Biomedical subjects

D M Murray

Publications and source records attributed to D M Murray.

At least 91 records · Page 5Linked to original sources

PubMed1993

A community education monitoring system: methods from the Stanford Five-City Project, the Minnesota Heart Health Program and the Pawtucket Heart Health Program.

Understanding the process of behavior change interventions is critical to achieving campaign effectiveness and successful program replication. The present article presents a community education monitoring system (CEMS) using data from the Stanford Five-City Project (FCP), the Minnesota Heart Health Program (MHHP) and the Pawtucket Heart Health Program (PHHP). CEMS records the number and type of intervention activities, outcome objectives, targets of change (individual, organizational or environmental), channel(s) of dissemination and proportion of programs funded by the community. These data illustrate (1) the application of theory for each project, (2) data-based program administration, (3) feedback for revising programs and (4) type of reach or 'dose' information obtained from intervention monitoring. Process evaluations such as CEMS provide critical links between field realities and evaluation outcomes. This type of evaluation develops standards for measuring program reach and allows comparisons with other programs. CEMS also illustrates how programs enact theory. Validation studies are critical to the continued successful use of CEMS. The first step, however, is to develop a uniform way of describing complex multichannel behavior change programs. CEMS in a refined form should prove invaluable to health promotion program planners whether in research or service settings.

Behavior Therapy↗

PubMed1993

The effect of live weight gain and live weight loss on body composition of merino wethers: noncarcass organs.

The weight of the noncarcass external tissues, thoracic organs, and visceral organs was measured during live weight gain (LWG) and live weight loss (LWL) to evaluate the effect of different periods of normal and retarded growth on noncarcass organs. Thirty-five Merino wethers were allowed ad libitum access to an experimental diet of 80% alfalfa chaff and 20% cereal grain (17.23% CP and 12.09 MJ/kg of DE) to grow from 23.0 to 33.0 kg live weight and then fed to lose 10 kg at 133 g/d. Groups of five animals were slaughtered at live weights of 23.0, 26.3, 29.6, and 33.0 kg during LWG and 29.6, 26.3, and 23.0 kg during LWL. Although total weight of noncarcass organs was significantly lower in LWL animals than in LWG animals at 23.0- and 26.3-kg (P < .05) common slaughter weights, the weight of some noncarcass organs was significantly greater in LWL animals. For example, the weight of the head at 23.0 and 26.3 kg (P < .05), of the feet and esophagus at 23.0 (P < .01) and 26.3 kg (P < .05), and of the total alimentary tract fat at 23.0 kg (P < .01) was greater in LWL wethers. Weights of other organs, however, were lower in LWL animals.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

PubMed1992

Serum ferritin in newly diagnosed and poorly controlled diabetes mellitus.

Serum ferritin was measured in 50 patients at diagnosis of diabetes mellitus (DM) and in 20 patients with established DM and poor metabolic control. Twenty-two patients had hyperferritinemia at diagnosis. Four patients had a recognised cause for their hyperferritinemia. In the remaining 18 patients ferritin levels decreased from a mean of 506 +/- 3.6 (SE) ug/l at diagnosis to 254 +/- 29.2 ug/l seven months later (p < 0.001). Metabolic control improved significantly over the same time. All 20 patients with established DM and poor metabolic control had normal ferritin levels. When compared with the newly diagnosed hyperferritinemic patients no difference was found in levels of glycosylated haemoglobin, but ferritin values differed significantly between the two groups (p < 0.001). These results indicate that transient hyperferritinemia is a feature of newly diagnosed DM but not of established DM with poor control. If used to screen diabetic patients for haemochromatosis, serum ferritin should be measured in established DM rather than at diagnosis.

Adolescent↗

PubMed1992

Results from a statewide approach to adolescent tobacco use prevention.

BACKGROUND: The 1985 Minnesota Legislature established guidelines for school-based tobacco-use prevention programming and provided financial incentives to school districts to encourage them to adopt a broad range of preventive measures. The Minnesota-Wisconsin Adolescent Tobacco-Use Research Project was funded by the National Cancer Institute in 1986 to evaluate the Minnesota initiative through two parallel studies. METHODS: The Four Group Comparison Study was a prospective study of 48 school "units" which were randomly assigned to one of four conditions in 1987. Baseline observations were taken in the sixth grade in 1987, interventions were delivered in the seventh grade, and follow-up observations were taken in the seventh, eighth, and ninth grades. The Four Group Comparison Study was designed to evaluate the three middle-school interventions that were most widely adopted by Minnesota school districts as a result of the 1985 legislation. The Two State Comparison Study was a serial cross-sectional study of representative districts in Minnesota and Wisconsin. Annual surveys of ninth graders were conducted from 1986-1990. The Two State Comparison Study was designed to determine whether tobacco-use patterns changed in Minnesota relative to Wisconsin following the Minnesota legislation. RESULTS: The prospective study indicated that none of the interventions was more effective in reducing adolescent tobacco use compared with a randomized control group. The serial cross-sectional study revealed that there was a modest net decline in Minnesota relative to Wisconsin from 1986 to 1990, but that it was within the range of chance variation. CONCLUSIONS: Taken together, these results indicate that this legislative initiative was insufficient to reduce adolescent tobacco use statewide during the 5-year study period. Together with results from other recent studies, they suggest that even more intensive efforts may be required to effect widespread reductions in adolescent tobacco use.

