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Biomedical subjects

R M Schmidt

Publications and source records attributed to R M Schmidt.

At least 19 recordsLinked to original sources
PubMed2001

The importance of hepatitis B vaccination among adolescents.

OBJECTIVE: To examine whether teens who have received an education about hepatitis B and demonstrated content mastery can apply this knowledge to evaluate their own risk of acquiring hepatitis B. METHODS: Nine hundred forty-three participants received a standard education and completed a questionnaire about hepatitis B; 769 participants who correctly answered the questions pertaining to risk factors for transmission participated. The questionnaire assessed demographic factors, self-reported risk behaviors, and attitudes toward hepatitis B and the immunization. Self-reported likelihood of acquiring hepatitis B and importance of hepatitis B immunization were measured on a 10-point Likert scale and served as outcome variables. Relationships were analyzed using frequency analysis, Mann-Whitney U and Kruskal-Wallis analysis of variance. RESULTS: Participants who were nonwhite (p <.001), had their bills paid by Medicaid (p =.007), were lower academic achievers (p =.011), had had sexual intercourse (p =.003), and had had a sexually transmitted disease (STD) (p =.028) were more likely to report that the hepatitis B immunization was more important to their health. Participants who reported they had smoked tobacco (p =.018) or consumed alcohol (p =.001) recently, had had sexual intercourse (p <.001), or had been diagnosed with an STD (p <.001) were more likely to report being at higher risk for acquiring hepatitis B. CONCLUSIONS: Most teens considered the hepatitis B immunization important to their health. Most adolescents did not think they were at significant risk for contracting hepatitis B; however, teens who reported increased individual risk factors also reported increased perceived risk of disease.

Adolescent↗
PubMed1999

Risk adjustment and hospital cost-based resource allocation, with an application to El Salvador.

Ignorance about the costs, case loads and case mixes of different hospitals within the public health system constitutes an important obstacle to reforming health care spending in many developing countries. National (tertiary) hospitals generally receive significantly larger budgets, per patient, than lower-level (district) hospitals. One reason for these differential allocations is the widely held belief that national hospitals treat persons with more difficult illnesses and persons who are more severely ill than do other, non-national, hospitals. This belief is but a presumption and one that warrants investigation. This paper analyzes expenditures among public hospitals in El Salvador over a 12-year period to address this question. While controlling for patient morbidity, outputs and other characteristics, district hospitals are found to be substantially underfunded relative to national hospitals. Four policy options to redress this situation are examined.

Budgets↗
PubMed1999

Longitudinal and cross-sectional analysis of HEALTH WATCH data with a subset of perimenopausal women and matched controls.

HEALTH WATCH is a longitudinal prospective study of healthy aging. This study began in 1970. It characterizes the biochemical, hematological, immunological, and physiological data of 2200 healthy men and women between the ages of 20 and 80. Well-being, stress, and sleep data are obtained annually as a self-administered HEALTH WATCH questionnaire. A subset of women from the HEALTH WATCH cohort who were actively followed in the 1970s and had perimenopausal years available was selected. This subset allows observation of the normal female aging related to the significant marker, cessation of menses. Critical selection criterion included a natural menopause and the absence of hormonal intervention. Computer selection identified 19 subjects. Three sets of matched, age-defined controls were selected. This study investigates changes of data from healthy women related to menopause status. Changes unique to perimenopause status include sleep, sex difficulties, alkaline phosphatase, phosphorous, and thyroxine.

Adolescent↗
PubMed1999

Evaluating the vocational rehabilitation program using longitudinal data. Evidence for a quasiexperimental research design.

The study presents benefit-cost ratios for 14 disability cohorts served by the Vocational Rehabilitation (VR) Program. The earnings impacts are estimated in a quasiexperimental framework using an internal comparison group. The earnings data are from a unique national panel constructed by linking client data of the Rehabilitative Services Administration with earnings histories from the Social Security Administration. These earnings data accommodate a series of statistical tests that allow us to identify and control for the presence of selection bias when estimating treatment impacts. The results indicate that the VR program is cost-effective in general, although not universally so across specific disabilities.

Adult↗
PubMed1998

Public hospital resource allocations in El Salvador: accounting for the case mix of patients.

National hospitals in developing countries command a disproportionate share of medical care budgets, justified on the grounds that they have a more difficult patient case mix and higher occupancy rates than decentralized district hospitals or clinics. This paper empirically tests the hypothesis by developing direct measures of the severity of patient illness, hospital case-mix and a resource intensity index for each of El Salvador's public hospitals. Based on an analysis of inpatient care staffing requirements, national hospitals are found to receive funding far in excess of what case-mix and case-load considerations would warrant. The findings suggest that significant system-wide efficiency gains can be realized by allocating hospital budgets on the bases of performance-related criteria which incorporate the case-mix approach developed here.

Bed Occupancy↗
PubMed1995

Aggregate population and economic growth correlations: the role of the components of demographic change.

The results of recent correlations showing a negative impact of population growth on economic development in cross-country data for the 1980s, versus "nonsignificant" correlations widely found for the 1960s and 1970s, are examined with contemporaneous and lagged components of demographic change, convergence-type economic modeling, and several statistical frameworks. The separate impacts of births and deaths are found to be notable but offsetting in the earlier periods. In contrast, the short-run costs (benefits) of births (mortality reduction) increase (decrease) significantly in the 1980s, and the favorable labor-force impacts of past births are not fully offsetting.

