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Biomedical subjects

C D Jenkins

Publications and source records attributed to C D Jenkins.

At least 37 records · Page 2Linked to original sources
PubMed1988

A scale for the estimation of sleep problems in clinical research.

Problems in sleeping are widely prevalent in modern society and are often one of the presenting complaints of patients consulting physicians. In addition, there is scattered epidemiologic evidence and considerable clinical support that disturbed or inadequate sleep may be a risk factor for clinical emergence of cardiovascular disease and for total mortality. The role of sleep problems both as a precursor and as a sequela of disease states could be better delineated in large groups by the availability of a brief, reliable and standardized scale for sleep disturbance. Such a scale could also be used to evaluate the impact of different therapies upon sleep problems. This paper presents data from two study populations responding to three and four item self-report scales. From 9 to 12% of air traffic controllers reported various sleep problems to have occurred on half or more of the days during the prior month, whereas 12-22% of patients 6 months after cardiac surgery reported such frequent sleep problems. Utilizing data from the 6 and 12 month follow-ups, test-retest reliability of the three-item scale in cardiac surgery patients was found to be 0.59. Internal consistency coefficients for the three and four-item scales were 0.63 and 0.79 respectively.

Adult↗
PubMed1987

A prospective study of the Jenkins Activity Survey as a risk indicator for coronary heart disease in the Netherlands.

Type A behavior was assessed in Rotterdam in 3171 males, aged 45-59 years, by the Jenkins Activity Survey (JAS) as part of the Kaunas-Rotterdam Intervention Study (KRIS). During a follow-up period of 9 1/2 years, 112 fatal and 157 non-fatal cases of myocardial infarction occurred. The JAS did not predict future cases of fatal or non-fatal myocardial infarction. Persons scoring highest on the hard-driving scale or the Dutch adaptation of the JAS tended to have higher incidences of angina pectoris. However, overall the validity of this test as a predictor of CHD was not substantiated in this population.

Angina Pectoris↗
PubMed1987

The prospective impact of psychosocial variables on rates of illness and injury in professional employees.

From a prospective study of health changes in air traffic controllers, it was determined that high scores on self-report measures of work-related life change distress, other life changes outside the work setting, the type A behavior pattern, and dissatisfaction with management were positively related to future rates of injuries and physician-diagnosed acute illness episodes. Depending on the risk factor involved, high scorers on these psychosocial risk predictors incurred from 80% to 252% more future accidental injuries and from 38% to 69% more future total morbidity over a 27-month follow-up period than the men in the low scoring groups. Moreover, coworker-rated amicability, probably an indication of the amount of social support available to an individual, was significantly protective against these outcome variables, with the rarely or never chosen group experiencing 60% more total morbidity and 174% more injuries than the often chosen group. A multiple-regression equation revealed that stress, amicability, type A, and satisfaction with management had an additive effect on the outcome variables. Work- and non-work-related life change distress subscales were similar in their ability to predict later morbidity. Prediction was stronger for 27-month follow-up than for only the first 9-month period. The findings, if replicated, raise the possibility of screening programs to identify employees at high risk of future illness and injury.

Adult↗
PubMed1986

The effects of antihypertensive therapy on the quality of life.

We conducted a multicenter randomized double-blind clinical trial among 626 men with mild to moderate hypertension to determine the effects of captopril, methyldopa, and propranolol on their quality of life. Hydrochlorothiazide was added if needed to control blood pressure. After a 24-week treatment period, all three groups had similar blood-pressure control, although fewer patients taking propranolol required hydrochlorothiazide. Patients taking captopril alone or in combination with a diuretic were least likely to withdraw from treatment because of adverse effects (8 percent vs. 20 percent for methyldopa and 13 percent for propranolol). The treatment groups were similar in scores for sleep dysfunction, visual memory, and social participation. However, patients taking captopril, as compared with patients taking methyldopa, scored significantly higher (P less than 0.05 to less than 0.01) on measures of general well-being, had fewer side effects, and had better scores for work performance, visual-motor functioning, and measures of life satisfaction. Patients taking propranolol also reported better work performance than patients taking methyldopa. Patients taking captopril reported fewer side effects and less sexual dysfunction than those taking propranolol and had greater improvement (P less than 0.05 to less than 0.01) on measures of general well-being. Our findings show that antihypertensive agents have different effects on the quality of life and that these can be meaningfully assessed with available psychosocial measures.

Adult↗
PubMed1985

Hospital readmissions among survivors six months after myocardial revascularization.