Adolescent↗

PubMed1992

Evaluation of new anti-infective drugs for the treatment of acute infectious diarrhea. Infectious Diseases Society of America and the Food and Drug Administration.

This guideline includes diarrhea causing infantile mortality in which a bacterial pathogen is recovered and for which oral rehydration therapy is an important component of care as well as traveler's diarrhea (with or without recovery of a pathogen). Diarrhea is defined as the passage of three or more unformed stools per day plus--in all patients except infants--one or more signs or symptoms of enteric infection. The preferred study design is prospective and randomized, with an active concurrent control and (when possible) blinding. Placebo-controlled trials may be performed if the severity of disease is judged by the investigator to be mild or moderate. It is desirable that both clinical and microbiological outcome be determined. Microbiological eradication is paramount.

Acute Disease↗

PubMed1992

Evaluation of new anti-infective drugs for the treatment of typhoid fever. Infectious Diseases Society of America and the Food and Drug Administration.

Typhoid fever is an acute febrile illness caused by Salmonella typhi. The evidence of blood-borne infection required for study entry includes clinical signs and symptoms plus confirmation of the presence of S. typhi in blood or other tissues or body fluids. The preferred study design is prospective and randomized with an active concurrent control. It is preferred that the investigator or an evaluator be blinded to therapy. In general, treatment should be administered for 2 weeks until it is demonstrated that a shorter course is as efficacious and as safe. Follow-up cultures of specimens from sites originally shown to be infected with S. typhi should be performed unless the diagnostic procedure places the patient at unnecessary risk.

Anti-Infective Agents↗

PubMed1992

Evaluation of new anti-infective drugs for the treatment of cholera. Infectious Diseases Society of America and the Food and Drug Administration.

Cholera is an acute gastrointestinal infection caused by Vibrio cholerae. It is characterized by watery diarrhea that may lead to massive fluid loss, which in turn may result in hypotension, shock, and death within hours. Key to the treatment of cholera is fluid replacement. Anti-infective therapy decreases the severity and duration of diarrhea and the duration of shedding of V. cholerae. Enrolled patients should have diarrhea that is moderate to severe and a culture that ultimately yields V. cholerae. A prospective, randomized, active-controlled clinical trial is preferred. Studies should be double-blinded or evaluator-blinded. The rapidity with which the organism is eliminated from stool may be assessed. Both clinical and microbiological outcome should be determined. Assessment of microbiological eradication is paramount, since fluid replacement may suffice for treatment of signs and symptoms.

Anti-Infective Agents↗

PubMed1992

Evaluation of new anti-infective drugs for the treatment of diarrhea caused by Giardia lamblia. Infectious Diseases Society of America and the Food and Drug Administration.

Giardia lamblia is a flagellate protozoan that produces symptoms by infecting the small bowel and biliary tract in the trophozoite form. Diagnosis is currently established by microscopic visualization of the organism in appropriate intestinal contents (stool, small-bowel contents, or biopsy specimen). Adult patients with diarrhea and one or more enteric symptoms may be enrolled in clinical trials of new drugs for the treatment of giardial disease. A randomized, double-blind, active-concurrent-control design is recommended. Post hoc stratification by age, immune status, chronicity of disease, and ease of establishing diagnosis (organism load) may be performed. Microbiological assessment 48 hours to 7 days after the completion of therapy is paramount for determining final outcome.

Anti-Infective Agents↗

PubMed1992

Evaluation of new anti-infective drugs for the treatment of diarrhea caused by Cryptosporidium. Infectious Diseases Society of America and the Food and Drug Administration.

Cryptosporidium is a coccidian protozoan that produces symptoms by infesting the small bowel. The illness is characterized by watery stools, anorexia, weight loss, and abdominal pain. Diagnosis is made by visualization of the organisms on microscopic examination of stool. There currently is no approved therapy for this infection. A randomized, double-blind, placebo-controlled study design is recommended. Stratification of patients by age and immune status should be considered. Two stool samples obtained 48 hours to 7 days after completion of therapy should be negative for Cryptosporidium oocysts. Assessment of microbiological outcome is paramount.

