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Biomedical subjects

E Butts

Publications and source records attributed to E Butts.

9 recordsLinked to original sources

Predictive value of prior Rose angina for myocardial infarction confirmation after emergency admissions.

The Rose Questionnaire, developed to facilitate screening for the presence of coronary artery disease, has shown good utility for white men and more variable utility among Latino, African-American, and female subjects. This study investigated its utility for prediction of outcome in patients with suspected myocardial infarction. A total of 1428 white, Latino, and African-American subjects completed questionnaires after emergency admission, which were correlated with diagnoses at the time of discharge from a public hospital and private hospital. Results indicated that subjects with positive questionnaires were less likely to have infarction confirmed at discharge, except for those with a prior history of myocardial infarction, than those with a negative response. These data are important in evaluating the overall utility of the Rose Questionnaire and the significance of angina.

Black or African American↗

Benefits of a multidisciplinary predialysis program in maintaining employment among patients on home dialysis.

We evaluated the benefits of a multidisciplinary predialysis intervention to help home dialysis patients maintain employment. This program was shown to be successful with in-center hemodialysis patients in a case-controlled study published in the American Journal of Kidney Disease in September, 1993. We looked at 30 patients on home dialysis (28 on continuous ambulatory peritoneal dialysis and 2 on home hemodialysis) as of March, 1995. The age of the patients ranged from 28 to 63 years, with a mean of 46.8 years. Forty-three percent of the patients were diabetic. The patients went through a multidisciplinary predialysis program which consisted of: (1) psychosocial assessment, (2) education about dialysis and choice of modalities, (3) orientation to dialysis unit, and (4) counseling sessions with patient, significant family members, and others. During this time, patients were referred to the program approximately six months before beginning dialysis. There was continued collaboration among members of the multidisciplinary team. Of the 30 patients, 11 were already disabled when beginning dialysis. Of the 19 who were working once dialysis began, 14 maintained employment (3 diabetic), with 1 retiring and 4 becoming disabled. Therefore, 74% of patients maintained employment. In conclusion, employment was maintained by this predialysis multidisciplinary program.

Adult↗

Differential perceptions, behaviors, and motivations among African Americans, Latinos, and whites suspected of heart attacks in two hospital populations.

To evaluate the hypothesis that socioeconomic status would exert greater influence on patients' care-seeking behavior than racial/ethnic group status, we undertook a sequential study of African-American, Latino, and white patients hospitalized for acute chest pain from August 1988 through July 1990 at two sites. The study took place in an urban public medical center and an urban private health maintenance organization medical center, which provide care to mixed racial/ethnic groups of lower and middle socioeconomic status, respectively, in Los Angeles. Three concurrent case series of African-American, Latino, and white patients hospitalized for acute chest pain were recruited. The racial/ethnic distribution of the total group was African Americans, 448; Latinos, 487; and whites, 499. The main outcome measure was the length of time patients spent in deciding to seek emergency medical care for acute chest pain and the associated perceptions, behaviors, and motivations involved in deciding to seek care. For the total group, public hospital site and lack of health insurance were the strongest significant predictors of a longer decision phase, whereas differential symptom perceptions, consultation with medical professionals, and use of paramedic transport were significant predictors of shorter duration. Multiple regression results were similar in separate analyses demonstrated significant differences in patients' perceptions of symptom intensity and incapacitation within racial/ethnic groups related to socioeconomic status, as well as in specific behavior and motivation in seeking care. The study concluded that socioeconomic status as determined by hospital site exerted a stronger influence on patients' care-seeking behavior for acute chest pain than racial/ethnic status. Specific care-seeking behaviors of minority and lower-socioeconomic-status patients in the use of medications and paramedics in the face of acute symptoms should be targeted in future educational programs.

Adult↗

An intervention for employment maintenance among blue-collar workers with end-stage renal disease.

An evaluation study was conducted to test the benefit of a predialysis intervention in assisting blue-collar workers with end-stage renal disease (ESRD) to maintain employment. Patients with ESRD were recruited from a large southern California health maintenance organization. In a nonrandomized control trial, employment status among 45 ESRD patients who received a predialysis orientation program followed by in-center dialysis was compared with that of 57 ESRD patients dialyzed at community centers not providing predialysis intervention. Participants had a mean age of 50 years. Sixty-two percent of participants were men and 38% were women. The sample was predominantly Afro-American (35.8%), Hispanic (28.9%), and white (24%). Employment status was assessed prior to dialysis and at least 6 months after beginning maintenance dialysis treatments. The intervention consisted of physician referral to a licensed clinical social worker prior to the initiation of in-center maintenance dialysis treatments, social worker assessment, patient education and counseling, orientation to the dialysis unit, and follow-up care from physicians, licensed clinical social workers, and other team members. A significantly higher proportion of blue-collar workers who received the intervention continued working after beginning dialysis (46.7%) when contrasted with control group blue-collar workers who did not receive the early intervention (23.5%) (chi-squared text = 3.78, P < 0.05). Odds ratio calculations showed that blue-collar workers who received the intervention were 2.8 times more likely to continue working than control group blue-collar workers. The effectiveness of the intervention highlights the importance of early psychosocial intervention in assisting in-center hemodialysis patients in maintaining employment.

Adult↗

FP/MIS: a management information system for a community family planning clinic.

The management information system (FP/MIS) used by the Howard University Center for Family Planning Services, which operates community family planning clinics in Washington, D.C. is described. The system was developed to satisfy program objectives in patient management, program planning and evaluation, resource management, federal reporting systems and clinical, epidemiological and health services research. The data collection forms used in the system and the output from the four data display groups--patient profile, resource management, quality of care and epidemiology-are described along with examples of their use.

Computers↗