Diabetes Self Management: Are Cuban Americans Receiving Quality Health Care?

Objectives: We investigated the relationship among factors predicting inadequate glucose control among 182 Cuban-American adults (Females=110, Males=72) with type 2 diabetes mellitus (CAA). Study Design: Cross-sectional study of CAA from a randomized mailing list in two counties of South Florida Methods: Fasted blood parameters and anthropometric measures were collected during the study. BMI was calculated (kg/ m2). Characteristics and diabetes care of CAA were self-reported Participants were screened by trained interviewers for heritage and diabetes status (inclusion criteria: self-reported having type 2 diabetes; age  35 years, male and female; not pregnant or lactating; no thyroid disorders; no major psychiatric disorders). Participants signed informed consent form. Statistical analyses used SPSS and included descriptive statistic, multiple logistic and ordinal logistic regression models, where all CI 95%. Results: Eighty-eight percent of CAA had BMI of ≥ 25 kg/ m2. Only 54% reported having a diet prescribed/told to schedule meals. We found CAA told to schedule meals were 3.62 more likely to plan meals (1.81, 7.26), p<0.001) and given a prescribed diet, controlling for age, corresponded with following a meal plan OR 4.43 (2.52, 7.79, p<0.001). The overall relationship for HbA1c < 8.5 to following a meal plan was OR 9.34 (2.84, 30.7. p<0.001). Conclusions: The advantage of having a medical professional prescribe a diet seems to be an important environmental support factor in this sample’s diabetes care, since obesity rates are well above the national average. Nearly half CAA are not given dietary guidance, yet our results indicate CAA may improve glycemic control by receiving dietary instructions.

A study for the establishment of higher foodservice standards in health-care facilities

1. Area of Investigation The relative need of higher standards in healthcare foodservice facilities. Individual opinions of foodservice directors. 2. Materials and Methods Used Existing text, trade publications, interviews with industry leaders, conferences with estemmed professors and the author's own experience were used for research and evaluation. An important method used to evaluate the need for higher standards was a descriptive survey and the analysis thereof. 3. Major Findings A. The survey showed, with a 42 percent response, that the overwhelming majority of the respondents have problems within their department. B. It is presumed that these problems are caused by a lack of standards and/or a failure to meet existing standards. 4. Results and Conclusions A. The objectives of the majority of health-care facilities is to provide the best possible care at lowest possible price. The objectives of the foodservice department is to provide the best possible food at the most reasonable cost. B. Continuous education of foodservice directors in all facets of the industry are necessary so that each foodservice director has the capacity to establish and maintain, and in some cases surpass his or her own standards. C. Where no standards exist minimum requirements should be set to satisfy the objectives and goals of both the facility and foodservice department.

A phenomenological perspective of the lived experiences of Jewish holocaust survivors seeking health care in the United States today

Seven Jewish Holocaust survivors were interviewed using a phenomenological method to determine the essence of the Jewish Holocaust survivor's experience with health care in the United States today. The transcriptions were analyzed using Colaizzi's approach to phenomenological research. This approach includes extraction of significant statements, from the transcriptions, that described the participant's health care behaviors and needs. Formulated meanings of the significant statements were then organized into six themes: Hiding and Avoidance, Self care, Fear/Trust Dichotomy, Security, Luck, and Need for Understanding. These six themes were forms of protection for the participants, which ultimately led to continued survival, the essence of their experience. Knowledge of their experience may direct the nurse in implementing creative and appropriate nursing interventions to provide comfort and assist the survivor with their needs in today's health care arena.

A simulação realística como estratégica de ensino-aprendizagem em enfermagem

The study aims to examine the methodology of realistic simulation as facilitator of the teaching-learning process in nursing, and is justified by the possibility to propose conditions that envisage improvements in the training process with a view to assess the impacts attributed to new teaching strategies and learning in the formative areas of health and nursing. Descriptive study with quantitative and qualitative approach, as action research, and focus on teaching from the realistic simulation of Nursing in Primary Care in an institution of public higher education. . The research was developed in the Comprehensive Care Health discipline II, this is offered in the third year of the course in order to prepare the nursing student to the stage of Primary Health Care The study population comprised 40 subjects: 37 students and 3 teachers of that discipline. Data collection was held from February to May 2014 and was performed by using questionnaires and semi structured interviews. To do so, we followed the following sequence: identification of the use of simulation in the discipline target of intervention; consultation with professors about the possibility of implementing the survey; investigation of the syllabus of discipline, objectives, skills and abilities; preparing the plan for the execution of the intervention; preparing the checklist for skills training; construction and execution of simulation scenarios and evaluation of scenarios. Quantitative data were analyzed using simple descriptive statistics, percentage, and qualitative data through collective subject discourse. A high fidelity simulation was inserted in the curriculum of the course of the research object, based on the use of standard patient. Three cases were created and executed. In the students’ view, the simulation contributed to the synthesis of the contents worked at Integral Health Care II discipline (100%), scoring between 8 and 10 (100%) to executed scenarios. In addition, the simulation has generated a considerable percentage of high expectations for the activities of the discipline (70.27%) and is also shown as a strategy for generating student satisfaction (97.30%). Of the 97.30% that claimed to be quite satisfied with the activities proposed by the academic discipline of Integral Health Care II, 94.59% of the sample indicated the simulation as a determinant factor for the allocation of such gratification. Regarding the students' perception about the strategy of simulation, the most prominent category was the possibility of prior experience of practice (23.91%). The nervousness was one of the most cited negative aspects from the experience in simulated scenarios (50.0%). The most representative positive point (63.89%) pervades the idea of approximation with the reality of Primary Care. In addition, professors of the discipline, totaling 3, were trained in the methodology of the simulation. The study highlighted the contribution of realistic simulation in the context of teaching and learning in nursing and highlighted this strategy while mechanism to generate expectation and satisfaction among undergraduate nursing students

