Biomedical subjects

Mohsen Bazargan

Publications and source records attributed to Mohsen Bazargan.

At least 19 recordsLinked to original sources

PubMed2006

Psychometric performance of the National Eye Institute visual function questionnaire in Latinos and non-Latinos.

OBJECTIVE: To compare the psychometric performance of Spanish versions of the 25-item National Eye Institute Visual Function Questionnaire (NEI VFQ-25) and the NEI VFQ-39 administered to Latino patients with the psychometric performance of the standard English NEI VFQ-25 and NEI VFQ-39 administered to non-Latino patients. DESIGN: Clinic-based cross-sectional survey. PARTICIPANTS: Four hundred three patients (160 Latinos and 243 non-Latinos) recruited from general ophthalmology clinics of an urban public hospital over a 6-month period. METHODS: Structured face-to-face interviews were conducted in Spanish and English to collect data for the NEI VFQ-25 and NEI VFQ-39. We calculated the mean, standard deviation, and percentage of participants having the minimum (floor) and maximum (ceiling) possible score for each item and scale. Internal consistency reliability of the NEI VFQ-25 and NEI VFQ-39 was estimated using the Cronbach alpha and average inter-item correlation. Construct validity for the instruments was assessed by comparing scores for participants classified as having normal versus impaired visual acuity. MAIN OUTCOME MEASURES: Instrument scales for general health; general vision; ocular pain; near activities; distance activities; vision-specific social functioning, mental health, role difficulties, and dependency; driving; color vision; and peripheral vision. RESULTS: Internal consistency reliability was significantly lower in the Spanish version than in the English version for 3 scales of the NEI VFQ-25. More importantly, 3 scales in the Spanish version manifested inadequate reliability (alpha< or =0.70), compared with only 1 inadequately reliable subscale in the English version. Reliability coefficients associated with the Spanish NEI VFQ-39 scales exceeded commonly accepted minimum standards. Comparison of reliability coefficients between Latino and non-Latino subgroups demonstrated statistically significant differences for 4 scales: Ocular Pain, Mental Health, Role Difficulties, and Dependency. In each case, the Latino group had the lower internal consistency reliability. However, only for the Ocular Pain subscale was reliability both significantly lower and inadequate (alpha<0.70). CONCLUSION: Overall performance of the NEI VFQ in Latino populations is adequate. However, in the absence of modifications to improve the reliability of specific Spanish version subscales, comparisons between Latino and non-Latino subgroups using the NEI VFQ must be interpreted with appropriate caution.

Adult↗

PubMed2006

Correlates of the intention to remain sexually inactive among underserved Hispanic and African American high school students.

The objective of this study was to apply the Information-Motivation-Behavior (IMB) theoretical framework to examine the correlates of the intention to remain sexually inactive among Hispanic and African American high school students. This study utilized a cross-sectional survey of high school students. The setting was the unified school districts in the County of Los Angeles, California. The participants comprised a geographically defined convenience sample of 502 Hispanic and African American high school students. This study found that only 50% of this sample reported that they plan to remain sexually abstinent until they graduate from high school. Another 21% rejected the notion of remaining abstinent, and 29% were uncertain about their intention to engage in sexual activities before they graduate from high school. Male and African American students were less likely than their female and Latino counterparts to report an intention to remain sexually inactive. Using multinomial logistic regression and controlling for demographic characteristics, this study documented that students with (1) a higher level of perceived peer pressure, (2) a lower level of behavioral and refusal skills for avoiding sexual activity, (3) a more positive attitude toward practicing safe sex, and (4) a lower level of perceived pregnancy repercussions were less likely to claim to remain sexually inactive. The data from this study support the IMB model, which suggests that intervention programs focusing on knowledge alone are inconsequential in altering the intentions of adolescents with respect to their decision to engage in sexual activity. Intervention programs should focus on encouraging youth to postpone sexual activity by reducing peer pressure and building self-efficacy through enhancing motivations and culturally appropriate behavioral skills.

