Predicting Diabetes amongst Native American Elders

2011 ◽  
Vol 3 (4) ◽  
pp. 27-43
Author(s):  
S. Upadhyaya ◽  
K. Farahmand ◽  
T. Baker-Demaray
Keyword(s):  
Native American ◽  
Native Americans ◽  
Rural Areas ◽  
Operating Characteristic ◽  
Healthcare Professionals ◽  
Characteristic Curve ◽  
Healthcare Providers ◽  
Prevention Strategies ◽  
Community Members ◽  
Policy Makers

One in three Americans will be diabetic by 2050, and the rate of diabetes is disproportionately high among Native Americans, especially among Native elders age 55 and older. Early identification and prevention strategies have been regarded as the cornerstone of preventative medicine. The objective of the authors’ research was to identify factors related to diabetes and their interactions specifically among Native elders and develop a simple prediction model which can be used by healthcare professionals while interacting with Native elders in remote or rural areas. Data from a survey of 18,078 Native American elders was used in their study. After eliminating outliers using Pearson’s residuals and Cook’s distance, the area under the receiver operating characteristic curve was 0.7812 for men and 0.7230 for women. The results from the authors’ analysis provide additional perspective on how diabetes affects Native elders thus helping healthcare providers and policy makers when dealing with these community members.

Algonquian Diasporas

Memory Lands ◽  
2018 ◽  
Author(s):  
Christine M. DeLucia
Keyword(s):  
Native American ◽  
Native Americans ◽  
New England ◽  
Atlantic World ◽  
Indigenous Populations ◽  
Community Members ◽  
King Philip's War ◽  
Native Communities ◽  
History Of ◽  
Native American Tribes

This chapter examines how King Philip’s War gave rise to a significant but often ignored or misperceived history of bondage, enslavement, and diaspora that took Native Americans far from their northeast homelands, and subjected them to a range of brutal conditions across an Atlantic World. It focuses on Algonquians’ transits into captivity as a consequence of the war, and historicizes this process within longer trajectories of European subjugation of Indigenous populations for labor. The chapter examines how Algonquian individuals and families were forcibly placed into New England colonial as well as Native communities at the war’s conclusion, and how others were transported out of the region for sale across the Atlantic World. The case of King Philip’s wife and son is especially complex, and the chapter considers how traditions around their purported sale into slavery in Bermuda interact with challenging racial politics and archival traces. Modern-day “reconnection” events have linked St. David’s Island community members in Bermuda to Native American tribes in New England. The chapter also reflects on wider dimensions of this Algonquian diaspora, which likely brought Natives to the Caribbean, Azores, and Tangier in North Africa, and propelled Native migrants/refugees into Wabanaki homelands.

Kangaroo mother care: Understanding community low birth weight baby care perceptions and practices for designing appropriate community based KMC implementation package: a formative research. (Preprint)

2021 ◽  
Author(s):  
Shabina Ariff ◽  
Ikram Maznani ◽  
Maria Bhura ◽  
Zahid Memon ◽  
Tayyaba Arshad ◽  
...  
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Rural Areas ◽  
Healthcare Providers ◽  
Newborn Care ◽  
Formative Research ◽  
Kangaroo Mother Care ◽  
Community Members ◽  
Hospital Administrators ◽  
Skin Contact

BACKGROUND Low birth weight (LBW) is a common outcome of preterm birth and increases the risk of an infant’s morbidity and mortality. About 20 million infants are born with low birth weight globally. Since a significant number of births in Pakistan take place at home, it is important to focus on the use of Kangaroo Mother Care (KMC) (skin-to-skin contact) in communities to prevent neonatal mortality and morbidity. OBJECTIVE We conducted a formative research in order to understand the context of communities and facilities with regards to neonatal care and KMC practice, inform the design and delivery of culturally appropriate platforms to introduce KMC in communities, and develop effective recruitment and retention strategies of KMC, in rural areas of district Dadu, in the Sindh province. METHODS We conducted focus group discussions, in-depth interviews and key informant interviews with families of LBW babies, community members, healthcare providers and hospital administrators to identify barriers, enablers and a knowledge base for KMC interventions. RESULTS Newborn care practices in communities were subpar. Although KMC practices are not commonly practiced in communities and facilities and the method is unknown to many, family members were willing to provide KMC to LBW babies to improve their health outcomes. Community members, hospital administrators and healthcare providers widely accepted the practice for neonatal health and found it feasible and convenient. CONCLUSIONS The KMC as a method of treating low birth weight babies is widely accepted in the community. This formative research provided strategically effective ways for developing effective implementation strategies by identifying common community practices for LBW babies, and barriers and enablers to KMC practice.

