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Biomedical subjects

P Pirie

Publications and source records attributed to P Pirie.

14 recordsLinked to original sources
PubMed1992

Cholesterol screening by primary care pediatricians: a study of attitudes and practices in the Minneapolis-St Paul metropolitan area.

A telephone survey of the 197 board-certified pediatricians actively engaged in primary care in the Minneapolis-St Paul metropolitan area was conducted to assess their cholesterol screening practices and hypercholesterolemia management. The response rate was 95%. Nearly all the pediatricians (90%) do some cholesterol screening, with the majority (58%) screening only children with a strong family history of coronary heart disease. Though only 33% screen all their patients, 66% advocate universal pediatric screening. Most of the pediatricians indicated they would manage hypercholesterolemia patients themselves, nearly always with dietary means. Despite their strong support for screening, the pediatricians expressed skepticism about the significance of childhood cholesterol level as a predictor of adult cardiovascular disease and doubted their effectiveness in getting patients to adopt a cholesterol-reducing diet. Their definition of elevated total cholesterol level in childhood was consistent with published recommendations, but only 29% could define elevated low-density lipoprotein cholesterol level. The pediatricians expressed strong opposition to pediatric cholesterol screening in schools or in any setting other than clinics and hospitals.

Attitude of Health Personnel↗
PubMed1991

Effects of nicotine gum on prevalence and severity of withdrawal in female cigarette smokers.

This study examines the extent to which 2 mg nicotine gum reduces the prevalence and severity of cigarette withdrawal signs and symptoms. The sample was comprised of women who were randomly assigned to chew 2 mg nicotine gum (N = 206) or no nicotine gum (N = 211). Signs and symptoms of withdrawal were assessed at days 2, 7, 14, and 28 post-cessation. The results showed a significant effect of 2 mg nicotine compared to no gum at 2 days post-cessation on the prevalence of the following symptoms: anxious/tense, difficulty concentrating, restless, impatient, somatic symptoms, insomnia, increased eating, and drowsiness. There were additional differences between the two groups for the severity of craving for cigarettes, irritable/angry, excessive hunger, and total withdrawal score. Over the course of 28 days post-cessation, significant Group and/or Group x Time interaction effects were found with regard to the severity of signs and symptoms for the following variables: impatient, insomnia, increased eating, irritable, difficulty concentrating, restless, somatic complaints, and total withdrawal score. These results are similar to those obtained from placebo-controlled trials for nicotine gum.

Adult↗
PubMed1990

Type A behavior and its association with cardiovascular disease prevalence in blacks and whites: the Minnesota Heart Survey.

Population-based surveys were conducted in 1985 and 1986 to measure the prevalence of coronary heart disease (CHD) history and risk factors in Black and White adults. Type A behavior was measured by the Jenkins Activity Survey (JAS). JAS scores were associated with age (negatively), education (positively), and sex (men greater than women) but were largely unrelated to CHD risk factors. Blacks had significantly lower age- and education-adjusted Type A and component scores than Whites, more so for men than women. Univariate analysis indicated that a history of angina and/or heart attack was positively associated with the Type A score in both Blacks and Whites. Following adjustment for known cardiovascular risk factors, Type A score remained positively and significantly associated with CHD prevalence. These findings are consistent with other cross-sectional studies and suggest that Type A behavior, as measured by the JAS, may increase the risk of CHD in both Blacks and Whites. Follow-up of these cohorts may help to clarify the complex relationship of Type A behavior to the risk of CHD.

Adult↗
PubMed1990

Patterns of self-initiated smoking cessation among young adults.

Prochaska and DiClemente's (1984) cyclic-stage model of self-initiated smoking cessation divides the cessation process into five stages. This model was applied to a young adult population to determine the cross-sectional distribution of stages and the frequency and pattern of changes among stages over time. Compared to older adults, the distribution of the stages differed substantially: There were twice as many relapsers and only half as many maintainers among young adults. One-year changes in stages were examined using a static model, which did not take into account the cyclic nature of the change process, and a more realistic dynamic model, which did. Both models, especially the dynamic model, suggested substantially more movement among stages in younger than in older adults.

Adolescent↗
PubMed1990

Hypertension prevention trial: do 24-h food records capture usual eating behavior in a dietary change study?

