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Biomedical subjects

D M Murray

Publications and source records attributed to D M Murray.

At least 109 records · Page 6Linked to original sources
PubMed1991

Gender differences in cigarette smoking and quitting in a cohort of young adults.

BACKGROUND: Smoking among young women is associated with a variety of negative health outcomes. Gender specific influences on smoking, quitting and attempting to quit are hypothesized to occur and may have implications for cessation programs. METHODS: Telephone surveys were conducted in a large (n = 6,711) cohort of young men and women (average age 19.2 years) which was first established in 1979 and has been resurveyed several times since then. Questions concerned smoking, successful and unsuccessful attempts to quit, withdrawal symptoms during quit attempts, and concerns about quitting. RESULTS: More women than men reported current smoking (26.5 vs 22.6 percent), but quitting attempts, successful and unsuccessful, were equally common. Withdrawal symptoms were reported equally, except for wanting to eat more than usual and weight gain, both of which were reported more often by women than men. Women smokers reported substantially more concern about weight gain if they quit smoking (57.9 vs 26.3 percent expressing concern). CONCLUSIONS: Targeted programs are needed to address issues of concern to young women smokers, particularly fear of gaining weight.

Adult↗
PubMed1990

Cholesterol reduction through low-intensity interventions: results from the Minnesota Heart Health Program.

The National Cholesterol Education Program has underscored the need for health professionals to work together to promote dietary changes and reduce blood cholesterol levels across the population. This article reports the results of an evaluation of several low-intensity intervention programs designed for the general public that could be offered on a larger scale, either through traditional outlets for short courses or on an outpatient basis after physician referral. The interventions were designed as classes, required approximately 8 hr of contact time with the participants, cost approximately $20 per participant, and were taught by nutritionists and dietitians recruited from the community and trained for this program. Results indicated that similar net reductions in total cholesterol of about 4% were achieved at 1-yr follow-up either from a course which focused on changing eating patterns or from one which focused on weight loss and weight-loss management. These results support the hypothesis that cholesterol reduction is possible with inexpensive and simple methods in healthy, low-risk populations.

Adult↗
PubMed1990

Planning for the appropriate analysis in school-based drug-use prevention studies.

School-based drug-use prevention studies often apply interventions to entire schools. A major problem for these studies results from the intragroup dependence often seen when intact social groups are assigned to study conditions. Analysis of data from 2 such studies revealed intraclass correlation coefficients between 0.02 and 0.05 for common drug use measures. Because even such modest intragroup dependence can invalidate the traditional fixed-effects analyses, researchers should adopt alternative methods that acknowledge this dependence. These alternative methods are reviewed, and appropriate methods for computing sample size requirements are illustrated. Investigators should consider these analysis issues when planning future studies, because the number of schools required for an unbiased analysis may be substantially greater than for the traditional methods.

Adolescent↗
PubMed1990

Patterns of self-initiated smoking cessation among young adults.

Prochaska and DiClemente's (1984) cyclic-stage model of self-initiated smoking cessation divides the cessation process into five stages. This model was applied to a young adult population to determine the cross-sectional distribution of stages and the frequency and pattern of changes among stages over time. Compared to older adults, the distribution of the stages differed substantially: There were twice as many relapsers and only half as many maintainers among young adults. One-year changes in stages were examined using a static model, which did not take into account the cyclic nature of the change process, and a more realistic dynamic model, which did. Both models, especially the dynamic model, suggested substantially more movement among stages in younger than in older adults.

Adolescent↗
PubMed1990

Evaluating the statewide dissemination of smoking prevention curricula: factors in teacher compliance.

As part of a larger study to evaluate the impact of a state-levied tax increase on tobacco products and the allocation of funds for smoking education, 81 schools were assigned randomly to one of four recommended smoking prevention programs for adolescents. The four programs differed in amount of program structure and extent of teacher training required. A one-session observation was made of 106 teachers in the 81 schools to assess the percentage of time allocated to recommended activities--those based on the social influences model. Data suggest an explicit curriculum with designed activities and face-to-face teacher training results in greater compliance to prescribed program components.

