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Biomedical subjects

C A Carson

Publications and source records attributed to C A Carson.

At least 37 records · Page 2Linked to original sources
PubMed1995

Fastpac visual field screening.

In epidemiology, screening for visual field defects has traditionally been expensive, time consuming and laborious. To achieve cost- and time-effective visual field screening, a faster algorithm has been developed for the Humphrey perimeter called Fastpac, which is designed to achieve threshold perimetry in two-thirds the time of the standard algorithm. We compared the Fastpac and conventional full-threshold 24-2 fields obtained in 39 eyes of 36 participants. We divided the participants' fields into normal (14) and glaucomatous (25) visual field groups, and compared the test times, number of questions asked and statistical parameters generated for each field for Fastpac as compared to the standard algorithm. Then we divided the participants' fields into Fastpac and standard fields and again compared the test times, number of questions and statistical parameters. Finally we asked trained observers to judge the fields as being normal or abnormal, in a masked fashion, and found a high degree of agreement between the fields generated by Fastpac and standard. Fastpac offers accurate full-threshold screening in two-thirds the time of the conventional algorithm and would be very useful for large scale prevalence studies in ophthalmic epidemiology.

Adult↗
PubMed1995

The epidemiology of cataract: a review of the literature.

Cataract is a major cause of blindness, accounting for nearly half of all blindness worldwide. Epidemiological research provides the principles and methods to assess the extent of cataract, and supplies the necessary information for policy planning. Obtaining accurate epidemiological data on cataract is essential to ascertain and estimate the cost of primary and secondary eye health care needs. Determining risk factors is also necessary to reduce the economic and social repercussions associated with the disease. The following paper presents a review of the epidemiology of cataract in the middle to elderly age group.

Aged↗
PubMed1995

Monitoring in methadone maintenance treatment.

Weekly preannounced and unannounced urine testing was compared in a counterbalanced design with two random samples of clients (n = 74) from a methadone maintenance program. Results indicated no significant differences in the detected rate of positive specimens for the two types of testing. Clients reported preference for the preannounced testing and indicated that testing was not very helpful in avoiding the use of illicit drugs. The merits of psychosocial procedures in response to the outcome of monitoring are discussed.

Adult↗
PubMed1994

Quality of published reports of the prognosis of community-acquired pneumonia.

OBJECTIVE: To systematically assess the quality of published reports of the prognosis of community-acquired pneumonia using a formal quality assessment instrument. DESIGN: Retrospective review of studies published during 1966-1991. ARTICLES: 108 articles related to the prognosis of community-acquired pneumonia retrieved by a computerized search. INTERVENTION: All articles, blinded to author(s), journal title, year of publication, and study institution(s), were independently reviewed by two investigators using a ten-item quality assessment instrument designed to evaluate: 1) identification of the inception cohort (4 items), 2) description of referral patterns (1 item), 3) subject follow-up (2 items), and 4) statistical methods (3 items). Adherence to each of the ten individual quality items and an overall quality score were calculated for all articles and across three time periods. MAIN RESULTS: Among all 108 articles that underwent quality assessment, 30 were published from 1966 to 1979, 61 from 1980 through 1989, and 17 from 1990 through 1991. The mean total quality score of all articles was 0.55 (range 0.22-0.90). There was a significant trend toward improvement in total quality scores over the three time periods (0.50 to 0.56 to 0.65; p < 0.001). However, several systematic errors in the study design or reporting of these studies were discovered throughout time: only 3.7% provided comparative information about nonenrolled patients, 28.7% determined whether the study institution was a referral center, 36.1% specified inclusion or exclusion criteria, and 45.5% used appropriate statistical analyses to adjust for more than one prognostic factor. CONCLUSIONS: Despite improvement in overall quality of published articles, systematic errors exist in the design and reporting of studies related to the prognosis of community-acquired pneumonia. The quality assessment tool employed in this study could be used to guide the development of high-quality outcomes research in the future.

Adult↗
PubMed1994

Coffee consumption: relationship to blood lipids in middle-aged women.

