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Biomedical subjects

T Toomey

Publications and source records attributed to T Toomey.

12 recordsLinked to original sources
PubMed2003

Social exchange of cigarettes by youth.

OBJECTIVE: This study seeks to determine the magnitude, nature, and correlates of social exchange of cigarettes among youth who smoke. DESIGN: Cross sectional survey. SETTING: Schools in 29 Minnesota communities. PARTICIPANTS: All students in grades 8, 9, and 10 (ages 13-16 years) in each participating school. The parent/child response rate for the survey was 90%. Analyses included 4124 respondents who smoked at least one cigarette in the month before the survey. OUTCOME MEASURES: Social exchange scale, consisting of 16 items assessing aspects of social provision and acquisition of cigarettes. RESULTS: Almost 90% of youth in this study had obtained a cigarette from, and about 75% of them had provided cigarettes to, another teen in the prior month. Daily smokers provided to more teens and provided more often than those who smoked less than daily. Daily smokers also reported having more social sources, both teens and adults, than lighter smokers, and were more likely to have both bought from and sold cigarettes to other teens (p < 0.0001 for all comparisons between daily and less than daily smokers). In a multivariate analysis, social exchange was associated with grade, whether siblings and friends smoke, level of smoking, age of smoking initiation, parental influences and community norms about teen smoking, and buying cigarettes. CONCLUSIONS: Social provision and acquisition of cigarettes among teens are widespread, reciprocal behaviours. Parental and community expectations about smoking influence social exchange, possibly by providing opportunities or barriers for social smoking. Commercial and social availability are not mutually exclusive; rather social exchange extends the reach of commercial sources.

Adolescent↗
PubMed1997

Environmental predictors of drinking and drinking-related problems in young adults.

We examined relationships among drinking norms, peer alcohol use, alcohol availability, drinking location, alcohol consumption, and drinking-related problems among young adult drinkers. The specific objectives of our study were to assess the relative contribution of normative and physical environmental factors to drinking and drinking consequences. Subjects were 3,095 young adults, aged eighteen to twenty years old who participated in the Communities Mobilizing for Change on Alcohol Project baseline survey. Alcohol consumption (i.e., number of drinks on the last occasion) and drinking consequences served as dependent variables. Multiple linear regression was used to identify predictors of alcohol consumption, and logistic regression was employed to identify predictors of drinking consequences. Drinking norms and peer alcohol use were positively related to alcohol consumption and to drinking consequences. Drinking in a public setting was positively related to alcohol consumption, but not to drinking-related problems. Findings suggest that policies and programs that alter the normative and physical environment surrounding drinking may reduce alcohol consumption and subsequent problems in young adults.

Adolescent↗
PubMed1997

Why and in what context adolescents obtain alcohol from adults: a pilot study.

Four focus groups involving 26 male and female high school seniors were conducted to provide insight into the context and settings in which alcohol is provided to youth, and why some youth choose certain sources of alcohol over others. Adults over the age of 21 years were the most common source of alcohol used by participants. Participants believe that it was less risky to ask an older adult to purchase alcohol than to attempt to buy it themselves. Few restrictions were placed on youth when alcohol was provided by an older adult. Youth may seek certain alcohol sources when they perceive that alcohol is available and risks of obtaining it are low.

Adolescent↗
PubMed1996

Changing the relationship among nurses' knowledge, self-reported behavior, and documented behavior in pain management: does education make a difference?

An educational program designed to change knowledge in order to change pain management practices and patient outcomes was offered to nurses who provide day-to-day care to patients with cancer in communities in a predominantly rural state. A quasi-experimental time-series design was used to measure the effectiveness of the program in changing nurse knowledge, attitude and behavior, and to evaluate the relationships between the outcomes. Data were collected from nurses (N = 29) and patient charts before (N = 209) and after (N = 163) the program. Nurses' knowledge increased, but the change was not statistically significant; the mean percent of correct answers on the three subtests were different and differences persisted throughout the study. Nurses believed that patients should be "pain free." Documentation of behaviors, for example, practice activities, occurred infrequently and showed little change until 6 months after the program. Increase in documentation of pain-intensity ratings, pain location, number of sites of pain, presence of confusion, anxious or depressed mood, sleep, nausea and vomiting, constipation, and general activity were noted. Documentation of the use of a propoxyphene-containing analgesic decreased; increase in the use of hydromorphone methadone and transdermal fentanyl was noted. Analysis of the relationships between correct responses to nurse knowledge questions and documentation of behavior provided interesting, statistically insignificant results that need to be reexamined in future research. Future programs should emphasize analgesic dosing and calculation of equianalgesic doses. Current practices in chart documentation may provide incomplete information regarding change in practice behaviors; more detailed documentation of pain management practices is needed. Nurses who participated in the program anecdotally reported feelings of increased credibility and effectiveness. Although change in behavior is slow to occur, education does make a difference.

Adult↗
PubMed1995

Managing cancer pain: content and scope of an educational program for nurses who work in predominantly rural areas.

A great deal of effort is being expended at national, state and local levels to improve cancer pain management in the United States. The fact that cancer patients continue to experience "unrelieved pain" is of concern to professional caregivers and families, as well as to the patients themselves. This article describes the content and scope of an educational program for nurses who work in predominantly rural areas. Content of the program and the evaluation process are described in detail in order to provide other caregivers with a model that could be implemented in similar settings.

Chronic Disease↗
PubMed1979

Behavior modification and haloperidol in chronic facial pain.

Neuralgiform pain and migrainous pain, both of which are amenable to drug therapy, comprise a relatively small percentage of the group of patients with facial pain who come to the practitioner's office. The largest group of facial pain patients are those with myofascial connective tissue disorders. A second group includes patients with neuropathic pain due to trauma such as oral surgery. A third group is made up of those without any identifiable focus of pain in the extracranial tissue. In these three nonneuralgiform and nonmigrainous groups, it is thought that personality factors affecting psychophysiologic mechanisms are of great importance. These patients are generally difficult to treat. A variety of modalities of therapy, such as behavior modification, hypnosis, and biofeedback, has been reported as helpful in some of these patients. In this report we focus on 12 subjects who failed with all these forms of therapy. We found that they responded to relaxation therapy (after Jacobson) along with haloperidol. We describe further characteristics of these patients and details of our method of treatment.

Chronic Disease↗
PubMed1977

Depression in medical outpatients: use of the Zung scale.

Sixty-nine randomly selected medical outpatients were clinically evaluated for depressive illness. A Zung Self-Rating Depressive Scale (SDS) was also administered to each patient. The prevalence of depression in the sample was 42%. The SDS picked up 30% of those depressed while missing those whose depression was presented under the guise of somatic illness. The SDS is thus a suitable instrument only in screening of the non-depressed medical patients.

Adolescent↗