Adolescent↗

PubMed2006

Impact of desire to work in underserved communities on selection of specialty among fourth-year medical students.

OBJECTIVE: The objective of this study was to explore the specific factors that influence medical student's choice of primary care as a specialty. Special attention is given to the influence of desire to work in underserved communities on selection of a specialty. DESIGN AND SETTINGS: A web-based survey of factors affecting choice of specialty was completed by 668 fourth-year students from 32 medical schools. RESULTS: Students interested in primary care reported an increased likelihood of working with underserved populations when compared with other specialties. The independent impact of both student's social compassion attitudes and values, and subjective and reinforcing influences on the selection of primary care, when compared with all other specialties, was strong. Personal practice-oriented considerations showed an independent negative impact on the selection of primary care when compared with surgery and support specialties. Financial considerations strongly influence the selection of support specialties. Medical training experiences showed an independent influence on the selection of surgery over primary care. CONCLUSION: The need for primary care physicians and specialists in underserved communities is considerable. Addressing health disparities in underserved communities requires a concerted effort to increase the availability of primary care providers in these communities. This study observed that primary care practice or specialty selection by medical students is influenced by individual values and subjective external influences other than predicted by medical training alone. This observation necessitates a closer determination of strategies required to ensure an increase in the number of primary care physicians serving underserved communities.

Career Choice↗

PubMed2006

Using resident focus groups to improve subspecialty consultations in a pediatric urgent care setting.

BACKGROUND: In a pediatric urgent care center, patients requiring management by subspecialty consultants have average waiting times of two hours. Pediatric resident input was sought in order to identify problems and propose urgently needed solutions. OBJECTIVES: 1) To define the dimensions on which residents measure quality of consultations; 2) To generate solutions for perceived problems. SETTING AND DESIGN: Mixed methods, including focus groups, survey questionnaires and an intervention, were used. Focus groups and questionnaires involved pediatric residents from a large public hospital that provides care to medically underserved African-American and Latino patients. RESULTS: Residents defined four dimensions of quality: waiting time, teaching, courtesy and overall quality of care. An intervention made with the service having the poorest ratings on the questionnaire consisted of a detailed discussion of focus group findings and recommendations. The overall effectiveness of the intervention was evaluated by analyzing pre- and postprogram measures. Postintervention ratings showed significant improvement of ratings along three of the four dimensions of concern. CONCLUSIONS: At minimal-to-no cost to an institution, focus groups composed of residents can generate viable solutions to observed problems. This form of feedback could be beneficially incorporated into an institution's continuous quality improvement processes.

Appointments and Schedules↗

PubMed2006

Demographic variations and clinical associations of episiotomy and severe perineal lacerations in vaginal delivery.

UNLABELLED: Primiparity, birthweight, operative delivery and obstetrical complications contribute to episiotomy and severe perineal lacerations. Episiotomy correlates with Hispanics, while African Americans correlate with severe perineal lacerations. OBJECTIVE: The purpose of this study was to identify risk factors for both episiotomy and severe perineal lacerations in a large population from a single institution. STUDY DESIGN: This was a review of 66,224 vaginal deliveries of African Americans or Hispanics delivering between 25-44 gestational weeks between 1981-2001. Univariate and multiple regression analysis were done as indicated. RESULTS: Independent predictors of episiotomy were: primiparity eight-fold, forceps delivery seven-fold, vacuum delivery five-fold, shoulder dystocia 3.6-fold, macrosomia 1.8-fold, epidural analgesia 1.6-fold, postdates 1.5-fold, Hispanics 1.4-fold. Independent predictors of severe perineal lacerations were; macrosomia seven-fold, episiotomy 4.5-fold, primiparity 4.4-fold, shoulder dystocia 3.6-fold, average birthweight 3.5-fold, forceps delivery 2.6-fold, vacuum delivery two-fold, epidural analgesia two-fold, African-American 1.5-fold. Nonreassuring fetal heart rate patterns, meconium and cord accidents appeared protective. CONCLUSION: Primiparous women with larger babies undergoing operative delivery with epidural analgesia are at risk for both episiotomy incisions and severe perineal lacerations. Though Hispanics are more likely to have an episiotomy, they are at significantly less risk for severe perineal lacerations compared to African Americans. Even though episiotomy is independently associated with severe perineal laceration, other factors such as macrosomia and primiparity are as important.

