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Biomedical subjects

P Messeri

Publications and source records attributed to P Messeri.

At least 19 recordsLinked to original sources
PubMed1999

Safer sex strategies for women: the hierarchical model in methadone treatment clinics.

Women clients of a methadone maintenance treatment clinic were targeted for an intervention aimed to reduce unsafe sex. The hierarchical model was the basis of the single intervention session, tested among 63 volunteers. This model requires the educator to discuss and demonstrate a full range of barriers that women might use for protection, ranking these in the order of their known efficacy. The model stresses that no one should go without protection. Two objections, both untested, have been voiced against the model. One is that, because of its complexity, women will have difficulty comprehending the message. The second is that, by demonstrating alternative strategies to the male condom, the educator is offering women a way out from persisting with the male condom, so that instead they will use an easier, but less effective, method of protection. The present research aimed at testing both objections in a high-risk and disadvantaged group of women. By comparing before and after performance on a knowledge test, it was established that, at least among these women, the complex message was well understood. By comparing baseline and follow-up reports of barriers used by sexually active women before and after intervention, a reduction in reports of unsafe sexual encounters was demonstrated. The reduction could be attributed directly to adoption of the female condom. Although some women who had used male condoms previously adopted the female condom, most of those who did so had not used the male condom previously. Since neither theoretical objection to the hierarchical model is sustained in this population, fresh weight is given to emphasizing choice of barriers, especially to women who are at high risk and relatively disempowered. As experience with the female condom grows and its unfamiliarity decreases, it would seem appropriate to encourage women who do not succeed with the male condom to try to use the female condom, over which they have more control.

Acquired Immunodeficiency Syndrome↗
PubMed1997

The application of meta-analysis in assessing racial differences in the effects of antihypertensive medication.

Meta-analysis is an important technique for synthesizing research findings. Although the statistical foundations of meta-analysis continue to be debated, few question its value as a rigorous framework for organizing literature reviews. In recent years, there has been increasing emphasis on the use of meta-analysis not only to summarize the central tendency of findings but also to explain variation between studies. This article reviews the major steps in a meta-analysis with an emphasis on comparative analysis of subgroups of studies. A meta-analysis of the antihypertensive efficacy of calcium channel blockers is used to illustrate how a comparative analysis can be applied to investigate racial variation in the effects of calcium channel blockers. A statistically significant trend is found between the proportion of African-American hypertensive subjects and the mean reduction in blood pressure. Meta-analytic techniques also are applied to explore possible confounders due to differences in research design and patient characteristics.

Age Factors↗
PubMed1993

Choosing optimal support groups: a review and reformulation.

There is considerable empirical research on the division of supportive and caregiving services among different network members. Yet the principles that govern the configuration of social support networks are still not well understood. Cantor's (1979) and Shanas' (1979) hierarchical-compensatory model and Litwak's (1985) task-specific model are among the more prominent formulations for explaining the choice of support groups. We propose that the former model is a special case of the latter one. The major conceptual features of both models are summarized here, followed by a qualitative review of 16 key empirical studies coupled with a meta-analysis to demonstrate the broader application of the task-specific model.

Caregivers↗
PubMed1990

A public health model for cardiovascular risk reduction. Impact of cholesterol screening with brief nonphysician counseling.

To examine the impact of cholesterol screening with brief nonphysician counseling on cardiovascular risk factors, 886 employees at a large financial services firm underwent fingerstick screening followed by brief (3- to 5-minute) counseling by a registered nurse. At the 6-month follow-up, there were significant declines in total cholesterol levels (5.9 to 5.5 mmol/L [228 to 213 mg/dL]), weight (78 to 75 kg), blood pressure (119/78 to 115/75 mm Hg), and number of people reporting smoking (16.8% to 14.5%) among participants with a baseline cholesterol value of 5.2 mmol/L (200 mg/dL) or greater. A randomized experiment was conducted on 137 participants initially classified as having a "borderline-high blood cholesterol" level (5.2 to 6.2 mmol/L [200 to 239 mg/dL]) to test the impact of frequency of follow-up. Those receiving frequent follow-up (cholesterol measurement and brief counseling at 2, 4, and 6 months) reported significantly greater dietary change and demonstrated a trend toward greater declines in total cholesterol compared with those receiving follow-up at 6 months only. The results of this study support the feasibility and efficacy of cholesterol screening utilizing brief nonphysician counseling on multiple cardiovascular risk factors and suggest an enhanced effect when patients receive more frequent follow-up.

