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Biomedical subjects

T L Patterson

Publications and source records attributed to T L Patterson.

88 records · Page 5Linked to original sources
PubMed1988

Early childhood diet: recommendations of pediatric health care providers.

With the abundance of literature on cardiovascular disease (CVD) prevention during childhood, recommendations for restricted dietary sodium and fat intakes during infancy and childhood are both advocated for preventive health care and criticized because the safety is undetermined. Dietitians, nurse practitioners, and pediatricians were surveyed to determine what dietary recommendations they give to parents and what source of information most influenced their decisions. A fourth group, pediatricians with particular expertise in nutrition, were surveyed as well. The overall response rate was 76%, with a total usable sample of 252. In all professional groups, 54% had no preference for any one commercially prepared formula. More importance was given to sodium content than to fat composition of formulas. On the choice of whole, low-fat, or non-fat milk for both 1- and 6-year-old children, professional groups differed significantly. Dietitians and the subgroup of pediatricians with nutrition expertise were more likely to recommend milk with higher fat content than other professional groups. Recommendations for both sodium- and fat-modified diets for children depended on CVD risk, and opinions varied between groups. Pediatricians and nurse practitioners were more likely to recommend dietary modifications for children with higher CVD risk. The variation in dietary recommendations within and between professional groups strongly indicates the need for research on the safety and efficacy of dietary restrictions in childhood.

Animals↗
PubMed1988

Family variables and physical activity in preschool children.

Correlates of the physical activity habits of preschool children were studied in a multiethnic sample. Physical activity levels of 33 low-income children were observed systematically during free-play periods at preschool. Children spent 58% of free-play time in sedentary activities (e.g., sitting), and were vigorously active only 11% of the time. Independent variables studied were child body mass index (BMI), teacher-rated Type A behavior, and parent-reported mother BMI, father BMI, parent vigorous activity, and family cardiovascular disease (CVD) risk. The multiple regression of moderate-intensity activity was significant, with family CVD risk, parent vigorous activity, and father BMI accounting for significant amounts of variance. The results suggest that the effects of parental role modeling on child physical activity levels may extend to free-play settings far beyond the confines of the home environment.

Body Weight↗
PubMed1987

The development of scales to measure social support for diet and exercise behaviors.

The purpose of this study was to develop measures of perceived social support specific to health-related eating and exercise behaviors. In Study I, specific supportive and nonsupportive behaviors were identified through interviews with 40 individuals making health-behavior changes. In Study II, items derived from the interviews were administered to 171 subjects. Support from family and friends was assessed separately for both diet and exercise habits. Meaningful factors were identified for each of the four scales, and some factors were similar for family and friend scales. Both test-retest and internal consistency reliabilities were acceptable, and six factors can be used as subscales. Social support scales were correlated with respective self-reported dietary and exercise habits, providing evidence of concurrent criterion-related validity. A measure of general social support was not related to the specific social support scales or to reported health habits. These scales are among the first measures of social support behaviors specific to dietary- and exercise-habit change.

Adolescent↗
PubMed1987

Aggregation of blood pressure in Anglo-American and Mexican-American families.

We investigated the aggregation of blood pressure within 95 Anglo-American and 111 Mexican-American families. Degree of genetic relatedness was evaluated by calculating separate correlations for spouses and for each spouse with both same-sex and opposite-sex offspring. In addition, sibling correlations were evaluated. These analyses were performed separately for Anglo-American and Mexican-American families. Replicating earlier findings, correlations between blood pressures of Anglo spouses were nonsignificant. However, there were significant spousal correlations in the Mexican-American group. For Anglo-American families, there were significant associations between blood pressures of fathers and sons and between blood pressures of mothers and daughters. Correlations between blood pressures for opposite-sex parent-child pairs were nonsignificant. In the Mexican-American group, there were significant correlations between fathers' blood pressures and those of both male and female offspring. For mothers, blood pressures were weakly correlated with all other family members. These relationships remained after adjustment for age, body mass index, and measures of dietary habits and activity levels. In general, blood pressure aggregation was greater in Mexican-American families.

Adult↗
PubMed1987

Adult heart disease prevention in childhood: a national survey of pediatricians' practices and attitudes.

