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Biomedical subjects

D Campos-Outcalt

Publications and source records attributed to D Campos-Outcalt.

48 records · Page 3Linked to original sources
PubMedDate not supplied

Prevalence of sexually transmitted diseases in Mexican-American pregnant women by country of birth and length of time in the United States.

BACKGROUND AND OBJECTIVES: The prevalence of sexually transmitted diseases in Hispanic prenatal patients has not been well documented. Studies of disease prevalence in Hispanic patients often are complicated by multiple countries of origin and the combining of foreign-born and U.S.-born Hispanics into a single category. GOAL OF THE STUDY: The purpose of this study was to document the prevalences of sexually transmitted diseases in low-income, pregnant Mexican-American women and to compare the prevalences of those born in the United States with those born in Mexico. We also compared the prevalence of those who recently arrived from Mexico with those who had been in the United States a longer time. STUDY DESIGN: Three-hundred-forty-seven pregnant women attending a clinic for low-income populations were screened for syphilis, gonorrhea, chlamydia, and hepatitis B virus on their first perinatal visit. RESULTS: Thirty-five women (10.1%) were positive for chlamydia, four (1.2%) for gonorrhea, one (0.3%) for syphilis, and none for hepatitis B virus. Women born in Mexico reported fewer past chlamydia and total sexually transmitted disease infections than Mexican-Americans and non-Hispanic whites born in the United States However, the prevalence of chlamydia and total sexually transmitted diseases did not differ by ethnicity, country of birth, or length of time in the United States The only variable correlated with chlamydia infection was the presence of vaginal discharge, but the sensitivity of this symptom was too low to be clinically useful as a means of selective screening. CONCLUSION: Low-income women of Mexican ancestry should be routinely screened for syphilis, gonorrhea, and chlamydia as part of their prenatal care in the United States. The value of hepatitis B virus screening in this population was neither supported nor refuted by this study.

Adult↗
PubMedDate not supplied

Family medicine research funding.

BACKGROUND AND OBJECTIVES: While the specialty of family practice has achieved parity with other specialties in many areas, it lags behind in research productivity. This article explores current and historical funding levels of family medicine research from the National Institutes of Health (NIH) and the Agency for Health Care Policy and Research (AHCPR). METHODS: Funding amounts from NIH to medical schools and family medicine departments were obtained for the years 1984-1997. Funding amounts from AHCPR awarded to family physicians and the total AHCPR research budget were obtained for 1991-1995. RESULTS: In 1997, family medicine departments were awarded $18.6 million from the NIH, .4% of the NIH research awards. The amount from NIH has increased progressively since 1984, but the proportion of the total NIH budget has increased only marginally (from .3% to .4%). In 1995, family medicine researchers obtained $6.7 million from AHCPR, 4.0% of the AHCPR research budget. Since 1991, this amount has increased slightly, but as a proportion of the AHCPR budget, it has declined (from 4.4% to 4.0%). DISCUSSION: The NIH is an increasingly important source of support for family medicine researchers, while AHCPR support has plateaued. Even though NIH support of family physician researchers is increasing, the proportion of NIH funding awarded to family medicine departments remains below the proportion of US medical school faculty who are family physicians. One possible cause of this discrepancy is a lack of a locus of primary care and family medicine research funding.

Family Practice↗
PubMedDate not supplied

Medical school financial support, faculty composition, and selection of family practice by medical students.

OBJECTIVE: This study examines the relationship between the choice of family practice by medical students in the 1986-1987 academic year and nine variables: ownership of school, weeks of required family medicine clinical training, age of school, and six variables related to medical school financial support and faculty composition. METHODS: In multivariate analysis, three variables were found to be significantly related to choice of family practice (R2 = .441): weeks of required family medicine clinical training, proportion of faculty in family practice, and ownership of the school. A cluster analysis was performed using nine variables. RESULTS: Along with the multivariate analysis, the resulting nine clusters demonstrate that additional variables need to be identified to explain the variance in percentage of students choosing family practice at different schools.

Career Choice↗
PubMedDate not supplied

Family practice specialty selection: a research agenda.

This article examines the declining interest in family practice by US medical students and trends in specialty selection over the past decade. Four factors affecting specialty choice (medical student characteristics, medical school, residencies, and certain aspects of the health care system) are discussed, and a research agenda is developed for each area. Researchers and funding agencies are urged to begin an exploration of these issues to better understand the dynamics behind current specialty choices so that successful policies to increase the number of students entering family practice can be developed.

Career Choice↗
PubMedDate not supplied

Reporting of communicable diseases by university physicians.

Billing records from the outpatient clinics of the University of Arizona were compared to case reports of communicable diseases received by the local health department. Of 286 cases of reportable diseases found, 183 (64 percent) were reported to the local health department. Sexually transmitted diseases were more likely to be reported than other diseases [risk ratio (RR) = 1.97; 95 percent confidence interval (CI), 1.62-2.39]. Diseases of residents of Pima County were more likely to be reported than those of residents of other Arizona counties (RR = 1.40; 95 percent CI, 1.11-1.77), and diseases in Arizona residents were more likely to be reported than those of residents of other States (RR = 2.37; 95 percent CI, 1.35-4.15). Diseases of citizens of other countries were never reported. The only significant difference found among the specialty clinics of the medical center was that pediatricians reported less frequently than others (RR = 0.75; 95 percent CI, 0.58-0.98).

