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Biomedical subjects

S L Luther

Publications and source records attributed to S L Luther.

13 recordsLinked to original sources
PubMed2001

A minimum data set and empirical model for population health status assessment.

BACKGROUND: The need to assess the health status of American communities in a comprehensive and systematic manner has been widely acknowledged. This study attempts to empirically derive a minimum core data set of indicators, in order to produce a uniform parsimonious model for population health status monitoring. METHODS: Five years of secondary data (1992-1996) for 113 indicators of community health for each of Florida's 67 counties were organized into 11 conceptual groups. Principal component analysis with orthogonal rotation was conducted separately on each group of indicators for each year. The component scores were converted to standard scores to further study the relationships among the conceptual groups measuring community health. A causal model was hypothesized and tested using ordinary least-squares path analysis. RESULTS: Nineteen principal components composed of 78 indicators were identified. The model demonstrated a large difference in the ability to explain variance in adult mortality (56%) compared with variance associated with adverse birth outcomes (13%). Both demographic and socioenvironmental factors have a direct effect on adult mortality. Socioeconomic factors, on the other hand, influence adult mortality indirectly through adequacy of primary care and other available resources. CONCLUSIONS: Minimum core data sets of indicators drawn from extant databases can be used to uniformly describe and explain variation in adult mortality. This research suggests caution in regard to the creation of integrated indices that combine mortality, morbidity, and other concepts such as quality of life into a single measure of community health. Further validation research employing a national sample of counties is recommended.

Adolescent↗
PubMed2001

Cost consequences of sentinel lymph node biopsy in the treatment of breast cancer. A preliminary analysis.

OBJECTIVES: To assess whether sentinel lymph node biopsy (SLNB), an alternative to axillary lymph node dissection in treating female breast cancer, affords any cost savings. METHODS: We profile cumulative treatment costs of 811 breast cancer patients, 555 of whom received SLNB. Univariate and multivariate statistical tests are used to appraise whether these cost profiles differ between SLNB and other patients. RESULTS: The statistical results are mixed. However, none supports the conjecture that SLNB necessarily lowers the cost of treating the average breast patient. CONCLUSIONS: SLNB may be cost-effective, but longer term costs and outcomes must be estimated before firm conclusions can be reached.

Axilla↗
PubMed2001

Fall risk assessment measures: an analytic review.

BACKGROUND: Clinicians are often unaware of the many existing scales for identifying fall risk and are uncertain about how to select an appropriate one. Our purpose was to summarize existing fall risk assessment scales to enable more informed choices regarding their use. METHODS: After a systematic literature search, 21 articles published from 1984 through 2000 describing 20 fall risk assessments were reviewed independently for content and validation by a panel of five reviewers using a standardized review form. Fourteen were institution-focused nursing assessment scales, and six were functional assessment scales. RESULTS: The majority of the scales were developed for elderly populations, mainly in hospital or nursing home settings. The patient characteristics assessed were quite similar across the nursing assessment forms. The time to complete the form varied from less than 1 minute to 80 minutes. For those scales with reported diagnostic accuracy, sensitivity varied from 43% to 100% (median = 80%), and specificity varied from 38% to 96% (median = 75%). Several scales with superior diagnostic characteristics were identified. CONCLUSIONS: A substantial number of fall risk assessment tools are readily available and assess similar patient characteristics. Although their diagnostic accuracy and overall usefulness showed wide variability, there are several scales that can be used with confidence as part of an effective falls prevention program. Consequently, there should be little need for facilities to develop their own scales. To continue to develop fall risk assessments unique to individual facilities may be counterproductive because scores will not be comparable across facilities.

Accidental Falls↗
PubMed2001

Comparing alternative methods for composing community peer groups: a data warehouse application.

