Biomedical subjects

Douglas R Smucker

Publications and source records attributed to Douglas R Smucker.

2 recordsLinked to original sources

PubMed2005

Partnering together? Relationships between faith-based community health centers and neighborhood congregations.

OBJECTIVE: The US Bureau of Primary Health Care has promoted collaboration between federally funded community health centers and neighborhood religious congregations, yet little is known about how such organizations currently interact in underserved neighborhoods. METHODS: Semistructured interviews were conducted with leaders from five faith-based, urban community health centers and 23 neighborhood congregations. Transcripts were coded for prevalent concepts and themes regarding collaborations between the two types of organizations. RESULTS: Collaborations between health centers and congregations are generally limited to modest sharing of resources and personnel and intermittent health promotion programs. Leaders of both types of organizations desire greater collaboration, but such desires appear to be frustrated by inadequate resources and differing priorities, visions, and philosophies. CONCLUSIONS: Increased collaboration between community health centers and neighborhood congregations will require efforts to overcome organizational differences, intercongregational tensions, and resource limitations. For the participants, comprehensive "faith partnerships" remain a desirable but elusive goal.

Attitude of Health Personnel↗

PubMed2002

Lymphadenopathy and malignancy.

The majority of patients presenting with peripheral lymphadenopathy have easily identifiable causes that are benign or self-limited. Among primary care patients presenting with lymphadenopathy, the prevalence of malignancy has been estimated to be as low as 1.1 percent. The critical challenge for the primary care physician is to identify which cases are secondary to malignancies or other serious conditions. Key risk factors for malignancy include older age, firm, fixed nodal character, duration of greater than two weeks, and supraclavicular location. Knowledge of these risk factors is critical to determining the management of unexplained lymphadenopathy. In addition, a complete exposure history, review of associated symptoms, and a thorough regional examination help determine whether lymphadenopathy is of benign or malignant origin. Unexplained lymphadenopathy without signs or symptoms of serious disease or malignancy can be observed for one month, after which specific testing or biopsy should be performed. While modern hematopathologic technologies have improved the diagnostic yields of fine-needle aspiration, excisional biopsy remains the initial diagnostic procedure of choice. The overall evaluation of lymphadenopathy, with a focus on findings suggestive of malignancy, as well as an approach to the patient with unexplained lymphadenopathy, will be reviewed.

Biopsy↗