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Biomedical subjects

R Lowry

Publications and source records attributed to R Lowry.

At least 37 records · Page 2Linked to original sources
PubMed1998

Youth risk behavior surveillance--United States, 1997.

PROBLEM/CONDITION: Priority health-risk behaviors, which contribute to the leading causes of mortality and morbidity among youth and adults, often are established during youth, extend into adulthood, and are interrelated. REPORTING PERIOD: February-May 1997. DESCRIPTION OF THE SYSTEM: The Youth Risk Behavior Surveillance System (YRBSS) monitors six categories of priority health-risk behaviors among youth and young adults--behaviors that contribute to unintentional and intentional injuries; tobacco use; alcohol and other drug use; sexual behaviors that contribute to unintended pregnancy and sexually transmitted diseases (STDs) (including human immunodeficiency virus [HIV] infection); unhealthy dietary behaviors; and physical inactivity. The YRBSS includes a national school-based survey conducted by CDC as well as state, territorial, and local school-based surveys conducted by education and health agencies. This report summarizes results from the national survey, 33 state surveys, 3 territorial surveys, and 17 local surveys conducted among high school students from February through May 1997. RESULTS AND INTERPRETATION: In the United States, 73% of all deaths among youth and young adults 10-24 years of age result from only four causes: motor vehicle crashes, other unintentional injuries, homicide, and suicide. Results from the national 1997 YRBSS demonstrate that many high school students engage in behaviors that increase their likelihood of death from these four causes--19.3% had rarely or never worn a seat belt; during the 30 days preceding the survey, 36.6% had ridden with a driver who had been drinking alcohol; 18.3% had carried a weapon during the 30 days preceding the survey; 50.8% had drunk alcohol during the 30 days preceding the survey; 26.2% had used marijuana during the 30 days preceding the survey; and 7.7% had attempted suicide during the 12 months preceding the survey. Substantial morbidity among school-age youth, young adults, and their children also result from unintended pregnancies and STDs, including HIV infection. YRBSS results indicate that in 1997, 48.4% of high school students had ever had sexual intercourse; 43.2% of sexually active students had not used a condom at last sexual intercourse; and 2.1% had ever injected an illegal drug. Of all deaths and substantial morbidity among adults > or = 25 years of age, 67% result from two causes--cardiovascular disease and cancer. Most of the risk behaviors associated with these causes of death are initiated during adolescence. In 1997, 36.4% of high school students had smoked cigarettes during the 30 days preceding the survey; 70.7% had not eaten five or more servings of fruits and vegetables during the day preceding the survey; and 72.6% had not attended physical education class daily. ACTIONS TAKEN: These YRBSS data are already being used by health and education officials to improve national, state, and local policies and programs to reduce risks associated with the leading causes of morbidity and mortality. YRBSS data also are being used to measure progress toward achieving 21 national health objectives and 1 of the 8 National Education Goals.

Accidents↗
PubMed1998

Weapon-carrying, physical fighting, and fight-related injury among U.S. adolescents.

INTRODUCTION: Access to firearms and other weapons has been cited as an important factor contributing to the rise in violence-related injury among adolescents in the United States. METHODS: Data from the Youth Risk Behavior Survey supplement to the 1992 National Health Interview Survey were analyzed to examine relationships among weapon-carrying, physical fighting, and fight-related injury among U.S. adolescents aged 12-21 years (N = 10,269). Adjusted odds ratios (OR) were used to describe the association of weapon-carrying during the past 30 days with physical fighting and fight-related injury during the past 12 months. RESULTS: Weapon-carrying (15%) and physical fighting (39%) were common among adolescents. One out of 30 (3.3%) adolescents reported receiving medical care for fight-related injuries. Controlling for demographic characteristics, youth who carried weapons were more likely than those who did not to have been in a physical fight (OR = 3.3). The association between weapon-carrying and physical fighting was stronger among females (OR = 5.0) than among males (OR = 2.9), but did not vary significantly by age, race/ethnicity, or place of residence (urban, suburban, rural). Controlling for frequency of physical fighting and demographics, adolescents who carried a handgun (OR = 2.6) or other weapon (OR = 1.6) were more likely than those who did not carry a weapon to have had medical care for fight-related injuries. CONCLUSIONS: Among adolescents, weapon-carrying is associated with increased involvement in physical fighting and a greater likelihood of injury among those who do fight. Efforts to reduce fight-related injuries among youth should stress avoidance of weapon-carrying.

Adolescent↗
PubMed1998

Managed care, school health programs, and adolescent health services: opportunities for health promotion.

