The intervention of lay health workers can be beneficial in increasing breast and cervical cancer screening among low-income Hispanic women, reports a new study.
Participants in this study were women 50 and older who were non-adherent to mammography or Pap test screening guidelines. Researchers developed an educational intervention ("Cultivando La Salud"/Cultivating Health), which was administered by lay health workers. After follow-ups, researchers found that screening completion was higher among women in the intervention group than in the control group for both mammography and Pap test screening.
The study's authors concluded, "Our study provided further evidence that the lay health worker model can increase breast and cervical cancer screening among low-income Hispanic women."
"Effectiveness of Cultivando La Salud: A Breast and Cervical Cancer Screening Promotion Program for Low-Income Hispanic Women"
The American Journal of Public Health is the monthly Journal of the American Public Health Association (APHA), the oldest and most diverse organization of public health professionals in the world. APHA is a leading publisher of books and periodicals promoting sound scientific standards, action programs and public policy to enhance health.
American Journal of Public Health
четверг, 28 июля 2011 г.
четверг, 21 июля 2011 г.
Kansas Gov. Parkinson Urged To Veto Removal Of Planned Parenthood Funding In Budget
Supporters of Planned Parenthood of Kansas and Mid-Missouri are urging Gov. Mark Parkinson (D) to veto a provision in a budget bill (H.B. 2373) that would eliminate the group's funding, the AP/Wichita Eagle reports. The bill aims to balance Kansas' budget for the fiscal year that begins July 1. The original bill was approved by the Legislature and former Gov. Kathleen Sebelius, who resigned in April to become HHS secretary. It included $250,000 in state funding for Planned Parenthood for FY 2010. However, lawmakers later amended the budget with a new bill that includes a provision eliminating the funding after state revenue projections declined, the AP/Eagle reports.
While antiabortion-rights advocates want Parkinson to retain the provision, about two dozen supporters of Planned Parenthood gathered on Tuesday to urge Parkinson to line-item veto the provision. They left petitions at the governor's office with about 3,500 signatures, the AP/Eagle reports. Planned Parenthood attorney Pedro Irigonegarary said the loss of funding would negatively impact "a large number of innocent people." He added that the group "is about family values. They have taken those two words from us and now it's time to take them back." According to the AP/Eagle, Planned Parenthood said the state funding is given to its Ellis and Sedgwick county clinics, which do not perform abortions. The group also noted that no state funds are used for abortion procedures performed at its clinics in Overland Park, a suburb of Kansas City.
The governor's office said that Parkinson intends to act on the bill sometime this week, although he will not announce what action he will take on any legislation in advance. Parkinson has said that he holds "very similar" views on abortion rights as Sebelius, who supports such rights. However, he has yet to act on any bills regarding abortion, the AP/Eagle reports. Mary Kay Culp, executive director of Kansans for Life, said that the group is asking members to contact legislators and the governor's office in support of retaining the measure. The AP/Eagle reports that if Parkinson vetoes the measure, lawmakers could attempt to override it (Manning, AP/Wichita Eagle, 5/19).
Reprinted with kind permission from nationalpartnership. You can view the entire Daily Women's Health Policy Report, search the archives, or sign up for email delivery here. The Daily Women's Health Policy Report is a free service of the National Partnership for Women & Families, published by The Advisory Board Company.
© 2009 The Advisory Board Company. All rights reserved.
While antiabortion-rights advocates want Parkinson to retain the provision, about two dozen supporters of Planned Parenthood gathered on Tuesday to urge Parkinson to line-item veto the provision. They left petitions at the governor's office with about 3,500 signatures, the AP/Eagle reports. Planned Parenthood attorney Pedro Irigonegarary said the loss of funding would negatively impact "a large number of innocent people." He added that the group "is about family values. They have taken those two words from us and now it's time to take them back." According to the AP/Eagle, Planned Parenthood said the state funding is given to its Ellis and Sedgwick county clinics, which do not perform abortions. The group also noted that no state funds are used for abortion procedures performed at its clinics in Overland Park, a suburb of Kansas City.
