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Comparisons of poverty and nonpoverty groups on dental status, needs, and practices.

Poverty and nonpoverty adults have been screened in a program of Multiphasic Health Testing in which dental examinations were provided and in which information on dental care behavior was obtained through a health inventory using a video-terminal for recording replies. Findings of the dental examination indicate that, whatever measure of oral health was used, oral health of the poverty group was poorer than that of the nonpoverty group. The poverty group, for example, had more dental problems, and the problems they had were more severe. They also had lower levels of oral hygiene and less restorative treatment. The poverty group also was more likely to be edentulous, and to have higher levels of untreated decay and periodontal diseases. They had more missing teeth, and fewer restored teeth. Nearly all poverty-nonpoverty differences persisted when the data were controlled for age and sex. Information from the health inventory indicates that the poverty group is less likely than those in the nonpoverty group to seek dental care in general, and also specifically for rreventive dental services. Even among the nonpoverty group, however, one third stated that they never sought dental care for "cleanings or checkups." Daily toothbrushing, on the other hand, was generally reported by both poverty-status groups. Consistent relations were found between oral health practices and oral health in both poverty and nonpoverty groups...

Adolescent↗

Biomedical engineering for "The Age of Health".

A systems approach to health care inevitably emphasizes shifting present emphasis from curative to preventive orientations. However, problems arise through the inertia and resistance of our politico-cultural system. The present highly-developed curative-oriented system depends heavily on technological and biomedial engineering expertise, as indeed will a preventive-oriented system. They must serve however within the priorities defined by the systems objectives in health care. This paper reviews, in terms of technological content and socio-political issues, some major developments including; multiphasic health testing and disease screening, health appraisals, clinical labs and other test procedures, protocols, computerized information systems, data bases and systems modelling.

Biomedical Engineering↗

Diseases and cancer rate of AMHTS examines in the Tokai University Hospital.

Studies were conducted on 10,261 subjects who had undergone checkups in an AMHTS (Automated Multiphasic Health Testing and Services) Center in the Tokai University Hospital. The breakdown of the screening at the time of the examinations was 48% abnormal and 52% borderline or normal. The disease ratio obtained in follow-up survey averaged 16% and increased as the subjects became older. There were 68 cancer patients, 0.7% of the total number of examinees, and it was found that 88% of the cancer cases definitely diagnosed as cancer within one year after the examinations received these diagnoses within three months from the day of the examinations.

Adult↗

The past, present and future of International Health Evaluation Association (IHEA).

In this paper I mention the 19-year history of International Health Evaluation Association (IHEA) which was started in Washington D.C. by the great effort of Dr. G. Gilbert in Hawaii. In 1973 three regions were organized in this Association: 1) U.S.A., 2) Europe and 3) Pan-Pacific including Asia. I also mention the history of periodical health check-ups in U.K., U.S.A. and Japan. In Japan it started in 1954, however, after adapting the system of Automated Multiphase Health Testing designed by the Kaiser Foundation of Auckland, Calif., in 1973, Japanese people paid much attention to this health screening system and the number of hospitals and clinics for health screening has increased tremendously and the number of examinees amounted to 2,875,449 in 2001. Finally, I conclude that IHEA should create a multidisciplinary system to sustain a lifestyle with a high level of Quality of Life (QOL) for the people who really want to live fruitful lives by the successive health education.

Congresses as Topic↗

Experiences with an interactive computer program for recording biometrical health screening data.

The nurses' measurements of biometrical health screening data comprise the central elements in our multiphasic preventive medical investigation in Malmö. It is also vitally important for the information processing, evaluation and actions of the screening that all test values and other data can be supplied to a uniform computer bank without delay in terms of secondary transferral routines. In our ongoing population investigation projectin Malmö, this has been accomplished by on-line computer programs for the different components of the screening. Here we describe the practical experiences with the subroutine use by the nurses to feed the biometrical test results to the computer bank.

Biometry↗

Sigmoidoscopy and mortality from colorectal cancer: the Kaiser Permanente Multiphasic Evaluation Study.