Adolescent↗

PubMed2005

Who is playing doctor? -- The gap between self-perceived versus professionally diagnosed chronic conditions among the underserved minority.

OBJECTIVE: To assess the gap between self-perceived and professionally diagnosed physical and mental conditions in underserved minority populations. STUDY SETTING: The study sample consisted of 287 African-American and Latino heads of households respondents, obtained from a geographically defined random sample of 418 households from three Urban Public Housing Communities in Los Angeles County, California. STUDY DESIGN: This study conducted a cross-sectional survey with face-to-face interviews. RESULTS: Eighty-five percent (245) of this sample reported that they were suffering from at least one chronic condition. However, 43% of participants who suffer from chronic condition(s) claimed that a physician had never diagnosed at least one of their chronic illnesses. Depression (16%), hearing impairment (10%), arthritis (8%), dental problems (7%), and vision conditions (7%) are the most frequently reported undiagnosed chronic conditions among these populations. CONCLUSION: This study documents significant disparities in the detection and treatment of specific medical conditions among Hispanic and African-American population residing in public housing, which often leads to end-stage complications due to lack of timely diagnoses and treatment.

Adult↗

PubMed2005

Evaluation of a brief intervention in an inner-city emergency department.

STUDY OBJECTIVE: This study tests the effect of a brief intervention with emergency department (ED) patients to reduce at-risk drinking. METHODS: We enrolled patients aged 18 years or older who screened positive for at-risk drinking in an urban academic ED and used alternative allocation to assign them to control or intervention status. A 20-minute, semiscripted, negotiated interview was conducted with the intervention group in English and Spanish by 3 health promotion advocates (peer educators). The Alcohol Use Identification Test (AUDIT) was administered at baseline and 3 months after enrollment. RESULTS: Among 1,036 patients screened for at-risk drinking, 295 with CAGE questionnaire score greater than 1 and no alcohol treatment in the past year enrolled in the study and were randomly assigned to the control arm (n=151) or the intervention arm (n=144). Follow-up was achieved with 88 patients in the intervention group and 97 patients in the control group (63% of enrollees). Among the 185 patients followed up, 64% of the intervention group versus 80% of the control group scored greater than 7 on the follow-up AUDIT (scored on a scale of 1 to 40; P<.05, odds ratio [OR] 2.35, 95% confidence interval [CI] 1.21 to 4.55). Multinomial logistic regression analysis demonstrates, after controlling for demographic characteristics and other independent variables, that assignment to intervention status decreased the odds of at-risk (moderate) drinking as defined by AUDIT scores of 7 to 18 (OR 0.42, P<.05, 95% CI 0.19 to 0.91) but did not affect patients with AUDIT scores in the 19 to 40 range. CONCLUSION: Brief motivational intervention administered by peer educators to ED patients appears to reduce moderately risky drinking and associated problems.

Adult↗

PubMed2005

Access to vision care in an urban low-income multiethnic population.

