Biomedical subjects

Kyndaron Reinier

Publications and source records attributed to Kyndaron Reinier.

8 recordsLinked to original sources

PubMed2006

Incidence of sudden cardiac arrest is higher in areas of low socioeconomic status: a prospective two year study in a large United States community.

BACKGROUND: A potential effect of socioeconomic status on occurrence of sudden cardiac arrest in the community is likely, but has not been evaluated fully. METHODS: All cases of sudden cardiac arrest in Multnomah County Oregon (population 660,486; February 2002-January 2004) were identified prospectively and categorized by census tract based on the address of residence and specific geographic location of occurrence of cardiac arrest. Each census tract was assigned to quartiles of median income, poverty level, median home value, and educational attainment. RESULTS: Of 714 cases (annual incidence 54 per 100,000), 697 (98%) had residential addresses that matched a county census tract successfully. For each socioeconomic status measure, the incidence of cardiac arrest was 30-80% higher in the lowest compared to the highest socioeconomic status census tracts. Annual incidence in census tracts in the lowest compared to the highest quartiles of median home value was 60.5 versus 35.1 per 100,000 (RR 1.7, 95% CI 1.4-2.2). This gradient was exaggerated significantly for age<65 years (34.5 versus 15.1 per 100,000, RR 2.3, 95% CI 1.6-3.3). Identical trends were observed for sudden cardiac arrest based on location, with 60% of all cases and 66% of cases age<65 years occurring in the two quartiles with lowest socioeconomic status. CONCLUSIONS: Low neighborhood socioeconomic status was associated with a significantly higher incidence of sudden cardiac arrest based on address of residence as well as location of cardiac arrest. For effective deployment of strategies for community-based prevention such as the automated external defibrillator, neighborhood socioeconomic status is likely to be an important consideration.

Adult↗

PubMed2005

Does extended proactive telephone support increase smoking cessation among low-income women using nicotine patches?

BACKGROUND: It is unclear whether proactive telephone support enhances smoking cessation beyond the provision of nicotine replacement therapy alone. METHODS: We randomly assigned 330 low-income women smokers to receive either free nicotine patches (control condition) or free nicotine patches with up to 16 weeks of proactive telephone support (experimental condition). All participants were assessed by telephone at baseline and at 2 weeks, 3 months, and 6 months post-baseline to determine smoking status. RESULTS: Results revealed a significant effect for the telephone support at 3 months, with 43% of experimental versus 26% of control condition women reporting 30-day point prevalent abstinence (P = 0.002). The difference was no longer significant at 6 months. A metaanalysis conducted with five randomized studies revealed a slight but non-significant long-term benefit of proactive telephone support when added to the provision of free nicotine patches for smoking cessation. CONCLUSIONS: This is the second study to demonstrate a short-term effect for proactive telephone support added to free nicotine replacement therapy; however, neither the current study, nor the metaanalysis including the four other published trials, confirmed a longer-term benefit.

Administration, Cutaneous↗

PubMed2005

Education as a determinant of career retention and job satisfaction among registered nurses.

PURPOSE: To compare job satisfaction and career retention in two cohorts of RNs, those whose highest degrees were the associate degree (AD) or the bachelor's degree (BS) in nursing. DESIGN: Survey. METHODS: Instruments included a career satisfaction scale and questions based on the ongoing U.S. Health and Retirement Survey. Three-thousand nurses in the U.S. state of Vermont were surveyed with a resulting response rate of 56.7%. Of these respondents, 878 RNs fit the study criteria. FINDINGS: BS RNs started their nursing careers earlier, were employed longer, had held more positions, and in the largest age cohort (age 40-54), were more likely to have been in their current positions at least 10 years. BS RNs scored significantly higher in job satisfaction related to: (a) opportunity for autonomy and growth, (b) job stress and physical demands, and (c) job and organizational security. AD and BS nurses were not significantly different in their satisfaction with supervision; career, continuing education, and promotion opportunities; or pay and benefits. CONCLUSIONS: These findings indicate support of bachelor's level education for individual and social return on investment, and they show that AD education might have unintended consequences. Implications for the nursing shortage and educational policy are discussed.

Adult↗

PubMed2005

Measuring the nursing workforce: clarifying the definitions.

Numerous articles have addressed the causes and implications of the current nursing shortage. Little has been published, however, about how to measure the nursing workforce. This article presents (1) a review of definitions for common workforce indicators such as vacancy and turnoverrates and the relationship between these indicators and the need for nurses,(2) a review of the calculation of vacancy and turnoverrates in several statewide and national surveys, and (3) the results from the development and pilot test of a health care workforce survey for use in Vermont. The review indicates that in practice, no standard method is used despite attempts to standardize the calculation of vacancy and turnover rates. The Vermont pilot study results demonstrate that a richer profile of the health workforce can be obtained by using both standard workforce measures and more subjective questions to assess a statewide need for nurses.

