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Biomedical subjects

Murray L Katcher

Publications and source records attributed to Murray L Katcher.

At least 19 recordsLinked to original sources
PubMed2005

Development of an advocacy curriculum in a pediatric residency program.

BACKGROUND: The Accreditation Council for Graduate Medical Education now requires pediatric residency programs to include advocacy training, but few guidelines for development exist. PURPOSE: To determine faculty and resident attitudes regarding advocacy training, and to develop consensus on the best method to teach and learn advocacy. METHODS: Pediatric residents (n = 28) and faculty (n = 51) participated in a survey about experience and training in advocacy, identified issues important to address in an advocacy curriculum, and rated a variety of learning methods. RESULTS: Nearly 90% of residents felt advocacy training was needed, and 82% felt advocacy activities would continue following residency. Faculty and residents agreed that participation in short-term or longitudinal projects was the best way to teach and learn advocacy skills. Respondents identified and ranked 45 issues to address through advocacy efforts and training, and these results were used to develop and implement an advocacy curriculum. CONCLUSIONS: Residents and faculty were interested in incorporating an advocacy curriculum, and survey results were used to guide curriculum development.

Curriculum↗
PubMed2005

Wisconsin's violent death reporting system: monitoring and responding to Wisconsin's violent deaths.

In 2003, the Centers for Disease Control and Prevention (CDC) awarded the Wisconsin Department of Health and Family Services, Injury Prevention Program, a grant to participate in a multistate project called the National Violent Death Reporting System (NVDRS). The purpose of the Wisconsin Violent Death Reporting System (WVDRS) is to link violent death records (death certificates, police reports, medical examiner and coroner reports, crime laboratories, and perhaps child fatality review teams) from the same event, promote more timely information retrieval, describe in detail circumstances that may have contributed to the violent death, and identify and characterize perpetrators and their relationships to victims. This article describes the development of WVDRS and its importance in understanding and preventing violent injury and death in Wisconsin.

Accidents↗
PubMed2005

Trends, risk factors, and prevention of falls in older adults in Wisconsin.

Wisconsin's death rate due to falls among adults 65 years and older is more than twice the national average. The hospitalization rate due to falls-related injuries in Wisconsin increased slightly from 1995 to 2002, with an injury rate of 2159 per 100,000 in 1995, and 2263 per 100,000 in 2002. Emergency department (ED) utilization and hospitalization rates for falls-related injury are higher for women than for men in Wisconsin. In 2002, the total statewide charges for hospitalizations and ED visits for falls-related injuries were more than $96 million. Two thirds of those admitted to the hospital for a falls-related injury were discharged to a nursing home or rehabilitation facility. Multifactorial intervention strategies have been shown to decrease the rate of falls in randomized, controlled trials. The purpose of this paper is to describe trends in falls-related injury fatalities, hospitalizations, and ED visits in Wisconsin. Also included are cost data related to falls, identification of risk factors, and descriptions of the possible role of physicians and other health care professionals in interdisciplinary, multifocal programs to prevent falls-related injuries in high-risk older adults.

Accident Prevention↗
PubMed2005

Improving awareness and use of booster seats in Head Start families.

OBJECTIVES: To determine the knowledge level of Head Start providers, parents, and students about booster seats and to directly observe booster seat use before and after a combined educational program and booster seat giveaway. METHODS: Before and after a short educational session and child safety seat giveaway, Head Start providers and parents received a brief questionnaire on booster seats and the state child restraint law. Direct parking-lot observation of booster seat use was performed before and after the giveaway. RESULTS: Forty-three students were enrolled in the study, with 33 receiving booster seats and 5 receiving forward-facing car seats, dependent on the weight and age of the child. Before the study, 15 (35%) of the children had weight/age appropriate child safety seats; after the giveaway, this number increased to 42 (98%; P<0.001). The proportion of children observed using booster seats before the giveaway was 6%, which increased to 34% after the giveaway (P<0.001). CONCLUSIONS: This study indicates that a booster seat giveaway can be successful in increasing the number of children who use booster seats; however, the majority (66%) of participating children still rode inappropriately restrained after the giveaway. Steps beyond providing booster seats, such as combining this intervention with ongoing parent and community education efforts, as well as legislation and enforcement, are needed to bring booster seat use to a high level. The information from this study may be helpful in designing future programs intended to increase booster seat use, as well as emphasizing the need for booster seat legislation.