OBJECTIVE: This study applied a well-known, recently revised theoretical model of healthcare access and utilization, the Behavioral Model for Vulnerable Populations, to examine the relationship between access to care and utilization of eye care services among a multiethnic, predominately minority sample of residents from low-income public housing. DESIGN: Population-based, cross-sectional survey of community sample. SETTING: Urban Public Housing Communities in Los Angeles County, California. PARTICIPANTS: A geographically defined stratified random sample of 152 residents (86% Latino or African American) 40 years of age and older from three urban public housing communities. RESULTS: Only 62% of our sample of persons 40 years and older had received an eye examination within the past 2 years. Sixty-one percent of participants reported having vision care coverage. Yet, one out of four respondents claimed that no health care provider had ever told them that they needed an eye-examination. Applying multiple logistic regression and controlling for a number of predisposing, enabling, and need-for-care characteristics, the variables 1) receiving advice from health care providers for eye examination (OR = 3.9, p < 0.01), 2) possessing coverage for eye-care (OR = 3.2, p < 0.01), and 3) having regular and continuity of medical care (OR = 2.4, p < 0.01) remained significant predictors of eye-examination within the past 2 years. CONCLUSION: This study documents significantly diminished utilization of eye care services relative to recommended guidelines for a low-income, predominately minority sample of residents from public housing communities. We documented no association between presence of diabetes or hypertension and recency of eye examination. Affordability, continuity, and regular sources of care, as well as receiving physician advice, remain the core factors significantly associated with receiving vision care. These results underscore the need for continued efforts to ensure that the medically underserved minority have access to vision care services. These findings also point toward the urgent need for educational and motivational interventions that encourage health care providers serving underserved communities to promote eye examination, particularly among diabetic patients, hypertensive patients, and other individuals at risk for eye-related disease and complications.

Adult↗

PubMed2005

The development of a mandatory medical thesis in an urban medical school.

BACKGROUND: The objective of this study was to describe the development of a primary care medical student's thesis. DESCRIPTION: In 1995, as part of its primary care clerkship, the Charles R. Drew University of Medicine and Science (Drew University), College of Medicine created a curriculum requiring medical students to develop, design, and implement a research project during their 2-year longitudinal clinical experience. For this study, we reviewed all student research projects generated between 1995 and 2004. EVALUATION: Among the 112 research projects, topics covered included internal medicine (29.5%), obstetrics and gynecology (OBGYN; 22%), psychosocial issues (20.5%), pediatrics (9%), public health/epidemiology (8%), medical education (8%), and surgery (3%). Mentors included faculty from internal medicine (16%), dean's office (16%), pediatrics (13%), family medicine (11%), non-Drew faculty (10%), OBGYN (9%), psychiatry (9%), surgery (9%), emergency medicine (4%), and pathology/radiology departments (3%). The students' survey showed that 83% agreed that the mentors were valuable, 72% admitted that their knowledge about the research process was improved, about 50% indicated that they were more competitive during residency application, and 80% claimed that they obtained satisfaction from accomplishing a goal. CONCLUSION: Students are able to conduct and present a primary care research project as a requirement of their medical training. Most students find the experience beneficial and positive.

Academic Dissertations as Topic↗

PubMed2005

Treatment of self-reported depression among Hispanics and African Americans.

This study applied the Behavioral Model for Vulnerable Populations framework to examine the correlates of depression and the receipt of medical treatment among low-income Hispanics and African Americans residing in public housing. We compared three groups: those who reported (1) self-diagnosed but without physician-diagnosed depression, (2) depression diagnosed by a physician but who did not receive pharmaceutical treatment, and (3) depression diagnosed by a physician and antidepressant pharmacotherapy consumed by patient. Random samples of 287 adults from three public housing communities were surveyed. Over 48% of this sample reported that they were suffering from depression. One out of three people who reported being depressed also said that a physician had never diagnosed his or her condition. Only 40% of those who said that a physician had diagnosed depression also reported taking antidepressant medication. Untreated depression among underserved racial and ethnic minorities is alarming and points to an urgent need for intervention.

Adult↗

PubMed2005

Alcohol use and adherence to prescribed therapy among under-served Latino and African-American patients using emergency department services.

