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Biomedical subjects

J W Finney

Publications and source records attributed to J W Finney.

At least 73 records · Page 4Linked to original sources
PubMed1992

The long-term course of treated alcoholism: II. Predictors and correlates of 10-year functioning and mortality.

This study examines factors related to mortality and 10-year posttreatment functioning for a sample of alcoholic patients who return to their families after an index residential treatment episode. Of the 113 patients followed 2 years after treatment, 20 had died by the time of the 10-year follow-up. Mortality risk was greater among patients who, prior to treatment, consumed more alcohol and were unemployed. Mortality was more strongly associated with medical conditions, liver problems, medication use and lack of confidants assessed 2 years posttreatment. The course for the surviving patients between the 2-year and 10-year follow-ups was one of improvement in terms of alcohol consumption, relative stability in terms of physical symptoms and depression, and an aging-related decline in social activities and employment. Life context and coping factors assessed 2 years after treatment were predictive of long-term outcome. Persons in less stressful life situations, in more cohesive and organized families, and who more frequently used active cognitive coping responses at the 2-year follow-up tended to function better at the 10-year follow-up. Overall, the findings support the value of embedding long-term follow-up studies in a theory of the disorder that is the target of the intervention.

Activities of Daily Living↗
PubMed1992

Conceptual and methodological issues for behavioral pediatrics research.

Three prescriptions are made to improve behavioral pediatrics research: (1) Focus behavioral pediatrics on preventive research from environmental and social perspectives. (2) Ground research questions more extensively within a conceptual framework. (3) Enhance research quality with reliable, valid measurement. Conceptual and methodological improvements in research will facilitate integration of the multidisciplinary, multimethodological, and multitheoretical scope of behavioral pediatrics and further its contributions to science.

Behavioral Medicine↗
PubMed1991

The Drinking Problems Index: a measure to assess alcohol-related problems among older adults.

Research on problem drinking among older adults has been hampered by the lack of specialized instruments to assess drinking problems. In this paper, we examine the psychometric properties of a 17-item measure specifically designed to assess drinking problems in this population. The Drinking Problems Index (DPI) exhibits excellent psychometric properties, with an internal consistency reliability estimate of .94, a cross-temporal correlation over a 1-year interval of .66, and cross-sectional correlations with alcohol consumption at two points a year apart of .37 and .42. In addition, the construct validity of the DPI is supported by significant concurrent correlations indicating that persons who have more drinking-related problems experience more depression, have less self-confidence, and participate in fewer social activities. Consistent with the high internal consistency reliability estimate, a factor analysis confirmed that the measure is largely unifactorial. Overall, the findings suggest that the DPI is a reliable and valid instrument for assessing problems associated with drinking in surveys of older persons.

Activities of Daily Living↗
PubMed1991

Psychology in primary health care: effects of brief targeted therapy on children's medical care utilization.

Evaluated the impact of psychological treatment for 93 children (ages 1-15) with common behavior, toilet, school, and psychosomatic problems. Children and parents, who were members of a health maintenance organization, had 1-6 visits to a primary care-based psychological consultation service. Individualized treatment was guided by problem-specific behavioral protocols. Parent outcome and behavior checklist ratings indicated improvement or resolution for 74% of children and high satisfaction with the psychological service. Children's use of medical services, especially acute primary care visits, was reduced during the year after treatment; a matched comparison group's use was unchanged. Addressing children's unmet mental health needs reduces medical care utilization. A primary health care model of psychological services provides an integrated system for serving the health and mental health needs of children.

Adolescent↗
PubMed1991

The long-term course of treated alcoholism: I. Mortality, relapse and remission rates and comparisons with community controls.

This study examines the course of alcoholism for a sample of patients who were followed 2 years and 10 years later after an index residential treatment episode. The alcoholic patients were 9.5 times as likely to die as matched community controls over the 8-year interval between the two follow-ups, a ratio considerably higher than that found in previous studies. Of the 83 surviving and successfully followed patients, 57% were classified as remitted at the 10-year follow-up. Of the patients classified as remitted at the 2-year follow-up and recontacted 8 years later, 77% had the same outcome status at the long-term follow-up, 67% of the initially relapsed patients retained that status at the 10-year follow-up. The 10-year remitted patients generally were functioning as well as matched, nonproblem-drinking community controls, whereas the relapsed patients exhibited dysfunction in a number of areas. Retrospective data on drinking patterns during each of the 6 years prior to the 10-year follow-up indicated a slight increase over time in the proportion of patients reporting abstinence or nonproblem drinking, with a concomitant decrease in the proportion indicating heavy or binge drinking. Overall, our data show a substantially elevated mortality risk among these alcoholic patients. For those patients who survive, however, the average course is one of modest improvement.

Adult↗
PubMed1990

Pediatric appointment keeping: improving adherence in a primary care allergy clinic.

We evaluated the effects of introducing and discontinuing an intervention designed to improve adherence with scheduled appointments in a pediatric allergy clinic. Five nonadherent and three adherent patients received reminders and incentives for keeping their scheduled appointments. Adherence with appointments increased for three of the five nonadherent children, who had an average increase of 13%, and adherent patients continued to keep appointments during the intervention condition. After 10 scheduled allergy clinic appointments had been kept, incentives were discontinued while reminders continued. Improvements in adherence were not maintained after incentives were discontinued and two children showed reductions in adherence to below-baseline levels. Incentive programs increase appointment keeping, but discontinuing incentives abruptly may result in the return of nonadherence, even when reminders are provided as a maintenance strategy. Future pediatric psychology research and practice should investigate both the benefits and limitations of strategies designed to improve adherence.

