scholarly journals Effectiveness of Flow Sheet Implementation on Diabetes Progression Screening at a Student-Run Free Clinic

2020 ◽  
Vol 13 ◽  
pp. 285-289
Author(s):  
Samuel Wilcox ◽  
Hayrettin Okut ◽  
Robert Badgett ◽  
Stephanie Hassouneh ◽  
Elizabeth Ablah
Keyword(s):  
Low Socioeconomic Status ◽  
Glycosylated Hemoglobin ◽  
Flow Sheet ◽  
Process Of Care ◽  
Low Socioeconomic ◽  
Patients With Diabetes ◽  
Diabetes Progression ◽  
One Year ◽  
Eye Exams ◽  
To Receive

Introduction: Diabetes mellitus (DM) disproportionately affects people with low socioeconomic-status (SES). Student-run free clinics (SRFC) aim to care for low SES populations and experience high clinician turnover. Flow sheets have been used to improve care for those with diabetes, yet no research has assessed the use of such a flow sheet in a SRFC. The aim of this project was to determine if use of a flow sheet improved care for people with DM in an SRFC.   Methods: Charts from all patients receiving care for DM at one SRFC in the year before (n=53) and after (n=56) implementation of the flow sheet were reviewed. Pre and post group comparisons and post subgroup comparisons were made for glycosylated-hemoglobin (HgbA1c), microalbumin, and foot and eye exams.   Results: During a one-year period, a larger proportion of patients who received care post flow sheet introduction received at least two HgbA1c tests (53%), a microalbumin test (46%), and a foot-exam (46%) compared to those receiving care before the flow sheet (28%, 2%, and 25%, respectively). There was no difference in proportions of patients undergoing eye exams. In post subgroup analysis, flow sheets were used for 50% of patients, and patients who received care with the flow sheet were more likely to receive at least two HgbA1c tests and a foot exam per year. Conclusions: Our study suggests that flow sheets can improve the process of care for patients with diabetes in a SRFC. A systematic integration of the flow sheet is being implemented in the SRFC now.

Disparities in Access to Cranial Remodeling Orthosis for Deformational Plagiocephaly

2021 ◽  
pp. 105566562110698
Author(s):  
Alexandra Junn ◽  
Jacob Dinis ◽  
Aaron Long ◽  
Sacha Hauc ◽  
Sarah Phillips ◽  
...  
Keyword(s):  
Low Socioeconomic Status ◽  
Demographic Variables ◽  
Delayed Presentation ◽  
Deformational Plagiocephaly ◽  
Low Socioeconomic ◽  
Delayed Treatment ◽  
Logistic Regressions ◽  
Insured Patients ◽  
To Receive ◽  
Income Quartile

Objective Moderate to severe cases of deformational plagiocephaly (DP) may be treated with cranial remolding orthoses (CRO). This study investigated the socioeconomic disparities in access to care for CRO for DP correction. Design This was a retrospective review of medical records from a single CRO company in Connecticut from 2014 to 2020. Methods Demographic variables were collected from all patients. Univariable logistic regressions were used to identify differences for presenting age at consultation, whether CRO was pursued, and length of CRO treatment by insurance payor and household income quartile. Results Of the 5620 patients identified, 4100 (73.0%) received CRO, with 674 (12.0%) receiving a second helmet. Of those receiving CRO, 1536 (37.5%) had Medicaid insurance while 2558 (62.4%) were commercially insured. Patients on Medicaid were 1.30 times more likely to have delayed presentation ( P  =  .017), while patients from the lowest income quartile were 1.26 1.50 ( P < .001) and 1.58 ( P < .001) times more likely to have a delayed presentation relative to those in the highest and second-highest income quartiles, respectively. Patients in the highest and second-highest income quartiles were also 1.55 ( P < .001) and 1.45 ( P < .001) more likely, respectively, to receive CRO after consultation than those from the lowest income quartile. Conclusions Lower income and Medicaid-insured patients had delayed presentation for CRO consultation. Those from the lowest income quartile were more likely to never receive CRO than those from wealthier backgrounds. Low socioeconomic status and Medicaid insurance, which can have more restrictive coverage policies for CRO, may result in the delayed treatment of DP.