Adolescent↗
PubMed1990

Potentiation of susceptibility to aminoglycosides by salicylate in Escherichia coli.

Susceptibility of Escherichia coli to kanamycin and seven other aminoglycosides has been found to be strongly potentiated by salicylate. At pH 7.5, in the presence of 15 mM salicylate and 0.5 micrograms of kanamycin per ml, the efficiency of plating of the bacteria was 2 x 10(-5), whereas there was no significant killing in the presence of kanamycin or salicylate alone. With 0.75 micrograms of kanamycin per ml, the addition of 2.5 mM salicylate was sufficient to reduce the efficiency of plating by more than 10(4)-fold. Synergistic effects were found also at pHs 6.5 and 8.5. To determine whether the action of salicylate resulted from its behavior as a weak acid or its salicyl structure, similar experiments were carried out with acetate and salicyl alcohol. Acetate, a membrane-permeating weak acid, showed a synergistic effect on kanamycin susceptibility at pH 6.5 that was comparable to the effect seen with salicylate at pH 6.5. However, acetate had no synergistic effect with kanamycin at pH 7.5 or 8.5. This is consistent with the ability of acetate to increase the membrane potential of cells and the dependence of susceptibility to kanamycin and other aminoglycosides on the membrane potential. Salicyl alcohol, which has a hydroxyl group in the place of the carboxyl group that is present in salicylate, was an effective synergist with kanamycin. It was equally effective at pHs 6.5 and 7.5 and somewhat more effective at pH 8.5. These results support the hypothesis that two effects are involved in the synergy between aminoglycosides and salicylate: a weak acid effect, possibly to increase the membrane potential, and an uncharacterized effect related to the salicyl structure.

Acetates↗
PubMed1990

Usefulness of biochemical screening of diabetic patients for hemochromatosis.

We assessed the prevalence of previously unrecognized hemochromatosis among patients in whom diabetes mellitus was diagnosed after the age of 30 yr, and we evaluated the positive predictive value of biochemical screening tests for hemochromatosis in diabetic subjects. Thirty-eight of 572 patients screened (6.6%) had a serum ferritin level greater than 324 micrograms/L; 16 patients had normal levels on repeat testing. Four patients' serum ferritin levels fell to less than 400 micrograms/L. Seven of 18 patients with a persistently elevated serum ferritin level did not undergo a liver biopsy because of a recognized cause of hyperferritenemia (carcinoma, alcoholism, or systemic lupus erythematosus). The diagnosis of hemochromatosis seemed certain in 1 of 3 patients who were not biopsied for technical reasons. Of 8 patients biopsied, 2 had hemochromatosis, 4 had fatty liver, 1 had hemosiderosis, and 1 had a chronic inflammatory cell infiltrate with no iron deposition. Of 4 patients with a raised transferrin saturation level, 2 had raised serum ferritin levels and hemochromatosis, 1 had raised serum ferritin and hemosiderosis on liver biopsy, and 1 had a normal transferrin saturation level on repeat testing. Two of 3 cases of hemochromatosis had other clinical markers of the condition. Therefore, routine screening of diabetic patients for hemochromatosis is not necessary, because patients with hemochromatosis will often have other clinical features of the disease. When screening diabetic patients for hemochromatosis, it should be remembered that a persistently raised serum ferritin level has a low positive predictive value (16.6%) and that a normal transferrin saturation level does not exclude the diagnosis.

Adult↗
PubMed1989

Hostility, coronary heart disease, and total mortality: a 33-year follow-up study of university students.

Hostility as measured by the Cook-Medley Hostility (HO) Scale on the Minnesota Multiphasic Personality Inventory has been suggested as a risk factor for coronary heart disease (CHD) and total mortality. This study tested the HO-CHD hypothesis in a sample of 1399 men who entered the University of Minnesota in 1953 and, as part of freshman orientation, completed the MMPI. Current health status was ascertained for 94% of the sample through telephone interviews 33 years later. Higher HO scores did not predict CHD mortality, CHD morbidity, or total mortality either before or after adjustment for baseline risk factors. Among the plausible explanations for these results are that (1) hostility is not a risk factor in all populations, (2) the HO scale at age 19 does not assess a stable psychological characteristic, or (3) the HO scale is not an adequate measure of hostility.