There is controversy about the role of pediatric care givers in reducing presumed risk factors for cardiovascular diseases in children. A national mail survey of 2,000 pediatricians was designed to determine the attitudes, current practices, and knowledge among primary care pediatricians regarding these risks. The response rate was 60% (779 primary care pediatricians). Responses indicated that a majority of pediatricians take a family history of cardiovascular diseases, assess BP, recommend exercise to school-aged children, and advise patients and parents against smoking. Few pediatricians felt confident in their ability to affect change in patient life-styles. There was a relatively low level of provision of dietary advice, and most pediatricians do not measure serum cholesterol levels, except in high-risk older children. A substantial minority do not discuss smoking, even with adolescents. Practices and attitudes varied with the age of the patient. Obesity was the topic most frequently chosen for continuing medical education. Older pediatricians were most likely to advocate and practice risk reduction in children. Attitudes and reported practices also varied by gender and geographic location of the pediatrician as well as the ethnic composition of the practice. Implications for continuing medical education are discussed.

Adult↗
PubMed1984

Behavioural factors in burn mortality and length of stay in hospital.

Numerous studies have examined the effects of burn size and depth, age, concomitant injury, and illness upon burn patient mortality and duration of stay in hospital, and other studies have stressed the importance of psychosocial factors in the causation of burns. However, scant attention has been given to the effects of psychosocial factors on burn mortality and length of stay in hospital. Data on psychiatric diagnoses, substance abuse, and factors in severity of injury were abstracted from the charts of patients admitted to the San Diego Regional Burn Treatment Center. Mortality data were analysed using logistic regression. After adjusting for severity of the burn injury, statistically significant increases in mortality are associated with the diagnosis of character or personality disorder, schizophrenia, alcohol intoxication at the time of injury, and a variable indication a psychiatric diagnosis or severe undiagnosed problems. Comments on individual charts suggest that overtly self-destructive behaviour during treatment caused the increased mortality. Data on duration of stay in hospital among survivors were analysed using multiple linear regression. After adjusting for severity of injury, significantly longer stays are associated with suicidal intention, diagnosis of character or personality disorder, schizophrenia, senility and a variable indicating a psychiatric diagnosis or severe undiagnosed problems. Overtly self-destructive behaviour, treatment of psychiatric problems, and the inability of some patients to care for themselves may each contribute to the longer stay in hospital.

Adult↗
PubMedDate not supplied

Correlates of life stress in an alcohol treatment sample.

Men in alcohol dependence treatment commonly report elevated levels of stressful life experiences prior to entering treatment. Clinical researchers have argued that training patients to cope with stress is an important aspect of therapy for alcohol dependence. Current age and age of onset of alcohol dependence are two patient characteristics that may relate to stress and allow mental health care providers to anticipate patient needs more readily. This study examines whether current age and age of onset of alcohol dependence are related to the type of stress experienced preceding treatment. Participants were 350 male veterans receiving inpatient treatment for alcohol dependence who completed a semistructured interview-based life stress assessment. The likelihood of life events related to achievement, relationship, and legal problems decreased with age; the likelihood of health difficulties increased with age; and age and age of onset of alcohol dependence interacted to predict health difficulties. These results indicate that the nature of some stress experiences prior to treatment for alcohol dependence may be related to current age and the course of alcohol dependence.

Adaptation, Psychological↗
PubMedDate not supplied

Somatization symptoms in chronic low back pain patients.

Chronic low back pain (CLBP) patients often are described as "somatizers", who report multiple somatic complaints beyond back pain itself, but the nature and clinical significance of this observation is poorly understood. To clarify the characteristics, correlates and severity of somatization in CLBP, we rigorously assessed somatization symptoms in a sample of patients not selected for psychiatric or pain clinic referral. Male CLBP patients (N = 97), attending a primary care orthopaedic clinic, and matched healthy controls (N = 49), were assessed using the Diagnostic Interview Schedule III-A (DIS), Beck Depression Inventory (BDI), Hamilton Rating Scale for Depression (HRSD), McGill Pain Questionnaire (MPQ), Sickness Impact Profile (SIP), and the Pain and Impairment Relationship Scale (PAIRS). Although none of the subjects met strict DSM-III criteria for a lifetime diagnosis of Somatization Disorder, 25.8% of CLBP patients reported a lifetime history of 12 or more somatic symptoms, as compared to only 4.1% of controls. In the less symptomatic ranges, patients still generally reported more symptoms than controls, with 51.5% of patients vs. 8.2% of controls reporting 7-11 symptoms, and 22.7% vs. 87.8% of controls reporting 0-6 symptoms (p < .001). Major depression and alcohol dependence were significantly associated with increased severity of somatization (p < .05). Lower mood and increased impairment, but not pain intensity, were related to greater number of somatic complaints. Symptoms of somatization are prevalent, but not universal, in CLBP and the pattern of these symptoms is reminiscent of the "spectrum of severity" reported in other medical populations. Recognizing this spectrum of somatization may lead to better patient-treatment matching and improved clinical outcomes.