The governor's office said that Parkinson intends to act on the bill sometime this week, although he will not announce what action he will take on any legislation in advance. Parkinson has said that he holds "very similar" views on abortion rights as Sebelius, who supports such rights. However, he has yet to act on any bills regarding abortion, the AP/Eagle reports. Mary Kay Culp, executive director of Kansans for Life, said that the group is asking members to contact legislators and the governor's office in support of retaining the measure. The AP/Eagle reports that if Parkinson vetoes the measure, lawmakers could attempt to override it (Manning, AP/Wichita Eagle, 5/19).
Reprinted with kind permission from nationalpartnership. You can view the entire Daily Women's Health Policy Report, search the archives, or sign up for email delivery here. The Daily Women's Health Policy Report is a free service of the National Partnership for Women & Families, published by The Advisory Board Company.
© 2009 The Advisory Board Company. All rights reserved.
четверг, 14 июля 2011 г.
Mastectomy Patients Prefer Silicone To Saline Breast Implants
New research from the US found that women who have silicone implants following a mastectomy as a result of
breast cancer are more satisfied with their breasts than women who have saline implants; the researchers hope their findings will
help doctors and their breast cancer patients discuss options for reconstructive surgery following breast removal.
You can read about the study, led by Dr Colleen McCarthy, a reconstructive surgeon at the Memorial Sloan-Kettering Cancer
Center in New York, online in the 8 November issue of the journal Cancer.
In the US, there are two types of breast implants available for women who want to have them fitted after having their breasts
removed as a result of cancer treatment: saline (the implant is filled with salt water), and silicone (the implant is filled with
silicone gel).
While both types are approved by the US Food and Drug Administration (FDA), they remain under close surveillance, and in
considering options, doctors and patients need the best information available, not only about safety and efficacy, but also in terms of patient satisfaction and impact on quality of life, which is why McCarthy and colleagues carried out their study.
McCarthy told the press that:
"We now know that women who elect to proceed with the placement of a silicone implant report higher satisfaction with their
reconstructed breasts than those who choose saline implants."
She said they also found that "satisfaction with post-mastectomy implant-based reconstruction is generally high", and that other
factors like type of implant explain only a small amount of the variance they found.
"Patient counseling should reflect these realities in order to reassure patients that high satisfaction may be obtained with both
saline and silicone implants," she added.
For the study, McCarthy and colleagues sent BREAST-Q (Reconstruction Module) questionnaires to 672 women who had
received post-mastectomy reconstructive surgery with implants at one of three centers in North America.
The results showed that:
482 of the women completed questionnaires.
The 176 patients with silicone implants were significantly more satisfied with their reconstructed breasts than the 306 who
had received saline ones.
Patients who also had radiation therapy after a mastectomy were significantly less satisfied with their breasts, in both silicone
and saline groups.
Satisfaction in both groups diminished over time.
The researchers concluded that:
"In the setting of postmastectomy reconstruction, patients who received silicone breast implants reported significantly higher
satisfaction with the results of reconstruction than those who received saline implants."
They recommended that these findings be used to "optimize shared medical decision-making by providing patients with realistic
postoperative expectations".
"Patient satisfaction with postmastectomy breast reconstruction."
Colleen M. McCarthy, Anne F. Klassen, Stefan J. Cano, Amie Scott, Nancy VanLaeken, Peter A. Lennox, Amy K. Alderman,
Babak J. Mehrara, Joseph J. Disa, Peter G. Cordeiro and Andrea L. Pusic
Cancer,
Article first published online : 8 NOV 2010.
DOI: 10.1002/cncr.25552
Additional source: Wiley-Blackwell.
: Catharine Paddock, PhD
breast cancer are more satisfied with their breasts than women who have saline implants; the researchers hope their findings will
help doctors and their breast cancer patients discuss options for reconstructive surgery following breast removal.
You can read about the study, led by Dr Colleen McCarthy, a reconstructive surgeon at the Memorial Sloan-Kettering Cancer
Center in New York, online in the 8 November issue of the journal Cancer.
