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Biomedical subjects

J B Skinner

Publications and source records attributed to J B Skinner.

9 recordsLinked to original sources
PubMed1996

Plasma lipids and desogestrel and ethinyl estradiol: a meta-analysis.

OBJECTIVE: To review the literature to determine the magnitude of the effect of 150 micrograms desogestrel-30 micrograms ethinyl E2, an oral contraceptive (OC) formulation, on plasma lipid concentrations in healthy women using meta-analysis techniques. DATA SOURCES: All English-language published reports (1981 to 1991) on lipid parameters in women taking 150 micrograms desogestrel and 30 micrograms ethinyl E2 for up to 6 months obtained via an Embase database search and via a subsequent review of the reference lists. METHODS OF STUDY SELECTION: Of 98 articles, 18 met eligibility criteria and were included in the meta-analysis. DATA EXTRACTION AND SYNTHESIS: Data on total cholesterol, high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), and triglycerides were extracted. The change in each parameter from baseline to cycle 6 was estimated as a weighted mean of changes reported in each study; a standard error of the estimate was calculated. This procedure was validated by goodness-of-fit tests. RESULTS: The following statistically significant changes from baseline to cycle 6 were estimated (mean +/- SE): HDL-C: 0.15 +/- 0.02 mmol/L (5.80 +/- 0.62 mg/dL); triglycerides: 0.28 +/- 0.03 mmol/L (24.49 +/- 2.59 mg/dL); and LDL: - 0.12 +/- 0.04 mmol/L (-4.53 +/- 1.55 mg/dL). There was a nonsignificant trend toward an increase in total cholesterol. CONCLUSION: When given in combination with 30 micrograms ethinyl E2, desogestrel increased HDL-C and triglycerides and decreased LDL-C. The positive impact on HDL-C and LDL-C suggests that a potential cardioprotective benefit (rather than an atherosclerosis risk) may occur with prolonged use of such an OC, but this hypothesis will be difficult to prove.

Cholesterol↗
PubMed1995

A revised Alcohol Expectancy Questionnaire: factor structure confirmation, and invariance in a general population sample.

OBJECTIVE: The alcohol expectancy construct has become prominent in contemporary psychosocial approaches to understanding alcohol use and abuse. In 1980 Brown and colleagues developed the 90-item Alcohol Expectancy Questionnaire (AEQ) to assess experiences. Rohsenow modified this instrument to create the 40-item Alcohol Effects Questionnaire (AEQ-2). In the present study, we replaced the dichotomous response format of the AEQ-2 with a six-point scale to create the AEQ-3. The purpose of the study was to evaluate the AEQ-3 for factor structure confirmation and invariance across gender and race subgroups. METHOD: We administered the AEQ-3 to a large general population sample (N = 1,260). The instrument was self-administered during a structured interview. RESULTS: Confirmatory factor analyses were conducted to test a correlated eight-factor model consisting of six positive expectancies and two negative expectancies. Fit indices revealed that the eight-factor model fit the data moderately well. Furthermore, the fit of the eight-factor model was largely invariant across race and gender subgroups. Nonetheless, factor intercorrelations and modification indices revealed inadequate discriminant validity. CONCLUSIONS: Based on these findings, we cautiously recommend the AEQ-3 as a measure of alcohol expectancies. Specific recommendations and limitations are discussed regarding future use of the AEQ-3.

Adult↗
PubMed1992

Stress and alcohol use: moderating effects of gender, coping, and alcohol expectancies.

A stressor vulnerability model of stress-induced drinking was tested in a stratified random sample of 1,316 Black and White adult drinkers. Stressors were highly predictive of both alcohol use and drinking problems among men who relied on avoidant forms of emotion coping or held strong positive expectancies for alcohol's effects and accounted for more than 35% of the variance in alcohol use among the subgroup of men who were high in both vulnerability factors. In contrast, stressors were negatively related among men who were low in both and were unrelated among women regardless of their coping or expectancies. These findings suggest that tension reduction theories of alcohol use are overly broad and that individual characteristics must be considered to account for stress-related effects on alcohol use and abuse.

Adaptation, Psychological↗
PubMed1990

The evaluation of a cognitive behavioural treatment programme in outpatients with chronic pain.

