Inadequate health literacy is a

Size: px
Start display at page:

Download "Inadequate health literacy is a"

Transcription

1 Testing the BRIEF Helth Litercy Screening Tool Jolie Hun, PhD, Virgini Nolnd-Dodd, PhD, MPH, Jill Vrnes, EdD, John Grhm-Pole, MD, Brbr Rienzo, PhD, nd Ptrici Donldson, RN Due to the oppressive strins lid on the ntion s helth cre system, efforts to prevent dverse outcomes relted to ptients indequte helth re wrrnted. By identifying ptients helth skills with this tool, these uthors strive not only to prevent personl nd system loss but lso to provide ptient-centered cre. Indequte helth is mjor problem in the United Sttes. Ptients helth skills ffect their bility to communicte with helth cre providers, dhere to helth cre regimens, ccess nd nvigte helth cre services, nd mnge helth issues. 1,2 Yet the Institute of Medicine estimted in 2004 tht nerly hlf of ll Americn dults (bout 90 million people) hve difficulty understnding nd cting upon helth informtion. 2 Ech yer, indequte helth results in pproximtely $73 billion in unnecessry helth cre costs. 3 In order to fcilitte effective nd timely interventions tht cn promote high qulity, cost-efficient helth cre experience, helth cre providers re in need of brief, effective tool for detecting indequte helth mong their ptients. At present, there re vlidted tools for ssessing At the time this rticle ws written, Dr. Hun ws doctorl student t the University of Florid (UF) College of Helth nd Humn Performnce, Ginesville. She is currently Ntionl Institutes of Helth postdoctorl fellow in the deprtment of fmily nd community medicine t the University of Arizon, Tucson. Dr. Nolnd-Dodd is n ssocite professor nd grdute coordintor nd Dr. Vrnes is professor, both in the deprtment of helth eduction nd behvior t UF. Dr. Grhm- Pole is professor emeritus in the deprtment of peditrics nd pllitive cre t the UF College of Medicine. Dr. Rienzo is n ssocite den for fculty ffirs nd professor in the deprtment of helth eduction nd behvior t UF. Ms. Donldson is nurse t the Mlcom Rndll VA Medicl Center, Ginesville, FL. helth, including the Short Test of Functionl Helth Litercy in Adults (STOFHLA) 4 nd the Rpid Estimte of Adult Litercy (REALM). 5 Current tools, however, either tke too long to dminister or re potentilly embrrssing to ptients. 6 Recent studies hve ttempted to crete brief nd effective helth screening tool. Chew nd collegues developed 16 helth screening questions nd dministered them, long with the STOFHLA, to 332 prticipnts. 6 They found tht, s determined by the STOFHLA, three of the new questions were effective t detecting indequte helth, tht these three questions were weker t detecting indequte/ mrginl helth, nd tht no combintion of the three questions ws more effective t identifying indequte helth thn ny of those individul questions. Wllce nd collegues dministered the sme three questions, long with the REALM, to 305 prticipnts who differed demogrphiclly from the prticipnts in Chew nd collegues study. 7 Their results indicted tht, s determined by the REALM, one of the questions ws ccurte in detecting limited nd limited or mrginl helth nd ws more ccurte thn ny combintion of the three questions. Lter, Bker sserted tht the inconsistencies between Chew nd collegues study nd Wllce nd collegues study indicte need for further reserch, 8 while Prker nd Kindig clled for more reserch on the mesurement of both individul nd popultion-level helth skills. 9 With these issues in mind, we developed the Brief Helth Litercy Screening Tool (known s the BRIEF) nd conducted study to determine its efficcy. The BRIEF consists of the three questions evluted by Chew nd collegues nd Wllce nd collegues, long with fourth question tht we developed. We investigted the tool s efficcy t detecting indequte nd indequte/mrginl helth in VA mbultory cre setting by using the STOFHLA nd the REALM s stndrds of ctul helth. In this rticle, we present our findings nd discuss how we hve implemented the BRIEF within our own helth cre system. Methods Our study involved the dministrtion of the BRIEF, the STOFHLA, the REALM, nd self-dministered survey to convenience smple of ptients presenting for cre in VA mbultory setting between Mrch nd August We employed n ction reserch method, through which 21 trined, volunteer helth cre providers collected ptient dt on site in the clinicl, mbultory cre setting. The dt collectors were from eight rurl 24 FEDERAL PRACTITIONER DECEMBER 2009

2 Tble 1. Ptients generl skills ccording to level nd score of the STOFHLA nd the REALM b Level Score Generl skills STOFHLA Indequte 0 16 Able to perform uncomplicted tsks involving brief nd uncomplicted texts nd documents Mrginl Able to locte informtion in text, mke low-level inferences using printed mterils, nd integrte esily identifible pieces of informtion Able to integrte informtion from reltively long or dense texts or documents, determine pproprite rithmetic opertions bsed on informtion contined in the directive, nd identify quntities needed to perform opertion Adequte Demonstrtes proficiencies ssocited with long nd complex documents nd text pssges; ble to determine nd interpret qulittive nd quntittive dt needed to perform n opertion REALM Limited 0 44 Not ble to red most low helth mterils; will need repeted orl instructions; mterils should be composed of illustrtions or video tpes; will need low mterils; my not be ble to red prescription lbel Mrginl Struggles with most ptient eduction mterils Adequte Able to red nd comprehend most ptient eduction mterils STOFHLA = Short Test of Functionl Helth Litercy in Adults. b REALM = Rpid Estimte of Adult Litercy. nd nonrurl VA mbultory cre clinics nd hospitls in northern Florid nd southern Georgi nd included 17 nurses, the principl investigtor, nutritionist, dentl technicin, nd nurse eductor volunteer. Once ptients greed to prticipte in the study, their dt were collected either by one of the provider dt collectors in their mbultory cre setting or by the principl investigtor in n exmintion room in the sme setting. Inclusion criteri required the ptients to ssent to their prticiption verblly nd in English. No incentives for prticiption were provided. The instruments The BRIEF consists of the following questions: (1) How often do you hve someone help you red hospitl mterils? ; (2) How confident re you filling out medicl forms by yourself? ; (3) How often do you hve problems lerning bout your medicl condition becuse of difficulty understnding written informtion? ; nd (4) How often do you hve problem understnding wht is told to you bout your medicl condition? For the first, third, nd fourth questions, response options re offered in the following five-point Likert scle: 1 = lwys, 2 = often, 3 = sometimes, 4 = occsionlly, nd 5 = never. For the second question, the following five-point Likert scle is offered: 1 = not t ll, 2 = little bit, 3 = somewht, 4 = quite bit, nd 5 = extremely. The first three questions were evluted in the studies by Chew nd collegues nd Wllce nd collegues. 6,7 We dded the fourth question to ssess difficulties with uditory helth informtion nd, thus, increse the tool s vlidity. The BRIEF cn be dministered nd scored in less thn two minutes. BRIEF scores rnge from 4 to 20. Bsed on the previous evlutions of the first three questions, 6,7 we set three criterion levels for BRIEF scores: indequte (scores of 4 to 12), mrginl (scores of 13 to 16), nd dequte (scores of 17 to 20). The STOFHLA nd the REALM were used to test the BRIEF s efficcy (Tble 1). The STOFHLA is shortened version of the Test of Functionl Helth Litercy, 10,11 nd it mesures ptients bility to red nd understnd two pssges. It includes 36 items, hs score rnge of 0 to 36, tkes up to seven minutes to dminister, nd tkes bout two dditionl minutes to score. STOFHLA scores divide helth skills into three criterion levels: indequte (0 to 16), mrginl (17 to 22), nd dequte (23 to 36). Continued on next pge DECEMBER 2009 FEDERAL PRACTITIONER 25

