Biomedical subjects

S Serxner

Publications and source records attributed to S Serxner.

11 recordsLinked to original sources

PubMed1993

Telephone health surveys: potential bias from noncompletion.

OBJECTIVES: Little is known about the effect of noncompletion on telephone surveys of health issues. This paper identifies a little-studied source of noncompletion, passive refusal, and evaluates its contribution to noncompletion bias along with two other sources: noncooperation and noncontact. Passive refusals include respondents who repeatedly request callbacks and households where interviewers repeatedly encounter an answering machine. METHODS: Measures of noncompletion (noncooperation, passive refusal, and noncontact), demographic and socioeconomic characteristics, health risk factors, and indicators of health care access and health status were collected through the Orange County Health Surveys on 4893 respondents. The surveys sampled by random-digit dialing and interviewed by computer-assisted telephone. RESULTS: Passive refusals have a substantial impact on completion rates and bias due to noncompletion. Commonly used definitions for completion rates may underestimate the bias due to noncompletion because they omit passive refusals. After we controlled for demographic and socioeconomic factors, few noncompletion biases appeared on selected health indicators. CONCLUSIONS: These results suggest improved reporting of completion rates and support a multivariate framework for studying noncompletion in telephone health surveys.

Adolescent↗

PubMed1993

A smoking cessation pilot program.

National health-care costs are continuing to climb and employers in Hawaii and across the nation are forced to increase their share of the burden. To limit these costs, worksite health promotion programs are increasing in number and in scope. Smoking control programs in particular now rank as the most prevalent type of worksite program; as the disability, absenteeism, and early death on the part of smokers have been well-documented as contributing to the cost of health care. Our research describes a year-long, pilot smoking-cessation program implemented at Hawaiian Telephone Company. Our program used a combination of behavioral-modification, social support and incentives technique to assist people to stop smoking or to maintain their nonsmoking behavior. The 12 volunteer participants provided a multiethnic, long-term, heavy smoker employee sample. Survey results at 1 year demonstrated that 4 of them quit smoking (quit rate = 50%), 2 reduced their tobacco intake, 2 dropped out of the program and continued to smoke. The 4 who had entered the program for maintenance purposes remained smoke-free. Cost-benefit analysis yielded conservative estimates indicating that the program had paid for itself and saved an additional $350 a year per participant who remained a nonsmoker.

Adult↗

PubMed1992

Neonatal mortality and the economy revisited.

The association between economic contraction and neonatal mortality previously reported in this Journal is retested using methods and data that respond to criticisms of aggregate time-series work. Results suggest that the risk of neonatal mortality among birth cohorts of black males in the Los Angeles County and Orange County metropolitan areas is increased by unexpectedly low levels of employment in the second trimester. The argument is made that the strength of the effect is probably not sufficient to make the case for stimulating regional economies more compelling.

Cohort Studies↗

PubMed1992

Influences on cigarette smoking quantity. Selection, stress, or culture?

The selection, job stress, and job culture models of the association between occupation and smoking quantity were empirically evaluated in a random sample of 556 employed smoking adults in Orange County, California. Almost three quarters of the sample were heavy smokers (20 or more cigarettes per day). The largest percent of heavy smokers were blue-collar workers (77%). Age, sex, ethnicity, and the industry in which one works were all associated with heavy smoking, implying that selection and culture models contribute to smoking behavior. For example, men had twice the odds of being heavy smokers than did women, and Anglos had almost two and a half times the odds of being a heavy smoker than did non-Anglos. Smokers employed in the service, financial, insurance, and retail industries were one fourth as likely to be heavy smokers as those employed in the public administration sector. Smokers employed in the public administration sector had the highest percent of heavy smokers (88.9%). Job stress was not associated with heavy smoking compared with light smoking. Smoking cessation and prevention programs should address the social and job cultures in which the behavior occurs. Job-culture models of intervention should include elements that focus on individual coping mechanisms involving susceptibility to social pressure; social environment models imply that change in organizational culture is necessary.

Adult↗

PubMed1992

The effect of ambient threats to employment on low birthweight.

The hypothesis that ambient threats to employment security are associated with increased rates of low birthweight is tested in two sites. The first test uses interrupted time-series methods to measure the association between a threatened reduction in the number of state workers and the incidence of low birthweight in Sacramento, California. The second test is of the association between unexpectedly low employment and low birthweight in Los Angeles, California. Both tests suggest that White males without Spanish surnames and Spanish-surnamed males are at elevated risk of low birthweight when the community is faced with a perceived threat to employment security. The implications of the findings for economic regulation and the provision of services are discussed.

California↗

PubMed1991

Tobacco use: selection, stress, or culture?

