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Biomedical subjects

D M Morrison

Publications and source records attributed to D M Morrison.

At least 19 recordsLinked to original sources
PubMed2003

The influence of psychosocial difficulties on women's attrition in an HIV/STD prevention program.

We examined attrition from an HIV/STD group counselling intervention in two ways: quantitative analyses of the entire sample (n=287) and structured interviews of a subset of 30 women with low attendance. In the interviews, the most common reasons for low attendance were time conflicts and enrolling primarily to obtain the monetary incentives given for completing research questionnaires. Latent class statistical analysis of the full sample identified two subgroups that differed from each other in the number of psychosocial problems recently experienced. Relative to the 'non-distressed' class, the 'distressed' class members had higher probabilities of psychological distress, low incomes, heavy substance use, sex for trade, relationship violence, and unstable housing. This group had higher HIV/STD risk, but lower intervention attendance. Members also had less education and less knowledge about HIV/STD. A higher proportion of the distressed group was African-American. Study findings suggest that in interventions for women at HIV/STD risk, it is not necessarily enough to ensure cultural relevance and to provide food, childcare, and transportation. To increase retention, interventionists should consider (1) the use of strategies to support attendance (such as monetary incentives and attention to group process factors) and (2) intervention formats that are brief, matched to participants' stage of change, population-specific, and/or maximally accessible.

Adolescent↗
PubMed2001

The use of diltiazem for treating rapid atrial fibrillation in the out-of-hospital setting.

STUDY OBJECTIVE: We sought to evaluate the use of intravenous diltiazem for treatment of rapid atrial fibrillation or flutter (RAF) in the out-of-hospital setting. METHODS: This study is a retrospective review of data with historical control subjects. Data were drawn from out-of-hospital patients reported to a statewide paramedic system who presented with atrial fibrillation or flutter and a ventricular response rate (VRR) of 150 beats/min or greater. The intervention (diltiazem) group included patients who received diltiazem during a 9-month period in 1999. The control group included patients from 1998 who did not receive diltiazem. Patients who were intubated or underwent cardioversion were omitted. Therapeutic response was defined as the occurrence of change to sinus rhythm, reduction of VRR to 100 beats/min or less, or reduction of baseline VRR by 20% or greater. Data were analyzed by using the chi(2) test, the Student's t test, and odds ratios (ORs). A Bonferroni adjusted P value of.005 was used to define statistical significance. RESULTS: Forty-three patients receiving diltiazem and 27 control subjects were included in the study. The mean total diltiazem dose was 19.8 mg (95% confidence interval 17.8 to 21.8). The diltiazem and control groups did not significantly differ with respect to age; sex; history of atrial fibrillation; prior use of digitalis, beta-blockers, or calcium channel blockers; concurrent out-of-hospital therapies; or baseline VRR or systolic blood pressure (P =.09 to 1.00). The difference in VRR reduction between the diltiazem and control groups was 38 beats/min (95% confidence interval 24 to 52); this difference was statistically significant (P <.001). The mean percentage reduction of VRR in the diltiazem group was -33.1%. The difference in systolic blood pressure change between the diltiazem and control groups was not statistically significant (P =.17). The diltiazem group had a higher prevalence of achieving VRR reduction to 100 beats/min or less than did the control group (OR 22.6; P <.001), of achieving a VRR reduction of 20% or greater (OR 19.3; P <.001), and of achieving overall therapeutic response (OR 19.3; P <.001). Few changed to sinus rhythm in either group (estimated OR 6.3; P =.15). No patients in the diltiazem group required treatment for hypotension, endotracheal intubation, resuscitation from cardiac arrest, or emergency treatment of unstable dysrhythmias. CONCLUSION: The effects of diltiazem on RAF can be appreciated within the constraints of the out-of-hospital environment. Diltiazem should be considered as a viable field therapy for rate control of RAF.

Aged↗
PubMed2001

Differences by gender and sexual experience in adolescent sexual behavior: implications for education and HIV prevention.

