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Biomedical subjects

J F Kerner

Publications and source records attributed to J F Kerner.

16 recordsLinked to original sources

Predictors of smoking prevalence among New York Latino youth.

BACKGROUND: We examined prevalence rates and risk factors for smoking among Latino adolescents, using a multiethnic sample of sixth- and seventh-grade students (n = 3129) in 47 New York City public and parochial schools. METHODS: The students completed questionnaires; self-reported smoking data were collected by means of the "bogus pipeline" technique. The largest group of Latino students (43%) was Puerto Rican; 20% were of Dominican background, 7% were Colombian, and 7% were Ecuadorian. "Current smoking" was defined as smoking at least once per month. RESULTS: A series of logistic regression analyses indicated that peer influence was the strongest predictor of smoking. Family influence was important as well. CONCLUSIONS: The results are discussed in terms of their implications for prevention.

Adolescent

Geographically-based cancer control: methods for targeting and evaluating the impact of screening interventions on defined populations.

Successful implementation of cancer control programs depends on efficient targeting to those at highest risk of developing and dying from the disease. This study presents a methodology for targeting cancer screening on the basis of population and disease variation among small geographic areas. Techniques for quantifying the impact of targeting on the predictive value of a positive test are demonstrated, using 329 New York City health areas. Age-truncated crude incidence, late-stage incidence and mortality rates for breast, cervix, and colorectal cancer are used, using site-specific truncation points relevant to the age groups appropriate for screening. Coefficient alpha was used to determine rate stability with 2, 3, 5 and 7 years of data. The stability of most small area rates was found to reach acceptable levels only with 5 and 7 years of data. Targeting into areas where breast cancer prevalence was high increased the expected predictive value of a positive test by as much as 50% when compared with areas of average prevalence. Geographic targeting will be most useful where between-area variability in prevalence is large and within-area variability is small. The implications of these results are discussed and future studies are suggested.

Adult

Day hospital service in rehabilitation medicine: an evaluation.

The purpose of this study was to evaluate Day Hospital care in rehabilitation medicine as an alternative to intensive inpatient care. The study design called for two groups of randomly selected patients who met all admission criteria for intensive inpatient rehabilitation, who had Medicare or Medicaid insurance coverage, and who had a responsible other person living in the home. Those in the Day Hospital group were sent home after a short period of family training and then were taken to the hospital for treatment five days a week. The control group remained in the hospital on the rehabilitation service as inpatients and received the routine care provided to all other inpatients on that service. Data on utilization of health services, both during and after rehabilitation, cost of services, medical, functional, psychologic and social outcomes were collected for all study participants and analyzed. Findings showed no essential difference between the two groups in physical or functional outcome; however at full capacity with the research costs removed, the Day Hospital method proved the more cost effective.

Cost-Benefit Analysis

A comparison of primary breast cancer management in small, intermediate and large community hospitals and a comprehensive cancer center.

The results presented above indicate clearly that the size of a hospital is associated not only with the type of patient population treated there in terms of demographic and disease related characteristics but also with the type of treatment given. Smaller hospitals were more likely to have older and later stage disease patients for whom they used fewer diagnostic tests and less conservative surgical procedures than larger hospitals. The patients in smaller hospitals also tended to stay for longer periods of time. Interestingly, in terms of the comparison between the community hospital groups and the comprehensive cancer center, no consistent pattern was found. Large hospitals were more like MSKCC in their patient population and length of stay, but the small hospitals were more like MSKCC in the number of tests and type of surgical procedures performed.

Aged

Activities of daily living: reliability and validity of gross vs specific ratings.

The inter-rater reliability and criterion validity of gross vs specific ratings of activities of daily living (ADL) were compared. Forty-three physical therapy students rated 6 patients performing 16 ADL on videotape. With controls for tape order presentation and order of protocol use, specific ratings were found to be more reliable than gross ratings in terms of total scores, transfers, and personal hygiene activities. Dressing activities were found to be reliably rated on both protocols, but locomotion activities presented problems on both. In terms of criterion validity, both protocols significantly differentiated dependent, middle-range, and independent patients, but the gross ratings were significantly lower for dependent and middle-range patients than specific protocols. It was concluded that when activities can be broken down into independent task components, specific protocols are the assessment method of choice. When activities are made up of highly interdependent task components, a behaviorially anchored gross rating protocol may be more effective. Implications for further research are discussed.

Activities of Daily Living