Colorectal cancer screening among African American church members: A qualitative and quantitative study of patient-provider communication

BACKGROUND: A healthcare provider's recommendation to undergo screening has been shown to be one of the strongest predictors of completing a colorectal cancer (CRC) screening test. We sought to determine the relationship between the general quality of self-rated patient-provider communication and the completion of CRC screening. METHODS: A formative study using qualitative data from focus groups and quantitative data from a cross-sectional survey of church members about the quality of their communication with their healthcare provider, their CRC risk knowledge, and whether they had completed CRC screening tests. Focus group participants were a convenience sample of African American church members. Participants for the survey were recruited by telephone from membership lists of 12 African American churches located in rural counties of North Carolina to participate in the WATCH (Wellness for African Americans Through Churches) Project. RESULTS: Focus Groups. Six focus groups (n = 45) were conducted prior to the baseline survey. Discussions focused on CRC knowledge, and perceived barriers/motivators to CRC screening. A theme that emerged during each groups' discussion about CRC screening was the quality of the participants' communication with their health care provider. Survey. Among the 397 participants over age 50, 31% reported CRC screening within the recommended guidelines. Participants who self-rated their communication as good were more likely to have been screened (36%) within the recommended guidelines than were participants with poor communication (17%) (OR = 2.8, 95% CI 1.2, 6.4; p = 0.013). Participants who had adequate CRC knowledge completed CRC screening at a higher rate than those with inadequate knowledge (p = 0.011). The percentage of participants with CRC screening in the recommended guidelines, stratified by communication and knowledge group were: 42% for good communication/adequate knowledge; 27% for good communication/inadequate knowledge; 29% for poor communication/adequate knowledge; and 5% for poor communication/inadequate knowledge. CONCLUSIONS: Participants who rated their patient-provider communication as good were more likely to have completed CRC screening tests than those reporting poor communication. Among participants reporting good communication, knowledge about colorectal cancer was also associated with test completion. Interventions to improve patient-provider communication may be important to increase low rates of CRC screening test completion among African Americans

Adherence to colorectal cancer screening guidelines in Canada

<p>Abstract</p> <p>Background</p> <p>To identify correlates of adherence to colorectal cancer (CRC) screening guidelines in average-risk Canadians.</p> <p>Methods</p> <p>2003 Canadian Community Health Survey Cycle 2.1 respondents who were at least 50 years old, without past or present CRC and living in Ontario, Newfoundland, Saskatchewan, and British Columbia were included. Outcomes, defined according to current CRC screening guidelines, included adherence to: i) fecal occult blood test (FOBT) (in prior 2 years), ii) endoscopy (colonoscopy/sigmoidoscopy) (prior 10 years), and iii) adherence to CRC screening guidelines, defined as either (i) or (ii). Generalized estimating equations regression was employed to identify correlates of the study outcomes.</p> <p>Results</p> <p>Of the 17,498 respondents, 70% were non-adherent CRC screening to guidelines. Specifically, 85% and 79% were non-adherent to FOBT and endoscopy, respectively. Correlates for all outcomes were: having a regular physician (OR = (i) 2.68; (ii) 1.91; (iii) 2.39), getting a flu shot (OR = (i) 1.59; (ii) 1.51; (iii) 1.55), and having a chronic condition (OR = (i) 1.32; (ii) 1.48; (iii) 1.43). Greater physical activity, higher consumption of fruits and vegetables and smoking cessation were each associated with at least 1 outcome. Self-perceived stress was modestly associated with increased odds of adherence to endoscopy and to CRC screening guidelines (OR = (ii) 1.07; (iii) 1.06, respectively).</p> <p>Conclusion</p> <p>Healthy lifestyle behaviors and factors that motivate people to seek health care were associated with adherence, implying that invitations for CRC screening should come from sources that are independent of physicians, such as the government, in order to reduce disparities in CRC screening.</p

Ballistic transport and boundary resistances in inhomogeneous quantum spin chains

Transport phenomena are central to physics, and transport in the many-body and fully-quantum regime is attracting an increasing amount of attention. It has been recently revealed that some quantum spin chains support ballistic transport of excitations at all energies. However, when joining two semi-infinite ballistic parts, such as the XX and XXZ spin-1/2 models, our understanding suddenly becomes less established. Employing a matrix-product-state ansatz of the wavefunction, we study the relaxation dynamics in this latter case. Here we show that it takes place inside a light cone, within which two qualitatively different regions coexist: an inner one with a strong tendency towards thermalization, and an outer one supporting ballistic transport. We comment on the possibility that even at infinite time the system supports stationary currents and displays a non-zero Kapitza boundary resistance. Our study paves the way to the analysis of the interplay between transport, integrability, and local defects

A922 Sequential measurement of 1 hour creatinine clearance (1-CRCL) in critically ill patients at risk of acute kidney injury (AKI)

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Resumen de tesis. Análisis del currículum de la educación nocturna formal de adultos y proposición de una estrategia de reestructuración curricular para los colegios nocturnos de la región Central de Costa Rica

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arquis40años

ResumenRevistArquis crea esta sección especial, para conmemorar los 40 años de historia de la Escuela de Arquitectura, de la Universidad de Costa Rica (1971-2011). La sección titulada "arquis40años" recoge una serie de artículos de diversas fuentes y autores, donde se exponen, a travez de: reseñas, reflexiones, entrevistas, ensayos, etc., narraciones del nacimiento y desarrollo de la Carrera de Arquitectura, su programa académico y sus constantes cambios (totales y parciales), el quehacer actual y aquellas pautas o directrices que tratan de guiar el futuro de una Carrera perteneciente a una Universidad estatal de prestigio internacional. Se retoma una entrevista de sus fundadores y se publican sus reflexiones recientes, se marcan los hitos de la historia de la Escuela, se analiza la evolución de sus planes de estudio, su "Intorno" .AbstractRevistArquis has created this special section to commemorate the forty year history of the School of Architecture (1971-2011). The section entitled Arquis40ños presents a series of articles from different sources and authors, which describe, by means of essays, interviews, narrations and reflections, the creation and development of the academic program in architecture, its present status and guidelines for a successful future as a vital component of a state university with international prestige.Contenido de esta Sección1- Entrevista a Felo García, Jorge Bertheau y Edgar Brenes2- Hitos Históricos de la Escuela de Arquitectura3- 40años4- El " Intorno" Original de la Escuela de Arquitectura5-La evolución de los contenidos del Plan de Estudios de la Escuela de Arquitectura, UCR.6-Reflexiones del Arquitecto Rafael "Felo" García7- Reflexiones del Arquitecto Jorge Bertheau Odio8-Reflexiones del Arquitecto Edgar Brenes M.9-Reflexiones del Arquitecto Franz Beer Ch.10-40 años celebración