The Hypertension Prevention Trial (HPT) was a randomized unmasked multicenter trial designed to address questions concerning the feasibility and efficacy of dietary intervention in the primary prevention of hypertension. Participants in the diet treatments were given counseling to achieve and sustain changes in calorie, sodium, and/or potassium intake. Diet composition, sodium and potassium excretion, and body weight were assessed for all participants at 6-mo intervals over 3 y. This paper provides information about extent and possible sources of bias in the dietary assessment methodology used in the HPT. Estimates of nutrient intake were derived from food records, urinalysis, and measurement of body weight. Reported potassium intake increased and sodium intake declined to a greater degree during the study than did potassium and sodium excretion. Our results indicate that repeated assessments of diet, which depend upon participant recording, may not accurately represent usual diet in a dietary trial.

Adult↗
PubMed1990

Parent involvement in cigarette smoking prevention: two pilot evaluations of the "Unpuffables Program".

Efforts to prevent the onset of cigarette smoking with young adolescents have been primarily successful in delaying onset, particularly with classroom curricula that emphasize social competencies. Maintenance of these reductions has been difficult to sustain into later adolescence, suggesting the need for programs to complement and supplement curricula. Since one group of adolescents more difficult to influence are those whose parents smoke, parental involvement in smoking prevention may be a powerful enhancer. This paper describes the "Unpuffables Program," an activity package program around smoking, for preadolescents and their parents. Two pilot evaluation studies in Minnesota and Massachusetts focus on the feasibility of and receptivity to the "Unpuffables Program." High awareness and participation rates were found in both settings. The program appears to provide an opportunity for smoking to be discussed at home, motivating smokers to consider cessation, and reinforcing nonsmoking parents' attitudes and behaviors.

Adult↗
PubMed1989

Five- and six-year follow-up results from four seventh-grade smoking prevention strategies.

Seven thousand one hundred twenty-four members of the Classes of 1985 and 1986 who had participated as seventh graders in one of several smoking prevention programs were tracked and surveyed for smoking habits at 5- and 6-year follow-up: participation exceeded 90% in both cohorts. These data indicated that participants who received seventh-grade interventions based on the social influences model had similar smoking patterns compared to participants in other conditions. This finding supports the call for booster sessions after the initial seventh-grade intervention program. Future follow-up studies will assess whether the earlier benefits associated with the social influences model will translate into measurable differences in adult smoking patterns.

Adolescent↗
PubMed1988

Four- and five-year follow-up results from four seventh-grade smoking prevention strategies.

Recent studies have suggested that a prevention program that addresses the social influences that encourage smoking can be effective in deterring cigarette use by adolescents. This study presents 4- and 5-year follow-up results from two studies which evaluated three variations of this social influences model and compared them to a health consequences program and an existing-curriculum condition. The results suggest that a seventh-grade program, built around the social influences model and taught jointly by same-age peer leaders and local classroom teachers, may reduce 4-year weekly- and daily-smoking cumulative incidence rates, providing the first evidence for any long-term effects for the social influences model. However, the results also suggest that any long-term effects from such interventions are probably limited and may depend heavily on the manner in which the social influences model is translated during the intervention. Additional follow-up studies are needed to clarify the long-term effects of these intervention programs.

Adolescent↗
PubMed1988

Lean meats make the grade--a collaborative nutrition intervention program.

Lean Meats Make the Grade is a collaborative nutrition intervention program involving the Minnesota Heart Health Program (MHHP), the Minnesota Beef Council, and the Pork Producers Council. The purposes of this program were to educate consumers about identification of leaner cuts of meat, low-fat preparation methods, and selection of appropriate meat portion size. Program components included training for meat managers, taste testing for consumers, recipes and customer information brochures, and labels on individual meat packages to assist in the identification of leaner cuts of meat. The program was implemented through grocery stores in two of the towns selected for MHHP intervention. Population-based telephone surveys indicated that respondents in the intervention towns were more aware of the lean meats program than those in the comparison communities. Knowledge of lean cuts of meat and low-fat preparation methods also increased as a result of the program. Independently collected sales data from five participating and two control stores provided some indications of a greater interest in lean cuts and 80% lean ground beef as a result of the intervention program. Programs such as this have potential for community-wide nutrition education.