The Kaiser Permanente Multiphasic Evaluation Study is often cited as evidence from a randomized trial that screening sigmoidoscopy reduces mortality from colorectal cancer. To examine the role of sigmoidoscopy in this reduction, we reviewed the 110 incident cases of colorectal cancer occurring among the 10,713 subjects from randomization in 1964 through 1982. Tumor stage at diagnosis, location, mode of discovery, and current mortality status were determined for each. We also reanalyzed chart review data for the years 1965 through 1974 to assess the difference in exposure to sigmoidoscopy between groups. Study group subjects, who were urged to have annual multiphasic health checkups (MHC), had both a lower cumulative incidence (4.3 vs 6.7 cases per 1000 persons) and a better stage distribution (86 vs 54% Stage B or better) than nonurged control subjects for colorectal cancers arising within reach of the sigmoidoscope. The lowered incidence accounted for two-thirds of the total difference in mortality. No appreciable difference in removal of colorectal polyps was seen between groups. Only a slight excess in exposure to sigmoidoscopy was seen in the study group (30 vs 25% of subjects examined at least once between 1965 and 1974), which was unlikely to account for more than a small fraction of the study group's decrease in mortality. Although the Multiphasic Evaluation Study did find a significantly lower mortality from colorectal cancer in the study group, it did not achieve a substantial difference in exposure to sigmoidoscopy. Its results are therefore inconclusive with respect to sigmoidoscopy and should not be used as evidence either for or against sigmoidoscopic screening.

Adult↗

Comparison of DWI offenders with non-DWI individuals on the MMPI-2 and the Michigan Alcoholism Screening Test.

Two groups of driving-while-intoxicated (DWI) offenders with either one DWI offense or with repeat offenses were compared to a group of nonoffenders using the Minnesota Multiphasic Personality Inventory (MMPI-2) and the Michigan Alcoholism Screening Test (MAST). Demographic information was also collected regarding their prior legal history, family history, and blood alcohol level at the time of the DWI arrest. The results indicated both DWI groups had scored significantly higher than the comparison group on the K, Psychopathic Deviate (Pd) Scale, Over-Controlled Hostility (O-H) Scale, and MacAndrews Alcoholism Scale-Revised (MAC-R). The first offenders and multiple offenders did not differ significantly from one another. On the MAST, both DWI offender groups scored significantly higher than the nonoffenders. This time, however, the multiple offenders scored significantly higher than the first-offender group. Unexpectedly, the first offenders and multiple offenders did not differ with regards to blood alcohol level at the time of arrest. There were no significant differences noted with regard to prior legal history or family history of alcoholism for all three groups. These results are discussed with regard to assessment implications.

Adolescent↗

A pediatric screening examination for psychosocial problems.

In an effort to avert the cumulative effects of unresolved emotional problems on children's social and school adjustment, a psychosocial phase was added to a pediatric multiphasic examination. Based upon a cumulative stress concept, the screening procedures included child behavior and family stress questionnaires for parents, and abbreviated standard psychological tests for children, administered by specially trained aides. Computerized results were reported to the child's pediatrician. Follow-up by mental health counselors attached to the pediatric clinic was provided for patients identified as being at high risk of serious psychosocial problems. Evidence of validity of the screen, factors affecting the scores, and effectiveness of clinical follow-up of high-risk patients are discussed. Valid semicomputerized screening of school-age children for serious psychosocial problems can be carried out routinely and at relatively low cost by paraprofessional personnel in a pediatric setting. Impediments to effective use of the screening results on the part of both health care provider and patient are discussed.

Adolescent↗

Automated multiphasic health testing: a diagnosis in three parts. Part I: Development of multiphasic health testing.

Automated Multiphasic Health Testing (AMHT) is a sophisticated, computer-based technique for patient data gathering, analysis, storage, and print-out. The technique has been erroneously associated in the minds of physicians with the single application of population health "screening" while it is, infact, broadly applicable to the entire health-care delivery process. During the past several years, the technique of AMHT has been refined, and computer-based systems have been applied to medical functions such as hospital pre-admission testing, the performance of triage in the HMO environment, and the development of patient histories and physiological data in the outpatient clinic. Such applications have been shown to reduce cost and increase physician productivity. This paper traces the history of AMHT over the past decade as seen through the eyes of a participant, from within the medical industry. A case is presented in this three-part paper for the use of AMHT techniques as basic tools in containing health-care costs and in providing expanded medical care throughout the United States.

Diagnosis, Computer-Assisted↗

Automated multiphasic health testing, a diagnosis in three parts: Parts II and III.

Automated Multiphasic Health Testing (AMHT) is a sophisticated, computer-based technique for patient data gathering, analysis, storage, and print-out. The technique has been erroneously associated in the minds of physicians with the single application of population health "screening" while it is, in fact, broadly applicable to the entire health-care delivery process. During the past several years, the technique of AHMT has been refined, and computer-based systems have been applied to medical functions such as hospital pre-admission testing, the performance of triage in the HMO environment, and the development of patient histories and physiological data in the outpatient clinic. Such applications have been shown to reduce cost and increase physician productivity. This paper traces the history of AMHT over the past decade as seen through the eyes of a participant, from within the medical industry. A case is presented in this three-part paper for the use of AMHT techniques as basic tools in containing health-care costs and in providing expanded medical care throughout the United States.

Attitude of Health Personnel↗

Prevalence of concurrent diabetes mellitus and idiopathic facial paralysis (Bell's palsy).

