Hmong Adults Self-Rated Oral Health: A Pilot Study

Since 1975, the Hmong refugee population in the U.S. has increased over 200%. However, little is known about their dental needs or self-rated oral health (SROH). The study aims were to: (1) describe the SROH, self-rated general health (SRGH), and use of dental/physician services; and (2) identify the factors associated with SROH among Hmong adults. A cross-sectional study design with locating sampling methodology was used. Oral health questionnaire was administered to assess SROH and SRGH, past dental and physician visits, and language preference. One hundred twenty adults aged 18–50+ were recruited and 118 had useable information. Of these, 49% rated their oral health as poor/fair and 30% rated their general health as poor/fair. Thirty-nine percent reported that they did not have a regular source of dental care, 46% rated their access to dental care as poor/fair, 43% visited a dentist and 66% visited a physician within the past 12 months. Bivariate analyses demonstrated that access to dental care, past dental visits, age and SRGH were significantly associated with SROH (P \u3c 0.05). Multivariate analyses demonstrated a strong association between access to dental care and good/excellent SROH. About half of Hmong adults rated their oral health and access to dental care as poor. Dental insurance, access to dental care, past preventive dental/physician visits and SRGH were associated with SROH

What do you do for a living? Toward a more succinct definition of health services research

This commentary discusses the need for, and the advantages of, a more concise, revised definition of the field of health services research. It argues for a definition that includes not only the topics on which health services research focuses but also the goals of health services research. A number of condensed definitions are provided for consideration

Sistema de processamento de imagens aéreas múlti espectrais para agricultura de precisão

Cuban agriculture has the growing need to increase its productivity. To achieve this, precision agriculture can play a fundamental role. It is necessary to develop an image processing system able to process all the crops information and calculate vegetation indexes in a satisfactory way. This will entail in accurate measurements of the nitrogen lack, the hydric stress, and the vegetal strength, among other aspects, seeking to improve the accuracy in the care of these aspects. This document reports the results of an investigation pointed to develop a procedure for capturing and processing multispectral aerial images obtained from Unmanned Aerial Vehicles [UAV]. This procedure searched to measure the vegetation indexes of sugarcane crops that may be correlated with the level of vegetal strength, the number of stems, and the foliar mass per lot. We used a USENSE-X8 UAV together with a Sequoia multispectral sensor and the QGIS processing software. The procedure was experimentally validated.La agricultura cubana tiene la necesidad creciente de aumentar su productividad, para lograrlo, la agricultura de precisión puede desempeñar un papel fundamental. Es necesario entonces desarrollar un sistema de procesamiento de imágenes capaz de procesar toda la información de los cultivos y calcular índices vegetativos de forma satisfactoria, para así medir con precisión el déficit de nitrógeno, el estrés hídrico y el vigor vegetal, entre otros aspectos, para que la atención de estos aspectos sea también precisa. Este documento reporta los resultados de una investigación dirigida al desarrollo de un procedimiento para la toma y procesamiento de imágenes multiespectrales aéreas obtenidas desde Vehículos Aéreos No Tripulados [VANT], para obtener índices vegetativos de sembrados de caña de azúcar que puedan ser correlacionados con el nivel de vigor vegetal, el número de tallos o la masa foliar por parcela. Se utilizó un VANT USENSE-X8 y sus componentes, un sensor multiespectral Sequoia y el software de procesamiento QGIS. El procedimiento fue validado de forma experimental.A agricultura cubana tem uma necessidade crescente de aumentar sua produtividade, e para isso, a agricultura de precisão pode desempenhar um papel fundamental. É necessário, portanto, desenvolver um sistema de processamento de imagens capaz de processar toda a informação dos plantios e calcular de forma satisfatória índices de vegetação, de forma de poder medir com precisão o déficit de nitrogênio, o estresse hídrico e o vigor vegetal, entre outros aspectos, para que a atenção desses aspectos também seja precisa. Este documento relata os resultados de uma pesquisa focada ao desenvolvimento de um procedimento para a obtenção e processamento de imagens aéreas múlti espectrais obtidas desde veículos aéreos não tripulados [VANT], para obter índices de vegetação de plantios de cana-de-açúcar que podem ser correlacionados com o nível de vigor vegetal, o número de hastes ou a massa foliar por parcela. Foi utilizado um VANT USENSE-X8 e seus componentes, um sensor múlti espectral Sequoia e o software de processamento QGIS. O procedimento foi validado experimentalmente

Assessing the context of health care utilization in Ecuador: A spatial and multilevel analysis

<p>Abstract</p> <p>Background</p> <p>There are few studies that have analyzed the context of health care utilization, particularly in Latin America. This study examines the context of utilization of health services in Ecuador; focusing on the relationship between provision of services and use of both preventive and curative services.</p> <p>Methods</p> <p>This study is cross-sectional and analyzes data from the 2004 National Demographic and Maternal & Child Health dataset. Provider variables come from the Ecuadorian System of Social Indicators (SIISE). Global Moran's I statistic is used to assess spatial autocorrelation of the provider variables. Multilevel modeling is used for the simultaneous analysis of provision of services at the province-level with use of services at the individual level.</p> <p>Results</p> <p>Spatial analysis indicates no significant differences in the density of health care providers among Ecuadorian provinces. After adjusting for various predisposing, enabling, need factors and interaction terms, density of public practice health personnel was positively associated with use of preventive care, particularly among rural households. On the other hand, density of private practice physicians was positively associated with use of curative care, particularly among urban households.</p> <p>Conclusions</p> <p>There are significant public/private, urban/rural gaps in provision of services in Ecuador; which in turn affect people's use of services. It is necessary to strengthen the public health care delivery system (which includes addressing distribution of health workers) and national health information systems. These efforts could improve access to health care, and inform the civil society and policymakers on the advances of health care reform.</p

