Blake Boursaw

Mindfulness meditation in older adults with postherpetic neuralgia: A randomized controlled pilot study

This parallel-group, randomized controlled pilot study examined daily meditation in a diverse sample of older adults with postherpetic neuralgia. Block randomization was used to allocate participants to a treatment group (n = 13) or control group (n = 14). In addition to usual care, the treatment group practiced daily meditation for six weeks. All participants completed questionnaires at enrollment in the study, two weeks later, and six weeks after that, at the studys end. Participants recorded daily pain and fatigue levels in a diary, and treatment participants also noted meditation practice. Results at the 0.10 level indicated improvement in neuropathic, affective, and total pain scores for the treatment group, whereas affective pain worsened for the control group. Participants were able to adhere to the daily diary and meditation requirements in this feasibility pilot study.

THE FUNCTIONAL EQUATION OF THE SQUARE ROOT SPIRAL

The square roots of the positive integers can be placed on a well known square root spiral. In order to characterize it, polar coordinates are introduced with θ = g(r). Then we find the general solution to the functional equation

Tobacco smoke exposure and impact of smoking legislation on rural and non-rural hospitality venues in North Dakota.

g\left( {\sqrt {r^2 + 1} } \right) = g(r) + \arctan \left( {\frac{1} {r}} \right)

Postpartum Care for Women with Gestational Diabetes.

where g(1) = 0 and g(r) is monotone increasing for r > 0. The resulting curve θ = g(r) gives a continuous square root spiral

The Impact of the Trafficking Victims Protection Act of 2000 on Trends in Federal Sex Trafficking Cases

This study assessed the importance of county characteristics in explaining county-level variations in health insurance coverage. Using public databases from 2008 to 2012, we studied 3112 counties in the United States. Rates of uninsurance ranged widely from 3% to 53%. Multivariate analysis suggested that poverty, unemployment, Republican voting, and percentages of Hispanic and American Indian/Alaskan Native residents in a county were significant predictors of uninsurance rates. The associations between uninsurance rates and both race/ethnicity and poverty varied significantly between metropolitan and non-metropolitan counties. Collaborative actions by the federal, tribal, state, and county governments are needed to promote coverage and access to care.

NEIGHBORHOOD HOUSING INVESTMENTS AND VIOLENT CRIME IN SEATTLE, 1981–2007*

The purpose of this cross-sectional study in a stratified random sample of 135 bars and restaurants in North Dakota was to describe factors that influenced tobacco smoke pollution levels in the venues; to compare the quantity of tobacco smoke pollution by rurality and by presence of local ordinances; and to assess compliance with state and local laws. In data collection in 2012, we measured the indoor air quality indicator of particulate matter (2.5 microns aerodynamic diameter or smaller), calculated average smoking density and occupant density, and determined compliance with state and local smoking ordinances using observational methods. As rurality increased, tobacco smoke pollution in bars increased. A significant association was found between stringency of local laws and level of tobacco smoke pollution, but the strength of the association varied by venue type. Compliance was significantly lower in venues in communities without local ordinances. Controlling for venue type, 69.2% of smoke-free policys impact on tobacco smoke pollution levels was mediated by observed smoking. This study advances scientific knowledge on the factors influencing tobacco smoke pollution and informs public health advocates and decision makers on policy needs, especially in rural areas.

Obesity and malnutrition among Hispanic children in the United States: double burden on health inequities

BackgroundAccumulating evidence suggests that clinician racial/gender decision-making biases in some instances contribute to health disparities. Previous work has produced evidence of such biases in medical students.ObjectiveTo identify contextual attributes in medical schools associated on average with low levels of racial/gender clinical decision-making biases.DesignA mixed-method design using comparison case studies of 15 medical schools selected based on results of a previous survey of student decision-making bias: 7 schools whose students collectively had, and 8 schools whose students had not shown evidence of such biases.ParticipantsPurposively sampled faculty, staff, underrepresented minority medical students, and clinical-level medical students at each school.Main MeasuresQuantitative descriptive data and qualitative interview and focus group data assessing 32 school attributes theorized in the literature to be associated with formation of decision-making and biases. We used a mixed-method analytic design with standard qualitative analysis and fuzzy set qualitative comparative analysis.Key ResultsAcross the 15 schools, a total of 104 faculty, administrators and staff and 21 students participated in individual interviews, and 196 students participated in 29 focus groups. While no single attribute or group of attributes distinguished the two clusters of schools, analysis showed some contextual attributes were seen more commonly in schools whose students had not demonstrated biases: longitudinal reflective small group sessions; non-accusatory approach to training in diversity; longitudinal, integrated diversity curriculum; admissions priorities and action steps toward a diverse student body; and school service orientation to the community.ConclusionsWe identified several potentially modifiable elements of the training environment that are more common in schools whose students do not show evidence of racial and gender biases.

Chronic Malnutrition Among Overweight Hispanic Children: Understanding Health Disparities

Purpose:To assess postpartum gestational diabetes mellitus (GDM) practice patterns of providers in a large, tertiary care hospital. A retrospective review of medical records for women with GDM receiving postpartum care in 2012 was conducted to estimate the percentage who received a postpartum visit, glucose testing, and preventive follow-up care. Study Design and Methods:A sample of 97 charts was reviewed. Pearsons chi-squared tests and Fishers exact test were used, as appropriate, to examine differences in documented care by race/ethnicity, insurance type, and type of medical provider. Results:Within the system of study, 53 of 97 women (55%) with GDM had a documented postpartum visit, with disparities by race/ethnicity and insurance type, and 18 (19%) had a documented oral glucose tolerance test after 6 weeks postpartum. Most providers routinely documented interacting with patients around infant feeding, family planning, and emotional status, but fewer documented providing specific care to help patients manage future diabetes risk, with advance practice nurses significantly more likely than physicians to document some aspects of preventive care. Clinical Implications:Postpartum GDM care could be improved by educating providers on the current postpartum GDM standard of care and use of the 5 As framework for health promotion; prompting providers to order appropriate screenings and document the 5 As; coordinating follow-up glucose screening and behavioral management with the postpartum visit and subsequent family planning visits; notifying primary care providers and pediatricians of the GDM diagnosis to ensure continuity of care; and referring to allied healthcare providers for intensive behavior change support.