J Natl Med Assoc
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People with heterozygous status for sickle cell disease (also called sickle cell trait) are essentially healthy, but evidence of rare health problems has increased interest in screening adolescents and young adults prior to enlisting in athletics or military service. Ironically, almost everyone with sickle cell trait is already identified during routine newborn screening for sickle cell disease, but this identification may never reach the parents. As part of a larger statewide study of communication after newborn screening, we decided to document the amount of labor required to connect sickle cell trait screening results with primary care providers (PCPs). ⋯ Cases demonstrate that it is possible to connect with most PCPs after newborn screening despite warnings about difficulties with this population. Success was due to persistence, relationships with clinics and hospitals, and Internet search capabilities. If sickle cell trait identification is necessary to protect health, then only modest increases in effort will be needed to reduce disparities in service.
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Adherence to emergency department (ED) discharge instructions among immigrant Spanish-speaking populations in the United States is suboptimal. Our objectives were to: (1) investigate associations between functional health literacy (FHL) and ED discharge instruction adherence in Spanish-speaking populations, and (2) compare the ED adherence rates of Spanish speakersto English speakers. ⋯ Spanish-speaking patients were less likely to comply with discharge instructions and scored lower on a test of FHL than English-speaking patients. Poor adherence to ED discharge instructions was associated with lower FHL scores for our Spanish-speaking population. Alternative methods of providing discharge instructions to this population of patients should be explored.
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African American women are faced with many challenges regarding their historical, cultural, and social structural position in the United States that may heighten their vulnerability for depression, one of the most prevalent disorders that can engender poor functionality. The purpose of this cross-sectional pilot study was to foster greater understanding about the occurrence and correlates of depressive symptoms among a diverse convenience sample of 63 African American women recruited from a comprehensive primary health care clinic (n = 23), a small private academic institution (n = 25), and an urban community setting (n = 15). Self-report data concerning selected psychological, sociocultural, and biological factors were collected. ⋯ Depressive symptoms were significant and positively associated with negative and ruminative thinking (r = 0.79, p < .01), low self-esteem (r = 0.58, p < .01), stressful life events (r = 0.43, p < .05), low social support (r = 0.46, p <.01), depression stigma (r = 0.36, p < 01), and indication of chronic diseases (r = 0.34, p < .01). Depressive symptoms were significant and negatively associated with resiliency (r = -0.48, p < .01) and spiritual well-being (r = -.47, p < .01). This research adds to the empirical data concerning contributors to depressive symptoms for African American women.