PubMed Health⌕ Search

Biomedical subjects

L Suarez

Publications and source records attributed to L Suarez.

85 records · Page 5Linked to original sources
PubMedDate not supplied

Predictive models in cirrhosis: correlation with the final results and costs of liver transplantation in Chile.

Medical scores for predicting survival are essential to stratify patients with end-stage liver disease (ESLD) for prioritization for liver transplantation (OLT). Recently the UNOS has adopted the Mayo Model for End-stage Liver Disease (MELD) score as the basis for liver allocation in the United States. We retrospectively evaluated and assessed the prognostic impact, the length of stay (LOS), and hospital charges for OLT using two severity scores (Child-Turcotte-Pugh [CTP] versus MELD) to stratify cirrhotic patients before OLT. Twenty-six consecutive adult cirrhotic patients (11 women, mean age 46 years) underwent LT between 2000 and 2002. The main causes for transplantation were alcohol and primary biliary cirrhosis. The mean CTP and MELD scores at the moment of listing for OLT were 8.9 and 16.3 points, respectively. The best discriminative values with prognostic impact in terms of outcome and costs of OLT were a Child Pugh score >/=11 points or a MELD score >/=20 points. Patients in these strata showed a significant increase in LOS in the hospital (from a mean of 12 to 22 days) and intensive care stay (from a mean of 4 to 14 days) post-OLT when compared with patients with a lower CTP or MELD score (P <.05). There was also a trend toward higher hospital charges (P =.06). Organ allocation by MELD score will probably adversely affect the LOS and hospital charges of patients being transplanted due to ESLD.

Adult↗
PubMedDate not supplied

Perceived family characteristic differences between depressed and anxious children and adolescents.

BACKGROUND: The present study compared anxious vs. depressed children's and adolescents' perceptions about their family environment. METHODS: One hundred inpatient youngsters were interviewed for the study. Of these participants, 21 who met criteria for a depressive disorder without an anxiety disorder and 18 who met criteria for an anxiety disorder without a depressive disorder were compared on several self-report family measures. These measures included the Family Adaptability and Cohesion Evaluation Scales-II (FACES-II), Family Strengths, and Social Support Questionnaire-Revised (SSQS-R). RESULTS: Youngsters with depressive disorders reported having less pride in their families and perceived their families as being less adaptable to problems than did anxious children. Also, depressed children expressed lower levels of satisfaction with their social network than did anxious children. LIMITATIONS: The fact that our study only included reports from inpatient youngsters, families of anxious and depressed children may differ in the way family members relate to one another and in the way they deal with everyday problems. CONCLUSIONS: Based on the evidence obtained in this study, anxiety and depression may be two distinct internalizing disorders with specific family characteristics.

Adolescent↗
PubMedDate not supplied

Advancing the role of participatory communication in the diffusion of cancer screening among Hispanics.

Based on previously demonstrated methods, a cancer prevention program combining media and interpersonal communication was conducted in a Texas border city (Brownsville) in 1995-1996. To evaluate the program a quasi-experimental panel design study followed 107 women in a program site and 105 women in a comparison site from 1994 to 1996. Women in the program site reported an increase in levels of Pap screening adherence.

Adult↗
PubMedDate not supplied

Predictors of stroke-associated mortality in the elderly.

Although stroke is a major cause of death in older adults, few studies have examined the independent contribution of cardiovascular disease risk factors to stroke mortality in the geriatric age group. We report here a nine-year followup of a Southern California community of 2107 men and women aged 65 to 84 years. In this older cohort, age was the most significant independent risk factor for stroke-associated mortality in both sexes. Systolic blood pressure was weakly but significantly associated with stroke mortality in this older age group. Cigarette smoking was positively related and educational level of head of household negatively related to stroke mortality in both sexes, with the predominant effect in women. No significant independent effect of cholesterol, fasting plasma glucose or obesity was discernible. Both blood pressure and cigarette smoking are potentially remedial risk factors for stroke after age 65.

Age Factors↗
PubMedDate not supplied

Hispanic women's breast and cervical cancer knowledge, attitudes, and screening behaviors.