Adult↗
PubMed1988

Differences in physician prevention practice patterns for white and minority patients.

A telephone survey of 120 randomly selected primary care physicians in New York City was completed in October, 1984 (response rate = 90%) concerning physicians' recommendations for health promotion and disease prevention. Responses from physicians with 50% or more Black and Hispanic patients were compared with responses from physicians with 50% or more White patients. The former were found to be less likely to follow guidelines from nationally recognized organizations for health promotion and disease prevention, although they were just as likely to value the importance of prevention in primary care. For example, physicians with predominantly Black and Hispanic patient populations were significantly less likely to recommend screening mammography (7% versus 23%) or recommend influenza vaccination for patients 65 or older (48% versus 74%) when compared with physicians with predominantly White patient populations. Factors that appeared to contribute to the difference in prevention practice patterns include physician training and education, the socioeconomic status of the patients, and the time physicians spend with patients. Differences in quality of preventive care provided to minority patients may be an additional factor in the disparity between the health status of White and non-White Americans.

Attitude of Health Personnel↗
PubMed1986

Drugs, lifestyle, and health: a longitudinal study of urban black youth.

The association of drug use with indicators of health status was studied in a representative sample of urban Black youth interviewed first in adolescence and then six to seven later in young adulthood. Seven substances, with interaction terms as appropriate, were tested against a psychophysical health scale and also against a more inclusive general health scale. Both measures of health outcomes yielded similar findings. Earlier inhalants use and, under certain conditions, methadone were linked to health change in males. Heroin had a delayed relationship to females' health. Additionally, methadone was associated with poorer health among young Black women who also were heavy alcohol drinkers. The observed relationships between drug use and health persisted after introducing controls for associated lifestyle factors.

Adolescent↗
PubMed1975

Dominance behavior: a phylogenetic analysis in the mouse.

Tube-dominance behavior differed significantly in C57BL/6By and BALB/cBy mice. Evaluation of these two inbred strains, and their recently developed recombinant inbred strains permitted the derivation of an hypothesis regarding possible genetic control of this behavior in mice. The results were analyzed by means of patristic matrices with accompanying phylogenetic tree analysis that marks the first occasion that such analysis has been used for a behavioral trait. Based on the data obtained and the statistical analyses and groupings of the various strains, the most satisfactory hypothesis that can be proposed at this time is one which assumes that dominance behavior, as measured in this experiment, is influenced genetically by at least 3 loci. Attempts to link these loci were not successful.

Aggression↗
PubMedDate not supplied

The effect of video interventions on improving knowledge and treatment compliance in the sexually transmitted disease clinic setting. Lesson for HIV health education.

Eight intervention studies investigating patient education and treatment adherence in the sexually transmitted disease (STD) clinic setting are reviewed. Across the eight studies selected for analysis, meta-analytic procedures were applied to compare the impact of educational and prevention approaches. The effect of video was compared with that of other modes of health education on: 1) knowledge and attitudes about STDs and condoms and 2) treatment compliance, as measured by return for test of cure, drug compliance, premature resumption of sexual activity, and condom coupon redemption rates. The largest effects were those for video on knowledge and attitudes about STDs and condoms, followed by the effects of other non-video interventions on STD knowledge. Lower effects were found among video and non-video interventions targeting treatment compliance outcomes. These results are consistent with prior prevention studies that have demonstrated difficulty in achieving behavior change.

Acquired Immunodeficiency Syndrome↗