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Biomedical subjects

T C Clark

Publications and source records attributed to T C Clark.

12 recordsLinked to original sources
PubMed2001

Adolescents' perceptions of a health survey using multimedia computer-assisted self-administered interview.

OBJECTIVE: To ascertain young people's perceptions of an adolescent health survey when administered by multimedia computer assisted self-administered Interview (M-CASI) through analysis of (1) questionnaire item responses and (2) focus group interviews. METHODOLOGY SETTING: Auckland, New Zealand, 1999. STUDY TYPE: Pilot testing of a 488-item branching questionnaire delivered using a youth-oriented and user-friendly M-CASI interface in a variety of settings using both desktop and laptop computers. Post pilot focus groups of participants identifying their perceptions and experiences of the survey. SAMPLE: 110 school students aged 12 to 18 years. RESULTS: The mean number of questions answered by participants was 316 with the median time to completion being 48 minutes. On average 65% of the total number of questions were seen and of these 1.5% were deliberately not answered. A high level of acceptability and enjoyment of M-CASI was found in the analysis of focus group responses and agreed with the item responses relating to M-CASI within the questionnaire itself. Participants identified privacy and confidentiality as being particularly important for the honesty of their responses. The passive matrix screens of the computers were popular as they could only be viewed from in front. CONCLUSIONS: M-CASI is an acceptable instrument for the administration of a youth health survey. Laptop computers with passive matrix screens are able to enhance perceptions of privacy and confidentiality, which may improve honesty of responses. IMPLICATIONS: M-CASI is now feasible and offers advantages in health surveying.

Adolescent↗
PubMed1996

Does pneumoperitoneum during laparoscopy increase bacterial translocation?

BACKGROUND: To evaluate the impact of laparoscopy in the presence of peritonitis, this study was designed to assess bacteremia caused by E. coli-induced peritonitis with a carbon dioxide pneumoperitoneum in a rat model. METHODS: Sixty Sprague-Dawley rats were divided into inoculum groups (no E. coli, 10(6) colony-forming units [CFU] E. coli, and 10(8) CFU E. coli), followed by induction of a carbon dioxide pneumoperitoneum or no pneumoperitoneum. Fifteen-minute-interval blood cultures were obtained to determine time of bacteremia development. Statistical assessment to determine significant differences among groups was done using ANOVA and t-test analysis. RESULTS: A total of 20 animals with E. coli introduced into the peritoneum and a carbon-dioxide-induced pneumoperitoneum had more frequent positive blood cultures at all time intervals compared to identical inoculum subgroups without a pneumoperitoneum. ANOVA revealed a significant difference in bacteremia within the same concentration inoculum groups in animals receiving a pneumoperitoneum vs none (p < 0.01). Bacteremia increased significantly as inoculum concentrations increased (25% with 10(6) E. coli inoculum vs 80% with 10(8) E. coli), especially among the insufflated subgroups (45% with 10(6) E. coli vs 100% with 10(8) E. coli) over 180 min (p < 0.01). CONCLUSION: Carbon dioxide pneumoperitoneum increases the incidence of E. coli bacterial translocation from the peritoneum into the bloodstream in this rat model.

Animals↗
PubMed1995

Health care for the uninsured in Duluth.

Providing health care for Minnesota's uninsured population continues to be both a clinical and political challenge. Between October 1, 1991, and September 30, 1993, 1,260 previously uninsured people received charity health care in Duluth. No one was excluded because of pre-existing conditions. Their utilization of services and associated costs can help project the health care needs and costs of care for uninsured Minnesotans. This group of uninsured people used a different mix of health care services compared with insured Minnesotans, and their total costs (including prescriptions) were about 15% greater. A large proportion of these uninsured Minnesotans had chronic health conditions and a "pent-up need" for services and medications. This experience demonstrated that it is possible to administer a limited benefits plan in coordination with existing public and private resources.

Adolescent↗
PubMed1994

The relationship of hearing-loss severity to demographic, age, treatment, and intervention-effectiveness variables.

