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Biomedical subjects

E M Foster

Publications and source records attributed to E M Foster.

At least 19 recordsLinked to original sources
PubMed1997

An economic analysis of developmental detection methods.

OBJECTIVE: To assess the costs and benefits of various approaches to early detection of developmental disabilities. DESIGN: Cost-benefit analyses based on data from previously published studies of developmental screening tests. SETTING: General pediatric practices and day care centers. PATIENTS AND OTHER PARTICIPANTS: A total of 247 parents and their 0- to 6-year-old children-103 from day care centers and 144 from pediatric practices. MAIN OUTCOME MEASURES: Licensed psychological examiners administered a screening test of parents' concerns about children's development and one or two direct screening tests: the Denver-II and/or the Battelle Developmental Inventory Screening Test. For the day care sample, examiners also administered to each child measures of intelligence, adaptive behavior, and language. In the pediatric sample, children were administered additional assessments. At the same time, diagnostic measures were administered to a randomly selected subsample to make determinations about developmental status. Each screening method was evaluated for its short-term costs (administration, interpretation, diagnosis, and treatment) and long-term benefits (impact of early intervention on adult functioning as inferred from longitudinal studies by other researchers). RESULTS: When the long-term costs and benefits were considered, none of the approaches emerged as markedly superior to another. When viewing the short-term costs, the various screening approaches differed markedly. The use of parents' concerns was by far the least costly for physicians to administer and interpret. CONCLUSION: Physicians can incur tremendous expenses when attempting to detect children with developmental problems. Although the benefits of early detection and intervention are substantial, physicians are not well-compensated for providing a critical service to society. Health policymakers and third-party payers must reconsider their minimal investment in early detection by health care providers. Nevertheless, our findings have encouraging implications for practice, because the use of parents' concerns as a screening technique offers substantial savings over and above other methods.

Child↗
PubMed1996

Who gets hospitalized in a continuum of care?

OBJECTIVE: To compare children and adolescents hospitalized under a continuum of care with those hospitalized under traditional insurance coverage. METHOD: With comprehensive data, logistic regressions were used to predict hospitalization and to identify its determinants. RESULTS: As expected, the probability of being hospitalized was much higher under traditional care. In addition, the predictors of hospitalization differed by site. Accuracy of predictions was high. CONCLUSIONS: Different kinds of children were hospitalized under a continuum of care than under a traditional insurance system. Hospitalizations under both systems were highly predictable.

Adolescent↗
PubMed1993

Reevaluating the costs of teenage childbearing.

Teenage childbearing in the United States has long been regarded as an important social problem with substantial costs to teen mothers and their children. Recently, however, several researchers have argued that the apparent negative effects of teenage childbearing primarily reflect unmeasured family background rather than the true consequences of a teen birth. To distinguish the effect of teen childbearing from that of family background, we use data from the Panel Study of Income Dynamics and compare teen mothers with their sisters. We find that accounting for unobserved family background reduces, but does not eliminate, the estimated consequences of early childbearing. Statistically significant and quantitatively important effects of teen parenthood remain for high school graduation, family size, and economic well-being.

Adolescent↗
PubMed1978

Psychiatric illness in the elderly. A comparison of GP records and survey findings.

The GP records of 200 elderly people living at home were scrutinized and estimation made of physical and psychiatric disability. These estimations were compared with those made independently by a psychiatrist interviewing the subjects at home. There was a reasonable agreement between the two assessments of functional disorder and between the two assessments of physical disabilities. Whereas the survey psychiatrist's diagnoses of mental disorder correlated positively with the presence of physical illness, this did not hold for those considered to have evidence of psychiatric illness using GP records alone. The duration of a positive psychiatric history obtained from GP records was consistent with a discrimination between late onset (recent) and chronic neurosis.

Aged↗
PubMed1978

Management of the demented elderly patient in the community.

Eighty-three consecutive patients with organic mental disorder were studied on their first admission to a psychiatric day hospital assessment unit in a general hospital. They were evaluated medically, psychiatrically and by social work, re-evaluated after 3 months, and again after 12 months or at death. The types of care, and the number of days in each setting, were recorded. Nearly three-quarters were dead or in institutions by 12 months: those initially living with spouses did worst, and those with their children did best, while those on their own became long-stay residents in institutions. Family support seeemed the most important factor determining continued life in the community, and increased help to families from social services appeared to be needed. The value of earlier psychiatric diagnostic and earlier treatment of physical ills is also discussed.

Aged↗
PubMed1978

Foodborne hazards of microbial origin.