PURPOSE: This study examined breast and cervical cancer knowledge, attitudes, and screening behaviors among different Hispanic populations in the United States. DESIGN: Data were collected from a random digit dial telephone survey of 8903 Hispanic adults from eight U.S. sites. Across sites, the average response rate was 83%. SETTING: Data were collected as part of the baseline assessment in a national Hispanic cancer control and prevention intervention study. SUBJECTS: Analysis was restricted to 2239 Hispanic women age 40 and older who were self-identified as either Central American (n = 174), Cuban (n = 279), Mexican American (n = 1550), or Puerto Rican (n = 236). MEASURES: A bilingual survey instrument was used to solicit information on age, education, income, health insurance coverage, language use, U.S.-born status, knowledge of screening guidelines, attitudes toward cancer, and screening participation. Differences in knowledge and attitudes across Hispanic groups were assessed by either chi-square tests or analysis of variance. Logistic regression models assessed the influence of knowledge and attitudes on screening participation. RESULTS: The level of knowledge of guidelines ranged from 58.3% (Mexican Americans) to 71.8% (Cubans) for mammography, and from 41.1% (Puerto Ricans) to 55.6% (Cubans) for Pap smear among the different Hispanic populations. Attitudes also varied, with Mexican Americans and Puerto Ricans having more negative or fatalistic views of cancer than Cuban or Central Americans. Knowledge was significantly related to age, education, income, language preference, and recent screening history. Overall, attitudes were not predictive of mammography and Pap smear behavior. CONCLUSIONS: Factors related to mammography and Pap smear screening vary among the different Hispanic populations. Limitations include the cross-sectional nature of the study, self-reported measures of screening, and the limited assessment of attitudes. The data and diversity of Hispanic groups reinforce the position that ethno-regional characteristics should be clarified and addressed in cancer screening promotion efforts. The practical relationships among knowledge, attitudes, and cancer screening are not altogether clear and require further research.

Adult↗
PubMedDate not supplied

Uses of data to plan cancer prevention and control programs.

Seven State health departments, those in Illinois, Nebraska, New Jersey, New York, North Carolina, Texas, and Wisconsin, have participated in an effort to utilize a variety of State-specific cancer-related data to describe the cancer burden in their State's population. The data were then used to develop a statewide cancer plan or supplement an existing plan to address the defined problems. Cancer data have not been well utilized in the planning of intervention programs in the past, and the efforts in these States can serve as models for data use in programs to prevent and control cancer and other chronic diseases. State-specific data can be used to rank needs and make a clear case that can influence decision makers regarding resource allocation. The purpose of this report is to describe the data sources and additional statistics that were used to provide a broad picture of the cancer burden that will aid in targeting and defining intervention needs. Mortality, incidence, risk factor prevalence, and hospital discharge data appear to be the most accessible and potentially useful of the data sources examined, whereas insurance claims data, sources of treatment data, and environmental data bases were less useful in planning intervention strategies.

Data Collection↗
PubMedDate not supplied

Validity of Pap smear and mammogram self-reports in a low-income Hispanic population.

This study measures the validity of self-reported mammography and Pap smear usage in Mexican-American women. We compared Pap smear and mammography reports in medical records to self-reports obtained in a household survey of 450 women in El Paso, Texas. The women were generally low-income, older, and Spanish-speaking. Forty-six percent of self-reported Pap smears in the previous year were verified (60.8% within previous two years, 67.1% within previous three years). Forty-nine percent of self-reported mammograms within the previous year were verified (74.7% within previous two years). For both Pap smears and mammograms, twice as many tests in the past five years were reported as were documented. Self-reports of Pap smears at a public health clinic were more valid than those at other sites. Denials of mammography within the past five years were more accurate (97.5%) than denials of Pap smears (81.8%). We conclude that self-reports of mammograms and Pap smears in Mexican-American women greatly overestimate the prevalence of screening. Intensive cancer prevention activities in this population are needed to approach the Year 2000 Objectives set by the U.S. Department of Health and Human Services.

Adolescent↗
PubMedDate not supplied

Use of peer role models to increase Pap smear and mammogram screening in Mexican-American and black women.

We evaluated the use of a community-based intervention model to increase Pap smear and mammogram screening in minority women. The community programs were based on the A Su Salud (To Your Health) model, which includes the presentation of positive role models in the media and positive social reinforcement by community volunteers. Mexican-American women 40-70 years of age in Corpus Christi, Texas, and black women 40-70 years of age in Galveston, Texas, were targeted. Role models from the target community told their personal stories about cancer screening through local media (television, radio, and newspapers). Volunteers reinforced media messages among the target audience by distributing newsletters. Preintervention and postintervention cross-sectional surveys among the target group measured relative increases in knowledge, attitude, and practice. Pap smear use (past two years) was not substantially improved. Mammogram use (past two years) increased 57% among Mexican-American women (prevalence rate ratio [PRR] = 1.57; 90% confidence interval [CI] = 1.19, 2.08) and 30% among black women (PRR = 1.30; 90% CI = 1.04, 1.63). We demonstrated the feasibility of implementing a peer role model intervention at the local health department level. The improvement in mammogram use among high-risk women is encouraging, but further controlled research is needed to test the effectiveness and cost-efficiency of this approach.

Adult↗
PubMedDate not supplied

Local health departments implement a theory-based model to increase breast and cervical cancer screening.

