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Biomedical subjects

G Ingersoll

Publications and source records attributed to G Ingersoll.

7 recordsLinked to original sources
PubMed1991

Relationships of somatic symptoms to behavioral and emotional risk in young adolescents.

Junior high students (n = 1508) from a midwestern community completed a health behavioral questionnaire that asked the frequency of headache and abdominal pain and of a number of behavioral and emotional risk indicators. Headache (24%) and abdominal pain (13%) were frequently reported among these young adolescents, particularly among girls. Those reporting frequent somatic complaints also reported significantly more behavioral and emotional symptoms indicative of risk (p less than 0.001). Further, the interaction between somatic complaint and gender significantly affected risk status (p less than 0.01). This interaction was greater with behavioral risk: boys with both abdominal pain and headaches reported higher behavioral risk than all other groups (p less than 0.0001). Somatic symptoms continued to account for a significant amount of variance in behavioral risk after the effects of emotional risk and age were removed. This suggests that behavioral risk and emotional risk are independently associated with somatic complaints. The evaluation of persistent somatic complaints in adolescents, particularly in boys with abdominal symptoms, should include careful examination of emotional risk factors and other health-endangering behaviors such as substance use, early sexual activity, and delinquency.

Abdominal Pain↗
PubMed1991

Premature sexual activity as an indicator of psychosocial risk.

Although unprotected premature sexual activity is associated with well-defined biologic risks of sexually transmitted disease and pregnancy, the concomitant psychosocial risks are less well documented. The strength of association (odds ratio) of coital status with other risk behaviors and feelings was examined in 1504 junior high school students. Among the 12 through 16-year-old students, 63% of the boys and 36% of the girls were nonvirginal (had had intercourse at least once). The proportion of sexually experienced boys and girls increased with age. Nonvirginal boys and girls were significantly (P less than .001) more likely than their virginal cohorts to engage in other activities considered risky. The odds ratios for nonvirginal youth ranged from 3.5 for girls having used drugs other than alcohol or marijuana, to 10.4 for girls having used marijuana. Nonvirginal boys and girls were also at significantly greater risk for engaging in minor delinquent acts and having school problems. Nonvirginal girls (but not boys) were 6.3 times more likely to report having attempted suicide. The strength of associations with feelings was weaker. Nonvirginal girls were at slightly greater risk for reporting feeling lonely, feeling upset, and having difficulty sleeping. A significant proportion of the students reported sexual experience and ever use of alcohol or marijuana (45% of boys, 27% of girls). There were strong age effects so that by age 15 years, 63% of the boys and 50% of the girls reported experience with both activities. The data suggest that early sexual experience among adolescents is associated with other potentially health-endangering behaviors and that the syndrome of problem behaviors is important in this age group.

Adolescent↗
PubMed1990

A time comparison study of the New York State Safety Belt Use Law utilizing hospital admission and police accident report information.

New York state enacted the first safety belt use law in the United States in 1984. We evaluated the effects of the law by reviewing all hospital admissions from motor vehicle crashes in Monroe County, New York. We compared admissions for the 18 months prior to the effective date of the law with those for the 18 months after the law became effective. Police accident reports and hospital records were coupled and intensively reviewed. Motorcyclists, pedestrians, and bicyclists (bicycle collisions with motor vehicles) became controls for the study. Seat belt usage was determined from police and hospital record information. Analysis of the data revealed that safety belt use among patients hospitalized because of motor vehicle accidents increased from 11.2% before the law became effective to 53% after the law became effective. Hospital admissions decreased 11.9% among motor vehicle occupants and increased 2.6% among controls. The ISS decreased from 16.01 to 14.55 for motor vehicle occupants and increased from 14.77 to 15.11 among controls. Among subjects all injuries decreased except injuries of the spine and abdomen, which increased in the postlaw period.

Abdominal Injuries↗
PubMed1988

Pubertal maturation and cognitive maturity in adolescents.

