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Biomedical subjects

C M Olson

Publications and source records attributed to C M Olson.

At least 19 recordsLinked to original sources
PubMed1998

Ethical issues in studying submissions to a medical journal.

A protocol to prospectively study characteristics of meta-analyses submitted to a weekly medical journal raised several ethical issues. In submitting a manuscript for publication, authors do not implicitly consent to have their work used for research. Authors must be free to refuse to consent, without it affecting their chances for publication. Systematically analyzing data on manuscript characteristics might influence the decision to publish. Having investigators who are not on the editorial staff or peer reviewers extract the manuscripts' characteristics breaks the confidentiality of the author-editor-reviewer relationship. In response to these issues, we added a statement to our journal's instructions for authors that submitted manuscripts may be systematically analyzed to improve the quality of the editorial or peer review process. Authors had to actively consent to participate, but editors and external reviewers were unaware of which authors were participating. The manuscript characteristics were not shared with authors, editors, or external reviewers. The investigators were blinded to each manuscript's author and institution. After we addressed ethical issues encountered in studying manuscripts submitted to a medical journal, 99 of 105 authors submitting a meta-analysis during the study's first 24 months agreed to participate.

Biomedical Research↗
PubMed1998

Food insufficiency exists in the United States: results from the third National Health and Nutrition Examination Survey (NHANES III).

OBJECTIVES: The purpose of this study was to estimate the prevalence of food insufficiency in the United States and to examine sociodemographic characteristics related to food insufficiency. METHODS: Data were analyzed from the third National Health and Nutrition Examination Survey, a cross-sectional representative sample of the civilian noninstitutionalized population living in households. Individuals were classified as "food insufficient" if a family respondent reported that the family sometimes or often did not get enough food to eat. RESULTS: From 1988 through 1994, the overall prevalence of food insufficiency was 4.1% and was primarily related to poverty status. In the low-income population, food insufficiency was positively associated with being Mexican American, being under the age of 60, having a family head who had not completed high school, participating in the Food Stamp Program, and not having health insurance. It was not related to family type or employment status of the family head. Over half of food-insufficient individuals lived in employed families. CONCLUSIONS: Food insufficiency is not limited to very low-income persons, specific racial/ethnic groups, family types, or the unemployed. Understanding food insufficiency is critical to formulating nutrition programs and policies.

Adolescent↗
PubMed1997

Parity-associated body weight: modification by sociodemographic and behavioral factors.

This research examines the association between parity and body weight and how this relationship is modified by sociodemographic and behavioral factors. Using multiple linear regression analysis, the study assessed the relationship between parity and relative body weight (as Body Mass Index, BMI) and how this relationship interacts with seven sociodemographic and seven behavioral factors in a national sample of 5,707 women from the Second National Health and Nutritional Examination (NHANES II) survey. After adjusting for sociodemographic factors, the amount of weight associated with parity averaged about 0.5 kg per child. However, parity-associated weight differed by sociodemographic and behavioral factors, and was much larger in some subgroups. Among 18-45 year olds, the amount of weight associated with parity was greater in blacks than in whites, less in employed than unemployed white women but greater in employed than unemployed black women, less in smokers than nonsmokers, less in those with a high level of recreational exercise, and differed with the level of nonrecreational physical activity depending on race. Among 46-74 year olds, the amount of weight associated with parity was greater in married than unmarried women, and less in those who were active outside of recreation versus those who were less active. These results suggest that sociodemographic and behavioral variables modify the relationship between parity and body weight, and provide insight for identifying women who are at risk for having greater BMI with higher parity. This information may be applicable to the targeting and design of interventions to prevent postpartum weight retention.

Adolescent↗
PubMed1997

Parity-associated weight gain and its modification by sociodemographic and behavioral factors: a prospective analysis in US women.