3 Continued from previous pge Tble 2. Demogrphic chrcteristics of the study prticipnts (N = 378) Chrcteristic Study popultion Age in yers Averge (SD) 61.5 (11.9) Rnge Gender, no. (%) Mle 356 (94.2) Femle 19 (5) Not reported 3 (0.8) Eduction level, no. (%) Elementry school (grdes 1 5) 4 (1.1) Junior high school (grdes 6 8) 11 (2.9) Some high school (grdes 9 12) 56 (14.9) High school/ged 98 (25.9) Some college 126 (33.3) College degree 80 (21.2) Trde school 1 (0.3) Not reported 2 (0.5) Ethnicity, no. (%) Blck 69 (18.3) White 278 (73.5) Hispnic/Ltino 12 (3.2) Ntive Americn 12 (3.2) Asin Americn 1 (0.3) Other 3 (0.8) Not reported 3 (0.8) GED = Generl Eductionl Development. The REALM ssesses helth by sking respondents to red list of 66 words loud. REALM scores rnge from 0 to 66 nd re divided into three criterion levels: limited (0 to 44), mrginl (45 to 60), nd dequte (61 to 66). Although the REALM hs been described s tking one to two minutes to dminister, 5 the pce of its dministrtion is set by respondents nd, in our experience, cn exceed two minutes considerbly. The self-dministered survey consisted of 19 items. Seven items ssessed demogrphic dt: ge, gender, mritl sttus, rce/ethnicity, lnguge, home ownership, nd eduction. One item ssessed English s first lnguge nd nother sked prticipnts to rte their reding bility on five-point Likert scle (1 = excellent nd 5 = poor). Three items pertined to helth sttus, ssessing whether ptients currently hd high blood pressure or dibetes or hd history of stroke. The lst eight items gthered miscellneous dt bout ccess to helth informtion resources. Dt nlysis Dt were mnged nd nlyzed using the SPSS 12.0 (SPSS Inc, Chicgo, IL) softwre pckge. The level of significnce ws set t 95% level of confidence, with P vlue of less thn.05. Univrite sttisticl nlyses were conducted to provide preliminry sttisticl informtion nd ssess dt ptterns. A Person product moment correltion coefficient ws clculted to determine the vlidity of the BRIEF in comprison to the REALM nd the STOFHLA. A principl component nlysis ws conducted to determine if, in fct, the BRIEF mesures one distinct construct helth. Our study utilized the mesures of sensitivity defined s the proportion of ptients who were positive for the test mong ll ptients with the disese 12 s the primry indictor of ccurcy of the BRIEF. Receiver opertor chrcteristic (ROC) curves were clculted to plot sensitivity. Ares under the ROC curve (AU- ROCs) were clculted to test the efficcy of ech of the BRIEF s four items individully nd the items grouped s the BRIEF, using the STOFHLA nd the REALM s stte vribles or true indictors of helth skills. Agin using the STOFHLA nd the REALM s stte vribles, AUROC curves were clculted to determine the degree to which the BRIEF identifies respondents with indequte helth skills nd those with indequte/mrginl helth skills ( composite grouping of respondents with indequte skills nd those with mrginl skills). An nlysis of vrince (ANOVA) lso ws conducted to test for group differences between the proposed BRIEF score levels to indicte optiml cutoff points for determining levels of helth. Results A totl of 378 ptients greed to prticipte, giving the study response rte of pproximtely 90%. Ptients resons for refusl were not ssessed. Of the prticipnts, 94% were mle nd 74% were white (Tble 2). 26 FEDERAL PRACTITIONER DECEMBER 2009

4 The men (SD) ge of the totl study cohort ws 61.5 (11.9) yers; by ethnicity, it ws 62.7 (11.4) yers for whites, 56.7 (12.1) yers for blcks, 61.9 (12.6) yers for Hispnics/Ltinos, nd 68.6 (11.4) yers for Ntive Americns. When sked to self-rte their reding bility, 85% of prticipnts sid it ws good to very good nd 15% sid it ws fir to poor. In ddition, 97% of prticipnts reported speking English s their first lnguge, 77% reported owning their home, 64% reported hving high blood pressure, 35% reported hving dibetes, nd 11% reported hving hd t lest one stroke. Helth Of the prticipnts, 20% showed indequte helth skills on the BRIEF, 7% showed indequte skills on the REALM, nd 9% showed indequte skills on the STOFHLA. Approximtely 37% of the prticipnts showed mrginl skills on the BRIEF, 30% showed mrginl skills on the REALM, nd 8% showed mrginl skills on the STOFHLA. Finlly, 43% of the prticipnts showed dequte skills on the BRIEF, 64% showed dequte skills on the REALM, nd 83% showed dequte skills on the STOFHLA (Figure). The verge (SD) scores for the three screening tools were s follows: BRIEF = (3.67); REALM = (8.96); nd STOFHLA = (8.03). % of ptients STOFHLA REALM BRIEF Indequte Mrginl Adequte Level of helth skills Figure. Study prticipnts levels of helth s indicted by the Short Test of Functionl Helth Litercy in Adults (STOFHLA), the Rpid Estimte of Adult Litercy (REALM), nd the BRIEF. BRIEF ccurcy Person correltion results were: r (378) =.40 (P <.01) for the BRIEF nd the REALM; r (378) =.42 (P <.01) for the BRIEF nd the STOF- HLA; nd r (378) =.61 (P <.01) for the REALM nd the STOFHLA. Since generl rule of thumb for determining if there is reltionship between vribles is minimum correltion coefficient of.3, 13 compred to stndrds, our results indicte there is n ssocition between ll three tools nd tht the ssocition between the BRIEF nd the vlidted tools is moderte. 14 The ddition of the fourth item to the BRIEF, How often do you hve problem understnding wht is told to you bout your medicl condition? incresed the internl vlidity of the screening mesure s indicted by the incresed correltion coefficient (Tble 3). The principl component nlysis findings suggested tht the BRIEF mesures one distinct construct, helth (eigenvlue = 2.388), ccounting for 60% of score vrince. The remining eigenvlues were less thn 1 nd, thus, were not retined. These findings vlidte the BRIEF s helth screening tool s compred to the REALM nd the STOFHLA. Using the REALM s the stte vrible, the BRIEF ws slightly more ccurte t identifying respondents with indequte skills thn it ws t identifying respondents with indequte/mrginl skills, s indicted by higher sensitivity (AUROC) scores for indequte versus indequte/ mrginl skills (Tbles 3 nd 4). Specificlly, the BRIEF demonstrted.79 sensitivity (95% confidence intervl [CI],.70.87) for detecting indequte skills nd.69 sensitivity (95% CI,.64.75) for detecting indequte/mrginl skills. Still using the REALM s the stte vrible, ll four BRIEF items together hd higher AUROC thn ny of the individul items (Tble 3), indicting tht the tool s whole is more sensitive thn its components for identifying indequte helth skills. With the STOFHLA s the stte vrible, the BRIEF remined slightly more sensitive for indequte helth skills thn for indequte/ mrginl helth skills (Tbles DECEMBER 2009 FEDERAL PRACTITIONER 27

5 Tble 3. Person product moment correltion nd AUROC vlues for the BRIEF s whole nd s individul items, with the REALM b nd the STOFHLA c s the stte vribles AUROC vlue (95% CI e ) Indequte Indequte/ Test vrible r d mrginl BRIEF compred to REALM BRIEF overll (.70.87).69 (.64.75) BRIEF item (.62.84).63 (.57.69) BRIEF item (.59.84).68 (.63.74) BRIEF item (.59.79).65 (.59.70) BRIEF item (.58.78).59 (.53.65) BRIEF compred to STOFHLA BRIEF overll (.69.83).74 (.67.80) BRIEF item (.56.77).64 (.56.72) BRIEF item (.65.84).69 (.61.77) BRIEF item (.56.74).66 (.59.73) BRIEF item (.59.78).66 (.59.74) AUROC = re under the receiver operting chrcteristic curve. b REALM = Rpid Estimte of Adult Litercy. c STOFHLA = Short Test of Functionl Helth Litercy in Adults. d r = Person product moment correltion coefficient. e CI = confidence intervl. 3 nd 4), with vlues of.76 (95% CI,.69.83) nd.74 (95% CI,.67.80), respectively. All of the items hd n AUROC greter thn.5 t 95% CI. And with the STOFHLA s the stte vrible, the BRIEF tool retined higher AUROC thn ny of its individul items (Tble 3). ANOVA results indicted tht the three proposed BRIEF levels were significntly different from one nother on the REALM (F score = 28.63, P <.0001) nd the STOFHLA (F score = 35.32, P <.0001). Posthoc Tukey nlyses suggest ll levels were significntly different t P < DISCUSSION Does the brief mesure up? Our findings indicte tht the BRIEF, the STOFHLA, nd the REALM re positively correlted nd tht the BRIEF cn ccurtely identify prticipnts with indequte nd indequte/mrginl helth skills. The BRIEF tkes shorter time thn either the STOFHLA or the REALM to dminister nd score. In ddition, we believe tht the BRIEF my offer n dvntge over the other two tools which involve testing ptients skills in tht it is less likely to be embrrssing to ptients. Despite the BRIEF s correltion with the other tools, however, its estimte tht 20.1% of prticipnts hd indequte helth ws much higher thn the REALM s estimte of 6.6% nd the STOFHLA s estimte of 9%. It should be noted tht the BRIEF estimte is closer to previous findings of lrger studies, which suggest tht 33% of ptients hve indequte helth skills. 1,2,15 Nevertheless, it is possible tht the BRIEF s ccurcy is hindered by flse positives. At present, it cnnot be determined if the discrepncies resulted from error in the BRIEF or from error in the REALM nd the STOFHLA, lthough these discrepncies probbly re relted to the tools mesurement of slightly different spects of helth. Findings from this study should be interpreted with cution. Further reserch is needed to vlidte the BRIEF s effectiveness t determining rtes of indequte helth in the generl popultion nd in priority subpopultions. Although the three mesures used in this study focus on different spects of the concept of helth, contributing to error in mesurement, the REALM nd the STOFHLA currently re the most studied nd vlidted helth screening mesures vilble. Efforts to mesure helth in diverse popultions remin impertive, s reserchers seek to understnd the interpersonl nd culturl contexts of communiction in medicl encounters. 16 Severl study limittions should be noted when interpreting our results. The homogeneous nture of our smll smple my hve influenced our findings, which cnnot be generlized to other popultions or geogrphicl regions of the United Sttes. Becuse the study did not use rndomized, controlled design, it my hve filed to ccount for confounding vribles tht introduced mesurement errors. The fct tht our dt were gthered through self-reports on the BRIEF nd on the prticipnt survey lso limits the inferences tht cn be mde from the study findings. The BRIEF in prctice Bsed on the outcomes of this study, the BRIEF ws pproved for clinicl Continued on pge FEDERAL PRACTITIONER DECEMBER 2009

