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Biomedical subjects

L Breslow

Publications and source records attributed to L Breslow.

At least 19 recordsLinked to original sources
PubMed1994

Hospital information system and patterns of cancer screening.

Relative ease, implied accuracy, and unprecedented possibilities of computerized health care information systems, is very tempting for researchers. Attempts at determining the referral patterns for cancer screening at a large county hospital through the use of computerized administrative and clinical files, and some of the problems encountered is reported here. Only 17% of women over 18, and 16% of women over 50 who visited this hospital were referred and received screening for cervical and breast cancer, respectively. Pap testing was concentrated at clinics dealing with reproductive health, and women with higher visit frequencies had a higher referral rate. Major problems encountered were lack of uniformity in capturing information for similar variables in different files, inconsistency in capturing data elements, and partial coverage. To enhance capabilities of computerized health information system, following principles must be incorporated in the designs: complete coverage, uniform collection of data across time and files, and inclusion of linking capabilities.

Adolescent↗
PubMed1993

Health practices and disability: some evidence from Alameda County.

With greater longevity people are increasingly concerned about how to avoid disability during their longer lives. Policy decisions concerning ways to extend health as well as life have become part of the nation's health agenda. Opportunity to examine that issue has arisen in the Alameda County Human Population Laboratory. Earlier studies there established seven health practices as risk factors for higher mortality: excessive alcohol consumption, smoking cigarettes, being obese, sleeping fewer or more than 7-8 hours, having very little physical activity, eating between meals, and not eating breakfast. Observation now reveals that, taking into account age, gender, physical health status, and social network index in 1965, the occurrence of disability was only about one-half as great among the cohort survivors in 1974 who reported good health practices in 1965 as among those with poor health practices; those with an intermediate level of health practices experienced about two-thirds the relative disability risk of those with poor health practices. Essentially similar relationships prevailed for the 1982/1983 survivors of the original (1965) cohort who, upon requestioning, had been found to be without disability in 1974.

Adult↗
PubMed1990

Worksite health promotion: its evolution and the Johnson & Johnson experience.

Worksite health promotion, a rapidly growing form of preventive health service, may include health risk appraisal with communication of findings to the individuals tested. It may also assist in achieving and maintaining physical and mental fitness, controlling alcohol use, avoiding or quitting tobacco and other drugs, and otherwise maintaining health protective habits, while providing opportunities to control high blood pressure, and reduce elevated blood cholesterol, obesity, and other health hazards. This article presents a synopsis of the evolution of that movement and reviews the experience of one industrial firm that has endeavored to document and evaluate its effort. Such a review may be helpful in consolidating the various findings to date and in indicating the complexity of assessing the health and economic consequences of such an endeavor in private companies.

Health Education↗
PubMed1989

Health status measurement in the evaluation of health promotion.

A step beyond treatment and even the prevention of disease is coming onto the health agenda. It is health promotion--"the advancement of well-being and the avoidance of health risks by achieving the optimal levels of the behavioral, societal, environmental and biomedical determinants of health." It differs from medical service in that the latter is directed largely toward overcoming poor health, disequilibrium with one's environment. Health promotion is aimed at maintaining the level of health and, insofar as possible, strengthening the potential (resources) for health. The emergence of health promotion raises an issue for those concerned with health status measurement: whether we consider health as having only biologic elements as traditionally understood in biomedical science, and role (performance) elements as traditionally understood in sociomedical science; or whether we add to these considerations a view of health as the dynamic equilibrium of individuals or groups of people with their environment, their capacity to live physically, mentally, and socially. The latter view entails measuring the health of people on a continuum extending from "perfect" harmony with one's environment and maximum potential for responding to adversities, on the one hand, to extreme invalidism and no reserves, i.e., the premorbid state, at the other extreme. That view also entails expanding attention to the whole population, not just the sick. It also means considering the relative emphasis to be given conceptual and methodologic work, individual versus community responsibilities for health, and the alleged medicalization of life.

Health Promotion↗
PubMed1988

Progress and objectives in cancer control.

This article reviews progress in cancer control and objectives for achieving further control. In particular, rather than relying on a single composite statistic such as the age-adjusted mortality rate, this review stresses trends in cancer mortality in the United States using a cohort analysis. That method reveals a decline in cancer mortality beginning with young children in the 1950s and proceeding up the age scale in subsequent decades to those persons who were approximately 50 years of age in the mid-1980s. From age 55 years upward, the continuing increase in cancer mortality is due to epidemic lung cancer. The principal cause of that disease and what must be done to control it are well understood. The objectives for cancer control by the year 2000 set by the National Cancer Institute and the feasibility of reducing cancer mortality by as much as 25% to 50% are also considered. Increased cancer prevention research is needed.

Adolescent↗
PubMed1986

The relationship between vitamin C intake, general health practices, and mortality in Alameda County, California.

