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Biomedical subjects

L E Duncan

Publications and source records attributed to L E Duncan.

17 recordsLinked to original sources

Sex, drugs, and hypertension: a methodological approach for studying a sensitive subject.

Sexual dysfunction is a recognized side effect of hypertension and antihypertensive medications in men, but is not established as a side effect in women, due to the lack of established methodology. An ambulatory medical record-based, case-control study was designed to study sexual function in treated and untreated hypertensive women and healthy controls. The research was performed in a teaching hospital with satellite clinics in upstate New York. There were 3312 medical records reviewed, 640 premenopausal Caucasian women in heterosexual relationships subjects were eligible for participatic diagnosis of mild hypertension (BP > or =140/90 mmHg and < 160/100 mmHg) for cases; no other significant medical history. A total of 241 women agreed to participate, 224 (35%) completed both a self-administered questionnaire and a telephone interview (112 healthy, 112 hypertensive). There was an initial 74% response rate among those eligible to participate, with 35% completing the entire study. Age and average blood pressure were not significant between 224 participants and 416 nonparticipants by 2-tailed t-test analysis. Seven composite variables were formed from a 47-item sexual response questionnaire. Initial unadjusted chi2 results reported women with hypertension had more difficulty than did healthy controls achieving lubrication and orgasm. Seven questions, each with the highest correlation to its respective composite variable (by Spearman's correlation), formed an abbreviated questionnaire. Quality of female sexual function was quantified in an ambulatory outpatient setting. A method was described to address hypertension, pharmacotherapy, and sexual functioning by employing self-administered questionnaires and telephone interviews. Initial analysis suggested that hypertensive women may have an impaired physiological sexual response. The abbreviated questionnaire generated from questions with the highest correlation to their respective composite variables may be useful in further evaluating this issue.

Adult↗

Does hypertension and its pharmacotherapy affect the quality of sexual function in women?

Considerable research has been conducted into the effects of antihypertensive drugs on male sexual functioning. This remains underexplored in women, even though almost half of treated hypertensives are women. An ambulatory medical record-based, case-control study was designed to study sexual function in treated and untreated hypertensive women and healthy controls. We conducted this study at a teaching hospital with satellite clinics in upstate New York. Of 3312 medical records reviewed, 640 premenopausal white women with or without mild hypertension (defined as blood pressure [BP] > or = 140/90 and < 160/110 mmHg), in heterosexual relationships, with no other significant medical history, were eligible. Of these, 241 women agreed to participate, and 224 (35%) completed both a self-administered questionnaire and a telephone interview. Analysis was conducted on 211 women (107 healthy controls, and 104 mild hypertensives, of whom 37 were unmedicated and 67 medicated). Questions on sexuality were classified into seven composite variables and later further divided. There were no demographic differences between participants and nonparticipants. Cases and controls differed only by age (P < .01); therefore, subsequent analysis was age-adjusted. Current smokers reported a significantly lower mean score for orgasm than did nonsmokers (P = .04). Women with unmedicated and medicated hypertension did not differ significantly on sexuality scores and were subsequently combined. Using age-adjusted ANOVA, women with hypertension reported significantly decreased lubrication and orgasm and increased pain compared to nonhypertensive women. There were no significant differences by ANOVA in the quality of sexual functioning between six treatment groups. In conclusion, the quality of female sexual functioning was quantified in an ambulatory outpatient setting. Hypertensive women, regardless of type of treatment, reported age-adjusted decrease in vaginal lubrication, less frequent orgasm, and more frequent pain when compared to nonhypertensive women. Emotional aspects of sexual functioning in hypertensive women do not appear to be impaired. These areas require further investigation. An incidental finding indicated diminished orgasm reported in current smokers, compared to nonsmokers, which was not associated with age or hypertension.

Adult↗

Personality and social change: individual differences, life path, and importance attributed to the women's movement.

This article identifies antecedent characteristics of individuals who found the women's movement important and then shows how finding it important was associated with personality change. Eighty-six women provided personality and life data as college seniors in 1958 or 1960, prior to the onset of the women's movement, and in 1981, after the movement gained momentum. A combination of openness, ambition, and dissatisfaction, as assessed by California Psychological Inventory (CPI; H. Gough, 1957/1966) in college, and subsequent life path from ages 28 to 43 significantly predicted importance attributed to the women's movement (IWM). On CPI scales, IWM was associated with significant increases on scales including Dominance, Self-Acceptance, Empathy, Psychological Mindedness, and Achievement via Independence. Correlates of IWM with self-reported feelings at ages 33 and 43 and observer-based personality ratings at age 43 supplemented analyses of personality change. Findings support the utility of examining the impact of social change on personality.

