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Biomedical subjects

C J Atkins

Publications and source records attributed to C J Atkins.

At least 37 records · Page 2Linked to original sources
PubMed1989

Stability of systolic blood pressure reactivity to exercise in young children.

Blood pressure reactivity to stress in childhood has predicted development of hypertension 45 years later, so it is important to understand the characteristics of blood pressure reactivity in childhood. The present study assessed the 1-week and 6-month stability of systolic blood pressure reactivity to a 40-meter run stressor in preschool children. Sixty-three low-income children (mean age, 3.9 years) were assessed on four different days over a 6-month period. One-week stability (r = 0.39 to 0.50) and 6-month stability (r = 0.56) of reactive systolic blood pressure levels were highly significant. Reactive systolic blood pressure level was more stable than resting systolic or diastolic blood pressure in this sample. Sex, body mass index, family cardiovascular disease history, and child Type A behavior all were unrelated to systolic blood pressure reactivity. Systolic blood pressure reactivity to exercise appears to be an enduring characteristic that emerges in early childhood.

Arousal↗
PubMed1988

Aggregation of physical activity habits in Mexican-American and Anglo families.

It is believed that families are important influences on the development of health habits, and the purpose of the present study was to examine the familial aggregation of physical activity. Physical activity habits were assessed by standardized interview in adults and children in 95 Anglo families and 111 Mexican-American families. The results indicated a moderate degree of aggregation of physical activity in both samples, and adjustment for body mass index was inconsequential. Intrafamily correlations tended to be higher in Mexican-Americans. Mother-child correlations usually were higher than father-child correlations. These findings support the hypothesis that the family is a significant influence on physical activity.

Adolescent↗
PubMed1988

Human alloantibodies detecting a red cell antigen apparently identical to MER2.

Three examples of an antibody were found to be detecting a red cell polymorphism probably identical to MER2. The antibodies were made by Jews originating from India and living in Israel. Two of them were sibs and the third was unrelated. All 3 had kidney disease requiring renal dialysis and regular blood transfusion. In 2 cases the antibodies were detected before dialysis was started and before the patients had been transfused. The human antibodies reacted with red cells of 90% of Israeli blood donors tested. In tests on selected blood donors, 82 English and 56 Israeli, one of the human antibodies gave almost identical reactions to those given by monoclonal anti-MER2. Anomalous reactions were probably due to anti-Bga. Two of the human antibodies completely blocked, and one partially blocked, the reaction of monoclonal anti-MER2 with MER2+ red cells.

Adolescent↗
PubMed1987

Selective attrition causes overestimates of treatment effects in studies of weight loss.

Selective attrition causes serious threats to the validity of experimental trials. Experimental studies in behavior therapy typically include only data from those who complete an experiment. In this paper, we examine the probability of dropping out of a study contingent upon failure to achieve desired benefits. The data are derived from an experimental trial evaluating the effects of weight loss for patients with Diabetes Mellitus. Seventy-six percent of the original participants completed the intervention and the follow-up assessments. However, the probability of failing to appear for follow-ups over an 18 month period was examined. The chances of dropping out of the study were significantly higher for those who did not achieve a goal of weight reduction. This selective loss to follow-up results in an overestimate of treatment effectiveness. By failing to acknowledge drop-outs, treatment failures may be systematically eliminated from the analyses.

Adult↗
PubMed1984

Validity of a quality of well-being scale as an outcome measure in chronic obstructive pulmonary disease.

This paper evaluates the validity of the Quality of Well-being Scale (QWB) as an outcome measure for research on Chronic Obstructive Pulmonary Disease (COPD). The Quality of Well-being Scale was originally designed for use as a general health outcome measure. One criticism of this approach has been that it may not be valid in studies limited to a specific disease or condition. We report correlations between the QWB and a variety of other outcome measures obtained in an experimental trial evaluating the benefits of behavioral programs for COPD patients. The data from the trial suggest that the QWB is substantially correlated with both performance and physiological variables relevant to the health status of COPD patients. An advantage of the QWB is that it can be transformed into well-year units for cost-effectiveness studies. It is concluded that the QWB has many advantages as an outcome measure for specific disease groups.

Cost-Benefit Analysis↗
PubMed1984

Specific efficacy expectations mediate exercise compliance in patients with COPD.

Social learning theory has generated two different approaches for the assessment of expectancies. Bandura argues that expectancies are specific and do not generalize. Therefore, he prefers measures of specific efficacy expectations. Others endorse the role of generalized expectancies measured by locus of control scales. The present study examines specific versus generalized expectancies as mediators of changes in exercise behavior among 60 older adult patients with Chronic Obstructive Pulmonary Disease. The patients were given a prescription to increase exercise and randomly assigned to experimental groups or control groups. All groups received attention but only experimental groups received training to increase their exercise. After 3 months, groups given specific training for compliance with walking significantly increased their activity in comparison to the control group receiving only attention. These changes were mediated by changes in perceived efficacy for walking, with efficacy expectations for other behaviors changing as a function of their similarity to walking. A generalized health locus of control expectancy measure was less clearly associated with behavior change. The results are interpreted as supporting Bandura's version of social theory.