The rapid expansion of managed care creates opportunities and dilemmas for those involved in school health and adolescent health promotion. Managed care organizations (MCOs), public health agencies, and school and adolescent health providers share certain common goals and priorities including an emphasis on prevention, cost-effectiveness, and quality of care--and a willingness to explore innovative approaches to health promotion and disease prevention. However, MCOs often face conflicting challenges, balancing the goals of cost containment and investment in prevention. In considering support for school health programs, MCOs will be interested in evidence about the effectiveness of services in improving health and/or reducing medical expenditures. Mechanisms for improving prevention efforts within MCOs include quality assurance systems to monitor the performance of health plans, practice guidelines from professional organizations, and the contracting process between payers and health care providers. Development of partnerships between MCOs and schools will be a challenge given competing priorities, variation in managed care arrangements, structural differences between MCOs and schools, and variability in services provided by school health programs.

Adolescent↗
PubMed1998

Youth Risk Behavior Surveillance--United States, 1997. State and Local YRBSS Coordinators.

Priority health-risk behaviors, which contribute to the leading causes of mortality and morbidity among youth and adults, often are established during youth, extend into adulthood, and are interrelated. The Youth Risk Behavior Surveillance System (YRBSS) monitors six categories of priority health-risk behaviors among youth and young adults--behaviors that contribute to unintentional and intentional injuries; tobacco use; alcohol and other drug use; sexual behaviors that contribute to unintended pregnancy and sexually transmitted diseases (STDs) (including human immunodeficiency virus [HIV] infection); unhealthy dietary behaviors; and physical inactivity. The YRBSS includes a national school-based survey conducted by the Centers for Disease Control and Prevention as well as state, territorial, and local school-based surveys conducted by education and health agencies. This report summarizes results from the national survey, 33 state surveys, 3 territorial surveys, and 17 local surveys conducted among high school students from February through May 1997. In the United States, 73% of all deaths among youth and young adults 10-24 years of age result from only four causes: motor vehicle crashes, other unintentional injuries, homicide, and suicide. Results from the national 1997 YRBSS demonstrate that many high school students engage in behaviors that increase their likelihood of death from these four causes--19.3% had rarely or never worn a seat belt; during the 30 days preceding the survey, 36.6% had ridden with a driver who had been drinking alcohol; 18.3% had carried a weapon during the 30 days preceding the survey; 50.8% had drunk alcohol during the 30 days preceding the survey; 26.2% had used marijuana during the 30 days preceding the survey; and 7.7% had attempted suicide during the 12 months preceding the survey. Substantial morbidity among school-age youth, young adults, and their children also result from unintended pregnancies and STDs, including HIV infection. YRBSS results indicate that in 1997, 48.4% of high school students had ever had sexual intercourse; 43.2% of sexually active students had not used a condom at last sexual intercourse; and 2.1% had ever injected an illegal drug. Of all deaths and substantial morbidity among adults greater than or equal to 25 years of age, 67% result from two causes--cardiovascular disease and cancer. Most of the risk behaviors associated with these causes of death are initiated during adolescence. In 1997, 36.4% of high school students had smoked cigarettes during the 30 days preceding the survey; 70.7% had not eaten five or more servings of fruits and vegetables during the day preceding the survey; and 72.6% had not attended physical education class daily. These YRBSS data are already being used by health and education officials to improve national, state, and local policies and programs to reduce risks associated with the leading causes of morbidity and mortality. YRBSS data also are being used to measure progress toward achieving 21 national health objectives and one of the eight National Education Goals.

Accidents↗
PubMed1997

Promoting sugar-free medicines: parents' views.

BACKGROUND: A long-standing concern among dental health professionals has been about the harmful effects of sugered medicines on teeth, especially in children who regularly take such medications. AIM: To investigate parental attitudes, perceptions, and motivations to sugar-free medicines so that an effective promotional campaign could be mounted. METHOD: A qualitative, focus group approach was used to gather data. RESULTS: These show the dominant influence of the doctor over the patient/parent, and the bearing this has on the prescribing of sugar-free medicines. CONCLUSION: This study highlights the scope for sugar-free medicine promotion for prescribed and over-the-counter products, and the polarizing of attitudes to the use of sugar-free medicines based on social class.

Attitude to Health↗
PubMed1996

The effect of socioeconomic status on chronic disease risk behaviors among US adolescents.

