Mammography Social Support for Women Living in a Midwestern City: Toward Screening Promotion via Social Interactions

Notwithstanding recommendations and interventions, the percentage of 50 – 74-year-old U.S. women who reported having had a mammography in the past two years remained below target coverage. Social interactions may influence mammography rates. To measure characteristics of social interactions in a Midwestern city as they relate to social support for mammography received by women older than 40 years of age. A cross-sectional study was conducted in Bloomington, Indiana, sending mail surveys to 3,000 telephone directory addresses selected by simple random sampling. An anonymous, self-administered, closed-ended, questionnaire with eight checklist items (for demographics) and six multipart semantic differential scale items (for social support), derived from validated instruments, was used. Social support for mammography in women who had undergone regular screening was analyzed using chi-square test and logistic regression. Of 450 respondents with valid responses, 91% were white; 47% were older than 80; 92% had good health insurance coverage; and 82% had undergone regular mammography. Healthcare workers provided the highest support, followed by children, siblings, and relatives. Friends, neighbors, and co-workers were least supportive. In social interactions, emotional support was the most prominent, followed by informational, appraisal, and instrumental supports. Having higher income and being married were associated with receiving greater support. Although mammography provides limited benefits after age 74, women older than 80 years of age received the highest support. Identifying the structural and functional characteristics of social interactions is important for: 1) designing interventions that enhance social support, and 2) expanding breast cancer screening via personalized approaches using existing social interactions

Untying the Gordian Knot: The Development of an Immunization Information Exchange

Legislative mandates require the sharing of immunization information among multiple stakeholders. This in turn requires the implementation of interoperable systems across various information systems. A key challenge to system interoperability is the need to integrate healthcare information and processes across different settings. This paper reports work in progress on the development of a student immunization Health Information Exchange (HIE). The system builds on a commercially available platform, appropriately modified on both front and backend, to meet the needs of school health professionals and other stakeholders involved in the production and maintenance of immunization information. We describe the situated change perspective as well as the iterative and incremental development process adopted for the project, and examine some of the lessons learned throughout

Attenuated PTH Responsiveness to Vitamin D Deficiency among Patients with Type 2 Diabetes and Chronic Hyperglycemia

Background The short and long-term relationship between hyperglycemia and PTH level among patients suffering from both diabetes type 2 and vitamin D deficiency were evaluated. Methods This was a cross sectional study performed at Dubai Diabetes Center, UAE. To demonstrate the relationship between hyperglycemia and PTH level, subjects with type 2 diabetes and vitamin D deficiency (124 adults) were divided into 4 groups based on their FPG and HbA1c levels. Results Mean vitamin D and PTH levels among subjects with HbA1c ≤ 7% (53 mmol/mol) were 14.05 ng/ml and 19.51 pg/ml respectively. On the other hand, mean vitamin D and PTH levels among subjects with HbA1c ≥ 10% (86 mmol/mol) were significantly lower at 11.77 ng/ml and 17.75 pg/ml respectively. The product of vitamin D and PTH among subjects with an HbA1c ≤ 7% (53 mmol/mol) was 250.380, compared with only 197.710 among subjects with HbA1c ≥ 10 (86 mmol/mol). Regression analysis for subjects older than 50 years shows a significant negative effect of HbA1c on the PTH level. Mean calcium level among subjects with HbA1c ≤ 7% (53 mmol/mol) was 8.80 mg/dl compared with 8.94 mg/dl when HbA1c is ≥10% (86 mmol/mol) with no statistical difference. Although high FPG was associated with a lower PTH level, such association was not statistically significant. Conclusions Chronic hyperglycemia, as assessed by A1C level, is associated with a significantly attenuated PTH responsiveness to vitamin D deficiency without a significant change in calcium level. On the other hand, there was no significant association between FPG and PTH level