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Biomedical subjects

B Thompson

Publications and source records attributed to B Thompson.

At least 109 records · Page 6Linked to original sources

Alcohol abuse screening instruments: normative test data collected from a first DWI offender screening program.

OBJECTIVE: A variety of instruments are used by Driving While Impaired (DWI) screening programs nationwide to assess offenders for alcohol- or drug-related problems. This study presents normative data from five standardized instruments administered by a DWI screening program: the MAC scale of the MMPI, the Alcohol Use Inventory (AUI), the Michigan Alcoholism Screening Test (MAST), the Drug Abuse Screening Test (DAST) and the Skinner's Trauma Scale (STS). METHOD: The population under study were 2,317 first DWI offenders who completed screening evaluations in 1989-91. The sample included 24% women; the racial distribution was 46% Hispanic, 43% non-Hispanic white, 8% Native American and 3% other races. A statistical model was developed to determine associations among scores on the various instruments and age, gender, ethnicity, education, blood alcohol concentration (BAC) and validity measures on the MMPI-2 (L and K scale scores) RESULTS: There were significant differences in test scores among the ethnic- and gender-specific client groups. Test scores were significantly higher among men than women for the MAST, the D1 and D2 scales of the AUI, the MAC, and the STS. Correlations among the instruments were generally low, and the percentage of persons who scored above instrument cut-points varied significantly. The MAST identified the highest percentage of persons as alcoholic. MMPI profile validity was the most significant independent variable associated with test scores. Persons with scores in the valid range had higher mean scores on each of the instruments. CONCLUSIONS: The choice of instruments used in the DWI assessment can greatly influence the percentage of offenders assessed as having alcohol-related problems.

Accidents, Traffic↗

Dietary intake and exposure to environmental tobacco smoke in a worksite population.

OBJECTIVES: Nonsmokers who live with smokers have poorer dietary habits than those who live in nonsmoking households. This relationship may be due to shared lifestyle patterns by spouses and family members. However, in order to fully understand the nature of this relationship, it is also important to examine the association between diet and exposure to environmental tobacco smoke (ETS) at the workplace. Further, blue collar workers' patterns of exposure to ETS both at work and at home have not been studied. The goal of this study is to examine the dietary intake of manufacturing workers as it relates to exposure to ETS at work and at home. METHODS: The Working Well Trial surveyed 10,833 nonsmokers about a variety of health behaviors, including smoking, dietary behaviors, and ETS exposure. RESULTS: Nonsmokers who had ETS exposure in their household had significantly lower intake of all target micronutrients, compared to those without household exposure. Exposure to ETS at the workplace was associated with lower intakes of vitamin C and fruits and vegetables, but not the other micronutrients examined. CONCLUSIONS: Exposure to ETS was associated with poorer dietary habits. Household exposure was a stronger predictor of intake than was workplace exposure. Because of the antagonistic effects of many components of a healthful diet in relation to the harmful effects of tobacco smoke, these findings have relevance larger than either ETS exposure or diet considered singly.

Adult↗

ETS exposure in the workplace. Perceptions and reactions by employees in 114 work sites. Working Well Research Group [corrected].

Employees are often exposed to and bothered by environmental tobacco smoke (ETS) in the workplace; however, little is known about correlates of workers' perceptions of their exposure. In this study, 20,801 employees in 114 work sites in the United States were surveyed; variables related to perceptions of exposure and being bothered by ETS were entered into regression models. Many of the workplaces had total or partial restrictions on smoking in the workplace; however, over half of the respondents (52.4%) reported they were exposed to ETS at work. Smoking policy, smoking status, age, gender, living with a smoker, and occupation contributed to models for perceived exposure and being bothered by tobacco smoke. Work site smoking restrictions seem to have an impact on employee attitudes concerning exposure to ETS. About 35% of employees were bothered regularly by smokiness at their workplaces, which made their working conditions both uncomfortable and exposed them to an unsafe working environment.

Adult↗

Clinical and arteriographic characterization of patients with unstable angina without critical coronary arterial narrowing (from the TIMI-IIIA Trial).

Previous studies have reported that some patients presenting with unstable angina are found at coronary angiography to have no critical coronary stenosis. This study evaluated the clinical presentation and arteriographic findings in patients enrolled in the Thrombolysis in Myocardial Ischemia (TIMI-IIIA) trial, which assessed the effect of tissue-type plasminogen activator added to conventional therapy on the coronary arteriographic findings in patients presenting with ischemic pain at rest. Three hundred ninety-one patients were enrolled in the TIMI-IIIA trial and underwent coronary arteriography within 12 hours of enrollment. Fifty-three patients (14%) had no luminal diameter stenosis of a major coronary artery of > or = 60% on the baseline arteriogram. Compared with patients with unstable angina with an identifiable culprit lesion, patients without critical coronary obstruction were more likely to be women and non-white and less likely to have ST-segment deviation on the presenting electrocardiogram. Arteriography in such patients revealed no visually detectable coronary stenosis in half of the group; the remaining patients had noncritical coronary narrowing (i.e., < 60% luminal diameter stenosis) without morphologic features (ulceration or thrombus) suggestive of unstable or active coronary plaque. Nearly one third of the patients without critical coronary stenosis had impaired angiographic filling, suggesting a possible pathophysiologic role for coronary microvascular dysfunction. These patients with unstable angina and no critical coronary obstruction had an excellent short-term prognosis; 2% died or had myocardial infarction compared with 18% of patients with critical obstruction.