Ambulatory Care Facilities↗
PubMedDate not supplied

Cardiovascular disease risk factors in native Americans: a literature review.

Cardiovascular disease (CVD) has become the leading cause of death for Native Americans and Alaska Natives. CVD risk factors (diabetes, hypertension, obesity, hypercholesterolemia, smoking, and sedentary lifestyle) have been studied in a number of Native American tribes, and such studies are increasing as the CVD mortality rate rises. This article reviews the literature between 1980 and 1991 concerning the prevalence of CVD risk factors in this population. In addition to summarizing the data, we describe limitations inherent in comparison and address the need for standardization of methodology in future studies.

Adult↗
PubMedDate not supplied

Mammography and Pap smear screening of Yaqui Indian women.

The Pascua-Yaqui Tribe of Arizona receives its health care services at a local neighborhood health center in Tucson and a satellite clinic located on the reservation. Using a computerized data base from the health center, the authors determined the use rates by Pascua-Yaqui women ages 35-65 of the Papanicolaou smear and mammography screening. Among active users of the health center, 31-36 percent had received a Papanicolaou smear, according to the yearly data bases examined from 1986 to 1990, while 65 percent of the women had received at least one smear test over the entire 5-year period. Regarding mammography screening, 41-43 percent of the women ages 50-65 had received a mammogram in the years studied, and 51-58 percent of the women ages 40-49 had been screened. In all, 67 percent had received at least one mammogram during the 1988-90 period when the center offered mammography. This population of 35-65-year-old American Indian women, for whom financial access is not a barrier, were receiving Papanicolaou smears and mammograms at rates comparable with other segments of the U.S. population but at lower rates than those recommended by the American Cancer Society and National Cancer Institute. The challenge for the health center is to reach those women who are eligible for services but do not use them and to address the nonfinancial barriers to care such as language, transportation, and gender-specific issues.

Adult↗
PubMedDate not supplied

Prevalence of cardiovascular disease risk factors in a southwestern Native American tribe.

A cross-sectional study was conducted among the Pascua Yaqui Indian tribe in Tucson, AZ, in 1990 to document the prevalence of cardiovascular disease risk factors. Cardiovascular disease is the leading cause of mortality for Native Americans and for members of the Pascua Yaqui tribe specifically. A total of 230 randomly selected adults, ages 25-65 years, who were listed as members on the tribal roll, participated, resulting in a 73-percent participation rate for those contacted. The five risk factors studied included diabetes, hypertension, hypercholesterolemia, obesity, and smoking. Only 14 percent of participants had none of the risk factors; 52 percent had two or more factors. Obesity was the most prevalent, being present in 69 percent of the women and 40 percent of the men, followed by diabetes, 35 percent of men and 39 percent of women. Twenty-six percent of the population had hypertension, and 43 percent of men were smokers, compared with 24 percent of women. Hypercholesterolemia was present in 19 percent of men and 14 percent of women. The rates of diabetes, obesity, hypertension, and smoking documented in this tribe are relatively high and can serve as a baseline for evaluating future prevention efforts.

Adult↗
PubMedDate not supplied

Accuracy of Pap smear and mammogram self-reports in a southwestern Native American tribe.

The use of Pap smears and mammograms in the Native American population is not well documented and the validity of women's self-reports is unknown. The purpose of this study was to examine the agreement between women's self-reports of their Pap smear and mammogram histories with their medical records in one Native American tribe. Two hundred fifty-one women between the ages of 35 and 65 answered questions regarding their Pap smear and mammogram histories. These women then underwent an education program and one year later they again answered questions about their Pap smear and mammogram histories. Two hundred four of the original 251 women completed the education program and the second questionnaire. On the first questionnaire, 51.0% of women's claims to have received a Pap smear within the past 12 months were verified by the record audit and 69.2% of claims of receiving a mammogram within the past 12 months were verified. On the second questionnaire, 46.7% of women who said they had received a Pap smear within the past 12 months had their claims verified by their records, and 45.2% of women's claims of receiving a mammogram within the past 12 months were verified. These results suggest that patient recall alone should not be used to determine date of last procedure.

Adult↗
PubMedDate not supplied

Incidence of infectious disease and the licensure of immunobiologics in the United States.

INTRODUCTION: Our objective was to investigate the relationship of vaccine or toxoid licensure with the incidence of the target disease in the United States. METHODS: We used a historical correlational study design with outcome measures of the national incidence and elimination rate of polio, pertussis, diphtheria, and measles as well as the New York City incidence and elimination rate of mumps, rubella, and tetanus. RESULTS: The licensure of pertussis, measles, polio, mumps, and rubella vaccine was followed by an increase in the elimination rate of disease. The elimination rates of diphtheria and tetanus apparently worsened following the licensure of the respective toxoids. CONCLUSIONS: Historical data provide evidence of proof of efficacy of mass immunization for measles, polio, rubella, mumps, and pertussis, but not for diphtheria or tetanus.

Communicable Disease Control↗
PubMedDate not supplied

A hypothetical model of the effect of medical education on specialty choice.

BACKGROUND AND OBJECTIVES: Using the Theory of Reasoned Action, we propose a model that diagrams medical school characteristics known or hypothesized to influence the process of specialty choice. The medical school characteristics we consider are administrative support, special programs, primary care funding, number and quality of primary care faculty, faculty influence, primary care residencies, committee representation, primary care environment, required time, and student contact. This model provides explicit hypotheses to be tested in future research on specialty choice.

Career Choice↗