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Biomedical subjects

R T Anderson

Publications and source records attributed to R T Anderson.

At least 37 records · Page 2Linked to original sources
PubMed1999

The role of marital status in health services expenditures for psychiatric outpatients.

This study tested the hypothesis that married psychiatric outpatients would have lower total health services expenditures than divorced or separated patients. Chart review of the 471 individuals attending an academic medical center outpatient psychiatric clinic during 1994 identified 131 married, 40 separated, and 93 divorced patients. Separated men had significantly higher average total charges ($16,890) than married ($5,279) or divorced ($5,539) men by one-way ANOVA (p < .05). The nonparametric Mann-Whitney test also showed that separated men had higher charges than married or divorced men. There were no differences between marital status groups for women.

Adolescent↗
PubMed1999

Microbial communities associated with anaerobic benzene degradation in a petroleum-contaminated aquifer.

Microbial community composition associated with benzene oxidation under in situ Fe(III)-reducing conditions in a petroleum-contaminated aquifer located in Bemidji, Minn., was investigated. Community structure associated with benzene degradation was compared to sediment communities that did not anaerobically oxidize benzene which were obtained from two adjacent Fe(III)-reducing sites and from methanogenic and uncontaminated zones. Denaturing gradient gel electrophoresis of 16S rDNA sequences amplified with bacterial or Geobacteraceae-specific primers indicated significant differences in the composition of the microbial communities at the different sites. Most notable was a selective enrichment of microorganisms in the Geobacter cluster seen in the benzene-degrading sediments. This finding was in accordance with phospholipid fatty acid analysis and most-probable-number-PCR enumeration, which indicated that members of the family Geobacteraceae were more numerous in these sediments. A benzene-oxidizing Fe(III)-reducing enrichment culture was established from benzene-degrading sediments and contained an organism closely related to the uncultivated Geobacter spp. This genus contains the only known organisms that can oxidize aromatic compounds with the reduction of Fe(III). Sequences closely related to the Fe(III) reducer Geothrix fermentans and the aerobe Variovorax paradoxus were also amplified from the benzene-degrading enrichment and were present in the benzene-degrading sediments. However, neither G. fermentans nor V. paradoxus is known to oxidize aromatic compounds with the reduction of Fe(III), and there was no apparent enrichment of these organisms in the benzene-degrading sediments. These results suggest that Geobacter spp. play an important role in the anaerobic oxidation of benzene in the Bemidji aquifer and that molecular community analysis may be a powerful tool for predicting a site's capacity for anaerobic benzene degradation.

Anaerobiosis↗
PubMed1998

The development of grammatical case distinctions in the use of personal pronouns by Spanish-speaking preschoolers.

Data on personal pronoun development in Spanish-speaking children was obtained in this study. Forty monolingual Puerto Rican Spanish-speaking children between the ages of 2;0 and 3;11 participated in the investigation. Two tasks were designed to obligate production of nominative and object pronouns in both reflexive and non-reflexive forms. Productive use and error analysis data were obtained and compared to previous data on pronoun development in English. By contrast with the order of productive use of grammatical case distinctions reported in the literature for English-speaking children, the children in the present study demonstrated a pattern in which nominative pronoun use preceded object case use. Implications of these findings for developmental theories that have been presented to explain pronoun development are discussed.

Child Language↗
PubMed1998

The timing of change: patterns in transitions in functional status among elderly persons.

Data from the Longitudinal Study on Aging (LSOA) were analyzed to describe the heterogeneity of functional status transitions over 2-years (single-state model), and to explore whether changes in status in the previous two to four year period enhance the prediction of a subsequent transition (two-state model). Multivariate logistic regression with a robust estimate of variance was used to analyze a 7-category nominal response of: functional status (4 levels), institutionalization, death, and missing. Weighted percentages for functional status transitions and stability (unchanged status) showed that unchanged or improved functioning were at least as common as death or worsened functional status. Initial disability level, morbidities, and self-rated health were the strongest predictors of disability status after 2-years. The two-state model revealed that a previous transition (positive or negative) increases the risk for a subsequent transition, independent of initial disability level. The predictive and explanatory quality of the two-state model is substantially improved over single-state models, particularly from its ability to identify subgroups of individuals with marked functional status instability.

