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Biomedical subjects

M C McIntosh

Publications and source records attributed to M C McIntosh.

9 recordsLinked to original sources
PubMed2001

Unusual reagent control of diastereoselectivity in the 1,2-addition of hard carbon nucleophiles to C(6)-heteroatom substituted cyclohexenones.

[reaction: see text] A surprising and synthetically useful counterion-dependent reversal of diastereoselectivity was found in 1,2-additions of hard carbon nucleophiles to C(6)-heterosubstituted cyclohexenones. In general, Grignard reagents added syn to the C(6)-substituent and Li reagents added anti, although some exceptions were found. Selectivities could be increased in some cases by appropriate choice of solvent and/or cosolvent.

Antineoplastic Agents, Phytogenic↗
PubMed1997

Reducing alcohol consumption. Comparing three brief methods in family practice.

OBJECTIVE: To compare the effects of three brief methods of reducing alcohol consumption among family practice patients. DESIGN: Patients randomly assigned to one of three interventions were assessed initially and at 3-, 6-, and 12-month follow-up appointments. SETTING: Family practice clinic composed of 12 primary care physicians seeing approximately 6000 adults monthly in a small urban community, population 40,000. PARTICIPANTS: Through a screening questionnaire, 134 men and 131 women were identified as hazardous drinkers (five or more drinks at least once monthly) during an 11-month screening of 1420 patients. Of 265 patients approached, 180 agreed to participate and 159 (83 men and 76 women) actually participated in the study. INTERVENTIONS: Three interventions were studied: brief physician advice (5 minutes), two 30-minute sessions with a physician using cognitive behavioural strategies or two 30-minute sessions with a nurse practitioner using identical strategies. MAIN OUTCOME MEASURES: Quantity and frequency (QF) of drinking were used to assess reduction in hazardous drinking and problems related to drinking over 12 months of follow up. RESULTS: No statistical difference between groups was found. The QF of monthly drinking was reduced overall by 66% (among men) and 74% (among women) for those reporting at least one hazardous drinking day weekly at assessment (N = 96). Men reported drinking significantly more than women. CONCLUSIONS: These results indicated that offering brief, specific advice can motivate patients to reduce their alcohol intake. There was no difference in effect between brief advice from their own physician or brief intervention by a physician or a nurse.

Adult↗
PubMed1994

Screening for hazardous drinking. Using the CAGE and measures of alcohol consumption in family practice.

OBJECTIVE: To determine the drinking practices of a family practice population, to examine the CAGE and questions about drinking as a method of screening for hazardous alcohol use, and to examine the relationship between alcohol consumption and CAGE items, particularly in a subgroup of hazardous drinkers. DESIGN: Random survey of patients representative of a clinic population. SETTING: Family practice clinic. PATIENTS: Of 1420 patients approached while waiting to see a family physician for medical reasons, 1376 agreed to participate; 1334 turned in usable questionnaires. MAIN OUTCOME MEASURES: Drinking measures and CAGE items; CAGE questions and levels of alcohol use were used to determine current drinking practices. A subgroup of hazardous drinkers was examined in greater detail. RESULTS: Forty percent of male patients and 11% of female patients reported at least one "hazardous" drinking (four or more drinks) day in the past month. Answering yes to CAGE items was more specific to drinking for male subjects, who also reported a greater number of maximum drinks with a CAGE score of 2 or more. CONCLUSIONS: This brief questionnaire was a feasible tool for identifying family practice patients who could be at risk for developing alcohol problems. All patients could be invited to complete the questionnaire while waiting for their appointments.

Adolescent↗
PubMed1985

Lifestyle assessment: applying microcomputers in family practice.

A randomised trial of assessment by computer was conducted with 180 patients in a family practice clinic. Histories of alcohol, tobacco, and drug use were obtained by computer (n = 60), interview (n = 60), or self completed questionnaire (n = 60). The results of previous research suggest that some patients may provide more accurate information about "sensitive" problems to a computer. No significant differences, however, in levels of consumption or problems were reported for the three methods of assessment. Patients gave differential ratings about the method of assessment, with the computer rated as more interesting but also more mechanical, cold, and impersonal. Although the interview was initially preferred by most, patients who completed the assessment by computer showed a significant increase (13% to 43%) in their preference for the computer after the assessment. The results of our study indicate that patients' acceptance of computers in family practice may be favourably influenced by direct experience with a microcomputer.

Computers↗
PubMed1985

Lifestyle assessment: just asking makes a difference.

A 10 minute assessment of 180 family practice patients showed that 11% indicated a problem with drinking alcohol, 20% with cigarette smoking, 36% with consumption of coffee or tea, and 3% with non-medical drug use, while 11% wanted to discuss their use of medications. Moreover, being asked questions resulted in a twofold or threefold increase in the patients' intentions of discussing such a problem with their doctor. Although there was good overall agreement in recognising a problem between the patient and doctor, in roughly 40% of instances where the patient indicated a problem the doctor was unaware of it. These patients tended to be young, well educated, and employed in professional occupations, and were on their first visit to the doctor. Such brief assessments of lifestyle should be routinely conducted in family practice for both case finding and prevention.

Adolescent↗
PubMed1984

Moderate drinking: an alternative treatment goal for early-stage problem drinking.

Family physicians are in a particularly good position to identify problem drinking in its early stages through the recognition of various psychosocial and medical indicators. Thorough history-taking or the use of a specific questionnaire should provide confirmation. Patients so identified can then be offered treatment designed to help them moderate their drinking, if not to achieve abstinence. The treatment strategy described in this paper involves specifying a safe drinking pattern, instructing the patient in the use of aids to appropriate drinking and seeing the patient at 1- to 2-month intervals for follow-up assessment. In a pilot study of this strategy 16 of 17 patients reduced their drinking substantially, and 8 were abstinent at the last follow-up visit. Only 1 of the 17 dropped out of treatment; the high rate of compliance may have been primarily due to the patient's need to see the family physician for other problems. Visits to the family physician for other medical problems provide an opportunity to motivate patients to continue monitoring their drinking.

Activities of Daily Living↗