Su Vida, Su Salud/Your Life, Your Health is a community program to increase participation in breast and cervical cancer screening. This program illustrates the diffusion of an innovative outreach strategy from a research environment to two local health departments. The program uses A Su Salud, the communication model in which positive role models are featured in the media, and community volunteers who give positive social reinforcement. Local health departments in Galveston and Corpus Christi, TX, were selected to implement the model because of excessive mortality rates in the region and the departments' adequate level of resources and commitment. Over an 18-month period, 54 stories of role models appeared in the media in Corpus Christi, and 60 appeared in Galveston. There were 490 volunteers active in Corpus Christi and 279 in Galveston. Of 365 inquiries to the Corpus Christi program, 35 percent were from the Mexican American target group of women ages 40-70. Of 1,457 women who contacted the Galveston program, 9 percent were from the African American target group ages 40-70. Local health departments are well-suited to participation in cancer control research applications because they have direct access to high-risk populations and have the authority to institutionalize effective interventions.

Adult↗
PubMedDate not supplied

Immunization rates among young children in the public and private health care sectors.

INTRODUCTION: To meet the national goal of 90% immunization levels in 2 year olds, both the public and private sectors must achieve optimal standards for immunization delivery. This study investigated differences in characteristics of children receiving immunizations from public and private providers and assessed parental attitudes about prevention, perception of barriers, and attitudes about vaccines. METHODS: Data are from a 1994 statewide household survey of 3,813 parents of children between the ages of 3 and 24 months. Information on the percentage of children up-to-date for recommended diphtheria and tetanus toxoids, pertussis, oral polio, measles, mumps, and rubella vaccines was based on parent-held immunization records (72%) and parental recall. RESULTS: The percentage of children up-to-date for their immunizations was higher for those attending public clinics (59.8%) than those at private offices (53.8%). Users of the public system were more likely to be Hispanic, not to have graduated from high school, to be < or = 100% of poverty, never married, and unemployed. These parents also were significantly more likely to wonder about the safety and efficacy of vaccines and to have their child's immunization record. Multiple logistic regression showed that possession of an immunization record accounted for differences in immunization levels. CONCLUSIONS: Public clinics can achieve immunization levels in their pediatric clients comparable to those for children in the private health sector. Levels in both public and private sectors are well below 90% and need to be improved.

Attitude to Health↗
PubMedDate not supplied

Knowledge, behavior, and fears concerning breast and cervical cancer among older low-income Mexican-American women.

INTRODUCTION: Although recent studies have documented the low participation level of Hispanic women in cancer screening, few have examined their predisposing knowledge and attitudes concerning cancer. We documented the knowledge and fears concerning cancer of an older population of Mexican-American women and how these factors relate to screening behavior and sociodemographic characteristics. METHODS: The data are from baseline surveys conducted before the start of a community cancer awareness and prevention program. Nine hundred twenty-three Mexican-American women were interviewed in-person about their knowledge, attitudes, and Pap smear and mammogram screening practices. RESULTS: Knowledge and attitude about cancer varied with age, education, type of health insurance, ability to speak English, and place of birth. Women 65 years of age and older were least knowledgeable of cancer-detection methods and screening guidelines. Those with only Medicare or Medicaid knew far less even compared to uninsured women. Women who did not speak English well were more likely not to know the cancer signs and symptoms, risk factors, and screening guidelines. Women who had knowledge of guidelines and detection methods were more likely to have had a recent screening. Older Mexican-American women with more fatalistic and fearful attitudes toward cancer were less likely to have had a recent Pap smear. CONCLUSIONS: The low screening participation among Mexican-American women may be due to their limited awareness and knowledge about breast and cervical cancer screening examinations. Our study highlights the need for wide-scale cancer screening interventions consistent with Mexican-American beliefs.

Adult↗
PubMedDate not supplied

Why a peer intervention program for Mexican-American women failed to modify the secular trend in cancer screening.

INTRODUCTION: We evaluated an intervention program for Mexican-American women to increase Pap smear and mammography screening. METHODS: The three-year intervention included the presentation of role models in the media and reinforcement by peer volunteers. We used a two-community (intervention and comparison) pre-post test design. Activities were targeted to a mainly Spanish-speaking, poverty-level, immigrant population. Pre- and postintervention screening rates were based on independent random samples of Mexican-American women 40 years and older. RESULTS: Women reported a 6% absolute increase in Pap smear use similar to the 7% increase in the comparison community. Both communities experienced large but similar increases in recent mammography use (17% and 19%). Adjusting for differences in demographic factors, intervention and comparison changes remained identical. CONCLUSIONS: Our peer intervention failed to accelerate the secular trend in cancer screening low-income Mexican-American women. Likely, promotional activities were too diffuse and the comparison community was contaminated with similar interventions. Strong social and market forces make it difficult to measure the effect of a specialized intervention on cancer screening rates.

Adult↗