Adult↗
PubMed1989

Five- and six-year follow-up results from four seventh-grade smoking prevention strategies.

Seven thousand one hundred twenty-four members of the Classes of 1985 and 1986 who had participated as seventh graders in one of several smoking prevention programs were tracked and surveyed for smoking habits at 5- and 6-year follow-up: participation exceeded 90% in both cohorts. These data indicated that participants who received seventh-grade interventions based on the social influences model had similar smoking patterns compared to participants in other conditions. This finding supports the call for booster sessions after the initial seventh-grade intervention program. Future follow-up studies will assess whether the earlier benefits associated with the social influences model will translate into measurable differences in adult smoking patterns.

Adolescent↗
PubMed1989

Tracking and attrition in longitudinal school-based smoking prevention research.

Research in the development of school-based smoking prevention programs has resulted in a set of approaches of known short-term efficacy. Further evaluation of these approaches now requires long-term follow-up of participants. To minimize the problems caused by attrition in these longitudinal studies, investigators have developed techniques for tracking study participants. Based primarily on the use of the telephone, mail, and public documents, these methods require good background information on both the study participants and their parents. This article summarizes the experience of three teams of researchers engaged in such follow-up studies. These investigators have identified the types of background information most useful in long-term follow-up of participants, have developed a set of strategies to obtain such background information, and have developed methods for successfully tracking participants after a lapse of several years.

Adolescent↗
PubMed1989

Decreased permeation of cephalosporins through the outer membrane of Escherichia coli grown in salicylates.

Escherichia coli K-12 cells grown in 1 to 5 mM sodium salicylate (SAL) or acetylsalicylate show increased phenotypic resistance to various antibiotics (J. L. Rosner, Proc. Natl. Acad. Sci. USA 82:8771-8774, 1985), including cephalosporins (this study). To determine whether these effects are caused by a decreased uptake of the antibiotics, the permeation of several cephalosporins through the outer membrane was measured. For E. coli K-12 grown in LB broth containing 5 mM SAL or acetylsalicylate, permeation of the outer membrane by the five cephalosporins tested decreased three- to fivefold compared with that in cells not grown in salicylates. Permeation of the outer membrane by cephaloridine decreased within 15 min of the addition of SAL to cells grown in broth and reached a minimum in 1 to 2 h. When cells were transferred from broth with SAL to broth without SAL, their permeability to cephaloridine increased slowly for the first 45 min and more rapidly over the next 1.5 h; the permeability then attained normal levels by 3 h. The permeability changes that occurred after media shifts, either to or from SAL, were prevented by concentrations of chloramphenicol that inhibited protein synthesis. These effects of SAL on outer membrane permeability are fully consistent with their effects on antibiotic resistance and with the report (T. Sawai, S. Hirano, and A. Yamaguchi, FEMS Microbiol. Lett. 40:233-237, 1987) that the outer membranes of SAL-treated cells are deficient in certain porins. Permeation of cephaloridine through the outer membrane also decreased when a virulent strain of E. coli K1 was grown in the presence of as little as 1 to 2 mM SAL. This raises the concern that high levels of salicylates in patients night interfere with cephalosporin or other antibiotic therapies.

Aspirin↗
PubMed1989

Measuring and tracking education program implementation: the Minnesota Heart Health Program experience.

In an overall framework uniting program planning and evaluation, process evaluation can assist community-based health promotion programs in establishing participation objectives, monitoring their achievement and the quality of interventions used, and translating these into useful information for managing and developing programs. This research reports on efforts by the Minnesota Heart Health Program to develop a system that permitted tracking educational program contacts, its implementation, and its use to make management decisions about program activities. The system was developed as part of a planning and evaluation framework with specific criteria for developing and tracking educational programs drawn from the social-learning literature. Overall, the system helped to make participation objectives more concrete, aided decision making about allocation of personnel and material resources, and encouraged the development of innovative programs.

Cardiovascular Diseases↗
PubMed1989

Parent involvement with children's health promotion: a one-year follow-up of the Minnesota home team.