Angina, Unstable↗

Predicting child abuse potential across family types.

The present study was conducted to explore whether stress, family resources, and social support are correlates of the child abuse potential of mothers, and whether prediction functions differ across families with children with disabilities and families with no children with disabilities. The design and analyses were correlational. Statistically and practically significant relationships were found. Stress in family functioning appears to be an important predictor of child abuse potential, and it is suggested that interventions might be designed to target related features of family functioning.

Adult↗

Randomized telephone smoking-intervention trial initially directed at blue-collar workers.

Although smoking prevalence in the United States has declined markedly in recent years, prevalence among blue-collar workers remains high and few successful methods of reaching this group have been identified. The present study was designed to test the relative efficacy of two different approaches to telephone smoking-cessation counseling for blue-collar workers. Our study built on the experience of the National Cancer Institute's Cancer Information Service (CIS) and compared the past CIS smoking-cessation counseling procedure and a modified version of the present procedure. In our trial, callers to a special telephone hotline who asked for information on smoking cessation were randomly assigned to receive counseling under one of two protocols: 1) the past CIS procedure, in which general information was given and cessation materials were sent to the callers, and 2) a version of the present CIS stage-model procedure, adapted by us for use with blue-collar workers, in which callers were given counseling specific to their stage in the smoking-cessation process. The general-information group contained 185 subjects; the stage-model group contained 197. Despite extensive efforts in the present study, it was not possible to recruit the number of blue-collar workers planned for our statistical analysis. Consequently, of a total of 382 subjects recruited, 93 (24.3%) were blue-collar workers, 181 (47.4%) were white-collar workers, and 108 (28.3%) were retired persons who worked part time, student workers, or the unemployed. Our results show no statistically significant differences in either short-term or long-term nonsmoking rates between the general-information group and the stage-model group.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

Analysis of behavior state conditions and associated environmental variables among students with profound handicaps.

State conditions in combination with environmental events and factors significantly affect the level of alertness and responsiveness among students with profound and multiple handicaps. State conditions and environmental variables over a continuous, 5-hour period for each of 25 students in classroom settings were measured. Data were assessed using transitional probability, time series, and correspondence analysis procedures. Results showed the presence of state sequence patterns, short state change periods, and a relatively small amount of association between specific behavior states and the environmental factors and events measured in the study.

Adolescent↗

Prehospital bicarbonate use in cardiac arrest: a 3-year experience.

The American Heart Association no longer recommends the routine use of sodium bicarbonate in cardiac arrests. Reasons cited include the lack of documented effect on clinical outcome and potential adverse effects of metabolic alkalosis and hypernatremia. We reviewed 36 months of experience with 619 nontrauma adult, prehospital cardiac arrest patients to identify 273 successful resuscitations who had emergency department blood gases and electrolytes performed. Determination of complications associated with prehospital intravenous sodium bicarbonate and its impact on survival in resuscitated patients was undertaken. Fifty-eight patients did not receive sodium bicarbonate (NO HCO3 group) and had short cardiopulmonary resuscitation (CPR) times (7.4 +/- 5.5 minutes). Two hundred fifteen patients did receive sodium bicarbonate (HCO3 group) and had significantly longer CPR times (23.3 +/- 13.5 minutes, P less than or equal to .001). Both groups demonstrated routine early chest compression and hyperventilation as evidenced by no significant difference in paramedic response time or rate of intubations. Initial emergency department blood gas results of both groups were not significantly different. No patients in the NO HCO3 group had hypernatremia (sodium [Na]+ greater than 150), whereas four patients (2%) in the HCO3 group were hypernatremic. Eight patients (14%) in the NO HCO3 group and 37 patients (17%) in the HCO3 group were alkalotic with pH values greater than 7.49 (P = NS). Six patients (10%) of the NO HCO3 group and 24 patients (11%) of the HCO3 group had a metabolic component to the alkalosis as defined by a positive base excess value (P = NS).(ABSTRACT TRUNCATED AT 250 WORDS)

Acid-Base Equilibrium↗

The structure and process of AIDS case management.

This article presents observations of case management in the Robert Wood Johnson Foundation AIDS Health Services Program. Case management is discussed in terms of assessment, care plan development, client links with services, monitoring, and advocacy. Recommendations are proposed to ensure that AIDS case management is delivered in a standard and equitable manner that can be monitored by quality assurance agencies.