Accidents, Traffic↗
PubMed2005

The role of the health care professional in bicycle safety.

Learning to ride a bicycle and enjoying the pleasures of cycling are synonymous with childhood; unfortunately, cycling does not come without risk of serious injury. Children under 15 years old account for the majority of cycling time in the United States, and on average, 1 child dies every day from a bicycle-related injury. Health care professionals can play an important role in making cycling a safe activity by encouraging and advocating for safe bicycling practices. Specific areas for physicians and health care professionals to emphasize involve the cyclist, environmental factors, and equipment factors. Helmet use by cyclists, avoidance of risk-taking, safe cycling road behavior, and proper cycling equipment fit and usage are all areas in which health care professionals can instruct families during office visits. The physician and the health care community can also be advocates for mandatory helmet legislation in order to achieve higher helmet usage rates and decreased cycling injuries. The health care professional's role in bicycle safety is an important component in building a foundation for safe cycling.

Accident Prevention↗
PubMed2005

Overweight among high school children: how does Wisconsin rank?

BACKGROUND: The rate of childhood overweight is increasing among our nation's youth. This epidemic has led to an increase of comorbidities such as high blood pressure and diabetes being treated in the pediatric population. This paper analyzes self-reported heights and weights to determine trends in the prevalence of overweight among US students in grades 9-12. METHODS: Data from the Youth Risk Behavior Surveillance System from 1999 to 2003 were used to determine the prevalence of overweight--which is defined as a BMI < 85th percentile for age and gender--in 41 participating states. (Data from the "at risk of overweight" group [defined as BMI > or = 85 percentile and < 95 percentile] and the "overweight" group [defined as BMI > or = 95 percentile] were combined and labeled as "overweight" [BMI > or = 85 percentile] to make communication of results more clear.) RESULTS: The prevalence of overweight adolescents in Wisconsin increased slightly during the past 4 years, from 22.6% in 1999 to 24.1% in 2003, with adolescent males 50% more likely than females to be overweight. In 2003, Wisconsin's rate of overweight was the 14th lowest among 41 states reporting to the Centers for Disease Control and Prevention. (Colorado is lowest at 15.7% and Mississippi is highest at 31.4%.) When examining races separately, Wisconsin's ranking decreases slightly, but remains in the top half of all states reporting. CONCLUSIONS: The prevalence of childhood overweight in Wisconsin appears to be rising, following the national trend. The prevalence of overweight among high school students is lowest in the Rocky Mountain states. Understanding reasons for these differences may shed light on strategies to decrease overweight in Wisconsin.

Adolescent↗
PubMed2005

Genetic services plan for Wisconsin.

During 1999-2001, a multidisciplinary group met to develop a plan for the future of genetic services in Wisconsin. The result was The Genetic Services Plan for Wisconsin (available at www.slh.wisc.edu/genetics/stateplan_toc.html), a problem-oriented needs-identification guide to address current and future challenges likely to affect the provision of genetic services in Wisconsin. The Plan is directed to all individuals who have a stake in the future of medical genetic services in Wisconsin. These include, but are not limited to, primary and other health care professionals, genetics professionals, governmental representatives, policy makers, legislators, educators, third-party payers, and current and potential consumers. This article provides an overview of The Genetic Services Plan for Wisconsin (Plan) and highlights the recommendations made for the continuing integration of new genetic knowledge across the continuum of medical care delivery in Wisconsin.

Genetic Services↗
PubMed2005

Wisconsin Emergency Assistance Volunteer Registry (WEAVR): how physicians can help and why they are needed.

