Biomedical subjects

A M McDaniel

Publications and source records attributed to A M McDaniel.

7 recordsLinked to original sources

PubMed1998

Health status and mammography use among older women.

OBJECTIVE: To assess the extent to which an age-associated reduction in mammography use can be explained by declining self-reported health status. DESIGN: We analyzed data from the 1992 National Health Interview Survey (NHIS) and Cancer Control Supplement. Logistic regression analysis was used to evaluate the association between age, health status (self-reported health and limitations in major activity), and other variables potentially related to mammography use within the past 1 year (recent mammography). PARTICIPANTS: Of 12,035 NHIS respondents we restricted our analysis to the 1,772 women aged 50 years or older who reported one or more lifetime mammograms. We excluded women without a mammogram (n = 937) because we were interested in factors related to recent use versus past use of mammography. MEASUREMENTS AND MAIN RESULTS: The percentage of women with a recent mammogram declined with increasing age, and the age association was independent of other factors including health status (adjusted odds ratio [OR] comparing women aged 75 years or older with those aged 50 to 64 years was 0.54; 95% confidence interval [CI] 0.41, 0.70). This age effect persisted in an analysis restricted to women reporting good or better health (adjusted OR was 0.60, 95% CI 0.44, 0.80). CONCLUSION: The observed decline in recent mammography use with advancing age was not explained by variation in health status. Because healthy elderly women may live long enough to realize the potential benefit of screening mammography, factors responsible for its reduced use should be identified. Doing so will allow for the selective promotion of screening mammography among those older women most likely to benefit.

Age Factors↗

PubMed1997

A study of pediatric brain tumors and their association with epilepsy and anticonvulsant use.

OBJECTIVES: To evaluate the risk of childhood brain tumor occurrence in relation to epilepsy and anticonvulsant use. STUDY DESIGN: As part of a multicenter case-control study of pediatric brain tumors, maternal report on epilepsy occurrence before diagnosis of her child's brain tumor was collected for 540 cases and compared with 801 control children. Mothers also reported on any long-term (> or = 2 weeks) use of medications by her child before the date of tumor diagnosis (or a comparable reference date for controls) and these medications were classified according to whether they contained barbiturates. RESULTS: As expected, because seizures are often an early brain tumor symptom, a strong association was observed between epilepsy and brain tumor occurrence (odds ratio, OR = 6.2; 95% confidence limit, CL = 2.9, 14). The association remained elevated even after a > or = 10-year interval between diagnoses of epilepsy and brain tumor (OR = 4.7; CL = 0.8, 48). Elevated odds ratios were observed both for epileptic children who were treated with anticonvulsants containing barbiturates (OR = 5.8; CL = 2.2, 18) and for those not treated with barbiturates (OR = 7.9; CL = 1.7, 74), relative to nonepileptic children. CONCLUSION: Whereas most of the brain tumor risk associated with epilepsy may be due to occult tumors, the finding of an elevated risk many years after diagnosis of epilepsy is of interest.

Adolescent↗

PubMed1996

Head injury as a risk factor for brain tumors in children: results from a multicenter case-control study.

We evaluated the risk of brain tumor occurrence in relation to previous head injury in a population-based case-control study of 540 children with a primary brain tumor and 801 control children. The risk of a brain tumor among children with a previous head injury that resulted in medical attention was slightly elevated when compared with children with no reported head injury [odds ratio (OR) = 1.4; 95% confidence limits (CL) = 1.0, 1.9]. This effect was stronger when we restricted the head-injured group to the few children with loss of consciousness (OR = 1.6; 95% CL = 0.6, 3.9) or an overnight admission to a hospital (OR = 1.7; 95% CL 0.7, 4.6), relative to those with no head injury. We observed no appreciable association between brain tumor occurrence and birth injury involving the head or a forceps delivery. Among the few children with either a birth injury or forceps delivery and a subsequent head injury, we observed approximately twofold elevations in risk. The OR was 2.6 (95% CL = 1.1, 6.9) for those with a birth injury and subsequent head injury, relative to those with neither a birth injury nor head injury. Our results provide only weak evidence in support of head injury as an etiologic agent for brain tumor occurrence in children, although most of our exposed group had only mild head injury.

Adolescent↗

PubMed1994

Using generalizability theory for the estimation of reliability of a patient classification system.

This article discusses the measurement issues associated with estimating the reliability of patient classification systems (PCSs). Generalizability theory is proposed as an approach to overcome the limitations of traditional methods of estimating reliability of PCSs. The results of a demonstration study in which generalizability theory is used to support the reliability of a PCS are reported. A coefficient of generalizability, analogous to the reliability coefficient, was computed based on the variance components estimated. The generalizability coefficient for the total PCS score was .034, which increased to .650 when one item was deleted. The generalizability coefficient for individual items ranged from .053 to .961. Suggestions for further instrument development are offered.

Bias↗

PubMedDate not supplied

Nurses' attitudes toward caring for patients with acquired immunodeficiency syndrome.

The purpose of this study was to examine nurses' attitudes toward caring for patients with acquired immunodeficiency syndrome (AIDS) and factors that might be related to these attitudes. One hundred thirty-eight (138) registered nurses responded to an anonymous mail survey. The survey instrument assessed the subjects' attitudes toward caring for AIDS patients along five dimensions: (1) fears and concerns relating to caring for AIDS patients, (2) attitudes toward health care utilization by AIDS patients, (3) attitudes toward caring for terminally ill patients, (4) attitudes toward homosexuality, and (5) attitudes of significant others toward AIDS patients. The data obtained were analyzed using frequency distributions, independent t tests, and analysis of variance. Results of this study indicated that educational background is not related to nurses' attitudes toward caring for patients with AIDS; however, nurses who have had experience caring for patients with AIDS have more positive attitudes towards health care utilization by AIDS patients (P < .05) and more positive attitudes toward homosexuality (P < .04) than nurses who have not cared for AIDS patients.

Acquired Immunodeficiency Syndrome↗

PubMedDate not supplied

Computer use in staff development. A national survey.

The Informatics Task Force of the National Nursing Staff Development Organization (NNSDO) conducted a national survey soliciting information about computer use in staff development. More than 600 members responded to the survey, suggesting that informatics and the issues surrounding nurses' use of computers are of concern to many staff development professionals. Responses from focus groups held at the National Nursing Staff Development Organization annual convention provided additional input. The results of the survey and discussion sessions have implications for preparing nurse educators for the specialty practice of staff development in the future.

Computer Communication Networks↗

PubMedDate not supplied

Developing and testing a prototype patients care database.

The purpose of the two pilot studies described in this article was to develop and evaluate a database for managing patient care information. A retrospective review of medical records for 67 patients was used for capturing nursing information. Three categories of data were obtained: (1) patient problems, (2) nursing interventions, and (3) patient outcome achievement. A total of 439 patient problems was identified. A total of 4541 discrete nursing interventions were coded, with assessment and surveillance activities accounting for 26% of the total. The degree to which targeted patient outcomes were achieved was assessed by analyzing documentation of patient outcomes in the medical record. Of 2326 expected patient outcomes identified, only 55% (1272) were documented as "met" in the medical records. Potential uses for the database include outlier analysis and outcomes assessment in specific patient populations.

Adult↗