Browsing by Subject "patients"
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Item A Six-Year Analysis of the Distribution of Time to Death Among Colorectal Cancer Patients in the State of Texas(2000-05-01) Williams, Vanessa P.; Rene, Antonio A.; Fairchild, Thomas J.; Blakley, SallyWilliams, Vanessa P., A Six-Year Analysis of the Distribution of Time to Death Among Colorectal Cancer Patients in the State of Texas. Master of Public Health (Epidemiology), May 2000, 55 pp., 11 tables, 9 figures, references, 52 titles. The cancer experience of Texans differs substantially by race/ethnicity. Among Caucasian, African American, and Hispanic men and women, colon cancer is either the second or third leading type of cancers among Texans. The distribution of time to death over a six-year period were assessed from a cohort of African American, Hispanic, and Caucasian men and women diagnosed with colon cancer in 1992. The purpose of this study is to determine if there is a difference in the overall death time distribution and tumor histology among African Americans, Hispanics, and Caucasian men and women who were diagnosed with colon cancer in 1992 in the state of Texas. Analysis results indicated that Hispanic females (65.59%) and Caucasian males (65.52%) had higher survival times among the race/ethnic groups. African American males (53.85%) and females (56.40%) experienced lower survival time for the cohort. For overall distribution of time to death among deceased subjects, African American males and Hispanic females experienced the lowest distribution times among the subjects. The overall distribution of time to death for all histology types were the same for each type.Item Demographics of a University Based Geratric Medicine House Call Program(1999-05-01) Dunn, Leslie K.There has been a steady decline in the frequency of house calls by physicians during the 20th century. The reasons most commonly given for not making house calls are time constraints and poor reimbursements for the amount of time spent (1). Unlike younger age groups, those 65 and older tend to have physical limitations that prohibit routine visits to clinics (2). In a university based geriatric practice, there is a subgroup of individuals who are unable to access health care or see a physician without considerable expense and effort via ambulance transportation services. Without a physician house call visit, these older adults would not have routine access to health care (3). The Gerontology Assessment and Planning Program (GAP) at the University of North Texas Health Science Center at Fort Worth (UNTHSC) is involved in providing a physician directed house call program. By 2030, it is estimated that the older adults will comprise 25% of the total population (4). Encouraging independent living supported by community-based services will result in a greater number of homebound older adults requiring house calls by physicians (5). The challenge is to determine those likely to require house call services and the medical conditions and physical disabilities leading to the need for in home services. To understand the conditions and needs of these geriatric patients, a retrospective chart review was conducted. The study reviewed the demographic characteristics of the patients seen through the house call program, prevalent sources of referrals, health assessment at the point of admission into the house call program, profile of primary care givers and factors in the decision making process that physicians used to place patients on the service. Outcome data are presented including hospital admissions and deaths while on the house call program.Item Hormone Replacement Therapy: Investigating Language Barriers(2002-04-26) Gamber, Mark A.; Marshall, Muriel; Ramirez, Gilbert; Knebl, JaniceHormone Replacement Therapy: Investigating Language Barriers. Mark Gamber, BA, BS; Muriel Marhsall, DO, DrPH; Gilbert Ramirez, DrPH, Janice Knebl, DO; Karen Godwin, PhD; Hector Balzacar, PhD; Craig Whiting, DO. Objective: To investigate the relationship between the language spoken (Spanish or English) by the Hispanic patient when talking to their doctor and the patient’s use of HRT. Design: Retrospective chart review. Setting: Northside Family Practice clinic, UNTHSC in Ft. Worth, Texas. 102 postmenopausal Hispanic women. Measurement: HRT use, Spanish or English speaking, natural or surgical menopause. Results: A total of 102 postmenopausal Hispanic females met the inclusion criteria for chart review. The mean age of English speakers is 66.7 years old. The mean age of the Spanish speakers is 64.93 years old. 54% (55) spoke Spanish at their clinic visit and 46% (47) spoke English. Of the 55 Spanish speakers, 36% had at some point used HRT while 64% had never used HRT. Of the 47 English speakers, 49% had at some point used HRT while 51% had never used HRT. There is not a significant difference (p=0.20) when comparing language spoken by the patient at the clinic visit and whether they are prescribed HRT. Conclusion: While a significant difference was not found between the two groups, a greater percentage of English speaker (48%) than Spanish speaking (36%) Hispanic females are prescribed HRT in this study. In fact, when adjusted for age, English speakers were 1.88 times more likely to have used HRT than Spanish speakers. Based on the apparent need to bridge the language barrier between physicians and patients over issues important as menopause and HRT, more research is needed in this area. Key Words: Hormone Replacement Therapy, Hispanic, Women. University of North Texas Health Science Center; Ft. Worth, Texas (MG, MM, GR, JK, KG, HB, CW) Address correspondence and reprint requests to Mark Gamber c/o Dr. Muriel Marshall, University of North Texas Health Science Center; 3500 Camp Bowie Blvd; Fort Worth, Texas 76107. 