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Biomedical subjects

J Guthrie

Publications and source records attributed to J Guthrie.

At least 19 recordsLinked to original sources
PubMed2005

Mental health treatments and associated factors amongst mid-aged Melbourne women.

The aim of this study was to describe lifetime treatment rate and the treatment modalities used for psychiatric problems and to identify variables associated with the history of psychiatric treatment among mid-aged Melbourne women.A longitudinal observational study was carried out using a population-based sample of 438 mid-aged women interviewed annually for eight years. The baseline data on sociodemographic profiles and premenstrual symptoms, and history of exposure to violence obtained at year 6 were included in this analysis. All other variables including psychiatric treatment history, psychosocial and lifestyle variables, chronic medical conditions and mood score were obtained at year 8. We found 22.2% of the women in this study had ever taken psychotropic medication. Antidepressants were the most used drugs. History of hospitalization for psychiatric problems was reported by 15 women (3.9%). 27 of 387 women (7%) reported they had received other types of treatment for psychiatric problems such as counseling or psychotherapy. Of all variables taken from the questionnaire about the treatment, only the history of psychotropic medication had a high enough frequency for regression analysis. History of psychotropic drug use was associated with interpersonal stresses, poor self-rated health, and prior history of depressive change during the premenstrual period. Socio-demographic variables, exposure to violence, lifestyle factors, and chronic physical conditions were not associated with psychotropic drug use.

Antidepressive Agents↗
PubMed2005

Self-reported arthritis and the menopause.

OBJECTIVES: To determine the prevalence of self-reported arthritis in a population-based cohort of mid-aged women and to identify health, social and lifestyle factors associated with self-reported arthritis. DESIGN: Cross-sectional population-based survey. METHOD: Data were obtained from a telephone-administered questionnaire of 2001 Australian-born women between 45 and 55 years old and residing in Melbourne. Information was collected on demographics, lifestyle factors and health conditions. RESULTS: The most commonly reported symptom in this cohort was aches and stiff joints, reported by 51.7% of the women; 34.4% of participants reported they had been diagnosed with arthritis. More postmenopausal women (39%) reported that they were diagnosed with arthritis compared to premenopausal women (27%, p < 0.001). Women who reported arthritis were more likely to be older (odds radio (OR), 1.09; 95% confidence interval (CI), 1.05-1.13), have a higher body mass index (OR, 1.04; CI, 1.02-1.07), be postmenopausal (OR, 1.88; CI, 1.33-2.66), have a higher negative mood (OR, 1.80; CI, 1.13-2.87), and report a decreased interest in sex (OR, 1.58; CI, 1.26-1.97). CONCLUSIONS: Aches and stiff joints are the most frequently reported symptom of mid-aged women. Reported arthritis is associated with postmenopausal status, age, body mass index, less interest in sex and lowered mood. Further longitudinal research is needed to determine the role of these factors in the development and impact of arthritis.

Arthritis↗
PubMed2002

The effects of the menopausal transition and biopsychosocial factors on well-being.

OBJECTIVE: The aim of this study was to determine whether women's well-being changed with the menopausal transition, and the effect on well-being of other biological, psychosocial and lifestyle factors. METHOD: A longitudinal observational study was carried out utilising a population-based sample of 438 mid-aged, Australian- born women. A total of 9 assessments were made at annual intervals. Mood was measured using the Affectometer 2. Mood, menopausal status, psychosocial and lifestyle variables and hormone levels were determined annually. 226 subjects who transited the natural menopausal transition were included in the analysis. RESULTS: As women pass from early in the menopausal transition to later in the transition, reporting at least 3 months of amenorrhoea, negative mood declines significantly, positive mood does not change and well-being significantly improves. Well-being scores are highly correlated over time, with early scores having a major effect on later scores. Well-being is also significantly affected by changes in marital status, work satisfaction, daily hassles and life events. CONCLUSIONS: Well-being improves as women enter the later stages of the menopausal transition and is also influenced significantly by psychosocial factors.

Affect↗
PubMed2002

Empty nest or revolving door? A prospective study of women's quality of life in midlife during the phase of children leaving and re-entering the home.

