PubMed Health⌕ Search

Biomedical subjects

Kenneth E Powell

Publications and source records attributed to Kenneth E Powell.

15 recordsLinked to original sources
PubMed2006

Self-reported injury and physical activity levels: United States 2000 to 2002.

PURPOSE: The aim of the study is to compare national estimates of the incidence of self-reported all-cause and activity-specific injuries in adults with differing leisure-time physical activity levels. METHODS: Data were analyzed from the 2000 to 2002 National Health Interview Survey. Leisure-time physical activity levels were categorized as active, insufficiently active, and inactive. RESULTS: Age-adjusted incidences of all-cause injury did not differ by leisure-time physical activity level (active, 89.3/1000; 95% confidence interval [CI], 81.8-96.8; insufficiently active, 81.6/1000; 95% CI, 73.1-90.1; and inactive, 86.3/1000; 95% CI, 78.6-93.9). Active respondents (29.4/1000; 95% CI, 25.2-33.6) had a greater incidence of injury related to sport and leisure-time activities than inactive respondents (15.2/1000; 95% CI, 12.1-18.3), whereas inactive respondents (71.1/1000; 95% CI, 63.9-78.2) had a greater incidence of injury related to nonsport and non-leisure-time activities than active respondents (59.9/1000; 95% CI, 53.6-66.2). Results were unchanged after multivariate control for confounding factors. CONCLUSIONS: Although the incidence of sport and leisure-time injuries is associated with participation in leisure-time physical activity, no association was observed between leisure-time physical activity and overall injuries.

Adolescent↗
PubMed2006

Characteristics of black and white suicide decedents in Fulton County, Georgia, 1988-2002.

OBJECTIVES: We compared the prevalence of risk factors for Black and White suicide decedents in Fulton County, Georgia, from 1988-2002. METHODS: We used data from the Fulton County Medical Examiner's Office to compile information on suicides that occurred in Fulton County between 1988 and 2002. We used the chi2 test and logistic regression to identify associations between suicide risk factors and race. RESULTS: Black suicide decedents were more likely than White suicide decedents to be male (odds ratio [OR]=2.06; 95% confidence interval [CI]=1.38, 3.09), to be younger, (< or =24 y [OR = 4.74; 95% CI = 2.88, 7.81]; 25-34 y [OR = 2.79; 95% CI = 1.74, 4.47]; 35-44 y [OR = 1.86; 95% CI = 1.13, 3.07]), and to hurt others in a suicide (OR = 4.22; 95% CI = 1.60, 11.15) but less likely to report depression (OR=0.63; 95% CI=0.48, 0.83), to have a family history of suicide (OR=0.08; 95% CI=0.01, 0.61), or to leave a suicide note (OR=0.37; 95% CI=0.26, 0.52). CONCLUSIONS: Future research should consider that Black suicide decedents are less likely to report depression than White suicide decedents. This suicide risk difference is important when developing effective suicide prevention programs.

Adult↗
PubMed2005

Validity and reliability of self-reported arthritis: Georgia senior centers, 2000-2001.

BACKGROUND: Arthritis and other rheumatic conditions are a common cause of disability among adults in the United States. Telephone interviews of the state-based Behavioral Risk Factor Surveillance System (BRFSS) are used by states and territories to estimate the prevalence of arthritis. The purpose of this study was to assess the validity and reliability of the 1996-2001 BRFSS arthritis case definition in a senior center population. METHODS: A total of 487 respondents at selected senior centers in Georgia were surveyed by telephone, evaluated 3 to 4 weeks later by board-certified rheumatologists, and completed a written survey in 2000 to 2001. Using the rheumatologists' summary assessment "Does this person have arthritis or a related condition" as the standard, the sensitivity and specificity of the BRFSS arthritis case definitions were calculated. Reliability for the BRFSS arthritis case definition was also calculated by comparing responses to the telephone survey with responses to a written survey. RESULTS: Sensitivity was 70.8% (95% confidence interval [CI]=65.9-75.6), and the specificity was 70.3% (95% CI=62.9-77.8). The agreement between the telephone and written responses indicating self-reported arthritis was high (kappa=0.68). Analyses were conducted in 2002 to 2004. CONCLUSIONS: Self-reported arthritis in the 1996-2001 BRFSS was highly reliable, and moderately sensitive and specific among these senior center participants.

