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Biomedical subjects

C D Jenkins

Publications and source records attributed to C D Jenkins.

At least 19 recordsLinked to original sources
PubMed1992

Relation of hostility to medication adherence, symptom complaints, and blood pressure reduction in a clinical field trial of antihypertensive medication.

The impact of hostility was examined in relation to the conduct and results of a clinical field trial. Data were derived from a multi-center randomized double-blind study of the comparative effects of antihypertensive therapy (captopril, methyldopa and propranolol) on the quality of life of 620 hypertensive men. Hostility levels were higher in subjects reporting skipping medication dosages compared to those reporting they always complied with the medication schedule. Reporting of symptoms often associated with antihypertensive drug regimens was positively related to hostility scores throughout the study, even during the blinded placebo period. Persons with high hostility scores showed the greatest decline in blood pressure independent of type of antihypertensive medication. However, there was some limited evidence that hostility levels were significantly reduced by one antihypertensive medication. Overall, the present findings suggest that double-blind pharmacologic clinical trials may benefit from using reliable measures of hostility as covariates in the evaluation of symptom reports and amount of blood pressure reduction.

Adult↗
PubMed1992

Assessment of outcomes of health intervention.

This paper proposes that the most comprehensive current approach to the assessment of health interventions is exemplified in the expanding field of research into health-related quality of life. The paper initiates discussion of 11 conceptual and methodological issues which should be dealt with explicitly rather than by default in any such research study. Decisions about these 11 issues will shape the future directions of the field of health outcomes research. Health policy decisions will increasingly be based on outcome studies of health-related quality of life.

Coronary Disease↗
PubMed1992

A two-dimensional intervention plan to reduce risk factors for ischaemic heart disease.

Although most cardiologists and public health officials are convinced of the great value of reducing risk factors for cardiovascular diseases, efforts to reduce these factors have seldom reached effectively beyond those persons in direct touch with physicians. This paper describes nine channels which health officials can utilise to inform, motivate, and change health behaviours in the general public. The channels are: individuals, family and friends, health professionals and institutions, schools and teachers, business and labour, mass media, local organizations, community leaders, regional and national government. Using all these channels in an integrated programme to reduce multiple risk factors in the community results in a two-dimensional intervention plan in which the various components reinforce one another. Specific programmatic suggestions are made for each of the following cardiovascular risk factors: cigarette smoking, high blood pressure, lack of exercise, high serum cholesterol, and stress.

Combined Modality Therapy↗
PubMed1990

The measurement of health-related quality of life: major dimensions identified by factor analysis.

The measurement of quality of life is becoming more important in the evaluation of medical technologies and pharmaceuticals. Particularly when the several available therapies have similar effects on survival, quality of life measures may help decide which should be the therapy of choice. The Recovery Study utilized a multidisciplinary array of indicators of health-related quality of life and recovery. This paper reports factor analyses of 58 outcome measures on a study group of 469 persons who had undergone coronary artery bypass or cardiac valve surgery 6-months previously. The factor analyses revealed 5 orthogonal dimensions. We have named them: low morale, symptoms of illness, neuropsychological function, interpersonal relationships, and economic-employment. The data argue that health-related quality of life is a multidimensional construct, and that these dimensions can be measured quantitatively with relatively simple interview and questionnaire approaches. The next research step is to determine whether the five dimensions of post-operative quality of life have different pre-operative predictors, and whether intervention on these predictors can improve the recovery and rehabilitation process.

Adult↗
PubMed1990

Randomised single blind trial to compare the toxicity of subconjunctival gentamicin and cefuroxime in cataract surgery.

Comparatively little attention has been paid to the conjunctival toxicity of antibiotics administered at the time of cataract surgery. We have observed the effect of subconjunctival gentamicin and cefuroxime injection, using colour photography in a randomised single blind trial of 121 patients undergoing routine cataract surgery. Our results suggest that a hyperaemic eye is likely to occur about twice as often in patients injected with gentamicin (p less than 0.001). Gentamicin is associated with more pain postoperatively (p less than 0.05). Significant manifestations of gentamicin toxicity are conjunctival oedema and capillary closure. Cefuroxime has some theoretical advantages over gentamicin in its antibacterial spectrum.

Cataract Extraction↗
PubMed1989

Genetic segregation and the maintenance of sexual reproduction.