BACKGROUND: This study documents changes in household composition and effects on women's quality of life of children leaving and returning home. METHODS: A 9-year annual prospective study of a population-based sample of mid-aged Australian-born women who were premenopausal at baseline (N = 438) was conducted. Documentation was made of household composition and change, well-being, bothersome symptoms, daily hassles, feelings for partner and frequency of sexual activities. RESULTS: There was an increase in the number of women living alone, and a reduction in number of households in which there were children or parents. Each year > 25% of women reported a change in household composition. In the first year after the last child departed (N = 155), there was an improvement in women's positive mood and total well-being and a reduction in negative mood and the number of daily hassles. This improvement in mood was confined to those women who at baseline were not worried about children leaving home. In the first year after children return home there was a trend towards reduced frequency of sexual activities but no mood changes. CONCLUSIONS: For the majority of women, the departure of the last child from the household leads to positive changes in women's mood state and a reduced number of daily hassles. Return of offspring may have an adverse effect on sexual relating of the parents.

Adult↗
PubMed2001

Genomics: implications for toxicology.

The primary goal of the Environmental Genome Project (EGP) is the identification of human polymorphisms indicative of susceptibility to specific environmental agents. Despite evidence for a substantial genetic contribution to disease variation in the population, progress towards identifying specific genes has been slow. To date, most of the advances in our understanding of human diseases has come from genetic analyses of monogenic diseases that affect a relatively small portion of the population. The principal strategy of the EGP involves resequencing DNA samples from populations representative of the US racial and ethnic groups to develop a database of variations. Polymorphisms in specific genes may also be detected by gene-expression profiling. The identification of polymorphisms by resequencing is straightforward, and can be accomplished with minimal difficulty. Gene-expression profiling is still problematic; however, determining the functional significance of the allelic variations will be a monumental challenge involving sophisticated proteomics and population-based and animal model studies. These studies will change radically the practice of public health and clinical medicine, and the approach to the development of pharmaceuticals.

Genetic Predisposition to Disease↗
PubMed2001

Factors contributing to positive mood during the menopausal transition.

This study determined which variables affect women's positive mood state during the menopausal transition using nine prospective annual assessments of a population based sample of 267 Australian mid-aged women. Longitudinal data analysis carried out by analysis of covariance on Summary Statistics found that positive mood scores remained stable over time and were not related to natural menopausal transition, age, or education. In the early phase of the menopausal transition, positive mood was adversely influenced by baseline interpersonal stress (p = .009) and negative attitudes to aging (p = .026). The most important predictor of positive mood at the phase of late peri-/ postmenopause was positive mood in the premenopause (p = .000). Other factors affecting positive mood in the late peri-/postmenopause were changes in dysphoric symptoms (p = .000), major life events (p = .041), daily hassles (p = .014), marital status (p = .007), and work satisfaction (p = .001). Structural equation modelling found a goodness of fit index of .821.

Affect↗
PubMed2001

A bold new direction for environmental health research.

The biotechnology revolution has opened new opportunities for addressing current inadequacies in decision making regarding environmental health. Strategic investments need to be made (1) to develop high-throughput technologies that could accelerate toxicity testing and generate a mechanistic understanding of toxicity, (2) to incorporate individual susceptibility into risk assessments, and (3) to establish a rational basis for testing and regulatory decision making. New initiatives of the National Institute of Environmental Health Sciences, including the Environmental Genome Project and the Toxicogenomics Center, are discussed.

Decision Making↗
PubMed2000

Laboratory expenditure in Pegasus Medical Group: a comparison of high and low users of laboratory tests with academics.