The Wisconsin Division of Public Health (DPH) and its partners have developed the necessary public health infrastructure and core expertise to prepare for, and respond to, public health threats and emergencies. The infrastructure includes 12 public health preparedness consortia that have been established across the state. An important part of the response plan is to assure that the responder workforce is adequate to meet the need at the local, regional, and statewide levels. The responder workforce includes health professional volunteers who, if called on, will take on a variety of assigned roles relevant to a defined incident. In order to facilitate an organized system for volunteers to indicate their skills and availability, DPH has developed a secure and confidential database--the Wisconsin Emergency Assistance Volunteer Registry (WEAVR)--to collect and organize contact information on health professional volunteers and to make contact with volunteers when needed. Physicians, as well as other health professional volunteers, are critical to protect the health and safety of the community, especially if the need to dispense prophylactic medications or to vaccinate the entire population of Wisconsin arises. At the time of an event, volunteers will receive "just-in-time" training after reporting to their assigned location. In other states, physicians have found this emergency training to be of value to their overall practice of medicine. Information about how to sign on to WEAVR is provided.

Emergencies↗
PubMed2005

Births to teens in Wisconsin: targeting high-risk populations.

BACKGROUND: Adolescents giving birth represents an important public health issue with social, economic, and health-related consequences. OBJECTIVE: Compare birth rates and trends in birth rates among adolescents age 15-19 years in Wisconsin and the United States by race/ethnicity. METHODS: Teen birth rates from 1998-2002, and trends in birth rates from 1995-2002 for Wisconsin and the United States were compared by race/ethnicity using data from the Wisconsin Interactive Statistics on Health and data from the Centers for Disease Control and Prevention. RESULTS: The general statewide birth rates and birth rates for Wisconsin white teens were lower than national rates, while birth rates for black, Hispanic, and American Indian teens were well above national rates from 1998-2002. Disparities between births to minority adolescents and white adolescents were higher in Wisconsin than in the United States. Although teen birth rates in general have declined nationally and in Wisconsin, rates among Hispanics in Wisconsin have increased during the 1995-2002 period. DISCUSSION: Racial disparities in teen birth rates in Wisconsin far exceed national disparities. These disparities result from far-ranging, long-term social and environmental differences in underlying determinants of health that relate to ethnic and cultural beliefs, variation in access to health care that provides family planning and reproductive health services, decreased availability of school-based clinics, lack of role models, education, and variations in income and social status. Wisconsin should focus its teen pregnancy prevention activities on the groups at highest risk.

Adolescent↗
PubMed2005

Youth suicide in Wisconsin: mortality, hospitalizations, and risk factors.

OBJECTIVE: To review Wisconsin data on youth suicide mortality, hospitalizations from nonfatal self-inflicted injuries, and self-reported risk behaviors. METHODS: Suicide mortality data for youth (defined here as persons 10-24 years of age) were obtained from the Centers for Disease Control and Prevention (CDC) for 1995-2001 and from the Wisconsin Division of Public Health for 2002. Hospitalization data for Wisconsin from 1995-2002 were obtained from the Wisconsin Division of Public Health. Survey data on self-reported risk behaviors were obtained from the CDC for 2001. RESULTS: While the rate of youth suicide declined by 24% in the United States during the 9-year period studied, Wisconsin's rate declined only slightly (8%). Firearms accounted for 60% of completed youth suicides in Wisconsin. Medication overdoses and cutting accounted for 88% of self-inflicted injury hospitalizations for Wisconsin youth from 1995 to 2002. Wisconsin high school students reported similar rates of risk factor behaviors as youth in New Jersey (the state with the lowest suicide rates in the nation), but were more likely to use firearms (60% versus 32%). CONCLUSION: Rates of suicide mortality, attempts, and self-reported risk behaviors among youth in Wisconsin continue to be unacceptably high. Physicians can play an important role in reducing youth suicide rates by acting within their clinical practices, as leaders in community suicide-prevention activities, and as advocates for policy change.

Adolescent↗
PubMed2004

Pediatricians advocating for children: an annotated bibliography.

