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Biomedical subjects

M McClatchey

Publications and source records attributed to M McClatchey.

7 recordsLinked to original sources
PubMed2001

Lay therapy intervention with families at risk for parenting difficulties: The Kempe Community Caring Program.

OBJECTIVE: To determine which areas of family functioning lay therapy intervention can improve in a home visitation program for first time mothers at high risk for parenting difficulties, including the potential for child abuse and neglect. METHODS: Families were assessed for risk of parenting difficulties using the Parent Readiness and Risk Assessment Checklists. Lay therapists completed the Scale of Family Functioning pre- and postintervention with 108 high risk families for whom they provided support, education, and referrals. RESULTS: Paired t tests were done to determine whether the eight categories of the Scale of Family Functioning improved from baseline to termination of the service. Four categories showed statistically significant improvement: social support (p = .001), self-esteem (p < .001), confidence as a parent (p < .001), and affective relationships (p = .003). CONCLUSIONS: Statistically significant improvement occurred in four of the eight categories on the Scale of Family Functioning indicating that home intervention programs can improve some categories of family functioning. Longer intervention and an increased focus on improving parent/infant interactions may be able to increase parental sensitivity and expectations. In this study, the categories of family conflict and stability/meeting basic needs were not amenable to change with lay therapy intervention.

Adult↗
PubMed2000

Validity of self-reported colorectal cancer screening behavior.

End points for trials promoting cancer screening are often based on self-reported screening behavior. This study was designed to evaluate and optimize the reliability of a computer-assisted telephone interview for collecting self-reported colorectal cancer screening behavior. Cases who had received a fecal occult blood test (FOBT), flexible sigmoidoscopy, and/or colonoscopy, and controls who had no record of colorectal screening were identified among 40-75-year-old members of the Denver Kaiser Permanente Health Care Program and were contacted by telephone. Sensitivities and specificities of self-reported screening were calculated by comparison of subjects' recall with Kaiser Permanente records. The questionnaire was revised based upon results of the pilot phase of the study. Using the revised questionnaire, the sensitivity of self-reported screening was 96.2% for the FOBT, 94.9% for flexible sigmoidoscopy, 88.7% for colonoscopy, and 96.2% for either endoscopic screening test. The specificity of self-reported screening was 85.9% for the FOBT, 92.2% for flexible sigmoidoscopy, 96.8% for colonoscopy, and 92.0% for either endoscopic screening test. No marked differences in the accuracy of the self-reports were detected as a function of gender, age, ethnicity, or family history of colorectal cancer of the participants. Self-reports of colon cancer screening behavior can be reliably used as end points for intervention trials when carefully phrased questions are used.

Adult↗
PubMed1991

Animal models for epididymoepididymostomy. Development of an alternative microsurgical procedure for vasoepididymostomy.

The present success rate for high level microsurgical vasoepididymostomy in patients with obstructive azoospermia is generally poor in comparison with more distal vasoepididymal bypasses, suggesting that the development of a high level bypass method which preserves the distal maturation and storage functions of the epididymis might increase the fertility success rate. To achieve this we have developed a segmental bypass of the distal caput-proximal corpus regions of the epididymis (epididymoepididymostomy) using the rat and rabbit as animal models. In this procedure the epididymides of 11 adult male Sprague-Dawley rats were exposed through a scrotal incision and a convolution of the duct in the proximal corpus region was attached to an opened convolution in the mid-caput epididymides using a standard microsurgical technique. Each male was rested for at least 3 months after the microsurgical bypass operation to allow the preoperative sperm contents of the caudal storage region to be replaced by post-bypass spermatozoa. Six of the 11 rats were proven fertile after surgery by siring litters from mating trials up to 11 months later. The patency of anastomoses was confirmed in 3 animals by laparotomy and recovery of large numbers of sperm with normal motility from the cauda epididymidis distal to the anastomosis site and also from the vas. Similar unilateral surgery in 2 adult male rabbits resulted in normal post-operative semen profiles in 1 and an in vivo fertilisation rate of 100% from 1 mating trial 8 months after surgery. The successful development of a reliable animal model for epididymoepididymostomy provides an experimental tool for studying the function of the epididymis. This technique may also have clinical application as an alternative to high level vasoepididymostomy in selected patients with obstructive azoospermia.

