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Biomedical subjects

L Dickey

Publications and source records attributed to L Dickey.

7 recordsLinked to original sources
PubMed1997

The Solution Method: 2-year trends in weight, blood pressure, exercise, depression, and functioning of adults trained in development skills.

This study describes changes observed during a 2-year period in participants enrolled in The Solution Method, a developmental skills training program for adult weight management. This intervention is the adult application of a model of treatment previously used only in the management of pediatric obesity (The Shapedown Program). Developmental skills training integrates understandings and methods from developmental, family systems, biomedical, genetic, and behavioral theories of the etiology of obesity. Twenty-two subjects (mean age = 43.4 +/- 8.5 years and mean body mass index = 33.1 +/- 5.3) completed a group intervention based on this method, which was conducted by a registered dietitian and a mental health professional. Questionnaire responses indicated the extent to which their weight was a medical and/ or psychosocial risk. Subjects attended 2-hour weekly sessions for an average of 18 weeks during which they were trained in six developmental skills: strong nurturing, effective limits, body pride, good health, balanced eating, and mastery living. Data, which were collected at the beginning of treatment and at 3, 6, 12, and 24 months, included weight, blood pressure, 7-day exercise recalls, and responses to depression and functioning (psychosocial, vocational, and economic) questionnaires. Participants' weights decreased throughout the 2-year period of the study: mean weight change was -4.2 kg (3 months), -6.0 kg (6 months), -7.0 kg (12 months), and -7.9 kg (24 months). In addition, compared with baseline values, systolic and diastolic blood pressure, exercise, and depression improved throughout the study period. These improvements were statistically significant at 24 months for weight (P < .01), systolic blood pressure (P < .02), diastolic blood pressure (P < .001), and exercise (P < .001); the results were not statistically significant for depression. Most participants reported improvement in a broad range of aspects of functioning. We conclude that this application of developmental skills training for adult weight management may produce significant long-term beneficial effects.

Adult↗
PubMed1996

An office system for organizing preventive services: a report by the American Cancer Society Advisory Group on Preventive Health Care Reminder Systems.

Despite increasing recognition of the importance of preventive services, such services are not provided in primary care practice as often as recommended. One of the most important reasons is the lack of a systematic, organized approach within practices. The American Cancer Society Ad Hoc Advisory Group on Preventive Health Care Reminder Systems reviewed evidence-based reports and expert opinion to summarize current knowledge about office systems for clinical preventive services. This article describes the process of developing an office system for preventive care, beginning with writing a practice policy, auditing charts for baseline performance, developing and implementing a plan for efficient delivery of preventive care, involving office staff, and monitoring progress. Strategies for dissemination of this approach to a wide range of primary care practices may involve professional medical organizations and managed care companies.

Ambulatory Care Information Systems↗
PubMed1995

Put prevention into practice: a systematic approach.

Use of a systematic program, such as Put Prevention Into Practice (PPIP), to improve the delivery of clinical preventive services by public health nurses is recommended. The Public Health Service, a part of the U.S. Department of Health and Human Services, designed PPIP to help achieve the goals of Healthy People 2000. PPIP is a research-based team approach using a kit of materials targeted at patients, providers, and the office/clinic system. It includes pocket-sized patient booklets, a Clinician's Handbook of Clinical Preventive Services, posters for the waiting and examination rooms, flowcharts and alert stickers for medical records, prescription pads, and reminder postcards. Sources of the materials, implementation and evaluation strategies, and groups implementing the program are discussed.

Delivery of Health Care↗
PubMed1986

DNA fragmentation and cytotoxicity from increased cellular deoxyuridylate.

Previous results from this laboratory have shown that thymidylate deprivation results in dramatic elevation of intracellular dUTP and incorporation of dUMP into DNA. The goal of the present studies was to determine whether the latter changes may play a part in the associated cytotoxicity ("thymineless death"), which is ordinarily assumed to be a direct result of reduced intracellular dTTP. The approach used here was to increase intracellular dUTP without allowing dTTP to diminish and observe the effects on cell viability. dUMP pools were expanded by exposure of cells to deoxyuridine [in cell growth medium containing hypoxanthine, methotrexate, and thymidine (HAT medium)], resulting in accumulation of dUTP to levels that approached those of dTTP, which were at, or higher than, the levels in untreated cells. In conjunction with this the cells became nonviable, and newly synthesized DNA was fragmented, both of which occur with thymidylate depletion and, we assume, result from the active process of excision repair at the many uracil-containing sites in DNA. The results indicate that, although the relative importance of low dTTP remains unknown, elevated dUTP can account for the cytotoxicity caused by thymidine starvation. Most of the "dTTP" measured by the DNA polymerase assay in cells treated with methotrexate (MTX) (plus purine supplement) was, in fact, dUTP, which may explain some previous observations of only modest depression of dTTP in cells treated with MTX or similarly acting drugs.

Animals↗