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Biomedical subjects

C L Shear

Publications and source records attributed to C L Shear.

47 records · Page 3Linked to original sources
PubMed1983

Characteristics of patients seeking family-oriented care.

A self-administered questionnaire was distributed to 570 adult patients at three family practice centers to identify the demographic characteristics of those whose entire household was cared for at the same facility. Two of the three centers were free-standing community-based ambulatory care sites, and the third was situated adjacent to a community hospital. Although 95 percent of respondents considered the family practice center their usual source of care, only 54 percent sought care for every household member. Among this latter group, marital status (divorced patients) and race (white) were shown to be a significant determinants of health care utilization by families. The implications of these findings are discussed with recommendations for further research to better define the characteristics and expectations of the population served by family physicians.

Adolescent↗
PubMed1982

Lung cancer mortality and residential proximity to industry.

A potential causal relationship has been suggested by other studies between air pollution and lung cancer. To attempt to define the risk of lung cancer associated with residential proximity to industry by type in Louisiana, lung cancer deaths occurring between 1960 and 1975 in residents of 20 parishes were compared to controls matched on age, sex, year of death and parish of residence. The comparisons were limited to cases (N = 1418) and controls (N = 1429) with known length of exposure to and residing within 0.99 mile (exposed and 1.0 to 3.0 miles (unexposed) radius of an industry type. Of the 13 industry types evaluated, the petroleum and chemical industries showed the highest consistent elevations in risk associated with closeness of residence to industry, whereas possible risks shown for food, grain, canning, and paper industries are less defined. For the petroleum industry, the risk was demonstrated in the group with 10 or more years of residential exposure to the industry in question. For the chemical industry, the residential risk was found in people employed in low risk occupations, who were exposed to large individual industries and was independent of length of exposure as determined for less or more than ten years, (RR = 4.5). The results suggest that residential proximity to petrochemical industries may make a contribution to the lung cancer mortality in Louisiana.

Adult↗
PubMed1980

Shellfishborne disease control in the United States: a commentary.

Shellfishborne disease control in the United States began in the 1920's. The water quality standard promulgated at that time to reduce the incidence of shellfishborne disease has never been adequately evaluated. Evidence suggesting such an evaluation is needed comes from 1) the frequency of shellfishborne disease outbreaks, 2) the changing nature of disease agents, 3) reports of shellfishborne disease in non-outbreak settings, and 4) microbiological studies indicating a lack of correlation between the standard and potential pathogenic organisms. A proper evaluation will define the standard's ability to protect human health and allow for the harvesting of an important food resource.

Animals↗
PubMed1979

Path analysis of environmental and genetic influences on blood pressure.

Familial aggregation of a trait (determined by the intraclass correlation coefficient) may result from genetic influence or from environment common to a household. The authors used path analysis to separate aggregation into the proportion of population variability due to genetic influence (h2 = heritability) and the proportion due to environment common to a household (c2). They used data from full siblings and maternal half siblings, aged two to 18 years, from Bogalusa, Louisiana, a biracial community. The statistically significant aggregation they found could be explained by either h2 or c2 except for two cases: systolic measurement in the pooled (black and white) sample requires h2; diastolic measurement in the white sample requires c2. The authors present a simplified explanation of the techniques they used.

Adolescent↗
PubMed1978

Childhood sibling aggregation of coronary artery disease risk factor variables in a biracial community.

To analyze aggregation of risk factors for coronary artery disease (CAD), the authors studied 4538 children from the biracial community of Bogalusa, Louisiana. Of these children ranging in age from two to 18 years, 2535 had at least one sibling, permitting the calculation of F-ratios and intraclass correlation coefficients. Those calculations revealed statistically signigicant F-ratios for all anthropometric, blood pressure and lipid variables studied. Of the lipoprotein variables studied only alpha-lipoprotein showed no statistically significant aggregation (for black children). The analysis failed to reveal any significant differences in intraclass correlations between black and white children.

Adolescent↗
PubMedDate not supplied

Evidence for space-time clustering of lung cancer deaths.

One parish in Louisiana has the highest reported incidence of lung cancer in the United States. Statistically significant space-time clustering (P < 1.0) was present among lung cancer deaths (1960-1975) in residents of the urban portion of this parish. The spatial distribution of cancer deaths in the urban portion of the parish was compared to age, year of death, race, and sex matched control deaths to determine the risk of lung cancer associated with residential proximity to industry. For industries with independently increased risks, the combination of industries produced risks of 1.9 to 3.2 (P < .05) for residing within 1.2 km of one or more industries to three or more industries, respectively. The results suggest residential exposure to industrial effluents is a factor contributing to the rate of lung cancer.

Female↗
PubMedDate not supplied

Correlates of high density lipoprotein cholesterol and apolipoprotein A-I levels in children. The Bogalusa Heart Study.

Levels of high density lipoprotein cholesterol (HDL-C) and apolipoprotein A-I (apo A-I) may provide independent information concerning cardiovascular disease risk. Therefore, possible correlates of HDL-C and apo A-I levels were studied in 2827 5- to 17-year-olds from a biracial community, and the possible differences in these relationships were assessed. The characteristics examined included sexual maturation, plasma levels of glucose and insulin, obesity, reported oral contraceptive use, alcohol consumption, and cigarette smoking. In addition, levels of endogenous sex hormones (testosterone, estrogen, and progesterone) were measured in 515 adolescent males. HDL-C and apo A-I levels showed different (p less than 0.001) relationships with both obesity and oral contraceptive use. Increases in subscapular skinfold thickness corresponded more closely to decreases in HDL-C, rather than apo A-I, levels; the relationship with HDL-C was probably mediated by triglyceride levels. In contrast, oral contraceptive use was associated with increases in mean levels of apo A-I (8 mg/dl, whites; 16 mg/dl, blacks), but with only very small changes in HDL-C. (High-estrogen oral contraceptives were related most closely to increases in levels of both HDL-C and apo A-I). Levels of both HDL-C and apo A-I were similarly related to sexual maturation and levels of testosterone (negatively in boys), cigarette smoking (negatively), and alcohol intake (positively). Since levels of apo A-I independently of HDL-C may indicate an increased risk of cardiovascular disease, characteristics related to apo A-I levels should be further examined.

Adolescent↗
PubMedDate not supplied

Determinants of no-show appointment behavior: the utility of multivariate analysis.

A multitude of determinants have been identified as predictive of broken appointments. The majority of prior studies have been limited to univariate analysis of the relationship between predictors and appointment keeping behavior. The present report studied 25 independent predictors of no-show behavior using both univariate and multivariate analyses. A total of 579 kept appointments and 84 failed appointments were analyzed. Results of univariate analysis indicated the following significant relationships with appointment behavior: age, ethnicity, marital status, mode of payment, chronic illness, telephone in house, type of care, prior visits to center, cost of care, transportation to center, physician ethnicity, and linguistic capability. However, multiple logistic function analysis revealed only six significant associations: type of care, chronic illness, linguistic capability, mode of payment, physician-patient sex differences, and marital status of the patient. Multivariate analysis may yield a more accurate and clinically useful model of no-show behavior. For example, language barrier may be more of a problem than the race of the patient. Prospective studies might benefit from these considerations.

Appointments and Schedules↗