The effects of selection, job stress, and culture models on the association between occupation and smoking were empirically estimated on a random sample of 2,362 employed adults in Orange County, California using data collected through the Orange County Health Survey. The largest percent of smokers were blue-collar workers (32.4%). The logistic regression analysis results indicated that age, sex, education, ethnicity, job stress, and the industry in which employees work had significant impact on the risk of smoking. The findings imply that all three models contribute to smoking behavior. Smoking cessation and prevention programs may include elements that address both stress and environment in intervention design. Stress models imply that such program should focus on change in individual coping mechanisms; social environment models imply that change in group norms and attitudes is necessary.

Adult↗

PubMed1989

Economic stress and suicide: multilevel analyses. Part 1: Aggregate time-series analyses of economic stress and suicide.

Of the research on health and economic stress, the approach that has produced the strongest findings has been the aggregate time-series analysis of unemployment and suicide rates. A review of the literature indicates that this aggregate work has been disputed on both methodological and interpretive grounds. To address these issues, two studies of the relationship between economic stress and suicide were conducted on the same population. The first, reported in this paper (Part 1), replicated the aggregate time-series work with improvements in method, using monthly data for 1975-1982 for Los Angeles. A second study (reported in Part 2) combined aggregate economic indicators with individual-level measures of stressful events, symptoms, and suicidal ideation.

Adult↗

PubMed1989

Economic stress and suicide: multilevel analyses. Part 2: Cross-level analyses of economic stress and suicidal ideation.

This paper reports the second of two studies of the hypothesis that the economy affects suicide; both studies were based in the same community during approximately the same time period. Although many aggregate-level tests have been conducted using archival measures of unemployment and suicide (the approach used in Part 1), the impact of economic climate on suicidal ideation has not been measured at the individual level. In the study reported here, aggregate economic indicators were combined with individual-level measures of stressful events, symptoms, and suicidal ideation obtained in a survey of Los Angeles from 1978 to 1982. Each of the two studies revealed small associations between economic stress and suicide or suicidal ideation, but they were inconsistent with respect to specific subgroups.

Adult↗

PubMed1987

Time series designs of potential interest to epidemiologists.

Recent developments in time-series designs that may be useful in epidemiology are described. The hypothesis that increased employment affects the rate of accidental injuries per worker month among manufacturing workers is tested to demonstrate the methods. Results suggest that increased employment increased the monthly rate of accidental injuries in San Diego and Los Angeles Counties in the 11-year period 1974 through 1984.

Accidents, Occupational↗

PubMed1987

A frequency of growth hormone secretion associated with catch-up growth in the rat detected by time domain (Box-Jenkins) analysis.

A time domain technique has been applied to the analysis of temporal patterns of GH concentrations determined at 15 min intervals for 24 h in rats undergoing catch-up growth after a fast and in controls. Three tests were performed on the data. The first compared the autocorrelation functions (ACF's) and partial autocorrelation functions (PACF's) of the series of the GH measurements for the two groups. The second determined whether the model which best fit the control group removed all the regular behavior from the fasted group. The third test, which was similar to the second, was carried out with the assumption that the behavior of both groups is best conceptualized as a binary pattern of periods in which GH is either secreted or not. In the first test the ACF's and PACF's indicated that both groups have a memory of 15 min and a cycle(s) with a periodic interval in the range of 75 to 105 min. There was an indication of a cycle with a periodic interval of 180 to 210 min in the fasted group. The second test confirmed that the cycle was present in only the fasted rats. The third test confirmed the result of the second test. The findings demonstrate the usefulness of time domain analysis in determining periodic behavior of GH secretion in the rat. We conclude that a frequency of GH secretion with a periodic interval of approximately 195 min is superimposed on normal basal rhythms of GH secretion during catch-up growth following a fast in rats.

Animals↗

PubMedDate not supplied

Trend analysis of social and economic indicators of mammography use in Hawaii.

We examine the relationship between ethnicity and income as determinants of mammography use over a span of four years as a means of assessing community intervention impacts. The sample consisted of 1,447 women older than 34 years, living in Hawaii, who participated in the Behavioral Risk Factor Surveillance System (BRFSS). The percentage of women in the sample reporting a screening mammogram within the past two years was 31.4% in 1987, 54.1% in 1989, and 51.6% in 1990. Women of Hawaiian ancestry had the lowest percentage of mammogram use in the past two years (38.7%), while Japanese women had the highest percentage (49.8%). Results of logistic regression analysis indicate a significant increase in mammography use from 1987 to 1989 and no difference from 1989 to 1990. Findings also showed an association between age, income, and ethnicity with use in the past two years. Greater age, higher income, and Japanese origin, compared to Hawaiian, were all independently associated with increased odds of having had a mammogram in the past two years. We discuss results in terms of program evaluation and future research implications for community health surveys.

Adult↗