6 Continued from pge 28 Tble 4. Performnce of the BRIEF in detecting indequte nd indequte/mrginl helth skills, by score, using the STOFHLA nd the REALM b s the stte vribles Indequte helth STOFHLA Indequte/ mrginl helth Indequte helth BRIEF score Sensitivity specificity Sensitivity specificity Sensitivity specificity Sensitivity specificity STOFHLA = Short Test of Functionl Helth Litercy in Adults. b REALM = Rpid Estimte of Adult Litercy. REALM Indequte/ mrginl helth tril in April 2007 within the prticipting North Florid/South Georgi Veterns Helth System (NFSGVHS). This tril resulted in the implementtion of the BRIEF throughout prticipting fcilities in the NFSGVHS. At these fcilities, the BRIEF is used to generte clinicl reminders within the electronic ptient medicl record system. When ptient s BRIEF score indictes indequte helth, this fct is entered into the electronic record. Therefter, screen prompt pops up in the record to provide clinicins with steps to help the ptient understnd helth informtion. From July 1, 2007 to July 1, 2009, the BRIEF ws used in NFSGVHS fcilities to screen 112,442 ptients 6,466 (6%) of whom were found to hve indequte helth. Recommendtions for the future We recommend tht other helth cre fcilities use the BRIEF to screen ptients helth levels, document these levels in ptient records, nd tilor their pproch to ptients ccordingly. It is impertive tht clinicins support ptients by creting shme-free, empowering pproch to ssessing nd responding to their helth needs. 17,18 Empowering ptients cn minimize the stigm ssocited with low nd cn help ptients to tke leding role in their helth cre. The prcticl nd legl implictions of identifying nd responding to individuls needs bsed on the documented results of the BRIEF need to be ddressed s prt of implementing the screening nd posting process. 30 FEDERAL PRACTITIONER DECEMBER 2009

7 Acknowledgements This reserch ws conducted in coopertion with the VA nd ws mde possible, in prt, by Grnt Number T32 AT from the Ntionl Center for Complementry nd Alterntive Medicine t the Ntionl Institutes of Helth. Author disclosures The uthors report no ctul or potentil conflicts of interest with regrd to this rticle. Disclimer The opinions expressed herein re those of the uthors nd do not necessrily reflect those of Federl Prctitioner, Qudrnt HelthCom Inc., the U.S. government, or ny of its gencies. This rticle my discuss unlbeled or investigtionl use of certin drugs. Plese review complete prescribing informtion for specific drugs or drug combintions including indictions, contrindictions, wrnings, nd dverse effects before dministering phrmcologic therpy to ptients. References 1. Prtnership for Cler Helth Communiction. Wht is helth? Ask Me 3 web site. Accessed November 17, Nielsen-Bohlmn L, Pnzer AM, Kindig DA, eds. Helth Litercy: A Prescription to End Confusion. Wshington, DC: Ntionl Acdemies Press; Center on n Aging Society, Georgetown University. Low helth skills increse nnul helth cre expenditures by $73 billion. Center on n Aging Society web site. georgetown.edu/gingsociety/pubhtml/helthlit. html. Accessed November 17, Bker DW, Willims MV, Prker RM, Gzmrrin JA, Nurss J. Development of brief test to mesure functionl helth. Ptient Educ Couns. 1999;38(1): Dvis TC, Long SW, Jckson RH, et l. Rpid estimte of dult in medicine: A shortened screening instrument. Fm Med. 1993;25(6): Chew LD, Brdley KA, Boyko EJ. Brief questions to identify ptients with indequte helth. Fm Med. 2004;36(8): org/fmhub/fm2004/september/lis588.pdf. Accessed November 19, Wllce LS, Rogers ES, Roskos SE, Holidy DB, Weiss BD. Brief report: Screening items to identify ptients with limited helth skills. J Gen Intern Med. 2006;21(8): ncbi.nlm.nih.gov/pmc/rticles/pmc /pdf /jgi pdf. Accessed November 19, Bker DW. The mening nd the mesure of helth. J Gen Intern Med. 2006;21(8): Prker RM, Kindig DA. Beyond the Institute of Medicine helth report: Are the recommendtions being tken seriously? J Gen Intern Med. 2006;21(8): Prker RM, Bker DW, Willims MV, Nurss JR. The test of functionl helth in dults: A new instrument for mesuring ptients skills. J Gen Intern Med. 1995;10(10): Nurss JR, Prker RM, Willims MV, Bker DW. TOFHLA: Test of Functionl Helth Litercy in Adults. Snow Cmp, NC: Peppercorn Books & Press; Espllrdo NL. Decisions on dignosis in fmily prctice: Use of sensitivity, specificity, predictive vlues nd likelihood rtios. Asi Pc Fm Med. 2003;2(4): /fm2.4/fm_95.pdf. Accessed November 17, Hinkle DE, Wiersm W, Jurs SG. Applied Sttistics for the Behviorl Sciences. 2nd ed. Boston, MA: Houghton Mifflin Compny; Frnzblu AN. A Primer of Sttistics for Non-Sttisticins. New York, NY: Hrcourt, Brce & World; Kirsch IS, Jungeblut A, Jenkins L, Kolstd A. Adult Litercy in Americ: A First Look t the Findings of the Ntionl Adult Litercy Survey. Wshington, DC: Ntionl Center for Eduction Sttistics, US Dept of Eduction; Street RL Jr. Communiction in medicl encounters: An ecologicl perspective. In: Thompson TL, Dorsey AM, Miller KI, Prrott R, eds. Hndbook of Helth Communiction. Mhwh, NJ: Lwrence Erlbum Assocites; 2003: Prikh NS, Prker RM, Nurss JR, Bker DW, Willims MV. Shme nd helth : The unspoken connection. Ptient Educ Couns. 1996;27(1): Bker DW, Prker RM, Willims MV, et l. The helth cre experience of ptients with low. Arch Fm Med. 1996;5(6): DECEMBER 2009 FEDERAL PRACTITIONER 31

PNEUMOVAX 23 is recommended by the CDC for all your appropriate adult patients at increased risk for pneumococcal disease 1,2 :

PNEUMOVAX 23 is recommended by the CDC for all your appropriate adult patients at increased risk for pneumococcal disease 1,2 : PNEUMOVAX 23 is recommended y the CDC for ll your pproprite dult ptients t incresed risk for pneumococcl disese 1,2 : Adults ged

More information

XII. HIV/AIDS. Knowledge about HIV Transmission and Misconceptions about HIV

XII. HIV/AIDS. Knowledge about HIV Transmission and Misconceptions about HIV XII. HIV/AIDS Knowledge bout HIV Trnsmission nd Misconceptions bout HIV One of the most importnt prerequisites for reducing the rte of HIV infection is ccurte knowledge of how HIV is trnsmitted nd strtegies