AIMS: To determine, through the use of clinical vignettes, whether low and high cost users of laboratory tests in Pegasus Medical Group (Pegasus) differed in their choice of laboratory tests from academics as a means of further investigating issues relating to quality and cost in laboratory testing. METHODS: Seven clinical vignettes were drawn up and sent to 30 selected members in Pegasus whose actual laboratory expenditure per consultation ranged from a mean of $2.3 in a low cost group (15 members) to $12.2 in a high cost group (15 members). The vignettes were also sent to 15 general practitioner academics. Respondents were requested to complete a laboratory form as to which tests they would use for each individual scenario. The answers were analysed for overall cost as well as numbers of laboratory tests requested. RESULTS: There were 14 academic responses and 13 each from the bottom and top laboratory users. Overall results for the seven vignette cases showed that low cost laboratory users would spend a total of $176.3, the academics $188.8, and the high cost users $219.5 on the cases. The mean per case costs were $25.2, $27.0 and $31.4 respectively. There was a clear tendency for high volume users of tests in each vignette to be high in others suggesting that doctor rather than patient factors were the main explanation of the variation. CONCLUSIONS: Clinical vignettes do not appear to be a useful strategy in clarifying issues related to quality and cost in laboratory utilisation. Test ordering behaviour appears, from the international literature and this study, to be determined more by personal doctor factors than by objective evidence and clinical need. Further work is needed to clarify the relationship between quality and the wide variation observed in utilisation and expenditure.

Adult↗
PubMed2000

Ongoing research to identify environmental risk factors in breast carcinoma.

Environmental exposures, timing and duration of exposure, and one's genetic susceptibility all contribute to breast carcinoma and its progression. The purpose of this article was to identify known and suspected environmental causes of breast carcinoma, identify some environmental risk factors that may represent significant risk factors for certain groups, and describe current studies, supported by the National Institutes of Health/National Institute of Environmental Health Sciences, that clarify how environmental factors contribute to the development of breast carcinoma. Known and suspected environmental risk factors include organochlorine pesticides and other synthetic chemicals, hormonal factors (including exogenous endocrine disrupters), diet, tobacco and alcohol use, radiation, and magnetic fields. In at least 50% of breast carcinoma cases, none of the known risk factors apply. It is likely that an environmental component accounts for much of the unknown 50% of risk. Knowing the environmental factors for breast carcinoma development is an area that should be investigated intensely because it offers our best hope for prevention. Understanding why African-American women have a more aggressive form of breast carcinoma, whether they receive adequate follow-up treatment, and how these factors contribute to increased mortality rates requires further exploration. Data that demonstrate the lower incidence rate of breast carcinoma in Asian women, the relation to low fat diets and diets high in phytoestrogens, and how this might serve as a model for all women should be investigated. Finally, differences in behavioral and cultural attitudes, ethnicity, economic status, and life-style influences among different groups of women require further study to determine how these factors contribute to enhancing or reducing breast carcinoma risk.

Alcohol Drinking↗
PubMed1999

An evaluation of pharmaceutical management and budget holding in Pegasus Medical Group.

AIMS: To describe and evaluate pharmaceutical management, including budget holding, in Pegasus Medical Group (Pegasus), to determine savings being achieved, to analyse variation in prescribing behaviour and to compare the findings with national and international experience. METHODS: Trends in pharmaceutical expenditure of the 150 Pegasus' 208 members who had a continuous prescribing record for the three years ending December 1996 were compared with national trends. Expenditure per member, per consultation and per item were also analysed. RESULTS: Pegasus has implemented a comprehensive and classical pharmaceutical management strategy. This includes active personalised feedback, information sharing, peer review groups and information system development, all within an incentive framework of retained savings for new services. Although about 5% savings of total pharmaceutical expenditure were identified by the above method, the real level may be higher. Wide variation between members in their prescribing behaviour was explained almost entirely by the volume rather than the price of the drugs prescribed. Targeting of the volume issue is therefore likely to have a much more significant effect in reducing inappropriate variation. CONCLUSION: The results indicate that the achievements of Pegasus, as for other independent practitioner associations, go far beyond the modest level of pharmaceutical savings achieved. These include the development of a substantial infrastructure, peer review processes, new internal and external relationships and accountability for the management of both quality and cost in what may be styled clinical governance. Such achievements put Pegasus and other independent practitioner associations into a strong position to take on new initiatives including integration with secondary care.

Budgets↗
PubMed1998

Relationships between premenstrual complaints and perimenopausal experiences.