Sexual reproduction confronts evolutionary biology with a paradox: other things being equal, an asexual (all-female) population will have twice the reproductive potential of a competing sexual population and therefore should rapidly drive the sexual population to extinction. Thus, the persistence of sexual reproduction in most life forms implies a compensatory advantage to sexual reproduction. Work on this problem has emphasized the evolutionary advantages produced by the genetic recombination that accompanies sexual reproduction. Here we show that genetic segregation produces an advantage to sexual reproduction even in the absence of an advantage from recombination. Segregation in a diploid sexual population allows selection to carry a single advantageous mutation to a homozygous state, whereas two separate mutations are required in a parthenogenetic population. The complete fixation of advantageous mutations is thus delayed in a heterozygous state in asexual populations. Calculation of the selective load incurred suggests that it may offset the intrinsic twofold reproductive advantage of asexual reproduction and maintain sexual reproduction in diploid populations.

Animals↗
PubMed1989

Type A, amicability and injury: a prospective study of air traffic controllers.

Recent research has suggested that only a subset of Type A's may be at higher risk for negative health outcomes. The present prospective study of 416 air traffic controllers attempted to determine if a sub-group of Type A's who were disliked by their co-workers had significantly higher risk of injury than liked A's and all Type B's over a 27-month period. Liked B's were not different in terms of injury incidence from their not liked B counterparts (mean annualised rates of injury = 1.9 and 2.1 respectively); not liked Type A's had the highest rates of injuries of any group (8.5) including liked Type A's (3.8). Some psychological instruments were useful in discriminating the Type A not liked group from their liked counterparts and from the Type B's. These discriminating variables were used as covariates to determine if the relationship between being classified a not liked Type A and elevated injury incidence remained. Multiple regression analysis showed that distress from life events and being a not liked Type A remained significantly correlated with later injury (standardised coefficients 0.16 and 0.25 respectively).

Adult↗
PubMed1979

Life changes. Do people really remember?

The question, "How well do people remember life changes?" was approached in a longitudinal study of nearly 400 healthy men in a responsible profession. Three scales for assessing life changes were administered by questionnaire at two examinations nine months apart. The subjects were asked to report life change events occurring during a specific six-month period--that which immediately preceded the first examination. For all three life change scales there was substantial forgetting over the interval between reports, with a second report yielding total scores 34% to 46% less than those from the first report for the same period. The amount of change over time varied greatly across persons. These findings raise serious questions about the validity of retrospective studies of life change and illness when the period being reported is greater than six months in the past. They do not, however, jeopardize the potential of the method for prospective studies.

Adult↗
PubMed1979

Cultural context of type A behavior and risk for CHD: a study of Japanese American males.

A total of 2437 Japanese American men living in Hawaii were given the Jenkins Activity Survey (JAS) and classified as either type A or type B. Only 18% of the sample scored in the type A direction, a much lower percentage than usually found among white American males. There was a slightly higher prevalence of CHD among type A Japanese Americans than among their type B counterparts (5.7% vs. 3.6%, respectively). A factor analysis of JAS data produced three new factors for this population: HS (hard-driving and impatient), JH (ability to function successfully in job setting), and HW (hard-working). Those men who were more Westernized had a higher prevalence of CHD, expecially if they were also type A, in terms of both geographical mobility and intergenerational change. The results are discussed in light of the dual role of sociocultural influences and behavioral characteristics (type A/B) which predispose an individual to CHD.

Aged↗
PubMed1979

Psychosocial modifiers of response to stress.

The impact of stress upon an organism is far more complex than the simple design of most stress research implies. We offer an expanded model for studying the relation of stressors to pathological outcomes, which takes into account both the adaptive capacity of the organism before the stressor occurs and the defenses marshalled in response to the stressor. The model also distinguishes among the initial responses of alarm, sustained defensive behaviors, and the relatively irreversible endstates which remain after resistance has ended. Realizing that only a multidiscomplinary approach can begin to capture the wholeness of human experience, this research paradigm anticipates that stressors, adaptive capacities, defenses, alarm reactions, and pathologial end-states will take place at the biological, psychological, interpersonal and sociocultural levels simultaneously and successively. Data on life change stress and psychological health outcomes gathered as part of the Air Traffic Controller Health Change Study are analyzed to illustrate the use of the model in identifying psychosocial and biological modifiers of response to stress.

Adaptation, Psychological↗