More information

Community. Profile Powell County. Public Health and Safety Division

Community. Profile Powell County. Public Health and Safety Division Community Helth Profile 2015 Powell County Public Helth nd Sfety Division Tble of Contents Demogrphic Informtion 1 Communicble Disese 3 Chronic Disese 4 Mternl nd Child Helth 10 Mortlity 12 Behviorl Risk

More information

Community. Profile Big Horn County. Public Health and Safety Division

Community. Profile Big Horn County. Public Health and Safety Division Community Helth Profile 2015 Big Horn County Public Helth nd Sfety Division Tble of Contents Demogrphic Informtion 1 Communicble Disese 3 Chronic Disese 4 Mternl nd Child Helth 10 Mortlity 12 Behviorl

More information

Community. Profile Yellowstone County. Public Health and Safety Division

Community. Profile Yellowstone County. Public Health and Safety Division Community Helth Profile 2015 Yellowstone County Public Helth nd Sfety Division Tble of Contents Demogrphic Informtion 1 Communicble Disese 3 Chronic Disese 4 Mternl nd Child Helth 10 Mortlity 12 Behviorl

More information

Community. Profile Anaconda- Deer Lodge County. Public Health and Safety Division

Community. Profile Anaconda- Deer Lodge County. Public Health and Safety Division Community Helth Profile 2015 Ancond- Deer Lodge County Public Helth nd Sfety Division Tble of Contents Demogrphic Informtion 1 Communicble Disese 3 Chronic Disese 4 Mternl nd Child Helth 10 Mortlity 12

More information

Community. Profile Lewis & Clark County. Public Health and Safety Division

Community. Profile Lewis & Clark County. Public Health and Safety Division Community Helth Profile 2015 Lewis & Clrk County Public Helth nd Sfety Division Tble of Contents Demogrphic Informtion 1 Communicble Disese 3 Chronic Disese 4 Mternl nd Child Helth 10 Mortlity 12 Behviorl

More information

Community. Profile Missoula County. Public Health and Safety Division

Community. Profile Missoula County. Public Health and Safety Division Community Helth Profile 2015 Missoul County Public Helth nd Sfety Division Tble of Contents Demogrphic Informtion 1 Communicble Disese 3 Chronic Disese 4 Mternl nd Child Helth 10 Mortlity 12 Behviorl Risk

More information

Community. Profile Carter County. Public Health and Safety Division

Community. Profile Carter County. Public Health and Safety Division Community Helth Profile 2015 Crter County Public Helth nd Sfety Division Tble of Contents Demogrphic Informtion 1 Communicble Disese 3 Chronic Disese 4 Mternl nd Child Helth 10 Mortlity 12 Behviorl Risk

More information

Clinical Study Report Synopsis Drug Substance Naloxegol Study Code D3820C00018 Edition Number 1 Date 01 February 2013 EudraCT Number

Clinical Study Report Synopsis Drug Substance Naloxegol Study Code D3820C00018 Edition Number 1 Date 01 February 2013 EudraCT Number EudrCT Number 2012-001531-31 A Phse I, Rndomised, Open-lbel, 3-wy Cross-over Study in Helthy Volunteers to Demonstrte the Bioequivlence of the Nloxegol 25 mg Commercil nd Phse III Formultions nd to Assess

More information

Supplementary Online Content

Supplementary Online Content Supplementry Online Content Zulmn DM, Pl Chee C, Ezeji-Okoye SC, et l. Effect of n intensive outptient progrm to ugment primry cre for high-need Veterns Affirs ptients: rndomized clinicl tril. JAMA Intern

More information

Assessment of Depression in Multiple Sclerosis. Validity of Including Somatic Items on the Beck Depression Inventory II

Assessment of Depression in Multiple Sclerosis. Validity of Including Somatic Items on the Beck Depression Inventory II Assessment of Depression in Multiple Sclerosis Vlidity of Including Somtic Items on the Beck Depression Inventory II Peggy Crwford, PhD; Noh J. Webster, MA Signs nd symptoms of multiple sclerosis (MS)

More information

Appendix J Environmental Justice Populations

Appendix J Environmental Justice Populations Appendix J Environmentl Justice s [This pge intentionlly left blnk] Tble of Contents REFERENCES...J-2 Pge LIST OF TABLES Pge Tble J-1: Demogrphic Overview of Bruinsburg Site Project Are... J-3 Tble J-2:

More information

Ethnic Disparities in Stroke Recognition in Individuals with Prior Stroke

Ethnic Disparities in Stroke Recognition in Individuals with Prior Stroke Reserch Articles Ethnic Disprities in Stroke Recognition in Individuls with Prior Stroke Chrles Ellis, PhD Leonrd E. Egede, MD, MS,c SYNOPSIS Ojective. Studies of stroke wreness suggest tht knowledge of

More information

Invasive Pneumococcal Disease Quarterly Report. July September 2017

Invasive Pneumococcal Disease Quarterly Report. July September 2017 Invsive Pneumococcl Disese Qurterly Report July September 2017 Prepred s prt of Ministry of Helth contrct for scientific services by Rebekh Roos Helen Heffernn October 2017 Acknowledgements This report

More information

CheckMate 153: Randomized Results of Continuous vs 1-Year Fixed-Duration Nivolumab in Patients With Advanced Non-Small Cell Lung Cancer

CheckMate 153: Randomized Results of Continuous vs 1-Year Fixed-Duration Nivolumab in Patients With Advanced Non-Small Cell Lung Cancer CheckMte 53: Rndomized Results of Continuous vs -Yer Fixed-Durtion Nivolumb in Ptients With Advnced Non-Smll Cell Lung Cncer Abstrct 297O Spigel DR, McCleod M, Hussein MA, Wterhouse DM, Einhorn L, Horn

More information

Impact of Pharmacist Intervention on Diabetes Patients in an Ambulatory Setting

Impact of Pharmacist Intervention on Diabetes Patients in an Ambulatory Setting Impct of Phrmcist Intervention on Dibetes Ptients in n Ambultory Setting Julie Stding, PhrmD, CDE, Jmie Herrmnn, PhrmD, Ryn Wlters, MS, Chris Destche, PhrmD, nd Aln Chock, PhrmD Dibetes is the seventh-leding

More information

Health Coaching: A Preliminary Report on the Effects in Traumatic Brain Injury/Polytrauma Patients

Health Coaching: A Preliminary Report on the Effects in Traumatic Brain Injury/Polytrauma Patients ORIGINAL RESEARCH Helth Coching: A Preliminry Report on the Effects in Trumtic Brin Injury/Polytrum Ptients Esmerld Mdrigl, MSW; Mx Gry, BA; Molly A. Timmermn, DO; Ttin Orozco, PhD; Dine Cowper Ripley,

More information

SYNOPSIS Final Abbreviated Clinical Study Report for Study CA ABBREVIATED REPORT

SYNOPSIS Final Abbreviated Clinical Study Report for Study CA ABBREVIATED REPORT Finl Arevited Clinicl Study Report Nme of Sponsor/Compny: Bristol-Myers Squi Ipilimum Individul Study Tle Referring to the Dossier (For Ntionl Authority Use Only) Nme of Finished Product: Yervoy Nme of

More information

Recall Bias in Childhood Atopic Diseases Among Adults in The Odense Adolescence Cohort Study

Recall Bias in Childhood Atopic Diseases Among Adults in The Odense Adolescence Cohort Study Syddnsk Universitet Recll Bis in Childhood Atopic Diseses Among Adults in The Odense Adolescence Cohort Study Mørtz, Chrlotte G; Andersen, Klus Ejner; Bindslev-Jensen, Crsten Published in: Act Dermto-Venereologic

More information

Single-Molecule Studies of Unlabelled Full-Length p53 Protein Binding to DNA

Single-Molecule Studies of Unlabelled Full-Length p53 Protein Binding to DNA Single-Molecule Studies of Unlbelled Full-Length p53 Protein Binding to DNA Philipp Nuttll, 1 Kidn Lee, 2 Pietro Ciccrell, 3 Mrco Crminti, 3 Giorgio Ferrri, 3 Ki- Bum Kim, 2 Tim Albrecht 1* 1 Imperil College

More information

Opioid Use and Survival at the End of Life: A Survey of a Hospice Population

Opioid Use and Survival at the End of Life: A Survey of a Hospice Population 532 Journl of Pin nd Symptom Mngement Vol. 32 No. 6 December 2006 NHPCO Originl Article Opioid Use nd Survivl t the End of Life: A Survey of Hospice Popultion Russell K. Portenoy, MD, Un Sibircev, BA,