This study evaluates whether a history of menstrually-related problems, termed premenstrual complaints (PMCs), is a significant predictive marker for a more symptomatic perimenopausal experience. Two hundred and ninety-one randomly selected urban women, aged between 45 and 55 years were interviewed yearly for three consecutive years to record their individual experiences and changes as they progressed through the menopause transition. Repeated measures were obtained on a range of physical, psychological and social indicators. The experiences of women who reported a self-defined history of premenstrual complaints (n = 104) were compared with those women with no prior premenstrual problems (n = 187) and predictors of perimenopausal symptoms were assessed. Relationships were found between a prior history of both physical and psychological premenstrual complaints and a more symptomatic perimenopause characterised by dysphoria, skeletal, digestive and respiratory symptoms (all ps < 0.05). The more symptomatic women also reported pronounced interpersonal stress (p < 0.001), significant 'hassles', current smoking and low exercise (ps < 0.05). The findings support predictive relationships between a prior history of premenstrual problems and a more problematic menopause transition. The issues of vulnerability and help-seeking behaviors are discussed.

Cross-Sectional Studies↗
PubMed1997

Early predictors of functional independence 2 years after spinal cord injury.

OBJECTIVE: To determine: (1) how well factors measured at admission to an acute care facility predict functional independence measure (FIM) scores, use of personal care assistance, and wheelchair ownership 2 years after traumatic spinal cord injury (SCI); (2) the extent that factors measured during inpatient stay add to these predictions; and (3) if FIM scores differ through use of assistance and wheelchair ownership 2 years after SCI. DESIGN: Prospective, longitudinal. SETTING: Tertiary care acute, rehabilitation hospitals and home settings. PATIENTS: One hundred sixty SCI admissions. MAIN OUTCOME MEASURES: FIM, use of personal care assistance (yes/no), and wheelchair ownership (manual/electric/none) 2 years after SCI. RESULTS: Year 2 FIM scores were highly correlated (> or = .68) to the ASIA admission and discharge light touch, pin prick, and motor scores. Admission neurological status and age accounted for 65% of year 2 FIM score variance. Adding hospital events and the discharge ASIA motor score increased prediction to 76% of the variance. A separate regression model using only year 2 neurological scores and age accounted for 73% of the total FIM variance. Discriminant function analysis indicated 86% correct classification regarding use of personal care assistance and 88% correct classification of wheelchair ownership. Using a separate cross-validation sample, overall classification accuracy for assistance was 80% and wheelchair ownership 67%. FIM scores were significantly lower in assistance users (78 +/- 24) than nonusers (120 +/- 8) and were significantly different between wheelchair ownership groups: manual (103 +/- 21), electric (61 +/- 15), and none (125 +/- 2). CONCLUSIONS: Late disability can be predicted using early impairment measures. The FIM prediction from variables measured during the early treatment phase was as good as prediction based on concurrent measures.

Activities of Daily Living↗
PubMed1996

Air toxics regulatory issues facing urban settings.

Biomarker research does not exist in isolation. Its usefulness can only be realized when it is translated into prevention strategies to protect public health. In the context of air toxics, these prevention strategies begin with the development of regulatory standards derived from risk assessment schemes. The Clean Air Act Amendments of 1990 list 189 air toxics, including many volatile organics, metals, and pesticides. The National Institute of Environmental Health Sciences (NIEHS), through its affiliation with the National Toxicology Program, has generated toxicity and carcinogenicity data on more than 100 of these air toxics. The NIEHS extramural and intramural research portfolios support a variety of projects that develop and validate biomarkers for use in environmental health science and risk assessment. Biomarkers have a tremendous potential in the areas of regulating air toxics and protecting public health. Risk assessors need data provided by biomarkers of exposure, biomarkers of dose/pharmacokinetics, biomarkers of susceptibility or individual variability, and biomarkers of effects. The greatest benefit would be realized if biomarkers could be employed in four areas of primary and secondary prevention. The first is the use of biomarkers to enhance extrapolation of animal data to human exposure situations in establishing risk standards. The second is the use of biomarkers that assess noncancer, as well as cancer, end points. Important health end points include pulmonary dysfunction, immunotoxicity, and neurotoxicity. Third, biomarkers that serve as early waming signs to detect intermediate effects would enhance our ability to design timely and cost-effective intervention strategies. Finally, biomarkers used to evaluate the effectiveness of intervention strategies, both in clinical and regulatory settings, would enable us to ensure that programs designed to protect public health do, in fact, achieve the desired outcome.

