Search PubMed⌕ Search

Biomedical subjects

David R Anderson

Publications and source records attributed to David R Anderson.

28 records · Page 2Linked to original sources
PubMed2003

The relationship between health promotion program participation and medical costs: a dose response.

The purpose of this research was to determine whether participation in the health risk assessment (HRA) component of a comprehensive health promotion program has an impact on medical costs, and whether the addition of participation in interventions has an incremental impact. Program participants (n = 13,048) were compared with nonparticipants (n = 13,363) to determine program impact on paid medical costs. Overall, HRA participants cost an average of $212 less than eligible nonparticipants. As HRA participation increased, cost savings also increased. Additionally, although participation in either an HRA or activities alone resulted in savings, participation in both yielded even greater benefits. The findings indicate that there is an independent benefit of each of these elements of participation, and that the sum of the elements provides a greater benefit than the impact of either of the individual elements alone.

Adult↗
PubMed2002

Using PCDD/F congener patterns to determine the source of elevated TEQ concentrations in cows milk: a case study.

PCDD/F congener profiles have been used to determine the source of elevated TEQ concentrations in cows' milk collected in the vicinity of several industrial sites. Principal components analysis and modelling of the air-to-milk transfer of individual PCDD/F congeners have shown that the milk fingerprint was related to that of sediment taken from the River Rother adjacent to the farm where the cows had grazed. It is suggested that sediment from the river had been washed onto the grazing land during periods of flooding, and this had been ingested by the grazing cows. This pathway could represent an important route of contaminant intake for livestock grazing on the regularly inundated floodplains of rivers containing contaminated sediments.

Air Pollutants↗
PubMed2002

Sources of dioxins in the United Kingdom: the steel industry and other sources.

Several countries have compiled national inventories of dioxin (polychlorinated dibenzo-p-dioxin [PCDD] and polychlorinated dibenzofuran [PCDF]) releases that detail annual mass emission estimates for regulated sources. High temperature processes, such as commercial waste incineration and iron ore sintering used in the production of iron and steel, have been identified as point sources of dioxins. Other important releases of dioxins are from various diffuse sources such as bonfire burning and domestic heating. The PCDD/F inventory for emissions to air in the UK has decreased significantly from 1995 to 1998 because of reduced emissions from waste incinerators which now generally operate at waste gas stack emissions of 1 ng I-TEQ/Nm3 or below. The iron ore sintering process is the only noteworthy source of PCDD/Fs at integrated iron and steelworks operated by Corus (formerly British Steel plc) in the UK. The mean waste gas stack PCDD/F concentration for this process is 1,2 ng I-TEQ/Nm3 based on 94 measurements and it has been estimated that this results in an annual mass release of approximately 38 g I-TEQ per annum. Diffuse sources now form a major contribution to the UK inventory as PCDD/Fs from regulated sources have decreased, for example, the annual celebration of Bonfire Night on 5th November in the UK causes an estimated release of 30 g I-TEQ, similar to that emitted by five sinter plants in the UK.

Air Pollutants↗
PubMed2002

Comparison of a nomogram and physician-adjusted dosage of warfarin for prophylaxis against deep-vein thrombosis after arthroplasty.