Adolescent↗

PubMed1992

Evaluation of new anti-infective drugs for the treatment of diarrhea caused by Entamoeba histolytica. Infectious Diseases Society of America and the Food and Drug Administration.

Entamoeba histolytica causes colonic infection that ranges from asymptomatic carriage to invasive disease with infection of extraintestinal organs, particularly the liver. The disease occurs in both sporadic and epidemic forms. Diagnosis requires visualization of trophozoites or cysts by microscopic examination of stool, colonic scrapings, or biopsy specimens. Patients with either asymptomatic or symptomatic disease may be eligible for clinical trials. A prospective, randomized, double-blind, placebo-controlled study design is recommended for asymptomatic carriers and an active-concurrent-control study design for symptomatic patients. Final outcome should be assessed 48 hours to 7 days after completion of therapy. Assessment of microbiological outcome is paramount.

Anti-Infective Agents↗

PubMed1992

Evaluation of new anti-infective drugs for the treatment of chronic carriage of Salmonella. Infectious Diseases Society of America and the Food and Drug Administration.

The chronic carriage of salmonellae is defined as the shedding of a Salmonella species for > or = 1 year, as documented by an initial positive culture of a stool sample obtained at least 1 month after resolution of the acute illness and repeated positive cultures for at least 1 year. Clinical trials of investigational anti-infective drugs for the treatment of the salmonella carrier state may be conducted with a placebo control or an active concurrent control. A crossover design also may be employed for establishing efficacy. Patients should generally receive therapy for at least 6 weeks. Outcome will be assessed only by microbiological criteria. Determination of the interval required for the suppression of salmonellae and follow-up for 6 months after completion of therapy are recommended.

Anti-Infective Agents↗

PubMed1992

Evaluation of new anti-infective drugs for the treatment of antibiotic-associated colitis. Infectious Diseases Society of America and the Food and Drug Administration.

Colitis due to Clostridium difficile is diagnosed in 10%-15% of hospitalized patients who develop diarrhea after treatment with antimicrobial drugs. Diagnosis is based on the concurrence of diarrhea, one or more signs or symptoms of enteric intoxication, and stool from which toxigenic C. difficile is isolated or from which its toxins are identified. Clinical trials evaluating therapy may be placebo controlled (for mild disease) or concurrently controlled with an active drug. A randomized, double-blind study design is preferred. Outcome should be assessed by monitoring of the degree of inflammation of the bowel mucosa, the intensity and severity of diarrhea, the duration of illness, changes in stool form, and the eradication of C. difficile or its toxins from stool. Because C. difficile can be a component of the normal gastrointestinal flora, assessment of clinical outcome is paramount.

Anti-Bacterial Agents↗

PubMed1992

Evaluation of new anti-infective drugs for the treatment of gastritis and peptic ulcer disease associated with infection by Helicobacter pylori. Infectious Diseases Society of America and the Food and Drug Administration.

Helicobacter pylori is a gram-negative, microaerophilic, spiral bacillus. Infection by this organism is currently believed to be the major cause of type B gastritis. Inflammation and infection may persist for years in the absence of therapeutic intervention. There is currently no approved antimicrobial therapy for gastritis. Clinical investigations have shown that combination regimens including bismuth salts and antimicrobial drugs result in the relief of symptoms, the resolution of histologic evidence of gastritis, the eradication of H. pylori, high rates of ulcer healing, and lower rates of ulcer relapse than have been found with other therapies (antacids and H2 antagonists). A randomized, double-blind, placebo-controlled study design is recommended for evaluation of new therapies. Study participants should have their progress monitored by endoscopy performed at enrollment, at completion of therapy, and 3 months thereafter. Assessment of microbiological outcome is paramount for final evaluation of the patient.

Anti-Bacterial Agents↗

PubMed1992

Communitywide smoking prevention: long-term outcomes of the Minnesota Heart Health Program and the Class of 1989 Study.

