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Biomedical subjects

J B Waller

Publications and source records attributed to J B Waller.

11 recordsLinked to original sources
PubMed1992

Correlates of battering during pregnancy.

Battering during pregnancy affects the health of both pregnant women and their unborn children. The purpose of this retrospective study of 488 primarily Medicaid-eligible postpartum women was to identify the constellation of factors associated with violence. The prevalence of battering during pregnancy was 7%, similar to that found in other studies. Significant correlates of battering included anxiety, depression, housing problems, inadequate prenatal care, and drug and alcohol use. Woman battering by a partner during pregnancy was associated with a greater severity of this constellation of patterns than those experiencing abuse before pregnancy only, or those experiencing physical attack by someone other than their partner. These factors are important to recognize in nursing assessment of pregnant women.

Adult↗
PubMed1992

Effects of a home visiting program on prenatal care and birthweight: a case comparison study.

Recent reports have stressed the importance of social support services to the health and well being of pregnant women and their newborns. The impact of paraprofessional support services on the amount of prenatal care received and birthweight was studied in a sample of 111 low-income women. Paraprofessionals were women who had been on public assistance and successfully attained health and human services for themselves and their infants. They were similar to the patients they served in educational background and ethnicity. A six-week training program prepared them to counsel and assist pregnant women with health and social services, housing, food, transportation and other basic necessities. Women attending a publically-funded prenatal clinic were randomly assigned to a paraprofessional. A comparison group matched for ethnicity, parity and trimester entering prenatal care was also selected. Women followed by a paraprofessional had significantly more prenatal appointments (8.0 vs 6.5 visits) and infants with average higher birthweight (3125 grams) over the matched comparison group (3273 grams). While intensity of contact with a paraprofessional contributed significantly to the amount of prenatal care received by patients of paraprofessionals, the mechanism for improvement in birthweight is unknown.

Adolescent↗
PubMed1991

Preventing homicide: an evaluation of the efficacy of a Detroit gun ordinance.

BACKGROUND: In November 1986, a Detroit, Michigan city ordinance requiring mandatory jail sentences for illegally carrying a firearm in public was passed to preserve "the public peace, health, safety, and welfare of the people." METHODS: We conducted a set of interrupted time-series analyses to evaluate the impact of the law on the incidence of homicides, hypothesizing that the ordinance, by its nature, would affect only firearm homicides and homicides committed outside (e.g., on the street). RESULTS: The incidence of homicide in general increased after the law was passed, but the increases in non-firearm homicides and homicides committed inside (e.g., in a home) were either statistically significant or approached statistical significance (p = .006 and p = .070, respectively), whereas changes in the incidence of firearm homicides and homicides committed outside were not statistically significant (p = .238 and p = .418, respectively). We also determined that the ordinance was essentially unenforced, apparently because of a critical shortage of jail space. CONCLUSIONS: Our findings are consistent with a model in which the ordinance had a dampening effect on firearm homicides occurring in public in Detroit. The apparent preventive effect evident in the time series analyses may have been due to publicity about the ordinance, whereas the small nature of the effect may have been due to the lack of enforcement.

Firearms↗
PubMed1988

Correlates of parenting on a neonatal intensive care unit: maternal characteristics and family resources.

The association of maternal characteristics, family resources, and receipt of prenatal care with parenting behaviors observed in a neonatal intensive care unit (NICU; n = 383) was assessed. The parenting behavior of mothers not receiving prenatal care (n = 128) was compared to that of mothers of the preceding and subsequent admissions (n = 256) by retrospective chart review. Parenting variables included frequency of visits to the NICU and evaluative ratings of parents' involvement with their infant. Parenting of the no-prenatal-care group was significantly less favorable than the control on all comparisons. Factor analysis supported a priori grouping of parenting variables. A stepwise multiple regression of maternal and family characteristics to the factor-derived variable, parenting, showed significant contributions for prenatal drug use and father involvement. Pediatric interventions assessing maternal social and behavioral characteristics are proposed.

Female↗
PubMed1988

Correlates of neonatal morbidity: maternal characteristics and family resources.

The association of mental characteristics, family resources, and receipt of prenatal care with infant birth weight, gestational age, and Apgar scores was assessed in a retrospective review of an extant computerized data base of admissions to a neonatal intensive care unit (NICU; n = 3,818). Prediction variables included mother's age, marital status, health insurance, parity, prenatal health problems, and prenatal drug use. Less favorable infant birth status was associated with prenatal health problems, being single, not having private insurance, obtaining a prior elective abortion, prenatal drug use, and not receiving prenatal care. Stepwise multiple regressions of predictor variables to birth weight and lack of prenatal care were performed. Low birth weight was associated with being single, receiving no prenatal care, and being Black. Lack of prenatal care was associated with mother's age, high parity, prenatal health problems, and prenatal illicit drug use. Pediatric interventions assessing maternal social and behavioral characteristics are proposed.

Apgar Score↗
PubMedDate not supplied

Development of a paraprofessional home visiting program for low-income mothers and infants.

This article reports the development of a paraprofessional home visiting program based upon empirically documented client needs, maintenance of the qualities of mutuality and cooperation found in the indigenous paraprofessionals, and methods of ongoing program revision. Three studies are described that suggested four areas of program emphasis: (1) continuity of services from pregnancy through infancy, (2) needs assessment procedures sensitive to a broad range of health and social problems, (3) an ongoing personal relationship with an indigenous paraprofessional, and (4) reduction of barriers to prenatal care inherent in the health care system itself. We provide examples of program application and revision through training of paraprofessionals, case management procedures, and interventions within the perinatal health care system.

Child, Preschool↗
PubMedDate not supplied

Racial and socioeconomic aspects of myocardial infarction recovery: studying confounds.

Cardiovascular disease rates illustrate the excess morbidity and mortality associated with race and social class. However, while prevalence and deaths from heart disease are greater among black and lower socioeconomic status (SES) populations, researchers rarely consider possible confounds between race and SES. In a longitudinal study of 246 older myocardial infarction (MI) patients, differences appeared in both morbid events and death for black and lower SES patients. Simultaneous comparison of race and SES showed significantly different outcomes among black low SES, black high SES, white low SES, and white high SES patients that confirmed the predicted ranking of these groups. Low SES black subjects ranked last in physical functioning and cardiac symptomatology, whereas high SES white subjects ranked first in preventive health opportunities. We also considered the potential race-SES confound as an interaction term in multiple regression analysis, and three recovery outcomes were significantly predicted by the joint effects of these variables. These findings demonstrate that failure to consider SES of black and white patients jointly, as well as individually, can lead to erroneous conclusions about health.

Black or African American↗