Demographic Profile Associated With Malnutrition

2021 ◽  
Vol 3 (2) ◽  
Author(s):  
Adnan Khalil ◽  
Shahid Bashir ◽  
Morad Yaser Al Mostafa
Keyword(s):  
Socioeconomic Status ◽  
Low Socioeconomic Status ◽  
Health Problem ◽  
Rural Areas ◽  
Sampling Technique ◽  
Questionnaire Data ◽  
Low Socioeconomic ◽  
Demographic Profile ◽  
Malnourished Children ◽  
One Year

Worldwide, malnutrition is the severe most health problem leading to the highest rate of disease andmortality among children less than 5 years of age. Objective: To find out the association betweenmalnutrition and demographic profile. Methods: 350 malnourished children were chosen by nonprobabilityconvenient sampling technique from Sir Ganga Ram Hospital, Lahore. Children wereassessed through pre-tested questionnaire. Data were analyzed by SPSS version 21.0. Results: 45%malnourished children were 1-3 years of age, majority of the children were females (52%), 89% childrenwere from rural areas, 82.6% children were from low socioeconomic status, 54.6% mothers wereuneducated, 50% malnourished children were not having their own house, 115 malnourished childrenwere having 3 or more siblings and 89 mothers were having less than one year of pregnancy gap.Conclusions: Low socioeconomic status, illiteracy of mothers, rural area, gap between pregnancy andfemale gender has been found to be linked with malnutrition in children below 5 years of age.

scholarly journals THE ILLNESS EXPERIENCE IN HYPERTENSION PATIENTS WITH LOW SOCIOECONOMIC STATUS

2020 ◽  
Vol 19 (4) ◽  
pp. 357-372
Author(s):  
Imam Faisal Hamzah ◽  
Subandi Subandi
Keyword(s):  
Socioeconomic Status ◽  
Low Socioeconomic Status ◽  
Interpretative Phenomenological Analysis ◽  
Qualitative Method ◽  
Social Resources ◽  
Structured Interviews ◽  
Excessive Pressure ◽  
Low Socioeconomic ◽  
Unpleasant Feeling ◽  
One Year

Hypertension is one type of disease that is usually experienced by adults, where arteries have excessive pressure, which is above 140 mm Hg for systolic and diastolic 90 mm Hg. Hypertension is not only a physical experience, but also needs to be understood as a psychological and social experience. Health is a social problem because it is related to how a person finances his health and access appropriate health facilities. The purpose of this study was to obtain psychosocial dynamics in the experience of hypertension in patients with low socioeconomic status. This study used a qualitative method with an Interpretative Phenomenological Analysis (IPA) approach through semi-structured interviews. Three participants involved were female, aged 30 to 45 years, and had more than one year suffered from hypertension. This study found six superordinate themes that focused on perceptions of causes, perceptions of hypertension, unpleasant feeling, social resources, improvement efforts, and health development.  

scholarly journals High rate of stroke and low rate of atrial fibrillation in low socioeconomic strata and blacks: the atrial fibrillation paradox

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
J.B Kostis ◽  
S Zinonos ◽  
J Cabrera ◽  
W.J Kostis
Keyword(s):  
Atrial Fibrillation ◽  
Low Socioeconomic Status ◽  
Proportional Hazards ◽  
Cox Proportional Hazards ◽  
High Rate ◽  
Low Ses ◽  
Low Socioeconomic ◽  
Socioeconomic Strata ◽  
One Year

Abstract Background and introduction Persons living in areas of low socioeconomic status (SES) usually have higher rates of adverse cardiovascular events (CVE) including stroke. Also, atrial fibrillation (AF) is associated with higher rate of CVEs. One would expect that both the rate of stroke and the occurrence of AF would be higher in areas of low SES. Purpose and methods Using MIDAS, a validated statewide data base of all hospitalizations for cardiovascular disease in NJ with follow up of more than 25 years, we examined the rate of hospitalization for AF by SES in patients with history of myocardial infarction for the years 1995 to 2015 (n=258,339). Zip codes in New Jersey were aggregated into 4 categories representing quarters of the distribution of SES areas. Results At one-year follow-up, patients in the lowest SES (lowest 25th percentile) and Blacks were more likely to suffer a stroke (p&lt;0.0001). During one-year follow-up, patients in the lowest 25th percentile (Figure) were significantly less likely (p&lt;0.0001) to be readmitted with a diagnosis of AF. Blacks had lower rate of admission with a diagnosis AF compared to Whites (p&lt;0.0001) (Figure). Cox proportional hazards regression adjusting for demographics and co-morbidities confirmed the validity of these differences. In this analysis patients in the lowest SES quartile and Blacks were less likely to be admitted with AF than those in the highest quartile (HR 0.95, 95% CI 0.92–0.99). Also, Blacks were less likely to be admitted with AF than Whites (HR 0.76, 95% CI 0.71–0.82). This phenomenon (AF paradox) of lower incidence of AF in low SES and in Blacks has been attributed to under-ascertainment of AF in these groups, that may lead to underuse of anticoagulation and result in the occurrence of stroke. Conclusion Atrial fibrillation is underdiagnosed in patients at low socioeconomic strata and in Blacks and may lead to underuse of anticoagulation and the occurrence of stroke. Special efforts are warranted in detecting AF in these groups. Funding Acknowledgement Type of funding source: None

scholarly journals Evaluation of molar pregnancy in Rajshahi Medical College Hospital