PURPOSE OF REVIEW: Pediatricians have for many years been strong advocates for the health and safety of children. This article reviews the health literature to provide a historical perspective of advocacy efforts of pediatricians and examples of advocacy for patients at the bedside, in the community, and through local, state, and federal legislation, as well as policymaking. Studying these advocacy activities and incorporating them into pediatric practice and education of residents will surely result in stronger, healthier, safer, and happier children and families. RECENT FINDINGS: Some of the cited works relate to pediatric advocacy in general, and some relate to advocacy for specific pediatric topics. Also, articles relating to the education of medical students and pediatric residents are reviewed; they may be of benefit to educators who develop advocacy curriculum. SUMMARY: A review of the MEDLINE literature database from 1966 through October 2003 was performed looking for the terms advocacy (child advocacy, consumer advocacy, legislative advocacy, patient advocacy), as well as advocacy education and training, and was limited to children from birth through 18 years. The titles and many of the abstracts of 4580 articles were reviewed, and 104 articles were read in full. From these, 68 were selected for review here; they were thought to be of particular interest to practicing pediatricians and pediatric educators.

Child↗
PubMed2004

Increasing access to affordable contraception: a look at the Wisconsin Medicaid Family Planning Waiver.

Approximately half of all pregnancies in the United States are unintended. The purpose of the Family Planning Waiver, a Wisconsin Medicaid program implemented in 2003, is to expand access to contraceptive care and other reproductive health services. The waiver provides women with birth control services and supplies, emergency contraception, routine reproductive health exams, and diagnosis and treatment of sexually transmitted diseases. With greater availability of contraception, the expected outcome is a reduction of unintended pregnancies and subsequent therapeutic abortion, which results in a decreased financial burden to the state, as well as an opportunity for women to experience motherhood when they are emotionally prepared to do so.

Adolescent↗
PubMed2004

Wisconsin Birth Defects Registry collecting data.

Wisconsin Statute 253.12 was enacted in May 2000 to create the Wisconsin Birth Defects Registry (WBDR), replacing the Birth and Developmental Outcome Monitoring Program, a previous birth defects and developmental disabilities reporting system initiated in 1989. In the summer of 2004, the new registry began collecting demographic, diagnostic, and identifying information for children from birth to 2 years of age who are born with reportable birth defects and/or are receiving health care services for them in Wisconsin. This article describes the development of the registry and outlines expectations for reporting of birth defects.

Congenital Abnormalities↗
PubMed2004

Trends in maternal and child health outcomes: where does Wisconsin rank in the national context?

BACKGROUND: The infant mortality rate (IMR), low birth weight (LBW) rate, and first trimester entry into prenatal care (PNC) are indicators that reflect the health of a population. OBJECTIVE: To examine these indicators in Wisconsin from 1979 through 2001 and compare them to those of the United States, looking at trends and relative rank compared with other states. METHODS: Three-year averages for IMR, LBW, and PNC were analyzed for the periods 1979-1981, 1984-1986, 1989-1991, 1994-1996, and 1999-2001 from data sources published by the Centers for Disease Control and Prevention. Wisconsin's rank relative to other states was compared for the overall, black, and white populations. RESULTS: Wisconsin's overall IMR was consistently at, or slightly better than, the national IMR. From 1979-1981 to 1999-2001, the US black IMR decreased by 37.4%, while the Wisconsin black IMR declined 12.4%; thus, Wisconsin's rank among the states fell from third best to 32 among 34 states with a sufficient number of black births. LBW rates for Wisconsin's black population were consistently at least twice that of the white population. In 1979-1981, early entry into PNC for all Wisconsin women (82.9%) was significantly higher than that of the US population (74.1%). Wisconsin's early PNC entry rates improved slightly; as other states also improved, Wisconsin's ranking dropped. Wisconsin's relative ranks for IMR, LBW, and PNC declined for all 3 indicators from 1979-1991 to 1999-2001. DISCUSSION: Birth outcome disparities in Wisconsin pose challenges for physicians, public health, and private agencies; all must collaborate and act to improve health, housing, employment, education, and the social capital and support that makes up the fabric of our society.

Birth Rate↗
PubMed2004

Pregnancy-associated deaths and pregnancy-related deaths in Wisconsin, 1998-2001.