Adaptation, Psychological↗
PubMedDate not supplied

Validity of the Quality of Well-Being Scale for persons with human immunodeficiency virus infection. HNRC Group. HIV Neurobehavioral Research Center.

To evaluate the validity of the Quality of Well-Being Scale (QWB) for studies of patients with human immunodeficiency virus (HIV) disease, 514 men were studied who were divided among four categories: Centers for Disease Control and Prevention (CDC) Group A (N = 272), CDC-B (N = 81), CDC-C (N = 47), and uninfected male controls (N = 114). The QWB and a variety of medical, neuropsychological, and biochemical measures were administered to all participants. When QWB scores were broken down by HIV group, the CDC-C group was significantly lower (.614) than the CDC-B (.679), CDC-A (.754), or control group (.801). The difference between Groups CDC-C and CDC-A was about .14 units of well-being, which suggests that individuals lose 1/7 equivalents of 1 well year of life for each year they are in Group CDC-C in comparison to the asymptomatic group (Group CDC-A). In comparison to the controls, this would equal a 1-year of life loss for each seven infected individuals. The QWB was shown to be significantly associated with CD4+ lymphocytes (p < .001), clinician ratings of neuropsychological impairment (p < .04), neurologists ratings of dysfunction (p < .001), and all subscales of the Profile of Mood States. Baseline QWB scores were significant prospective predictors of death over a median follow-up time of 30 months. Multivariate models demonstrated high covariation between predictors of QWB. It was concluded that the QWB is a significant correlate of biological, neuropsychological, neurological, psychiatric, and mortality outcomes for male HIV-infected patients.

AIDS Dementia Complex↗
PubMedDate not supplied

Chronic life stress alters sympathetic, neuroendocrine, and immune responsivity to an acute psychological stressor in humans.

OBJECTIVE: Life stress is hypothesized to alter the dynamic regulation of the autonomic, neuroendocrine, and immune systems. This study examined the effects of antecedent chronic life stress on psychological and physiological responsivity after acute challenge with a psychological stressor. METHOD: Using a within-subject mixed design, male volunteers with (N = 12) and without chronic life stress (N = 11) were administered a 12-minute laboratory stressor (mental arithmetic) vs a video control. RESULTS: Acute psychological stress induced subjective distress, increases of circulating concentrations of epinephrine, norepinephrine, beta-endorphin, adrenocorticotropic hormone (ACTH), and cortisol, and a selective redistribution of natural killer (NK) cells into the peripheral blood as compared with the video control condition. Although the two groups were almost identical at baseline in psychological, sympathetic, neuroendocrine, and immune domains, the chronic stress group showed greater subjective distress, higher peak levels of epinephrine, lower peak levels of beta-endorphin and of NK cell lysis, and a more pronounced redistribution of NK cells in response to the acute psychological challenge than the controls. Furthermore, the acute stressor induced a protracted decline in NK lysis per NK cell in the chronic stress group but had no effect in the controls. CONCLUSIONS: In summary, when persons who are undergoing chronic life stress are confronted with an acute psychological challenge, an exaggerated psychologic and peak sympathomedullary reactivity occurs that is associated with decrements in individual NK cell function and is protracted beyond termination of the stressor and sympathomedullary recovery.

Adrenal Medulla↗
PubMedDate not supplied

Immunity to reinfection and immunization of male guinea pigs against urethral infection with the agent of guinea pig inclusion conjunctivitis.

BACKGROUND AND OBJECTIVES: There is little information available on immunity of males to chlamydial infection after recovering from a primary urethral infection or after immunization with chlamydial antigen. The guinea pig model of genital infection using the chlamydial agent of guinea pig inclusion conjunctivitis was utilized to evaluate the protective immune response in these circumstances. GOAL: To determine whether immunity to reinfection develops after a primary urethral infection and whether immunity develops as a result of immunization with inactivated chlamydiae. STUDY DESIGN: Groups of five male guinea pigs each in two separate experiments were infected in the urethra with chlamydiae and challenged with a fresh inoculum at either 30, 75, or 150 days after infection. The course of the challenge infection was then determined. Similarly, guinea pigs were immunized subcutaneously with ultraviolet-inactivated chlamydial elementary bodies and the course of urethral infection was determined when inoculated 2 weeks after immunization. RESULTS: Male guinea pigs were highly resistant to reinfection after a primary urethral infection. Animals that were immunized with inactivated chlamydiae generally became infected upon challenge, but the intensity of the infection was markedly reduced. CONCLUSIONS: Male guinea pigs possess protective mechanisms that make them more resistant to repeat chlamydial genital infection for a longer period of time than is seen in female guinea pigs. In addition, immunization of males with inactivated chlamydial antigen by a parenteral route is able to elicit a protective response to urethral infection with chlamydiae.