Birth Rate↗
PubMed1993

An artificial intelligence system to predict progression of immune dysfunction in healthy older patients.

In 1983, forty nine participants returning for their annual HEALTH WATCH evaluation were assessed for immune function status and served as healthy controls in an early study of "normal" reference values for T4 and T8 lymphocyte counts and T4/T8 lymphocyte ratios, B lymphocyte counts, and other laboratory tests for immune function then available. Balascopy, a computer-assisted pattern recognition system for detection, quantification and cognition of multiple imbalances among clinical laboratory and health behavioral parameters, facilitates identification of otherwise healthy individuals with evidence of early immune dysfunction. When the T4 and T8 immunology tests were combined with 7 health index behavioral subscores, and 24 routine clinical laboratory tests, we are able to obtain a bodyprint unique for each patient, providing a comprehensive health status profile specific for that individual. These bodyprints serve as tools for the evaluation of otherwise undetectable metabolic, immunological and behavioral imbalances in a given patient in an unprecedented individualized manner. We show here a longitudinal look at a balascopic evaluation of one patient who has evidence of progressive immune dysfunction with development of only mild clinical symptoms.

Aged↗
PubMed1993

George Zur Williams.

Explore the source record for details and available documents.

History, 20th Century↗
PubMed1993

HEALTH WATCH: health promotion and disease prevention in primary care.

HEALTH WATCH, a longitudinal prospective study of healthy aging, was designed to characterize a healthy population of 2,200 men and women, ages 20-80 years in 1970. Biochemical, hematological, and physiological tests are performed annually over three weekly visits, combined with a self-administered HEALTH WATCH questionnaire to measure health status and behaviors in seven areas (with over 1,330 variables). In 1988, the HEALTH WATCH study was modified to assess characteristics of an oldest old "productive aging" cohort in Kauai, Hawaii. Nutrition, physical activity, extended family, and spirituality were found to be major health determinants. During 1989 to 1991 a controlled intervention study (ten local primary care physicians and their patients, aged 65-89 years) was completed in the Sun Cities, Arizona. These studies provide evidence that primary care physicians can promote positive health outcomes in patients of any chronological age and baseline health status through active healthy aging interventions.

Aged↗
PubMed1990

Acoustic power measurements of Doppler ultrasound devices used for perinatal and infant examinations.

Acoustic power output levels were measured in four different pulsed Doppler systems (transcranial, Duplex mode, colour mode, miniature for continuous monitoring) currently used for examination of fetal and infant blood flow velocities. The frequencies of the transducers ranged from 2 to 8 MHz. The devices were studied at three to five different intensity settings. The measurements were performed using the radiation force balance of the Fraunhofer-Institut, which was especially adapted for this study. Each of the four devices was tested while running in its commonly used mode, and comparison showed that their acoustic power values varied widely: 96.8 mW (2 MHz, EME TC2-64B), 8.7 mW (5 MHz, ATL Mk 500), 61.9 mW (3.5 MHz, Acuson 128) and 13.5 mW (5 MHz, HP 77020). All transducers had total power output levels below the limits recommended by the American Institute for Ultrasound in Medicine and Biology in the conclusions on a thermal bioeffects mechanism, which were approved in October 1987.

Acoustics↗
PubMed1989

[Etiologic and pathogenetic aspects of the demyelinating process in multiple sclerosis].

In our opinion there is no specific germ for multiple sclerosis. The pathogenic process is developed after a clinically "silent" period and results in a demyelinization process. Partially genetical aspects have to take into account for certain disease processes. Up to now both, the theory of infection as well as the neuroallergetic theory are of importance.

Adult↗
PubMed1987

A classification of cardiac allograft rejection. A modification of the classification by Billingham.

We herein propose a classification of rejection in cardiac allografts based on the original Stanford work. Our modified classification, as a work hypothesis, defines the following grades: mild acute rejection (A-1), corresponding to Billingham's "mild rejection"; mild acute rejection with probable conversion to moderate rejection (A-2); moderate acute rejection (A-3), comparable to Billingham's "moderate rejection"; and severe acute rejection (A-4), morphologically identical with the respective grade in the Billingham classification. The resolution of rejection has been classified into two grades--early (A-5a) and late (A-5b) resolution--according to the development of granulation tissues. We also grade the degree of vasculopathy (B-1, B-2) and chronic rejection (C), which is characterized by aggressive fibrosis and persistent vasculopathy. Mild rejection with possible conversion to moderate rejection is defined by an increasing quantity of retrogressive changes in myocytes. Changes not related to transplantation are characterized in our classification by descriptive diagnosis. The proposed classification was validated by 1 year of clinical experience and by the evaluation of possible prognostic aspects of the classification.

Biopsy↗
PubMed1987

Research approaches on the diagnosis of multiple sclerosis by CSF examination.

The diagnostic value of CSF oligoclonal IgG bands, intrathecal IgG synthesis, cytology and markers of myelin breakdown in the cerebro-spinal fluid were evaluated in multiple sclerosis. None of the various immunological alterations were unique to MS. The diagnosis depends therefore mainly on course and clinical symptoms, but can be supported by CSF analysis.

Cerebrospinal Fluid↗