Change and Continuity, Practice and Memory: Native American Persistence in Colonial New England

2009 ◽  
Vol 74 (2) ◽  
pp. 211-230 ◽  
Author(s):  
Stephen W. Silliman
Keyword(s):  
Native American ◽  
Native Americans ◽  
Material Culture ◽  
New England ◽  
Cultural Change ◽  
Cultural Practices ◽  
Community Members ◽  
Cultural Persistence ◽  
Colonial New England ◽  
Eastern Pequot

The archaeological study of Native Americans during colonial periods in North America has centered largely on assessing the nature of cultural change and continuity through material culture. Although a valuable approach, it has been hindered by focusing too much on the dichotomies of change and continuity, rather than on their interrelationship, by relying on uncritical cultural categories of artifacts and by not recognizing the role of practice and memory in identity and cultural persistence. Ongoing archaeological research on the Eastern Pequot reservation in Connecticut, which was created in 1683 and has been inhabited continuously since then by Eastern Pequot community members, permits a different view of the nature of change and continuity. Three reservation sites spanning the period between ca. 1740 and 1840 accentuate the scale and temporality of social memory and the relationships between practice and materiality. Although the reservation sites show change when compared to the "precontact baseline," they show remarkable continuity during the reservation period. The resulting interpretation provides not only more grounded and appropriately scaled renderings of past cultural practices but also critical engagements with analytical categories that carry significant political weight well outside of archaeological circles.

scholarly journals Heat Emergencies: Perceptions and Practices of Community Members and Emergency Department Healthcare Providers in Karachi, Pakistan: A Qualitative Study

2021 ◽  
Vol 18 (9) ◽  
pp. 4736
Author(s):  
Uzma Rahim Khan ◽  
Naveed Ahmed ◽  
Rubaba Naeem ◽  
Umerdad Khudadad ◽  
Sarwat Masud ◽  
...  
Keyword(s):  
Qualitative Study ◽  
Healthcare Professionals ◽  
Health Workers ◽  
Heat Waves ◽  
Healthcare Providers ◽  
Community Members ◽  
Home Based ◽  
Facility Level ◽  
Training Community ◽  
Access And Quality

Heat waves are the second leading cause of weather-related morbidity and mortality affecting millions of individuals globally, every year. The aim of this study was to understand the perceptions and practices of community residents and healthcare professionals with respect to identification and treatment of heat emergencies. A qualitative study was conducted using focus group discussions and in-depth interviews, with the residents of an urban squatter settlement, community health workers, and physicians and nurses working in the emergency departments of three local hospitals in Karachi. Data was analyzed using content analysis. The themes that emerged were (1) perceptions of the community on heat emergencies; (2) recognition and early treatment at home; (3) access and quality of care in the hospital; (4) recognition and treatment at the health facility; (5) facility level plan; (6) training. Community members were able to recognize dehydration as a heat emergency. Males, elderly, and school-going children were considered at high risk for heat emergencies. The timely treatment of heat emergencies was widely linked with availability of financial resources. Limited availability of water, electricity, and open public spaces were identified as risk factors for heat emergencies. Home based remedies were reported as the preferred practice for treatment by community members. Both community members and healthcare professionals were cognizant of recognizing heat related emergencies.

scholarly journals An approach to predicting patient experience through machine learning and social network analysis

2020 ◽  
Vol 27 (12) ◽  
pp. 1834-1843
Author(s):  
Vitej Bari ◽  
Jamie S Hirsch ◽  
Joseph Narvaez ◽  
Robert Sardinia ◽  
Kevin R Bock ◽  
...  
Keyword(s):  
Machine Learning ◽  
Social Network ◽  
Social Network Analysis ◽  
Network Analysis ◽  
Patient Experience ◽  
Operating Characteristic ◽  
Characteristic Curve ◽  
Healthcare Providers ◽  
Hospital Consumer Assessment ◽  
Consumer Assessment