To determine the relationship between puberty and cognitive development, 135 students, ages 11 through 19 years, were studied. The participants were 73% white, 55% female, and of predominantly middle-class backgrounds with a mean Hollingshead score of 37.1 +/- 16.3. Measures of general intelligence (IQ), cognitive complexity (conceptual level), and cognitive style (perceptual field dependence-independence) were administered. Students rated their own level of sexual maturity (Tanner stage). Mean Tanner stage of 4.0 +/- 0.9 was consistent with the mean age of 14.2 +/- 2.2 years. General intelligence was average (105 +/- 18.2). Most did not demonstrate the use of mature cognitive processes, as reflected in low conceptual level scores (1.19 +/- 0.5) and a more field-dependent cognitive style (7.9 +/- 4.9). Older adolescents (r = 0.377; p less than 0.001), females (r = 0.217; p less than 0.005), and those with a higher IQ (r = 0.329; p less than 0.001) were cognitively more complex. Using an analysis of covariance to control for colinearity of variables, differences in conceptual level and cognitive style as functions of levels of sexual maturity were compared. Once the statistically significant colinear effects of age, gender, and IQ (p less than 0.0001) were removed, no statistical contribution was left attributable to the level of sexual maturity. In other words, when the effects of age were controlled, more advanced Tanner stage was not a predictor of more mature cognitive processes. Physical growth and development during puberty do not appear to affect cognitive development.

Adult↗
PubMed1988

Pubertal maturation and adolescent self-esteem.

One hundred thirty-five students attending a suburban junior and senior high school were studied to examine the relationships between self-esteem and age, gender, and pubertal events. Forty-five percent of the subjects were male, and 24% were black. Mean Hollingshead Two Factor Index of Social Position was 37.1 +/- 16.3, reflecting their predominantly middle-class background. Self-esteem was not related to age but did correlate with intelligence (r = 0.233, p = 0.003). Females had significantly lower self-esteem than males (p = 0.001). Pubertal status (Tanner stage) did not affect self-esteem. However, our data suggest that a subtle relationship between timing of sexual maturation and self-esteem may exist for males. Perhaps more sensitive measures of early pubertal maturation (such as hormone levels) may clarify the extent of this relationship and the gender differences found prior to age 11 years.

Adolescent↗
PubMed1983

Toward strategies for cost containment in surgical patients.

The University of Rochester, Department of Surgery, in response to an experimental community-wide limit on hospital budgets, studied high-cost general surgical patients as a potential source of leverage for containment of hospital costs. It was found that a small number of patients impact significantly on hospital costs. In 1980, 3935 patients at Strong Memorial Hospital (SMH) had at least one contact with a general surgical patient care or intensive care unit; 261 patients (6.6%) had total 1980 charges of more than $20,000 each. They contributed 32% of the total of both general surgical charges and patient days. A subset of 2021 patients was selected to represent more precisely the general surgical patient. The 85 high-cost patients (4.2%) of this subset were chosen for intensive study. These patients generated a significant and disproportionate per cent of total (2021) general surgical charges (26.8%) and hospital days (27.6%). Average total charges were more than 8 times those of the complementary general surgical subset (1936). Nineteen of the 85 patients (22.3%) died in the hospital and 42 patients (49.4%) were dead within 2 1/2 years. Forty patients (of the 85) were then further identified as "complex", based on multiple, usually unrelated, illnesses and multiple annual admissions. Tending to be elderly with poor prognoses, 60% of them had died by April 1983. The major criterion of complexity was the lack of a well-focused medical problem; the cure for one problem simply relinquished primacy to another. A parallel study of hospital ancillary procedures disclosed a similar high-cost pattern. Of approximately 4000 ancillary procedures, 100 (2.5%) had annual charges of $100,000 or over, accounting for two-thirds of total 1980 ancillary charges. Roughly 20% of a single patient's ordered procedures accounted for 80% of the patient's ancillary charges, thus allowing concentrated study of a relatively small number of charges. Means for cost containment may be applied logically to the high-cost patient and particularly toward the complex patient. The complex patient is especially suited for consideration, since it is postulated that these patients are endemic to all general hospitals and to all clinical services. Strategies to be developed should include: 1) a managerial system in which physicians have an incentive to contain costs, 2) an online data system, 3) an accurate, efficient way to identify prospective high-cost and complex patients and, 4) awareness by physicians, patients, and society that less expensive modes of diagnosis and therapy are an appropriate response to rationed health resources.

Adolescent↗