Researchers examined individual characteristics and peer influences related to adolescents' sexual behavior, taking gender and sexual experience into account. As part of a larger, longitudinal study investigating youth health awareness, 8th, 9th, and 10th graders reported their intentions to engage in sexual activity and use condoms in the next year, the amount of pressure they felt to engage in sexual activity, and their perceptions about the number of their peers engaging in sexual activity. Findings suggest intentions to engage in sexual behavior and use condoms, feelings of pressure to have sex, and perceptions about the number of friends engaging in sexual intercourse differ by gender and sexual experience status. Implications of these findings for health and sexuality education, as well as HIV prevention programs targeted at adolescents, are discussed.

Adolescent↗
PubMed2000

The relative costs and benefits of telephone interviews versus self-administered diaries for daily data collection.

This article compares two methods of collecting daily data: self-administered diaries and telephone interviews. Study participants included 44 men and 56 women between the ages of 16 and 35 who participated in a larger study of drinking, drug use, and sexual activity. Participants were randomly assigned to either the written diary or the telephone interview conditions; question wording and format were identical in both conditions. Daily data were collected for a period of 8 weeks. Results indicate that although telephone interviews resulted in slightly more missed days of data collection, they generally yielded less item-level missing data, produced cleaner data and therefore were less costly to process, and were as palatable to participants as self-administered diaries. Except for reports of drinking and vegetable consumption, telephone and diary conditions did not differ in the amount of behavior reported; more drinking and vegetable consumption were reported with telephone interviews, however. Telephone interviews also imposed considerably higher overall personnel costs.

Adolescent↗
PubMed1999

Management of hysteroscopic surgery complications.

Hysteroscopic surgery is considered a safe, routine gynecologic procedure performed in the OR and in office settings. Complications are rare; however, when complications do occur they can be severe and rapid. The surgical team members must understand the significance of patient monitoring and proper equipment operation to ensure positive patient outcomes. This article discusses complications from intravasation of various distending media used during hysteroscopy and the complication of hyponatremia. A physiologic approach to these problems enhances awareness of the significance of patient monitoring during hysteroscopic procedures.

Body Fluids↗
PubMed1998

Comparison of diary and retrospective measures for recording alcohol consumption and sexual activity.

This study examines issues in the measurement of HIV risk factors, using daily diaries to collect data on both alcohol use and sexual behavior. Seventy-nine adolescents and young adults recruited from an STD clinic and from a university campus were studied. Participants gave daily reports of their drinking, drug use, and sexual activities for 4 weeks. Respondents then completed a retrospective questionnaire asking about the frequencies of these behaviors during the preceding period. Diary reports of behavior were strongly correlated with retrospective reports. More frequent drinking was reported on the diary measure than the retrospective measure, and this discrepancy was larger for more frequent drinkers. Frequency of sexual activity was overreported on the retrospective measure only among adolescents. Errors in the measurement of alcohol use, sexual behavior, or their co-occurrence could affect estimations of the relationship of alcohol use to sexual behavior. The types of error inherent in these measures may differ, resulting in different tendencies toward over- or underreporting of alcohol use and sexual behavior, depending on frequency of the behavior and the characteristics of the subject population.

Adolescent↗
PubMed1998

Children's beliefs about drinking.

This paper reports the results of a study in which age (grade level), racial/ethnic, and gender differences in beliefs and perceived norms about drinking were examined in a multi-ethnic urban sample of 4th through 7th grade children. Results showed that older children held beliefs and perceived norms that were more favorable toward drinking than younger children. The major difference between older and younger children lay in their differential estimates of the likelihood of certain consequences occurring and not in their evaluation of these consequences of drinking. Further, older children not only displayed less motivation to comply with their parents and greater motivation to comply with their peers, but they also perceived their parents, as well as their peers, as less disapproving of drinking than did younger children. There were few gender or race/ethnicity differences at these ages in children's beliefs and perceived norms about drinking.