Adolescent↗
PubMed1990

Health education for testicular cancer.

The incidence of testicular cancer is rapidly increasing. It is highly curable when detected and treated early, yet 500 to 1,000 men die from this cancer each year. Most victims are young men whose deaths account for a large number of potential years of life lost. Risk factors for testicular cancer are known but they cannot account for the increase in incidence. Only one age group, men between 15 and 34 years, is currently exhibiting an increase in incidence and mortality and should therefore comprise the primary at-risk group. Health education for the at-risk group, including promotion of regular and accurate testicular self-examination (TSE), could lead to earlier tumor detection and treatment and thereby save lives.

Adolescent↗
PubMed1990

Promoting parent-provider interaction during young children's health-supervision visits.

We prompted parents to increase their interactions with health-care providers during their children's health-supervision visits. Before scheduled appointments we asked parents of 32 infants and young children if they had specific child health questions or concerns. Sixteen parents randomly assigned to the prompted group were then prompted to initiate discussions of their concerns. Sixteen control parents discussed unrelated topics before their appoitments. Prompted parents initiated significantly more interactions with health-care providers and more health and behavioral topics were discussed during their appointments. Both parent groups reported satisfaction with health-care services. Further research is needed to determine the clinical significance of outcomes associated with enhanced parent-provider interaction during children's health-supervision visits. These visits are ideal settings for behavioral research on improving health care for children and their families.

Child Health Services↗
PubMed1989

Years of potential life lost: evaluating premature cancer death in men.

Cancer is one of the most serious health concerns facing the nation. Health care policy makers who determine cancer research and treatment priorities must analyze death rates as an indicator of public health priorities. Two additional indexes that account for premature death include years of potential life lost (YPLL) and potential years of life lost per death (YPLL/D). Data for ten leading causes of cancer death in men from 1974-1983 were analyzed and the YPLL and YPLL/D corresponding to these cancers was calculated. Each cancer was then ranked from most to least significant according to each index. The analyses show that using YPLL and YPLL/D to evaluate cancer death in men results in rankings that differ from those obtained when using death rates alone. The premature death indexes, when used in combination with traditional mortality indexes, would enhance the data base used by funding agencies who select and evaluate cancer treatment and prevention programs.

Adolescent↗
PubMed1988

Do encopretic children have clinically significant behavior problems?

Pediatricians are increasingly recognized as the providers of choice for children with functional encopresis. The presence of clinically significant behavior problems could interfere with pediatric regimens for encopresis, however. To study the extent to which encopretic children exhibit behavior problems, we compared the scores on a standardized behavioral checklist for three randomly selected samples: a sample group of children with encopresis, a sample group of children with behavior problems, and a sample group of children without encopresis or behavior problems. All three samples were matched for age and gender. An analysis of variance showed that the scores of children with encopresis did not differ from the normative sample but were significantly lower than the scores from the behavior problem sample (P less than .00001). The results support the appropriateness of the trend toward expanding the primary pediatrician's role in the treatment of encopresis.

Child↗
PubMed1986

Preventing common feeding problems in infants and young children.

Feeding is one of many important ways that parents nurture their infants and children. When parents are overly concerned about feeding, they can exacerbate temporary feeding difficulties and misbehaviors by their inappropriate responses to the child's behavior. Child health supervision visits provide opportunities for the early detection of feeding problems, for education about early feeding experiences and typical child behavior at mealtimes, and for suggestions about the prevention of feeding problems. Handouts and printed materials can provide useful guidelines for introducing solid foods and for managing children's mealtime behavior. Early detection might reduce the likelihood that minor feeding disturbances will develop into severe feeding problems. Behavior management strategies and a pleasant social context for mealtimes can improve children's eating and mealtime behavior. Impairments in the parent-infant relationship may lead to serious feeding problems and referrals to appropriate support services are necessary. Prevention and early treatment of feeding problems can be facilitated by health education about early food experiences and the common developmental behaviors that occur as children grow and develop.

Behavior Therapy↗
PubMed1986

Matching patients with treatments: conceptual and methodological issues.

The current enthusiasm for matching patients with optimal treatments rests on limited conceptual analyses. In addition, much of the existing research on patient-treatment matching has been based on methodological assumptions that are not commensurate with the complexity of the matching problem. Six key conceptual and methodological issues that underlie attempts to match patients with optimal forms of treatment and to conduct research on patient-treatment matching are outlined. The conceptual issues are: selecting effective matching variables, specifying the end result that matching is to enhance and determining the stage(s) in the treatment process at which matching decisions are to be made. The three methodological issues deal with the type of patient-treatment match or interaction effect and include: nonlinear interaction effects, higher-order interaction effects and multilevel interaction effects. Examples clarifying these issues are drawn from the literature on treating alcohol-dependent persons, but the issues are discussed at a broad level that permits generalization to treatment for many disorders. Implications for research on and the practice of "prescriptive treatment" are considered.

Alcohol Drinking↗
PubMed1986

Testicular self-examination: validation of a training strategy for early cancer detection.

Testicular self-examination (TSE) can lead to early diagnosis and treatment of testicular cancer, the third leading cause of death in young men. We evaluated the effectiveness of a brief and specific checklist for teaching TSE skills. Ten men were videotaped while performing testicular self-examinations before and after training. The TSE training resulted in large and significant increases in the number of TSE steps completed and duration of the TSE. Two urological validation measures supported the improvements observed in the mens' self-examinations. Subjects reported continued performance of TSE during a follow-up telephone interview. This pilot study indicates that a brief and specific checklist is an effective strategy for teaching early cancer detection skills.

Adult↗