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Biomedical subjects

J P Winter

Publications and source records attributed to J P Winter.

14 recordsLinked to original sources
PubMed2001

Should disability items in the census be used for planning services for elders?

PURPOSE: The main goal of this study was to determine how well the disability questions of both the 1990 and 2000 Census correlated with a standard measure of disability. If the census questions were to correlate moderately well with a standard measure of disability, then Area Agencies on Aging (AAA) and other organizations would be able to use census information in estimating service needs for their catchment (service) area. DESIGN AND METHODS: Questionnaires containing both the census disability questions and a standard measure of disability were mailed to 4,508 older adults; 1,514 completed surveys were returned. In order to assess reliability, 472 of the respondents who completed the mail survey were reinterviewed by phone. All three disability measures were collapsed into the following three categories: no needs, instrumental activities of daily living (IADL) needs only, and activities of daily living (ADL) needs. RESULTS: All three disability measures exhibited moderate to good test-retest reliability. Using a standard measure of disability as the criterion, validity for the 1990 Census measure was quite low (Kappas of approximately 0.35). Validity for the 2000 Census measure was moderate to good (Kappas of approximately 0.60). IMPLICATIONS: These results suggest that the 2000 Census disability questions may be sufficiently valid for planning purposes. However, additional research with more representative samples of older adults is needed.

Activities of Daily Living↗
PubMed2001

Reducing overclaiming in needs assessment studies. An experimental comparison.

A randomized experiment investigated the effect of various instructional sets on reducing agency awareness overclaiming, that is, claiming knowledge of fictitious agencies. As predicted, respondents who were warned that the list contained fake agencies exhibited less agency awareness overclaiming than respondents who were not warned. However, providing respondents a memory retrieval strategy had no effect on agency awareness overclaiming. A multivariate model, which included demographic variables, response style variables, and knowledge variables, explained 40% of the variance of agency awareness overclaiming.

Black or African American↗
PubMed2000

Do consumers who have a choice of treatment have better outcomes?

This study used a non-equivalent control group design to investigate the effect of consumer choice of treatment on both process and outcome variables. All study participants suffered from severe mental illness, were homeless at baseline, and were enrolled in a modified Assertive Community Treatment (ACT) program. Consumers in the choice condition had selected the ACT program from a menu of five treatment programs; clients in the no-choice condition were simply assigned to the ACT program by an intake worker. Results found that consumers in the choice condition visited the ACT staff at their offices more than consumers in the no-choice condition, but there were no significant differences between groups on the other treatment process variables. Although consumers in the choice condition increased their income more than consumers in the no-choice condition, there were no significant differences between groups on the other outcome variables (stable housing, psychotic symptoms, depression, and substance abuse).

Adult↗
PubMed2000

The Dartmouth Assertive Community Treatment Scale (DACTS). A generalizability study.

Generalizability theory was used to assess the reliability of the Dartmouth Assertive Community Treatment Scale (DACTS), which was developed to assess treatment reliability to assertive community treatment (ACT). Program staff and local evaluators who were participating in a national demonstration program to serve homeless mentally ill clients provided data. The total scale score for the DACTS demonstrated acceptable internal consistency and interrater reliability. Although the stability of the total DACTS score was quite low, many items on the DACTS were quite stable. The generalizability analyses provide additional detail on the effects of site, occasion, and site by occasion interactions on the reliability of the DACTS.

Humans↗
PubMed1999

Understanding and controlling response bias in needs assessment studies.

This study demonstrated that estimates of agency awareness in the typical needs assessment study are probably inflated by a response bias labeled "agency awareness overclaming." Overclaimers (respondents who reported being aware of fictitious agencies) reported being aware of more real agencies than other respondents. Estimates of agency awareness may also be biased, because certain segments of the population were more likely to exhibit agency awareness overclaiming. Age was positively correlated with overclaiming, and African Americans were more likely to exhibit agency awareness overclaiming than Caucasians. General overclaiming was correlated with agency awareness overclaiming, but social desirability and acquiescence were not.