Diabetes mellitus was present in 11.4 per cent of 684 patients with Bell's palsy, in 28.4 per cent of the sixty-seven with recurrent or bilateral palsy, and in 16.8 percent of the 440 with palsy who were thirty years or older. Diabetes was present in only 3.8 per cent of 27,399 persons thirty years or older who had never had Bell's palsy and who underwent multiphasic health testing. These figures clearly indicate that diabetes is more common among patients with Bell's palsy than among persons who have never had that disease; and that the risk of Bell's palsy is increased in patients with diabetes. The diabetic patient is more prone than the non-diabetic person to nerve degeneration, and this tendency to nerve degeneration is not age-related. Although 10 per cent of our patients with Bell's palsy and known diabetes were younger than thirty-nine years, we now advise screening for blood sugar elevation only for patients who are forty years or older, or who have recurrent or bilateral facial paralysis.

Adolescent↗

Validation of the psychopathic personality inventory on a female inmate sample.

This investigation evaluated the construct validity of the Psychopathic Personality Inventory (PPI; Lilienfeld & Andrews, 1996), a self-report measure designed to assess psychopathy. One hundred and two incarcerated females were administered the Kaufman Brief Intelligence Test (K-BIT), an oral alcohol and drug screening measure, a demographic interview, the Minnesota Multiphasic Personality Inventory-2 (MMPI-2), the Psychopathy Checklist-Revised (PCL-R), and the PPI. There were significant correlations among the PPI, MMPI-2 scales, and the PCL-R. In addition, the correlations between the PPI and the separate PCL-R factors were not significantly different from each other, indicating that the PPI is assessing both facets of the psychopathy construct to some extent. A high correlation between the PPI and the DSM-IV criteria, which assesses adult antisocial behaviors, revealed adequate concurrent validity. Nonsignificant or negligible correlations between the PPI and the MMPI-2 scales provided some support for discriminant validity. The results are discussed with respect to the clinical and forensic utility of the PPI, the limitations of the study, and the need for further research.

Adolescent↗

A Variable Response Inconsistency scale and a True Response Inconsistency scale for the Millon Adolescent Clinical Inventory.

Variable Response Inconsistency (M-VRIN) and True Response Inconsistency (M-TRIN) scales were developed for the Millon Adolescent Clinical Inventory using 104 male and 78 female delinquents, ages 13-17 years. M-VRIN efficacy was assessed by comparing nonrandom protocols of 76 male and 34 female delinquents, ages 13-17 years, with 100 computer-generated random protocols. Nonrandom protocols were screened using a matched-pair Minnesota Multiphasic Personality Inventory-Adolescent or Jesness Inventory. M-TRIN efficacy was assessed by comparing protocols with 160 simulated acquiescent and nonacquiescent protocols. Specificities of .95 or higher showed sensitivities up to .89 for M-VRIN, and .90 and .79 for M-TRIN. Predictive power and overall effectiveness are reported for several base rates. Small relationships may exist between M-VRIN and race, and between M-TRIN and gender.

Adolescent↗

Effectiveness of screening older people for impaired vision in community setting: systematic review of evidence from randomised controlled trials.

OBJECTIVE: To assess whether population screening for impaired vision among older people in the community leads to improvements in vision. DESIGN: Systematic review of randomised controlled trials of population screening in the community that included any assessment of vision or visual function with at least 6 months' follow up. SUBJECTS: Adults aged 65 or over. MAIN OUTCOME MEASURE: Proportions with visual impairment in intervention and control groups with any method of assessing visual impairment. RESULTS: There were no trials that primarily assessed visual screening. Outcome data on vision were available for 3494 people in five trials of multiphasic assessment. All the trials used self reported measures for vision impairment, both as screening tools and as outcome measures. The inclusion of a visual screening component in the assessment did not result in improvements in self reported visual problems (pooled odds ratio 1.04:95% confidence interval 0.89 to 1.22). A small reduction (11%) in the number of older people with self reported visual problems cannot be excluded. CONCLUSIONS: Screening of asymptomatic older people in the community is not justified on present evidence. Visual impairment in this age group can usually be reduced with treatment. It is unclear why no benefit was seen. Further work is needed to clarify what interventions are appropriate for older people with unreported impairment of vision.

Aged↗

Automated multiphasic health testing. Diagnostic and testing results obtained at the Health Evaluation Center. Public Health Service Hospital, Baltimore.

