Biomedical subjects

G Leonardson

Publications and source records attributed to G Leonardson.

10 recordsLinked to original sources

PubMed1994

Cultural factors associated with health-risk behavior among the Cheyenne River Sioux.

A field study was conducted to identify cultural factors--values, beliefs, and related characteristics--associated with health-risk behavior among adult members of the Cheyenne River Sioux Tribe. The Cultural Values Survey (CVS), an instrument for measuring cultural values and related characteristics, was developed and pilot tested in the study population. This instrument, along with the Health Risk Appraisal (HRA) (an instrument developed by the Centers for Disease Control to quantify major health-related behaviors), was administered to a random sample of 429 adults in the study community. Significant differences between females and males for both cultural characteristics and health-risk behaviors were found. Females had significantly higher HRA-calculated Health Index values than males, reflecting overall healthier behaviors. Females who scored higher on cultural factors consistent with more traditional Lakota Indian lifestyles (e.g., degree of Indian blood, Lakota language spoken in the home, traditional Lakota beliefs) had higher HRA Health Index values than females scoring lower in these characteristics. Males who scored higher in factors related to self-determination (e.g., hard work, personal control, industriousness, individual action) had higher Health Index values than those who scored lower in these areas. Further testing of the CVS instrument, as well as further research from both epidemiologic and social science perspectives is essential to elucidate the nature of the relationship between cultural factors and health-related behavior.

Adolescent↗

PubMed1992

Does prenatal care decrease the incidence and cost of neonatal intensive care admissions?

This study was conducted to examine the potential effects of expanded Medicaid coverage for low income women. Statewide birth data for 1983 to 1985 were examined to determine the relationship between prenatal care and admissions to neonatal intensive care units (NICUs) and the costs of this care. An NICU sample was constituted from infants who were discharged live following more than 7 NICU days, were referred to an out of state tertiary center, or died following NICU admission. Inadequate care (no prenatal care, only last trimester care, or less than five visits) was received by 11% of the total birth cohort and by 18% of the infants in the NICU sample (p less than 0.001). Infants with inadequate care had a NICU admission rate of 5.10% versus 2.86% for those with adequate prenatal care (p less than 0.001). The hospital billings for infants in the NICU sample with inadequate care were significantly higher than were those for infants with adequate care (p less than 0.05). Assuming that economic resources limit access to prenatal care, the projection can be made that had all women with inadequate prenatal care received Medicaid-covered adequate prenatal care, expenditure for this care would yield more than a two to one return in savings in NICU costs.

Adolescent↗

PubMed1992

The benefits of isoniazid chemoprophylaxis and risk factors for tuberculosis among Oglala Sioux Indians.

In a case-control study of 92 Indian patients, 46 with active tuberculosis (cases) and 46 tuberculin reactors without the disease (control subjects), significantly more control subjects than patients had prior adequate isoniazid chemoprophylaxis. While the Indian Health Service recommends treating all tuberculin reactors with isoniazid prophylaxis, most (75%) of our tuberculosis (TB) cases could have been prevented if the guidelines of the American Thoracic Society had been followed. Diabetes, alcohol abuse, and chronic renal failure were risk factors for active TB. Despite marked reductions in TB morbidity and mortality rates among American Indians and Alaska Natives over the past 30 years, their TB rates are still two to three times higher than overall United States and white rates. Enhanced TB control programs with an emphasis on preventive therapy for patients at risk for developing active disease, especially those with diabetes and chronic renal failure, could decrease the incidence and eventually eliminate TB among American Indians and Alaska Natives.

Adult↗

PubMed1986

Volume reduction of the uterus during and soon after hysterectomy.

Gynecologists observe perceptible and variable reduction from uterine size in vivo to subsequent size in the pathology laboratory. To measure this decrease in uterine size, the thickness, breadth, and height of the corpus were measured four times: as soon as the abdomen had been opened, as soon as the uterine arteries had been ligated, as soon as the uterus was removed, and after 45 minutes in fixative. The cervical diameter and length were measured two times as soon as the uterus was removed and after 45 minutes in fixative. Reduction in volume varies from 20% to 64% in different specimens. Reduction in volume is greatest in women who have uterine hypertrophy and hypermenorrhea. It is least in postmenopausal women who have atrophic uteri.

Adult↗

PubMed1985

Consistency of care in an intensive care nursery staffed by nurse clinicians.

Variables related to both the process and outcome of newborn intensive care were studied to evaluate care consistency in a level 3 Newborn Intensive Care Unit (NICU) where neonatal nurse clinicians function in a role usually held by pediatric house officers. In routine delivery of intensive care, there were no statistically significant diurnal variations in the overall mortality, maintenance of intravenous infusions, tolerance of oral feedings, or respiratory care except a decrease in frequency of blood gas sampling during the weekday days as compared with nights. Our data suggest that a tertiary NICU in which medical coverage by neonatologists is supplemented by carefully trained and supervised neonatal nurse clinicians provides a consistent level of care that does not vary between night and day or day of the week.