Adult↗
PubMed1991

Absorption of iron after experimental overdose of chewable vitamins.

Even though ingestion of chewable iron preparations is much more common, treatment recommendations for iron overdose are usually based on experience with nonchewable preparations. To determine the optimal time to measure serum iron concentrations, five volunteers were given chewable iron in 5 mg/kg and 10 mg/kg doses and their serum iron concentrations monitored. Peak levels occurred at 4.2 and 4.5 hours, respectively, after ingestion, and levels drawn at 3 hours were within 90% of the peak. Nausea and headache were experienced by all volunteers, and serum iron exceeded baseline total iron binding capacity in two subjects at the 10 mg/kg dose. In minor iron overdose resulting from the ingestion of chewable vitamins, serum iron concentrations measured between 3 and 7 hours (95% confidence level of peak concentrations) may be adequate in assessing the peak serum iron concentration.

Administration, Oral↗
PubMed1989

Early fresh frozen plasma prophylaxis of abnormal coagulation parameters in the severely head-injured patient is not effective.

Serious head injury may be complicated by coagulation abnormalities. Fresh frozen plasma (FFP) has been advocated as resuscitation fluid, in patients with head injury, to prevent the development of abnormal coagulation. The efficacy of this practice has never been established. We retrospectively reviewed the records of 149 head-injured patients having a Glasgow Coma Scale of 9 or less. One hundred six received FFP and were without evidence of coagulopathies, while 42 received no FFP or had coagulopathies. Group 1 received FFP within a time from injury (T1) and group 2 received FFP after time (T2) or not at all. Groups were similar in demographics, injuries, presenting Glasgow Coma Scale, and presenting hematologic parameters in serial pretreatment or posttreatment hematologic parameters (P less than .05). There were no differences between patients receiving "early" FFP, as compared with those receiving FFP later or not at all. The time of FFP administration did not appear to be critical for effective prophylaxis against coagulopathy.

Blood Coagulation Disorders↗
PubMed1988

Analysis of initial requests for information of non-exposure related topics at a regional poison center.

Regional poison centers have experienced continued growth for drug exposure related information. At our regional poison center, because of increased requests for information which is non-drug or non-exposure related, we chose to select a sampling of telephone inquiries to document such topics. We wished to document the demographics of the caller, the major category of information requested, the triage of the call, the pertinent history and quote of the call, and the interpretation of the call by our poison information specialists. Of the 164 calls sampled, the majority of the calls were initiated from a home site (89%) with an adult (79.3%) female (62.2%) asking for the information. Of the ten major categories of non-drug or non-exposure related issues, general medical information was most often requested (65.2%). The poison specialists' triage of calls required no follow-up in 72% of calls, however 5.5% of the callers were directed to an emergency department, with 12.2% directed to another health agency for additional information. As funding for all medical and health related resources becomes limited, it is important the public be made aware of its own utilization of public resources. This will enable a basis for obtaining financial support outside of drug-related arenas, will return a positive statement to the public that not only do poison centers consult on exposures; but also that the dollars spent are utilized in an extremely widened brevity of information for the publics consumption. This information will support enhanced budget requests for personnel education and training in areas of non-drug or non-exposure related issues.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1986

A pictorial portrayal of poisoning possibilities: a public awareness approach.

Areas of a high density university housing cooperative were randomly photographed following reports of decreased child supervision and increased potential for childhood poisoning and injury. A slide show was developed using these actual settings which revealed potential exposure to multiple toxic chemicals. This show was presented to the residents and demonstrated the high risk situations. Residents discovered that toxic chemicals were present in their own living environment, that many routes of exposure were possible and the high susceptibility of children during unsupervised play. As a result of this educational program, a poison prevention policy was approved with subsequent visible improvement in the community awareness and environment. This pictorial approach is a useful method for educating residents of a high density housing development about potential poisonings in their home environment and may be applied to other similar settings.

Audiovisual Aids↗