A method for assessing the health status of communities has been under development for a decade at the University of South Florida. Known as CATCH (Comprehensive Assessment for Tracking Community Health), the method utilizes health status indicators from multiple data sources. With federal grant support, a unique data warehouse has been created to automate CATCH assessments and to enhance online analytical processing for efficient data browsing, knowledge discovery, and model testing. A comparison of two peer grouping methods (population size versus predicted age-adjusted mortality) is reviewed to demonstrate the warehouse capabilities.

Community Health Planning↗
PubMed2001

Rating the health status of U.S. communities.

Although the existence of small-area variation in health care utilization and quality had been acknowledged decades ago, and the public release of data about the performance of hospitals and physicians is no longer controversial, the wide range of variability in the health status of U.S. communities has received relatively little attention. The authors demonstrate (using Florida data) an empirically derived national system for rating the health status of communities, presented in a simplified consumer-type format, using a symbol-graded report card. This system is intended to keep the symbols of poor health status prominently in the minds and on the political agendas of community leaders.

Benchmarking↗
PubMed1999

Awareness of and compliance with recommended screening procedures: a comparison of HMO and fee-for-service enrollees.

Managed care organizations, particularly HMOs, have emphasized disease prevention and early detection (screening) programs as a component of high-quality, cost-effective medical care. Studies in the 1980s found higher levels of utilization of screening by HMO enrollees compared with individuals enrolled in fee-for-service (FFS) plans, although this pattern is less clear in more recent reports. This paper reports on an analysis of a survey designed to determine awareness, compliance, and potential barriers to participating in common screening tests by adults living in Hillsborough County (greater Tampa), Florida. A random digit--dialing telephone survey of a stratified random sample of 500 adults over 18 years of age was conducted. Health plan enrollees were found to be younger, more likely to receive health insurance through an employer, and were more likely to have a regular source of health care. Few statistically significant differences, however, were detected in awareness of or compliance with recommended screening procedures between HMO and FFS enrollees in the study. Consistent with other recent research, these findings suggest that the changing nature of managed care, from traditional staff models toward IPA or network-hybrid models, has somewhat reduced HMOs' influence on prevention and screening services.

Adult↗
PubMed1999

Sampling.

Explore the source record for details and available documents.

Cluster Analysis↗
PubMed1987

Measuring common public misperceptions about cancer.

A 32 item criterion-referenced knowledge questionnaire was developed to measure the level of common misperceptions about the nature of cancer and cancer treatments held by the public. A sample of 353 respondents were contacted and agreed to complete the questionnaire through a random telephone survey technique (Random Digit Dialing). An extensive analysis of the responses to the survey was performed and supported the validity and reliability of the instrument. Results of the survey indicate that the prevalence of misperceptions held by the public is high. The total mean score correct on the questionnaire was only 17.2 out of a possible 32. No differences were found for total mean score on the questionnaire based on the respondents' age, sex, or whether they or someone close to them had ever had cancer. Statistically significant differences, however, were found for the total mean score on the questionnaire based on the respondent's level of education and how they responded to two attitudinal questions on the questionnaire. The most prevalent misperceptions about cancer related to questions about side effects from the treatment for cancer, followed by questions about proven cancer treatments and unproven or quack cancer treatments. The least prevalent misperceptions about cancer related to questions about the nature of cancer.

Adult↗
PubMed1981

Burns and their psychological effects on children.

Thousands of children are burned each year, and hundreds die from their burns. The physical wounds of burns take less time to heal than psychological wounds caused by the burns. The child will need to make adjustments in self-concept and body image as well as social adjustments. Through support of school programs in safety education and education of the community, health educators and school nurses can help prevent the high incidence and seriousness of burns.

Adolescent↗
PubMed1980

Child sexual abuse: a review.

The sexual abuse of children is a significant problem in the United States. It is a traditionally touchy subject which has been hidden by cultural stereotypes and taboos. It is only in the last 10, and especially the last 5 years that the true scope and essence of child sexual abuse has begun to be understood. This article reviews the recent literature dealing with child sexual abuse and identifies the role health educators can play in combating this problem.

Adolescent↗