OBJECTIVES: The Class of 1989 Study is part of the Minnesota Heart Health Program (MHHP), a populationwide research and demonstration project designed to reduce cardiovascular disease in three educated communities from 1980 to 1993. This paper describes an intensive, school-based behavioral intervention on cigarette smoking, comparing long-term outcomes in one of the intervention communities with those in a matched reference community. METHODS: Beginning in sixth grade (1983), seven annual waves of cohort and cross-sectional behavioral measurements were taken from one MHHP intervention community and its matched pair. All students in each community were eligible to participate (baseline n = 2401). Self-reported data collected at each period described prevalence and intensity of cigarette smoking. RESULTS: There were no differences at baseline for either weekly smoking prevalence or intensity of smoking. Throughout the follow-up period, however, smoking rates as determined by these measures were significantly lower in the intervention community: 14.6% of students were weekly smokers at the end of high school compared with 24.1% in the reference community. CONCLUSIONS: These results suggest that multiple intervention components such as behavioral education in schools, booster programs to sustain training, and complementary communitywide strategies may all be needed for lasting reductions in adolescent tobacco use.

Adolescent↗

PubMed1992

The effect of live weight gain and live weight loss on body composition of merino wethers: chemical composition of the dissected components.

Chemical composition of the dissected side parts and dissected side was measured during live weight gain (LWG) and live weight loss (LWL) to determine effects on the chemical composition of the dissected side parts. Thirty-five Merino wethers had ad libitum access to the experimental diet (17.23% CP and 12.09 MJ/kg of DE) to grow from 23.0 to 33.0 kg live weight and then were fed to lose a total of 10 kg in three periods of 25 d each at the rate of 133 g/d. Groups of five animals were slaughtered at live weights of 23.0, 26.3, 29.6, and 33.0 kg during LWG and 29.6 kg (first period), 26.3 kg (second period), and 23.0 kg (third period) during LWL. The greater dissected side weight in LWL animals than in LWG animals at 23.0 kg of live weight was due to the significantly greater chemical fat (P < .05) in the LWL animals than in the LWG animals at 23.0 kg. There were no significant differences between treatments in the protein and water weights in the dissected side. The general increase in the chemical fat in the dissected side of the LWL animals was due to the significant increase in the chemical fat in the muscle (P < .01) and bone (P < .01, 23.0 and 26.3 kg and P < .05, 29.6 kg) at each common slaughter weight and subcutaneous fat (P < .05), intermuscular fat (P < .05) kidney and channel fat (P < .05), and total side fat (P < .01) at 23.0 kg.(ABSTRACT TRUNCATED AT 250 WORDS)

Adipose Tissue↗

PubMed1992

The effect of live weight gain and live weight loss on body composition of Merino wethers: dissected muscle, fat, and bone.

Sheep were slaughtered after live weight gain (LWG) and live weight loss (LWL) to evaluate the effect of different periods of normal and retarded growth on dissected carcass components. Thirty-five Merino wether sheep were allowed ad libitum access to the experimental diet of 80% alfalfa chaff and 20% cereal grain (17.23% CP and 18.10 MJ/kg of GE) to grow from 23.0 to 33.0 kg live weight and then fed to lose 10 kg at 133 g/d. Five animals were slaughtered at live weights of 23.0, 26.3, 29.6, and 33.0 kg during LWG and 29.6, 26.3, and 23.0 kg during LWL. Fleece-free empty BW was similar in both LWG and LWL animals at all common slaughter weights because of the lesser and greater weights of the alimentary tract contents and the fleece, respectively, in the LWL animals. Carcass weight or dissected side weight was greater in LWL animals at each common slaughter weight but significantly so (P less than .05) at the 23.0 kg live weight only. Total side muscle weight was similar in LWG and LWL animals at each common slaughter weight, but the proportion of muscle in the dissected side weight was lower (P less than .05) in LWL animals at 23.0 kg live weight. Total side fat, subcutaneous fat, intermuscular fat, and kidney and channel fat weights were all greater in LWL animals at each common slaughter weight, but significantly so (P less than .05) at the 23.0 kg live weight only. Total side bone weight was higher at both 26.3 kg (P less than .01) and 23.0 kg (P less than .05) in the LWL animals. Weight loss in young sheep mobilized more weight of muscle than fat from the carcass, whereas bone weight was constant.

Adipose Tissue↗

PubMed1991

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↗

PubMed1991

Comparison of smoking prevalence in school students sampled from the United States of America and the Union of Soviet Socialist Republics.

To assess the smoking prevalence among adolescents in the USA and the USSR, students in Moscow and Minneapolis were surveyed by common protocol and identically trained staff. Smoking habits were measured by a self-report questionnaire and an expired air sample of carbon monoxide (CO). Significant gender differences were found between the two national groups. Among girls in the USA, there was a significantly higher rate of weekly smoking as compared to girls in the USSR. Among boys in the USSR as compared to those in the USA, there was a significantly higher rate of ever smokers and daily smokers, but also of ex-smokers. These gender differences may reflect cultural differences in smoking patterns between the two countries. Cigarette smoking is clearly a public health problem in both countries with its onset in adolescence.

Adolescent↗