In the US, there are two types of breast implants available for women who want to have them fitted after having their breasts
removed as a result of cancer treatment: saline (the implant is filled with salt water), and silicone (the implant is filled with
silicone gel).
While both types are approved by the US Food and Drug Administration (FDA), they remain under close surveillance, and in
considering options, doctors and patients need the best information available, not only about safety and efficacy, but also in terms of patient satisfaction and impact on quality of life, which is why McCarthy and colleagues carried out their study.
McCarthy told the press that:
"We now know that women who elect to proceed with the placement of a silicone implant report higher satisfaction with their
reconstructed breasts than those who choose saline implants."
She said they also found that "satisfaction with post-mastectomy implant-based reconstruction is generally high", and that other
factors like type of implant explain only a small amount of the variance they found.
"Patient counseling should reflect these realities in order to reassure patients that high satisfaction may be obtained with both
saline and silicone implants," she added.
For the study, McCarthy and colleagues sent BREAST-Q (Reconstruction Module) questionnaires to 672 women who had
received post-mastectomy reconstructive surgery with implants at one of three centers in North America.
The results showed that:
482 of the women completed questionnaires.
The 176 patients with silicone implants were significantly more satisfied with their reconstructed breasts than the 306 who
had received saline ones.
Patients who also had radiation therapy after a mastectomy were significantly less satisfied with their breasts, in both silicone
and saline groups.
Satisfaction in both groups diminished over time.
The researchers concluded that:
"In the setting of postmastectomy reconstruction, patients who received silicone breast implants reported significantly higher
satisfaction with the results of reconstruction than those who received saline implants."
They recommended that these findings be used to "optimize shared medical decision-making by providing patients with realistic
postoperative expectations".
"Patient satisfaction with postmastectomy breast reconstruction."
Colleen M. McCarthy, Anne F. Klassen, Stefan J. Cano, Amie Scott, Nancy VanLaeken, Peter A. Lennox, Amy K. Alderman,
Babak J. Mehrara, Joseph J. Disa, Peter G. Cordeiro and Andrea L. Pusic
Cancer,
Article first published online : 8 NOV 2010.
DOI: 10.1002/cncr.25552
Additional source: Wiley-Blackwell.
: Catharine Paddock, PhD
четверг, 7 июля 2011 г.
Lack Of Control Over Work Hours Leads To Physician Burnout
A new national survey of physicians has found that a lack of control of their work hours and schedule often leads to burnout, while many other difficult issues that physicians face do not seem to diminish their career satisfaction.
Viewed against the backdrop of recent studies suggesting that dissatisfaction and burnout are on the rise among physicians, the results of this study by researchers at the University of Michigan Health System are particularly timely.
"The strongest predictors of whether physicians will experience burnout and career dissatisfaction are how much control they have over their schedules and over the total number of hours worked in a week," says Kristie Keeton, M.D., MPH, a fellow in maternal-fetal medicine at the U-M Medical School Department of Obstetrics and Gynecology.
"The good news is that I think career satisfaction among physicians can be improved if we work toward ways that physicians can have more control over their schedules and their work hours," continues Keeton, lead author of the study, which appears in the current issue of the journal Obstetrics & Gynecology.
Researchers began the study with a questionnaire sent to randomly selected physicians around the country, including internists, pediatricians, general surgeons, family practitioners and obstetrician-gynecologists. Results were based on the 935 completed surveys.
In general, the analysis of the results revealed that female and male physicians are highly satisfied with their careers. Both women and men reported moderate levels of satisfaction with work-life balance, moderate levels of emotional resilience and high levels of personal accomplishment.
Somewhat surprisingly to the researchers, the physicians' work-life balance does not predict their satisfaction with their careers that is, physicians can struggle with work-life balance and still remain highly satisfied with their careers. On the other hand, personal accomplishment and emotional resilience both were connected strongly with the level of the physicians' career satisfaction.
Control over one's schedule and the number of hours of work each week was tied to how the physicians felt about their personal accomplishment, emotional resilience and other factors that affect burnout and career satisfaction.