OBJECTIVE: To examine the relationship between socioeconomic status and risk behaviors for chronic disease among a nationally representative sample of adolescents in the United States. DESIGN: Household survey, the Youth Risk Behavior Survey supplement to the 1992 National Health Interview Survey. SETTING: United States. PARTICIPANTS: Nationally representative sample of 6321 adolescents aged 12 to 17 years. MAIN OUTCOME MEASURES: Standardized prevalence rates and logistic and multiple regression models were used to examine the effect of educational level of the responsible adult and family income on 5 risk behaviors for chronic disease among adolescents--cigarette smoking, sedentary lifestyle, insufficient consumption of fruits and vegetables, excessive consumption of foods high in fat, and episodic heavy drinking of alcohol. RESULTS: Most adolescents (63%) reported 2 or more of the 5 risk behaviors. Controlling for age, sex, race/ethnicity, and school enrollment status of adolescents, as the educational level of the responsible adult increased, cigarette smoking, sedentary lifestyle, and insufficient consumption of fruits and vegetables were less likely among adolescents. Among girls, but not boys, consumption of foods high in fat decreased as education of the responsible adult increased. As family income increased, adolescents were less likely to smoke cigarettes, less likely to be sedentary, and less likely to engage in episodic heavy drinking. CONCLUSION: Among adolescents, risk behaviors for chronic disease are common and inversely related to socioeconomic status. Improved community- and school-based programs to prevent such behaviors among adolescents are needed, especially among socially and economically disadvantaged youth.

Adolescent↗
PubMed1996

Analysis of allogeneic and syngeneic rat heart transplants using 23Na magnetic resonance spectroscopy.

This study defines the total sodium-23 magnetic resonance spectroscopy (23Na MRS) signal from in vivo heterotopic rat heart transplants in the early post-transplant period and examines the utility of this noninvasive method for monitoring allograft rejection. Measurements were performed at 4.7 T. Syngeneic (n = 6) and allogeneic (n = 6) donor hearts were transplanted into the neck of recipient rats. There were 27 MRS observations between days 0 and 29 post-transplant. Heart grafts were excised at various intervals post-transplant for histologic examination. Allogeneic heart grafts rejected between days 4 and 5 post-transplant while syngeneic grafts continued to beat. All hearts showed ischemic damage. Allogeneic hearts showed cellular rejection by Day 1. 23Na MRS showed a steady elevation in signal in the 3 days prior to rejection and a sharp rise after rejection. 23Na MRS accurately identified full rejection and was also sensitive to the rejection process.

Animals↗
PubMed1996

School-associated violent deaths in the United States, 1992 to 1994.

OBJECTIVES: To conduct the first nationwide investigation of violent deaths associated with schools in the United States, to quantify the risk of school-associated violent death, and to identify epidemiologic features of these deaths. DESIGN: Descriptive case series. SETTING: United States, July 1, 1992, through June 30, 1994. METHODS: School-associated violent deaths were identified by study collaborators and through 2 online news databases. Police reports, medical examiners' records, and interviews with police and school officials provided detailed information about each case. RESULTS: In a 2-year period, 105 school-associated violent deaths were identified. The estimated incidence of school-associated violent death was 0.09 per 100 000 student-years. Students in secondary schools, students of minority racial and ethnic backgrounds, and students in urban school districts had higher levels of risk. The deaths occurred in communities of all sizes in 25 different states. Homicide was the predominant cause of death (n = 85 [80.9%]), and firearms were responsible for a majority (n = 81 [77.1%]) of the deaths. Most victims were students (n = 76 [72.4%]). Both victims and offenders tended to be young (median ages, 16 and 17 years, respectively) and male (82.9% and 95.6%, respectively). Approximately equal numbers of deaths occurred inside school buildings (n = 31 [29.5%]), outdoors but on school property (n = 37 [35.2%]), and at off-campus locations while the victim was in transit to or from school (n = 37 [35.2%]). Equal numbers of deaths occurred during classes or other school activities (n = 46 [43.8%]) and before or after official school activities (n = 46 [43.8%]). CONCLUSIONS: School-associated violent deaths were more common than previously estimated. The epidemiologic features of these deaths were similar to those of homicides and suicides that occur elsewhere. A comprehensive approach that addresses violent injury and death among young people at school and elsewhere in the community is suggested.

Adolescent↗
PubMed1994

General anaesthesia: who decides, and why?

This study sought to determine the relative influence dentists and parents have on the decision to give a general anaesthetic to a child, and to identify the factors that influence that decision. The research involved group discussions and in-depth interviewing as a method of investigating attitudes and behaviour in greater detail. The results indicated that parents are not able to make informed choices about general anaesthesia being used on their child; the dentist has the greatest influence on the decision to use general anaesthesia; and that this decision is often influenced by non-clinical factors. These non-clinical factors were identified as: the norms of the dentist, overall attitudes to general anaesthesia and how general anaesthesia provision was structured locally. The findings suggest that any attempt to reduce the current levels of general anaesthesia further must address these factors, whilst taking into account the needs of patients and dentists.

Adolescent↗
PubMed1994

The effect of anticholinergic bronchodilator therapy on cough during upper respiratory tract infections.