Anastomosis, Surgical↗
PubMed1986

Yersinia infections: a cause of abdominal pain in childhood.

Children admitted with abdominal pain were studied prospectively to determine the incidence of Yersinia infections. The three proven cases in a series of 65 children reflected the variation in severity of the illness. Specific stool culture was the most useful method of detecting the organism. Management of ill children with abdominal signs, for whom no diagnosis can be reached, should include treatment for Yersinia infections.

Abdomen↗
PubMedDate not supplied

A self-help intervention for African American smokers: tailoring cancer information service counseling for a special population.

BACKGROUND: African Americans remain a critically underserved group for smoking cessation interventions. This study tested the effectiveness of a tailored, culturally sensitive intervention for African American smokers who called the NCI Cancer Information Service (CIS) for help to quit smoking. METHODS: This paper presents results of a 2-year study of tailored counseling strategies among African American smokers (n = 1,422) who called four regional CIS offices in response to a radio-based media campaign in 14 communities. Callers were randomly assigned to receive either the standard CIS quit smoking counseling and guide (Clearing the Air) or counseling and a guide (Pathways to Freedom) tailored to the quitting needs and barriers of African American smokers. Callers were predominantly female (63.6%). ages 20-49 (88%), with a high school education or more (84%). Median smoking history was 17 years; median smoking rate was 20 cigarettes/day. Standard (n = 689) and Tailored (n = 733) group subjects did not differ on most baseline measures. RESULTS: On most measures, Standard and Tailored counseling/guides received similar ratings, but the Tailored guide was rated as having more appealing photos (P = 0.001) and as being more appropriate for family members (P = 0.003). Six-month follow-up with 893 subjects (response rates were 63% Standard, 62% Tailored, ns) showed significantly more quit attempts (P = 0.002) and greater use of prequitting strategies (P < 0.05) among Tailored than among Standard subjects, but no differences in self-reported 1-week abstinence (14.4% Standard, 16.2% Tailored) (ns). An opportunistic 12-month follow-up of subjects recruited in the last year of the study (n = 445) (response rates were 57% Standard, 60% Tailored, ns) showed a significantly higher quit rate (15.4% Standard, 25.0% Tailored) for Tailored subjects (P = 0.034). CONCLUSIONS: Results show promise for tailored approaches to boost quit attempts and success rates among African American smokers.

Adult↗
PubMedDate not supplied

Cost-effective diagnostic test sequencing.

Proper diagnostic test selection and logical sequencing can minimize cost without compromising care. This study analyzes the logic for sequencing tests either in series (one after another) or in parallel (simultaneously). A model is created using 2 diagnostic tests for 2 diseases. Tests are assumed to have perfect performance characteristics. Factors involved in cost-effective test sequencing include cost of each test, test performance characteristics, per diem hospital charge, and the clinician's prior probability of the suspected diagnosis based on history, physical examination, and previous laboratory data. At a given point of clinical suspicion, cost-effective sequencing strategy should shift. In general, a cheap test can effectively be used in parallel even at low diagnostic probabilities; an expensive test should, in general, be used in series only when there is a high prior probability of diagnosis. High per diem hospitalization costs--such as for a patient in the intensive care unit--favor in parallel testing. Clinical acumen and suspicion of diagnosis (prior probability) primarily direct cost-effective diagnostic test sequencing. Decision analysis of diagnostic test sequencing represents a technique for making cost-effective decisions for sequencing and, thereby, minimizing costs while achieving optimal patient care.

Cost-Benefit Analysis↗