This study compares the long-term outcomes of a school-based program to an equivalent home-based program with 2250 third-grade students in 31 urban schools in Minnesota and North Dakota in order to detect changes in dietary fat and sodium consumption. The school-based program, The Adventures of Hearty Heart and Friends, involved 15 sessions over five weeks in the third-grade classrooms. The home-based program, the Hearty Heart Home Team, involved a five-week correspondence course with the third graders, where parental involvement was necessary in order to complete the activities. Outcome measures included anthropometric, psychosocial, and behavioral assessments at school, and dietary recall, food shelf inventories, and urinary sodium data collected in the students' homes. Participation rates for all aspects of the study were notably high. Eighty-six percent of the parents participated in the Home Team and 71% (almost 1000 families) completed the five-week course. Students in the home-based program reported more behavior change at posttest, had reduced the total fat, saturated fat, and monounsaturated fat in their diets and increased their complex carbohydrate consumption. The changes derived from the dietary recall data did not maintain after one year. The data converge to suggest the feasibility and importance of parental involvement for initiating health behavior changes with children of this age.

Child↗
PubMed1989

Analysis issues in school-based health promotion studies.

In school-based research, usually the nature of the intervention or other practical factors indicate that assignment of treatment be done by school or classroom rather than by individual student. In this situation, randomization of schools (or classrooms) and analysis by school means (or classroom means) provide a firm statistical basis for internal validity of the study. When the number of schools available is small, this approach is not practicable, and therefore the investigator must be both more creative in developing solutions and more cautious in interpreting the results. This article provides a number of suggestions which the authors hope will assist the field in dealing with such circumstances. The authors stress that the best approach to assessing treatment effect is a well-designed, properly analyzed randomized experiment. The suggestions in this article attempt to indicate how one might make the most that one can from more limited data.

Data Interpretation, Statistical↗
PubMed1989

Validity of telephone surveys in assessing cigarette smoking in young adults.

Self-reports of cigarette smoking in a sample of young adults, aged 17 to 21 (n = 359) obtained by telephone were validated by home interview and saliva cotinine measurement. While most subjects were in agreement for their reported behaviors, the telephone methodology underestimated cigarette smoking rates by 3 to 4 per cent. Reported quitting by telephone was an unstable category with 35 per cent of quitters reporting smoking on home interview. Reliance on telephone methods alone may underestimate smoking behavior. Validation of surveys, preferably by biochemical methods, is recommended.

Adolescent↗
PubMed1988

Four- and five-year follow-up results from four seventh-grade smoking prevention strategies.

Recent studies have suggested that a prevention program that addresses the social influences that encourage smoking can be effective in deterring cigarette use by adolescents. This study presents 4- and 5-year follow-up results from two studies which evaluated three variations of this social influences model and compared them to a health consequences program and an existing-curriculum condition. The results suggest that a seventh-grade program, built around the social influences model and taught jointly by same-age peer leaders and local classroom teachers, may reduce 4-year weekly- and daily-smoking cumulative incidence rates, providing the first evidence for any long-term effects for the social influences model. However, the results also suggest that any long-term effects from such interventions are probably limited and may depend heavily on the manner in which the social influences model is translated during the intervention. Additional follow-up studies are needed to clarify the long-term effects of these intervention programs.

Adolescent↗
PubMed1988

Smokeless tobacco use among ninth graders in a north-central metropolitan population: cross-sectional and prospective associations with age, gender, race, family structure, and other drug use.

Smokeless tobacco use was analyzed in relation to demographic factors and to past and current use of tobacco, alcohol, and marijuana in 4,249 ninth graders in the Twin Cities metropolitan area. Smokeless tobacco use was found to be more common among males, particularly whites; among whites relative to blacks; among adolescents from one-parent households; and among those who reported current or prior use of cigarettes, alcohol, or marijuana. Smokeless tobacco use was also very common among the Native Americans and Hispanics sampled. The results suggest that smokeless tobacco may be joining the list of common recreational drugs that have potential for both short and long-term danger to the adolescent user.

Adolescent↗