OBJECTIVE: To examine how the relationship between parity increase and weight gain is modified by sociodemographic and behavioral factors. DESIGN: Prospective longitudinal data from the first National Health and Nutrition Examination Survey (NHANES I, 1971-75) and its follow-up of those aged 25 y and older, the NHANES I Epidemiologic Follow-up Survey (NHEFS, 1982-84). SUBJECTS: The analytical sample was nationally representative of the United States and included 2952 white or African-American non-pregnant women aged 25-45 y at baseline, who were re-measured approximately 10 y later. MEASUREMENTS: Statistical interactions in multiple linear and logistic regression models were examined to identify how eight sociodemographic and three behavioral factors modified the effect of parity increase on body weight change and risk of substantial weight gain. RESULTS: Factors that increased parity-associated weight gain included being African-American, living in a rural area, not working outside the home, having fewer children, lower income and lower education, and being unmarried. Among white women, being younger and having higher body weight at baseline increased parity-associated weight gain, while among African-American women, being older and having lower body weight increased parity-associated weight gain. African-American smokers gained less weight with an increase in parity, while the interactions between smoking and physical activity with parity-associated weight gain in whites were complex. CONCLUSION: The effects of sociodemographic and behavioral factors on parity-associated weight gain varied by race and parity change, with the most consistent findings being that unmarried and unemployed white women had greater parity-associated weight gain, while both white and African-American women who smoked, had higher education, or higher parity had lower parity-associated weight gain. This information may contribute to better targeting and more effective interventions to prevent postpartum weight retention.

Adult↗
PubMed1997

A discriminant function for preeclampsia: case-control study of minor hemoglobins, red cell enzymes, and clinical laboratory values.

A case-control study was performed in eight pairs of women to determine whether preeclamptic women developed abnormalities in minor hemoglobins, glycolytic enzymes, or other blood components that might provide insight into the pathophysiology of preeclampsia, or that in combination might be used as a marker for the condition. These variables and standard clinical tests were analyzed as discriminators between preeclamptic and control women. The subjects were matched for age, ethnicity, parity, and gestational age. Blood samples were taken at the time of diagnosis of preeclampsia and at comparable gestational ages for matched normal controls. Variables differing significantly between groups included increases in uric acid (UA), low-density lipoproteins (LDL), phosphoglycerate kinase (PGK), and mean platelet volume (MPV), and decreases in glyceraldehyde phosphate dehydrogenase (G3PD) in preeclamptic women compared to normal controls. Discriminant analysis revealed the following function to separate the groups: 0.7764 (UA) + 0.8086 (PGK) -0.7032 (G3PD) + 0.1399 (LDL) -0.2386 (MPV). A discriminant score of > or = 275 indicated a > or = 90% probability of preeclampsia. The results are consistent with perturbations in red cell glycolysis in preeclampsia. Further prospective studies are warranted to test the efficacy of this discriminant function in predicting preeclampsia.

Adult↗
PubMed1997

Questionnaire-based measures are valid for the identification of rural households with hunger and food insecurity.

This study assessed the validity of questionnaire-based measures for the identification of rural households with hunger and food insecurity. Data used were from a 1993 survey of 193 households with women and children living at home in a rural county. Two interviews provided data on demographics, factors contributing to food insecurity, coping strategies, fruit and vegetable consumption, disordered eating behaviors, height, weight, dietary recall and household food-stores inventory. This information was used to develop a definitive criterion measure for hunger and food insecurity to compare with hunger and food insecurity items from Radimer/Cornell, the Community Childhood Hunger Identification Project (CCHIP) and the Third National Health and Nutrition Examination Survey (NHANES III). The Radimer/Cornell and CCHIP questionnaire-based measures had good specificity (i.e., percentage of truly food secure correctly classified; 63-71%) and excellent sensitivity (i.e., percentage of truly food insecure correctly classified; 84-89%) when compared with the criterion measure. Estimates of the prevalence of household food insecurity from the criterion, Radimer/Cornell and CCHIP measures were almost identical. The overall agreement of the Radimer/Cornell and CCHIP measures was very good. These measures can be validly used to screen for hunger and food insecurity among rural households similar to those studied and to target subpopulations for food programs. The NHANES III item alone had excellent specificity but poor sensitivity, and underestimated prevalence.

Adaptation, Psychological↗
PubMed1997

[A combined methodology for understanding the duration of breast feeding the poor neighborhoods of Managua, Nicaragua].

