4 results on '"Webber MP"'
Search Results
2. Nested case-control study of selected systemic autoimmune diseases in World Trade Center rescue/recovery workers.
- Author
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Webber MP, Moir W, Zeig-Owens R, Glaser MS, Jaber N, Hall C, Berman J, Qayyum B, Loupasakis K, Kelly K, and Prezant DJ
- Subjects
- Adult, Aged, Antiphospholipid Syndrome epidemiology, Arthritis, Rheumatoid epidemiology, Case-Control Studies, Emergency Medical Technicians statistics & numerical data, Female, Firefighters statistics & numerical data, Granulomatosis with Polyangiitis epidemiology, Humans, Incidence, Lupus Erythematosus, Systemic epidemiology, Male, Middle Aged, Myositis epidemiology, Odds Ratio, Scleroderma, Systemic epidemiology, Sjogren's Syndrome epidemiology, Spondylarthropathies epidemiology, Young Adult, Autoimmune Diseases epidemiology, Emergency Responders statistics & numerical data, Environmental Exposure statistics & numerical data, Rescue Work, September 11 Terrorist Attacks
- Abstract
Objective: To test the a priori hypothesis that acute and chronic work exposures to the World Trade Center (WTC) site on or after September 11, 2001 were associated with risk of new-onset systemic autoimmune diseases., Methods: A nested case-control study was performed in WTC rescue/recovery workers who had received a rheumatologist-confirmed systemic autoimmune disease diagnosis between September 12, 2001 and September 11, 2013 (n = 59), each of whom was individually matched to 4 randomly selected controls (n = 236) on the basis of year of hire (±1 year), sex, race, and work assignment (firefighter or emergency medical service). Acute exposure was defined according to the earliest time of arrival (morning of 9/11 versus later) at the WTC site, and chronic exposure was defined as duration (number of months) of WTC site-related work. Rheumatologists were blinded with regard to each subject's exposure status. The conditional odds ratios (CORs) with 95% confidence intervals (95% CIs) for incident autoimmune disease were derived from exact conditional logistic regression models., Results: Rheumatoid arthritis was the most common autoimmune diagnosis (37% of subjects), followed by spondyloarthritis (22%), inflammatory myositis (14%), systemic lupus erythematosus (12%), systemic sclerosis (5%), Sjögren's syndrome (5%), antiphospholipid syndrome (3%), and granulomatosis with polyangiitis (Wegener's) (2%). The COR for incident autoimmune disease increased by 13% (COR 1.13, 95% CI 1.02-1.26) for each additional month worked at the WTC site. These odds were independent of the association between high acute exposure (working during the morning of 9/11) and disease outcome, which conveyed an elevated, but not statistically significant, risk (COR 1.85, 95% CI 0.86-3.89)., Conclusion: Prolonged work at the WTC site, independent of acute exposure, was an important predictor of post-9/11 systemic autoimmune diseases. The WTC Health Program should expand surveillance efforts for those with extended exposures, as early detection can facilitate early treatment, which has been shown to minimize organ damage and improve quality of life., (© 2015, American College of Rheumatology.) more...
- Published
- 2015
- Full Text
- View/download PDF
Catalog
3. Do school-based health centers provide adequate asthma care?
- Author
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Oruwariye T, Webber MP, and Ozuah P
- Subjects
- Child, Child, Preschool, Cross-Sectional Studies, Female, Humans, New York City, Odds Ratio, Schools statistics & numerical data, Surveys and Questionnaires, Asthma prevention & control, Child Welfare, Health Education organization & administration, Primary Prevention methods, School Health Services standards
- Abstract
School-based health centers (SBHCs) are increasingly charged with providing primary care services including asthma care. This study assessed SBHC provider adherence to the National Heart, Lung, and Blood Institute (NHLBI) asthma care guidelines and the association among provider adherence, patient characteristics, and asthma outcomes. A cross-sectional study design was used to assess SBHC chart data from 415 children with asthma attending four inner-city elementary schools (K-5) in the Bronx, NY. Asthma symptoms, peak flow use, follow-up visits, and referrals to asthma specialists were documented in the charts of 60%, 51%, 22%, and 3% of subjects, respectively. Thirty-three percent of charts had SBHC clinician-documented severity classifications, of which 70% had appropriate medications prescribed. Asthma education and an asthma plan were documented in 18% and 10% of charts, respectively. Environmental triggers and tobacco exposures were documented in 71% and 49% of charts, respectively. Older children (> 8 years) were more likely to have documentation of peak flow use for asthma management, asthma education, follow-up visits, and written asthma plans, whereas younger children (< 8 years) were more likely to miss more days of school (all p < .05). Overall, provider adherence to NHLBI guidelines was inadequate, with adherence somewhat better for older children. more...
- Published
- 2003
- Full Text
- View/download PDF
4. Comparing frequent and average users of elementary school-based health centers in the Bronx, New York City.
- Author
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Baquiran RS, Webber MP, and Appel DK
- Subjects
- Adolescent, Age Factors, Child, Child, Preschool, Diagnosis-Related Groups statistics & numerical data, Female, Health Services Research, Humans, Insurance, Health statistics & numerical data, Male, Medically Underserved Area, Needs Assessment organization & administration, New York City, Registries, Retrospective Studies, Sex Factors, Socioeconomic Factors, Utilization Review, Community Health Centers statistics & numerical data, School Health Services statistics & numerical data, Urban Health Services statistics & numerical data
- Abstract
This study analyzed health care utilization at three school-based health centers (SBHCs) in the Bronx, New York City, and compared characteristics of "frequent" and "average" service users. Encounter form data for visits by 2,795 students who received services at least once between September 7, 1998, and June 30, 1999, were reviewed. Demographic comparisons between clinic users and the total school population, and between "frequent" (five or more visits/year) and "average" (one to four visits/year) users were made. The two groups also were compared after primary diagnoses were classified into five general categories. Some 96% (3,469/3,614) of students were registered in the SBHCs, of whom 81% (2,795/3,469) used clinic services at least once during the school year. Clinic users did not differ from the general school population by gender, but were younger (p < 0.01). "Frequent" users were more likely than "average" users to be older (p < 0.01), but they did not differ by gender, race/ethnicity, or insurance status. "Frequent" users comprised 28% of the clinic-using population, but accounted for 72.5% of all visits. Similarly, "average" users comprised 72.4% of the clinic-using population, but accounted for 27.5% of all visits. "Frequent" users generated most visits for mental health and chronic medical conditions, while "average" users generated most visits for preventive care, acute medical care, and injuries/emergencies (p < 0.01 for all). Important challenges for elementary SBHCs include developing new approaches that meet children's needs while protecting clinic resources, like scheduling group interventions for those with on-going health care needs who require frequent use of school health services. more...
- Published
- 2002
- Full Text
- View/download PDF
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