UNLABELLED: Non-adherence to prescribed therapy is a factor that results in many patients attending emergency departments. However, increasingly, we recognize that patients who seek health care from inner-city emergency departments are among those experiencing health disparities. For these marginalized patients, emergency departments can play an important role in complementing the process of individualized care to achieve successful health outcomes. Research that examines socio-psychological characteristics and correlates of healthcare utilization of emergency department service users among under-served minority patients is needed for redirecting appropriate care among this segment of our population. OBJECTIVE: This study examines the prevalence and correlates of adherence to prescribed therapy among patients presenting to an inner-city emergency department for a medical emergency or trauma injury. Specific attention is paid to the role of alcohol. METHOD: A cross-sectional face-to-face survey was conducted among a consecutive sample of 412 Hispanic and African Americans aged 18 years and older who sought care at an inner-city emergency department facility. RESULTS: Among patients who use medication (N=145), 32% reported low adherence. More than 24% scored positive for alcohol problems based on the Alcohol Use Disorders Identification Test (AUDIT). Results of multivariate regression analysis showed that those emergency department patients who: 1) identified themselves as Hispanic, 2) reported excessive use of alcohol, 3) reported a higher number of depressive symptoms, and 4) reported a higher number of alcohol related consequences were less likely to adhere to prescribed therapy. CONCLUSION: Future investigation regarding factors related to adherence to prescribed medication among emergency department patients should take into consideration the role of alcohol and depression in this process. Further research is also needed to factor in patient's ethnicity in the context of treatment adherence.

Adult↗

PubMed2005

Prevalence and incidence of diabetes in HIV-infected minority patients on protease inhibitors.

In HIV-infected patients, the use of protease inhibitors (PIs) is associated with a constellation of abdominal obesity; buffalo hump; decreased facial and subcutaneous fat; hyperlipidemia and type-2 diabetes mellitus, a so-called HAART-associated dysmetabolic syndrome. The incidence and prevalence of one of its components, the type-2 diabetes mellitus, among minority population is unknown. In August and September 1999, we reviewed 101 charts of HIV-infected patients who visited an inner-city HIV outpatient clinic. The age, gender, ethnicity, BMI, fasting plasma glucose, random serum glucose, triglycerides, CD4 counts, and the type and duration of antiretroviral drugs were recorded. Three years later (2002), the same patient charts were reviewed for evidence of new-onset diabetes. Ten percent of the subjects were identified as diabetic at baseline. The prevalence of diabetes was 12% among those who were taking PIs, compared to 0% among those who were not taking PIs. The incidence of newly diagnosed diabetes during this three-year period was 7.2%. Diabetes occurred only in the group taking PIs. Diabetic subjects were older than their nondiabetic counterparts. All were African Americans. Our study suggests that PIs increase the likelihood of diabetes developing with increasing age in African Americans infected with HIV.

Adult↗

PubMed2005

Alternative healthcare use in the under-served population.

OBJECTIVE: To apply the Behavioral Model for Vulnerable Populations to the examination of the correlates of alternative healthcare utilization among Hispanic and African-American adults residing in public housing. DESIGN: Cross-sectional survey of a community-based sample. SETTING: Urban public housing communities in the county of Los Angeles. PARTICIPANTS: A geographically defined random sample of 287 African-American and Latino heads of households from three urban public housing communities. RESULTS: The use of alternative health care was assessed with three indices reflecting how frequently respondents used alternative sources of health care: 1) to prevent sickness; 2) to treat sickness; and 3) to substitute for conventional health care. Multivariate analysis of data indicates that lower education, greater perceived racial discrimination, and poorer health status were associated with the use of alternative health care to prevent sickness. Furthermore, greater perceived racial discrimination, greater financial strain, and poorer health status were associated with the use of alternative health care to treat sickness. In addition, four variables were associated with increased frequency of alternative healthcare utilization as a substitute for conventional care, namely: 1) diminished belief that powerful individuals (such as healthcare professionals) control one's health; 2) greater perception of racial discrimination; 3) greater financial strain; and 4) reduced access to health care. CONCLUSION: Enabling characteristics helped explain the use of alternative health care to treat sickness as a substitute for conventional health care, but not to prevent sickness, in this population. Perceived racial discrimination was the strongest correlate for each type of alternative healthcare use, while health status was also a strong predictor. The use of alternative health care for prevention and for substitution should be examined separately in disadvantaged minority populations.

