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Biomedical subjects

J Garrett

Publications and source records attributed to J Garrett.

104 records · Page 6Linked to original sources
PubMed1967

Acoustic trauma from rock-and-roll music.

Analysis of certain measurements of noise levels and frequency distributions in two rock-and-roll music establishments indicated that this program material can produce temporary auditory threshold shifts and is of an order that has been recognized as entailing risk of permanent ear damage.

Amplifiers, Electronic↗
PubMedDate not supplied

A randomized controlled trial of a physician-directed treatment program for low-income patients with high blood cholesterol: the Southeast Cholesterol Project.

OBJECTIVE: To assess the effectiveness of a cholesterol-lowering intervention designed to facilitate the management of hypercholesterolemia by primary care clinicians. DESIGN: Randomized controlled trial, with randomization of clinician-patient groups. SETTING: Twenty-one community and rural health centers in North Carolina and Virginia. PARTICIPANTS: Primary care clinicians (n = 42, 71% physicians) and the patients they enrolled with high cholesterol (n = 372). Twenty-two clinicians were randomized to give the special intervention (184 patients) and 20 to give usual care (188 patients). Two thirds of participating patients were women, 40% were African American, and 11% were Native American. INTERVENTION: A 90-minute tutorial to train clinicians how to use a structured assessment and treatment program (Food for Heart Program) consisting of a brief dietary assessment and three 5- to 10-minute dietary counseling sessions given by the primary care clinician, referral to a local dietitian if the low-density lipoprotein cholesterol (LDL-C) remained elevated at 4-month follow-up, and a prompt for the clinician to consider lipid-lowering medication based on the LDL-C at 7-month follow-up. MAIN OUTCOME MEASURES: Changes in total and LDL cholesterol at 4-month follow-up and averaged over a 1-year follow-up period (4-, 7-, and 12-month follow-up). RESULTS: At 4-month follow-up, total cholesterol decreased 0.33 mmol/L (12.6 mg/dL) in the intervention group and 0.21 mmol/L (8.3 mg/dL) in the control group: the difference was 0.11 mmol/L (4.2 mg/dL) (90% confidence interval [CI], -0.02 to 0.24 mmol/L [-0.7 to 9.1 mg/dL]). The average reduction during the 1-year follow-up period was 0.09 mmol/L (3.6 mg/dL) greater in the intervention group (90% CI, -0.01 to 0.19 mmol/L [-0.3 to 7.5 mg/dL]). Eight percent of intervention patients were taking lipid-lowering medication at follow-up visits compared with 15% of control patients. In a subgroup analysis restricted to the 89% of returnees who were not taking lipid-lowering medication, the reduction in total cholesterol at 4-month follow-up was 0.14 mmol/L (5.5 mg/dL) greater in the intervention group (95% CI, 0.01 to 0.28 mmol/L [0.3 to 10.7 mg/dL]); averaged over 1 year, it was 0.14 mmol/L (5.3 mg/dL) greater (95% CI, 0.03 to 0.24 mmol/L [1.2 to 9.4 mg/dL]). Changes in LDL-C were similar. CONCLUSIONS: Total cholesterol and LDL-C decreased more in the intervention group than in the control group. Overall, the difference in lipid reduction between groups was modest and of borderline statistical significance; among participants who did not take lipid-lowering medication during follow-up, the difference in lipid reduction between groups was larger. We conclude that primary care clinicians can be trained to give a cholesterol-lowering intervention to low-income patients that results in modest, short-term reductions in total cholesterol and LDL-C.

Cholesterol, LDL↗
PubMedDate not supplied

Prosocial coping and substance use during pregnancy.

In structured interviews of pregnant inner-city residents, 38 substance users reported more current liking of drugs and polysubstance use, disengagement coping, depressive symptoms, negative affect, and antisocial behavior than did 45 nonusers. During videotaped interviews, trained observers coded less warmth and less prosocial information exchange (e.g., self-disclosure, question asking) among users. Factor analysis of measures of coping and its concomitants yielded a three-factor (prosocial, antisocial, asocial) solution, with asocial and antisocial coping predominating among substance users. These results suggest that coping has emotional, social, and cognitive elements. This study is the first to demonstrate an association between a substance-using lifestyle and limited prosocial information exchange.

Adaptation, Psychological↗
PubMedDate not supplied

ARISE: a method for engaging reluctant alcohol- and drug-dependent individuals in treatment. Albany-Rochester Interventional Sequence for Engagement.

A method, the Albany-Rochester Interventional Sequence for Engagement (ARISE), is described for engaging highly ambivalent alcohol- and/or drug-dependent individuals in treatment. A three stage interventional sequence is presented, which begins when a family member or concerned other contacts a treatment program regarding a substance abuser who needs help. At that point a process is set in motion for collaboration with significant others toward client enrollment. Staff move to the next stage in a graduated operating procedure if initial, less demanding efforts do not succeed. The final stage, if needed, is a modified Johnson Institute Intervention. The overall procedure is designed to maximize the probability of patient recruitment, while minimizing the amount of time and energy required of staff. The method compares favorably with results obtained with other approaches, such as coercion (legal, employer) and client self-referral.

Adult↗
PubMedDate not supplied

The ARISE Intervention. Using family and network links to engage addicted persons in treatment.

An alternative method to the Johnson Institute's "Intervention" is presented which, while incorporating many of Johnson's innovations, is, additionally: (a) less confrontative, thereby avoiding the reactivity in clients and family members that such confrontational approaches have tended to evoke; (b) takes into account both the needs of the chemically dependent person as well as the needs of the larger family and network system; and (c) aimed toward enrolling substance abusers in outpatient (as well as inpatient) treatment, thus placing it more in line with managed care priorities. Principles for treatment engagement are presented, accompanied by case examples. The approach is part of a more comprehensive model designed to maximize successful engagement with a minimum amount of professional time and effort.

Adult↗
PubMedDate not supplied

Endotoxemia after burn injury: effect of early excision on circulating endotoxin levels.

Serial circulating endotoxin measurements (quantitative chromogenic limulus assay) were performed in sera from 19 burned patients to determine the profile of circulating serial circulating endotoxin after burn and the effect of early wound excision on serial circulating endotoxin level. Results indicate an early endotoxemia with the peak serial circulating endotoxin levels 7 to 12 hours and 4 days after burn. More importantly, the level of circulating serial circulating endotoxin can be diminished by early excision; late wound excision was associated with a transient increase of serial circulating endotoxin level. Early excision, therefore, may play a critical role in limiting endotoxemia after burn injury.

Adult↗
PubMedDate not supplied

Evaluation of regional ventricular wall motion by ECG-gated CT.

A conventional whole body CT scanner equipped for electrocardiographic gating was used to evaluate regional left ventricular function and the findings were compared with a corresponding analysis by two-dimensional echocardiography and left ventriculography. Twenty-two patients between the ages of 40 and 77 years with a documented anterior or posterolateral myocardial infarction were studied together with a control group comprising 10 patients. The gated CT studies were obtained using three 1 cm levels selected through the mid, apical, and basal regions of the left ventricle. Qualitative analysis of segmental wall motion (p less than 0.0001) correlated with angiography in 82% and with two-dimensional echocardiography in 86% (p less than 0.0001). Computed tomography correctly identified the location of prior myocardial infarction in all but one patient. The results of this study suggest that gated CT may provide an accurate assessment of regional left ventricular function (for anterior and posterolateral myocardial infarction) and that this technique may prove to be clinically useful if these early results are confirmed by further experience.

Adult↗