Acquired Immunodeficiency Syndrome↗

Congenital chylothorax and mediastinal neuroblastoma.

This is the first reported association of congenital chylothorax and mediastinal neuroblastoma in a newborn infant. The infant exhibited features of both congenital and acquired chylothorax. Resolution of the chylothorax occurred following ligation of thoracic duct after failure of conservative management with multiple thoracentesis and chest tube drainage.

Chylothorax↗

Some factors in the choice of male or female sterilisation in Aberdeen.

In a random sample of 84 men and 167 women, medical considerations, an intransigent attitude of one partner or a fear of adverse effects, were related to the decision on which partner should seek sterilisation. Only 19% of couples felt that they had a real choice between male and female sterilisation.

Female↗

Infertility--epidemiology and referral practice.

A questionnaire-based study of infertility has been carried out in two age cohorts of women in a defined geographical region. Women were aged 36-40 years or 46-50 years at the time of the survey. The prevalence of infertility (no conception after 2 years of trying) was approximately 14% in both age cohorts. However, a significantly higher proportion of younger women had sought medical help. In both age cohorts there was a higher incidence of spontaneous abortion among infertile women. These findings suggest no significant increase in the prevalence of infertility over a decade but a considerable increase in the use of medical services.

Abortion, Spontaneous↗

Experience with sperm counts following vasectomy.

The records of Aberdeen men requesting vasectomy between 1978 and 1981 were studied and a sample of men were interviewed about 3 years after the operation; 85% completed the standard requirements for seminal analysis and were given the "all clear"; two-thirds were cleared after sending 2 samples and usually within 20 weeks after vasectomy; 10% of men sent at least 1 sample but were never cleared and the remaining 5% ignored the requirements. Information from 70 men (63 interviews, 7 questionnaires) gave some indication of reasons, often multiple, for incomplete or non-compliance; these included embarrassment, ambiguous feelings about having more children, inadequate understanding of reproductive physiology and blind faith in the surgeon.

Humans↗

Infection control of parenteral nutrition solutions.

Microbial contamination of parenteral nutrition solutions is a preventable cause of in patients receiving nutrition support. The components of the parenteral nutrition solutions have variable microbial growth potential. Crystalline amino acid and dextrose solutions are poor growth media for bacteria but may support fungal growth. Lipid emulsions provide an excellent medium for growth of bacteria and fungal species. Total nutrient admixtures will support microbial growth better than standard parenteral nutrition solutions will but less well than will lipid emulsion alone. Control of infection related to contaminated infusate depends on compounding procedure, quality control, appropriate storage, and procedures to prevent in-use contamination. Guidelines are presented for the preparation and administration of parenteral nutrition infusates that will minimize microbial contamination.

Cross Infection↗

Community-based programs for smoking cessation.

Overall, there is a wide range of programs offered at the community level. Most of the group cessation clinics, both nonprofit and commercial, typically offer group support, behavior modification, and stress and weight management, with similar emphases in their companion self-help manuals. It often is difficult to distinguish between the various methods employed by the diverse programs, with those that offer maintenance and relapse prevention components faring the best. In general, the multiple-component programs, whether group or self-help packages, seem to hold the most promise for achieving and maintaining abstinence; however, there is some evidence that overwhelming the smoker with too many new behaviors and skills lowers the effectiveness of otherwise successful components. The challenges for community-based programs will be to modify and adapt their materials and sessions to address the needs uncovered in the recent emphasis on the process of smoking cessation. Specifically, program content must address the issue of recycling and relapse prevention. Smokers who have made unsuccessful quit attempts must be able to reframe those attempts in a positive manner, so that they are motivated to try again. Similarly, recent quitters need the skills and motivation to remain abstinent. Although some cessation programs allow clients to participate in future sessions or meetings for little or no extra cost, few have any strategies for dealing with long-term maintenance. As community-based programs incorporate these elements of cessation, quit rates are likely to increase. An additional challenge is found in the difficulty of reaching the hard-core, heavy smoker. There is little doubt that light-to-moderate smokers find it easier to achieve long-term cessation. Cessation programs that motivate heavy smokers to attempt to quit or that include adjunct therapies to assist the heavy smoker (i.e., nicotine gum) to quit smoking are likely to be positively received. Currently, however, efforts specifically designed to assist heavy smokers are experimental. A final challenge is to adapt materials and sessions to motivate and assist the hard-to-reach smokers. Increasingly, smoking is becoming a habit of individuals in lower socioeconomic groups, including minorities, non-high school graduates, and young women. Avenues that have been used to reach white middle-class Americans are not easily transferred to such groups. Some attention is already being paid to development of more culturally appropriate materials (e.g., the ALA Manual oriented to blue collar workers and the ACS focus on pregnant women); however, it remains a challenge to motivate members of these groups to participate in smoking cessation activities.(ABSTRACT TRUNCATED AT 400 WORDS)

Community Health Services↗