Adolescent↗

PubMed2005

A profile of chronic mental and physical conditions among African-American and Latino children in urban public housing.

OBJECTIVE: This study provides a profile of chronic mental and physical conditions among African-American and Latino children in urban public housing communities in Los Angeles, California. METHODS: The study focused on 187 African-American and Latino households with children, 65% of a random sample of 287 households in three urban public housing communities. RESULTS: The findings suggest that minority children residing in public housing are one of the more severely health-compromised groups among under-served communities. Children of Latino and African-American families in our sample are two to four times more likely to suffer from chronic physical and mental conditions than the general population. The top five childhood chronic conditions reported by parents for one or more children in their households were asthma (32%), eye/vision problems (24%), dental problems (16%), Attention Deficit Hyperactivity Disorder (17%), and depression (8%). CONCLUSION: This study documents significant health disparities in this population and strongly suggests the need for future investigations in similar settings nationwide.

Adolescent↗

PubMed2004

ImmunoDip: an improved screening method for microalbuminuria.

BACKGROUND: It is important to test for microalbuminuria in patients with diabetes, hypertension and possible insulin resistance syndrome. Current screening methods are suboptimal. This study evaluates a new office screening test for microalbuminuria that utilizes a monoclonal antibody against human serum albumin (ImmunoDip). METHODS: 182 urine samples were collected from patients attending diabetes, nephrology or hypertension clinics. The ImmunoDip screening test was carried out in the 182 samples after which albumin and creatinine concentrations were measured quantitatively in a reference laboratory. RESULTS: Screening the 182 patient samples with ImmunoDip and designating an albumin:creatinine ratio of > or =30 microg/mg as positive yielded a sensitivity of 96%, a specificity of 80%, a positive predictive value (PPV) of 66% and a negative predictive value (NPV) of 98%. The reduced specificity and PPV were not due to an intrinsic inaccuracy with ImmunoDip screening of these samples, but rather was shown to be due to the discordance between the accepted upper limits of normal for the albumin:creatinine ratio (30 microg/mg) and the albumin concentration (20 mg/l), the latter corresponding to a ratio of 20 microg/mg. In 35 samples with albumin concentrations of 20-50 mg/l, ImmunoDip screening yielded only one false negative (FN) result. CONCLUSIONS: ImmunoDip is an excellent screening tool for microalbuminuria.

Albuminuria↗

PubMed2004

Adequacy of urinary tract infection management among minority underserved children.

Urinary tract infection (UTI) is one of the common bacterial infections in children and may lead to substantial morbidity. This study examines (1) the frequency of the performance of follow-up urine cultures and imaging studies for children diagnosed with UTI and (2) the relationship of the demographic and insurance status of patients with the management and follow-up of UTI. We conducted a retrospective chart review of children with first-time documented UTI at six different county medical center satellite outpatient clinics and hospital-based pediatric outpatient walk-in clinics, serving an indigent minority community, from January 1998 to December 2000. We identified 144 children with confirmed UTI. Of 144 subjects in our study, 44% had follow-up urine cultures and 43% of these children showed continued infection after a full course of antibiotics. Renal ultrasonography and voiding cystourethrogram were performed in 53% and 39% of children, respectively. Of those patients who did not receive follow-up imaging, 67% had no documentation for follow-up appointments. However, in 29% of cases attempts had been made to contact patients who were scheduled for follow-up, but they did not return for the studies. These data suggest there is a significant failure rate for the follow-up of pediatric UTI. There is need for educational intervention among pediatricians who provide medical care to ethnically diverse underserved, often uninsured, minority children. This intervention should reinforce compliance with the standard recommendations for appropriate UTI follow-up studies and imaging and provide realistic strategies for achieving recommended outcomes in these high-risk populations.

Child, Preschool↗

PubMed2004

Effect of Pancreas Tonic (an ayurvedic herbal supplement) in type 2 diabetes mellitus.