História oral de vida de pessoas com úlcera venosa nos serviços de atenção primária à saúde

The Chronic Venous insufficiency is characterized as a set of physical changes including how most serious complication of venous ulcers, characterized by irregular and progressive loss of continuity of the skin. The occurrence of venous ulcers in people with chronic venous insufficiency generates dependence on them with health services, with long-term treatments that cause limitations and high-impact changes, affecting their quality of life, affecting the physical, psychological, social, cultural and spiritual as an important public health problem. This study aimed to describe the experience of having a venous ulcer, in the scenario of primary health care services to Health, which includes Primary Care Units and Family Health Strategy in the city of Natal / RN, based on the life histories of users. This is a qualitative study, exploratory and descriptive, with the Oral History of Life as a methodological framework. From the ponto zero was the recruitment of participants who formed the network, totaling six employees, of both sexes and aged between 57 and 79 years. After approval by the Research Ethics Committee - UFRN under the Protocol 653 788/2014 and CAAE 30408014.0.0000.5537 was held data collection, between the months of July and August, through interviews, using identification and characterization of the instrument employees and open questions. Interviews were recorded, transcribed, transcriadas and returned to employees for a conference. The narratives were subjected to Content thematic analysis technique, according to Bardin, allowing the construction of three themes that encompass categories, namely: Axis I - Perspectives on the changes: the impact wound in social relations (changes with ulcer venous, venous ulcer and social and family relationships); Axis II - Brands in body and soul: the story of being hurt (conceptions of the body injured; therapeutic itinerary in primary care services); and Axis III - Reconstruction of being hurt: coping mechanisms (redefinition of the wounded body, resilience to chronic wound). The impact of having a chronic venous ulcer generates impact of physical, psychological and social order. As aspects related to changes after the appearance of venous ulcers, survey participants reported the presence of pain, physical limitations, psychological distress, social and emotional isolation, incapacity, aesthetic discomfort and dependency on health services; the family was the aspect thatshowed no significant change after the occurrence of wound for most participants, an ally in the therapeutic process as a support network. The redefinition of the body and the wound are the main coping mechanism of chronic condition. The services in the Primary Care Network play a fundamental role in the rehabilitation of patients with venous ulcers, although there are difficulties in accessing appropriate treatment and need for expanded services, with permanent professional training of health teams and providing the resources managers to strengthen the comprehensive care of people with venous ulcers in Health Primary Care.

Acompanhamento coletivo do crescimento e desenvolvimento infantil: participação de mães/cuidadores

This study aimed to analyze the participation of mothers/caregivers from the perspective of the health care model that directs the collective monitoring of child growth and development. This is an exploratory and descriptive research with qualitative approach, carried out in two Family Health Units located in the city of Natal/RN. Data were collected between August and September 2014, through participant observation and semi-structured interview technique, with mothers of infants seen at follow-up visits collective child growth and development. A total of 13 mothers were included who met the following inclusion criteria: being a mother/caregiver responsible for the care of children who have attended one or more meeting of collective monitoring of child growth and development. Exclusion criteria was established: users outside the area covered by the Health Unit Family and who did not use the National Health System as the primary health care service. For the treatment of the collected material, the content analysis was used, thematic Bardin. The study followed the ethical and legal principles governing the scientific research on human subjects recommended by Resolution nº. 466/2012 of the National Health Council and its realization occurred with the approval of the project in the Research Ethics Committee of the Federal University of Rio Grande do North, which was approved by Opinion Embodied nº. 719 949, of June 27, 2014, and Certificate Presentation of Findings Ethics No 32510514.7.0000.5537. Although not conceptualize theoretically mothers demonstrated that collective consultations of child growth and development are actions aimed at health surveillance model, since most pointed monitoring your child to actions that can be measured. Even with that, it was established the existence of health promotion actions by reporting the exchange of experience and leadership of the subjects in collective action, factor facilitated by the link established between users and professionals and users. In this action there is the induction of permanent horizontal relationship where we seek to combine popular knowledge to scientific knowledge in order to promote the integral care for the child. However, it is still possible to find professionals who directs its assistance only to pathological processes and fail to create comprehensive care alternatives. In addition, there is still embezzlement in multi that should provide care to the child population. This factor may be related to their professional training, and thus an issue that can last for a few years. We conclude that it is necessary to incorporate alternatives and models of care that support overcoming limitations and enhancing the health of the population, involving it in the prospect of a better quality of life and therefore health.

A postcolonial queer analysis of aboriginal queer clients' experiences of health care services in St. John's, Newfoundland

This thesis examines the gaps between health care services aimed at Aboriginal queer individuals living in St. John’s, Newfoundland and their health care needs. I used a multi-methods research design that includes interviews and demographic surveys, unobtrusive observation and qualitative content analysis. I conducted semi-structured interviews with institutional representatives from selected health related organizations – Eastern Health, Planned Parenthood Newfoundland and Labrador, the AIDS Committee of Newfoundland and Labrador, and St. John’s Native Friendship Center; as well as a transgender activist and three people who identify as Aboriginal and queer. I conducted observational research at two public seminars on Aboriginal people and health. Finally, I carried out qualitative content analysis of organizational reports and webpages of the selected community organizations. Using a postcolonial queer framework that analyzes how Newfoundland and Labrador’s colonial history is reflected in current health care realities I argue that the lack of appropriate services and culturally insensitive delivery of services reproduce the historical marginalization of an already vulnerable group.