Aged↗
PubMed2004

Sensitivities of three county health department surveillance systems for child-related dog bites: 261 cases (2000).

OBJECTIVES: To determine incidence of child-related dog bites and sensitivities of 3 county health department dog-bite surveillance systems. DESIGN: Retrospective study. STUDY POPULATION: Child-related dog-bite data obtained from surveillance systems of 3 counties in Georgia in the year 2000. PROCEDURE: To characterize the sensitivity of health department dog-bite surveillance systems, 9 other potential sources of dog-bite records that matched records by victim name, age, gender, and incident date were evaluated. The number of reported bites and the most productive sources for identifying additional cases were determined. The Chandra Sekar-Deming capture-recapture method was used to estimate the number of unreported bites, and estimates of dog-bite incidence rates were made. RESULTS: 40, 36, and 185 dog bites were reported in the 3 counties, respectively. Capture-recapture calculations estimated an additional 9, 5, and 128 dog bites in these counties, respectively. Local health departments recorded 45.5% to 82.5% of dog bites. Local hospital emergency departments, police departments, and a rabies-testing laboratory received additional reports. Among these data sources, local hospital emergency department records were the best source for identifying additional cases. CONCLUSIONS AND CLINICAL RELEVANCE: Dog bites are a preventable cause of childhood injuries, and surveillance is a critical tool for tracking childhood dog bites in the community. Counties should use combined data from local health departments, local hospital emergency departments, and police departments to implement or revise dog-bite prevention programs.

Adolescent↗
PubMed2004

Why population attributable fractions can sum to more than one.

BACKGROUND: Population attributable fractions (PAFs) are useful for estimating the proportion of disease cases that could be prevented if risk factors were reduced or eliminated. For diseases with multiple risk factors, PAFs of individual risk factors can sum to more than 1, a result suggesting the impossible situation in which more than 100% of cases are preventable. METHODS: A hypothetical example in which risk factors for a disease were eliminated in different sequences was analyzed to show why PAFs can sum to more than 1. RESULTS: PAF estimates assume each risk factor is the first to be eliminated, thereby describing mutually exclusive scenarios that are illogical to sum, except under special circumstances. PAFs can sum to more than 1 because some individuals with more than one risk factor can have disease prevented in more than one way, and the prevented cases of these individuals could be counted more than once. Upper and lower limits of sequential attributable fractions (SAFs) can be calculated to describe the maximum and minimum proportions of the original number of disease cases that would be prevented if a particular risk factor were eliminated. CONCLUSIONS: Improved descriptions of the assumptions that underlie the PAF calculations, use of SAF limits, or multivariable PAFs would help avoid unrealistic estimates of the disease burden that would be prevented after resources are expended to reduce or eliminate multiple risk factors.

Chronic Disease↗
PubMed2004

Involvement in physical activity and risk for nearly lethal suicide attempts.

BACKGROUND: Although substantial research suggests that involvement in physical activity is associated with mental health benefits, relatively little is known about the association between physical activity and suicidal behavior. This study compared reports of recent physical activity among those surviving a nearly lethal suicide attempt to reports from community controls. METHODS: Analyses were conducted on data collected between November 1992 and July 1995 for a population-based, case-control study of nearly lethal suicide attempts among people aged 13 to 34 years. Logistic regression analyses were used to test the association between suicide attempts and physical activity, including the intensity, frequency, and duration of activity, while controlling for demographic factors and potential explanatory variables, such as depression, alcoholism, and the presence of a serious medical condition. RESULTS: Suicide attempters were far less likely than controls to report involvement in physical activity in the past month (48% vs 85%, respectively). Intensity, frequency, and duration of activity did not affect this association. The association persisted after adjusting for demographics and potential explanatory variables. CONCLUSIONS: Additional research is needed to explain the process through which the association occurs. The strong protective association observed is consistent with other research on the mental health benefits of physical activity and recommendations of involvement in regular physical activity.

Adolescent↗
PubMed2003

Prevalence and impact of asthma in children, Georgia, 2000.

