Biomedical subjects
Publications and source records attributed to G E Fryer.
A clinical study to evaluate the analgesic efficacy of carprofen was conducted at the University of Colorado School of Dentistry. In a 6-month period, 248 patients underwent the surgical removal of wisdom teeth for analysis of postoperative pain relief.
Child protection workers in 33 states and the District of Columbia participated in a survey conducted by the C. Henry Kempe National Center for the Prevention and Treatment of Child Abuse and Neglect to determine the attitudes and attributes of workers who terminate their careers in child protection. A year after the survey, telephone follow-up was done to identify respondents to the survey who had left the child protection field. Attributes and attitudes were then linked directly to whether workers had terminated or continued child protective service. Just 8.0% (15 of 187) of the workers had left the field. There were few differences between workers that departed and those whose services were retained. Both were generally dissatisfied with their profession at the time of the survey. The shrinking social service labor market and worker investment in the field are discussed as factors impeding turnover among child protection workers.
Structured interviews were administered to 168 male veterans from five locations to examine the relationship between attitudes toward dental esthetics, age, self-concept, and dental status. Results indicate the following. 1. Subjects who had a more positive self-concept rated their current dental condition higher. 2. Veterans who use dentures do not have a lower self-concept than those who have remaining natural teeth and feel more positively about their dental appearance. 3. Among the sample studied, dental appearance was considered less important than function or comfort. 4. Diminished self-concept is not associated with greater concern for dental esthetics.
This study ascertained the efficacy of hospitalization of children with nonorganic failure to thrive (NOFTT). A meta-analysis was performed on previously published research findings which met certain criteria for inclusion in the analysis. Two categories of outcome measures, physical growth pattern and psychosocial development, were quantitatively synthesized separately using standard meta-analytic techniques. Hospitalization was found to significantly enhance the probability of sustained catch-up physical growth among NOFTT children, but only a comparatively small effect size for hospitalization on their psychosocial development was documented. There remains need for prospective longitudinal study of effectiveness in treating NOFTT children. But meta-analysis is a powerful technique which introduces scientific rigor to the review of study results, none of which is singularly conclusive.
County child protection units throughout the United States were surveyed to (1) profile the attributes of child protection workers, (2) determine their prevailing attitudes and needs, and (3) assess their access to and utilization of professional literature and consultation resources. Responses were received from 301 child protection workers employed in 33 different states. Respondents were generally depressed about their working conditions, the burden of huge caseloads, and unrealistic expectations of them. Job dissatisfaction was especially prevalent among workers who had been in the field for longer periods of time. Many workers had developed attitudes of resignation to their inability to help clients and had a tendency to avoid client contact. Workers reported doing very little professional reading due to the service requirements of their large caseloads and inaccessibility to journals and other meaningful literature pertinent to the field of child abuse and neglect. The availability of consultation in major specialty areas related to the performance of their child protective duties was frequently inadequate to meet their needs. Participation in formal training prior to first case involvement promoted professional reading and worker confidence in the quality of service provided. Worker job satisfaction and self-perceived professional skills were enhanced by membership in professional associations or societies and membership in or use of multidisciplinary teams. These results suggest the need to further develop national and regional resource centers in support of the practice of child protective service (CPS) workers.
Previous efforts to measure the effectiveness of child abuse prevention programs have relied on proximate measures presumed to be predictive of actual skills. This paper presents documentation that brings those assumptions into question, describes actual observation and measurement of behavioral change in children before and after prevention education, and correlates that behavioral response with more traditional measures of effectiveness. Unique to the evaluation was the staging of an actual situation in which each of the children had an opportunity to leave the school building with a stranger. Each simulation was videotaped and conducted in such a way that the children remained unaware of the fact that they had been tested. In addition, tests of language development, self-esteem and knowledge of prevention and safety concepts were administered before and after participating in the Children Need to Know Personal Safety Training Program [1]. Several findings have significant value for future examinations and programming. The effectiveness of a primary prevention program based on age-appropriate, experiential and interactive instruction was empirically documented. Traditional instrumentation which elicits written or verbal responses to cognitive questions about safety may be misleading in assessing children's vulnerability. Higher self-esteem before instruction and higher knowledge/attitude scores after instruction were found to be predictive of a reduction in vulnerability. While this is a significant series of findings, some children did not achieve the objectives of the prevention program. These results suggest further possibilities for evaluation and some direction for improving prevention education.