Activities of Daily Living↗
PubMed1998

The use of decision-analytical modelling in economic evaluation of patch testing in allergic contact dermatitis.

OBJECTIVE: The objective of this observational prospective study was to demonstrate the cost effectiveness of patch testing in patients suspected of allergic contact dermatitis (ACD) and to determine the order in which different severity groups rank in terms of cost effectiveness. DESIGN AND SETTING: This observational study was conducted on 567 patients from 10 investigator sites in the US over a period of 1 year. All patients with a suspicion of contact allergy who exhibited at least moderate disease activity were included in the study and were stratified according to disease severity and whether or not they were patch tested. In each severity category, the cost effectiveness of patch testing was evaluated. Patients who were ruled out for contact allergy (without the use of patch test) by the first 6 months after admission were excluded. A validated dermatology-specific quality of life (DSQL) instrument was administered to all patients at the start of the study, and at 6 and 12 months thereafter. The cost-effectiveness analysis is demonstrated using a decision-analytical model. Costs included office visits and prescription costs without generic substitution. The cost of patch testing was not included due to the large variation in price among commercially available products. MAIN OUTCOME MEASURES AND RESULTS: Patch testing was performed on 22% of patients with mild disease, 41% of patients with moderate disease and 50% of those with severe disease. There was a significant difference between the patch-tested and non-patch-tested groups in terms of the time to obtain a confirmed diagnosis (medians = 8 and 175 days, respectively) and a significant difference in the ratio of patients who had a confirmed diagnosis (88 and 69%, respectively). As a result of changes made in their lifestyle, 66% of patients in the patch-tested group and 51% in the non-patch-tested group reported 75% or more improvement in their disease symptoms after 6 months. Early confirmation of diagnosis helped reduce the prediagnosis cost of treatment which was mostly based on preliminary diagnosis. The greatest quality-of-life (QOL) benefits from patch testing relative to nonpatch testing occurred in patients with recurrent/chronic ACD. CONCLUSIONS: Patch testing is most cost effective and reduces the cost of therapy in patients with severe ACD. Greater improvements in quality of life were seen in patients with recurrent/chronic ACD who were patch tested than patients who were not patch tested within the same group. Results were not sensitive to changes due to the addition of indirect costs or costs using generic substitution.

Anti-Allergic Agents↗
PubMed1998

An economic evaluation of patch testing in the diagnosis and management of allergic contact dermatitis.

BACKGROUND: A previous retrospective study indicated that patch testing is cost-effective and well accepted by patients. OBJECTIVE: The objective of this observational prospective study was to show the cost-effectiveness of patch testing in patients suspected of allergic contact dermatitis (ACD) and to determine the order in which different severity groups rank in terms of cost-effectiveness. METHODS: This observational study was conducted in 567 patients from 10 investigator sites over a period of 1 year. All patients with a suspicion of contact allergy who exhibited at least moderate disease activity were included in the study and were stratified according to disease severity and whether or not they were patch tested. In each severity category, the cost-effectiveness of patch testing was evaluated. Patients who were ruled out for contact allergy by the first 6 months after admission were excluded. A validated dermatology-specific quality of life instrument was administered to all the patients at entrance into the study and at 6 and 12 months after that. The cost-effectiveness analysis is shown using a decision analysis model. RESULTS: Patch testing was performed on 22% of patients with mild disease, 41% of patients with moderate disease, and 50% of patients with severe disease. As a result of changes made in their lifestyle, 66% in the patch-tested group and 51% in the non-patch-tested group reported 75% or more improvement in disease symptoms after 6 months. Early confirmation of diagnosis helped reduce the prediagnosis costs of treatment, which was mostly based on preliminary diagnosis. The greatest quality of life benefits from patch testing, relative to no patch testing, occurred in subjects with recurrent or chronic ACD. CONCLUSION: Patch testing is most cost-effective and reduces the cost of therapy in patients with severe ACD.