Foods can serve as vehicles of many pathogenic and toxigenic agents of disease. Bacterial agents comprise three groups: 1) those that grow in the food and produce an active toxin before consumption (e.g., clostridium botulinium); 2) those that merely exist as contaminants in the food but are able to initiate infection when swallowed (e.g., Salmonella spp.); and 3) those that multiply and produce large numbers of vegetative cells in the food, then release an active enterotoxin when they sporulate in the gut. A few parasitic (e.g., Trichinella spiralis) and viral agents (e.g., hepatitis A) also can be transmitted by food. Botulinum poisoning is the deadliest foodborne disease. The potential danger of botulism from cured meats is a major factor in the argument over use of nitrites as meat curing agents. A new disease called infant botulism has been recognized since 1976. Apparently it is not foodborne but results from intraintestinal growth of C. botulinum in very young infants. Salmonellosis is the most important of the foodborne diseases from the standpoint of overall human health. The primary vehicles are contaminated raw meat, poultry, and eggs. Faulty food handling practices are responsible for most food poisoning in the United States.

Bacillus cereus↗
PubMed1977

Cognitive function and length of survival in elderly subjects living at home.

177 people aged 65 or over, chosen at random from larger representative samples of elderly people living at home in Newcastle upon Tyne, were given the Weschler Adult Intelligence Scale (WAIS) or a shortened form of it, and followed up for 7 years or till death. Discriminated function analysis showed that the power of the test score to predict death occurring within 2 years was not explained away by its correlations with age, sex, social class or physical disability. Exclusion of clinically diagnosed chronic brain syndromes reduced but did not abolish the relationship found to exist between test score and outcome. The ascertainment of impaired cognitive functioning has important applications in the assessment of prognosis and in the planning of care of elderly people.

Aged↗
PubMed1976

The characteristics of old people receiving and needing domiciliary services: the relevance of psychiatric diagnosis.

A sample of 447 people aged 65 years and over, randomly selected from electoral rolls, were visited in their homes, independently, by a medical social worker and a psychiatrist. Twelve per cent were receiving domiciliary services from the Local Authority and a further 20% were considered to require them. The types of services received and recommended are described and the medical, social and psychiatric services of those receiving services, in need of them, and the remainder are compared. The high priority for the support of persons with chronic brain syndrome and their relatives is emphasized. Functional psychiatric symptoms were found by the psychiatrist, in a high proportion of those considered by the medical social worker to need services. Psychiatric assessment and treatment which might reduce the need for social services in some cases, would be greatly assisted by the development of a reliable screening device for the use of the primary care team.

Activities of Daily Living↗
PubMed1970

Unde et quo.

Explore the source record for details and available documents.

Congresses as Topic↗
PubMed1968

Survival and outgrowth of Clostridium botulinum type E spores in smoked fish.

Chub injected in the loin muscle with 10(6)Clostridium botulinum type E spores were smoked to an internal temperature of 180 F (82.2 C) for 30 min, sealed in plastic bags, and incubated at room temperature (20 to 25 C) for 7 days. Viable type E spores were found in practically all such fish. Toxin formation by the survivors in the smoked fish was dependent on the brine concentration of the smoked fish. A brine concentration of 3% or higher, as measured in the loin muscle, inhibited toxin formation. Six different type E strains gave similar results. Only a few hundred of the million spores in the inoculum survived the smoking. Moisture in the atmosphere during smoking did not reduce the incidence of fish with type E survivors.

Clostridium botulinum↗
PubMed1968

Role of curing agents in the preservation of shelf-stable canned meat products.

Experiments were conducted to gain a better understanding of the mechanism by which sodium chloride, sodium nitrate, and sodium nitrite supplement the action of heat in preserving canned cured meat products. Heated spores of putrefactive anaerobe 3679h were less tolerant of all three curing agents in the outgrowth medium than were unheated spores. When the curing agents were added to the heating menstruum, but not to the outgrowth medium, sodium chloride and sodium nitrate tended to protect the spores against heat injury, but sodium nitrite did not. When the spores were both heated and cultured in the presence of the curing agents: (i) nitrate and salt increased the apparent heat resistance at low concentrations (0.5 to 1%) but decreased it at concentrations of 2 to 4%; (ii) nitrite was markedly inhibitory, especially at pH 6.0. At the normal pH of canned luncheon meats (approximately 6.0), nitrite appears to be the chief preservative agent against spoilage by putrefactive anaerobes.

Bacteria↗
PubMed1968

Effect of sodium nitrite, sodium chloride , and sodium nitrate on germination and outgrowth of anaerobic spores.

The effects of meat-curing agents on germination and outgrowth of putrefactive anaerobe 3679h (PA 3679h) spores were studied in microcultures. Nitrite concentrations up to 0.06% at pH 6.0 or between 0.8 and 1% at pH 7.0 allowed emergence and elongation of vegetative cells but blocked cell division. The newly emerged cells then lysed. With more than 0.06% nitrite at pH 6.0 or more than 0.8 to 1% at pH 7.0, the spores lost refractility and swelled, but vegetative cells did not emerge. Even as much as 4% nitrite failed to prevent germination (complete loss of refractility) and swelling of the spores. Sodium chloride concentrations above 6% prevented complete germination (i.e., the spores retained a refractile core). In the presence of 3 to 6% sodium chloride, most of the spores germinated and produced vegetative cells, but cell division was often blocked. Sodium nitrate had no apparent effect on germination and outgrowth at concentrations up to 2%.

Bacteria↗