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Biomedical subjects

C McBride

Publications and source records attributed to C McBride.

At least 37 records · Page 2Linked to original sources

A randomized trial of self-help materials, personalized feedback, and telephone counseling with nonvolunteer smokers.

The incremental effects of (a) a self-help booklet alone, (b) self-help booklet with computer-generated personalized feedback, and (c) self-help booklet, personalized feedback, and outreach telephone counseling were evaluated in a population-based, nonvolunteer sample of smokers. Smokers (N = 1,137) were identified through a telephone survey of a random sample of 5,903 enrollees in a health maintenance organization and randomized to a no-treatment control group or 1 of the 3 intervention conditions. Smoking status was ascertained 3, 12, and 21 months postrandomization. Cotinine validation of self-reported cessation was obtained at the 12-month follow-up. Overall, the telephone counseling significantly increased smoking cessation at the 3-month follow-up, but not at 12 or 21 months. Among smokers who were precontemplative at baseline, telephone counseling significantly increased prevalent abstinence at 3 and 12 months and continuous abstinence at 21 months (defined as self-reported abstinence at 3, 12, and 21 months).

Adult↗

A comparative study of patient satisfaction with health care in Japan and the United States.

Patient satisfaction with medical care received at selected medical facilities in the United States (895 patients) and in Japan (856 patients) was compared using self-administered questionnaires. In each country, patients at a large government hospital and a smaller affiliated clinic were surveyed. Patients responded to questions concerning specific aspects of medical care, general satisfaction with the care received, waiting time to see the physician and time spent with the physician. Results suggest that patients at study sites in both countries were generally satisfied with the medical care they received. However, American patients were more likely to report satisfaction than their Japanese counterparts on each dimension of health care measured. The largest discrepancies were found in satisfaction with waiting time to see the doctor and time spent with the doctor. Stepwise discriminant analyses indicated that provider skill may be the most important predictor of overall satisfaction with medical care in both countries. These results are discussed in the framework of the underlying health care system.

Adult↗

Implementation and acceptance of outreach telephone counseling for smoking cessation with nonvolunteer smokers.

Brief supportive telephone counseling is a promising adjunct to self-help smoking cessation programs. This article reports rates of participation, predictors of participation, and content of telephone counseling calls with nonvolunteer smokers who were identified through health surveys administered to a random sample of enrollees in a health maintenance organization. Eighty-six percent of smokers accepted at least one of three counselor calls; 66% accepted all three calls. Baseline characteristics associated with acceptance of calls included being female and greater average length of time to the first cigarette of the day. Acceptance did not differ significantly by stage of cessation. First calls with smokers who accepted all three calls were longer and were more likely to be with smokers who were willing to take a specific next action step. Overall, 12% of the sample reported having quit smoking by the third counseling call, with the highest quit rate (23%) among smokers who, at baseline, were planning to quit in the next month. Implications for large-scale interventions with smokers in health care and other organizations are discussed.

Adult↗

A randomized trial of the impact of risk assessment and feedback on participation in mammography screening.

BACKGROUND: Although rates of mammography screening among women in the general population have been increasing they still fall short of national goals. This study evaluated the effects on rates of participation in mammography screening of obtaining risk factor information and providing general or personalized risk information through direct mailed correspondence. METHODS: Women enrollees in a health maintenance organization (N = 2,076), age 50 and above, were randomized to one of the following four groups: (a) no risk factor questionnaire + generic invitation, (b) no risk factor questionnaire + general risk invitation, (c) risk factor questionnaire + general risk invitation, and (d) risk factor questionnaire + personal risk invitation. Computerized visit records were monitored for 12 months following a mailed invitation to assess whether a mammogram had been obtained. RESULTS: Overall participation was 37.5% and the rate of participation did not differ significantly across groups (P = 0.26). Participation was related to age (P < 0.02), with rates highest for women ages 60-69 years (42.7%) compared with those for women ages 50-59 (35.5%) and those age 70+ (33.7%). Among women with a family history of breast cancer, the personalized risk invitation was associated with significantly higher participation compared with general risk invitation (66.7 versus 42.9%, respectively; P < 0.003). CONCLUSIONS: Women with a family history of breast cancer are more likely to obtain a mammogram if that fact is reinforced as a risk factor. Research on environmental barriers to mammography screening may suggest alternative strategies for increasing participation.

Adult↗

Resectable gastric carcinoma. An evaluation of preoperative and postoperative chemotherapy.

Patients with locoregional gastric carcinoma often die because of the low rates of curative resection and frequent appearance of distant metastases (mainly peritoneal and hepatic). To evaluate the feasibility of preoperative and postoperative chemotherapy, 25 consecutive previously untreated patients with potentially resectable locoregional gastric carcinoma received two preoperative and three postoperative courses of etoposide, 5-fluorouracil, and cisplatin (EFP). Ninety-eight courses (median, five courses; range, two to five courses) were administered. Six patients had major responses to EFP. Eighteen patients (72%) had curative resections, and three specimens (12%) contained only microscopic carcinoma. At a median follow-up of 25 months, the median survival of 25 patients was 15 months (range, 4 to 32+ months). Peritoneal carcinomatosis was the most common indication of failure. One patient died of postoperative complications, but there were no deaths due to chemotherapy. EFP-induced toxic reactions were moderate. Preoperative and postoperative chemotherapy for locoregional gastric carcinoma is feasible, and additional studies to develop regimens that could result in 5% to 10% complete pathologic responses may be warranted.