Animals↗
PubMed1987

Relationships among type A behavior, employment experiences, and gender: the Minnesota Heart Survey.

Previous studies indicate that Type A behavior is more prevalent among men than women. This sex difference may reflect variations in men's and women's job experiences, some of which may act as catalysts for Type A behavior. This study examines the relationship of Type A behavior (measured by the Jenkins Activity Survey) to men's and women's work hours, occupational mobility, and job-related interactions, using data from a population-based survey of 2512 employed men and women conducted in Minneapolis-St. Paul, Minnesota, between 1980 and 1982. Among both sexes, Type A behavior is related to long work hours, high occupational mobility, and nonsupportive interactions with co-workers, all job experiences more common for men than for women. No sex differences are found in the relationships between Type A behavior and these job experiences. Also, no sex difference is observed in the unadjusted Type A scores or in these scores when either age, education, or marital status is taken into account. The expected direction of the sex difference in Type A behavior is reversed when work hours are controlled: women have a higher Type A score than men when work hours are considered.

Adult↗
PubMed1987

Recruitment in the Coronary Artery Disease Risk Development in Young Adults (Cardia) Study.

Coronary Artery Disease Risk Development in Young Adults (CARDIA) is a longitudinal study designed to trace the development of risk factors for coronary heart disease in 5100 individuals 18-30 years old. The study will compare, by cross-sectional and longitudinal analyses, trends and processes involved in risk factor development by sex, race, age, and other sociodemographic characteristics. Participants for the approximately 4 1/2-hour baseline examination were randomly selected and recruited by telephone from census tracts in Minneapolis and Chicago, by telephone exchanges within the Birmingham city limit, and from lists of the Kaiser-Permanente Health Plan membership in Oakland and Berkeley. A major issue was the desirability of sampling approximately equal numbers by age, race, sex, and education as compared with sampling numbers representative of the population base. The recruitment goal of 5100 was achieved on schedule.

Adolescent↗
PubMed1986

Marital status and cardiovascular risk: the Minnesota Heart Survey and the Minnesota Heart Health Program.

The relationship between marital status and cardiovascular risk was examined among 7,849 midwestern men and women in a community-based study. Separated/divorced persons report the highest rates of hospitalization for heart attack/stroke. Married and widowed persons report lower and intermediate rates, respectively, of such hospitalization. Never-married persons report hospitalization as low or lower than those of married persons. Analysis of specific risk characteristics suggests that different marital groups would benefit from different primary prevention programs. Separated/divorced persons report higher levels of smoking, drinking, and physical activity than married persons. Married men, however, have higher levels of total cholesterol and lower levels of serum high-density lipoprotein cholesterol. Characteristics of never-married persons tend to resemble those of the married, particularly at older ages; widows and widowers tend to have risk characteristics intermediate between those who are married and those who are separated/divorced. Findings indicate that marital status is important in identifying, understanding, and altering behavior known to increase risk for cardiovascular disease.

Adult↗
PubMed1986

Population strategies to enhance physical activity: the Minnesota Heart Health Program.

A population-wide, community-based program in cardiovascular disease prevention, the Minnesota Heart Health Program (MHHP), has been designed to promote more frequent and vigorous physical activity in North American communities, along with improved eating and smoking patterns. The physical activity component of this broad-based education strategy is based on the facilitation which physical activity provides to lowering of other risk characteristics for heart disease and its enhancement of other healthy behaviors and on the potential for prevention of elevated risk in the first place. The rationale for a population strategy to complement medical approaches to prevention is that exercise patterns are largely socially learned and culturally determined. The MHHP Physical Activity Program is implemented through three major education strategies: direct education, community organization, and mass communications. Early results from this 10-year project indicate that it is feasible to enter U.S. communities and to involve their leadership actively in MHHP activities of health promotion. Moreover, attitudes, knowledge, awareness, participation, and behaviors related to exercise and eating patterns appear to be changed by the program. Nevertheless, there are problems in the design, implementation, analysis and interpretation of population changes in physical activity and other health behaviors in community demonstration programs. These issues, along with their solutions, should provide useful information for medical science and for the public health about population strategies of disease prevention and health promotion.

Adolescent↗