Ray Shields

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OBJECTIVES This study evaluated the quality of diabetes care for older American Indians and Alaska Natives. METHODS We analyzed the Indian Health Service Diabetes Care and Outcomes Audit to determine whether completion of indicators of diabetes care differed as a function of age and whether additional patient and program factors were also associated with(More)
OBJECTIVE The Neonatal Resuscitation Program (NRP) has transitioned to a simulation-based format. We hypothesized that immersive simulation differentially impacts similar trainee populations' resuscitation knowledge, procedural skill and teamwork behavior. STUDY DESIGN Residents from NICU and non-NICU programs were randomized to either control or a(More)
OBJECTIVE The purpose of this study was to compare the quality of diabetes care provided to American Indians/Alaska Natives (AI/AN) by urban and rural Indian health programs. DESIGN Medical record review data collected by the Indian Health Service as part of the Diabetes Care and Outcomes Audit in 2002. SETTING Seventeen urban Indian health clinics and(More)
OBJECTIVES This paper examines differences between joiners and nonjoiners of a voluntary smokers' registry. METHODS A baseline prevalence survey was used to identify characteristics of smokers who joined or did not join a smokers' registry. RESULTS Communities varied significantly in registry enrollment rates. Heavy-smoking joiners expressed more desire(More)
OBJECTIVE The World Health Organization recommends visual inspection with acetic acid (VIA) for cervical cancer screening in resource-limited settings. In Cameroon, we use digital cervicography (DC) to capture images of the cervix after VIA. This study evaluated interobserver agreement of DC results, compared DC with histopathologic results, and examined(More)
e20516 Background: An important objective of the patient self determination act is for patients to see their wishes fulfilled, particularly at the end of life. Studies by Tiernan et al have shown that up to 80% of patients prefer to die at home however only a small proportion of patients actually die at home. Our work on support care networks show that a(More)
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