750 research outputs found

    PERSPECTIVES ON THE ILLINOIS HEALTHCARE DELIVERY SYSTEM CHALLENGES, STRUCTURAL ISSUES AND OPPORTUNITIES FOR REFORM

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    As fourth year students in the program, students at SIU School of Medicine have enrolled in classes at the Institute and have spent a rotation studying public policy choices that impact the delivery of health care services and the profession itself. The choices made by these public entities will have ramifications for physicians, nurses, administrative support staff and most importantly, for patients and their families. Students have studied state healthcare policy formation up-close and have learned a great deal about the forces and factors that shape their fields of study. Common to all students’ findings and much of the literature generally is a need to bring about a greater alignment of public policy and actual practice in medicine. After observing the healthcare policy formation process, these students have all written about their experiences, pointing out issues of concern, and offering suggestions for improvement. In lieu of a single paper prepared on one topic, I am including three reports to share with the reader each of the students’ observations on the intersection of health care and public policy. Isaac Tan makes an interesting proposal to assist physicians with the costs of providing indigent care. He offers a plan to allow physicians to receive a tax credit for indigent care provided during the course of a year, which would offset a significant share of the overall cost. Clare Zimmerman assesses deficiencies in nutrition among children in Illinois’ foster care program. Her assessment led her to suggest incorporating nutritional education and a monitoring system into the overall foster care regime. Rustin Meister assesses the ongoing challenges to childhood immunization regulations and proposes removing or reducing the number of available exemptions. Each of the papers was developed with the idea of proposing systemic reforms in Illinois healthcare service delivery, designed to address problems that the students witnessed firsthand

    Group-Based Interventions Using a Low-Fat Diabetes Diet to Improve Self-Efficacy and HBA1C Levels in African American Type 2 Diabetics

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    Background and Problem Type two diabetes mellitus (T2DM) is a chronic medical condition of impaired glucose metabolism that has significantly impacted the health of Americans. According to Centers for Disease Control and Prevention (CDC), T2DM is the seventh leading cause of death making up over 270,000 deaths in 2017 (CDC, 2020a). There are noted disparities among African Americans who are disproportionately affected by T2DM more than Caucasians. African Americans account for 13% of the population in the United States of which 11.7% are diagnosed with T2DM as compared to Caucasians who make up 76.3% of the population of which 7.5% have T2DM (United States Census Bureau, 2021; Haw et al., 2021). Minorities such as African Americans are least likely to achieve glycemic control and are greater than 50% more likely to suffer from the complications of T2DM than their Caucasian counterpart (Canedo et al., 2018; Cunningham et al., 2018). It is projected that without strategic interventions T2DM diabetes will affect one out of six Americans and one out of four African Americans by 2060 (Lin et al. 2020). Traditional diabetes education programs have not been effective in lowering hemoglobin A1C levels in African Americans (Lynch et al., 2019; Cunningham et al., 2018). Barriers include poor food choices, poor self-efficacy in making dietary changes, culture, and the social rewards attached to food. It is the burden of healthcare providers to develop creative ways to confront these barriers to improve dietary practices and build selfefficacy for better glycemic control. Purpose Statement The purpose of this project was to improve dietary self-management efficacy and blood glucose levels through the implementation of group-based lunch-and-learn educational sessions that emphasize a low-saturated fat diabetes diet consisting of whole grains, legumes, fruits, and vegetables. Method A convenience sample of African Americans with T2DM visiting the Benton Harbor Health Center participated in a quantitative, quasi-experimental pilot study that utilized a weekly 45-minute lunch-and-learn educational session emphasizing a low-fat, low carbohydrate diet for six weeks. Pre- and post-intervention self-efficacy and hemoglobin A1c values were measured. Results A paired t-test was used to evaluate whether the pre-intervention mean self efficacy for healthy diet scores and HbA1c levels improved post-intervention. The results demonstrated a statistically significant improvement in self-efficacy scores (p =.002). However, the HbA1c levels showed no improvement, but an increase post-intervention (p= 0.306). Significance With the increasing prevalence of T2DM and the disease burden from its complications in African Americans, practitioners must use a different approach to traditional diabetes self-management education and support (DSMES) that place emphasis on increasing dietary self-efficacy which is a predictor of behavioral change. The data from this project supports the lunch-and-learn format is an experiential method that helps the T2D to translate diabetes knowledge into real-life application through improved self-efficacy which can ultimately improve glycemic control. Achieving glycemic control leads to improved morbidity and mortality rates, lower healthcare costs and improved quality of life

    Importance and Fulfillment of Family Needs in the ICU

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    The family is a major source of support for the intensive care patient. To provide optimal support to the patient the family’s needs must be met. A convenience sample of thirty family members of intensive care patients were interviewed. The continuing importance of primary needs established in previous studies was demonstrated. None of the needs were universally perceived as being fulfilled. The nurse was most often cited as the best person to meet needs. Many respondents couldn’t choose a single best person emphasizing the need for a multi disciplinary approach to meeting needs. Seven additional needs were identified (a) to know their right to question patient care, (b) to have a secure place to store belongings, (c) to have a place to sleep, (d) to have a member of the clergy available, (d) to be assured the patient is comfortable (e) to have a place for emotional outlets, and (f) to be assured patient confidentiality is maintained