1. Oxitropium bromide (Oxivent), an anticholinergic bronchodilator, inhibits coughing induced by hypotonic aerosols in both asthmatic and non-asthmatic individuals. We have now extended this work to investigate whether this antitussive activity is reproducible in cough associated with viral infection. 2. The effect of oxitropium bromide (200 micrograms three times daily) on cough and pulmonary function has been studied in 56 non-asthmatic volunteers with upper respiratory tract infections (URTI) in a double-blind, randomised, parallel group, placebo controlled study over 10 days. 3. Lung function, symptom questionnaire and cough response to ultrasonically nebulised distilled water (UNDW) inhalation were initially recorded within 72 h of development of cough and again after the 10 day treatment period. By use of a diary card at home, frequency and severity of cough, nocturnal symptoms and general malaise were assessed daily throughout the treatment period using 5 cm visual analogue scales (VAS). Peak expiratory flow rate (PEFR) was recorded thrice daily before treatment over this 10 day period. 4. VAS scores of symptoms and UNDW-induced cough frequency all decreased over the 10 days of observation whether oxitropium bromide or placebo was administered. The mean PEFR showed a statistically significant fall in morning values during the early stages of infection which lessened with recovery but no effect of treatment with oxitropium bromide was observed (P > 0.05). 5. Oxitropium bromide, which inhibits the cough response to UNDW, does not offer an effective therapy for cough associated with an upper respiratory tract viral infection.

Adolescent↗
PubMed1994

Changes in HIV-related information sources, instruction, knowledge, and behaviors among US high school students, 1989 and 1990.

OBJECTIVES: Few data have been available among adolescents to determine behavioral changes that may prevent human immunodeficiency virus (HIV) infection. This analysis examines changes in the prevalence of self-reported HIV-related information sources, instruction, knowledge, and behaviors among high school students in the United States. METHODS: Two independent, multistage national probability samples of students in grades 9 through 12 were surveyed in 1989 (n = 8098) and 1990 (n = 11,631) with self-administered, anonymous questionnaires that included similar items. RESULTS: Compared with students surveyed in 1989, a significantly greater proportion of students surveyed in 1990 had received HIV instruction in school. Significant decreases were found in the proportion of White and female students who reported having had sexual intercourse, in the proportion of White students reporting two or more lifetime sex partners, and in the proportion of 15- and 16-year-olds, White students, and female students who reported having had four or more lifetime sex partners. For both years, students who had a greater level of HIV knowledge were less likely to have had multiple lifetime sex partners or to have injected illicit drugs. CONCLUSIONS: The findings suggest that school-based HIV education and knowledge may be contributing factors in reducing certain risk behaviors that can lead to HIV transmission among secondary school youth.

Acquired Immunodeficiency Syndrome↗
PubMed1994

Substance use and HIV-related sexual behaviors among US high school students: are they related?

OBJECTIVES: This study was undertaken to examine whether use of alcohol, cigarettes, marijuana, cocaine, and other illicit drugs is related to the likelihood of sexual behaviors that increase risk for human immunodeficiency virus (HIV) infection among youth. METHODS: The 1990 national Youth Risk Behavior Survey was used to collect self-reported information about a broad range of health risk behaviors from a representative sample of 11,631 high school students in the United States. RESULTS: Students who reported no substance use were least likely to report having had sexual intercourse, having had four or more sex partners, and not having used a condom at last sexual intercourse. Adjusted for age, sex, and race/ethnicity, odds ratios for each of these sexual risk behaviors were greatest among students who had used marijuana, cocaine, or other illicit drugs. Students who had used only alcohol or cigarettes had smaller but still significant increases in the likelihood of having had sexual intercourse and of having had four or more sex partners. CONCLUSIONS: HIV prevention programs for youth should recognize that substance use may be an important indicator of risk for HIV infection and acquired immunodeficiency syndrome through its association with unsafe sexual behaviors.

Adolescent↗
PubMed1994

The use of aspirin in children under 12 years old attending a paediatric dentistry department in a dental hospital.

For several years it has been recommended that aspirin should be avoided in children under the age of 12 years because of the risk of Reye's Syndrome. In this study we investigated the reported use of analgesics among children who attended the Children's Department of the Dental Hospital in Newcastle upon Tyne. In addition the study also investigated the complaints that led to use of analgesics, the dose and frequency of administration of the analgesic, and past and current contact with medical services. Of 179 children investigated, 129 were under 12 years-old; of these 129 children under 12 years-of-age, 72 (56%) had taken an analgesic within the previous six months, 12 (17%) of whom took aspirin. Three of these children who had taken aspirin were reported to have had a serious illness in their lives, and would therefore have had significant contact with medical services. One-quarter of all children who had taken an analgesic did so for toothache. Inappropriate use of aspirin in children under 12 years-of-age indicates that health education about the possible risks of Reye's Syndrome needs to be improved.

Aspirin↗