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Biomedical subjects

I McDowell

Publications and source records attributed to I McDowell.

71 records · Page 4Linked to original sources
PubMed1982

On the measurement of happiness. An examination of the Bradburn scale in the Canada Health Survey.

Certain characteristics of the Bradburn scale of psychologic well-being which have been criticized in recent discussions are re-examined using data from the 1978-1979 national Canada Health Survey. This large data set (N = 17,279) enabled the authors to examine the questions in a representative sample of the noninstitutionalized population. Reference standards are derived showing response frequencies by age and sex. In addition, the validity of the theoretic foundation of the scale is examined. The conclusions suggest that the items measure two dimensions of affect and are applicable in at least two different cultural groups. However, under certain circumstances the affect balance score does not provide the most adequate summary of the data, and the notion of independence between positive and negative affect does not hold for all of the questions. The authors conclude that two of the questions in particular appear weak, but that the design of the scale as a whole shows advantages over alternative instruments as an indicator of emotional well-being in general population surveys. They advocate that the scale continue to be used until a more adequate set of questions can be developed.

Adolescent↗
PubMed1982

Interpretation of arm circumference as an indicator of nutritional status.

Data from a longitudinal study of 1342 Zambian children aged between 0 and 60 months are used to derive reference standards for mid-upper arm circumference. To determine the sensitivity, specificity, and predictive value of the arm circumference measurement as an indicator of nutritional status, associations between arm circumference and other anthropometric and clinical indicators of nutritional status are presented. Although none of the anthropometric indices accurately reflects the clinical judgement of nutritional status, arm circumference is shown to be similar in accuracy to weight for age and to weight for length as an indicator of clinical malnutrition; it provides a viable alternative to these more cumbersome measurements for use in field surveys.

Anthropometry↗
PubMed1981

Screening for disability. An examination of the O.E.C.D. Survey questions in a Canadian study.

The objective of this study was to identify 25 questions suitable for detecting disability in the general population. The questions will ultimately be incorporated within larger surveys, and seek to identify the physical, social and emotional effects of illness. From a review of existing questionnaires, 64 questions were selected for trial; the OECD questions were among them. The 64 questions were tested in interviews with psychiatric outpatients and with physical medicine (rehabilitation) patients. For all cases an extensive assessment was made by the attending physician. Analysis of response rates, and the comparisons between question replies and the physicians' judgments showed that the OECD questions compared favourably with questions from other sources. Recommendations are made on which questions should be included in a disability screening instrument for use in Canada.

Activities of Daily Living↗
PubMed1976

Problems and new directions in the evaluation of primary care.

The nature of many contacts between patients and first-contact doctors (e.g. general practitioners) is such that the traditional morbidity and mortality indices of outcome are inadequate for evaluating the care provided. Preliminary results of a study developing a more appropriate index of the outcome of primary care, expressed in terms of the patient's functional abilities, are discussed. Beyond its use in evaluating the social and psychological components of care, the method may be applicable in population health surveys and in estimating the need for care.

Activities of Daily Living↗
PubMed1976

Health status: patient and physician judgments.

Patients at a rehabilitation center in Derbyshire, England, were asked to assess their own functional abilities at admission and again at discharge, using an 82-item questionnaire concerning 12 areas of daily living. Questionnaire responses were correlated with results of physical examinations, assessments by center personnel, and assessments of capacity for specific body movements. The highest correlations were observed in areas that related most directly to physical movements and to dressing and toileting. The results suggest that self-assessment of health status using this questionnaire may provide a viable alternative to judgments made by trained assessors.

Activities of Daily Living↗
PubMedDate not supplied

Use of medical care after a community-based health promotion program: a quasi-experimental study.

PURPOSE: To assess the effects of health promotion on the use of medical care services in a community setting. DESIGN: Quasi-experimental, multiple time points, case-comparison group. SETTING: Community health center in Ottawa, Canada. SAMPLE: 520 volunteer participants in a health promotion program and 932 matched comparison subjects. INTERVENTION: The health promotion program consisted of a weekend workshop on health behaviors, lifestyle assessment, and identification of weekly goals for change. This was followed by 18 months of support (5 group sessions, weekly telephone calls, and optional individual sessions). MEASUREMENT: Computerized data on health care use 6 months before, 18 months during, and 6 months after the program were obtained from Ontario's universal Health Insurance Plan (OHIP). These data were used to determine the number and system costs of visits made by participants and comparisons. RESULTS: When controlling for baseline differences through analysis of covariance, program participants were found to have higher costs and more visits for ambulatory care during the first year (p < .01) and second year (p < .05) of follow-up. Participants used significantly more diagnostic services than comparisons during both years of follow-up. Participants were also more likely to use more counseling and psychotherapy services in year 1 (relative risk, 1.53; 95% confidence interval, 1.28, 1.81) and year 2 (relative risk, 1.57; 95% confidence interval, 1.31, 1.89). No differences were found between participant and comparison groups in visits for medical consultations and assessments or preventive services. CONCLUSION: No evidence shows that this health promotion program reduced use in this population over the 2-year follow-up period.

Analysis of Variance↗
PubMedDate not supplied

A follow-up study of patients advised to obtain influenza immunizations.

Computers have been used in general practice to issue reminders to patients overdue for preventive procedures. Although effective, issuing reminders may be inconsistent with the belief that patients should take responsibility for their own health. To assess the effect of a reminder on subsequent use of influenza prevention services, this study examined the three-year immunization behavior of 1,175 patients 65 years or older who were part of a randomized controlled trial. During the middle year only, reminders were issued to patients in the experimental group. A comparison of immunization patterns over the three years in experimental and control groups indicated that the reminder both promoted independent action and engendered dependency on the reminder. The former, favorable effect was more frequent among younger patients; the latter, adverse effect was more common among older patients who visited the practice more frequently.

Aged↗
PubMedDate not supplied

Man the risk taker.

Most approaches to preventing chronic disease involve changing personal behavior. Appeals to change are often made on the grounds that certain behavior incurs a risk to health, but evaluative studies of health education suggest that this may not be a persuasive argument. Humans have always lived with risks and do not necessarily equate risk with personal danger. Many forces, both social and psychological, underlie the willingness to tolerate risks, and altering familiar behaviors may seem to the individual to be more of a loss than a benefit. If we seek to change health behavior, we must acknowledge this and recognize that factual information on risks will not encourage change unless the change forms part of a broader reappraisal of the person's values. Individual appeals for change will have little impact as long as broader social forces continue to encourage health risk behavior.

Attitude to Health↗