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D L Cohen

Publications and source records attributed to D L Cohen.

13 recordsLinked to original sources
PubMed1992

Health survey methods with minority populations: some lessons from recent experience.

Until recently, minority populations have been inadequately or inaccurately represented in health research. Researchers are now recognizing the need to improve the validity and reliability of data on the health status and health-related behaviors of minorities. This paper discusses important methodological issues in conducting health survey research in minority communities: construction of an appropriate sampling frame, response rates, attrition from panel studies, and response patterns. These themes are illustrated with data from three field studies at the New England Research Institute. Two of these studies focus on inner-city Puerto Rican youth, a group rapidly increasing in size. The extent and multiplicity of problems experienced by this group affect the complexity of survey protocols. The third study is a random-digit-dial telephone survey on health care utilization for coronary heart disease by black and white adults from three inner-city neighborhoods in Boston. The conclusions drawn from the Institute's experience are corroborated by other scientific studies. First, the sociocultural characteristics of the community or group selected for study must be considered in planning and implementing any survey research on minority populations. Second, ensuring the quality of field work with minority groups may be expensive because of high residential mobility and lack of preexisting sampling frames. Third, there is no reason to expect any diminution of data quality with minority groups, provided the resources for data collection are adequate. The quality of data is undoubtedly proportional to the field efforts expended, but the costs of high-quality survey work are often not appreciated. The paper questions the utility of the term "minority research," for it disregards the considerable variation between and within minority groups and subcultures.

Black or African American↗
PubMed1991

A population-based study of the incidence of complications associated with type 2 diabetes in the elderly.

One hundred and eighty-eight known Type 2 diabetic patients aged over 60 years identified by a geographically based survey of a population of 40,076 were followed for a median of 6 years to determine the incidence of various complications. There were 63 deaths and two patients were lost to follow-up. The presence of complications was determined using a structured questionnaire and clinical examination. Incidence rates of ischaemic heart disease, stroke, and peripheral vascular disease (PVD) were 56 (95% CI 41-75), 22 (13-35), and 146 (117-174) 1000-person-years-1 of follow-up, respectively. Rates of stroke and PVD rose significantly with age. Retinopathy occurred at a rate of 60 (42-83) 1000-person-years-1 and cataract at 29 (17-46) 1000-person-years-1 although visual acuity in survivors did not deteriorate overall, probably reflecting the high mortality associated with cataract. The rate of proteinuria (albumin concentration greater than 300 mg l-1) was 19 (9-34) 1000-person-years-1. Incidence rates were unrelated to sex or duration of diabetes. Diabetes is associated with a continuing incidence of complications into old age. Adequate facilities are required to assess and treat the resulting morbidity in a population with an increasing proportion of elderly people.

Age Factors↗
PubMed1991

Serum cholesterol and older people.

Serum cholesterol is positively associated with coronary heart disease (CHD) at all ages. Evidence from trials in middle-aged men with CHD suggests that morbidity and mortality can be reduced after only a few years of lipid-lowering treatment. Although older patients and women have not been included in these trials, both UK and USA expert committees' recommendations on measurement and reduction of cholesterol have not excluded such people. The literature on this issue is reviewed in order to put these recommendations into context.

Adult↗
PubMed1990

Informed consent and the "medical student psychiatrist".

The involvement of medical students in the clinical assessment of psychiatry patients raises concerns that have ethical and possibly legal implications. Responses to a 1986 questionnaire by 91 departments of clinical psychiatry in U.S. medical schools reveal that a substantial proportion (29.3%) of these departments were not fully compliant with established guidelines for obtaining informed consent from patients for students' participation in the patients' assessment and psychiatric care. Medical educators in psychiatry should recognize the importance of consent as a topic in the educational process and should establish policies that correct the discrepancies between institutional practices and informed consent guidelines.

Disclosure↗
PubMed1990

Lens opacity and mortality in diabetes.

A population-based cohort of 294 diabetic patients were examined for the presence of lens opacities and followed up for a median of 6 years. Only two patients were lost to follow-up but there were 73 deaths, 49 in the 108 patients with opacities and 24 in the 184 patients without (odds ratio 2.4, 95% Cl 1.5-3.9). Lens opacities were a powerful predictor of death and the effect was independent of other prognostic factors. The presence of cataract identifies a high risk sub-group of elderly diabetic patients.

Age Factors↗