This study examined the relationship of several maternal variables to the duration of exclusive breast-feeding and the total duration of breast-feeding, along with attitudes, perceptions, and beliefs about breast-feeding among women living in poor neighborhoods of Managua, Nicaragua. The field work was carried out in December 1992 and January 1993 using qualitative and quantitative methods. A structured questionnaire was administered in interviews with 556 mothers of children under 12 months of age, and meetings of four directed discussion groups were held, in which a total of 20 women participated. At one week of age, almost all the children of the mothers who were surveyed had been breast-fed, but only 45% had been exclusively breast-fed. At 12 weeks old, 30% were already completely weaned. The discussion groups revealed the coexistence of positive opinions about both breast-feeding and bottle-feeding. However, exclusive breast-feeding was considered harmful for the mother, and breast milk was not thought to be sufficient nourishment for the child. Previous experience was strongly related to the duration of exclusive breast-feeding and to total breast-feeding duration. Attitudes, social support, and work situation were important factors influencing the total length of time women breast-fed a child. In general, the results obtained through the interviews and in the discussion groups were in agreement and showed that the elements needed to promote exclusive breast-feeding were social support, a favorable community environment, and policies that dealt with problems faced by working mothers. The complementary research methods were useful for obtaining information about the relative importance of different factors that determine the duration of breast-feeding and for understanding that practice in greater depth from the mother's point of view.

Adolescent↗
PubMed1996

Reporting approval by research ethics committees and subjects' consent in human resuscitation research.

OBJECTIVE: To determine how frequently reports of research in human cardiopulmonary resuscitation mention approval by a research ethics committee and address subjects' consent. METHODS: Retrospective review of published reports of interventional research in human cardiopulmonary resuscitation. Reports were retrieved from the MEDLINE database and selected according to pre-established criteria. Data were abstracted independently by the two authors with differences resolved by mutual agreement. Results were analyzed according to whether the research took place in the prehospital setting, the emergency department, or the hospital; whether it was conducted within or outside the United States; whether it received any funding from the US government; its randomization scheme; the year of publication; and whether the journal's instructions required mention of REC approval or subjects' consent. RESULTS: Reports of 47 studies met our criteria for inclusion. Of these, 24 (51%) mentioned approval by a research ethics committee and 12 (26%) addressed subjects' consent. Significantly more studies reported ethics committee approval or addressed consent during more recent years. Authors were more likely to report consent, REC approval, or both when journal instructions required that REC approval be mentioned. CONCLUSION: Reports of resuscitation research have not consistently mentioned approval from a research ethics committee or addressed subjects' consent for interventional studies using human subjects. However, they are doing so more frequently in recent years as journal requirements for reporting change. REC approval is now almost always being reported, but subjects' consent is often not addressed. Journal editors and reviewers should ensure that authors adhere to the journal's instructions about reporting ethical conduct of experiments.

Adult↗
PubMed1996

Relationship of hunger and food insecurity to food availability and consumption.

OBJECTIVE: To describe the relationship of new measures of hunger and food insecurity to household food supplies and individual food and nutrient intake. DESIGN AND SETTING: A questionnaire containing the Radimer/Cornell hunger and food insecurity items and questions on eating patterns and the frequency of fruit and vegetable consumption was administered to subjects during a personal interview in their homes. A 24-hour diet recall and a household food inventory were conducted at the initial interview and at a follow-up visit. SUBJECTS: Participants were 193 women drawn from a random sample of 308 women who had completed a previous health census in a rural New York State county. Subjects' ages ranged from 15 to 40 years. All had children living at home and less than 16 years of education. STATISTICAL ANALYSES: Regression analysis was used to test for linear trends across food insecurity groups for the household food inventory scores and for the frequency of consumption of fruits and vegetables. t Tests were used to assess differences between the food secure and food insecure groups for nutrient and food group means. A chi 2 test for trend was used to examine differences in the distribution of nutrient and fruit and vegetable intake between the food secure and food insecure groups. RESULTS: A significant decrease in the frequency of consumption of fruits and vegetables and the amount of food in the household and a significant increase in scores indicative of disordered eating patterns were associated with a worsening of food insecurity status. Potassium and fiber intake and fruit consumption differed significantly between the food secure and food insecure groups. The percentage of respondents consuming less than the Recommended Dietary Allowance for vitamin C and fewer than five fruits and vegetables per day was significantly greater among food insecure respondents than food secure respondents. APPLICATIONS/CONCLUSIONS: The quantity of food available in households and consumption of fruits and vegetables decreased with increasingly severe problems with food insecurity and hunger. In this rural population, the Radimer/ Cornell measures were useful in identifying households experiencing food insecurity and providing information about the nature of the food supply and the dietary intake problems experienced by food insecure households and persons, suggesting that these measures may be useful on community surveys designed to examine food insecurity issues.

Adolescent↗
PubMed1995

Informed consent in emergency research. Consensus statement from the Coalition Conference of Acute Resuscitation and Critical Care Researchers.