BACKGROUND: Although the risk of dying during childbirth or from complications afterward has been greatly reduced during the past 100 years, the current rate of approximately 1 death in 10,000 live births is still too high. The goal of the US Department of Health and Human Services is to reduce this rate by more than half by the year 2010. OBJECTIVE: To present Wisconsin data regarding pregnancy-associated deaths and pregnancy-related deaths. METHODS: Cases in which a woman had died during pregnancy or within 1 year of the end of her pregnancy were identified, and case-specific data were collected. The Wisconsin Maternal Mortality Review Team then conducted systematic reviews of the information, summarized issues related to maternal mortality, considered the relationship to pregnancy and factors of avoidability, and made recommendations to improve maternal health and survival. Finally, pregnancy-associated and pregnancy-related mortality ratios were calculated. RESULTS: From 1998 through 2001, 23 Wisconsin women died as a result of their pregnancy or from complications up to a year later. This gives a Wisconsin pregnancy-related mortality ratio of 8.4 per 100,000 live births. This ratio was higher in African American women and in women who smoked. The primary cause of death was embolic disease. Almost half of the pregnancy-related deaths (48%) occurred during the postpartum period, and nearly one-quarter (22%) were avoidable. CONCLUSIONS: The disparity in pregnancy-related mortality ratios among ethnic groups and the finding of avoidable deaths are areas that should be targeted by health care providers and public health workers. Six areas on which to focus include the following: addressing racial disparities, assuring the performance of autopsies, lifestyle changes related to obesity and smoking, and management of embolic and cardiovascular disease, as well as postpartum hemorrhage.

Adolescent↗
PubMed2004

National survey of children with special health care needs: Wisconsin-specific data.

BACKGROUND: The National Center for Health Statistics developed and conducted (2000-2002) the National Survey of Children with Special Health Care Needs (CSHCN), a module of the State and Local Area Integrated Telephone Survey (SLAITS). OBJECTIVE: The purpose of this paper is to present the Wisconsin-specific data derived from analysis of the national survey and to make a comparison with the United States as a whole. RESULTS: In Wisconsin, approximately one fifth (21%) of households have CSHCN, and 13.4% of children have a special health care need; US comparison data are 20% and 12.8%, respectively. When examined by type of special need, Wisconsin shows slightly higher proportions of CSHCN in all categories, when compared with U.S. data, with the exception of limitation in activity. Families in Wisconsin with CSHCN are more likely to report being involved with medical decision making and satisfied with services they receive (67%); having a medical home (57%); having adequate insurance; easy use of community-based service systems (81%); and receiving services to make transition to adult life (7.5%). CONCLUSION: Though Wisconsin has a slightly higher proportion of CSHCN than the United States as a whole, a greater proportion of Wisconsin families receive important services. These measurements allow us to strive for further improvement through coordination of services in the private health care delivery sector with public health programs.

Adolescent↗
PubMed2003

Pesticides and your children: a randomized controlled evaluation of a pamphlet.

BACKGROUND: Maternal and pediatric residential pesticide exposure has been identified as a risk factor for birth defects, pediatric cancers, and neurological damage, and it may play a role in other disease processes. OBJECTIVE: To examine whether the use of a pamphlet with a brief educational message in a clinic setting would increase the knowledge and/or change the attitudes of pregnant women and mothers about pesticide use and alternatives, as well as promote pesticide safety. METHODS: A group of 103 women currently pregnant and/or with children less than 6 years of age were recruited at 2 Special Supplemental Nutrition Program for Women, Infants and Children (WIC) clinics for the study. Participants were given a 16-question true/false oral survey testing their baseline knowledge about pesticide safety and safer alternatives to pesticide use. Participants were then randomly assigned to a control group or to the intervention group, which received the pamphlet and a 2-minute scripted overview of its contents. Approximately 2 to 3 weeks later, all participants received a follow-up telephone call by a researcher blinded to the original group assignment, and the original survey questions were repeated. RESULTS: Follow-up assessments were completed for 73 (71%) of the participants. The mean improvement in correct responses on the follow-up survey was +0.39 for the control group and +3.1 for the intervention group (P<.001). Item analysis revealed that the intervention produced a significantly higher number of correct answers to 9 of the 16 survey questions. Providing mothers and pregnant women CONCLUSIONS: Providing mothers and pregnant women with a pamphlet and a brief message about pesticide safety and safer alternatives to pesticides in a clinic setting may be effective in improving knowledge and beliefs about pesticides.

Adult↗