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Biomedical subjects

V A Clark

Publications and source records attributed to V A Clark.

At least 73 records · Page 4Linked to original sources

Telephone versus in-person surveys of community health status.

Reports of physical morbidity are compared among a community sample of Los Angeles County adults (N = 546) randomly assigned to either in-person or telephone interviews. No statistically significant differences were found between the two interview methods for overall assessment of health status, illnesses reported for the previous four months, or reports of hospitalization. A significantly greater proportion of in-person respondents, however, reported the presence of restricted-activity days during the previous two weeks. This difference could not be directly attributed to sociodemographic characteristics or reported physical health status of the two samples.

Adolescent↗

Predicting the risk of cancer at the time of breast biopsy. Variation in the benign to malignant ratio.

The benign to malignant ratio (B:M ratio) among breast biopsies (number of benign breast lesions divided by number of breast cancers) is widely believed to be around 4:1 or 5:1. This belief appears to be based upon experience from the 1950's and 1960's. We investigated possible reasons for the current wide variability of the B:M ratio. A straight line relationship between the log B:M ratio and age exists in our data. The B:M ratio is sensitive to racial differences between patient groups but in only minimally affected by varied histologic inclusion criteria. The overall B:M ratio should not be used to counsel women about their breast cancer risk at the time of biopsy. Age-specific B:M ratios provide a more realistic risk assessment.

Age Factors↗

Mortality in persons with multiple sclerosis in the Seattle and Los Angeles areas.

Case-mortality and survival rates of more than 2,000 prevalent cases of multiple sclerosis (MS) residing in either Los Angeles County, California, or King and Pierce Counties, Washington, and followed up for 105 months, are reported. Case-mortality at the end 105 months was 16.9% of the total group. All age and sex groups had a lower survival rate than the US general population; this difference was especially pronounced in the high-disability groups. There was a trend toward higher case-mortality in high-disability Los Angeles County patients when compared with high-disability patients from King and Pierce Counties.

Adolescent↗

Two populations with multiple sclerosis. Clinical and demographic characteristics.

Cross-sectional data from 1,793 cases of definite or probable multiple sclerosis (MS) identified in an extensive population survey in King and Pierce (K-P) Counties, Washington and Los Angeles (LA) County, California, were analyzed. Compared to the U.S. population as a whole, patients were more likely to be divorced and to have more years of schooling. The prevalence of MS was higher for females, and for northern-born, regardless of sex. Reconstructed age-, sex-specific incidence rate estimates for natives of the two areas showed a much higher peak annual incidence occurring in an older age group in K-P than in LA. Earliest symptoms in both areas were numbness in the legs, double vision, and loss of vision in one or both eyes. Weakness in arms, speech difficulties, and urinary incontinence tended to be late symptoms. The overall assessment of disability levels showed more than half of the patients to be fully ambulatory at the time of the first interview, with a somewhat higher proportion of each sex severely disabled in California. The ages of onset tended to be younger in LA than in K-P. The earlier onset of disease and the higher proportion of patients with high disability in Los Angeles County suggest that the course of disease is more malignant in this low-prevalence area.

Adolescent↗

Analysis of effects of sex and age in response to items on the CES-D scale.

Analyses of differences in response to individual items in the Center for Epidemiologic Studies Depression (CES-D) scale based on sex and age breakdown are reported for a sample of 1,000 adults from Los Angeles County. Overall, results are comparable to those obtained in other population studies. Analyses performed separately for age and sex groups show response differences on individual items which affect the summated score. The interitem correlations are shown to be much higher for women that men, but overall the index assesses a comparable underlying dimension of depression for the two sexes.

Adolescent↗

Prevalence of depression in Los Angeles County.