Chronic Disease↗
PubMed1997

Development and validation of a quality of life instrument for cutaneous diseases.

BACKGROUND: The Dermatology-Specific Quality of Life (DSQL) instrument is a new tool to quantify the effects of skin disease on physical discomfort and symptoms, psychologic well-being, social functioning, self-care activities, performance at work or school, and self-perceptions. OBJECTIVE: Our purpose was to describe the reliability and validity of the DSQL in two disease cohorts comprising patients with contact dermatitis and acne vulgaris. METHODS: Reliability was assessed from the internal consistency of the items, and correlations were made between DSQL scores from a 3- to 7-day retest. Validity was assessed from correlations of DSQL scales with global ratings of bothersome symptoms and perceived severity and by discrimination of clinically defined severity groups. RESULTS: The DSQL scales had high internal consistency (0.70 to > 0.90) and test-retest reliability (r = 0.81 to 0.89), and were moderately to highly correlated with patient global ratings of symptom distress (r = 0.25 to 0.67) and overall disease severity (r = 0.19 to 0.54). Patients rated with severe contact dermatitis or acne scarring had higher DSQL scores than those with less severe skin disease. Factor analyses found separate dimensions of physical, emotional, and social functioning involvement from skin disease. CONCLUSION: The DSQL provides valid and reliable assessments of quality of life impacts associated with acne and contact dermatitis.

Acne Vulgaris↗
PubMed1997

Mortality effects of community socioeconomic status.

We linked data from the National Longitudinal Mortality Study to census tract information on 239,187 persons to assess 11-year mortality risk among black and white women and women associated with median census tract income, adjusted for individual family income from the Current Population Survey. We stratified Cox proportional hazards models by ages 25-64 years and 65 years and older. We used a robust covariance matrix to obtain standard errors for the model coefficients that account for correlation among individuals in the same census tract. Both income indicators were independently related to all-cause mortality. Among persons age 25-64 years, the rate ratios (RR) for individual family income and the median census tract income, respectively, for low income relative to high income were RR = 2.10 vs. 1.49 for black men, RR = 2.03 vs 1.26 for white men; and RR = 1.92 vs 1.30 for black women and RR = 1.61 vs 1.16 for white women. Among persons age 65 years or greater, only individual family income was associated with mortality, and only for white men. Although family income has a stronger association with mortality than census tract, our results indicate that, more broadly, area socioeconomic status makes a unique and substantial contribution to mortality and should be explored in health policy and disease prevention research.

Adult↗
PubMed1997

Baseline correlates with quality of life among men and women with medication-controlled hypertension. The trial of nonpharmacologic interventions in the elderly (TONE).

OBJECTIVES: To examine Quality of Life (QOL) and its correlates among older adults with medication-controlled hypertension. DESIGN: Baseline data from the TONE clinical trial. MEASUREMENTS: Demographic variables (age, race, income), hypertension treatment (medication class, years treated), health status (obesity, physical symptoms), and QOL status (MOS-Short-Form 36, Jenkins Sleep Disturbance, and CES-D Depression). PARTICIPANTS: A total of 975 men and women, aged 60 to 81 years and free of major diseases and disability, with a screening blood pressure (BP) of < or = 145/85 mm Hg, treated medically for hypertension with antihypertensive medication. RESULTS: On average, TONE participants reported a QOL level on the SF-36 that was similar to or better than that reported by older adults in the general population. However, there was a strikingly high prevalence of physical complaints or symptoms: 90.3% of men and 93.3% of women experienced one or more physical symptoms or complaints, and nearly 50% reported that such symptoms had disrupted their daily functioning. Among variables-considered, only the physical symptoms index score, number of severe symptoms, and obesity status were correlated consistently with QOL among TONE men and women. Lower QOL scores were associated with higher symptom scores and with obesity. Neither medication class nor age were appreciably associated with QOL status. CONCLUSIONS: Physical symptoms, rather than medication class and age, were the strongest correlates of QOL in TONE. This underscores the importance of identifying the etiology of symptoms as a means to improve the QOL of order hypertensive persons rather than substituting medication. The association of poorer physical well-being with obesity suggests that weight reduction to manage BP may also improve QOL for some individuals.