Although there is widespread use of herbal dietary supplements that are believed to benefit type 2 diabetes mellitus, few have been proven to do so in properly designed randomized trials; their efficacy for intermediate-term glucose control remains unclear. Pancreas Tonic is a botanical mixture of traditional Indian Ayurvedic herbs currently available as a dietary supplement. We report the results of a single-center, randomized, double-blind, placebo-controlled 3-month trial of Pancreas Tonic in type 2 diabetic patients inadequately treated with diet/lifestyle or stable doses of sulfonylureas and/or metformin for at least 3 months. Patients with type 2 diabetes for >/= 1 year were entered into 2 strata of hemoglobin A(1c) (HbA(1c)) levels (stratum 1: 8.0% to 9.9%; stratum 2: 10.0% to 12.0%). All subjects began a 1-month single-blind placebo run-in phase, followed by randomization in a 2:1 ratio of active treatment: placebo, to 3 months of double-blind treatment with either Pancreas Tonic or matching placebo (2 capsules 3 times a day). Concurrent oral agents were continued unchanged throughout the study. The primary outcome was the change in HbA(1c) from randomization; results of each stratum were analyzed independently. The baseline characteristics of 36 subjects who completed the study were comparable between treatment groups. Nineteen subjects entered stratum 1 and 17 entered stratum 2. A statistically significant reduction of HbA(1c) from randomization to end-of-study was seen in the stratum 2 subjects (Pancreas Tonic: 10.1% +/- 1.0% to 8.8% +/- 1.9%, P =.004; placebo: 10.8% +/- 1.4% to 11.2% +/- 1.8%, not significant [NS]). No significant HbA(1c) reductions were seen in the stratum 1 subjects. There were no significant treatment-related differences in the fasting plasma glucose (FPG), lipids, body mass index (BMI), body composition, blood pressure, insulin sensitivity estimates using the minimal model, glucose and insulin responses to a meal challenge, quality of life, adverse events, or other safety indices between treatment groups. Pancreas Tonic was well tolerated. Treatment with Pancreas Tonic (2 capsules 3 times per day) for 3 months significantly improved glucose control in type 2 diabetic patients with HbA(1c) levels between 10.0% to 12.0%. This study represents the first properly designed, prospective intervention trial of therapy with an Ayurvedic herbal supplement for intermediate-term glucose control in type 2 diabetes.

Adult↗

PubMed2004

Correlates of cervical cancer screening among underserved Hispanic and African-American women.

BACKGROUND: Substantial subgroups of American women, specifically those of ethnic minorities, have not been screened for cervical cancer or are not screened at regular intervals. The rates for receipt of female-related cancer screening tests remain far below the goals set forth in Healthy People 2010. OBJECTIVE: This study applied a well-known, recently revised theoretical model of health care access and utilization, the Behavioral Model for Vulnerable Populations, to examine the correlates of the adherence to cervical cancer screening guidelines among publicly housed Hispanic and African-American women, two of the most vulnerable segments of our population. METHODS: This study conducted a cross-sectional survey of a community-based random sample of 230 African-American and Latino female heads of household, from a geographically defined area, the three urban public housing communities in Los Angeles County, CA. RESULTS: Only 62% of our sample had received a screening for cervical cancer within the past year. Yet, 29% of the sample claimed that no health care provider had ever told them that they needed a screening test for cervical cancer. Hispanic and older women are by far less likely to adhere to screening guidelines; in this study, 51% of Hispanics and 22% of African-Americans reported no screening within the last year. Multivariate analysis shows that affordability, continuity of care, and receiving advice from health care providers regarding a Papanicolaou (Pap) smear were significant predictors of up-to-date to cervical cancer screening. CONCLUSION: This study documents a significant disparity in screening for cervical cancer among underserved minorities, particularly Hispanic, uninsured, and older women. The continuity of obtaining medical services and receiving recommendations from physicians remain the core factors that are significantly associated with obtaining cervical cancer screening. These results underscore the need for continued efforts to ensure that medically underserved minority women have access to cancer screening services.

Adult↗