Abstract Objective Improving the patient experience has become an essential component of any healthcare system’s performance metrics portfolio. In this study, we developed a machine learning model to predict a patient’s response to the Hospital Consumer Assessment of Healthcare Providers and Systems survey’s “Doctor Communications” domain questions while simultaneously identifying most impactful providers in a network. Materials and Methods This is an observational study of patients admitted to a single tertiary care hospital between 2016 and 2020. Using machine learning algorithms, electronic health record data were used to predict patient responses to Hospital Consumer Assessment of Healthcare Providers and Systems survey questions in the doctor domain, and patients who are at risk for responding negatively were identified. Model performance was assessed by area under receiver-operating characteristic curve. Social network analysis metrics were also used to identify providers most impactful to patient experience. Results Using a random forest algorithm, patients’ responses to the following 3 questions were predicted: “During this hospital stay how often did doctors. 1) treat you with courtesy and respect? 2) explain things in a way that you could understand? 3) listen carefully to you?” with areas under the receiver-operating characteristic curve of 0.876, 0.819, and 0.819, respectively. Social network analysis found that doctors with higher centrality appear to have an outsized influence on patient experience, as measured by rank in the random forest model in the doctor domain. Conclusions A machine learning algorithm identified patients at risk of a negative experience. Furthermore, a doctor social network framework provides metrics for identifying those providers that are most influential on the patient experience.

scholarly journals Translation, reliability, and validity of Japanese version of the Respiratory Distress Observation Scale

PLoS ONE ◽  
2021 ◽  
Vol 16 (8) ◽  
pp. e0255991
Author(s):  
Hideaki Sakuramoto ◽  
Chie Hatozaki ◽  
Takeshi Unoki ◽  
Gen Aikawa ◽  
Shunsuke Kobayashi ◽  
...  
Keyword(s):  
Operating Characteristic ◽  
Healthcare Professionals ◽  
Characteristic Curve ◽  
Japanese Version ◽  
Weighted Kappa ◽  
Validity And Reliability ◽  
English Version ◽  
Observation Scale ◽  
Weighted Kappa Coefficient ◽  
Ventilated Patients

Dyspnea is a common, distressing symptom of cardiopulmonary and neuromuscular diseases and is defined as “a subjective experience of breathing discomfort that consists of qualitatively distinct sensations that vary in intensity.” However, Japanese intensive care units (ICUs) do not routinely screen for dyspnea, as no validated Japanese version of the Respiratory Distress Observation Scale (RDOS) is available. Therefore, we aimed to translate the English version of this questionnaire into Japanese and assess its validity and reliability. To translate the RDOS, we conducted a prospective observational study in a 12-bed ICU of a universal hospital that included 42 healthcare professionals, 10 expert panels, and 128 ventilated patients. The English version was translated into Japanese, and several cross-sectional web-based questionnaires were administered to the healthcare professionals. After completing the translation process, a validity and reliability evaluation was performed in the ventilated patients. Inter-rater reliability was evaluated using Cohen’s weighted kappa coefficient. Criterion validity was ascertained based on the correlation between RDOS and the dyspnea visual analog scale. The area under the receiver operating characteristic curve analysis was used to evaluate the ability of the RDOS to identify patients with self-reported dyspnea. The average content validity index at the scale level was 0.95. Data from the 128 patients were collected and analyzed. Cohen’s weighted kappa coefficient and the correlation coefficient between the two scales were 0.76 and 0.443 (95% confidence intervals 0.70–0.82 and 0.23–0.62), respectively. For predicting self-reported dyspnea, the area under the receiver operating characteristic curve was 0.81 (95% confidence interval 0.67–0.97). The optimal cutoff used was 1, with a sensitivity and specificity of 0.89 and 0.61, respectively. Our findings indicated that the Japanese version of the RDOS is acceptable for face validity, understandability, criterion validity, and inter-rater reliability in lightly sedated mechanically ventilated patients, indicating its clinical utility.