Activities of Daily Living↗
PubMed1997

Benefits of linkage to the National Death Index in the Longitudinal Study of Aging.

To reduce the potential bias resulting from differential loss to follow-up in the Longitudinal Study of Aging (LSOA), information obtained from household contact methods was supplemented with information from the National Death Index (NDI). This article examines the degree of agreement in the vital status data from two sources (reinterview contacts and the NDI system) and evaluates the potential gains of using the NDI data as a supplement to define participants' vital status. Results reveal that NDI information, used to supplement reinterview information, can substantially reduce bias due to the differential loss of participants to follow-up. Reliance on reinterview information alone was less likely to capture those deaths occurring in study participants who at the initial contact lived alone, were below the poverty index, were interviewed without use of a proxy, did not supply a phone number, and did not own a home.

Aging↗
PubMed1997

The profile of a patient with contact dermatitis and a suspicion of contact allergy (history, physical characteristics, and dermatology-specific quality of life).

According to the National Center for Health Statistics Survey, a large proportion of patients with contact dermatitis, atopic dermatitis, or eczema visit nondermatologists, and only approximately 40% visit dermatologists. Therefore, the prompt, proper diagnosis of the cause and prescription of precise treatment can be delayed. We wanted to create a clear understanding of the nuances of the allergic contact dermatitis and its effect on the economics and life quality of the patients for not only the dermatologists but also the primary care physicians. In an observational multicenter study planned for a span of 1 year with approximately 570 patients suspected of allergic contact dermatitis, data were collected at enrollment on their history, physical characteristics, and quality of life and were analyzed using routine statistical procedures. The "quality of life" data on these patients, most of whom have a history of long-standing disease, show a high correlation between the clinical factors such as symptom activity and frequency of episodes and the subscales of quality of life. These patients had a lesser score on mental and vital subscales (SF-36) than US population norms, showing a moderate impact of the disease on their mental health and vitality. There is an urgent need for a simpler and quicker method that could lead to an earlier and more precise diagnosis so the causal substance can be identified and avoided and the disease treated in a timely and cost-effective manner.

Dermatitis, Allergic Contact↗
PubMed1996

Oxidation of Polycyclic Aromatic Hydrocarbons under Sulfate-Reducing Conditions.

[(sup14)C]naphthalene and phenanthrene were oxidized to (sup14)CO(inf2) without a detectable lag under strict anaerobic conditions in sediments from San Diego Bay, San Diego, Calif., that were heavily contaminated with polycyclic aromatic hydrocarbons (PAHs) but not in less contaminated sediments. Sulfate reduction was necessary for PAH oxidation. These results suggest that the self-purification capacity of PAH-contaminated sulfate-reducing environments may be greater than previously recognized.

Journal Article↗
PubMed1996

Nasometric values for normal Spanish-speaking females: a preliminary report.

Most normative data available for assessing resonance through instrumentation have been collected with English-speaking individuals. The present study aimed at providing initial data on Spanish for use with the nasometer. Mean nasalance scores were obtained from 40 normal Puerto Rican Spanish-speaking females while they read three types of stimuli: (1) sentences containing nasal consonants, (2) a reading passage with both oral and nasal consonants, and (3) a reading passage with oral consonants. Results indicated significant differences in mean nasalance scores across the nasal sentences, as well as the two paragraph stimuli. In addition, a high degree of intersubject variability in the production of the target stimuli was evidenced. Comparisons with previous English normative data with similar reading stimuli are made and possible avenues for further research on the use of the nasometer with Spanish-speaking populations are discussed.

Acoustics↗
PubMed1996

A review of the progress towards developing health-related quality-of-life instruments for international clinical studies and outcomes research.