This study is an attempt to investigate the efficacy of an outpatient cognitive behavioural group programme for the rehabilitation of patients with chronic pain. The programme, which took place over one afternoon per week for seven weeks and was conducted by a multidisciplinary team, aimed to increase patients' skills for coping with chronic pain and its social, emotional and physical consequences. Measures of pain intensity, mood, coping skills, physical disability and medication consumption were obtained on four separate occasions: twice pre-treatment, immediately post-treatment and at one month follow-up. Repeated measures analysis of variance showed significant improvements in mood, coping skills, physical disability and analgesic consumption despite less clear-cut improvement in ratings of pain intensity. These results parallel the findings of similar studies in the U.S.A. and their implications for the provision of services to chronic pain patients in the U.K. is discussed.

Adaptation, Psychological↗
PubMed1988

Early measures of maternal alcohol misuse as predictors of adverse pregnancy outcomes.

Pregnancy outcome was studied in 531 obstetric outpatients with respect to maternal alcohol consumption prior to pregnancy recognition, (absolute alcohol per day prior to pregnancy, PPAA) and indications of problem drinking (IPD). Multiple regression was used to predict pregnancy outcome with PPAA and IPD, controlling for potentially confounding sociodemographic and health factors. PPAA predicted spontaneous abortion and lowered Apgar scores. The risk of spontaneous abortion increased an average of 25% for each additional ounce of absolute alcohol consumed per day (p less than 0.05). Adverse pregnancy outcomes related to intrauterine growth were more strongly related to IPD than PPAA, and IPD remained a significant predictor even after controlling for PPAA. The strongest association was with head circumference (p less than 0.01); logistic regression indicated that for each additional indication of problem drinking reported, risk of head circumference below the 10th percentile increased 2.77 times. Other pregnancy outcome measures negatively related to IPD were 5-min Apgar scores (p less than 0.05), birth weight (p less than 0.10), and 1-min Apgar scores (p less than 0.10). No significant curvilinear alcohol effects or interactions were observed. These findings highlight the potential clinical utility of PPAA and IPD in the early identification of women whose alcohol use puts their pregnancies at high risk.

Abortion, Spontaneous↗
PubMed1988

Analogue measurement of alcohol consumption: effects for task type and correspondence with self-report measurement.

Properties of a widely used measure of analogue alcohol consumption, the taste-rating task, were investigated. It was predicted and found that the taste-rating task led to more frequent sipping, smaller sip volume and a steeper decline in sipping across the 15 min drinking period than a procedurally similar tavern-evaluation task. These data demonstrate that the taste-rating task conveys implicit "how to drink" demands that seem to alter natural drinking topography. Examination of the correspondence between self-report and analogue consumption revealed that preexperimental estimates of typical drinking were significant yet modest predictors of analogue consumption. Moreover, postexperimental estimates of analogue consumption revealed that subjects accurately self-reported laboratory drinking, with taste-rating subjects showing more accuracy. Limitations of taste-rating methodology and directions for further investigation of analogue consumption measures are discussed.

Adult↗
PubMed1987

Anaphylactoid reaction to alcuronium.

A 67-year-old woman suffered cardiovascular collapse during induction of anaesthesia. This was later shown to be anaphylactic in origin; the causative agent was alcuronium. In vitro testing showed a highly specific sensitivity to alcuronium with minimal cross-reactivity. Future anaesthesia with decreased risk was thereby assured. The clinical nature of this reaction and a review of the literature implicate the cardiovascular system as the principal target in this type of reaction to alcuronium and suggest that the heart is directly involved.

Aged↗
PubMed1983

The use of computerized learning in intensive care: an evaluation of a new teaching program.

A computer-assisted learning program in respiratory intensive care was introduced into the undergraduate curriculum at University College Hospital. Educational effectiveness was assessed. This method of learning was found to be highly acceptable to students. The improvement in students knowledge of the subject was up to three times greater in those who used the computer program, than a control group of students who received only teaching by conventional means, (P = 0 X 016). The results of a questionnaire designed to elicit students' attitudes to this learning experience are discussed.

Anesthesiology↗