Critical Contexts for Biomedical Research in a Native American Community: Health Care, History, and Community Survival

2012 ◽  
Vol 36 (3) ◽  
pp. 1-18 ◽  
Author(s):  
Puneet Sahota
Keyword(s):  
Health Care ◽  
Native American ◽  
Native Americans ◽  
Biomedical Research ◽  
Tribal Community ◽  
Community Members ◽  
Native Women ◽  
Care Community ◽  
Forced Sterilization ◽  
Qualitative Interview Study

Native Americans have been underrepresented in previous studies of biomedical research participants. This paper reports a qualitative interview study of Native Americans' perspectives on biomedical research. In-depth interviews were conducted with 53 members of a Southwest tribal community. Many interviewees viewed biomedical research studies as a necessary source of health care, particularly for chronic disease prevention and management. While interviewees viewed biomedical research on diabetes as critical for ensuring their community's future survival, they also mistrusted both research and health care. Community members' complex perceptions of research were rooted in painful historical events, such as forced sterilization of Native women.

Keeping Up the Momentum: Early Career Scientists in Policy-making and Community Science

2020 ◽  
Author(s):  
Caitlyn Hall ◽  
Ethan Howley ◽  
Evvan Morton ◽  
Erin Murphy ◽  
Hannah Bercovici ◽  
...  
Keyword(s):  
Climate Change ◽  
Native American ◽  
Science Policy ◽  
Early Career ◽  
Decision Makers ◽  
Community Leaders ◽  
Policy Network ◽  
Community Members ◽  
Policy Makers ◽  
The Impact

<p>To make an impact on science policy, a relationship between scientists, community leaders, and decision-makers cannot stop at one successful event – it must grow and evolve. The Arizona Science Policy Network aims to facilitate collaboration between early career scientists and decision-makers to draft science-informed policy. Beyond providing interactive and cross-disciplinary training and curriculum to scientists, we facilitate opportunities to practice in real situations, including speaking at town halls and public hearings, organizing public science science cafes and science days, writing policy memos and briefs, and advising on bills. In 2019, we successfully brought more than 60 early career scientists to the Arizona State Capitol to discuss drafts of the complex, multi-state Drought Contingency Plan with decision-makers. Since then, the state government has invited us to help draft sustainability- and climate change-focused legislation. We consider issues like climate change, water quality and availability, heat adaptation and mitigation, science education, ecological and social impacts of mining and industry, waste management, and emerging technologies. As we worked in impacted communities, we soon realized that we were missing the voices of community leaders in the conversation between scientists and policy-makers. In order to correct this, we hosted several science forums in breweries and cafes throughout Arizona. The science cafes initiated collaboration between policy-makers, scientists and community stakeholders, including Native American tribes. These meetings gave scientists, community members, and policy-makers a platform to discuss the environmental and socio-economic  impact of mining sites specific to each forum’s location. Early career scientists contributed their scientific expertise to explain how we can address region-specific problems. Community members also shared their knowledge of each unique area and context of the impact of current business and policy. Policy-makers brought their perspective on how science is used to enact change. From these efforts, we have fostered a more equitable and inclusive environment to ensure that all perspectives and knowledge are included in new bills and policies. Our program has provided a unique experience for scientists to further understand the broader impacts of science on communities and society. This presentation will reflect on the lessons learned in drafting policy with decision-makers and community leaders.</p>

Genetic histories: Native Americans’ accounts of being at risk for diabetes

2012 ◽  
Vol 42 (6) ◽  
pp. 821-842 ◽  
Author(s):  
Puneet Chawla Sahota
Keyword(s):  
At Risk ◽  
Native American ◽  
Native Americans ◽  
Healthcare Providers ◽  
Diabetes Risk ◽  
Modern World ◽  
Tribal Community ◽  
Genetics Research ◽  
Ethnographic Interviews ◽  
The Face

