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Biomedical subjects

G Leonardson

Publications and source records attributed to G Leonardson.

8 recordsLinked to original sources

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

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

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

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

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

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

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

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