The purpose of this study was to demonstrate how hearing-loss severity and the variables of demographics, age, treatment, and intervention effectiveness were related for 2519 children served by SKI*HI home-based programs between July 1979 and June 1991. Relationships between hearing-loss severity and demographic variables were negligible to small. Severity was inversely associated with identification, amplification, and program-start ages. The relationship between severity and early versus late program start was small; this was also true for the relationship between severity and communication methodology. Severity was positively associated with treatment duration; however, severity was not associated with treatment density. Intervention effectiveness for the severity levels, based on expressive and receptive language scores, was examined using three predictive models. These included the residuals between actual and predicted posttest scores, proportional change indices, and value-added gains per month. The usefulness of the three procedures for clinical and program-evaluation purposes is discussed.

Age Factors↗
PubMed1993

Screening procedures used to identify children with hearing loss.

This study focused on the hearing-screening procedures used to identify children who have hearing losses who were later enrolled in SKI*HI parent/infant programs throughout the country. Responses to a questionnaire for 1,404 children indicated that although auditory brainstem response (ABR) technology provided the lowest mean identification age, informal hearing-screening procedures (parental suspicion and referral) were the procedure of identification for 80% of the children. The data suggest that formal screening programs are not presently locating the vast majority of infants who have hearing losses. Recommendations for professional and parental education in the area of hearing-loss screening are provided.

Age Factors↗
PubMed1991

A coactive sign system for children who are dual-sensory impaired.

The SKI*HI Institute developed a system of coactive signing to help alleviate communication and instructional barriers for children who are dual-sensory impaired (deaf and blind). The system also can be used to help children who are severely multihandicapped learn how to communicate. The system includes optimized coactive signs that are functional, easy to feel, easy to relate to the referent, and easy to make, and it also includes techniques related to effective coactive sign use. The coactive sign system is illustrated on a series of video tapes that has been field tested and produced and is being disseminated throughout the United States and Canada.

Blindness↗
PubMed1980

Respiratory effects of exposure to dust in taconite mining and processing.

Taconite is a low-grade iron ore consisting of iron, quartz, and numerous silicates. Taconite from the eastern tip of the Mesabi Iron Range contains the amphibole silicate cummingtonite-grunerite, which is a mineral relative of amosite asbestos. In the present study, data were collected from 249 men with 20 or more years of exposure to taconite dust and 86 men without history of intimate exposure to taconite dust. Bronchitic symptoms and impairment of expiratory flow correlated significantly with history of cigarette smoking, but not with exposure to dust. Chest radiographs revealed three cases of possible silicosis. No case of definite interstitial fibrosis, ill-defined diaphragm, pleural calcification, or mesothelioma was found. We conclude that (1) cigarette smoking is significantly correlated with bronchitic symptoms and impairment of expiratory flow; (2) taconite workers are at risk of silicosis; (3) if dust containing cummingtonite-grunerite has biologic activity comparable to that of dust from asbestos, it is not evident after 20 years of low-level exposure.

Adult↗
PubMedDate not supplied

Comparison of health-risk behaviours among students in alternative high schools from New Zealand and the USA.

OBJECTIVES: To describe the prevalence of health-risk behaviours of New Zealand alternative education students, and to compare these behaviours to similar students in the USA. METHODS: Thirty-six alternative education schools in the northern region of New Zealand were surveyed. A total of 269 students completed a youth health questionnaire using laptop computers. These data were compared to data from an equivalent population of alternative education students in the USA. RESULTS: Alternative education students from New Zealand and the USA engage in similar high levels of health-risk behaviours. Female students in New Zealand are at particularly high risk of poor health and social outcomes due to high levels of alcohol and marijuana use, driving under the influence of alcohol and high prevalence of risky sexual behaviours. Such health-risk behaviours place alternative education students at greater risk of some of the leading causes of morbidity and mortality in both youth and adult populations. CONCLUSIONS: Findings from the present study support the need for specific health policies and programmes for alternative high school students. Providers of New Zealand alternative education should be aware that female students are at particularly high risk of many health-risk behaviours.

Adolescent↗