More information

Computer-Aided Learning in Insulin Pump Training

Computer-Aided Learning in Insulin Pump Training Journl of Dibetes Science nd Technology Volume 4, Issue 4, July 2010 Dibetes Technology Society TECHNOLOGY REPORTS Computer-Aided Lerning in Insulin Pump Trining Sergey V., M.Sc., 1 nd Chrles J. George,

More information

Physicians prescribing a new medication often fail to discuss basic. Intervention to Enhance Communication About Newly Prescribed Medications

Physicians prescribing a new medication often fail to discuss basic. Intervention to Enhance Communication About Newly Prescribed Medications to Enhnce Communiction About Newly Prescribed Medictions Derjung M. Trn, MD, PhD 1 Debor A. Pterniti, PhD 2 Deborh K. Orosz, BA 3 Chi-Hong Tseng, PhD 4 Neil S. Wenger, MD, MPH 4 1 Deprtment of Fmily Medicine,

More information

Teacher motivational strategies and student self-determination in physical education

Teacher motivational strategies and student self-determination in physical education Loughborough University Institutionl Repository Techer motivtionl strtegies nd student self-determintion in physicl eduction This item ws submitted to Loughborough University's Institutionl Repository

More information

Health-Related Quality of Life and Symptoms of Depression in Extremely Obese Persons Seeking Bariatric Surgery

Health-Related Quality of Life and Symptoms of Depression in Extremely Obese Persons Seeking Bariatric Surgery Oesity Surgery, 15, 3-39 Helth-Relted Qulity of Life nd Symptoms of Depression in Extremely Oese Persons Seeking Britric Surgery Anthony N. Frictore, PhD; Thoms A. Wdden, PhD; Dvid B. Srwer, PhD; Myles

More information

Diagnostic Accuracy of Mini-Mental Status Examination and Revised Hasegawa Dementia Scale for Alzheimer s Disease

Diagnostic Accuracy of Mini-Mental Status Examination and Revised Hasegawa Dementia Scale for Alzheimer s Disease Originl Reserch Article Dement Geritr Cogn Disord 2005;19:324 330 DOI: 10.1159/000084558 Accepted: Novemer 1, 2004 Pulished online: Mrch 22, 2005 Dignostic Accurcy of Mini-Mentl Sttus Exmintion nd Revised

More information

ENERGY CONTENT OF BARLEY

ENERGY CONTENT OF BARLEY ENERGY CONTENT OF BARLEY VARIATION IN THE DIETARY ENERGY CONTENT OF BARLEY Shwn Firbirn, John Ptience, Hnk Clssen nd Ruurd Zijlstr SUMMARY Formultion of commercil pig diets requires n incresing degree

More information

Input from external experts and manufacturer on the 2 nd draft project plan Stool DNA testing for early detection of colorectal cancer

Input from external experts and manufacturer on the 2 nd draft project plan Stool DNA testing for early detection of colorectal cancer Input externl experts nd mnufcturer on the 2 nd drft project pln Stool DNA testing for erly detection of colorectl cncer (Project ID:OTJA10) All s nd uthor s replies on the 2nd drft project pln Stool DNA

More information

Management and Outcomes of Binge-Eating Disorder in Adults: Current State of the Evidence

Management and Outcomes of Binge-Eating Disorder in Adults: Current State of the Evidence Clinicin Summry Mentl Helth Eting Disorders Mngement nd Outcomes of Binge-Eting Disorder in Adults: Current Stte of the Evidence Focus of This Summry This is summry of systemtic review evluting the evidence

More information

Effects of physical exercise on working memory and prefrontal cortex function in post-stroke patients

Effects of physical exercise on working memory and prefrontal cortex function in post-stroke patients Effects of physicl exercise on working memory nd prefrontl cortex function in post-stroke ptients M Moriy, C Aoki, K Sktni Grdute School of Helth Sciences Reserch, Mjor of Physicl Therpy, TeikyoHeisei

More information

University of Texas Health Science Center, San Antonio, San Antonio, Texas, USA

University of Texas Health Science Center, San Antonio, San Antonio, Texas, USA Lung Cncer Chemotherpy Given Ner the End of Life by Community Oncologists for Advnced Non-Smll Cell Lung Cncer Jose R. Murillo, Jr., Jim Koeller b,c Methodist Hospitl, Houston, Texs, USA; b University

More information

The Acute Time Course of Concurrent Activation Potentiation

The Acute Time Course of Concurrent Activation Potentiation Mrquette University e-publictions@mrquette Exercise Science Fculty Reserch nd Publictions Exercise Science, Deprtment of 1-1-2010 The Acute Time Course of Concurrent Activtion Potentition Luke Grceu Mrquette

More information

ORIGINAL ARTICLE. Diagnostic Signs of Accommodative Insufficiency. PILAR CACHO, OD, ÁNGEL GARCÍA, OD, FRANCISCO LARA, OD, and M A MAR SEGUÍ, OD

ORIGINAL ARTICLE. Diagnostic Signs of Accommodative Insufficiency. PILAR CACHO, OD, ÁNGEL GARCÍA, OD, FRANCISCO LARA, OD, and M A MAR SEGUÍ, OD 1040-5488/02/7909-0614/0 VOL. 79, NO. 9, PP. 614 620 OPTOMETRY AND VISION SCIENCE Copyright 2002 Americn Acdemy of Optometry ORIGINAL ARTICLE Dignostic Signs of Accommodtive Insufficiency PILAR CACHO,

More information

Reducing the Risk. Logic Model

Reducing the Risk. Logic Model Reducing the Risk Logic Model ETR (Eduction, Trining nd Reserch) is nonprofit orgniztion committed to providing science-bsed innovtive solutions in helth nd eduction designed to chieve trnsformtive chnge

More information

Geographical influence on digit ratio (2D:4D): a case study of Andoni and Ikwerre ethnic groups in Niger delta, Nigeria.

Geographical influence on digit ratio (2D:4D): a case study of Andoni and Ikwerre ethnic groups in Niger delta, Nigeria. Journl of Applied Biosciences 27: 1736-1741 ISSN 1997 5902 Geogrphicl influence on digit rtio (2D:4D): cse study of Andoni nd Ikwerre ethnic groups in Niger delt, Nigeri. Gwunirem, Isrel U 1 nd Ihemelndu,

More information

Original Research Article. Dement Geriatr Cogn Disord 2007;24: DOI: /

Original Research Article. Dement Geriatr Cogn Disord 2007;24: DOI: / Originl Reserch Article Dement Geritr Cogn Disord 2007;24:288 293 DOI: 10.1159/000107592 Accepted: June 26, 2007 Published online: August 24, 2007 A Normtive Study of the Revised Hsegw Dementi Scle: Comprison

More information

The Effects of Small Sized Rice Bowl on Carbohydrate Intake and Dietary Patterns in Women with Type 2 Diabetes

The Effects of Small Sized Rice Bowl on Carbohydrate Intake and Dietary Patterns in Women with Type 2 Diabetes Originl Article doi: 10.4093/kdj.2010.34.3.166 pissn 1976-9180 eissn 2093-2650 The Effects of Smll Sized Rice Bowl on Crbohydrte Intke nd Dietry Ptterns in Women with Type 2 Dibetes Hee-Jung Ahn 1, *,

More information

Longitudinal Association of Maternal Attempt to Lose Weight During the Postpartum Period and Child Obesity at Age 3 Years

Longitudinal Association of Maternal Attempt to Lose Weight During the Postpartum Period and Child Obesity at Age 3 Years nture publishing group Longitudinl Assocition of Mternl Attempt to Lose Weight During the Postprtum Period nd Child Obesity t Age 3 Yers Kendrin R. Sonneville 1,2, Sheryl L. Rifs-Shimn 3, Emily Oken 3,

More information

Safety and Tolerability of Subcutaneous Sarilumab and Intravenous Tocilizumab in Patients With RA

Safety and Tolerability of Subcutaneous Sarilumab and Intravenous Tocilizumab in Patients With RA Sfety nd Tolerbility of Subcutneous Srilumb nd Intrvenous Tocilizumb in Ptients With RA Pul Emery, 1 Jun Rondon, 2 Anju Grg, 3 Hubert vn Hoogstrten, 3 Neil M.H. Grhm, 4 Ming Liu, 4 Nncy Liu, 3 Jnie Prrino,

More information

Body mass index, waist-to-hip ratio, and metabolic syndrome as predictors of middle-aged men's health