The results of the study occur at a time, Keeton notes, when the current generation of medical students, residents and junior faculty is believed to value time-off and a balanced life more than the "Boomer" generation tended to. Because of that, she says, this generation tends to be more interested in selecting specialties that allow for a controllable lifestyle.
The senior author of the paper was Rodney A. Hayward, M.D., professor in the Department of Internal Medicine at the U-M Medical School and the Department of Health Management and Policy at the U-M School of Public Health, and director of the VA Center for Practice Management and Outcomes Research. Other authors were Dee E. Fenner, M.D., professor in the Department of Obstetrics and Gynecology, and director of gynecology; and Timothy R.B. Johnson, M.D., chair of the Department of Obstetrics and Gynecology, and Bates Professor of the Diseases of Women and Children.
Funding for the research came from the Robert Wood Johnson Foundation, the Department of Veterans Affairs Health Services Research and Development Service, and the National Institute of Diabetes and Digestive and Kidney Diseases of the National Institutes of Health. This work represents the research and views of the authors and does not necessarily represent the views or positions of the funding organizations.
Reference: Obstetrics & Gynecology, April 2007, 109: 949-955.
University of Michigan Health System
2901 Hubbard St., Ste. 2400
Ann Arbor, MI 48109-2435
United States
med.umich.edu
Viewed against the backdrop of recent studies suggesting that dissatisfaction and burnout are on the rise among physicians, the results of this study by researchers at the University of Michigan Health System are particularly timely.
"The strongest predictors of whether physicians will experience burnout and career dissatisfaction are how much control they have over their schedules and over the total number of hours worked in a week," says Kristie Keeton, M.D., MPH, a fellow in maternal-fetal medicine at the U-M Medical School Department of Obstetrics and Gynecology.
"The good news is that I think career satisfaction among physicians can be improved if we work toward ways that physicians can have more control over their schedules and their work hours," continues Keeton, lead author of the study, which appears in the current issue of the journal Obstetrics & Gynecology.
Researchers began the study with a questionnaire sent to randomly selected physicians around the country, including internists, pediatricians, general surgeons, family practitioners and obstetrician-gynecologists. Results were based on the 935 completed surveys.
In general, the analysis of the results revealed that female and male physicians are highly satisfied with their careers. Both women and men reported moderate levels of satisfaction with work-life balance, moderate levels of emotional resilience and high levels of personal accomplishment.
Somewhat surprisingly to the researchers, the physicians' work-life balance does not predict their satisfaction with their careers that is, physicians can struggle with work-life balance and still remain highly satisfied with their careers. On the other hand, personal accomplishment and emotional resilience both were connected strongly with the level of the physicians' career satisfaction.
Control over one's schedule and the number of hours of work each week was tied to how the physicians felt about their personal accomplishment, emotional resilience and other factors that affect burnout and career satisfaction.
The results of the study occur at a time, Keeton notes, when the current generation of medical students, residents and junior faculty is believed to value time-off and a balanced life more than the "Boomer" generation tended to. Because of that, she says, this generation tends to be more interested in selecting specialties that allow for a controllable lifestyle.
The senior author of the paper was Rodney A. Hayward, M.D., professor in the Department of Internal Medicine at the U-M Medical School and the Department of Health Management and Policy at the U-M School of Public Health, and director of the VA Center for Practice Management and Outcomes Research. Other authors were Dee E. Fenner, M.D., professor in the Department of Obstetrics and Gynecology, and director of gynecology; and Timothy R.B. Johnson, M.D., chair of the Department of Obstetrics and Gynecology, and Bates Professor of the Diseases of Women and Children.
Funding for the research came from the Robert Wood Johnson Foundation, the Department of Veterans Affairs Health Services Research and Development Service, and the National Institute of Diabetes and Digestive and Kidney Diseases of the National Institutes of Health. This work represents the research and views of the authors and does not necessarily represent the views or positions of the funding organizations.
Reference: Obstetrics & Gynecology, April 2007, 109: 949-955.
University of Michigan Health System
2901 Hubbard St., Ste. 2400
Ann Arbor, MI 48109-2435
United States
med.umich.edu
Подписаться на:
Комментарии (Atom)