Search PubMed⌕ Search

Biomedical subjects

B Arroll

Publications and source records attributed to B Arroll.

At least 55 records · Page 3Linked to original sources

Prevalence of acne vulgaris in Auckland senior high school students.

AIM: To assess the prevalence and severity of acne vulgaris in adolescent students. METHOD: 867 students in Auckland sixth and seventh form classes were interviewed on the subject of acne vulgaris. Of these 847 students were examined and graded for severity of their acne using a modification of the Leeds technique which ranks severity according to number, extent and nature of the acne lesion. RESULTS: Ninety-one percent of males and 79% of females had some acne. Severe acne was present in 6.9% males and 1.1% females. Severe and moderately severe acne was significantly more common in males (OR = 2.6 95% Cl 1.73 < OR < 3.9). In the univariate analysis there was no association of moderately severe and severe acne with parental occupational group nor ethnicity. CONCLUSION: Moderate and severe acne is a common finding in Auckland senior high school classes with males being more affected than females.

Acne Vulgaris↗

Salt restriction and physical activity in treated hypertensives.

AIM: To determine the effect on blood pressure from brisk walking with or without salt restriction in a community based sample of treated hypertensives. METHODS: The intervention was undertaken in a community setting with a factorial randomised controlled trial and blinded assessment of blood pressure. One hundred and eighty one healthy adult volunteers with a sedentary lifestyle and on pharmacological therapy for hypertension briskly walked for 40 minutes three times per week with or without salt restriction. Systolic and diastolic blood pressure were assessed at three and six months. RESULTS: Of the original 208 participants 181 (87%) completed the study. significant reductions of up to 7 mm Hg were found in systolic blood pressure at 3 months for brisk walking alone (p = 0.04) and salt restriction alone (p = 0.03) but not for the combined intervention (p = 0.17). No significant change was found for diastolic blood pressure. There was no significant change in blood pressure at 6 months. CONCLUSIONS: Simple advice on exercise and sodium restriction in a community setting can significantly lower systolic blood pressure at least for 3 months. The combination of the two interventions was less effective than each therapy alone.

Combined Modality Therapy↗

Management of hypertension and the core services guidelines: results from interviews with 100 Auckland general practitioners.

AIM: To determine if the management of a hypothetical case of essential hypertension by general practitioners conforms with the Report to the National Advisory Committee on Core Health and Disability Services guidelines on the Management of Raised Blood Pressure in New Zealand (Core Services Report on Hypertension) sent to all general practitioners in November 1992. METHOD: A cross-sectional survey of a random sample of 100 Auckland general practitioners using a standard case of a 60 year old man with essential hypertension. Seventy interviews were conducted by a face-to-face interview and 30 by telephone interview. The main outcome measures were. Initial choice of medication and levels at which blood pressure would require treatment. RESULTS: Forty one percent of the interviewed doctors had read the Core Services report on hypertension. Fifty percent of the doctors indicated they would use the recommended first line antihypertensive medication (ie, diuretic or beta blocker). Doctors who prescribed beta blockers had been graduated a significantly longer time than those who did not. The majority of doctors indicated that they would initiate pharmacological treatment at lower blood pressures in younger patients than older patients contrary to the recommendation of the report. CONCLUSIONS: Current reported practice is only partially consistent with that suggested by the Core Services report on hypertension. Approximately half of the doctors interviewed were prescribing the recommended first line medication. Treatment was more likely to be initiated at lower levels in younger patients than in older patients in spite of the higher absolute risk and potential absolute benefit in the latter group. Adherence to the guidelines could see a shift from overtreatment of younger patients to an increase in treatment for older patients who are at higher risk of blood pressure related disease. More specific graduate educational measures will be needed if the Core Services report on hypertension are to be implemented.

Adult↗

Pathological gamblers--will they use a new telephone hotline?

AIMS: This paper reports on the preparedness of pathological gamblers to seek help through a new national toll-free telephone hotline and compares these callers, on some key dimensions, with a representative sample of pathological gamblers living in the community. METHODS: Callers were assessed using standard diagnostic screens. Sociodemographic data and reported symptoms of stress and depression were also recorded. Callers identified as pathological gamblers were compared with their counterparts in a recent nationwide epidemiological survey. RESULTS: During the first 3 months of operation, 1506 calls were received from 329 callers. Of these 167 were pathological gamblers, 117 were partners or family members and 45 were from various agencies. Pathological gamblers contacting the hotline resembled those from the community survey with respect to gender and age. Maori and Pacific Islanders were underrepresented. Suicidal ideation was reported by over 90% of pathological gambler callers. CONCLUSIONS: The new service provides a means to reach people with serious gambling-related problems and provides information to family members and helping agencies. High reported suicidal ideation was consistent with previous studies showing elevated rates of stress and depression among pathological gamblers. Underutilization by Maori, Pacific Islanders and people with less severe gambling disorders indicates the need to find better ways to engage these groups.

Gambling↗

The effect of exercise episode duration on blood pressure.

