Behavioral and Environmental Explanations of Elevated Blood Lead Levels in Immigrant Children and Children of Immigrants.

Immigrant/refugee children sometimes have substantially higher blood lead levels (BLLs) than US-born children in similar environments. We try to understand why, by exploring the relationship between immigration status of mother and the BLLs of US-born children. We compared BLLs of children born in Michigan to immigrant and non-immigrant parents, using the Michigan database of BLL tests for 2002-2005, which includes the child's race, Medicaid eligibility and address.

The predictive value of self-report questions in a clinical decision rule for pediatric lead poisoning screening.

Objective: We derived a clinical decision rule for determining which young children need testing for lead poisoning. We developed an equation that combines lead exposure self-report questions with the child's census-block housing and socioeconomic characteristics, personal demographic characteristics, and Medicaid status. This equation better predicts elevated blood lead level (EBLL) than one using ZIP code and Medicaid status.

Acculturation and glycemic control of Asian Indian adults with type 2 diabetes.

The prevalence of type 2 diabetes is disproportionately high among Asian Indians (AI), one of the fastest growing immigrant groups in the United States (US). Poorly controlled diabetes associated with inadequate self-management increases complications and thus medical costs. Acculturation may be an important determinant of diabetes self-management and hence control.

Feeding behaviors of low-income mothers: directive control relates to a lower BMI in children, and a nondirective control relates to a healthier diet in preschoolers.

Background: A topic of interest in the etiology of child obesity is whether and how parental feeding behaviors are associated with the food intake and weight status of children.

Objective: The objective was to explore whether and how directive (overt) and nondirective (covert and food environmental structure) types of parental feeding control were associated with children's food intake and weight status.

Design: This was a cross-sectional exploratory study using structural equation modeling to determine directional associations between maternal feeding practices and children's food intake and weight status.

Confirmatory factor analysis of a questionnaire measuring control in parental feeding practices in mothers of Head Start children.

Parental control in child feeding has focused primarily on directive types of control, such as pressure to eat and food restriction. This study aimed to develop an instrument to assess other types of directive control and two additional aspects of parental child feeding, non-directive and food environmental control. Mothers of Head Start children (n=330) completed a 29-item instrument designed to assess these three feeding constructs and reported their children's food intakes.

Provider communication and patient participation in diabetes self-care.

Objective: To determine the effect size of provider communication about self-care and the provider's following treatment guidelines on the self-care behaviors of people with Type 2 diabetes (T2DM).

Methods: Data were from the TRIAD telephone surveys of Michigan patients in managed care with T2DM (n=1438). The survey asked about the patients' self-care and provider communication about blood glucose monitoring, exercise, foot care, flu vaccination and annual retina screening.

Comparing lead poisoning risk assessment methods: census block group characteristics vs. zip codes as predictors.

Objective: We determined which children should be tested for elevated blood lead levels (BLLs) in the face of financial and practical barriers to universal screening efforts and within 2009 Centers for Disease Control and Prevention recommendations allowing health departments to develop BLL screening strategies.

Methods: We used the Michigan database of BLL tests from 1998 through 2005, which contains address, Medicaid eligibility, and race data. Linking addresses to U.

The effects of physician empathy on patient satisfaction and compliance.

The present study attempted to develop new scales of patient-perceived, empathy-related constructs and to test a model of the relationships of physician empathy and related constructs to patient satisfaction and compliance. Five hundred fifty outpatients at a large university hospital in Korea were interviewed with the questionnaire. The data were analyzed using structural equation modeling.

Cancer patients' desires for communication of prognosis information.

A mail survey was sent to cancer patients to determine how often they want, request, and receive a qualitativeprognosis (i.e., will they die from the disease?) and a quantitative estimate (how long they will survive).