BACKGROUND: There is controversy about the relationship between coffee intake and blood lipids in women and many studies fail to control for potential confounding factors. METHODS: In 1983 and 1984, 541 randomly selected premenopausal women were recruited from a list of licenced drivers, aged 42-50, within selected areas in Allegheny County, Pennsylvania. They were invited to participate in a 5-year study of biological and behavioural changes associated with menopause. At baseline and the first follow-up visit, lipoprotein, lipid and apoprotein levels, physical activity, dietary intake and coffee consumption were measured. Pearson correlations between coffee consumption and the various lipid values were calculated. Multivariate analyses, which controlled for the potential confounding effects of body mass index, alcohol intake, percent of calories from carbohydrate and fat, number of cigarettes smoked per day, physical activity level, and age in months, were also employed to investigate the relationships. RESULTS: Mean coffee consumption for the group was 3.35 cups of coffee per day at baseline and 3.02 cups per day at follow-up. Results of analyses of correlation between coffee consumption and blood lipids as well as multiple regressions to control for menopausal status at follow-up were non-significant (P > 0.05) for all blood lipid values with the exception of triglycerides, which were inversely related to coffee consumption at follow-up. CONCLUSIONS: These results do not support a relationship between coffee consumption and lipoprotein, lipid or apoprotein levels with the exception of an inverse relationship between coffee consumption and triglyceride level at follow-up.

Adult↗
PubMed1994

Comparison between Fastpac and conventional Humphrey perimetry.

As part of the Melbourne Visual Impairment Project, a substudy was performed to determine the efficacy of the newly released Fastpac program for the Humphrey Field Analyser. A comparison was performed of the Fastpac and conventional full threshold 24-2 fields obtained in 39 eyes of 36 participants. Also a comparison study was performed of the standard and non-standard 80-point screening tests to the standard 24-2 full threshold test in 23 eyes of 23 participants. In the full threshold comparison there was 100% agreement between the two with Fastpac being 32% to 39% faster than standard. In the 80-point screening test comparison, non-standard was no faster than standard. Sensitivities were 17/17 (1.0) for non-standard and 15/18 (0.83) for standard, as compared with the standard 24-2 full threshold test. Fastpac software offers accurate screening and threshold testing in less time than the standard algorithm.

Algorithms↗
PubMed1994

CDC's consensus set of health status indicators: monitoring and prioritization by state health departments.

A survey assessed the extent to which state health departments monitor and prioritize the Centers for Disease Control and Prevention's consensus set of health status indicators. A response rate of 100% was obtained. Although mortality indicators are often monitored, only 75.5% of the states monitor work-related injury deaths. Most states monitor the incidence of acquired immunodeficiency syndrome, measles, tuberculosis, and syphilis. Low birthweight, births to adolescents, and lack of prenatal care are monitored in nearly all states and are considered high-priority problems. Only 46.9% of states are monitoring poor air quality, and only 58.8% are monitoring childhood poverty. Survey results suggest a need for standardized assessment of indicators for policy development and program planning.

Adolescent↗
PubMed1994

Methods for a population-based study of eye disease: the Melbourne Visual Impairment Project.

The methodology of the Melbourne Visual Impairment Project, a major population-based survey of eye disease on 3,500 randomly selected individuals aged 40 years of age and over in the Melbourne metropolitan region, is presented. The aims of the study are to determine the distribution and determinants of eye disease in an urban population; the impact of eye disease on visual function and the activities of daily living; and the accessibility of eye health care services in the community. All procedures are conducted according to a standardised protocol to allow for comparison with other population-based studies, both in Australia and overseas. Information collected from this study will be employed in the development of recommendations related to eye health care service delivery and establishment of priorities for future public education programmes and health research.

Activities of Daily Living↗
PubMed1994

Impact of immunosuppression on health care use by men in the Multicenter AIDS Cohort Study (MACS).