The results of automated multiphasic health testing (AMHT) were evaluated with special attention to diagnoses made by physicians and to false positive results, as well as to laboratory test results. The study population consisted of 1,157 patients at the Health Evaluation Center of the Public Health Service Hospital in Baltimore. Although 95 percent of the patients had at least one newly diagnosed disease or condition., the percentage dropped to 78 percent when dental abnormalities were excluded and to 70 percent when dental, vision, and hearing abnormalities were excluded. Abnormal laboratory test results were observed for 98 percent of the patients, and 36 percent had at least one false positive test result. The study results indicated that AMHT is a highly productive method for comprehensive medical testing with a variety of uses other than mass screening. The productive diagnostic yield combined witha high percentage of false positive results dictate the need for careful planning for followup care, strict attention to quality control, and excellent communication between the AMHT center and the practicing physician.

Adolescent↗

Evaluation of multiphase implants for repair of focal osteochondral defects in goats.

The use of biodegradable scaffolds for articular cartilage repair has been investigated by numerous researchers. The objective of this screening study was to examine how the mechanical and physical properties of four multiphase implants can affect the cartilage healing response. Multiphase implant prototypes were prepared using poly(D,L)lactide-co-glycolide as the base material. PGA fibers (FR), 45S5 Bioglass (BG) and medical grade calcium sulfate (MGCS) were used as additives to vary stiffness and chemical properties. Osteochondral defects (3 mm dia. and 4 mm in depth) were created bilaterally in the medial femoral condyle (high-weight bearing) and the distal medial portion of the patellar groove (low-weight bearing) of 16 Spanish goats. Half of the implants were loaded with autologous costochondral chondrocytes. Defect sites (total n = 64, 4 sites/treatment) were randomly treated and allowed to heal for 16 weeks, fully weight bearing. At euthanasia, gross evaluations and biomechanical testing were conducted. Histological sections of the defect sites were stained with H and E, Safranin O/Fast Green or processed to analyze collagen architecture. Sections were semi-quantitatively scored for repair tissue structure. Qualitative evaluations showed that all groups had a high percentage of hyaline cartilage and good bony restoration, with new tissue integrating well with the native cartilage. Gross and histology scoring indicated a significantly higher score for defect healing in the condyle than in the patellar groove, but no difference in healing for implant types or addition/omission of cells was found. This investigation demonstrates that focal, osteochondral defects in caprine distal femurs treated with various implant constructs were repaired with hyaline-like cartilage and good underlying bone. The multiphase implants show potential for treatment of osteochondral defects and long-term studies need to be undertaken to confirm the longevity of the regenerated tissue.

Animals↗

A cluster-analytic investigation of MMPI profiles of serious male and female juvenile offenders.

OBJECTIVE: To use cluster analysis to identify psychological profiles and related mental health symptoms among male and female juvenile offenders. METHOD: Juvenile offenders (N = 141) incarcerated in the California Youth Authority completed the Minnesota Multiphasic Personality Inventory (MMPI) and the Massachusetts Youth Screening Instrument-Version 2 (MAYSI-2). RESULTS: MMPI cluster analysis revealed four distinct profiles: two for male and two for female juvenile offenders. Among males, we identified one Normative cluster with no clinically elevated scores. A second male cluster, labeled Disorganized, exhibited clinical elevations on scales 8 (Schizophrenia), 6 (Paranoia), 4 (Psychopathic Deviate), and 7 (Psychasthenia). Among females, two clinically elevated profiles emerged. One Impulsive-Antisocial cluster consisted of clinical elevations on scale 4 (Psychopathic Deviate), which has been consistently associated with delinquent and antisocial behavior. The second cluster, labeled Irritable-Isolated, produced elevations on MMPI scales 4 (Psychopathic Deviate), 8 (Schizophrenia), 6 (Paranoia), and 7 (Psychasthenia). There were no significant sex, ethnicity, or offense differences across clusters, but the clusters exhibit distinct psychiatric profiles (MMPI) and mental health symptoms (MAYSI-2). CONCLUSIONS: The findings indicate that not only do female offenders have more acute mental health symptoms and psychological disturbances than male offenders, they exhibit qualitatively distinct psychiatric profiles. Results reinforce the need for assessment of mental health symptoms for male and female juvenile offenders as well as sex-appropriate treatments.

Adolescent↗

Psychopharmacologic investigations in healthy elderly volunteers: MMPI depression scale.

The Depression Scale of the Minnesota Multiphasic Personality Inventory (MMPI) was used as a screening test for healthy volunteers in a psychopharmacologic research study. Data were collected on 43 men and 46 women under age 35 versus 33 men and 43 women over age 65 (plus a subsequent group of 40 men over age 65), and comparisons were made with more extensive data from the Mayo Clinic. The evidence indicates that elderly subjects differ strikingly from young subjects in their responses to items in the MMPI self-ratings of depression. Revised information on normative responses is needed. At present there are too many problems of interpretation when the Depression Scale items are applied to t.he elderly.

Adult↗