To evaluate the relation between vitamin C intake and mortality, a prospective follow-up study was carried out among 3,119 noninstitutionalized adult residents of Alameda County, California who had completed a detailed lifestyle questionnaire around the beginning of 1974. During 10 years of follow-up, 276 deaths have been identified. The questionnaire information and mortality data indicate that this sample is fairly representative of the county population and similar to the United States population. There is no important relation between the estimated 1974 vitamin C intake at levels above and below 250 mg per day and subsequent mortality from cancer, circulatory disease, all other causes, or all causes combined. However, there is an inverse relation between combinations of several health habits and total mortality. The health habits include never smoking cigarettes, regular physical activity, moderate or no use of alcohol, 7-8 hours of sleep per day, and maintaining proper weight. The conclusions with regard to vitamin C are limited by the crudeness with which the dietary intake has been estimated and changes in intake over time. Nevertheless, these results are not consistent with any substantial relation between vitamin C intake and subsequent mortality.

Adolescent↗
PubMed1984

Physician-patient partnerships for lifelong health monitoring.

Progress against disease has created in some parts of the world a situation in which people can expect good health into the eighth decade of life and beyond. Ideally that involves a physician-patient partnership for health maintenance, wherein a patient actively develops a life-style that is conducive to health. The scientific base for health maintenance has been growing through epidemiologic demonstration of the relationship between health and such living habits as smoking, diet, exercise and the use of alcohol, and the significance of blood pressure and other precursors of health effects that can be determined by physical examination.Lifelong health monitoring of patients by physicians builds on this scientific base for health maintenance, which merely extends the presently well-established schema for monitoring health during pregnancy and infancy. Public readiness for a health-oriented, in addition to a disease-oriented, medical service is growing.

Adolescent↗
PubMed1984

Structural and functional perspectives on classification and seriation in psychotic and normal children.

This study describes a strategy for examining cognitive functioning in psychotic and normal children without the usual confounding effects of marked differences in cognitive structure that occur when children of the same age are compared. Participants were 14 psychotic children, 12 males and 2 females, mean age 9-2, matched with normal children at preoperational and concrete operational stage levels on a set of Piagetian classification tasks. The mean age of the normal children was 6-4, replicating the usually found developmental delay in psychotic samples. Participants were then compared on both structural level and functional abilities on a set of tasks involving seriation of sticks; the higher-level children were also administered a seriation drawing task. Analysis of children's processes of seriating and seriation drawings indicated that over and above the structural retardation, psychotic children at all levels showed functional deficits, especially in the use of anticipatory imagery. The implications for general developmental theory are that progress in structural development is not sufficient for imaginal development, and that structural development of logical concepts is relatively independent of the development of imagery. It was suggested that "thought disorder" may not be a disordered structure of thinking or a retardation in psychotic populations but rather a mismatch between higher-level logical structures and lower-level functions.

Autistic Disorder↗
PubMed1983

Health promotion programs sponsored by California employers.

A survey of California employers with more than 100 employees at one or more sites was undertaken to determine: 1) the nature and extent of health promotion activities; 2) plans for continuation and/or expansion of these activities; 3) plans for initiation of new activities; and 4) the relationship between reported health promotion activities and other characteristics of employers. Of 511 employers with whom interviews were attempted, 49 possible respondents could not be reached and 38 respondents refused to be interviewed, leaving 424 or 83 per cent. Almost one-half of the sites where interviews were conducted had fewer than 200 employees. A total of 332 (78.3 per cent) of employers offered one or more health promotion activities. The most frequent activities provided were accident prevention (64.9 per cent) and CPR (52.8 per cent) with other frequent programs including alcohol/drug abuse (18.6 per cent), mental health counseling (18.4 per cent), stress management (13.0 per cent), fitness (11.6 per cent), hypertension screening (10.1 per cent), and smoking cessation (8.3 per cent). Employers with at least one activity averaged 2.8 activities. The likelihood of having health promotion activities increased with company size. Establishment of new programs appeared to accelerate rapidly in recent years.

California↗
PubMed1983

Patterns of vitamin C intake from food and supplements: survey of an adult population in Alameda County, California.

Use of vitamin C in food and pills and its association with health habits and health status were investigated in a random sample of 3,119 adults in Alameda County, California. Vitamin C intakes of nearly 80 per cent of respondents met or exceeded Recommended Daily Dietary Allowances. Fourteen per cent or fewer appeared to have inadequate vitamin C intake. Vitamin C supplements were taken daily by 29 per cent, occasionally by 21 per cent. Most respondents obtained 100 mg or less of vitamin C daily; 2 per cent had more than 2000 mg. Proportionately, more women than men took vitamin C pills daily. Men aged 16 to 44 were the most likely to have neither vitamin C foods nor pills. Persons 45 years and older tended to take vitamin C pills daily, younger persons to take them occasionally. Respondents who did not eat breakfast or who smoked cigarettes had lower vitamin C intakes. People in poor health took more vitamin C than those in good health. Health status may have influenced vitamin C intake rather than vitamin C intake influencing health status.

Adolescent↗