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PubMedDate not supplied

Citrobacter diversus at Grace Hospital, Detroit, Michigan.

Over a six-month period from December 1973 to June 1974, isolations of Citrobacter diversus were obtained from nine patients at Grace Hospital. Our initial experience was with a patient who developed pneumonitis and a massive fatal empyema due to this organism. Seven of the nine patients were 50 years of age. Three patients had an underlying malignancy. Four patients experienced significant clinical infections. Isolations in three patients were considered to be commensal, and two isolations were of indeterminate significance. Our Citrobacter diversus isolates, which can be confused with Escherichia coli, were uniformly resistant to ampicillin and carbenicillin and sensitive to the cephalosporins, tetracyclines, and gentamicin. These results agree with previous reports. Citrobacter diversus appears to be capable of causing serious clinical disease. Patients most at risk are elderly compromised hosts and infections are usually hospital acquired.

Adult↗
PubMed1993

Patterns of use of mammography among inner-city Detroit women: contrasts between a health department, HMO, and private hospital.

This study assessed the pattern of utilization of mammography among 2,880 inner-city minority women 40 years of age or older who received ongoing primary care services during 1988 or 1989 at four practice sites operated by a health department (two sites), Health Maintenance Organization (HMO), and private hospital. Mammography referral could be documented for 23% to 32% of age eligible women and completed mammograms for 15% to 26%. Among women without a mammogram, 85% had never been referred while 15% were referred but unable to complete the procedure. In multiple logistic regression analysis, factors associated with mammography include age less than 70 years, presence of a breast cancer risk factor and more frequent clinic visits. Mammography was somewhat more frequent at the HMO and hospital clinic than at the health department, but this relationship varied with the women's previous visit and mammography experience. At sites serving uninsured women, mammography use was not associated with the presence or absence of health insurance. It is concluded that the underutilization of mammography is a substantial barrier to the early detection of breast cancer in each of the three different health care organizations studied, and that interventions to improve breast cancer control should focus upon facilitating physician referral practices.

Adult↗
PubMed1979

Resentful and reflective coping with arbitrary authority and blood pressure: Detroit.

Two hypotheses about coping with an arbitrary authority, an angry boss, were tested: (1) styles of handling anger vary with social status, and (2) these styles are in turn related to blood pressure levels. Two styles of coping were tested: model R-R, Resentful vs. Reflective, and model I/O/R, Anger-In, Anger-Out, and Reflective. Handling an angry boss by Reflection is reported by more women than men, by those in middle-class areas rather than lower class, and does not vary by race. Working class report more use of Anger-Out than middle class who in turn report more use of Reflection. In general, the Anger-In response did not vary by race, sex, or area of residence (12-18%). For model R-R, Reflection of boss's anger was related to lower blood pressure when compared to Resentful responses, within sex, race, and residence groups. For model I/O/R, working-class, high stress persons who expressed Anger-Out showed the highest mean levels. Reflection is an appraisal response related to vascular and neural deceleration in stress experiments. This mode can be learned, and may aid in handling daily emotional-loaded stimuli to control blood pressure, along with learning a relaxation response.

Adaptation, Psychological↗
PubMed1998

Conducting a participatory community-based survey for a community health intervention on Detroit's east side.

This article describes a participatory action research process that brought together community members, representatives from community-based organizations and service providers, and academic researchers to collect, interpret, and apply community information to address issues related to the health of women and children in a geographically defined urban area. It describes the development and administration of a community-based survey designed to inform an intervention research project; discusses the establishment of a community/research partnership and issues that the partnership confronted in the process of developing and administering the survey; and examines the contributions of participants, and implications for research and collective action.

Adolescent↗
PubMed2003

Increased prevalence of G1P[4] genotype among children with rotavirus-associated gastroenteritis in metropolitan Detroit.

The G and P genotypes of rotavirus stool isolates from 100 children were determined by reverse transcription-PCR and nucleotide sequencing. G1P[4] was the most prevalent genotype(41%), followed by G1P[8] (16%) and G4P[4] (14%). The G genoypes detected were G1 (73%), G4 (17.4%), G9 (6.3%), and G2 (2.8%). The P genotypes were P[4] (71%) and P[8] (29%). Coinfection with more than one G genotype occurred in 12 patients, and coinfection with more than one P genotype occurred in 11 patients.

Child↗
PubMed1999

Previous exposure to trauma and PTSD effects of subsequent trauma: results from the Detroit Area Survey of Trauma.

OBJECTIVE: With the exception of a few reports of higher rates of childhood trauma in Vietnam veterans with posttraumatic stress disorder (PTSD), little is known about the influence of previous exposure to trauma on the PTSD effects of subsequent trauma. The authors examine interrelated questions about the effects of previous exposure to trauma. METHOD: A representative sample of 2,181 individuals in southeast Michigan were interviewed by telephone to record lifetime history of traumatic events specified in DSM-IV as potentially leading to PTSD. PTSD was assessed with respect to a randomly selected index trauma from the list of events reported by each respondent. RESULTS: History of any previous exposure to traumatic events was associated with a greater risk of PTSD from the index trauma. Multiple previous events had a stronger effect than a single previous event. The effect of previous assaultive violence persisted over time with little change. When they examined several features of the previous exposure to trauma, the authors found that subjects who experienced multiple events involving assaultive violence in childhood were more likely to experience PTSD from trauma in adulthood. Furthermore, previous events involving assaultive violence--single or multiple, in childhood or later on--were associated with a higher risk of PTSD in adulthood. CONCLUSIONS: Previous exposure to trauma signals a greater risk of PTSD from subsequent trauma. Although these results are consistent with a sensitization hypothesis, like the results from previous research on PTSD, they do not address the mechanism of increased responsivity to trauma. Long-term observational studies can further elucidate these observations.

Adolescent↗
PubMedDate not supplied

Integrating health care for women diagnosed with HIV infection, substance abuse, and mental illness in Detroit, Michigan.

This article describes the evolution of Personalized Nursing, a comprehensive nursing practice model of care. Findings from several nursing research studies contributed to the development of Personalized Nursing. The model includes a practice model of the art of nursing care based on nursing theory and a specific nursing process that directs nursing care delivery. The process of care delivery includes location of hard-to-reach clients; linkage to health care providers; integration of care among providers for clients diagnosed with HIV, mental illness, and substance abuse; and strategies to promote retention in health care. Use of Personalized Nursing is designed to assist clients to improve their well-being and increase positive health-related behaviors. Personalized Nursing has been used in urban landscapes to serve multiply diagnosed clients at risk for HIV infection. The model is currently being used in a study targeting multiply diagnosed women who are lost to follow-up from medical care.

Community Health Nursing↗
PubMed2002

Predictors of perceived control among African American women in Detroit: exploring empowerment as a multilevel construct.

Efforts to enhance empowerment toward the aim of improved health require an understanding of factors that contribute to perceived control at multiple levels, as a dimension of empowerment. In this article, the authors examine hypothesized predictors of perceived control at multiple levels among urban, African American women. Variables that predict perceived control include greater participation in change-related action; level of activity within respondents' most important organizations; and attempts made by those organizations to influence public officials, businesses, and other groups. Results suggest that (1) perceived control is a context-specific, multilevel construct; (2) citizen participation is an important factor in control and influence at multiple levels; and (3) organizations that are involved within neighborhoods and in the broader community can help to increase control and influence at multiple levels in marginalized communities. Implications for health education practice and research are discussed.

Adult↗