Body mass index, waist-to-hip ratio, and metabolic syndrome as predictors of middle-aged men's health Originl Article - Sexul Dysfunction/Infertility pissn 2005-6737 eissn 2005-6745 Body mss index, wist-to-hip rtio, nd metbolic syndrome s predictors of middle-ged men's helth Jung Hyun Prk *, In-Chng Cho

More information

Metabolic Syndrome and Health-related Quality of Life in Obese Individuals Seeking Weight Reduction

Metabolic Syndrome and Health-related Quality of Life in Obese Individuals Seeking Weight Reduction Metbolic Syndrome nd Helth-relted Qulity of Life in Obese Individuls Seeking Weight Reduction Adm Gilden Tsi 1, Thoms A. Wdden 1, Dvid B. Srwer 1, Robert I. Berkowitz 1, Leslie G. Womble 1, Louise A. Hesson

More information

Lifetime and 12-Month Prevalence of Psychiatric Disorders in 8,169 Male Vietnam War Era Veterans

Lifetime and 12-Month Prevalence of Psychiatric Disorders in 8,169 Male Vietnam War Era Veterans MILITARY MEDICINE, 169, 11:896, 2004 Lifetime nd 12-Month Prevlence of Psychitric Disorders in 8,169 Mle Vietnm Wr Er Veterns Gurntor: Seth A. Eisen, MD Contributors: Seth A. Eisen, MD* ; Kristin H. Griffith,

More information

Utilization of dental services in Southern China. Lo, ECM; Lin, HC; Wang, ZJ; Wong, MCM; Schwarz, E

Utilization of dental services in Southern China. Lo, ECM; Lin, HC; Wang, ZJ; Wong, MCM; Schwarz, E Title Utiliztion of dentl services in Southern Chin Author(s) Lo, ECM; Lin, HC; Wng, ZJ; Wong, MCM; Schwrz, E Cittion Journl Of Dentl Reserch, 2001, v. 80 n. 5, p. 1471-1474 Issued Dte 2001 URL http://hdl.hndle.net/10722/53200

More information

Work-related musculoskeletal disorders (WMSDs) among nursing personnel

Work-related musculoskeletal disorders (WMSDs) among nursing personnel Work-Relted Musculoskeletl Injuries nd Disorders Among Occuptionl nd Physicl Therpists Amy R. Drrgh, Wendy Huddleston, Phyllis King KEY WORDS ccidents, occuptionl moving nd lifting ptients musculoskeletl

More information

Consumer perceptions of meat quality and shelf-life in commercially raised broilers compared to organic free range broilers

Consumer perceptions of meat quality and shelf-life in commercially raised broilers compared to organic free range broilers Consumer perceptions of met qulity nd shelf-life in commercilly rised roilers compred to orgnic free rnge roilers C.Z. ALVARADO 1 *, E. WENGER 2 nd S. F. O KEEFE 3 1 Texs Tech University, Box 42141 Luock,

More information

HEMOGLOBIN STANDARDS*

HEMOGLOBIN STANDARDS* HEMOGLOBIN STANDARDS* RUSSELL L. HADEN Clevelnd Clinic, Clevelnd, Ohio Estimtions of hemoglobin often re unstisfctory to the lbortory worker nd the reports my be confusing to the clinicin. Unfortuntely,

More information

The diagnosis of autism and Asperger syndrome: findings from a survey of 770 families

The diagnosis of autism and Asperger syndrome: findings from a survey of 770 families The dignosis of utism nd Asperger syndrome: findings from survey of 770 fmilies Ptrici Howlin*, Deprtment of Psychology, St George s Hospitl Medicl School, London; Ann Asghrin, Deprtment of Psychology,

More information

Reports of cases of AIDS, HIV infection, and HIV/AIDS 1

Reports of cases of AIDS, HIV infection, and HIV/AIDS 1 Reports of cses of AIDS, HIV infection, nd HIV/AIDS 1 The HIV/AIDS Surveillnce Report is published nnully by the Division of HIV/AIDS Prevention Surveillnce nd Epidemiology, Ntionl Center for HIV, STD,

More information

Development and Validity of a 2-Item Screen to Identify Families at Risk for Food Insecurity

Development and Validity of a 2-Item Screen to Identify Families at Risk for Food Insecurity Development nd Vlidity of 2-Item Screen to Identify Fmilies t Risk for Food Insecurity WHAT S KNOWN ON THIS SUBJECT: Food insecurity (FI) in the United Sttes is public helth problem. FI mong young children

More information

Many authors have recognized the lack of continuity in cancer

Many authors have recognized the lack of continuity in cancer Fmily Physicin Involvement in Cncer Cre Follow-up: The Experience of Cohort of Ptients With Lung Cncer Michèle Aubin, MD, PhD, CCFP, FCFP 1,2,3,4 Lucie Vézin, MA 4 René Verreult, MD, PhD, FCFP, CCFP 1,5

More information

Efficacy of Pembrolizumab in Patients With Advanced Melanoma With Stable Brain Metastases at Baseline: A Pooled Retrospective Analysis

Efficacy of Pembrolizumab in Patients With Advanced Melanoma With Stable Brain Metastases at Baseline: A Pooled Retrospective Analysis Efficcy of Pembrolizumb in Ptients With Advnced Melnom With Stble Brin Metstses t Bseline: A Pooled Retrospective Anlysis Abstrct 1248PD Hmid O, Ribs A, Dud A, Butler MO, Crlino MS, Hwu WJ, Long GV, Ancell

More information

May 28, Congressional Requesters

May 28, Congressional Requesters United Sttes Government Accountbility Office Wshington, DC 20548 My 28, 2010 Congressionl Requesters Subject: Federl Funds: Fiscl Yers 2002-2009 Obligtions, Disbursements, nd Expenditures for Selected

More information

Summary. Effect evaluation of the Rehabilitation of Drug-Addicted Offenders Act (SOV)

Summary. Effect evaluation of the Rehabilitation of Drug-Addicted Offenders Act (SOV) Summry Effect evlution of the Rehbilittion of Drug-Addicted Offenders Act (SOV) The Rehbilittion of Drug-Addicted Offenders Act (SOV) ws lunched on April first 2001. This lw permitted the compulsory plcement

More information

Diabetes affects 29 million Americans, imposing a substantial

Diabetes affects 29 million Americans, imposing a substantial CLINICAL Comprtive Effectiveness nd Costs of Insulin Pump Therpy for Dibetes Ronld T. Ackermnn, MD, MPH; Amish Wlli, MD, MS; Rymond Kng, MA; Andrew Cooper, MPH; Theodore A. Prospect, FSA, MAAA; Lewis G.

More information

A review of the patterns of docetaxel use for hormone-resistant prostate cancer at the Princess Margaret Hospital

A review of the patterns of docetaxel use for hormone-resistant prostate cancer at the Princess Margaret Hospital MEDICAL ONCOLOGY A review of the ptterns of docetxel use for hormone-resistnt prostte cncer t the Princess Mrgret Hospitl S.N. Chin MD,* L. Wng MSc, M. Moore MD,* nd S.S. Sridhr MD MSc* ABSTRACT Bckground

More information

JOB DESCRIPTION. Volunteer Student Teacher. Warwick in Africa Programme. Warwick in Africa Programme Director

JOB DESCRIPTION. Volunteer Student Teacher. Warwick in Africa Programme. Warwick in Africa Programme Director JOB DSCRIPTION POST TITL: DPARTMNT: POST RSPONSIBL TO: SALARY: Volunteer Student Techer Wrwick in Afric Progrmme Wrwick in Afric Progrmme Director Voluntry position, ll your costs will be covered (flights,

More information

Trends in antihypertensive and lipidlowering therapy in subjects with type II diabetes: clinical effectiveness or clinical discretion?