Blood Gas Analysis↗

PubMed1985

Factors predictive of physician location.

The results of a survey of 182 graduates from the University of South Dakota School of Medicine between 1969 and 1973 are reported and discussed. The study was designed to determine which factors are predictive of practice location. Individual factors found to be related significantly to physician location were size of community where the physician grew up, size of community where the physician's spouse was raised, size of the physician's high school graduating class, number of contacts with other physicians, importance to the physician of continuing medical education opportunities, importance to the physician of professional growth opportunities, and importance of the availability of medical facilities. In addition, a multiple regression procedure was used to determine the viability of a number of independent variables in predicting physician location. From a total of 29 independent variables obtained from the survey instrument, nine factors were found to contribute significantly to the overall prediction of practice location.

Humans↗

PubMed1984

Pregnancy complications in Sioux Indians.

The poor health status of Sioux Indians residing on reservations in South Dakota has been recognized for many years. The present report documents evidence of a high incidence of socioeconomic health-related disorders and pregnancy-related complications by comparing 342 pregnant white women and 405 pregnant Sioux Indian women. In collaboration with the Aberdeen Area Indian Health Service, beginning in 1976, a program was initiated to identify, assess risks, and provide patient management for pregnant Sioux Indians. This prenatal consultative program has proved effective in the reduction of fetal and infant mortality.

Adult↗

PubMedDate not supplied

Low national breast and cervical cancer-screening rates in American Indian and Alaska Native women with diabetes.

BACKGROUND: The cervical cancer mortality rate for American Indian and Alaska Native women is twice that of all races in the United States. To date the only published national breast and cervical cancer-screening rates for American Indian and Alaska Native women are based on self-reported data. When the Indian Health Service (IHS) conducts an annual audit on patients with diabetes, it includes cancer screening. This observational study presents national breast and cervical cancer-screening rates for American Indian and Alaska Native women with diabetes. METHODS: Cancer-screening rates were extracted from the 1995 diabetic audit for the 12 IHS areas. These rates were compared with rates for women without diabetes of the same age, 50 to 69 years, by chart review, at four IHS hospitals in the Aberdeen IHS area. RESULTS: Screening rates for women with diabetes in the 12 areas varied: mammogram (ever) 35% to 78%; clinical breast examination (last year) 28% to 70%, and Papanicolaou smear (last year) 26% to 69%. The Aberdeen IHS area women with diabetes had 51% more clinic visits per year than women without diabetes, but the groups had similar screening rates. CONCLUSION: Cancer-screening rates for American Indian and Alaska Native women vary by region. In the Aberdeen IHS area, women with diabetes had more visits (missed opportunities) but similar screening rates as women without diabetes. The diabetic audit could be used to monitor national IHS cancer-screening trends for women with diabetes and in the Aberdeen IHS area for all women aged 50 to 69 years.

Aged↗

PubMedDate not supplied

Rates of domestic violence against adult women by men partners.

This study examines the rate of domestic violence against adult women by men partners. Two hundred eighteen women at two primary care clinics responded anonymously to a questionnaire. Forty-eight percent reported verbal abuse, 44 percent minor physical abuse, and 28 percent severe physical abuse. Abuse was common (16 percent) before marriage. Respondents whose partners were reported to be chemically dependent or sexually abusive were at greater risk for verbal and physical abuse. Respondents with lower socioeconomic status were at increased risk for verbal and physical abuse, as were women whose partners had less formal education. Ages of respondents and partners were not significant factors in abuse. Boyfriends not cohabitating were the least abusive, while couples together for 4 to 6 years had more domestic violence than other couples. Because spouse abuse is common and the consequences are devastating, it is important that family physicians become astute in making this diagnosis and initiate early treatment.

Adult↗

PubMedDate not supplied

Cancer risk factors in three Sioux tribes. Use of the Indian-specific health risk appraisal for data collection and analysis.

Cancer mortality rates for Aberdeen Area Indians exceed U.S. rates with lung cancer being the leading cause of cancer death. The Sioux Cancer Study, an ancillary study of the Strong Heart Study, investigated cancer and cancer risk factors among tribal members aged 45-74 in three Sioux tribes in North and South Dakota. An Indian-specific health risk appraisal was used to collect data and provide specific recommendations to participants. The high rates of smoking (56% for men and 48% for women) explain the high lung cancer mortality rates. Intensive smoking cessation and prevention programs will likely have the greatest impact in reducing preventable cancer deaths. More accessible cervical and breast cancer screening provided by female health care providers is needed to reduce preventable cancer deaths among Sioux women. Pap smear screening is an especially high priority since cervical cancer mortality is 4.4 times higher than U.S. rates, all races. Programs targeted to reduce obesity and excessive alcohol use will also likely reduce preventable cancer deaths associated with high rates of obesity, diabetes and binge drinking. Community-based cancer prevention and control programs tailored to the cancer risk factor profile of the community are the best strategy to reduce preventable cancer deaths in Indian communities.

Aged↗