The occurrence of depression was determined during the summer of 1979 in a multi-ethnic probability sample of 1003 adults (66% participation) in Los Angeles County, as part of a community survey of the epidemiology of depression and help-seeking behavior. The primary measure of depression was the 20-item CES-D scale developed by the Center for Epidemiologic Studies. The overall prevalence of depression based on a CES-D cutpoint definition of 16 or greater was 19.1%. The prevalence of depression was greatest among Hispanics (27.4%) and least among whites (15.6%), with blacks and others at an intermediate level (21.8% and 21.2%, respectively). Females (23.5%) were nearly twice as likely to be depressed as males (12.9%). By age, persons 18-24 years reported the highest rate of depression (27.4%), while those 45-64 years reported the lowest (16.3%). As expected, the prevalence of depression was strongly related to family income, with the highest level reported for those earning less than $8500 (29.3%); the lowest level for those earning more than $25,000 (9.0%). After controlling for effects of selected demographic and socioeconomic variables, neither race nor ethnicity were significantly related to the presence of depression. This suggests that the economic strain experienced by many minorities may be an important determinant of higher rates of depression among blacks and Hispanics.

Adolescent↗

Smoking and depression: a community survey.

Smoking status and symptoms of mental depression were determined as part of a community survey of adults in Los Angeles County. Nearly 42 per cent of the males and 31 per cent of the females wee current smokers. Smokers compared to nonsmokers reported significantly higher levels of depression as measured by the Center for Epidemiologic Studies--Depression (CES-D) index (10.02 vs 8.76, p < .05). The differences were not significant, however, when analyzed by sex. Furthermore, there were no significant differences in the CES-D score when comparing those who had never smoked, ex-smokers, current smokers who wanted to quit, and current smokers who did not want to quit. After controlling in a linear regression analysis for the effects of income, age, employment status, and sex, none of the smoking status variables contributed significantly to explaining the variance of the CES-D score. While both mental depression and smoking are individually major public health problems, the results of this investigation suggest that there is little relationship between the two in the general community.

Adult↗

Nutrient estimates from computerized questionnaires vs. 24-hr. recall interviews.

A computerized nutritional assessment service used by dentists was investigated. Daily nutrient intake of forty-six adult subjects was estimated from replies to a computerized food frequency questionnaire and the results compared with the average nutrient intakes of the same individuals obtained during five 24-hr. dietary recall interviews. Although the two methods produced essentially the same mean for carbohydrate intake and a minimal difference in the mean caloric values, mean estimates of the other nutrients were 6 to 88 per cent greater with the computerized data than via the dietary recalls. The dietary assessment service included unwarranted recommendations for vitamin and mineral supplementation.

Adult↗

Rodney.

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Humans↗

Effect of nutrition education on the nutritional status of low-income pregnant women of Mexican descent.

Low-income pregnant women of Mexican descent were studied to determine whether their food habits could be improved by nutrition education. Biochemical indices of nutritional status were also investigated. Twenty-four-hour dietary recalls were obtained at an initial interview and again at a final interview after a nutrition education program, which was offered to a randomly selected treatment group. At the initial interview, the mean nutrient intakes that were most often below two-thirds of the Recommended Dietary Allowance (RDA) were iron, vitamin A, thiamin, and calcium. The mean energy value of the diets was also frequently below the RDA. At the final intakes, although the mean energy values and the calcium and carbohydrate of both the control and treatment groups increased significantly, the following improvements in dietary intakes were seen only within the treatment group: 1) there were significant increases in the mean intake of protein, ascorbic acid, niacin, riboflavin, and thiamin, 2) there were significant decreases in the percentage of intakes below two-thirds of the RDA for ascorbic acid and riboflavin, and 3) there was a significant decrease in the incidence of multiple low nutrient intakes. These dietary improvements, which occurred only in the treatment group, suggest the effectiveness of the nutrition education program. The most common biochemical deficiencies were of folic acid, thiamin, and riboflavin. Except for an improvement in mean serum folate levels, the biochemical indices for the treatment group did not appear to be influenced by the nutrition education. It is possible that the vitamin and mineral supplements which were taken by 80% of the women could have obscured improvements in biochemical indices which may have been due to the education program.

Adult↗

Evaluation of a ghetto school breakfast program.

A program was initiated to provide a free breakfast at a ghetto elementary school. Community support was achieved at the expense of randomization of study subjects. While no significantly greater increase in school attendance or performance was detected in comparison with a control school, none of the students was malnourished and diets of students in the control school were as adequate as those in the breakfast school. Thus, it cannot be concluded that school breakfast programs would not benefit malnourished children or teen-agers who most often go without breakfast.

Black People↗