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Biomedical subjects

J B McClure

Publications and source records attributed to J B McClure.

13 recordsLinked to original sources
PubMed2001

Are biomarkers a useful aid in smoking cessation? A review and analysis of the literature.

Healthcare providers' ability to motivate people to try to quit smoking or to remain abstinent is limited. Even with our best treatments, most smokers relapse within 1 year. Therefore it is important that we constantly strive to develop and test new, effective smoking interventions. Providing feedback on one's biomarkers (e.g., biological indices of smoking-related harm, harm exposure, or genetic susceptibility to disease) have been suggested as potentially useful for increasing smokers' motivation or ability to quit smoking. In fact, variations of this strategy are commonly incorporated into behavioral smoking-cessation interventions, but little empirical evidence has specifically addressed whether this approach is effective. In this article, the author reviews the theoretical rationale and empirical evidence regarding this practice. Although the preliminary evidence is promising, more research is needed to determine the efficacy of using biomarkers and the limits of the strategy's effectiveness. Future investigations should address these issues.

Biomarkers↗
PubMed1999

Gender differences in response to nicotine replacement therapy: objective and subjective indexes of tobacco withdrawal.

K. A. Perkins (1996) recently proposed that nicotine reinforcement controls smoking to a greater degree among men than women and that consequently, nicotine replacement therapy (NRT) during smoking cessation should benefit men more than women. The authors tested this hypothesis. Polysomnographic measures of sleep and self-report indexes of tobacco withdrawal were collected pre- and postcessation from an active nicotine patch group and a placebo patch group in a randomized, double-blind clinical trial (N = 34). Objective sleep parameters supported Perkins's hypothesis and indicated that among women, NRT may be less effective at suppressing certain withdrawal responses compared with men and may produce some iatrogenic effects. Valid and reliable self-report measures of withdrawal did not reveal gender differences in response to NRT.

Adult↗
PubMed1999

Predictors of outpatient medical appointment attendance among persons with HIV.

Non-adherence to medical regimens is a critical threat to the health of HIV-infected individuals. Patients who do not adhere to routine medical care cannot fully benefit from the increasingly efficacious treatments available to them. Consistent attendance at medical appointments plays a central role in both prolonging life and enhancing quality of life for persons living with HIV/AIDS. By identifying why many patients do not reliably attend medical services, interventions can be undertaken to improve appointment-keeping. The primary purpose of the present study was to identify factors predictive of HIV-related medical appointment attendance. One-hundred-and-forty-four outpatients in a public hospital ambulatory care HIV clinic were followed for seven months. Demographic, medical care and psychosocial factors were measured in order to prospectively predict the percentage of missed clinic appointments by persons with HIV disease. Greater outpatient appointment non-attendance was associated with younger age, minority status, less severe illness and lower perceived social support. Treatment duration, provider consistency, hopelessness and religious coping did not emerge as significant predictors of outpatient appointment-keeping in this sample. Practical and theoretical implications of these findings are discussed in light of recent medical advances in HIV/AIDS care.

Acquired Immunodeficiency Syndrome↗
PubMed1998

Smoking cessation: recent developments in behavioral and pharmacologic interventions.

Smoking kills more than 430,000 people each year in the United States and is currently estimated to be responsible for 30.5% of all cancer-related deaths in our society. The majority of these deaths could be prevented, however, if people refrained from usage of tobacco products. It is, therefore, essential that smoking cessation treatment become an integral component of all types of health care. In order to help clinicians better serve their smoking patients, we present an overview of current trends in the behavioral and pharmacologic treatment of smoking cessation. Although popular with patients, standard self-help interventions provide little clinical utility. A review of the current literature supports the use of behavioral counseling and nicotine replacement therapy as the most efficacious forms of intervention, particularly when combined. Recent trends in cessation research have also included nonnicotine medications, such as antidepressants, anxiolytics, and nicotine antagonists. Although there is insufficient evidence to mandate inclusion of most of these medications in standard smoking cessation treatment at this time, preliminary studies have not ruled out their potential effectiveness.