Aged↗
PubMed1984

The costs and effects of behavioral programs in chronic obstructive pulmonary disease.

This paper uses a General Health Policy Model to determine the cost-effectiveness of an experimental behavioral program for patients with chronic obstructive pulmonary disease (COPD). Patients were randomly assigned to either experimental or control groups, and only those in the experimental groups were given the behavioral strategies. Health status information was collected over 18 months, and the Health Policy Model translated program outcomes into well-year equivalents. At the end of the program, greater improvements in health status were observed in the experimental subjects, and a total of 4.41 well-years were produced. Costs of the program were gathered on a per-year basis using an administrative perspective. Both costs and health effects were discounted to present value using a 5% discount rate. Dividing costs by effects, the COPD program produced well-years at a unit cost of $24,256. Comparing the cost-utility figure to those of other health care programs using the General Health Policy Model, the behavioral program appears reasonably cost-effective as an adjunct therapy for patients suffering from COPD.

Behavior Therapy↗
PubMed1984

Penicillamine and other remittive agents in rheumatoid arthritis: comparisons and interaction.

Penicillamine treatment of rheumatoid arthritis was compared with gold and other remittive agents by reviewing the literature and studying the patients in our penicillamine clinic with respect to their previous responses to chrysotherapy. Penicillamine compares well with other remittive agents with respect to efficacy and toxicity. Prior chrysotherapy does not determine or predict the subsequent efficacy of penicillamine . Patients who reacted adversely to gold tended to react adversely to penicillamine; proteinuria and rash tended to recur.

Anti-Inflammatory Agents↗
PubMed1983

Penicillamine compared to previous chrysotherapy in rheumatoid arthritis.

Of 331 patients in our 3 penicillamine clinics, 312 had been taking chrysotherapy previously. In 232 patients, responses to both drugs could be determined: there was no difference in the response rate to penicillamine when patients in the largest clinic with good and those with poor responses to gold were compared. Adverse reactions to penicillamine were more frequent in patients who had reacted adversely to gold in 2 of the 3 clinics. Proteinuria tended to occur more frequently in patients who had had proteinuria when taking gold than in patients who had not had gold-induced proteinuria.

Adolescent↗
PubMed1982

Coping with a stressful sigmoidoscopy: evaluation of cognitive and relaxation preparations.

Sigmoidoscopy involves the insertion of a small scope into the anal cavity to inspect for abnormalities in the colon. Although the procedure is not believed to be painful, it is often noxious for patients because it produces embarassment and discomfort. We examined the effectiveness of two brief interventions designed to enhance coping: self-instructional training and relaxation. In the self-instructional conditions patients were given brief training to focus their attention on either their own (internal) or the doctor's (external) ability to regulate the situation. A third (control) group received attention but did not experience self-instructional training. Half of each of these three groups also received relaxation training, while the other half did not. Planned comparisons demonstrated that subjects in the self-instructional strategies rated themselves as less anxious, had fewer body movements during the exam, and emitted fewer verbalization than those in an attention control group. Patients in the external condition estimated that the exam took less time but tended to have elevated heart rates during the procedure. Those experiencing relaxation training tended to overestimate the duration of the exam, but made fewer requests to stop the exam and rated themselves as less anxious than patients who did not receive relaxation training.

Adaptation, Psychological↗
PubMed1980

Adverse effects of D-penicillamine in rheumatoid arthritis.

Adverse effects to D-penicillamine were studied prospectively over 3 years in 259 patients with rheumatoid arthritis. Ninety-five percent had had gold therapy previously, yet 70% benefited from D-penicillamine therapy. Of the 275 courses given, 160 (58%) were complicated by at least one reaction, including rashes (44%), dysgeusia (20%), gastrointestinal upset (18%), stomatitis (10%), proteinuria (7%), thrombocytopenia (3%), and leukopenia (2%). Their occurrences peaked in the first 6 months of treatment, except for proteinuria and thrombocytopenia, which peaked in the second 6 months. Reactions were commoner at daily doses above 250 mg; mean daily doses for proteinuria, thrombocytopenia, and leukopenia were higher (approximately 600 mg/d) than for the others (approximately 500 mg/d). Of 114 discontinued courses, 73 (27%) were due to adverse reactions. The remaining reactions were controlled by altering dosages and symptomatic treatment. Only obliterative bronchiolitis (two cases) was irreversible; it resulted in the only death in our series, possibly attributable to penicillamine.

Adolescent↗