tribally applicable assessment instrument; and 4) improved collaboration between the Tribe and the scientific community. This project demonstrated that public health assessment in tribal communities is feasible and valuable. Further; the development of a tribally applicable instrument highlights a significant tribal contribution to research and assessment. | 15682773 | [
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Using focus groups to understand health-related practices and perceptions of African Americans: Nashville REACH 2010 preliminary findings. | To gain an understanding of health-related practices and perceptions; Nashville REACH 2010 conducted focus studies among 5 community groups. Attitudes about health; personal risk behaviors; quality of health care; and models of personal behavior change were assessed. All focus-group sessions were transcribed and analyzed using a consensus panel methodology. A combined analysis of the focus groups revealed 3 categories of barriers to healthier living: 1) personal; 2) environmental; and 3) systemic. Personal | 15682774 | [
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Using focus groups to understand health-related practices and perceptions of African Americans: Nashville REACH 2010 preliminary findings. | barriers included lack of adequate finances; physical limitations; lack of knowledge; and stress. Environmental barriers were related to the unavailability of healthy food choices and adequate places to exercise in the community. The accessibility and quality of health care were the most pervasive systemic barriers identified. Though these findings are not novel to urban African-American communities; they will serve as the framework by which Nashville REACH 2010 will implement strategies to reduce and; ulti | 15682774 | [
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Using focus groups to understand health-related practices and perceptions of African Americans: Nashville REACH 2010 preliminary findings. | mately; eliminate cardiovascular disease and diabetes disparities. | 15682774 | [
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A qualitative assessment of Charlotte REACH: an ecological perspective for decreasing CVD and diabetes among African Americans. | An ecological perspective of health promotion was used as the framework for a Charlotte community-based intervention to eliminate rates of health disparities in cardiovascular disease and diabetes. Interventions are targeted on 5 levels of influences; with interaction between levels creating a supportive system for sustained change. The purpose of this qualitative assessment was to explore changes that have occurred among and between the following levels of influences: intrapersonal; interpersonal; organiza | 15682775 | [
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A qualitative assessment of Charlotte REACH: an ecological perspective for decreasing CVD and diabetes among African Americans. | tional; community; and policy. Data from 10 focus groups were analyzed to identify overarching themes and subthemes. Results support positive changes within and between levels of change. REACH participants reported an increase in knowledge of preventative health behaviors; the development of health-related skills; and the diffusion of knowledge to family. Fellowship was identified as the primary motivator to continue positive health behaviors. Community Lay Health Advisors (LHAs) reported changes in individ | 15682775 | [
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A qualitative assessment of Charlotte REACH: an ecological perspective for decreasing CVD and diabetes among African Americans. | ual health perceptions from disease-to prevention-oriented; and positive community changes; including the establishment of walking groups; and a farmers' market. The REACH program staff reported that collaboration between staff and LHAs was crucial to program success. The results of this assessment provide feedback for improving community health promotion activities and developing program sustainability. | 15682775 | [
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A community-based approach to diabetes control in multiple cultural groups. | Diabetes mellitus is one of the most common; serious; and costly chronic diseases; and is a leading cause of death in the United States. Communities of color bear a disproportionate burden of diabetes risk; prevalence; complications; and mortality. REACH 2010 Seattle and King County provides socio-ecological interventions to reduce diabetes disparities among African-American; Cambodian; Chinese; Filipino; Korean; Latino/Hispanic; Vietnamese and soon Samoan; and Vietnamese groups. This paper reports evaluati | 15682776 | [
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A community-based approach to diabetes control in multiple cultural groups. | on results of REACH classes and support groups. Results from participant pre- and post-surveys demonstrated increases in self-reported physical activity and healthier eating; and increased self-efficacy in managing diabetes. Qualitative focus group results revealed participants' enthusiasm for classes tailored to their ethnic groups; and for intervention impact on management of their diabetes. Qualitative results confirmed survey findings that group participation resulted in significant changes in diet and | 15682776 | [
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A community-based approach to diabetes control in multiple cultural groups. | physical activity. The results underscore the need for more widespread adoption of culturally competent diabetes education and support programs. | 15682776 | [
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Wellness Within REACH: mind, body, and soul: a no-cost physical activity program for African Americans in Portland, Oregon, to combat cardiovascular disease. | Wellness Within REACH (WWR) aims to saturate the heart of the African-American community in Portland; Oregon; with culturally appropriate physical activity opportunities. The purpose of this project is to develop and implement no-cost physical activities to increase the number of African Americans leading active lifestyles; while shifting the community norm. Certified African-American instructors conduct exercise classes at community venues. A pre- and post-questionnaire is administered to participants atte | 15682777 | [
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Wellness Within REACH: mind, body, and soul: a no-cost physical activity program for African Americans in Portland, Oregon, to combat cardiovascular disease. | nding exercise classes each quarter; to assess frequency of attendance; lifestyle changes; and attitudes over time. To date; more than 700 individuals have participated in the WWR classes. Participants (58%) in a recent sample (N=75) reported exercising more now than in the 6 months prior to joining the program. Community members are bringing members of their social networks to try classes otherwise not available or affordable to them. By centering classes around the culture of this specific community; WWR | 15682777 | [
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Wellness Within REACH: mind, body, and soul: a no-cost physical activity program for African Americans in Portland, Oregon, to combat cardiovascular disease. | has become a "movement" of healthy; active living. | 15682777 | [