BACKGROUND: Asthma is a common chronic condition with significant impact on those who have it. Information about children with asthma was sought to guide state program planning. METHODS: A random-digit-dial telephone survey of 1503 households with 2700 children was conducted in Georgia. Primary caretakers were interviewed. Results for households, children, and caretakers were weighted by number of telephone lines; results for children were also weighted to the Georgia 1998 estimated population. Data were collected and analyzed in 2000. RESULTS: Asthma prevalence among children in Georgia aged 0 to 17 years was 10.5% (95% confidence interval [CI]=9.2%-11.9%). Among children with asthma, 64.8% (95% CI= 58.5-71.1) had an attack and 30.0% (95% CI=24.2-35.8) visited an emergency department in the last year. In the past year, 53.9% (95% CI=46.8-61.0) of school-aged children with asthma and 29.7% (95% CI=23.7-35.7) of adults in households of children with asthma missed school or work because of the child's asthma. Among children with asthma, 56.1% (95% CI=48.6-63.6) lived in a household where neither caretaker nor child has taken a course or been taught about managing asthma, and 28.6% (95% CI=22.1-35.1) lived in a household where adults smoked inside the house. CONCLUSIONS: Asthma has a substantial effect on the lives of children in Georgia, including medical events and missed school, and on adult caretakers in terms of missed work due to the child's asthma. To reduce the burden of asthma in Georgia, exposure of people with asthma to tobacco smoke in the home should be eliminated and training in asthma management should be more widely available.

Adolescent↗
PubMed2003

Initial behavior outcomes for the peacebuilders universal school-based violence prevention program.

PeaceBuilders is a universal, elementary-school-based violence prevention program that attempts to alter the climate of a school by teaching students and staff simple rules and activities aimed at improving child social competence and reducing aggressive behavior. Eight matched schools (N > 4,000 students in Grades K-5) were randomly assigned to either immediate postbaseline intervention (PBI) or to a delayed intervention 1 year later (PBD). Hierarchical linear modeling was used to analyze results from assessments in the fall and spring of 2 consecutive school years. In Year 1, significant gains in teacher-rated social competence for students in Grades K-2, in childself-reported peace-building behavior in Grades K-5, and reductions in aggressive behavior in Grades 3-5 were found for PBI but not PBD schools. Differential effects in Year 1 were also observed for aggression and prosocial behavior. Most effects were maintained in Year 2 for PBI schools, including increases in child prosocial behavior in Grades K-2. Implications for early universal school-based prevention and challenges related toevaluating large-scale prevention trials are discussed.

Child↗
PubMed2002

An evaluation of hospitalizations for Kawasaki syndrome in Georgia.

OBJECTIVE: To evaluate and describe the epidemiologic characteristics of Kawasaki syndrome (KS) hospitalizations in Georgia. DESIGN: We reviewed hospital discharge data and corresponding medical records for Georgian patients discharged with a KS diagnosis during 1997 and 1998. RESULTS: During the study period, 233 KS hospital discharges were recorded in Georgia; 177 (76%) were for children younger than 5 years. Twenty-one (9%) of 233 of the hospital discharges represented multiple hospitalizations. Medical records for 211 KS discharges (91%), representing 197 patients (93%), were reviewed. For those 189 patients whose medical records were reviewed and had sufficient information, 139 (74%) either had a documented illness that met the Centers for Disease Control and Prevention (CDC) definition for KS (n = 135) or had coronary artery abnormalities without meeting the CDC definition for KS (atypical KS; n = 4). Eight patients had only a history of KS. Excluding multiple hospitalizations and patients with only a history of KS, 158 hospitalizations were for patients younger than 5 years (14.0 per 100 000 children); 110 of these patients met the KS or atypical KS definition (9.8 per 100 000 children). CONCLUSIONS: Hospital discharge data are useful for KS surveillance. However, analysis of hospital discharge data may slightly overestimate the KS hospitalization rates because some discharges may represent multiple hospitalizations or hospitalizations of patients with only a history of KS. The incidence and epidemiology of KS in Georgia are consistent with findings from other continental US studies. Physicians should exercise their best clinical judgment in identifying and treating patients with KS who may not meet standard case definitions.