The effects of human immunodeficiency virus type 1 (HIV-1) serostatus, AIDS, and level of immunosuppression on health service use were examined in the Multicenter AIDS Cohort Study. Data on self-reported hospitalizations, outpatient medical services (non-emergency room) and emergency room care during the preceding 6 months were collected for 3,447 homosexual/bisexual men returning for their 14th and/or 15th semiannual visits in Chicago, Baltimore, Los Angeles, and Pittsburgh. AIDS-free seropositive men with CD4+ cells < 200/microliters were more likely to be hospitalized [odds ratio (OR) = 2.3, 95% confidence limits (CL) = 1.4, 3.8] and use outpatient medical care (OR = 7.9, 95% CL = 4.9, 12.6), compared with seronegative men. Increased outpatient care was initiated at the earliest stages of HIV-1 infection, even when CD4+ cells were > 500/microliter. Dramatic increases in outpatient care for each level of immunosuppression were observed. HIV-1-related symptoms were associated with increased hospitalizations (OR = 4.8, 95% CL = 3.2, 7.3), use of outpatient medical services (OR = 3.3, 95% CL = 1.9, 5.6), and emergency room care (OR = 3.1, 95% CL = 2.1, 4.6). Persons with AIDS and < or = 50 CD4+ cells/microliter most likely to be hospitalized (OR = 8.1; 95% CL = 4.4, 14.9). No significant difference (p > 0.05) in emergency room use was observed according to HIV-1 serostatus, AIDS, or immunosuppression, after adjusting for insurance and clinical symptoms. To the extent that CD4+ cell counts are used as one of the criteria for an AIDS diagnosis and such a diagnosis broadens available benefits to persons with HIV disease, the pattern of health care services described here will be important for health care providers and planners.

Acquired Immunodeficiency Syndrome↗
PubMed1993

Relation of caffeine intake to blood lipids in elderly women.

The relation of the consumption of caffeine from coffee, tea, and all caffeine-containing soft drinks (hereafter referred to as "cola") to blood lipid levels was studied in 1,035 white women ranging in age from 65 to 90 years (mean, 71.2 years) from October 1986 through October 1988. All study subjects were participants in the Pittsburgh, Pennsylvania, clinic of the Study of Osteoporotic Fractures. Fasting blood samples were tested for total cholesterol, triglycerides, apolipoproteins A-I and B-100, total high-density lipoprotein (HDL) cholesterol, and the HDL2 and HDL3 subfractions. Low-density lipoprotein (LDL) cholesterol was calculated using the Friedewald equation. Current consumption of coffee, tea, and cola was assessed by means of a self-administered personal habits questionnaire. Potential confounders, such as body mass index (weight (kg)/height (m)2), waist/hip ratio, smoking status, and alcohol intake were also measured for each woman. Analyses of variance and tests for mean differences revealed an inverse relation between the consumption of tea and apolipoprotein B-100 and a positive association between the consumption of cola and apolipoprotein B-100. Apolipoprotein A-I levels were found to be positively related to coffee consumption and negatively related to tea consumption. There was no consistent relation between caffeine consumption and total cholesterol, LDL cholesterol, total HDL cholesterol and its subfractions, or apolipoprotein B-100. Adjustment for potential confounders yielded no remaining significant associations between caffeine from any of the major beverage sources and any of the lipid fractions. In conclusion, the inconsistent relations between caffeine from various sources and blood lipids do not support a significant association of blood lipid levels with caffeine consumption in elderly women.

Aged↗
PubMed1993

Epidemiologic indicators of health status to guide health care management decision making.

Health objectives, developed by the United States Department of Health and Human Services, were published recently in the document entitled Healthy People 2000: National Health Promotion and Disease Prevention Objectives. They were developed to guide national and local health policy toward actions to increase the health of the nation. To effectively apply these objectives locally, epidemiologists and health planners must work together. Through collaboration, the Healthy People 2000 objectives can be prioritized to guide health policy and planning on a regional basis. The purpose of this study was to assess certain health status indicators in southwestern Pennsylvania to determine whether it was likely that the year 2000 targets would be met if trends from the past 20 years were to continue. The following mortality rates were analyzed: heart disease, homicide, breast cancer, colon cancer, lung cancer, suicide, motor vehicle accidents, work-related injury, and infant mortality. In addition, incidence of the following diseases was evaluated against the year 2000 targets: gonorrhea, primary and secondary syphilis, measles, tuberculosis, and AIDS. By employing epidemiological principles and considering strategic planning needs, it is possible to prioritize some of the health care needs in local areas for the next decade.

Data Collection↗