Analysis of five-year trends in self-reported language preference and issues of item non-response among Hispanic persons in a large cross-sectional health survey: implications for the measurement of an ethnic minority population

<p>Abstract</p> <p>Background</p> <p>Significant differences in health outcomes have been documented among Hispanic persons, the fastest-growing demographic segment of the United States. The objective of this study was to examine trends in population growth and the collection of health data among Hispanic persons, including issues of language preference and survey completion using a national health survey to highlight issues of measurement of an increasingly important demographic segment of the United States.</p> <p>Design</p> <p>Data from the 2003-2007 United States Census and the Behavioral Risk Factor Surveillance System were used to compare trends in population growth and survey sample size as well as differences in survey response based on language preference among a Hispanic population. Percentages of item non-response on selected survey questions were compared for Hispanic respondents choosing to complete the survey in Spanish and those choosing to complete the survey in English. The mean number of attempts to complete the survey was also compared based on language preference among Hispanic respondents.</p> <p>Results</p> <p>The sample size of Hispanic persons in the Behavioral Risk Factor Surveillance System saw little growth compared to the actual growth of the Hispanic population in the United States. Significant differences in survey item non-response for nine of 15 survey questions were seen based on language preference. Hispanic respondents choosing to complete the survey in Spanish had a significantly fewer number of call attempts for survey completion compared to their Hispanic counterparts choosing to communicate in English.</p> <p>Conclusions</p> <p>Including additional measures of acculturation and increasing the sample size of Hispanic persons in a national health survey such as the Behavioral Risk Factor Surveillance System may result in more precise findings that could be used to better target prevention and health care needs for an ethnic minority population.</p

Comparative Performance of Comorbidity Indices in Predicting Health Care-Related Behaviors and Outcomes among Medicaid Enrollees with Type 2 Diabetes

Abstract No single gold standard of comorbidity measure has been identified, and the performance of comorbidity indices vary according to the outcome of interest. The authors compared the Charlson Comorbidity Index, Elixhauser Index (EI), Chronic Disease Score (CDS), and Health-related Quality of Life Comorbidity Index (HRQL-CI) in predicting health care-related behaviors (physicians' concordance with diabetes care standards and patients' oral antidiabetic drug [OAD] adherence) and outcomes (health care utilization and expenditures) among Medicaid enrollees with type 2 diabetes. A total of 9832 diabetes patients who used OAD were identified using data from the MarketScan Medicaid database from 2003 to 2007. Predictive performance of the comorbidity index was assessed using multiple regression models controlling for patient demographics, diabetes severity, and baseline health care characteristics. Among the 4 indices, the CDS was best at predicting physician's concordance with care standards. The CDS and HRQL-CI mental index performed better than other indices as predictors of medication adherence. The EI was best at predicting health care utilization and expenditures. These results suggest that, for these low-income diabetes patients, the CDS and HRQL-CI mental index were relatively better risk-adjustment tools for health care-related behavior data evaluation and the EI was the first choice for health care utilization and expenditures data. (Population Health Management 2012;15:220?229)Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/98469/1/pop%2E2011%2E0037.pd

Primary source of income is associated with differences in HIV risk behaviors in street-recruited samples

BACKGROUND: The relationship between primary source of income and HIV risk behaviors and the racial/ethnic differences in risk behavior profiles among disadvantaged populations have not been fully explored. This is unusual given that the phenomenon of higher risk in more disadvantaged populations is well-known but the mechanisms remain unclear. We examined the relationship between primary source of income and differences in HIV risk behaviors among four racial/ethnic groups in the southern United States. METHODS: Self-reported data on primary source of income and HIV risk behaviors were collected from 1494 African American, Hispanic, Asian, and White men and women in places of public congregation in Houston, Texas. Data were analyzed using calculation of percentages and by chi-square tests with Yates correction for discontinuity where appropriate. RESULTS: Data revealed that a higher proportion of whites were involved in sex for money exchanges compared to the other racial groups in this sample. The data suggest that similar street sampling approaches are likely to recruit different proportions of people by primary income source and by ethnicity. It may be that the study locations sampled are likely to preferentially attract those involved in illegal activities, specifically the white population involved in sex for drug or money exchanges. Research evidence has shown that people construct highly evolved sexual marketplaces that are localized and most unlikely to cross racial, ethnic, and socioeconomic or geographical boundaries. Thus, the areas that we sampled may have straddled a white sexual marketplace more than that of the other groups, leading to an over-representation of sex exchange in this group. Drug use was highest among those with illegal primary sources of income (sex exchange and drug dealing and theft), and they were also those most likely to have injected drugs rather than administered them by any other route (p < 0.001). In addition, bisexual or homosexual identification was reported by more respondents in the sex exchange as primary source of income category. The number of sexual partners in the last three months followed a similar pattern, with those whose primary source of income was drug dealing or theft reporting relatively high partner numbers. CONCLUSIONS: These data suggest that social disadvantage is associated with HIV risk in part by its association with drug and sex work for survival, and offers one variable that may be associated with the concentration of disease among those at greatest disadvantage by having an illegal and unstable primary income source