KYAMC Journal ◽  
2018 ◽  
Vol 9 (1) ◽  
pp. 24-27
Author(s):  
Mosammat Nargis Shamima ◽  
Rubayet Zereen ◽  
Mohd Alamgir Hossain ◽  
Nargis Zahan ◽  
Nurjahan Akter ◽  
...  
Keyword(s):  
Low Socioeconomic Status ◽  
Hydatidiform Mole ◽  
Treatment Protocol ◽  
Medical College Hospital ◽  
Molar Pregnancy ◽  
College Hospital ◽  
Low Socioeconomic ◽  
Medical College ◽  
One Year ◽  
Abnormal Vaginal Bleeding

Background: A molar pregnancy is also known as hydatidiform mole which is a benign tumour that develops in the uterus. It begins when an egg is fertilized but normal viable pregnancy not occurs, rather than the placenta develops into an abnormal mass of cyst. In all cases of molar pregnancy observation is essential to detect the reawakening of chorionic activity.Objectives: The aim of the study was to explore the incidence, clinical presentation, management and outcome of the molar pregnancy in our hospital.Materials & Methods: This prospective study was conducted in Rajshahi Medical College Hospital, Rajshahi, Bangladesh over a period of one year from July 2016 to June 2017. All pregnant women who were diagnosed as molar pregnancy were included in the study.Results: In this study the incidence of molar pregnancy was 5.3 per 1,000 deliveries that was 1 in 188 deliveries. Among the patients 54.7% were between (23 - 27 years) age group, 81.2% cases were multiparous and 58.4% patients belonged to low socioeconomic status. The prevalent blood group was A and constitute 56.6%. About 62.2% patient presented with amenorrhoea and abnormal vaginal bleeding. 45.3% admitted between (12-16) weeks of gestation. Most of the patients 58.4% were managed by suction and evacuation. Among all the cases 92.4% were complete mole and only 16.9% came for follow up.Conclusion: Results from this study showed that a small portion of patient of molar pregnancy came for routine follow up. To achieve high cure rate and low chemotherapy rate an effective registration programme and treatment protocol should be established.KYAMC Journal Vol. 9, No.-1, April 2018, Page 24-27

scholarly journals Preterm labour and its effect on perinatal morbidity and mortality

2018 ◽  
Vol 7 (5) ◽  
pp. 1993 ◽  
Author(s):  
Neetu Gupta ◽  
Pragati Divedi ◽  
Deepti Dwivedi
Keyword(s):  
Low Socioeconomic Status ◽  
Apgar Score ◽  
Preterm Labour ◽  
Preterm Births ◽  
Morbidity And Mortality ◽  
Care Hospital ◽  
Perinatal Morbidity ◽  
Low Socioeconomic ◽  
Spontaneous Labour ◽  
One Year

Background: This study was performed to find out the incidence and identification of risk factors of preterm labour and also to find out the incidence of perinatal outcome in the form of morbidity and mortality.Methods: Total 720 antenatal cases with preterm labour admitted and studied in total one-year duration in UPUMS Saifai, Etawah. Out of 720 cases, 692 pregnant patients underwent preterm birth. Thorough history taking, general, systemic and obstetrical examination was done for each patient. APGAR Score and birth weights of the new borns were noted at the time of birth and they were followed up throughout the hospital stay. Incidence and perinatal morbidity and mortality of preterm births were calculated.Results: Incidence of preterm labour and births were 28.5% and 27.9% respectively. Among various causes of pre-term birth, spontaneous labour with intact membranes is the most common cause. Lack of antenatal check-up was found to be most common risk factor of preterm labour followed by infection and low socioeconomic status. Majority of the new-borns had low APGAR score (<6) in the present study. Total perinatal morbidity in the present study group was 67.2%Conclusions: We concluded that higher incidence of perinatal morbidity and mortality may be due to that the study was conducted at tertiary health care hospital which mostly receive high risk cases and majority of cases belonged to low socioeconomic group and also that the incidence of perinatal morbidity and mortality may be more in this part of country.