This article reviews the international adaptation and use of generic health-related quality-of-life (HRQL) measures over the last several years. It focuses, as examples, on the Nottingham Health Profile (NHP), the Sickness Impact Profile (SIP), the Medical Outcomes Study Short-Form 36 Item Health Survey (MOS SF-36), the EuroQoL, Dartmouth Primary Care Cooperative Information Project (COOP) chart system, the European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire (QLQ) and the World Health Organization's WHOQOL. These instruments exemplify several different models for developing or adapting HRQL measures described in the literature, each model choosing unique approaches to the process of validation for cross-national use. There has been considerable scientific activity in recent years aimed at advancing the capabilities for international HRQL assessments. Whereas prior adaptation work was focused exclusively on translation issues, recent work has begun to rely on common methodology for translation and validation of key measurement properties across language versions. Although the major HRQL measures reviewed have not yet reached the point at which there is sufficient evidence for measurement equivalence across different language versions, internationally coordinated projects are planned and under way for these instruments to advance and refine this capacity. Preliminary evidence suggests that there are few prominent differences between countries in ranking of health states that are representative of major HRQL dimensions, and in the levels of impact of illnesses on well-being within those dimensions. Future studies should collect additional psychometric data to more fully quantify measurement equivalence among the various language versions in which each instrument is available. Additionally, more work is required to address cultural differences within nations or language groups.

Clinical Trials as Topic↗
PubMed1995

Rural and urban differences in mortality among Americans 55 years and older: analysis of the National Longitudinal Mortality Study.

Previous research on rural and urban differences in risk of mortality has been inconclusive. This article used data from the National Longitudinal Mortality Study to establish whether all-cause mortality risk among persons 55 years and older varies by degree of urbanization, controlling for the potential sociodemographic confounders of age, gender, race/ethnicity, education, income, and marital status. Using the Cox Proportional Hazards Regression Procedure, the authors found that persons living in the most rural locales and those living in rural communities in standard metropolitan statistical areas (SMSAs) have the lowest risk of mortality, while those living in SMSA central cities had the highest risk of dying during the study period. The protective effect of rural residence declines in older age cohorts.

Age Factors↗
PubMed1994

The investigation and outcome of reported cases of elder abuse: the Forsyth County Aging Study.

This study summarizes the outcome of all investigations of elder abuse conducted in Forsyth County, North Carolina, during a 3-year period ending December 1991. Of the 123 cases investigated, 23 were confirmed as elder abuse. There were no statistically significant differences in age, sex, race, living arrangements, mental status, mobility, or source of report between confirmed and unconfirmed cases. Unconfirmed compared to confirmed cases were more likely to reside in a nursing home and/or to be ill. The most frequently substantiated charge was exploitation of resources (46%). Only 3% of charges of physical abuse were substantiated. Among confirmed cases, 70% were offered and accepted protective services.

Aged↗
PubMed1993

Critical review of the international assessments of health-related quality of life.

This paper reviews the international adaptation and use of generic health quality of life measures over the last several years, including the Nottingham Health Profile (NHP) the Sickness Impact Profile (SIP), the Medical Outcomes Short-Form 36 (MOS SF-36), the EuroQol, and Dartmouth COOP Charts. International work with disease or condition specific HRQL measures is exemplified with the European Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire (QLQ), and the Spitzer Quality of Life (QL) Index. Progress towards cross national measurement equivalence in HRQL measures reported in the literature has been uneven. Results show that the development of language-adapted versions of HRQL measures to date have mostly concerned translation issues, within the context of independently conducted studies. Substantially less focus has been placed on psychometric equivalence across language versions necessary for coordinated international studies, such as multi-national clinical trials. However, this picture is rapidly changing with recent projects underway to develop and refine new or existing HRQL measures. Overall, the lack of prominent differences found between countries in ranking of health states in major HRQL measures supports the feasibility of developing internationally applicable HRQL instruments. Recommendations are made for additional data needed to better ascertain the degree of measurement equivalence developed in the various versions of each instrument reviewed.

Cross-Cultural Comparison↗