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Biomedical subjects

J P Fulton

Publications and source records attributed to J P Fulton.

At least 73 records · Page 4Linked to original sources
PubMed1987

The hierarchical relationship between activities of daily living and instrumental activities of daily living.

A three-level hierarchical scale including IADL (shopping and transportation) and ADL (bathing, dressing, transferring, and feeding) was tested and validated based on secondary analysis of three studies of elders in the community: a population-based sample, the Cleveland-GAO, and two service-based samples, the Alternative Health Services Project, a study of Medicaid-eligible elders in Georgia, and the Section 222 Homemaker-Day Care study, a sample of Medicare-eligible elders. Scalability analysis included evaluation of Kronbach's alpha, Guttman analysis, and analysis of the pairwise association of individual items using phi/phi max. Validation included discriminant validity and predictive validity. With respect to discriminant validity, the negative association between functional ability (as measured by the scale) and age was observed. With respect to predictive validity, the negative relationship between functional ability (as measured by the scale) and risk of decline to ADL, death, and hospitalization in a year was observed. A six-level scale similar in structure and detail to the Katz Index of ADL was examined with the three studies. This scale can be used to described a broader range of needs of elders in the community and will be particularly useful to health services planners, practitioners, and researchers.

Activities of Daily Living↗
PubMed1986

Acceptance of hepatitis B vaccine among hospital workers: a follow-up.

We reported earlier on 1,500 hospital employees whose desire for hepatitis B vaccine was assessed. We followed 229 of these subjects to measure the effect of a voluntary educational intervention on desire for vaccine. Acceptance of vaccine declined in 37 per cent of subjects and increased in 13 per cent. One of the extraneous influences on demand for vaccine may have been high-profile media coverage of the AIDS (acquired immune deficiency syndrome) epidemic.

Attitude to Health↗
PubMed1986

Acceptance of hepatitis B vaccine among hospital workers.

Data on sociodemographic status, health beliefs, knowledge of hepatitis B, experience with prior vaccinations, health locus of control, and desire to receive hepatitis B vaccine were assessed in 1,500 hospital employees. Twenty per cent of the variance of the decision to accept vaccine could be explained; beliefs about the safety and efficacy of vaccine influenced acceptance most. Beliefs concerning the likelihood of contracting hepatitis B and the chance of becoming severely ill were less important determinants of vaccine acceptance. Additional factors studied, including knowledge, experience with vaccinations, and sociodemographic status, were important independent determinants of health beliefs. We conclude that the beliefs of health care providers, particularly regarding the safety and efficacy of hepatitis B vaccine, have a major impact on their decision to accept or reject vaccine. Health education interventions may be most effective when addressing beliefs about vaccine safety and efficacy.

Attitude of Health Personnel↗
PubMed1985

The use of the "range of uncertainty".

Most laboratory tests are hampered by overlap of the population with a disease and the population without the disease. An efficient approach to clinical problem solving is to order tests in sequence and focus on the overlap zone of each test--the "range of uncertainty." Indeed, only cases that fall in that range need further workup. All others will have the suspected diagnosis made or excluded with reasonable confidence and need no further testing. To demonstrate the application of this concept, we correlated the iron saturation test and ferritin levels sequentially with the presence or absence of stainable iron in the bone marrow of 139 patients. This model should be suitable for other laboratory tests; it may decrease the use of the laboratory in clinical decision making and reduce the discomfort and cost of additional tests.

Anemia, Hypochromic↗
PubMed1984

Predicting the outcome of hospitalization for elderly persons: home versus nursing home.

Fifty elderly persons who had been admitted to an acute care hospital from home and discharged to nursing homes were compared with 50 elderly persons who had been admitted to the same hospital from home and discharged to home during the same period. Discriminant function analyses were done to predict discharge status from patient characteristics at the time of admission as well as later in the hospital stay. Discharge status was predicted correctly for 88% of men and 75% of women, using patient characteristics available at the time of admission. When certain characteristics available later in the hospital stay were added, prediction improved to 98% for men and 86% for women.

Activities of Daily Living↗
PubMed1980

Electrical wiring configurations and childhood leukemia in Rhode Island.

The study of the relationship between childhood leukemia and electric power line configurations in the greater Denver, Colorado, area by Wertheimer and Leeper (Am J Epidemiol 109:273-284, 1979) was repeated in Rhode Island, focusing on leukemia (age at onset, 0-20 years; year of onset, 1964-1978). The addresses of 119 leukemia patients and 240 controls were studied by mapping power lines within 50 yards (45.72 m) of each residence. The shortest distance between each power line and the point of the residence closest to it was found; the number and types of wires in each power line were noted. Exposure weights were assigned each type of wire using Wertheimer and Leeper's median field strength reading for each. Assuming that the strength of the field decreases with the square of the distance from its source, and that fields generated by different wires grouped in the same power line are simply additive, a summary value of relative exposure was calculated for each address. Quartile exposure values for controls were used to group patient exposures. Contrary to Wertheimer and Leeper's results, no relationship was found between leukemia and electric power line configurations.

Child↗
PubMed1980

Socioeconomic forces as determinants of childhood mortality decline in Rhode Island, 1860-1970: a comparison with England and Wales.

The author tests McKeown's hypothesis that socioeconomic improvement was the most important cause of mortality decline in England and Wales. First, McKeown's basic work is replicated using data on childhood mortality in Rhode Island between 1860 and 1970. "Then the effect of socioeconomic change on mortality change is examined in ways that differentiate it from other effects. Next, socioeconomic and public health effects on disease are differentiated by computing case-fatality and incidence rates." The results provide support for McKeown's argument.

Americas↗