OBJECTIVE: A coalition conference of acute resuscitation researchers was held to discuss the feasibility of applying current federal research regulations regarding informed consent to the emergency setting. This article presents consensus recommendations for regulatory changes for consent in emergency research. PARTICIPANTS: Representatives from the Society for Academic Emergency Medicine and the American Heart Association identified several professional organizations as stakeholders in this issue, including research, clinical, bioethics, legal, and patient advocacy groups. The Office for Protection From Research Risks (OPRR), the Food And Drug Administration (FDA), and staff from specific legislative offices were also invited to observe. Forty-three participants attended, including representatives from 12 professional organizations, five medical institutions, and the FDA and OPRR. This was a closed meeting. Participants were self-funded or sponsored by their professional organizations. EVIDENCE: Before the meeting, a draft of a position statement was developed by the conference organizers based on the current literature and discussions with experts in the field. This draft, copies of the current federal research regulations, and supporting articles were distributed before the conference. CONSENSUS PROCESS: Participants rotated through moderated discussion sessions to comment on subsections of the draft. Following discussion, a working draft was developed and distributed to each participant and represented organizational board for final review. All comments were considered in the final version of the document. CONCLUSIONS: We believe there are circumstances when it is not feasible to obtain prospective or proxy consent for enrollment into an emergency research protocol. In these circumstances, patients are vulnerable, not only to research risks, but also to being denied potentially beneficial therapy when there is no known effective treatment for their life-threatening condition. We offer recommendations that should be met when the critical nature of the illness or injury or the need to apply an investigational therapy rapidly precludes prospective consent for participation in emergency research.

Consensus↗
PubMed1995

Validation of the Radimer/Cornell measures of hunger and food insecurity.

Hunger and food insecurity have been identified as core indicators of an individual's nutritional state that should be assessed in nutrition surveillance activities. Such an assessment requires a valid measure of these phenomena. This paper describes further work on the construction of measures of hunger and food insecurity based on the Radimer/Cornell items and provides an assessment of their validity. A random sample survey of 193 households with women and children living at home was conducted in 1993 in a rural county in New York State. A questionnaire containing the Radimer/Cornell hunger and food insecurity items, information about demographic characteristics, frequency of fruit and vegetable consumption, and household food supplies was administered to subjects. Measures were constructed that identified households experiencing household- and individual-level food insecurity and households with hungry children. The construct and criterion-related validity of the measures was assessed. In relation to criterion-related validity, as food insecurity worsened, there was a significant and progressive increase in the percentage of subjects participating in food programs and having low income, education and employment and a significant decline in average household food availability and fruit and vegetable consumption. These results support the validity of the Radimer/Cornell measures and illustrate their ability to differentiate among groups of households experiencing increasingly severe food insecurity and hunger.

Adolescent↗
PubMed1994

Promoting positive nutritional practices during pregnancy and lactation.

This paper describes three key elements for promoting positive nutrition practices among women during pregnancy and lactation: 1) increasing access to prenatal care; 2) redirecting the content of prenatal care to include a greater emphasis on screening and intervention for behavioral risk factors, including poor nutritional practices; and 3) delivering nutritional care based on recent Institute of Medicine guidelines. These guidelines advise the practitioner to determine prepregnancy body mass index (BMI) and to recommend different weight gains during pregnancy according to BMI category, to assess dietary and lifestyle factors to determine the need for nutrient supplements and to base the supplement composition on the nature of the nutritional need identified, to provide routine supplementation of only 30 mg iron beginning in the second trimester of pregnancy, and to base the diagnosis of anemia on different cutoff values by stage of pregnancy and smoking status.

Dietary Services↗
PubMed1993

Dissemination and use of a school-based nutrition education program for secondary school students.

Program dissemination and implementation represent critical components of effective school-based health promotion interventions. This study examined the dissemination and implementation of a nutrition teaching program, Nutrition For Life, in New York State secondary schools. Some 1,312 health, home economics, and physical education teachers in junior and senior high schools provided information through random sample mail surveys. Logistic regression procedures examined teacher and school characteristics associated with receipt and use of the program. Overall, 50% of junior high school and 33% of senior high school teachers received the program and three-quarters of these teachers used it. At both levels, home economics teachers were more likely to receive and use the program than health teachers. Peer-led teacher training workshops organized through an existing community-based network provide an effective and efficient mechanism for disseminating nutrition teaching programs.

Adolescent↗