Rachel Mayo

Importance of Fatalism in Understanding Mammography Screening in Rural Elderly Women

ABSTRACT This study examined the relationship between demographic factors and other correlates of fatalism, and assessed the impact of fatalistic beliefs on the participation in breast cancer screening in rural women. The subjects were 220 women aged 50 and over recruited from 6 large rural counties in South Carolina. Data were collected using a demographic questionnaire and the revised Powe Fatalism Inventory. Results show significant associations between fatalism and increased age (p = 0.005), race (p = 0.0001), doctor recommendation (p =.0034) and decreased educational level (p = 0.001). Fatalism was associated with noncompliance with mammography screening in univariate analysis among African-American women (OR =.362; 95% CI: 1.11, 11.8). After adjusting for possible confounders (age, education, and doctor recommendation), fatalism was not significantly associated with non-compliance with screening. These results illustrate age, race, and education may be important predictors of fatalism and that fatalism may be one barrier that has previously gone unmeasured and unchallenged in understanding screening behavior in older women.

Knowledge, Perceptions, and Motivations Related to HPV Vaccination Among College Women

Little research exists on the factors that affect the uptake patterns of the recently developed Gardasil® vaccine among young women. Human papillomavirus (HPV)-related knowledge, attitudes, beliefs, and behaviors of 18–24-year-old female students (n = 1,975) were assessed via an electronic survey. Mean HPV knowledge score, on a 10-point scale, was 6.8. A weak positive correlation (r (1,976) = 0.123, p < 0.001) was found between knowledge score and having received the vaccine. Parent recommendation, doctor recommendation, and perceiving the consequences of HPV as severe and prevalent were strongly related to previous vaccination. Data suggest a need for increased education about the vaccine and the importance of physician recommendation in increasing vaccine uptake.

Nutritional Beliefs, Attitudes and Practices of Elderly, Rural, Southern Women

Abstract Six focus groups were held with 49 rural southern women, 92% of whom were over 65 years of age. Discussions covered influences on food choices, supplement use and meal frequency; problems with buying, preparing and storing food; participation in food assistance programs; nutrition information sources; and preferred methods of nutrition education. Data analysis revealed six major themes: food preferences based upon taste and childhood familiarity; beliefs about benefits and detriments of eating certain foods; influence of health conditions on food choices; perceived barriers to purchasing, preparing and consuming certain foods; cues to action regarding food selection, supplement use and meal patterns; and nutrition information needs.

Gestational Diabetes Mellitus: Its Epidemiology and Implication beyond Pregnancy

Gestational diabetes mellitus (GDM), defined as glucose intolerance with onset or first recognition during pregnancy, is the most common pregnancy complication worldwide. Recent data have shown a substantial rise in the prevalence of GDM among women of various ethnic/racial backgrounds and in different geographic regions. The purpose of the current review is to summarize recent studies about GDM diagnosis, prevalence, and long-term impact on women’s later life and their offspring’s health, and to provide an updated review to guide future research. Currently, available evidence indicates that GDM presents a significant risk factor for development of type II diabetes (T2D) and cardiovascular disease in women. Children whose mothers had diabetes during pregnancy are at increased risk of having obesity and T2D at a young age. Future research will be needed to address how to determine whether better glucose control during pregnancy would prevent long-term consequences for both women and their children.

A Novel Testing Model for Opportunistic Screening of Pre-Diabetes and Diabetes among U.S. Adults

Objective The study aim was to evaluate the performance of a novel simultaneous testing model, based on the Finnish Diabetes Risk Score (FINDRISC) and HbA1c, in detecting undiagnosed diabetes and pre-diabetes in Americans. Research Design and Methods This cross-sectional analysis included 3,886 men and women (≥ 20 years) without known diabetes from the U.S. National Health and Nutrition Examination Survey (NHANES) 2005-2010. The FINDRISC was developed based on eight variables (age, BMI, waist circumference, use of antihypertensive drug, history of high blood glucose, family history of diabetes, daily physical activity and fruit & vegetable intake). The sensitivity, specificity, and the receiver operating characteristic (ROC) curve of the testing model were calculated for undiagnosed diabetes and pre-diabetes, determined by oral glucose tolerance test (OGTT). Results The prevalence of undiagnosed diabetes was 7.0% and 43.1% for pre-diabetes (27.7% for isolated impaired fasting glucose (IFG), 5.1% for impaired glucose tolerance (IGT), and 10.3% for having both IFG and IGT). The sensitivity and specificity of using the HbA1c alone was 24.2% and 99.6% for diabetes (cutoff of ≥6.5%), and 35.2% and 86.4% for pre-diabetes (cutoff of ≥5.7%). The sensitivity and specificity of using the FINDRISC alone (cutoff of ≥9) was 79.1% and 48.6% for diabetes and 60.2% and 61.4% for pre-diabetes. Using the simultaneous testing model with a combination of FINDRISC and HbA1c improved the sensitivity to 84.2% for diabetes and 74.2% for pre-diabetes. The specificity for the simultaneous testing model was 48.4% of diabetes and 53.0% for pre-diabetes. Conclusions This simultaneous testing model is a practical and valid tool in diabetes screening in the general U.S. population.

Guidelines for public health practitioners serving as student preceptors.

Student fieldwork and service learning are valuable strategies for developing the skills of future public health professionals. Practitioners who serve as preceptors to students often receive little preparation for guiding and evaluating students. Findings from a review of fieldwork and service learning literature and a program evaluation of an undergraduate public health program at a large southern public university were used to construct guidelines for the practitioners supervising students in the field. These guidelines should aid practitioners in their role as preceptors of public health students. The guidelines address assessing student competencies, developing student competencies, writing learning objectives, evaluating students, maximizing the student precept or relationship, and managing problems.

Early Treatment for Neonatal Abstinence Syndrome: A Palliative Approach.

Objective To describe medical, safety, and health care utilization outcomes associated with an early treatment model for neonatal opioid withdrawal. Study Design This is a retrospective review of 117 opioid‐exposed infants born in a large regional hospital and treated in the level I nursery with methadone initiated within 48 hours of birth. Results For this cohort, mean length of stay was 8.3 days. Hospital safety events were infrequent; there were no medication errors or deaths. Within 30 days of discharge, 14% of infants visited the emergency department; 7% were readmitted. Per birth, mean hospital charges were

Cutting Corners Provider Perceptions of Interpretation Services and Factors Related to Use of an Ad Hoc Interpreter

10,946.96; mean costs were

Early Treatment Innovation for Opioid-Dependent Newborns: A Retrospective Comparison of Outcomes, Utilization, Quality, and Safety, 2006–2014

5,908.93. Conclusion This study is the first to describe an early treatment model in a low‐acuity nursery to prevent severe neonatal opioid withdrawal. The described model may be safe, effective, low‐cost, and feasible for replication.

Assessing medical student cultural competence: what really matters

Introduction: This study assessed health providers’ perceptions of factors related to professional interpretation services and the association between these factors and the potential use of ad hoc interpreters. Method: Data were collected from a convenience sample of 150 health services providers at a large, regional health system in South Carolina. Results: Providers rated “ability to communicate effectively during a clinical encounter” as paramount regarding the use of interpretation services. The most important factors related to the likely use of ad hoc interpreters (cutting corners) included locating a qualified interpreter, having to wait for a qualified interpreter, and technical difficulties regarding phone and video technology. Conclusion: Health care organizations may benefit from increasing staff awareness about patient safety and legal and regulatory risks involved with the use of ad hoc interpreters.