Data Collection↗

PubMed2005

Attitudes and beliefs of primary care physicians regarding prostate and colorectal cancer screening in a rural state.

BACKGROUND: Screening for prostate cancer (PC) is paradoxically more prevalent than for colorectal cancer (CRC). METHODS: Primary care physicians (PCPs) in Vermont were surveyed concerning PC and CRC screening. RESULTS: Aggressive screening for PC and CRC remains widespread. PCPs reported that they controlled screening decisions for the majority of their patients. A belief that evidence favored PC screening for no patients was associated with less aggressive screening for PC as well as CRC. CONCLUSIONS: Aggressive screening behavior is frequent, physician-driven and correlates with physician beliefs. Better education of PCPs is the key to changing screening behavior.

Adult↗

PubMed2004

Development and evaluation of parental occupational exposure questionnaires for a childhood leukemia study.

OBJECTIVES: This paper presents the results of a pilot study of job-specific modules developed for use in the study questionnaire of the Northern California Childhood Leukemia Study (i) to estimate the variability in response between people administered the same module and (ii) to estimate the number of modules required per family. METHODS: For 63 participants in the pilot study, between-person variability was assessed by comparing reported job tasks among the respondents administered the same job-specific module. Within-respondent variability was assessed by examining changes in the timing and frequency of the job tasks and product use across critical time segments from 12 months before the child's birth to 3 years of age. Parental occupational histories were reviewed to estimate the expected number of job-specific modules required per family. RESULTS: Considerable variability was identified for the tasks performed by the respondents with similar jobs and in the timing of tasks and products used across critical time windows. Parents' occupational histories indicated that detailed exposure information could be obtained for 95% of the families with a maximum of two job-specific modules added to the study interview. CONCLUSIONS: The job-specific modules captured individualized exposure information for the parents of cases and controls and thus reduced the potential for nondifferential misclassification when compared with the use of a job title approach, while avoiding an exposure checklist approach. These improvements in exposure estimation may increase the statistical power for identifying any true association between parental occupational exposures and childhood leukemia.

Adolescent↗

PubMed2002

Critical windows of exposure to household pesticides and risk of childhood leukemia.

The potential etiologic role of household pesticide exposures was examined in the Northern California Childhood Leukemia Study. A total of 162 patients (0-14 years old) with newly diagnosed leukemia were rapidly ascertained during 1995-1999, and 162 matched control subjects were randomly selected from the birth registry. The use of professional pest control services at any time from 1 year before birth to 3 years after was associated with a significantly increased risk of childhood leukemia [odds ratio (OR) = 2.8; 95% confidence interval (CI), 1.4-5.7], and the exposure during year 2 was associated with the highest risk (OR = 3.6; 95% CI, 1.6-8.3). The ORs for exposure to insecticides during the 3 months before pregnancy, pregnancy, and years 1, 2, and 3 were 1.8 (95% CI, 1.1-3.1), 2.1 (95% CI, 1.3-3.5), 1.7 (95% CI, 1.0-2.9), 1.6 (95% CI, 1.0-2.7), and 1.2 (95% CI, 0.7-2.1), respectively. Insecticide exposures early in life appear to be more significant than later exposures, and the highest risk was observed for exposure during pregnancy. Additionally, more frequent exposure to insecticides was associated with a higher risk. In contrast to insecticides, the association between herbicides and leukemia was weak and nonsignificant. Pesticides were also grouped based on where they were applied. Exposure to indoor pesticides was associated with an increased risk, whereas no significant association was observed for exposure to outdoor pesticides. The findings suggest that exposure to household pesticides is associated with an elevated risk of childhood leukemia and further indicate the importance of the timing and location of exposure.

Adolescent↗

PubMedDate not supplied

The volunteer potential of inactive nurses for disaster preparedness.

OBJECTIVES: Inactive nurses' interest in volunteering for emergency preparedness was examined. METHODS: A mail survey was sent to the entire Vermont Board of Nursing list of in-state inactive and lapsed registered nurses (n = 3,682). A high rate of undeliverable surveys (60%) was found and 611 surveys were returned for a 20% response rate. RESULTS: Twenty-seven percent of the respondents were interested in volunteering. Those interested in participating in volunteer work as part of a national homeland security effort were significantly more likely to (a) be younger in age (p < 0.0001); (b) identify themselves as "being a nurse" (p = 0.001); (c) be employed versus retired (p = 0.002); and (d) be currently volunteers (p = 0.001). CONCLUSIONS: Because 33% of the nation's nurses are over age 50, inactive nurses offer a potentially large pool of volunteers for emergency preparedness training and response in the years to come.

Adult↗