BACKGROUND: Warfarin is an effective agent for prophylaxis against deep-vein thrombosis following total hip or knee arthroplasty. However, management with warfarin in the postoperative setting is problematic because of the need for anticoagulant monitoring. We developed a nomogram for the dosing of warfarin that was specific for joint arthroplasty. The objective of this study was to compare the performance of this nomogram with that of physician-adjusted dosing of warfarin for patients undergoing total hip or knee arthroplasty. METHODS: The study involved two cohort trials. The historical control group consisted of 1024 patients who underwent total hip or knee arthroplasty during the course of a clinical trial (the Post-Arthroplasty Screening Study [PASS]) in which all warfarin dose adjustments were made by two hematologists. The first dose of warfarin was given on the evening of the surgery, and the warfarin dose was adjusted daily on the basis of the international normalized ratio and was discontinued at the time of discharge from the hospital. In the PASS study, the dosage of warfarin was designed to prolong the international normalized ratio to 1.7 by postoperative day 4 and to maintain it between 1.8 and 2.5 until discharge from the hospital. Subsequently, a warfarin nomogram was developed on the basis of the dose adjustments used in the PASS study, and it was used prospectively to manage a cohort of 729 patients undergoing total hip or knee arthroplasty. In the nomogram cohort, the initial dose of warfarin was given on the evening of the surgery. Both cohorts were followed for twelve weeks after the surgery to determine if any venous thromboembolic complications had developed. RESULTS: The nomogram cohort and the control cohort had similar daily doses of warfarin (mean, 3.2 versus 3.3 mg) and levels of international normalized ratio on postoperative day 4 (mean, 1.9 versus 1.9) (p > 0.2). The average number of days to achieve an international normalized ratio of >1.7 was 4.0 for the nomogram cohort compared with 4.3 for the control cohort (p = 0.01). The percentage of days that the international normalized ratio was between 1.8 and 2.5 was 61% for the nomogram cohort and 58% for the control cohort (p < 0.01), and the percentage of days that the international normalized ratio was >3.0 was only 6.5% for the nomogram cohort and 6.0% for the control cohort (p > 0.2). Eighty-two percent of the patients managed with the nomogram achieved an international normalized ratio of >1.7 by the time of discharge from the hospital compared with 92% in the control cohort (p = 0.01). In the three-month follow-up period, a deep-vein thrombosis or a nonfatal pulmonary embolism developed in nineteen patients (2.6%; 95% confidence interval, 1.6% to 4.0%) in the nomogram cohort compared with fourteen patients (1.4%; 95% confidence interval, 0.7% to 2.3%) in the control cohort. No major bleeding event or fatal pulmonary embolism was observed in the patients managed with use of the nomogram. CONCLUSION: This study demonstrated that the administration of warfarin during hospitalization with use of a nomogram designed for the prevention of deep-vein thrombosis following total hip or knee arthroplasty provided effective and safe prophylaxis that was comparable with that provided by physician-adjusted dosing of warfarin.

Anticoagulants↗
PubMedDate not supplied

Understanding the relationship between health risks and health-related costs.

Dr. Anderson reflects on the lack of consistency in studies on the relationship between health risks and medical costs. Part of the inconsistency is caused by differences in risk assessment instruments, but a more important concern is lack of clear conceptualization and statement of research goals. One reason for exploring this relationship is to be able to predict health care costs accurately: a very different reason is to identify causal variables, the modification of which will have an impact on costs.

Health Care Costs↗
PubMedDate not supplied

Review of the studies cited in the DataBase section of the American Journal of Health Promotion.

PURPOSE OF THE REVIEW: To analyze the characteristics of the articles reviewed in the DataBase section of the American Journal of Health Promotion and to summarize this review in tabular format. DATA SOURCES: All 350 entries in the American Journal of Health Promotion DataBase section beginning with issue 1:3 (Winter 1987) through issue 17:3 (January/February 2003) were included in this review. STUDY INCLUSION AND EXCLUSION CRITERIA: Every study summarized in the DataBase section was included. Five duplicate sets of entries existed in the DataBase section. One entry from each set was excluded based upon author consensus. Thus, this review includes 345 unique entries. DATA EXTRACTION METHODS: All data reported in the DataBase section (e.g., sample sizes, measurement tools, study duration), as well as additional data derived directly from the studies (i.e., cross-sectional versus longitudinal study design, unit of analysis, and study topic) were entered in SPSS 11.5 for PC (SPSS, Inc, Chicago, Illinois). DATA SYNTHESIS: Data were synthesized to identify the frequency of entry by research question, research design and internal validity rating, unit of analysis, measurement tool(s), and health topics addressed. MAJOR CONCLUSIONS: The majority of articles included in the DataBase received the highest research design rating, had robust sample sizes, and were of a meaningful duration. Additionally, a wide variety of topics were addressed. Overall, these strengths indicate that a solid foundation of research has been established on many of the most critical issues facing the health promotion field.

Behavioral Research↗
PubMedDate not supplied

Building program participation: strategies for recruitment and retention in worksite health promotion programs.

Building program participation is vital for all health promotion programs. There are a large variety of strategies that have been used to enhance recruitment and retention in worksite health promotion programs. Many of these strategies are examined and their significance in the design and operation of health promotion programs in worksite settings is reviewed.

Community Participation↗