Development of a carpal tunnel syndrome screening method using structured interviews and vibrotactile testing

Carpal tunnel syndrome (CTS) is a debilitating and expensive health problem. An inexpensive screening method that would differentiate between people who do not have CTS and those that may have CTS would be useful. The screening methodology investigated here had two phases: a structured interview and provocative vibrotactile testing (VT). The control group (n = 36) was composed of asymptomatic college students and faculty, the case group was composed of patients currently visiting an occupational medicine clinic for symptoms consistent with CTS. The case group was subdivided into positive and negative for nerve conduction latency, NCL+ (n = 21) and NCL- (n = 13), respectively. Using a scored, structured interview, 33 of the controls and none of the symptomatic cases were identified as non-CTS. The results from the provocative flexion VT indicated that if the difference between the age corrected baseline and the threshold at 15 minutes is 15 microm or more, the subject was likely to be NCL+ (odds ratio 12.6, 95% CI 3.8 to 41.8). Further research may improve this screening methodology to not only determine whether or not a person has CTS, but also to determine the level of median nerve impingement or damage.     

A components method for measuring the impact of a family planning program on birth rates

One of the major goals of family planning programs worldwide has been to reduce the level of fertility in hopes of slowing the rate of natural increase and promoting social and economic development. Such programs have now been in existence for sufficient lengths of time to have had an impact on fertility levels. In general countries with organized family planning programs, marked declines in fertility levels have been observed. The extent to which such declines may be credited to organized programs has not been rigorously measured because an appropriate research methodology has been lacking. This paper describes one method of directly linking declines in fertility levels to the contraceptive protection experienced by a population. The contribution of organized family planning programs is estimated by decomposing the amount of total contraceptive protection into within-program and outside-program sources.     

Comparison of pro-choice and pro-life activists: Their values,attitudes, and beliefs

This article reports a survey of two statewide abortion related organizations: Missouri Citizens for Life and the Abortion Rights Alliance (N=524). The two groups differed signficantly on 12 of 18 Rokeach terminal values and on eight of 13 NORC instrumental values. Salvation was the value which most successfully differentiated the two groups. The two groups were used to establish the construct validity of 18 abortion attitude items. Members of the two groups also differed significantly on each of 18 beliefs, indicating that they tend not only to accept assertions made by their own group but also to reject assertions made by the other group. Anti-abortion were more likely than pro-abortion respondents to expect an increase in restrictions on abortion five years from now. Proabortion respondents attributed significantly more pro-abortion sentiment to U.S. adults than did the anti-abortion respondents.The cooperation of Maureen McCarthy, Ann O'Donnell and Kathy Edwards is gratefully acknowledged. This research project benefited greatly from the assistance of Mary Harbourt, Kathy Dunsford, Sherry Kilgore, Barbara Breen, Janice Warneke, Lynn Taylor, Janice Sato, Beth Wellman Granberg, Karen Quiring, and Patricia Shanks. Data collection was funded by a grant from the Graduate Research Council of the University of Missouri—Columbia. The analysis was funded by National Institute of Child Health and Human Development Grant No. 1-HD-82834. Tom Smith of the NORC at the University of Chicago provided the marginals on the abortion items from the 1980 General Social Survey. Requests for reprints should be sent to Donald Granberg, Center for Research in Social Behavior, 111 E. Stewart Road, University of Missouri—Columbia, Columbia, MO 65211.     

Open and closed birth intervals for once-married spouse-present white women

Using the 1970 1/1,000 Public Use Sample of the U.S. population, the relationships of the closed and open birth intervals with parity and mother's age, with parity and marital duration, and with children ever born/marital duration and mother's age are analyzed. These findings both replicate and expand on Srinivasan's earlier research on the open interval. The open interval is more sensitive as an index of marital fertility when marital duration and parity are controlled than when mother's age and parity are controlled.     

A critique of the Urban Institute's claims of cost free immigration: Early findings confirmed

This text addresses the critiques from the Urban Institute and other immigrant advocacy groups concerning the findings of an earlier study, The Cost of Immigration released in the summer of 1993. That study showed that the public costs associated withimmigrants settling here since 1970 amounted, in 1992, to $42.5 billion more in services and assistance than the $20.2 billion which immigrants paid in taxes (Huddle, 1993). The updated assessment takes into account previously unavailable figures and revises some methods and assumptions used in the earlier work. The updated bottom line is fully consistent with initial findings on immigrant costs for 1992.     

The influence of the family on premarital sexual attitudes and behavior

This research has expanded our understanding of the determinants of adolescent sexuality in several directions. We have used a study of mothers and children to construct and estimate a model of the intergenerational transmission of sexual attitudes and behavior. With data collected from both mothers and children, we were able to proceed further than most past research and to consider both the attitudes and behaviors of mothers as reported by the mothers themselves. These data permitted an investigation of the determinants of maternal attitudes concerning adolescent sexuality as well as an examination of the influences of the attitudes and experiences of mothers on the attitudes, perceptions, and behavior of children. Obviously, limiting the study to white families prevents generalization of our findings to other subgroups of the population. The findings demonstrate the importance and relevance of parental and adolescent attitudes in understanding adolescent sexuality. Premarital sexuality is a salient issue to both young people and their parents. There are, however, very important and substantial differences in the attitudes of parents and children. On average, the attitudes of young people today are much less restrictive than those of their parents, reflecting either life cycle differences or the impact of social change. The intergenerational difference is recognized by young people themselves and probably affects the ability of parents to assist their maturing children in adjusting to and dealing with their sexuality--a difficulty likely to be reflected in the relative lack of success sexually active young people have in preventing pregnancy. Our findings also add to the research literature in demonstrating that although children, on average, have more permissive attitudes than their parents, the attitudes of individual parents tend to be reflected in the attitudes of individual children. Children whose mothers have less restrictive attitudes have, on average, less restrictive attitudes themselves. Further, the attitudes of mothers are also reflected in the behavior of their children, so on average, mothers with more permissive attitudes have children who are more sexually active. The influence of maternal attitudes, however, is stronger for children's attitudes than for their behavior. Of course, variability in children's attitudes and behavior--and even their perceptions of maternal attitudes--can only be partially explained by the attitudes of their mothers; but presumably, if the attitudes of other important family members, including fathers and siblings, were known, the prediction of adolescent attitudes would improve.(ABSTRACT TRUNCATED AT 400 WORDS)     

Dealing with noncompliance and missing outcomes in a randomized trial using Bayesian technology: Prevention of perinatal sepsis clinical trial,Soweto, South Africa

The success of interventions designed to address important issues in social and medical science is best addressed by randomized experiments. With human beings there are often complications, however, such as noncompliance and missing data. Such complications are often addressed by statistically invalid methods of analysis, in particular, intention-to-treat and per-protocol analyses. Here we address these two complications using a statistically valid approach based on principal stratification with a fully Bayesian analysis. This analysis is applied to a randomized trial of a potentially important intervention designed to reduce the transmission of bacterial colonization between mothers and their infants through vaginal delivery in South Africa: the Prevention of Perinatal Sepsis (PoPs).