    High resolution near-infrared imaging of submillimeter galaxies

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    We present F110W (~J) and F160W (~H) observations of ten submillimeter galaxies (SMGs) obtained with the Hubble Space Telescope's (HST's) NICMOS camera. Our targets have optical redshifts in the range 2.20<z<2.81 confirmed by millimeter CO or mid-IR spectroscopy, guaranteeing that the two bands sample the rest-frame optical with the Balmer break falling between them. Eight of ten are detected in both bands, while two are detected in F160W only. We study their F160W morphologies, applying a maximum-deblending detection algorithm to distinguish multiple- from single-component configurations, leading to reassessments for several objects. Based on our NICMOS imaging and/or previous dynamical evidence we identify five SMGs as multiple sources, which we interpret as merging systems. Additionally, we calculate morphological parameters asymmetry (A) and Gini coefficient (G); thanks to our sample's limited redshift range we recover the trend that multiple-component, merger-like morphologies are reflected in higher asymmetries. We analyze the stellar populations of nine objects with F110W/F160W photometry, using archival HST optical data when available. For multiple systems, we are able to model the individual components that build up an SMG. With the available data we cannot discriminate among star formation histories, but we constrain stellar masses and mass ratios for merger-like SMG systems, obtaining a mean log(M_*/M_sun)=10.9+/-0.2 for our full sample, with individual values log(M_*/M_sun)~9.6-11.8. The morphologies and mass ratios of the least and most massive systems match the predictions of the major-merger and cold accretion SMG formation scenarios, respectively, suggesting that both channels may have a role in the population's origin.Comment: 41 pages preprint, 3 figures, published in ApJ on 2013 May 1

    A Compact Starburst Core in the Dusty Lyman Break Galaxy Westphal-MD11

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    Using the IRAM Plateau de Bure Interferometer, we have searched for CO(3-2) emission from the dusty Lyman break galaxy Westphal-MD11 at z = 2.98. Our sensitive upper limit is surprisingly low relative to the system's 850 um flux density and implies a far-IR/CO luminosity ratio as elevated as those seen in local ultraluminous mergers. We conclude that the observed dust emission must originate in a compact structure radiating near its blackbody limit and that a relatively modest molecular gas reservoir must be fuelling an intense nuclear starburst (and/or deeply buried active nucleus) that may have been triggered by a major merger. In this regard, Westphal-MD11 contrasts strikingly with the lensed Lyman break galaxy MS1512-cB58, which is being observed apparently midway through an extended episode of more quiescent disk star formation.Comment: 5 pages, 1 figure (emulateapj), accepted by ApJ

    A brief cognitive behavioural intervention for regular amphetamine users. A treatment guide.

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    A brief intervention using motivational and cognitive behavioural approaches to help change drug use. Also offer alternative brief interventions for clients not suited to the current approach. This manual is divided into five sections: Section 1. Context • Key points from the National Drug Strategy Monograph No 51. Models of Intervention and Care for Psychostimulant Users are included to present the evidence supporting this type of intervention for regular amphetamine users. • A flow-chart to place the intervention in a treatment context. Section 2. Brief background to the study and summary of results of evaluation • A brief description of how the study was developed, undertaken and evaluated. • A brief description of the evaluation outcome data (detailed results will be published separately). Section 3. The intervention • The CBT intervention is presented in a clear and easy to use format for practitioners. Section 4. Suggested alternative brief interventions for those not suitable for the current intervention • This section provides an overview of recommendations for alternative interventions for psychostimulant users who are unsuitable for the CBT intervention (e.g. those who are not considering change, experimental users etc). Section 5. Other available resources • This section lists a range of other resources that are currently available for practitioners working with psychostimulant users. This treatment guide has not been designed to stand alone. Rather, practitioners are encouraged to: 1. Acquaint themselves with the current research and clinical literature. The recently completed monograph Models of Intervention and Care for Psychostimulant Users is an excellent resource for current evidence supporting practice in this area. 2. Undertake training in CBT and motivational enhancement techniques if unfamiliar with these approaches. 3. Obtain ongoing clinical supervision

    The Ursinus Weekly, January 19, 1959

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    Progoff addresses Forum; Discusses depth psychology • WSGA plans board for information and registration • Radio station receives campus approval • WSGA sets dates, elects chairmen; Plans activities • Junior class meeting • Negro student T. Y. Rogers is vesper speaker • Dr. Conyers Read talks to frosh hist. section • Bob Schmoyer tapped for \u2758 soccer honors • MSGA to review 1960 custom program • APO has formal initiation • Editorial: Jazz • Student opinion • Prof\u27s opinion • A criticism • Protest • Sports team in full swing after finals • Track team plans for 1959 season • Matmen whip Albright in thriller by 19 to 13 • Courtmen lose to Drexel, PMC; 8th loss in row • Bell\u27s speech at employees banquet • Art Alliance presents one-man showshttps://digitalcommons.ursinus.edu/weekly/1376/thumbnail.jp
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