OBJECTIVE: To investigate the effect on blood pressure for 10-min compared with 40-min episodes of physical activity for 4 days. DESIGN AND METHODS: The design used a randomized crossover trial of two exercise episode durations, involving 17 subjects, which were performed in a university setting. The intervention was exercise on a stationary bicycle for four consecutive days, at 50% of maximal oxygen uptake (determined by heart rate), for episode durations of 10 or 40 min. A rest period of 10 days followed before exercise for the alternative duration was performed. The main outcome measure was blinded assessment of blood pressure 24 h after the last exercise episode. RESULTS: Significant reductions were found in systolic and diastolic blood pressure after 4 days of 40 min but not after 4 days of 10 min stationary cycling. The reduction in blood pressure was significant for both systolic and diastolic blood pressure for 4 days of 40 min of exercise episodes. CONCLUSION: Exercise of moderate intensity on a stationary bicycle for 10 min for 4 days is not effective in lowering blood pressure in comparison with the same exercise for 40 min for 4 days. The experimental design employed in the present study has potential for monitoring the effects of exercise on blood pressure.

Blood Pressure↗

Cervical screening: what do Auckland general practitioners do?

AIMS: To assess the frequency of cervical screening; average age of screened women and adequacy of decontamination practices of vaginal specula by Auckland general practitioners. METHODS: A random sample of 96 Auckland general practitioners completed a questionnaire at the time of consultation describing the screening history and decontamination practices for vaginal specula from five consecutive patients having a cervical smear test. RESULTS: Of the 96 doctors 68 completed the questionnaire for the five consecutive patients. The majority of women were aged below 50 years and the median time since the last smear for women with a previously normal smear was 18 months. Although the majority of doctors adhered to Health Department guidelines for decontamination, deviations occurred by: reusing plastic specula; using only disinfection as a means of decontamination and not boiling specula for 30 minutes. CONCLUSIONS: The majority of women being screened are young and there is a high level of very frequent screening in women with previously normal smears. Closer adherence to the 1991 cervical screening recommendations and Health Department guidelines for decontamination of vaginal specula is required for some Auckland general practitioners.

Adolescent↗

Screening for cervical cancer: attitudes and policies among Auckland general practitioners.

OBJECTS: to survey Auckland general practitioners and evaluate their attitudes and policies toward screening for cervical cancer. METHODS: an interviewer administered questionnaire asking questions based mainly on the recommendations of the 1985 Working Party on screening for cervical cancer and on some issues resulting from the Cartwright Inquiry. RESULTS: the response rate was 96% of the 100 general practitioners approached. The mean screening interval was 24.1 months. Eighty-eight percent of Auckland general practitioners used a recall system for cervical cancer screening. Doctors more likely to report adherence to the recommendations of the Working Party on screening for cervical cancer were: members and associates of the Royal New Zealand College of General Practitioners; doctors with less than 15 years experience; female doctors; doctors with a diploma of obstetrics and doctors in group practices. CONCLUSIONS: the majority of Auckland general practitioners adhere to the recommendations of the 1985 Working Party on screening for cervical cancer although there is some evidence of overscreening. Areas for improvement include the need for more general practitioners to have a recall system and the need to increase the rate of referral for women with two consecutive smears showing mild dysplasia.

Age Factors↗

Does physical activity lower blood pressure: a critical review of the clinical trials.

This review critically appraises 22 recent articles of trials of physical activity, as a means of reducing blood pressure. The quality of the literature remains poor and of the 13 controlled trials of habitual activity only one did not have a major design fault. Overall, blood pressure was reduced by physical activity in both hypertensive and normotensive persons. This effect was independent of weight loss and in some studies blood pressure reduction occurred in the presence of weight gain. The average reduction in the better designed studies was approximately 6-7 mmHg for both systolic and diastolic blood pressure which compares favourably with studies of pharmacological treatment. The better designed studies reported smaller reductions than studies with poorer design. All activities, including circuit weight training, lowered blood pressure and daily activity produced greater blood pressure reduction than when performed three times per week. It is concluded that physical activity has an independent capacity to lower blood pressure.

Adolescent↗

The Auckland diet: results from a seven day food diary.

Dietary intakes of 113 men and women aged 50-66 years, sampled from the Auckland electoral roll, were measured by a prospective seven day dietary diary. The mean intakes of percentage of energy due to fat and saturated fat were 32% and 16% in men and 34% and 15% in women. Compared with earlier New Zealand dietary studies, which used different methods, there has been an apparent decrease in both the absolute amount and proportion of cholesterol and saturated fat. The absolute and relative amount of protein consumed appears to have remained stable while carbohydrate intake has increased. In comparison with current guidelines for dietary fat intake there remains a need for further improvement in the typical New Zealand adult diet.

Aged↗

Validation of a three-month physical activity recall questionnaire with a seven-day food intake and physical activity diary.

We assessed the validity of a three-month physical activity questionnaire. The validation instrument was a seven-day self-report diary of physical activity and food intake, given to 113 randomly selected persons. We obtained Spearman correlations of 0.60, 0.48, and 0.91 and kappa scores of 0.36, 0.23, and 0.62 from the physical activity recall and diary for moderate, vigorous, and total activity. We conclude that the three-month recall questionnaire reasonably reflects activity in this community-based sample.

Diet↗

Potential misclassification in studies of physical activity.

Regular physical activity is associated with a reduced risk of coronary heart disease, although debate still occurs over the level of intensity required for cardioprotection. The use in epidemiological studies of the arbitrarily defined categories of light, moderate, and hard, as proxy measures of relative intensity has administrative merit but risks potential misclassification, particularly in women and the elderly. This potential misclassification is the result of the inappropriate categorizing of activity based upon absolute intensity values regardless of age or gender. Coronary heart disease is more common in the elderly and recent activity more important than remote for cardiac benefit. It is thus essential to resolve the issue of the level(s) of exercise intensity needed to provide health benefits. Only when this information is available will it be possible to give rational and safe public health advice.

Age Factors↗