Air Pollutants↗
PubMed1991

Glucocorticoid growth suppression response in 13762NF adenocarcinoma-derived Con8 rat mammary tumor cells is mediated by dominant trans-acting factors.

The in vitro and in vivo growth of Con8 cells, a single cell-derived subclone of the 13762NF-transplantable rat mammary adenocarcinoma, is strongly suppressed by glucocorticoid hormones. Hybrids were formed between glucocorticoid-suppressible Con8.hD6 mammary tumor cells (Con8 transfected with the histidinol dehydrogenase selectable marker) and either glucocorticoid-resistant 8RUV7 mammary tumor cells (derived from Con8) or MCT-HTC rat hepatoma cells. Both of the glucocorticoid-resistant 8RUV7 and MCT-HTC fusion partners express functional glucocorticoid receptors, since hormone-responsive genes such as plasminogen activator inhibitor are fully dexamethasone inducible. Karyotypic analyses revealed that the hybrid cell populations possessed the appropriate number of chromosomes for a fusion between the glucocorticoid-suppressible and either of the two resistant cell types. Moreover, Northern blots showed that the intertissue hybrids expressed transcripts for both the milk fat globule membrane protein gene originating from the parental Con8.hD6 mammary tumor cells as well as mouse mammary tumor virus glycoprotein sequences which had been transfected into the MCT-HTC hepatoma cells as a molecular tag. Analysis of DNA content and [3H]thymidine incorporation demonstrated that growth of both the intratissue (Con8.hD6 x 8RUV7) and intertissue (Con8.hD6 x MCT-HTC) hybrids was glucocorticoid suppressible, even though the absolute rates of proliferation differed depending on the parental cells. Analysis of conditioned medium isolated from glucocorticoid-treated and untreated Con8.hD6 cells indicated that the growth suppression response is not mediated through the elaboration of an extracellular growth inhibitor. Taken together, our results demonstrate that the glucocorticoid-suppressible phenotype of Con8 rat mammary tumor cells is dominant, suggesting the existence of intracellular regulatory factors under glucocorticoid control that may function as trans-acting suppressors of tumor cell growth.

Adenocarcinoma↗
PubMed1991

Growth and differentiation of pancreatic acinar cells: independent effects of glucocorticoids on AR42J cells.

Dexamethasone (DEX) inhibits growth and induces differentiation in rat pancreatic acinar AR42J cells. We wished to determine whether growth and differentiation are mutually exclusive in AR42J cells and whether DEX effects on growth and differentiation are mutually dependent or independent. Inhibition of DNA synthesis, assessed by [3H]thymidine incorporation, was detectable after 6 h, half-maximal after 12 h, and complete after 18-h DEX treatment, at which time incorporation was reduced to 9.0% of control. The half-maximal effective dose for inhibition of DNA synthesis was 0.5 nM, and maximal inhibition was achieved with 10 nM DEX. This dose-response was similar to that previously reported for DEX-induced parameters of differentiation. The rank order of potency for inhibition of DNA synthesis by various steroid hormones was DEX greater than corticosterone greater than aldosterone greater than progesterone. Hydroxyurea or serum starvation inhibited growth to the same extent as DEX but did not induce differentiation. Moreover, hydroxyurea or serum starvation did not block the ability of DEX to induce differentiation. Addition of either EGF or insulin significantly reversed the growth inhibitory effects of submaximal (1 nM) DEX. In cultures released from growth inhibition, 1 nM DEX increased cellular amylase content 5.9- to 6.5-fold, similar to the amylase increase in growth-inhibited cultures. Therefore, growth inhibition and differentiation are independent delayed events regulated by DEX in AR42J cells.

Adrenal Cortex Hormones↗