Behavior↗
PubMed1997

Smoking cessation. 1: An overview of research.

Although tobacco smoking has long been recognized as having negative health consequences, more than one quarter of the US adult population smokes. This article presents (a) national trends in the prevalence of tobacco smoking, (b) health consequences associated with tobacco smoking and tobacco's mode of action (how tobacco/nicotine cause the problems), and (c) a brief overview of the smoking cessation treatment literature and several recommendations based on the review of research.

Female↗
PubMed1997

Smoking cessation. 2: Components of effective intervention.

Smoking cessation treatment is an essential component of comprehensive healthcare, but many healthcare providers lack formal training and are hesitant to provide such intervention. The recently published US Agency for Health Care Policy and Research (AHCPR) Smoking Cessation Clinical Practice Guideline provided empirically based recommendations to address these issues. The most effective components of smoking cessation include the use of nicotine replacement therapy, provider support and encouragement, and training in such skills as problem solving and coping. Methods of using these recommendations are illustrated, and sample scripts are offered to serve as references for providers from various disciplines who conduct smoking cessation interventions.

Adaptation, Psychological↗
PubMed1997

Smoking cessation. 3: Needed healthcare policy changes.

Smoking is the primary preventable cause of mortality and morbidity in our society, killing more than 430,000 people each year--more than 1,000 a day. Despite this deadly record, the treatment of nicotine dependence has not been integrated into routine medical care. Although professionals from many healthcare fields can be effective providers of smoking cessation treatment, relatively few actually advise patients to quit smoking; and even fewer assist their patients in quitting. Systematic changes in healthcare policies are needed to rectify these problems and improve the provision of smoking cessation services. In this article, the issues of who should be providing cessation treatment, why more providers do not offer this service, and what changes should be made to ensure more widespread inclusion of smoking cessation treatment in future healthcare practice are examined.

Cost-Benefit Analysis↗
PubMed1996

Factors associated with depression in a heterogeneous HIV-infected sample.

The present study examined factors contributing to depressive symptomatology in a low SES, heterogeneous HIV seropositive sample. The sample was comprised of 120 HIV-infected patients who completed psychosocial measures upon their initial visit to an outpatient HIV clinic. Length of time since HIV seropositive notification and HIV-related symptomatology were also assessed. Social support, major life stress, and HIV-related symptomatology were significantly associated with depression. Perceived availability of social support accounted for the greatest variance in depression scores. Length of time since seropositive notification was not significantly associated with depression. These findings extend previous research with middle-class, homosexual, white males to the rapidly growing minority, heterosexual, and low SES populations and point to the need for the inclusion of social support interventions in the provision of services of these individuals.

Adult↗
PubMed1975

Endodontic implants.

Explore the source record for details and available documents.

Dental Implantation, Endosseous, Endodontic↗
PubMedDate not supplied

Scheduled reduced smoking: effects on smoking abstinence and potential mechanisms of action.

Although most smokers in our society report that they would like to quit, smoking prevalence rates have remained relatively unchanged during most of the 1990s. This is in contrast to a nearly 50% reduction in prevalence observed over the past 3 decades. Presently, an estimated 25.5% of adults (48 million people) continue to smoke, although most smokers would like to quit. Recent research on the treatment of nicotine dependence has focused primarily on events that occur after the initial cessation period (i.e., the prevention of relapse with behavioral counseling and/or the management of withdrawal symptoms with nicotine replacement therapy). Although these methods are effective, there is evidence that cessation rates may also be enhanced by manipulating smoking behavior prior to quitting. One promising approach is scheduled reduced smoking. Early work with this approach has yielded superior abstinence rates compared to gradual reduction and abrupt "cold turkey" quitting techniques. In this article, we present an overview of research on scheduled reduced smoking and discuss the effects of the treatment on smoking urges, negative affect, and self-efficacy.

Adult↗