Trends in antihypertensive and lipidlowering therapy in subjects with type II diabetes: clinical effectiveness or clinical discretion? ORIGINAL ARTICLE Trends in ntihypertensive nd lipidlowering therpy in subjects with type II dibetes: clinicl effectiveness or clinicl discretion? MC Gulliford, J Chrlton nd R Ltinovic Deprtment of Public

More information

Factors influencing help seeking in mentally distressed young adults: a cross-sectional survey

Factors influencing help seeking in mentally distressed young adults: a cross-sectional survey L Biddle, D Gunnell, D Shrp nd J L Donovn Fctors influencing help seeking in mentlly distressed young dults: cross-sectionl survey Lucy Biddle, Dvid Gunnell, Debbie Shrp nd Jenny L Donovn SUMMARY Bckground:

More information

Anemia in pediatric hemodialysis patients: Results from the 2001 ESRD Clinical Performance Measures Project

Anemia in pediatric hemodialysis patients: Results from the 2001 ESRD Clinical Performance Measures Project Kidney Interntionl, Vol. 64 (2003), pp. 1120 1124 Anemi in peditric hemodilysis ptients: Results from the 2001 ESRD Clinicl Performnce Mesures Project DIANE L. FRANKENFIELD, ALICA M. NEU, BRADLEY A. WARADY,

More information

Epilepsy & Behavior 20 (2011) Contents lists available at ScienceDirect. Epilepsy & Behavior. journal homepage:

Epilepsy & Behavior 20 (2011) Contents lists available at ScienceDirect. Epilepsy & Behavior. journal homepage: Epilepsy & Behvior 20 (2011) 52 56 Contents lists vilble t ScienceDirect Epilepsy & Behvior journl homepge: www.elsevier.com/locte/yebeh Detecting helth disprities mong Cucsins nd Africn-Americns with

More information

abstract ARTICLE Kent Page, MStat, h J. Michael Dean, MD, h Frank W. Moler, MD, d on behalf of the THAPCA Trial Group

abstract ARTICLE Kent Page, MStat, h J. Michael Dean, MD, h Frank W. Moler, MD, d on behalf of the THAPCA Trial Group Neurobehviorl Outcomes in Children After Out-of-Hospitl Crdic Arrest Beth S. Slomine, PhD,, b, c Fye S. Silverstein, MD, d, e Jmes R. Christensen, MD, c, f, g Richrd Holubkov, PhD, h Kent Pge, MStt, h

More information

Global Intellectual Deficits in Cystinosis

Global Intellectual Deficits in Cystinosis Americn Journl of Medicl Genetics 49:83-87 (1994) Globl Intellectul Deficits in Cystinosis Brbr L.H. Willims, Jerry A. Schneider, nd Doris A. Truner Deprtments of Neurosciences (B.L.H.W.. D.A.T.) nd Peditrics

More information

Human Immunodeficiency Virus / Acquired Immunodeficiency Syndrome Knowledge and Risk Factors in Ethiopian Military Personnel

Human Immunodeficiency Virus / Acquired Immunodeficiency Syndrome Knowledge and Risk Factors in Ethiopian Military Personnel MILITARY MEDICINE, 169, 3:221, 2004 Humn Immunodeficiency Virus / Acquired Immunodeficiency Syndrome Knowledge nd Risk Fctors in Ethiopin Militry Personnel Gurntor: Ludmil N. Bkhirev, MD MPH Contributors:

More information

Effect on Glycemic, Blood Pressure, and Lipid Control according to Education Types

Effect on Glycemic, Blood Pressure, and Lipid Control according to Education Types Originl Article http://dx.doi.org/10.4093/dmj.2011.35.6.580 pissn 2233-6079 eissn 2233-6087 D I A B E T E S & M E T A B O L I S M J O U R N A L Effect on Glycemic, Blood Pressure, nd Lipid Control ccording

More information

Analytic hierarchy process-based recreational sports events development strategy research

Analytic hierarchy process-based recreational sports events development strategy research ISSN : 0974-7435 Volume 0 Issue 6 An Indin Journl Anlytic hierrchy process-bsed recretionl sports events development strtegy reserch Weihu Yo School of hysicl Eduction, Luoyng Norml University, Luoyng

More information

Employment Status and Depressive Symptoms in Koreans: Results From a Baseline Survey of the Korean Longitudinal Study of Aging

Employment Status and Depressive Symptoms in Koreans: Results From a Baseline Survey of the Korean Longitudinal Study of Aging Jng, S-N., Cho, S-I., Chng, J., Boo, K., Shin, H-G., Lee, H., & Berkmn, L.F. (2009). Employment sttus nd depressive symptoms in korens: results from bseline survey of the koren longitudinl study of ging.

More information

Urinary Tract Infection in Men

Urinary Tract Infection in Men C H A P T E R 1 9 Urinry Trct Infection in Men Toms L. Griebling, MD Associte Professor & Vice Chir of Urology University of Knss Knss City, Knss Contents INTRODUCTION........................................623

More information

Quantifying perceived impact of scientific publications

Quantifying perceived impact of scientific publications Quntifying perceived impct of scientific publictions Filippo Rdicchi, Alexnder Weissmn, nd John Bollen Center for Complex Networks nd Systems Reserch, School of Informtics nd Computing, Indin University,

More information

Residency Curriculum Improves Breastfeeding Care

Residency Curriculum Improves Breastfeeding Care Residency Curriculum Improves Brestfeeding Cre Lori Feldmn-Winter, Luren Brone, Brry Milcrek, Krystl Hunter, Jon Meek, Jne Morton, Tr Willims, Audrey Nylor nd Ruth A. Lwrence Peditrics 2010;126;289-297;

More information

PATTERNS OF FAMILY RESPONSES TO ALCOHOL AND TOBACCO PROBLEMS

PATTERNS OF FAMILY RESPONSES TO ALCOHOL AND TOBACCO PROBLEMS Drug nd Alcohol Review 15:171-181, 1996. PATTERNS OF FAMILY RESPONSES TO ALCOHOL AND TOBACCO PROBLEMS Robin Room Addiction Reserch Foundtion 33 Russell St. Toronto, Ontrio M5S 2S1, Cnd ABSTRACT Ptterns

More information

Addendum to the Evidence Review Group Report on Aripiprazole for the treatment of schizophrenia in adolescents (aged years)

Addendum to the Evidence Review Group Report on Aripiprazole for the treatment of schizophrenia in adolescents (aged years) Addendum to the Evidence Review Group Report on Aripiprzole for the tretment of schizophreni in dolescents (ged 15-17 yers) Produced by Authors Correspondence to Southmpton Helth Technology Assessments

More information

Potassium Intake of the U.S. Population

Potassium Intake of the U.S. Population Food Surveys Reserch Group Dietry Dt Brief No. 10 September 2012 Highlights The verge potssium intke of the U.S. popultion 2 yers nd older ws 2640 mg per dy nd intke of the U.S. popultion hs remined reltively

More information

In 2006, the prevalence of bipolar

In 2006, the prevalence of bipolar With Bipolr Disorder Annette M. Mtthews, MD; Vness B. Wilson, BA; Suznne H. Mitchell, PhD; nd Peter Huser, MD This study of smoking ehviors nd smoking chrcteristics in veterns with ipolr disorder contriutes

More information

Psychiatry and Clinical Neurosciences 2014; 68:

Psychiatry and Clinical Neurosciences 2014; 68: Psychitry nd Clinicl Neurosciences 214; 68: 759 767 doi:1.1111/pcn.12188 Regulr Article Relibility nd vlidity of Brief Problem Monitor, n bbrevited form of the Child Behvior Checklist Brin J. Piper, PhD,

More information

Effectiveness of Belt Positioning Booster Seats: An Updated Assessment

Effectiveness of Belt Positioning Booster Seats: An Updated Assessment ARTICLES Effectiveness of Belt Positioning Booster Sets: An Updted Assessment AUTHORS: Kristy B. Arbogst, PhD, Jessic S. Jermkin, DSc, Michel J. Klln, MS, b nd Dennis R. Durbin, MD, MSCE,b Center for Injury

More information

Review TEACHING FOR GENERALIZATION & MAINTENANCE

Review TEACHING FOR GENERALIZATION & MAINTENANCE Gols By the end of clss, you should be ble to: Explin wht generliztion is, why it is criticl for techers to know how to tech so tht it occurs, nd give n exmple of it from your own experience in the clssroom

More information

Communication practices and preferences between orthodontists and general dentists

Communication practices and preferences between orthodontists and general dentists Originl rticle ommuniction prctices nd preferences between orthodontists nd generl dentists Kevin ibon ; hvn Shroff b ; l M. est c ; Steven J. Linduer d STRT Objective: To evlute similrities nd differences

More information

Potential for Interactions Between Dietary Supplements and Prescription Medications a

Potential for Interactions Between Dietary Supplements and Prescription Medications a CLINICAL RESEARCH STUDY Potentil for Interctions Between Dietry Supplements nd Prescription Medictions Amit Sood, MD, MSc, Rich Sood, MD, b Frncis J. Brinker, ND, Rvneet Mnn, MBBS, c Lur L. Loehrer, Dietlind

More information

EVALUATION OF DIFFERENT COPPER SOURCES AS A GROWTH PROMOTER IN SWINE FINISHING DIETS 1

EVALUATION OF DIFFERENT COPPER SOURCES AS A GROWTH PROMOTER IN SWINE FINISHING DIETS 1 Swine Dy 2001 Contents EVALUATION OF DIFFERENT COPPER SOURCES AS A GROWTH PROMOTER IN SWINE FINISHING DIETS 1 C. W. Hstd, S. S. Dritz 2, J. L. Nelssen, M. D. Tokch, nd R. D. Goodbnd Summry Two trils were

More information

Course of Skin Symptoms and Quality of Life in Children Referred for Patch Testing A Long-term Follow-up Study

Course of Skin Symptoms and Quality of Life in Children Referred for Patch Testing A Long-term Follow-up Study Act Derm Venereol 2015; 95: 206 210 CLINICAL REPORT Course of Skin Symptoms nd Qulity of Life in Children Referred for Ptch Testing A Long-term Follow-up Study Anne B. SIMONSEN 1, Mette SOMMERLUND 1, Mette

More information

DXA: Can It Be Used as a Criterion Reference for Body Fat Measurements in Children?