Adolescent↗
PubMed1997

Effects of a skill-based intervention to encourage condom use among high risk heterosexually active adolescents.

OBJECTIVES: In this article we describe the development and testing of three behavioral interventions to reduce the risk of contracting HIV/AIDS and other sexually transmitted diseases among heterosexually active adolescents. METHODS: The interventions include a comic book, a videotape, and a group skill training curriculum that emphasize skill development--for communicating and negotiating condom use with partners, in addition to providing basic information. Participants included 228 youths sampled in juvenile detention and 168 youths sampled from public health STD and other similar clinics. The samples included both young men and women, and were comprised of African American and European American adolescents, ages 14-19. RESULTS: Examination of the relative efficacy of the interventions at three and six months following intervention show very few differences among conditions, despite the fact that the interventions contained most of the elements that previously have been defined as essential for effective interventions. CONCLUSIONS: In the discussion, we consider possible reasons for this outcome and make recommendations for future research.

Adolescent↗
PubMed1996

Drug use among adolescent mothers: prepregnancy to 18 months postpartum.

PURPOSE: Little is known about the substance use patterns of adolescent mothers, particularly in the postpartum period. This study provides descriptive, longitudinal data on the substance use behavior of a cohort of adolescent mothers. METHODS: A total of 241 pregnant adolescents, under 18 years old and planning to carry the pregnancy to term, completed the initial interview. Respondents were interviewed again at 1, 6, 12, and 18 months postpartum. The data reported here are based on the 229 respondents who completed all five interviews. RESULTS: Use of all substances decreased substantially during pregnancy, but increased steadily in the first 6 months postpartum. A similar pattern was observed for regular use of multiple substances. Regular use before and after the pregnancy, but not during it, was the most common pattern of substance use. CONCLUSIONS: The prevalence of substance use among adolescent mothers is significant. To capitalize on the large decreases in use during pregnancy, drug prevention programs for adolescent mothers should target the first 6 months postpartum.

Adolescent↗
PubMed1996

Using the theory of reasoned action (TRA) to understand the decision to use condoms in an STD clinic population.

The theory of reasoned action (TRA) provides useful information when designing health education interventions. In this study, 703 heterosexual STD clinic clients responded to a TRA-based survey. With steady partners, social norms and attitudes toward condom use were significant predictors of intention for both men and women. The interaction of attitude and norm increased prediction for men (R = .64, p < 0.001) and women (R = .70, p < 0.001). With casual partners, attitude was a predictor for men and social norm was a predictor for women. Prior use of condoms increased prediction for men (R = .38, p < 0.001) and women (R = .47, p < 0.001). Findings suggest that, in addition to traditional TRA model variables, the relationship between sexual partners and the individual's prior experience with condom use should be incorporated into attempts to understand this complex, dyadic behavior. Examining specific outcome and normative beliefs also provides important information for intervention design.

Adult↗
PubMed1995

Misconceptions about AIDS among children who can identify the major routes of HIV transmission.

Described knowledge about HIV transmission among 1,048 third, fourth, fifth, and sixth graders from a multiethnic urban school district. Participants answered questions about behaviors leading to HIV transmission and about mechanisms of transmission. Children at all grade levels demonstrated a high level of recognition of the three primary routes of HIV transmission (through sex, through drug needle sharing, and in utero). However, children who knew about these routes also had many misconceptions about the mechanisms involved in acquiring HIV through these routes and about the ways HIV is not transmitted. Misconceptions decreased with grade and socioeconomic status (SES). Although there were no race/ethnicity differences in knowledge of actual routes and mechanisms of HIV transmission, there were more misconceptions about routes and mechanisms of HIV transmission among African American and Asian American children than among white children.

Acquired Immunodeficiency Syndrome↗
PubMed1994

Beliefs about condoms and their association with intentions to use condoms among youths in detention.

