Search PubMed⌕ Search

Biomedical subjects

K W Simmons

Publications and source records attributed to K W Simmons.

5 recordsLinked to original sources
PubMed2001

Measuring clinical performance: comparison and validity of telephone survey and administrative data.

OBJECTIVE: To compare and validate self-reported telephone survey and administrative data for two Health Plan Employer Data and Information Set (HEDIS) performance measures: mammography and diabetic retinal exams. DATA SOURCES/STUDY SETTING: A telephone survey was administered to approximately 700 women and 600 persons with diabetes randomly chosen from each of two health maintenance organizations (HMOs). STUDY DESIGN: Agreement of survey and administrative data was assessed by using kappa coefficients. Validity measures were assessed by comparing survey and administrative data results to a standard: when the two sources agreed, that was accepted as the standard; when they differed, confirmatory information was sought from medical records to establish the standard. When confirmatory information was not available ranges of estimates consistent with the data were constructed by first assuming that all persons for whom no information was available had received the service and alternately that they had not received the service. PRINCIPAL FINDINGS: The kappas for mammography were .65 at both HMOs; for retinal exam they were .38 and .40. Sensitivity for both data sources was consistently high. However, specificity was lower for survey (range .44 to .66) than administrative data (.99 to 1.00). The positive predictive value was high for mammography using either data source but differed for retinal exam (survey .69 to .78; administrative data .99 to 1.00). CONCLUSIONS: Administrative and survey data performed consistently in both HMOs. Although administrative data appeared to have greater specificity than survey data the validity and utility of different data sources for performance measurement have only begun to be explored.

Adult↗
PubMed2000

Self-reported childhood sexual and physical abuse and adult HIV-risk behaviors and heavy drinking.

CONTEXT: Although studies of clinical samples have identified links between childhood abuse, especially sexual abuse, and adult health-risk behaviors, the generalizability of these findings to the population and the relative importance of different types of abuse in men and women are not known. OBJECTIVE: To estimate the risk of self-reported adult HIV-risk behaviors and heavy drinking that is associated with self-reported childhood histories of physical and/or sexual abuse for men and women in a general-population sample, after controlling for age and education. A second objective is to determine whether, among women, early and chronic sexual abuse is associated with heightened risk compared to later or less extensive abuse. DESIGN: A population-based telephone survey, the 1997 Washington State Behavioral Risk Factor Surveillance System (BRFSS), asked a representative sample of adults whether they had ever been physically or sexually abused in childhood, and if so, the age at first occurrence and number of occurrences. The survey also asked about levels of alcohol use and, for those under 50 years, about HIV-risk behaviors. PARTICIPANTS: Three thousand four hundred seventy-three English-speaking non-institutionalized civilian adults in Washington State. MAIN OUTCOME MEASURES: Self-reported HIV-risk behaviors in the past year and heavy drinking in the past month. RESULTS: We identified associations between reported abuse history and each health-risk behavior that we examined. For women, early and chronic sexual abuse (occurring without nonsexual physical abuse) was associated with more than a 7-fold increase in HIV-risk behaviors (odds ratio [OR], 7.4; 95% confidence intervals [CI] 2.4 to 23.5); and any sexual abuse, combined with physical abuse, was associated with a 5-fold increase in these risk behaviors (OR, 5.0; 95% CI, 2.2 to 11.5). For women, only combined sexual and physical abuse was associated with heavy drinking (OR, 6.2; 95% CI, 2.2 to 16.9). Physical abuse alone was not associated with either health-risk behavior for women. For men, any sexual abuse was associated with an 8-fold increase in HIV-risk behaviors (OR, 7.9; 95% CI, 1.8 to 35.1). Physical abuse alone was associated with a 3-fold increase in risk of HIV-risk behaviors (OR, 3.2; 95% CI, 1.3 to 7.9) and a similar increase in risk of heavy drinking (OR, 3.2; 95% CI, 1.8 to 5.5). Although only 29% of the women and 19% of the men who were asked about HIV-risk behaviors reported any history of childhood abuse, these accounted for 51% and 50% of those reporting HIV-risk behaviors, respectively. For heavy drinking the corresponding figures were 25% of the women and 23% of the men reporting any abuse, who accounted for 45% and 33% of those reporting heavy drinking, respectively. CONCLUSIONS: Efforts to prevent or remediate adult health-risk behaviors should consider the possibility of a history of childhood abuse, as one third to one half of those reporting HIV-risk behaviors or heavy drinking in a general-population survey also reported childhood abuse.

Adult↗
PubMed1988

Comparison of virulence factors and R plasmids of Salmonella spp. isolated from healthy and ill swine.

The antibiotic resistance and virulence profiles of Salmonella spp. isolated from healthy (group 1) and ill (group 2) swine were compared. Parameters studied included colicin and siderophore production; mannose-sensitive hemagglutination of erythrocytes; resistance to the lethal effect of serum complement; resistance to antibiotics; and the transmissibility of these characteristics to recipient organisms. Group 1 (19 isolates) had 14 serotypes, and group 2 (20 isolates) had 2 serotypes. Isolates from group 2 were resistant to more antibiotics and had a greater ability to hemagglutinate erythrocytes and transfer R plasmids to recipient organisms, but a lesser ability to produce siderophore than group 1. All 39 isolates resisted the lethal effects of serum complement. Colicin was produced by 1 of 19 from group 1 and 0 of 20 from group 2. A donor Escherichia coli isolated from a pig with enteritis transferred R plasmids to 62% of group 1 and 0% of group 2 Salmonella spp. when they were used as recipient organisms. A transconjugant from the mating of donor E. coli to a group 1 Salmonella spp. was further able to pass an R plasmid to recipient E. coli and salmonellae. Plasmid isolation from group 1 yielded 1 of 19 strains with a 56-megadalton plasmid, while 20 of 20 strains from group 2 contained three to five plasmids from 2.4 to 60 megadaltons in size.

Animals↗
PubMed1986

Effect of EDTA-tris on an Escherichia coli isolate containing R plasmids.

Solutions of ethylenediaminetetraacetate (EDTA)-tris combined with antibiotics have been shown to be effective in treating selected cases of persistent bacterial infections. Basic techniques in microbial genetics, including mating frequencies, chemical elimination of R plasmids, isolation of plasmid DNA and agarose gel electrophoresis, were used to determine if EDTA-tris has a curing effect on an R plasmid as part of its clinical action. Results of this study indicated that EDTA-tris by itself eliminated an antibiotic resistance marker from a clinical isolate of Escherichia coli and when combined with another chemical curing agent altered the isolate's mating frequency.

Conjugation, Genetic↗