In an age of genetic medicine, ethnic groups are increasingly being labeled at risk for chronic diseases. Biomedical and genetics research studies have had a significant impact on Native Americans’ perceptions of diabetes risk. Ethnographic interviews with 53 Native Americans were conducted in a tribal community that has participated extensively in studies of diabetes. Tribal members had varying reactions to research labeling them at risk genetically for diabetes, from fatalism to motivation for changing diet/exercise habits. Interviewees spontaneously discussed the ‘thrifty genotype’ hypothesis in diverse ways. Some felt Native Americans had ‘weak genes’ that made them ‘poorly adapted’ to modern society’s diet, while others stated that Native Americans had ‘survival genes’ that historically helped them thrive in harsh environments. Interviewees used genetics as a metaphor for expressing vulnerability in the face of a challenging history that resulted in rapid changes to Native American lifestyles. Interestingly, some tribal members saw biomedical research as a tool to help them ‘adapt’ to the modern world. Collaborative research may provide tribes with unique opportunities to actively address the diabetes epidemic. Researchers’ and healthcare providers’ descriptions of diabetes risk have important implications for how community members perceive their ability to prevent or manage the disease.

scholarly journals Healthcare Engagement and Encounters in a Rural State: A Focus Group Study

2018 ◽  
Vol 9 (1) ◽  
pp. 5
Author(s):  
Reshmi Singh ◽  
Heather Scott ◽  
Kem Krueger ◽  
Erin J Bush
Keyword(s):  
Health Care ◽  
Focus Group ◽  
Health Care Providers ◽  
Rural Areas ◽  
Healthcare Professionals ◽  
Conflicts Of Interest ◽  
Healthcare Providers ◽  
Original Research ◽  
Care Providers ◽  
Healthcare Experiences

Introduction: Rural populations have many barriers to quality health care including lack of access to primary care and specialty care and a greater likelihood to be underinsured or uninsured. They are also less likely to use preventive screening, or to participate in self-care and engage in their health when compared to urban residents. The purpose of this paper was to describe patients’ healthcare experiences in a rural western state focusing on their healthcare expectations and engagement. Methods: This qualitative study was conducted using a focus group protocol to elicit rural patients’ healthcare experiences. A purposeful sample of English speaking adult residents from a single county who were willing to discuss their healthcare experiences was included. Patients and community members (21 years and older) were recruited through a local hospital as well as via flyers posted throughout the community. Each audio-recorded group took about two hours. A total of 15 focus groups were conducted to obtain sufficient text for theoretical saturation and thematic analysis. Each group had a range of 3-8 participants. A $25 visa gift card and lunch were provided for each participant as an incentive. Results: ‘Encounters with Healthcare Professionals’ and ‘Engagement in Health’ were the two dominant dimensions with two themes each. Themes centered around what characterized the best or worst encounters. Trust and Communication - both were based on time spent with the provider and establishment of rapport with the providers. The best encounters were those with health care providers or pharmacists who had sufficient time, adequately explained a diagnosis and new medications did not dismiss patient concerns, and treated individuals with respect. Typical responses describing the worst encounters included examples of misdiagnosis, dismissing patient’s symptoms, healthcare professionals whose attention was not focused on the patient, pushing too many medications, rushed encounters, and providers with poor bedside manner. ‘Engagement in Health’ dimension included the theme of Self-management Process such as taking things one day at a time, taking medication daily, and good stress management. The second theme was Barriers to Engagement and included issues regarding inclement weather, lack of sidewalks, stress, lack of time and the financial constraints for eating healthy, going to a gym, and/or problems with payer source. Participants also described a number of technological tools they utilized to engage with their healthcare including appointment reminders, health-based websites, symptom trackers, online portal systems for health care records, and online bill pay. Many used apps on smart phones to track calories and exercise as well as online community groups to encourage fitness. Conclusions: The results from this study highlighted some of the gaps in healthcare for rural areas. A large number of participants indicated a lack of trust of their providers and only a few had any communicative interaction with their pharmacist. Future studies could evaluate training designed to teach healthcare providers and pharmacists how to engage patients in their own care. Use of technology by healthcare providers might be another way to improve healthcare engagement. Conflict of Interest "We declare no conflicts of interest or financial interests that the authors or members of their immediate families have in any product or service discussed in the manuscript, including grants (pending or received), employment, gifts, stock holdings or options, honoraria, consultancies, expert testimony, patents and royalties". Acknowledgements: This study was funded by the University of Wyoming College of Health Sciences (UW CHS) Faculty Seed Grant awarded to first author Dr. Singh in April 2015. Interim results of this study have been presented at the Health Literacy Research Conference (HARC) in November 2015. Treatment of Human Subjects: IRB review/approval required and obtained   Type: Original Research

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