One neglected but important measure of early morbidity after coronary artery bypass graft (CABG) operations is rehospitalization. As part of a prospective study of recovery after elective CABG procedures conducted at four academic medical centers, data from all readmissions occurring within the first six postoperative months were collected for 326 patients. A total of 24% of patients had readmissions. The most common categories of readmission discharge diagnoses were cardiac (57%), noncardiac (26%), and surgical sequelae (17%). Factors from the initial hospitalization identified as risk factors for rehospitalization included: length of stay in intensive care unit after surgery, severe noncardiac complications, duration of preoperative cardiac symptoms, intra-aortic balloon insertion, and preoperative resting angina. These findings help to identify a subset of at risk patients for whom more careful surveillance might be beneficial.

Adult↗
PubMed1984

Functional benefits following coronary artery bypass graft surgery.

While some studies of patients who undergo cardiac surgery have included such outcome measures as amounts of symptom reduction and rates of resumption of employment, little attention has been focused on the extent to which these patients have experienced the simple, yet very important, broad range of functional benefits that might be anticipated by clinicians to result from operation. The present report seeks to document the extent of improvement that does exist in terms of physical, sexual, and social-role functioning. In a cohort of 340 patients (age, 32 to 69 years) studied before and six months after coronary artery bypass operation, improvements were noted in each of three dimensions of functional benefit: physical functioning (fewer total activity restrictions or incapacitated days per month), sexual functioning (through increased energy and desire and decreased pain and worry), and role functions (ability to work, social participation, and pursuit of hobbies). Further improvements might be anticipated with additional months of recovery.

Activities of Daily Living↗
PubMed1984

Optimal resources for primary prevention of atherosclerotic diseases. Atherosclerosis Study Group.

This statement is an update of the 1970 Inter-Society Commission for Heart Disease Resources ( ICHD ) report, "Primary Prevention of the Atherosclerotic Diseases." The charge to the Study Group was to assess relevant new data and, where the evidence is less than definitive, to formulate conclusions and recommendations based on best judgment. Current developments are reviewed, and issues raised in response to the earlier recommendations are considered. Recommendations are intended to serve as a guide for individual behavior, physician practice, and the formulation of public health policy.

Alcohol Drinking↗
PubMed1984

Optimal resources for primary prevention of artherosclerotic diseases. Atherosclerosis Study Group.

This statement is an update of the 1970 Inter -Society Commission for Heart Disease Resources (ICHD) report, Primary Prevention of the Atherosclerotic Diseases. The charge to the Study Group was to assess relevant new data and, where the evidence is less than definitive, to formulate conclusions and recommendations based on best judgment. Current developments are reviewed, and issues raised in response to the earlier recommendations are considered. Recommendations are intended to serve as a guide for individual behavior, physician practice, and the formulation of public health policy.

Adult↗
PubMed1983

Coronary artery bypass surgery. Physical, psychological, social, and economic outcomes six months later.

To evaluate the benefits of coronary artery bypass graft (CABG) surgery, we interviewed and tested 318 patients (268 men and 50 women) younger than age 70 before and six months after elective CABG at four university medical centers. Biomedical, psychoneurological, physical function, role function, occupational, social, family, sexual, emotional, and attitudinal variables were assessed. Quantitative comparisons showed improvement on many factors. Angina was completely relieved for 69% to 85% of persons, depending on whether it had been induced by exertion or other events. Disability days were reduced more than 80%. Seventy-five percent of employed persons had returned to work. Anxiety, depression, fatigue, and sleep problems declined. Vigor and well-being scores rose significantly. When losses were expected (eg, psychoneurological function, marital adjustment), they generally were not found. For none of the more than 60 outcome variables was widespread serious worsening found. The findings suggest that the great majority of patients are able to resume normal economic and social functioning within six months after CABG.

Adult↗
PubMed1983

Predictors of employment status after cardiac surgery.

Preoperative predictors of postoperative employment status were studied in 228 patients (aged 25 to 64 years) who underwent cardiac surgery. Of the 150 patients working in the year before surgery, 73% returned within six months. Of those not so employed, 18% started working. Patients who expected preoperatively to return to work did so at an 82% rate compared with 39% of the others. This was a strong predictor in the multiple regression analysis. Educational level and family income were stronger predictors than occupation or level of physical exertion required. Rates of return were higher in patients with less severe angina and less fatigue preoperatively, but did not differ significantly by sex, surgical procedure, or duration of illness. Seven variables predicted work status correctly for 86% of persons. These results suggest that determinants of return to work are largely present before surgery and that patients' attitudes and expectations play an important role.

Adult↗
PubMed1983

Does blood pressure usually rise with age? . . . Or with stress?