Adenocarcinoma↗

Sensitivity and specificity of saliva thiocyanate and cotinine for cigarette smoking: a comparison of two collection methods.

Saliva samples returned by mail were compared to duplicates returned by interviewers in terms of the sensitivity and specificity of cotinine and thiocyanate analyses performed on those samples to detect tobacco use. Compared to the samples returned by interviewers, those returned through the mail were slightly lower in specificity but similar in sensitivity. These findings confirm that saliva samples do not deteriorate during transit via the postal service, although substantial questions remain that concern the validity of such samples in the evaluation of cessation programs.

Adolescent↗

Effects of nicotine gum on prevalence and severity of withdrawal in female cigarette smokers.

This study examines the extent to which 2 mg nicotine gum reduces the prevalence and severity of cigarette withdrawal signs and symptoms. The sample was comprised of women who were randomly assigned to chew 2 mg nicotine gum (N = 206) or no nicotine gum (N = 211). Signs and symptoms of withdrawal were assessed at days 2, 7, 14, and 28 post-cessation. The results showed a significant effect of 2 mg nicotine compared to no gum at 2 days post-cessation on the prevalence of the following symptoms: anxious/tense, difficulty concentrating, restless, impatient, somatic symptoms, insomnia, increased eating, and drowsiness. There were additional differences between the two groups for the severity of craving for cigarettes, irritable/angry, excessive hunger, and total withdrawal score. Over the course of 28 days post-cessation, significant Group and/or Group x Time interaction effects were found with regard to the severity of signs and symptoms for the following variables: impatient, insomnia, increased eating, irritable, difficulty concentrating, restless, somatic complaints, and total withdrawal score. These results are similar to those obtained from placebo-controlled trials for nicotine gum.

Adult↗

Public support for policy initiatives regulating alcohol use in Minnesota: a multi-community survey.

Public support for policies to control alcohol sales and consumption was surveyed in seven Minnesota communities. A total of 438 women and 383 men were asked to indicate their level of support of or opposition to nine different proposals designed to regulate alcohol. There was general support for all policies, which was strongly related to characteristics of respondents and type of policy proposed. Women were significantly more supportive of all items than were men. Marriage, older age and low alcohol consumption were also associated with support. Education and voter status generally were not. Policies and activities that serve primarily to protect youth received the strongest support. Restrictions and prohibitions such as limiting advertisements were less popular. The least support was expressed for increases in taxes on alcohol and for measures that would eliminate an existing practice such as prohibiting wine-cooler sales at convenience stores. The majority of respondents also indicated that they felt the individual, as opposed to the manufacturer or retailer, was responsible for problems associated with alcohol and should be the focus of intervention. Strategies for shifting the focus from the individual to environmental and regulatory control are discussed.

Adolescent↗

Public support for policy initiatives regulating high-fat food use in Minnesota: a multicommunity survey.

Public support of eight policies to regulate the sale and consumption of high-fat food was evaluated in a survey of 438 women and 383 men in seven Minnesota communities. The survey was part of the ongoing activities of the Minnesota Heart Health Program (MHHP). Respondents, when asked to indicate their level of support or opposition to each of eight policies, expressed general support for all but two. Women were consistently more supportive than men. Other sociodemographic characteristics and reported use of food and other substances were generally not predictive of support. Policies that would control conditions of sale or information about the product were the most strongly supported. Taxation as an incentive to food producers to provide alternatives to high-fat food or as a disincentive to consumers to purchase these foods was moderately supported. A proposal to limit sale of high-fat food to children was the most strongly opposed. The majority of respondents indicated that they felt the individual consumer, as opposed to the producer or retailer, is most responsible for problems associated with high-fat food use. The three communities which had received MHHP health promotion activities were significantly more supportive than the comparison communities on two of the eight proposals. There is a moderate level of support in the general public for additional policies to regulate the sale and consumption of high-fat foods. These policy level interventions, similar to policies common in the regulation of alcohol and tobacco use, may be a feasible strategy to help moderate use of potentially health-compromising food products.

Adolescent↗

Improving the efficiency of wound drainage catheters.

We have modified the most commonly utilized wound drainage system to further reduce the incidence of postoperative accumulation of fluid under the skin flaps. This modification allows more efficient removal of debris, loose tissue fragments, and clots from the wound catheters and insures a constant negative pressure in the system. These maneuvers lengthen the usefulness and improve the efficiency of the catheters and have reduced the incidence of fluid accumulation.

Catheterization↗

The distribution and properties of aspartyl transfer RNA in human and animal tumors.

The elution profile of aspartyl transfer RNA (aspartyl-tRNA) from reversed phase 5 chromatography for tRNA from a spectrum of animal tissues and tumors and human tumors has been examined. It was found that SV40-induced hamster tumors, BHK21/cl 13 cells in culture, certain carcinogen-induced tumors in the Ehrlich ascites tumor, and a number of human carcinomas and adenocarcinomas contained a distinct increase (3- to 20-fold) in the percentage of a late-eluting aspartyl-tRNA over that found in nonmalignant tissues, other animal tumors, and in human melanomas and sarcomas. The ability of the late-eluting aspartyl-tRNAAspIV to bind to ribosomes in the presence of the codons for aspartic acid was compared to that of aspartyl-tRNAAspIII and was found to be approximately the same. Also, the ability of each of the 4 isoaccepting species of aspartyl-tRNA to engage in ribosomal incorporation of aspartic acid into a polypeptide was determined. All 4 isoacceptors function equally well in the amino acid incorporation.

Adenocarcinoma↗