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A birth records analysis of the Maternal Infant Health Advocate Service program: a paraprofessional intervention aimed at addressing infant mortality in African Americans. | Recognizing that no single intervention was likely to eliminate racial disparities; the Genesee County REACH 2010 partnership; utilizing both "bench" science and "trench" knowledge; developed 13 broad-based; multi-faceted interventions to eliminate infant mortality. This article provides highlights from a recent birth records comparison analysis of the Maternal Infant Health Advocate Service (MIHAS) intervention; and is solely based on the records of 111 MIHAS clients; and a random sample of 350 African-Ame | 15682778 | [
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A birth records analysis of the Maternal Infant Health Advocate Service program: a paraprofessional intervention aimed at addressing infant mortality in African Americans. | rican women residing in Flint; Michigan. The MIHAS clients were more likely than the comparison sample not to have graduated from high school (56% vs 35%; respectively; P<.0001). The MIHAS clients were more likely to report at least some smoking during pregnancy (20% vs 15%; respectively; P<.05). However; after controlling for age and education; these results were no longer statistically significant. In terms of birth outcomes; the comparative odds of MIHAS clients delivering a low birth-weight infant are 1 | 15682778 | [
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A birth records analysis of the Maternal Infant Health Advocate Service program: a paraprofessional intervention aimed at addressing infant mortality in African Americans. | .124 (95% CI: 0.620-2.038); the odds of their delivering an infant at 37 weeks or earlier are 1.032 (0.609-1.749). Although the MIHAS clients did not have statistically better birth outcomes than those of the general African-American population in Flint; the MIHAS clients did not demonstrate the outcomes one would expect; given their higher level of risk. Based on this analysis; the MIHAS intervention may have brought its clients "up to par" with the general community on several birth outcomes. | 15682778 | [
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Eliminating disparities in HIV disease: community mobilization to prevent HIV transmission among Black and Hispanic young adults in Broward County, Florida. | A coalition led by public health professionals adopted the PRECEDE-PROCEED model for community planning and health promotion to eliminate local disparities in HIV disease. Discussion groups and other formative evaluation activities conducted during the first year of the project maximized input from community members and community-based organizations. Twelve of 53 ZIP-code areas; which accounted for 73% of reported AIDS cases among Black and Hispanic young adults (18 to 39 years) from 1994 through 1999; were | 15682779 | [
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Eliminating disparities in HIV disease: community mobilization to prevent HIV transmission among Black and Hispanic young adults in Broward County, Florida. | selected as the primary sites for intervention. Horizontal outreach to residents; vertical outreach to stakeholders and gatekeepers; strategic communications; and capacity building and infrastructure development; were chosen as the most promising activities to promote behavioral and social change. Results from baseline computer-assisted telephone-interview (CATI) surveys completed with 2;011 community residents in 2001; and first-year follow-up interviews with 2;381 in 2002; indicated that: awareness of pr | 15682779 | [
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Eliminating disparities in HIV disease: community mobilization to prevent HIV transmission among Black and Hispanic young adults in Broward County, Florida. | ogram efforts had increased from 5.4% in 2001 to 6.7% in 2002; recognition of the extent of the HIV/AIDS problem had increased from 27.5% in 2001 to 35.3% in 2002; and participation in HIV-prevention efforts had increased significantly. Interventions are reaching the target audience; informing young adults of the risks of HIV infection; and encouraging them to take ownership and action. | 15682779 | [
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Practice-based interventions to improve health care for Latinos with diabetes. | This study examined diabetes-related health disparities in a Latino population in terms of prevalence of the disease; and the extent to which practice-based interventions improve health care and health for the Latinos who have diabetes. Previous research has shown that Latinos; overall; are at greater risk for diabetes; but less is known for those of Puerto Rican and Dominican origin. Two interventions were implemented in a large primary care practice: an ADA-recognized Diabetes Self Management Education pr | 15682780 | [
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Practice-based interventions to improve health care for Latinos with diabetes. | ogram; and clinical information feedback loops to providers regarding adherence to the Massachusetts Guidelines for the Care of Diabetes. The study identified the prevalence of diabetes to be 13.7% among Puerto Ricans; and 9.1% among Dominicans; rates 2-to-3 times that for the general population. Latino patients (N=567) who participated in a Diabetes Self Management Education Program maintained lower Hb A1c values than did a comparison group (N=432). For a random sample of Latinos with diabetes (N=98) in th | 15682780 | [
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Practice-based interventions to improve health care for Latinos with diabetes. | is study; 6 measures of health care improved significantly from 2001 to 2003. Areas of improvement among healthcare providers were: ordering a microalbumin level measurement when appropriate; prescribing ACE inhibitors as needed; providing pneumococcal and influenza vaccines; reviewing activity status and exercise; identifying smoking status; and prescribing lipid-lowering agents; as appropriate. Body mass index (BMI) for the 98 patients remained the same for both measurement periods at 32.8. Although this | 15682780 | [
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Practice-based interventions to improve health care for Latinos with diabetes. | initial study spanned only 2 years; improvements in health care and health indices for the population are encouraging. Further study is underway to expand on these gains. | 15682780 | [
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Increasing Vietnamese-American physicians' knowledge of cervical cancer and Pap testing: impact of continuing medical education programs. | Vietnamese-American women who regularly see Vietnamese-American physicians are less likely to obtain Pap tests; perhaps because of the physicians' limited training in preventive medicine and the women's discomfort receiving Pap tests from male physicians. To address this problem; during 2001-2003; the University of California; San Francisco's (USCF) Vietnamese Community Health Promotion Project collaborated with the Vietnamese Physician Association of Northern California to organize 3 continuing medical edu | 15682781 | [
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