Adult↗

Traits and motives: toward an integration of two traditions in personality research.

After reviewing classic and current conceptions of trait (as measured by questionnaires) and motive (as measured by the Thematic Apperception Test [TAT] or other imaginative verbal behavior), the authors suggest that these 2 concepts reflect 2 fundamentally different elements of personality--conceptually distinct and empirically unrelated. The authors propose that traits and motives interact in the prediction of behavior: Traits channel the behavioral expression of motives throughout the life course. The authors illustrate this interactive hypothesis in 2 longitudinal studies, focusing on the broad trait of extraversion and the 2 social motives of affiliation and power. In interaction with extraversion, both motives show predicted and replicated relations to independently measured life outcomes in the domains of relationships and careers. Extraversion facilitates unconflicted motive expression, whereas introversion deflects social motives away from their characteristic goals and creates difficulties in goal attainment.

Adult↗

Family status, preference for sport aggressiveness, and sport fan motivation.

This study tested two hypotheses involving the use of sport spectating as an opportunity to spend time with one's family. First, it was hypothesized that scores on Family Motivation would be higher for fans who were married or had children than for unmarried fans without children. Second, it was predicted that among sport fans who were married or had children, those preferring a Nonaggressive sport would report higher scores on Family Motivation than those preferring an Aggressive sport. Analysis confirmed the first hypothesis while refuting the second.

Adolescent↗

The intersection of life stage and social events: personality and life outcomes.

Two studies examined the intersection of life stage with the experience of social events. Study 1 tested whether social events coinciding with early adulthood are more meaningful to individuals than events during other life stages (K. Mannheim, 1972; A. J. Stewart & J. M. Healy, 1989). In 4 of 5 samples of college-educated women (3 age cohorts), the hypothesis was supported. Study 2 examined the impact of the women's movement on the personalities and careers of women who experienced the movement during early adulthood versus early middle adulthood. Women in both cohorts who found the movement meaningful attained higher education, work status, and income levels; were employed in upwardly mobile careers; and were more assertive and self-confident at midlife than women who found the movement less important. Consistent with hypotheses, finding the women's movement meaningful was associated with personality change in the older cohort.

Adult↗

Investigation of an outbreak of typhoid fever in two settlements near Port Moresby.

From November 1985 to February 1986 two unplanned settlements near Port Moresby experienced a small person-to-person outbreak of typhoid fever, which included one death. Investigation showed that of the 20 individuals who were diagnosed as either ill, culture positive or a carrier, 15 were related by blood, marriage or through shared living quarters. The remaining 5 lived in the same house, but were not related to the larger group. Drinking water was contaminated with coliforms, but was not implicated. The outbreak resolved with no additional cases after February 1986. Outbreaks of this nature highlight the need for continuing public health education for local health officers in contact tracing, field testing and transportation of specimens, and epidemiological skills in ivestigating person-to-person outbreaks. They also make a strong case for public health laboratories equipped to perform rapid, comprehensive pathological examination of specimens collected during any outbreak of infectious illness.

Adolescent↗

Tuberculin sensitivity and HIV-1 status of patients attending a sexually transmitted diseases clinic in Lusaka, Zambia: a cross-sectional study.

A cross-sectional study to estimate the prevalence of latent tuberculosis (TB) in a group of Zambians at high risk of human immunodeficiency virus type 1 (HIV-1) infection and to examine the effect of HIV-1 infection on the tuberculin response was conducted in the University Teaching Hospital in Lusaka, Zambia during July to September 1990. Patients were selected from those presenting to the out-patient clinic for first referral with either sexually transmitted or skin disease. 268 adults were included in the study; 158 (59%; 95% confidence interval [CI] = 53-65%) were HIV-1 antibody positive. Of 82 HIV-1 negative participants who returned for Mantoux skin test reading, 51 (62%; 95% CI = 57-67%) had a positive test reaction (diameter > or = 10 mm) after receiving 2 units of RT-23 tuberculin. Of 106 HIV-1 positive participants who returned, only 32 (30%; 95% CI = 26-34%) had a diameter > or = 10 mm. Nine (28%) of the HIV-1 positive and Mantoux positive participants had large reactions > or = 30 mm, compared to 4 (8%) of the HIV-1 negative, Mantoux positive participants (P = 0.03). Results in the HIV-1 negative group indicated a prevalence of latent TB of 62% in this population. HIV-1 infection was associated with a much higher frequency of negative response to tuberculin and with a few large skin test responses. Thus, in populations where HIV seropositivity is high, Mantoux skin tests cannot be used to assess those with latent TB who might benefit from chemoprophylaxis.

AIDS-Related Opportunistic Infections↗