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Biomedical subjects

M H Boyle

Publications and source records attributed to M H Boyle.

84 records · Page 5Linked to original sources
PubMed1985

Selecting measures of emotional and behavioral disorders of childhood for use in general populations.

This paper puts forward suggestions for assessing the suitability of existing measures of emotional and behavioral disorders of childhood for use in general populations. Specific attention is focused on the definition of emotional and behavioral disorder, measurement approaches and guidelines for choosing which disorders to study. The measurement criteria under review include acceptability, applicability, procedural adequacy, reliability and validity. These criteria are applied to seven instruments previously described as suitable for epidemiological and clinical research. Among these instruments, the ones developed by Rutter, Achenbach and Quay best meet the criteria and show the most promise of being useful in general populations. Among research priorities for the future, the foremost should include the specification of rules of evidence for establishing the validity of new measures of emotional and behavioral disorder.

Adolescent↗
PubMed1984

Developing multiattribute health indexes.

This article reviews the procedures for developing a multiattribute health index for use in population health studies and program evaluations. The development of such indexes involves two steps: 1) the creation of a multiattribute health state classification system; and 2) the mapping of the system into a single metric scale. The system must be relevant for its intended use and as concise as possible. Because a limit exists in the number of attributes that can be included in the system while maintaining reliable measurement, there may be a trade-off between specificity of detail and breadth of coverage. When mapping the system into a scale of cardinal values, five issues arise: 1) the selection of a scaling technique; 2) the use of mathematic models to quantify health; 3) the selection of anchor points; 4) the selection of raters; and 5) the identification of factors that influence raters' judgments. The article reviews the procedures that are used, discusses the issues that arise, and proposes some solutions for the development of multiattribute health indexes.

Classification↗
PubMed1983

Economic evaluation of neonatal intensive care of very-low-birth-weight infants.

We evaluated the economic aspects of neonatal intensive care of very-low-birth-weight infants, using outcomes and costs of care before and after the introduction of a regional neonatal-intensive-care program. Neonatal intensive care increased both survival rates and costs. For newborns weighing 1000 to 1499 g, the cost (in 1978 Canadian dollars) was $59,500 per additional survivor, $2,900 per life-year gained, and $3,200 per quality-adjusted life-year gained; intensive care resulted in a net economic gain when figures were undiscounted but a net economic loss when future costs, effects, and earnings were discounted at 5 per cent per annum. For infants weighing 500 to 999 g, the corresponding costs were $102,500 per additional survivor, $9,300 per life-year gained, and $22,400 per quality-adjusted life-year gained; intensive care resulted in a net economic loss. By every measure of economic evaluation, the impact of neonatal intensive care was more favorable among infants weighing 1000 to 1499 g than among those weighing 500 to 999 g. A judgment concerning the relative economic value of neonatal intensive care of very-low-birth-weight infants requires a comparison with other health programs.

Adolescent↗
PubMed1983

Maternal and infant characteristics in abuse: a case control study.

Eighty-six abused children identified by two Children's Aid Societies in Hamilton-Wentworth County, Ontario, were compared with 86 controls born in the same hospital. Three factors were significantly more common in the abused group: (1) low socioeconomic status of the mother, (2) younger age at time of delivery, and (3) indication of a psychosocial problem recorded in the medical chart. The failure to find significant differences between abused children and controls in birthweight, Apgar score, and prematurity contrasts with earlier investigations of infant characteristics and child abuse.

Adult↗
PubMed1982

Mortality and morbidity of 500- to 1,499-gram birth weight infants live-born to residents of a defined geographic region before and after neonatal intensive care.

All very low-birth-weight infants live-born to residents of an urban southern Ontario county were studied before (1964 to 1969) and after (1973 to 1977) the introduction of neonatal intensive care. Mortality at hospital discharge decreased from 89.4% to 77.6% among infants whose birth weights were 500 to 999 gm and from 37.6% to 22.8% among infants with birth weights of 1,000 to 1,499 gm. The families of 121/150 (81%) and 134/151 (89%) of all children from the two cohorts who were discharged from the hospital alive were surveyed. At follow-up 7/121 (6%) and 4/134 (4%) had died. Major damage was reported for 13/121 (11%) and 18/134 (13%) of the children. Neonatal intensive care was associated with a significant reduction in mortality but there has not been a significant change in morbidity.

Adolescent↗
PubMed1981

Evaluation of neonatal-intensive-care programs.

Within the past 15 years, regional neonatal-intensive-care programs have been introduced and have expanded rapidly. The efficacy of some of the individual interventions that constitute neonatal intensive care has been validated in randomized, controlled clinical trials. It is therefore generally assumed that neonatal-intensive-care programs that incorporate these maneuvers are effective in reducing death and disability. However, the overall effectiveness of these programs has not been tested experimentally. Moreover, much of the non-experimental evidence supporting their value is based on the experience of referral units and does not measure the impact on the populations they serve. A definitive economic evaluation of neonatal intensive care has not yet been reported, despite the high cost of such programs. We conclude that neonatal-intensive care programs require further evaluation with rigorous scientific methods.

Clinical Trials as Topic↗
PubMedDate not supplied

Application of multi-attribute utility theory to measure social preferences for health states.

A four-attribute health state classification system designed to uniquely categorize the health status of all individuals two years of age and over is presented. A social preference function defined over the health state classification system is required. Standard multi-attribute utility theory is investigated for the task, problems are identified and modifications to the standard method are proposed. The modified methods is field tested in a survey research project involving 112 home interviews. Results are presented and discussed in detail for both the social preference function and the performance of the modified method. A recommended social preference function is presented, complete with a range of uncertainty. The modified method is found to be applicable to the task--no insurmountable difficulties are encountered. Recommendations are presented, based on our experience, for other investigators who may be interested in reapplying the method in other studies.

Adolescent↗
PubMedDate not supplied

Familial influences on substance use by adolescents and young adults.

This study uses data from the Ontario Health Survey to examine within-family influences (sibship number, age and sex composition; family structure and parental substance use) on the use of tobacco, alcohol and marijuana in households (N = 4,643) among offspring aged 12 to 24 years. Using a modification of the kappa statistic, concordance among siblings is modest generally and undifferentiated across substance type. Concordance is stronger among sibships that are either all male or older (19-24 years) and is particularly strong for siblings < or = two years apart in age. The dominant influence of substance use behaviour appears to be from older siblings to younger siblings and not from parents to offspring. Sibling concordance for substance use suggests that the treatment and prevention of substance use (and abuse) among adolescents and young adults might be enhanced by including a family focus, especially where there are two or more siblings at home.

Adolescent↗
PubMedDate not supplied

Correlates of children's use of physician and dentist services: Ontario Child Health Study follow-up.

OBJECTIVE: (1) To explore the correlates of dental and medical care utilization for children in Ontario and (2) to explore the stability of correlates of medical care use over time. METHOD: Data from the Follow-up Survey of the Ontario Child Health Study were used. Since likelihood of use of both dental and medical care clustered within households, one randomly chosen child per household, aged 8-16 years, contributed data to the analysis. Bivariate associations between use of services and descriptors of the child and his/her family were examined. RESULTS: Younger age, urban residents and parental perception of poorer health or hay fever/asthma increased the odds of a child receiving medical care in the previous six months. Dental care utilization was associated with younger age of child, higher education of mother and high family income. CONCLUSIONS: Across time, consistency was observed in the factors linked to children's use of medical services. Perceived need, the child's age and an urban location are related to greater probability of use.

Adolescent↗