Roy Yawn

The estimated cost of school scoliosis screening.

Study Design. This is a population-based, longitudinal retrospective study of one community’s school-based scoliosis screening program. Objective. To report the estimated costs of mass school-based screening for scoliosis. Summary of Background Data. School scoliosis screening has been reported to cost from as little as

Exploring rural medicine : current issues and concepts

0.06 to as much as

Adolescent pregnancies in rural America: a review of the literature and strategies for primary prevention.

194 per child. The lower estimate considered only the cost to the school, and the higher estimate defined all children with curves of 5° or more as cases. Methods. School scoliosis screening results were linked with the medical and chiropractic care records of all referred children to identify outcomes and scoliosis-related health service utilization from Grade 5 through graduation or age 19 years. Costs are presented per child screened, per child with a spinal curve of 20° or more, and per child treated for scoliosis and are based on scoliosis-related health care utilization and school costs. Results. Ninety-two (4.1%) of 2197 children screened were referred for further evaluation of possible scoliosis, and 68 (74%) of those had documented evaluation for possible scoliosis. Five of the 92 children referred were treated for scoliosis by age 19. Sixty-six scoliosis-related primary care visits, 79 scoliosis-related orthopedist visits, and 79 full spine radiographs followed referral but preceded treatment. Case-finding costs for screening were

The gender specific frequency of risk factor and CHD diagnoses prior to incident MI: A community study

24.66 per child screened (n = 2197),

A Population-Based Study of School Scoliosis Screening

3,386.25 per child with a curve of 20° or more (n = 16) and

An In-School CD-ROM Asthma Education Program

10,836.00 per child treated for scoliosis (n = 5). Conclusion. School scoliosis screening is significantly more costly than has previously been reported.

Preterm Birth Prevention in a Rural Practice

Rural Medical Practice - Barbara P Yawn Present and Future Labor and Delivery Crises - Charles S Field and Barbara P Yawn Rural Solutions Stabilization and Transport of the Ill Newborn Infant - Theodore R Thompson Bronchopulmonary Dysplasia - John J McNamara and Nancy N Hoogenhous After the Infant Goes Home Attention Deficit-Hyperactivity Disorder - Carolyn McKay Recognition and Evaluation of Child Abuse - Daniel D Broughton Adolescent Pregnancies in Rural America - Barbara P Yawn and Roy A Yawn A Review of the Literature and Strategies for Prevention Common Mental Health Problems - Lawrence P Peterson Environmental Hazards - Barbara P Yawn Managing Trauma in the Rural Emergency Department - David M Larson Basic Organization Managing Trauma in the Rural Emergency Department - David M Larson Specific Problems Treatment of Acute Myocardial Infarction with Thrombolytic Drugs in the Rural Hospital - Roy A Yawn Womens Health Issues - Cheri L Olson Caring for the AIDS Patient in a Rural Practice - Richard D Simon Jr Treatment of Patients with Terminal Cancer - Wayne H Thalhuber Caring for Dying Patients and Their Families - Norma Wylie Health Maintenance in Clinical Practice - Paul S Frame Strategies and Barriers Patient Education in the Rural Practice - Patricia A Gibson and Claudia J Kapp Making Your Practice Palatable for Your Patients - Barbara P Yawn and Angeline Bushy Cultural Competency Ethics Dilemmas in Rural Practice - Angeline Bushy and J Randall Rauh Quality Assessment in Rural Practice - Peter G Harper, Charles E McCoy and Angeline Bushy Living Through Malpractice Litigation - J Randall Rauh and Angeline Bushy

Primary Care Physicians’, Nurse Practitioners’ and Physician Assistants’ Knowledge, Attitudes and Beliefs Regarding COPD: 2007 to 2014

In the United States over 1 million women under the age of 19 conceive children every year. 40% of these have abortions 13% miscarry and the rest keep the child. At least 20% of teen births are among rural adolescents. Pregnant teens are at high risk of poverty in adulthood. A study of a rural Minnesota community with a primarily Caucasian population showed that by the 12th grade 36.9% of boys and 52.4% of girls had had sexual intercourse. 27.2% of boys and 11.7% of girls claimed that they had 5 or more partners. Contraceptives were used by 76.1% of boys and 79.9% of girls. In metropolitan teens aged 15-19 42.3% had had premarital sexual intercourse and 7% of girls had 4-5 partners while 8.9% had 6 or more. 76% used contraceptives. Adolescents sexual intercourse is influenced by maturation (estrogen and progesterone levels in teen girls and testosterone levels in boys); social factors (socioeconomic status ethnicity religion); racial and cultural factors (Blacks start earlier than Whites so do Hispanics); media exposure (adolescents watching much television were more sexually active); parental role (early sexual experience of the mother was associated with early sex especially for girls); peer groups (teens perception of their peers actions are decisive); personality and self-esteem (independence lower academic achievement less parental influence and more problem behavior predisposes to early sexual activity); perception of risk and benefit (Black males perceived the least risk compared to White males and Black females); and societal trends (recent decline in sexual activity is attributable to more parental control religious revival and fear of AIDS). Current prevention programs are based in communities schools churches girls clubs and YMCAs. These entail messages about abstinence by improving parent-child communication target males school sex education programs and adolescent health clinics. The St. Paul Minnesota school clinic program showed a decline in birth rates from 59/1000 in 1976-77 to 26/1000 in 1983-84. In Baltimore the Johns Hopkins University high school program cut pregnancy rates by 30.1%.

Telmisartan - An effective antihypertensive for 24-hour blood pressure control

BackgroundCHD is a chronic disease often present years prior to incident AMI. Earlier recognition of CHD may be associated with higher levels of recognition and treatment of CHD risk factors that may delay incident AMI. To assess timing of CHD and CHD risk factor diagnoses prior to incident AMI.MethodsThis is a 10-year population based medical record review study that included all medical care providers in Olmsted County, Minnesota for all women and a sample of men residing in Olmsted County, MN with confirmed incident AMI between 1995 and 2000.ResultsAll medical care for the 10 years prior to incident AMI was reviewed for 150 women and 148 men (38% sample) in Olmsted County, MN. On average, women were older than men at the time of incident AMI (74.7 versus 65.9 years, p < 0.0001). 30.4% of the men and 52.0% of the women received diagnoses of CHD prior to incident AMI (p = 0.0002). Unrecognized and untreated CHD risk factors were present in both men (45% of men 5 years prior to AMI) and women (22% of women 5 years prior to first AMI), more common in men and those without a diagnosis of CHD prior to incident AMI (p < 0.0001).ConclusionA CHD diagnosis prior to incident AMI is associated with higher rates of recognition and treatment of CHD risk factors suggesting that diagnosing CHD prior to AMI enhances opportunities to lower the risk of future CHD events.