817-735-2440; 817-735-2137 (fax). mgamber@hotmail.com. Word Count: 1311. Number of Tables: 1. Number of References: 16. Date of Submittal: 4/26/02.Item Implementation of a Pain Management Protocol in Abdominal Surgery Patients Involving an Investigational Fentanyl Patient-Controlled Transdermal System--Issues Involving Patient Enrollment(2005-05-01) Hiraki, Stephanie J.; Harold Sheedlo; Don Peska; John AschenbrennerHiraki, Stephanie J., Implementation of a Pain Management Protocol in Abdominal Surgery Patients Involving an Investigational Fentanyl Patient-Controlled Transdermal System-Issues Involving Patient Enrollment. Master of Science (Clinical Research Management), May 2005, 112 pp., 2 tables, 6 illustrations, bibliography, 42 titles. An open label, randomized, comparative, parallel, phase III multicenter study will be the main focus in the surgery department at the University of North Texas Health Science Center Patient Care Center. The study will evaluate the safety and efficacy of the fentanyl patient-controlled transdermal system (PCTS) versus an intravenous patient controlled anesthesia morphine pump (PCA pump) for abdominal surgery postoperative pain management. Patient enrollment is essential. Slow patient enrollment in clinical trials will lead to a delay in the sponsor’s submission of the investigational product for review and approval from the FDA. The barriers and facilitators to the accrual and retention of patients in this study will be covered.Item Interpreter Narratives: End-Of-Life Conversations in a Pediatric Hospital(2007-10-01) Warren, Corinne Neitzke; Lurie, SueWarren, Corinne Neitzke., Interpreter Narratives: End-of-Life Conversations in a Pediatric Hospital. Master of Public Health (Health Interpreting and Health Applied Linguistics), October 2007, 162 pp., bibliography, 74 titles. Aspects of communication between caregivers and patients/families are noted consistently in the literature as important to perceptions of quality of care at the end of life (EOL). Healthcare interpreters, along with providers, can be “deliverers of bad news.” EOL encounters create challenging and unique role and performance demands for interpreters; as active participants in these conversations, interpreters intervene in various ways that impact the communication process. While they may view providers as having the central role in an encounter, aspects of their performance suggest the pivotal nature of their own participation. This exploratory, qualitative research aimed to understand and represent interpreters’ perceptions of the EOL communication they facilitate when providers and pediatric patients and families don’t share language or culture. Their perspectives were revealed in their stories of EOL encounters, as they recounted personal reactions to specific circumstances and conversation exchanges as well as how they handled interpretation in particular situations.Item Predictors of In-Hospital Mortality Among Acute Myocardial Infarction Patients in a Large Health Care System(2001-07-01) Zhang, Huiling; Singh, Karan; Rene, Antonio; Blakley, SallyZhang, Huiling. Predictors of In-hospital Mortality Among Acute Myocardial Infarction Patients in a Large Health Care System. Master of Public Health, July 2000, 29 pp., 4 tables, 29 references. Background---There is increasing interest in the identification of risk predictors for in-hospital mortality due to acute myocardial infarction (AMI). To date, there has been no AMI in-hospital mortality prediction models developed using clinical database. Methods and Results---The study population consists of 4,167 AMI cases admitted to 36 hospitals in 3 states. Thirty variables were selected as candidate predictors, and 19 showed significant bivariate association with AMI in-hospital mortality. By applying multiple logistic regression and stepwise selection, 10 variables were selected for inclusion in the final prediction model: age, arrive from cardiac rehabilitation center, CPR on arrival, Killip class, AMI with comorbidities, AMI with complications, PCTA performed, beta-blockers given, ACE inhibitors given, Plavix given. Conclusion---A ten-variable in-hospital mortality prediction model for AMI patients, which includes both risk factors and beneficial treatment procedures, was developed. Chi-square goodness of fit test suggested a very good fit for the model.