The Impact of Postnatal Depression on Child Cognitive Functioning at Four Years

2008 ◽  
Vol 25 (2) ◽  
pp. 49-61
Author(s):  
Catherine McMahon ◽  
Tania Trapolini ◽  
Alison Cornish ◽  
Judy Ungerer
Keyword(s):  
Cognitive Functioning ◽  
Low Socioeconomic Status ◽  
Postnatal Depression ◽  
Verbal Iq ◽  
Low Socioeconomic ◽  
Iq Scores ◽  
One Year ◽  
The Impact ◽  
Depressed Children ◽  
Performance Scale

AbstractStudies investigating the impact of postnatal depression on later child cognitive functioning report mixed results. Some show ongoing effects of depression in the first postnatal year, others show no lasting adverse effects, yet others report effects only when the depression is chronic and coupled with additional risks to development such as low socioeconomic status. This study examined the impact of depression in the first postnatal year and subsequent episodes between one and four years postpartum in a sample of 92 mothers and their four year old children from a relatively high socioeconomic group. Children were administered the WPPSI-R at four years of age. Findings revealed only modest effects. Compared to those whose mothers were not depressed, children whose mothers were diagnosed with depression in the first postnatal year had lower verbal IQ scores, but there were no differences on the performance scale. There were also no differences between children whose mothers recovered after one year and those whose mothers experienced further depression between one and four years. Effects were similar for boys and girls.

scholarly journals Understanding the relationship between socioeconomic status, smoking cessation services provided by the health system and smoking cessation behavior in Brazil

2013 ◽  
Vol 29 (3) ◽  
pp. 485-495 ◽  
Author(s):  
André Salem Szklo ◽  
James F. Thrasher ◽  
Cristina Perez ◽  
Valeska Carvalho Figueiredo ◽  
Geoffrey Fong ◽  
...  
Keyword(s):  
Socioeconomic Status ◽  
Smoking Cessation ◽  
Low Socioeconomic Status ◽  
P Value ◽  
Low Socioeconomic ◽  
Quit Smoking ◽  
Quit Attempts ◽  
And Gender ◽  
To Receive ◽  
The Relationship

Increasing the effectiveness of smoking cessation policies requires greater consideration of the cultural and socioeconomic complexities of smoking. The purpose of this paper is to explore the association between socioeconomic status and "selected midpoints" linked to smoking cessation in Brazil. Data was collected from a representative sample of urban adult smokers as part of the ITC-Brazil Survey (2009, N = 1,215). After controlling for age and gender, there were no statistically significant differences quit attempts in the last six months between individuals with different socioeconomic status. However, smokers with high socioeconomic status visited a doctor 1.54 times more often than those with low socioeconomic status (p-value = 0.017), and were also 1.65 times more likely to receive advice to quit smoking (p-value = 0.025). Our results demonstrate that disparities in health and socioeconomic status are still a major challenge for policymakers to increase the population impact of tabacco control actions worldwide.

Distance Between Home and the Admitting Hospital and Its Effect on Survival of Low Socioeconomic Status Population With Staphylococcus aureus Bacteremia

2021 ◽  
pp. 003335492199489
Author(s):  
Emi Minejima ◽  
Joshua Wang ◽  
Stormmy Boettcher ◽  
Lihua Liu ◽  
Mimi Lou ◽  
...  
Keyword(s):  
Low Socioeconomic Status ◽  
Proportional Hazards ◽  
Proportional Hazards Model ◽  
Cox Proportional Hazards ◽  
Cox Proportional Hazards Model ◽  
Low Ses ◽  
Process Of Care ◽  
Low Socioeconomic ◽  
Staphylococcus Aureus Bacteremia ◽  
Hazards Model

Objective Bacteremia is the presence of bacteria in the bloodstream. The objective of this study was to determine the relationship between low socioeconomic status (SES) and the epidemiology, process of care, and outcomes of patients with Staphylococcus aureus bacteremia (SAB). Methods We conducted a multicenter, retrospective, cohort study that evaluated adult patients with SAB in 3 Los Angeles County hospitals from July 15, 2012, through May 31, 2018. We determined SES (low SES, intermediate SES, and high SES) for each patient and compared sociodemographic and epidemiologic characteristics, management of care received by patients with SAB (ie, process of care), and outcomes. We used a Cox proportional hazards model to determine predictors of 30-day mortality for each SES group. Results Of 915 patients included in the sample, 369 (40%) were in the low-SES group, 294 (32%) in the intermediate-SES group, and 252 (28%) in the high-SES group. Most significant predictors of 30-day mortality in the Cox proportional hazards model were admission to an intensive care unit (hazard ratio [HR] = 9.04; 95% CI, 4.26-19.14), Pitt bacteremia score ≥4 indicating critical illness (HR = 4.30; 95% CI, 2.49-7.44), having ≥3 comorbidities (HR = 2.05; 95% CI, 1.09-3.85), and advanced age (HR = 1.03; 95% CI, 1.01-1.05). Distance between home and admitting hospital affected mortality only in the low-SES group (HR = 1.02; 95% CI, 1.00-1.02). Conclusions SES did not independently affect the outcome of SAB; however, the farther the patient’s residence from the hospital, the greater the negative effect on survival in a low-SES population. Our findings underscore the need to develop multipronged, targeted public health efforts for populations that have transportation barriers to health care.

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