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Biomedical subjects

G R Leonardson

Publications and source records attributed to G R Leonardson.

17 recordsLinked to original sources

Spirometry reference values for American Indian adults: results from the Strong Heart Study.

STUDY OBJECTIVE: To derive spirometry normative values from a large population of American Indian adults and compare them to reference values for white adults. DESIGN: Pulmonary function was assessed using spirometry in participants of the Strong Heart Study, a multicenter, community-based, prospective study of cardiovascular risk factors and disease in American Indians, utilizing American Thoracic Society guidelines and a vigorous quality assurance program. SETTING: Central Arizona, southwestern Oklahoma, central South Dakota, and northeastern North Dakota. PARTICIPANTS: Acceptable spirometry results were obtained from 1,619 women and 1,005 men aged 45 to 74 years. RESULTS: Internal reference values and normal ranges for FEV(1), FVC, and the FEV(1)/FVC ratio were derived from a healthy subgroup of 253 women and 190 men, identified by excluding participants with factors associated with a lower FEV(1). Ten percent of the entire cohort (269 of 2,624 subjects) had airways obstruction, as defined by an FEV(1)/FVC below the lower limit of the normal (LLN) using the internal reference equations. After allowing for measurement "noise," 31 participants were below the LLN using reference equations for white adults from the large National Health and Nutrition Examination Study (NHANES) III study but were normal using the internal reference equations (1.3% false-positive), while 27 participants were classified as normal using NHANES III equations but had airways obstruction using the internal reference equations (1.2% false-negative). Similarly low misclassification rates were seen for a low FVC (prevalence, 17.6%). CONCLUSION: For clinical purposes, NHANES III spirometry reference equations for white adults may be used when testing American Indian women and men aged 45 to 74 years.

Aged↗

Validation of a self-administered questionnaire to screen for prenatal alcohol use in Northern Plains Indian women.

OBJECTIVE: This study among American Indian prenatal patients was conducted to validate a self-administered questionnaire (SAQ) designed to (1) identify women who had consumed alcohol during pregnancy, (2) identify women who may be at risk of drinking during pregnancy, and (3) determine the quantity and frequency of alcohol and other substance use just before and during pregnancy. METHODS: The validation involved three components: (1) review of the SAQ responses by a public health nurse; (2) structured patient interview with the research nurse; and (3) medical record abstraction postpartum. RESULTS: Compared to extensive interview and medical record data, the SAQ is sensitive (76.6%) and specific (92.8%) in detecting pregnant women who had consumed alcohol during pregnancy. CONCLUSION: The SAQ is a useful screening tool for alcohol use in this population.

Adolescent↗

The prevalence of diabetic retinopathy and associated risk factors among Sioux Indians.

OBJECTIVE: To estimate the prevalence of and risk factors for diabetic retinopathy among Sioux Indians of South Dakota. RESEARCH DESIGN AND METHODS: Strong Heart Study (SHS) participants with diabetes who are members of the Cheyenne River Sioux Tribe and the Oglala Sioux Tribe were invited to have ophthalmological examinations in 1991. A total of 417 people had eye examinations out of the 488 diabetic SHS participants of the two tribes (85% participation rate). Fundus photographs were obtained of each eye and graded for severity of retinopathy using the modified Airlie House Classification Scheme. Risk factors for retinopathy were determined from the SHS database. RESULTS: The prevalence of diabetic retinopathy among participants from these tribes was 45.3%. Risk factors associated with severity of retinopathy include mean fasting glucose, level. HbA1c, systolic blood pressure, urinary albumin-to-creatinine ratio, renal dialysis, and duration of diabetes. CONCLUSIONS: The prevalence of diabetic retinopathy among diabetic Sioux Indians is similar to or higher than the prevalence in other diabetic Indian and non-Indian populations. Aggressive glycemic and blood pressure control is urgently needed to reduce this high rate, and annual eye examinations to detect and treat diabetic retinopathy should be emphasized.

Aged↗

Practice location factors influencing South Dakota School of Medicine graduates (1977-85).

Physician numbers and placement continue to be major health delivery concerns in the rural state of South Dakota. This study of four-year graduates (1977-1985) of the South Dakota School of Medicine looks at current factors affecting physician placement and compares placement and location selection factors to a previous study of graduates of the medical school when it was a two-year program (1969-1973). Factors influencing physicians locating in South Dakota were: closeness to their home town and or spouses' home town, residency training in small towns, payment of educational loans, medical school clerkships, time of decision, etc. Factors influencing physicians locating in rural communities (less than 5,000) were: growing up in small communities, residency training in small communities, early location decisions, payment of loans, and high medical need.

Career Choice↗

The microcomputer as a clinical research tool.

A microcomputer system has been developed for clinical perinatal-neonatal research. This system is composed of commercially available hardware and software that is readily available, relatively inexpensive, and easy to learn to use. Systems like this permit compilation of data, statistical analysis, and the possibility of intercommunication with other microcomputers and mainframe systems in collaborative research endeavors. Further, microcomputer systems allow investigators immediate access to data and data analysis within their own offices.

Data Collection↗

The relationship between self-concept and selected academic and personal factors.

One-hundred sixty-five high school students were the subjects in a study to determine if selected personal and academic variables were predictive of self-concept scores. The full model was moderately predictive of self-esteem, accounting for approximately 46% of the variance of the criterion variable. Also, it was found that, as a subset of variables, both academic and personal variables made a significant, unique contribution to the prediction of self-concept scores. Of the eleven independent variables used in this study, it was noted that grade point average, extracurricular activities, health, and home life individually made a unique contribution to the prediction of self-concept scores. These four variables also were found to be significantly correlated with self-concept. Other independent variables found to be significantly correlated with self-concept were: parents married and parents divorced. However, these variables were not considered as making a unique contribution to the prediction of self-concept.

Achievement↗

A multifaceted intervention strategy for reducing substance use in high-risk women.

A multifaceted intervention procedure was used at nine sites to reduce the substance use of high-risk women of child-bearing age. The intervention arm featured an intensive home visit/case management system delivered by support specialists through direct programming or referrals. Six domains (mental health, social support, family functioning, self-efficacy/general well being, alcohol use, and tobacco and other drug use) were the focus of the program. Substance use was significantly correlated (P<0.05) with specific measures of mental health, social support, family functioning, and self-efficacy/general well being, supporting the viability of the project domains. Improvements were statistically significant (P<0.05) in 14 of the 16 areas rated. The first phase of the intervention project suggests that the approach is effective.

Adolescent↗

Relationship of prenatal alcohol use with maternal and prenatal factors in American Indian women.

Demographic factors and patterns of substance use among women who did not consume alcohol during pregnancy were compared to women who did consume alcohol during pregnancy. One-hundred seventy-seven Northern Plains Indian women who received prenatal care at an urban clinic in a rural state were screened for substance use as part of the validation study with a self-administered questionnaire. Women who drank during pregnancy were more likely to be single and have less education than women who did not drink. While most of the women in the study had available transportation resources, the women who drank during pregnancy were less likely to have transportation than the women who did not drink. Women who drank during pregnancy consumed more alcohol more frequently before pregnancy than did women who drank before but not during pregnancy. Compared to women who did not drink during pregnancy, women who drank during pregnancy were more likely to smoke cigarettes and use illicit drugs, to have parents who drank, to feel they drank the same or more than other pregnant women, or to have experienced more relationship breakups and physical and emotional abuse. Prenatal patients who drink alcohol during pregnancy need more intensive counseling regarding their multiple risk behaviors.

Adult↗