PURPOSE: Youths in detention have been identified as a high-risk group for AIDS. To help inform AIDS-prevention efforts targeted for these youths, we surveyed youths in detention regarding their sexual behaviors, beliefs about condoms, intentions to use condoms, and actual condom use. We examined race and gender differences in these beliefs and behaviors, and we studied the relationship of these beliefs to condom-use intentions. METHODS: Questionnaires were administered to a sample of 201 youths in detention who were, on average, 16 years old. The sample was stratified on gender and race (African-American and white), with approximately equal numbers in each group. RESULTS: The results indicate that these youths had engaged in behaviors that put them at high risk of acquired immunodeficiency syndrome (AIDS) and other sexually transmitted diseases. Although they used condoms somewhat more consistently with casual partners than with their steady partners, the majority did not use condoms consistently with either partner type. Very few race or gender differences were found with regard to condom use, intentions to use condoms, or beliefs about the consequences of using condoms. Beliefs associated with intentions to use condoms with steady partners included protection against sexually transmitted diseases (STDs), and the beliefs that condoms reduce pleasure, are artificial, unromantic, and interrupt sex. In contrast, only the belief that condoms prevent pregnancy was related to intentions to use condoms with casual partners. CONCLUSION: The results suggest that interventions targeted at African-American and white males and females in detention need not differ greatly in content as long as they include the most salient concerns of each group; that interventions include content on the two protective benefits of condom use (pregnancy and STD prevention), as well as on how to minimize the perceived negative aspects of condom use; that they stress the need for condom use with steady as well as casual partners; and that they stress that anal intercourse is especially risky with regard to AIDS transmission.

Acquired Immunodeficiency Syndrome↗
PubMed1994

Sexual behavior of American adolescents: results from a U.S. national survey.

PURPOSE: This paper reports on data from a 1990 U.S. national survey of the sexual behavior of male and female adolescents aged 12-17. METHODS: A household survey using a multi-stage area probability sample of the United States was undertaken in 1990. Adolescents were interviewed about sexual history, contraceptive use, and motivations, attitudes, and expectations with regard to sexual behavior and risk. RESULTS: The majority of 17-year-olds and about half of 16-year-olds, both male and female, had initiated sexual activity, with males initiating at younger ages than females. Sexual activity was episodic; only half of sexually experienced adolescents reported having sex in the month prior to the interview. Many sexually active respondents expressed less desire to have sex than confidence that they would have sex. Over half of respondents reported using a condom at most recent intercourse, with boys being more likely than girls to report condom use. Condom use at last intercourse was unrelated to perceptions of risk and concern about AIDS. CONCLUSIONS: Given the importance of some of the undesirable consequences of sexual activity in adolescents, such as AIDS and unwanted pregnancy, accurate and up-to-date information on sexual behavior of this age group is crucially important. The results of this study underscore the need for in-depth, population-based research on adolescent sexual behavior.

Acquired Immunodeficiency Syndrome↗
PubMed1994

Children's knowledge and beliefs about AIDS: qualitative data from focus group interviews.

Focus groups were used as a qualitative technique to elicit knowledge and attitudes of children in Grades 3 to 6 about acquired immune deficiency syndrome (AIDS). Twenty-seven small groups of children responded to open-ended questions about general AIDS knowledge; transmission, causation, consequences, and prevention of AIDS; emotional response to AIDS; and susceptibility. Results indicate that children have a high level of awareness about AIDS and correct knowledge about the modes of human immunodeficiency virus (HIV) transmission. They understand that AIDS is a serious illness that cannot be cured and know the main ways of preventing HIV infection. Participants had more difficulty explaining causation and greatly overestimated the number of people their age and in high school that might be infected. They also had difficulty applying accurate knowledge to the hypothetical situation of encountering a child with AIDS in school. Misconceptions about AIDS exist at all grade levels, but appear more prevalent in lower grades, whereas increased complexity seems to characterize responses of older children. Recommendations for health educators are made.

Acquired Immunodeficiency Syndrome↗