This paper describes an evaluation which builds upon an earlier project to measure actual behavioral change in the form of reduction of vulnerability to abduction and abuse by strangers; change attributable to participation in a primary prevention program. Simulations, life-like scenarios previously described, were used to address three key questions: Did children who had demonstrated mastery of prevention skills acquired six months earlier retain those skills? Would reteaching the prevention program result in mastery for those children who failed to demonstrate required skills after the first presentation of the prevention program? Could the experimental group results of the first project be repeated with the previous control group? Several findings validated the earlier work and enhanced the understanding of what can be accomplished through prevention programing. Thirty of the original 44 children who participated six months earlier were again available to take part in the final simulation. Of those, all of the previous experimental group children who had performed successfully when participating in the simulation upon completion of the first project were again successful six months later in resisting the invitation of a stranger to leave their school. Each of the previous control group children were successful in the final simulation after participation in the program. But reteaching of the prevention program was successful for just two of the four children who had earlier failed following participation in the program. These findings document the immediate and continued benefits which may accrue from experientially based prevention programing and suggest an important research agenda to facilitate the further evolution of prevention programing and evaluation.
The Federal government has in the past initiated a variety of programs in an effort to address the issue of medical underservice throughout the United States. The results of two such programs sponsored by the University of Colorado Health Sciences Center are examined. Their federal and state support have been decreased at a time when encouraging progress was being made in reducing rural Coloradoans' inaccessibility to medical care, although much of the state remains designated a primary care health manpower shortage area. This paper challenges the Federal Government's policy of temporarily "seed" funding programs whose interventions require several years to complete, under the assumption that state legislatures will eagerly pick up financial support for all that document continuing need and effectiveness. It also describes the difficulties this policy and prevailing state legislative attitude pose for program evaluators in performing their professional function.
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Neonatal mortality in Colorado in the 3-year period 1977-1979 has been analyzed by means of standardized neonatal mortality ratios derived from birth weight-specific mortality for every obstetric facility. The standardized neonatal mortality ratios adjusted for the percentage of neonatal deaths due to untreatable disorders are presented as one possible method for comparing the neonatal outcome in obstetric populations of dissimilar risk. We have suggested that facilities with adjusted standardized neonatal mortality ratios significantly above 1 are those that might benefit from an in-depth review of perinatal services.
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Population-to-practitioner ratios have long been the primary index in the designation of health manpower shortage areas. This paper documents that application of the widely used population-to-dentist index results in understatement of the need for dental health manpower in rural areas. Through the analysis of utilization data collected from a statewide health screening program in Colorado, the practice of sole reliance on the population-to-dentist indices as an indicator of need was tested. Another measure, the area-(square miles) to-dentist ratio was formulated, examined, and found to be a more useful referent of the need for additional health manpower in rural areas. Utilization of dental services in sparsely settled rural counties of Colorado was unrelated to population-to-dentist ratios. A strong, statistically significant association of utilization with land area-to-dentist ratios was found. The findings of this analysis suggest a need for reevaluation of needs assessment methodologies used in the designation of health manpower shortage areas. Indices more sensitive to consumer circumstance than to the number of health care providers available must be considered.
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The SEARCH program (Colorado's area health education program) is designed to alleviate the maldistribution in health manpower by recruiting new professionals to underserved areas through student/resident rotations and to retain those professionals already there by providing accessible continuing education. Data obtained on SEARCH during the first two years of operation are encouraging. Nearly 75 percent of rural physicians practicing in self-assessed areas of need wanted contact with medical students, and the number of University of Colorado medical graduates taking residencies in Colorado increased dramatically. The retention rate of physicians in Colorado was 97.2 percent during this two-year period for those physicians serving as medical student preceptors, whereas it would have been expected to be 83.5 percent based on 1979 data.
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Explore the source record for details and available documents.