Age Distribution↗
PubMed2002

The effectiveness of interventions to increase physical activity. A systematic review.

The Guide to Community Preventive Service's methods for systematic reviews were used to evaluate the effectiveness of various approaches to increasing physical activity: informational, behavioral and social, and environmental and policy approaches. Changes in physical activity behavior and aerobic capacity were used to assess effectiveness. Two informational interventions ("point-of-decision" prompts to encourage stair use and community-wide campaigns) were effective, as were three behavioral and social interventions (school-based physical education, social support in community settings, and individually-adapted health behavior change) and one environmental and policy intervention (creation of or enhanced access to places for physical activity combined with informational outreach activities). Additional information about applicability, other effects, and barriers to implementation are provided for these interventions. Evidence is insufficient to assess a number of interventions: classroom-based health education focused on information provision, and family-based social support (because of inconsistent findings); mass media campaigns and college-based health education and physical education (because of an insufficient number of studies); and classroom-based health education focused on reducing television viewing and video game playing (because of insufficient evidence of an increase in physical activity). These recommendations should serve the needs of researchers, planners, and other public health decision makers.

Evidence-Based Medicine↗
PubMed2002

Pediatrician counseling about preventive health topics: results from the Physicians' Practices Survey, 1998-1999.

OBJECTIVE: Government agencies and national organizations recommend that physicians counsel their child and adolescent patients about preventive health topics. Using data from a national survey, we describe the counseling patterns of pediatricians in regard to 9 recommended preventive health topics. METHODOLOGY: Between October 1998 and April 1999, information was collected from 907 of 1760 primary care pediatricians randomly selected from a nationally representative sample. Through either a telephone interview or a mail survey, pediatricians were asked how frequently in the past month they counseled about 9 preventive health topics during the well-care visits or routine check-ups of their patients. Pediatricians answered questions regarding their patients aged 2 to 5, 6 to 12, and 13 to 18 years. RESULTS: Over 80% of the pediatricians counseled about 1 or more recommended preventive health topics during the well-care visits or routine check-ups of their patients. As compared with pediatricians who did not counsel about any topic, pediatricians who counseled were significantly more likely to be female and spend longer amounts of time with their patients during these visits. The frequency with which specific preventive health topics were discussed varied with the topic and the age of the patient. CONCLUSION: Most pediatricians routinely counsel about some, but not all, recommended preventive health topics. An understanding of why pediatricians selectively counsel about specific topics is needed.

Adolescent↗
PubMedDate not supplied

Administrative data as a tool for arthritis surveillance: estimating prevalence and utilization of services.

The public health burden of arthritis and related conditions is incompletely described by commonly used public health surveillance systems. We examined the potential of administrative data as a supplement. The administrative data sources we used underestimated the prevalence of arthritis and overestimated service utilization for persons with arthritis when data from only one year were used. The use of five year's data doubled the prevalence estimate and reduced the service utilization estimate by half. The demographics of the population covered by administrative data also influence the prevalence estimate. Administrative data may usefully supplement routine public health surveillance systems but must be used with caution.

Adolescent↗
PubMedDate not supplied

Asthma management practices among children in Georgia.

BACKGROUND: Asthma self-management, the involvement of patients or their caregivers in the management of their disease, reduces healthcare visits and costs. We assessed selected asthma self-management practices among a representative sample of children in Georgia to guide statewide asthma control programs. METHODS: A random-digit-dialed telephone survey of 2,121 households with 3,896 children 17 years of age or younger was conducted. Primary caretakers were asked about asthma and medication use of their children. Child data were weighted according to the number of telephone lines in the household and to the 2000 Georgia Census population. RESULTS: Approximately 10 percent of children in Georgia had asthma. Among children with asthma, 30 percent did not have regular asthma checkups and 66 percent did not have a written management plan; 19 percent filled 2 or more prescriptions per year for quick-relief medicine but did not take control medication. For children with asthma for whom tobacco exposure was a known trigger, 35 percent were exposed to tobacco smoke in the home. CONCLUSIONS: Opportunities exist to improve self-management, pharmacotherapy, and exposure to triggers for children with asthma. These data can be used to guide organizations and agencies working to reduce the burden of asthma.

Adolescent↗