To determine whether blood pressure increases commonly accompany the aging process or reports of psychological distress during adulthood, successive blood pressure readings from eight to 14 annual health examinations of 172 employed men were studied. Longitudinal analysis showed that blood pressures tended to decline on the average over the first four examinations, possibly a familiarization effect. Even during the later period (extending four to ten years), 45 percent had no systematic increase in systolic pressure and 60 percent no systematic increase in diastolic pressure (i.e., averaging 0.5 mm/Hg per year or greater). Older and heavier men had higher mean pressures, as did those men with higher anxiety and hostility scores. The slope of blood pressure increase in the later part of the period of observation was greater for individuals who reported lower amounts of stress. There is need to discover additional correlates of systematic blood pressure increase over time. It appears, however, that about half of adult men do not experience steady blood pressure increases with aging. While anxiety and hostility correlate with concurrent blood pressure levels, neither these variables nor other estimates of stress were positively correlated with increasing blood pressure levels over these years.

Adult↗
PubMed1983

Correlates of angina pectoris among men awaiting coronary by-pass surgery.

Biomedical, behavioral, and psychological correlates of angina pectoris were identified in 204 men awaiting coronary artery by-pass graft surgery. Angina was rated by use of a precoded series of interview questions. Four circumstances of anginal symptoms were investigated: exertional, emotional, post-prandial, and while resting or sleeping. These were uncorrelated with one another, except for exertional and post-prandial. Two-thirds of these patients experienced angina less often than daily in the most recent unrestricted month. Severity of coronary artery obstruction was not positively associated with frequency or severity of any type of angina, and were primarily behavioral and psychological. Disturbances of sleep, physical inactivity, history of cigarette smoking, distressed response to life crises, life dissatisfactions, hostility, use of propranolol, duration of cardiac illness, and age were among the predictors in the multiple regression equations. These results from selected by-pass candidates may apply more directly to such persons than to unselected community residents reporting angina symptoms. The findings suggest the need for greater focus on sources of variability in myocardial oxygen supply and demand in understanding the dynamics of angina episodes.

Adult↗
PubMed1983

Physical, psychologic, social, and economic outcomes after cardiac valve surgery.

Eighty-nine patients receiving cardiac valve replacement or surgery consisting of valve replacement and coronary artery bypass grafts in four teaching hospitals were studied before surgery and again six months after surgery. More than 60 indicators of the quality of life were assessed. The majority of persons showed improvement in physical function, emotional states, and social activity. Of those with exertional angina or dyspnea before surgery, about two thirds were completely relieved at six months after surgery. There was a substantial reduction in number (from 31 to seven) of persons with five or more days of disability per month due to cardiac symptoms. The majority remained the same in their usual level of physical activity, most psychological traits, and attitudes and social support networks. Most previously employed persons returned to work. Improvements in the conditions of patients who had valve surgery closely paralleled those of patients who had undergone coronary artery bypass surgery in the same hospitals.

Activities of Daily Living↗
PubMed1982

Coronary-prone behavior in the Netherlands: a cross-cultural validation study.

As part of the Kaunas-Rotterdam Intervention Study (KRIS), the Jenkins Activity Survey (JAS), designed to measure the coronary-prone behavior pattern type A, was administered to 2712 males who participated in a health intervention program. A JAS score was computed by a maximum-likelihood method for item analysis and test scoring using the structured interview as the criterion. The Dutch adaptation classified 73% of the subjects correctly. Those who were treated at the moment of screening for one or more cardiovascular risk factors and those who suffered from angina pectoris had higher mean JAS scores that those without concurrent cardiovascular complaints. Those results provide some evidence that the type A coronary-prone behavior pattern, as measured by the JAS, is linked to coronary heart disease outside the United States.

Angina Pectoris↗
PubMed1982

Endocrine activity in air traffic controllers at work. I. Characterization of cortisol and growth hormone levels during the day.

This is the first in a series of three reports on repeated endocrine studies in the working environment for a group of 416 air traffic controllers. Twenty-minute integrated concentrations for plasma cortisol and human growth hormone across five-hr work periods are described and compared with a selection of studies of normal males reported in the literature. On average, across three repeated studies, controllers were secreting more cortisol and less growth hormone than the most comparable group of normal males. Cortisol and growth hormone levels were not appreciably related, and both hormones showed a lack of consistency across repeated studies in terms of average level or measures of episodic secretory activity. Small increases in cortisol secretion in response to venipuncture were apparent in some controllers during the morning hours; on the other hand, no growth hormone responses were evident. Neither hormone showed decreased secretion with repeated blood collections. Relationships between hormone secretion and the work environment, which possibly explain the lack of hormone consistency across time, will be examined in the second report.

Adult↗