DXA: Can It Be Used as a Criterion Reference for Body Fat Measurements in Children? nture publishing group rticles methods AND techniques DXA: Cn It Be Used s Criterion Reference for Body Ft Mesurements in Children? Romn J. Shypilo 1, Nncy F. Butte 1 nd Kenneth J. Ellis 1 Objective: Dul-energy

More information

Between 45% and 85% of the approximately 4 million people

Between 45% and 85% of the approximately 4 million people CLINICAL Incresing Heptitis C Screening in Lrge Integrted Helth System: Science nd Policy in Concert Crl V. Rodriguez, PhD; Kevin B. Rubenstein, MS; Benjmin Lins, MD; Hihong Hu, MS; nd Michel Horberg,

More information

A Comparison of Serum Magnesium Level in Pregnant Women with and without Gestational Diabetes Mellitus (GDM)

A Comparison of Serum Magnesium Level in Pregnant Women with and without Gestational Diabetes Mellitus (GDM) Brief Report J Bbol Univ Med Sci Vol 18, Issu 12; Dec 2016. P:71-75 A Comprison of Serum Mgnesium Level in Pregnnt Women with nd without Gesttionl Dibetes Mellitus (GDM) Z. Bouzri (MD) 1, F. Elmi(MD) 2,

More information

Preventive Neuromuscular Training for Young Female Athletes: Comparison of Coach and Athlete Compliance Rates

Preventive Neuromuscular Training for Young Female Athletes: Comparison of Coach and Athlete Compliance Rates Journl of Athletic Trining 2016;51(12):000 000 doi: 10.4085/1062-6050-51.12.20 Ó by the Ntionl Athletic Triners Assocition, Inc www.ntjournls.org originl reserch Preventive Neuromusculr Trining for Young

More information

Comparison of three simple methods for the

Comparison of three simple methods for the J. clin. Pth. (1967), 2, 5 Comprison of three simple methods for the ssessment of 'free' thyroid hormone T. M. D. GIMLETTE1 From the Rdio-Isotope Lbortory, St. Thoms's Hospitl, London SYNOPSIS A dilysis

More information

Original Article. T Akter 1, N Islam 2, MA Hoque 3, S Khanam 4, HA khan 5, BK Saha 6. Abstract:

Original Article. T Akter 1, N Islam 2, MA Hoque 3, S Khanam 4, HA khan 5, BK Saha 6. Abstract: Fridpur Med. Coll. J. 214;9(2):61-67 Originl Article Nebuliztion by Isotonic Mgnesium Sulphte Solution with Provide Erly nd Better Response s Compred to Conventionl Approch ( Plus Norml Sline) in Acute

More information

BMI and Mortality: Results From a National Longitudinal Study of Canadian Adults

BMI and Mortality: Results From a National Longitudinal Study of Canadian Adults nture publishing group BMI nd Mortlity: Results From Ntionl Longitudinl Study of Cndin Adults Hether M. Orpn 1, Jen-Mrie Berthelot 2,3, Mrk S. Kpln 4, Dvid H. Feeny 5,6, Bentson McFrlnd 7 nd Nncy A. Ross

More information

Metabolic syndrome (MetS) is defined by a group

Metabolic syndrome (MetS) is defined by a group ORIGINAL ARTICLE Prevlence of Metolic Syndrome in Lrge Integrted Helth Cre System in North Crolin Rohn Mhleshwrkr, Yhenneko J. Tylor, Melnie D. Spencer, Svet Mohnn ckground Metolic syndrome (MetS) is cluster

More information

Fat intake in patients newly diagnosed with type 2 diabetes: a 4-year follow-up study in general practice

Fat intake in patients newly diagnosed with type 2 diabetes: a 4-year follow-up study in general practice Originl ppers Ft intke in ptients newly dignosed with type 2 dibetes: 4-yer follow-up study in generl prctice Floris A vn de Lr, Eloy H vn de Lisdonk, Peter L B J Lucssen, J M H Tigchelr, Sski Meyboom,

More information

Staffing Model for Dental Wellness and Readiness

Staffing Model for Dental Wellness and Readiness MILITARY MEDICINE, 169, 8:604, 2004 Stffing Model for Dentl Wellness nd Rediness Gurntor: LTC Jeffrey Chffin, DC USA Contributors: COL Lrry G. Rothfuss, DC USA* ; LCDR Scott A. Johnson, NC USN* ; MAJ Stephen

More information

METHOD 4010 SCREENING FOR PENTACHLOROPHENOL BY IMMUNOASSAY

METHOD 4010 SCREENING FOR PENTACHLOROPHENOL BY IMMUNOASSAY METHOD 4010 SCREENING FOR PENTACHLOROPHENOL BY IMMUNOASSAY 1.0 SCOPE AND APPLICATION 1.1 Method 4010 is procedure for screening solids such s soils, sludges, nd queous medi such s wste wter nd lechtes

More information

Supplementary Online Content

Supplementary Online Content Supplementry Online Content Rieckmnn N, Kronish IM, Shpiro PA, Whng W, Dvidson KW. Serotonin reuptke inhibitor use, depression, nd long-term outcomes fter n cute coronry : prospective cohort study. JAMA

More information

A Two-Stage Sampling Method for Clinical Surveillance of Individuals in Care for HIV Infection in the United States

A Two-Stage Sampling Method for Clinical Surveillance of Individuals in Care for HIV Infection in the United States Reserch Articles A Two-Stge Smpling Method for Clinicl Surveillnce of Individuls in Cre for HIV Infection in the United Sttes Ptrick S. Sullivn, DVM, PhD John M. Kron, PhD Fye E. Mlitz, MPH b Stephnie

More information

URINARY incontinence is an important and common

URINARY incontinence is an important and common Urinry incontinence in older people in the community: neglected problem? Helen Stoddrt, Jenny Donovn, Elise Whitley, Deborh Shrp nd In Hrvey SUMMARY Bckground: The prevlence nd impct of urinry incontinence

More information

EFFECTS OF INGREDIENT AND WHOLE DIET IRRADIATION ON NURSERY PIG PERFORMANCE

EFFECTS OF INGREDIENT AND WHOLE DIET IRRADIATION ON NURSERY PIG PERFORMANCE Swine Dy 21 EFFECTS OF INGREDIENT AND WHOLE DIET IRRADIATION ON NURSERY PIG PERFORMANCE J. M. DeRouchey, M. D. Tokch, J. L. Nelssen, R. D. Goodbnd, S. S. Dritz 1, J. C. Woodworth, M. J. Webster, B. W.

More information

An Assessment of Health Status among Medical Research Volunteers Who Served in the Project Whitecoat Program at Fort Detrick, Maryland

An Assessment of Health Status among Medical Research Volunteers Who Served in the Project Whitecoat Program at Fort Detrick, Maryland MILITARY MEDICINE, 170, 3:183, 2005 An Assessment of Helth Sttus mong Medicl Reserch Volunteers Who Served in the Project Whitecot Progrm t Fort Detrick, Mrylnd Gurntor: COL Phillip R. Pittmn, MC USA Contributors:

More information

Maximize Your Genetic Return. Find your Genetic Solution with Boviteq West

Maximize Your Genetic Return. Find your Genetic Solution with Boviteq West Mximize Your Genetic Return. Find your Genetic Solution with Boviteq West Boviteq West is comprehensive reproductive solutions provider, imed t finding the right genetic solution for every niml nd every

More information