Animals↗
PubMedDate not supplied

Construct validities of the Quality of Well-Being Scale and the MOS-HIV-34 Health Survey for HIV-infected patients.

This research assessed the construct validities of two health-related quality-of-life instruments: the Quality of Well-Being Scale (QWB) and the Medical Outcomes Study 34-item HIV Health Survey (MOS-HIV-34). A sample of 100 adult male, HIV-infected patients, across six HIV disease classifications, was used as subjects. Four convergent validity measures of health-related quality of life were used: CD4 cell counts, beta-2 microglobulin levels, disease classification, and age. All convergent validity measures were significant for the QWB. Forty percent of the convergent validity comparisons with the MOS-HIV-34 were statistically significant. Because the two measures provide different perspectives on health-related quality of life, both instruments appear to be useful in measuring health-related quality of life in this patient population.

Adult↗
PubMedDate not supplied

Predictors of dietary change in Mexican American families participating in a health behavior change program.

Previous research indicates that Mexican Americans have dietary patterns related to cardiovascular disease risk factors. Research on health beliefs in this ethnic group suggests that Mexican Americans may be less amenable to interventions based on cognitive-behavioral change models. Our study derives from the experience in a community trial, the San Diego Family Health Project, in which Mexican American families were recruited for a structured heart health intervention program. We examined correlations between one-year dietary change scores (three-day sodium, three-day fat, 24-hour sodium, 24-hour fat) and a set of predictor variables derived from social learning theory. Both adults and children had lower intake scores after the intervention, except for children's 24-hour sodium scores. Our correlational analysis found only weak and somewhat inconsistent relationships between theoretically based predictor and outcome variables for adults. The children's results showed statistically significant correlations between two theoretical variables (self-efficacy and supporting others' dietary change) and three-day fat and 24-hour sodium intake. We discuss the implications for cardiovascular disease risk reduction interventions with Mexican Americans.

Adult↗
PubMedDate not supplied

Aggregation of dietary calories, fats, and sodium in Mexican-American and Anglo families.

There seems to be a consensus that family influences on dietary habits are important, but few studies have addressed this issue directly. To clarify inconsistent findings, we studied the aggregation of dietary fats, sodium, and calories in 95 Anglo and 111 Mexican-American families. Their diet was determined by 24-hour recall, a three-day food record, and a food frequency questionnaire, along with a measure of the urinary sodium-potassium ratio. There was evidence of moderate aggregation of all dietary variables in both ethnic groups. In Anglo families, spouse-spouse, but not sibling-sibling, correlations tended to be significant. The diets of the younger children, but not the older children, were related to their parents' diets. In Mexican-American families, both spouse-spouse and sibling-sibling correlations tended to be significant. The mothers' diets were more highly correlated with the children's diets than were the fathers'.

Diet Surveys↗
PubMedDate not supplied

Recruitment issues, health habits, and the decision to participate in a health promotion program.

To understand the external validity of experimental studies, it is important to estimate the extent to which the participants are representative of the general population. This paper describes recruitment methods and considers the representativeness of participants in the San Diego Family Health Project. The study was designed to experimentally evaluate the effectiveness of a family-based behavior change intervention in Anglo and Mexican-American families. Initial contact with the families was made through a household health survey that was sent home with all fifth- and sixth-grade children in 12 participating elementary schools. The survey asked about a variety of demographic characteristics, dietary habits, and physical activity habits. Parents were also asked if they were interested in participating in the project. Respondents were classified by level of participation into one of three groups: not interested, expressed initial interest but did not attend the recruitment meeting, and volunteered to participate. Level of participation was the independent variable in the analyses. In separate analyses for Anglo and Mexican-American responders, our data suggested many similarities and a few differences among participant groups. The differences that were observed suggest that participants may already have healthier diets than nonparticipants, although only one of four dietary variables differed by participation status in each ethnic group. The external validity of these data and general recruitment issues are discussed.

Adolescent↗