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Biomedical subjects

J G Joseph

Publications and source records attributed to J G Joseph.

31 records · Page 2Linked to original sources
PubMed1988

Effects of HIV infection, perceived health and clinical status on a cohort at risk for AIDS.

Data from a general population sample of 621 healthy homosexual men are used to evaluate the social and emotional effects of HIV antibody status, clinical signs detected by medical examination, and subjectively perceived symptoms. Participants are unaware of their serologic status at the time of data collection, thus allowing the effects of the virus to be separated from reactions to the knowledge of serologic status. The data show that seropositivity for HIV is not associated with elevated levels of social or emotional impairment. Clinical signs lead to impairment in baseline data, but these effects do not persist at a second wave. This weakening suggests that the effects are mediated by psychological pathways rather than biologic ones. This suspicion is confirmed in further analyses, which show that the effects of clinical signs are mediated by subjectively perceived symptoms. These results show that neither social nor emotional impairment is likely to be a prodromal sign of HIV infection in otherwise healthy homosexual men. The substantial levels of distress found among these men is more directly influenced by psychological determinants than biologic ones. This suggests that physicians should be aware of the psychological toll imposed on gay men who develop health problems in the current atmosphere of uncertainty regarding risk of AIDS.

AIDS Serodiagnosis↗
PubMed1988

AIDS and behavioral change to reduce risk: a review.

Published reports describing behavioral changes in response to the threat of AIDS (acquired immunodeficiency syndrome) are reviewed. These studies demonstrate rapid, profound, but expectably incomplete alterations in the behavior of both homosexual/bisexual males and intravenous drug users. This is true in the highest risk metropolitan areas such as New York City and in areas with lower AIDS incidence. Risk reduction is occurring more frequently through the modification of sexual or drug-use behavior than through its elimination. In contrast to aggregate data, longitudinal descriptions of individual behavior demonstrate considerable instability or recidivism. Behavioral change in the potentially vulnerable heterosexual adolescent and young adult populations is less common, as is risk reduction among urban minorities. Reports of AIDS-related knowledge and attitudes generally parallel the pattern of behavioral changes. Nonetheless, few studies investigate the relationship of knowledge and attitudes to risk reduction. Future studies should provide much-needed information about the determinants as well as the magnitude of behavioral changes required to reduce the further spread of AIDS.

Acquired Immunodeficiency Syndrome↗
PubMed1986

Breast self-examination in an urban population: estimates of prevalence and quality of performance.

Interview data from 434 women (aged greater than or equal to 20 years) in two Wellington suburban areas were used to estimate the prevalence and quality of performance of breast self-examination. Although 98% of women were familiar with breast self-examination, and 73% had performed it at least once, only 39% did so at least monthly. Its practice was significantly more common in the middle years (30-59), among Europeans, and in women with tertiary education. Thoroughness or quality of performance was assessed by comparison with Cancer Society recommendations. Scores for examination technique were generally high (mean = 73%) compared with those assessing timing (mean = 47.5%) and conditions under which breast self-examination was performed (mean = 43.3%). Results from this study were compared with 1975-76 New Zealand survey data which produced lower estimates of the prevalence of monthly breast self-examination. Both studies found that more than a quarter of women have never practiced it. Future research and intervention efforts should be directed toward this group of women.

Adult↗
PubMed1985

Major colorectal cancer aetiological hypotheses do not explain mortality trends among Maori and non-Maori New Zealanders.

New Zealand colorectal cancer mortality rates are presented for the period 1947-1980. Mortality has been increasing and is now the highest in the world for both males and females in the age range 35-64; indeed New Zealand mortality rates for those aged 35-44 are approximately twice those of other countries with high mortality. By contrast, colorectal cancer mortality rates among Maoris, the indigenous New Zealanders of Polynesian descent, have been decreasing so that they are now less than half the non-Maori mortality rates. These findings cannot be explained by ethnic differences in consumption of the major proposed dietary risk factors: total fat, cholesterol, meat, fibre and beer. Possible differences in the prevalence of lactose malabsorption, in faecal mutagen activity, and in the prevalence of colorectal polyps warrant further investigation.

Adult↗
PubMed1985

Longitudinal analysis of the relationship between blood pressure and migration: the Tokelau Island Migrant Study.

The Pacific atoll population of Tokelau has been followed since 1968 to assess the health consequences of migration to a western society. The blood pressure of a cohort of 532 adults who were still living in Tokelau in 1976 (nonmigrants) are compared with those of a cohort of 280 adults who had migrated to New Zealand (migrants). Significant differences between migrants and nonmigrants were detected in the rates of change of both systolic and diastolic pressures in men, and in the rates of change of diastolic pressures in women. The age-, body mass, and blood pressure-corrected rates of change were greater in migrants than in nonmigrants, and greater in men than in women. Blood pressures tend to rise 1 mmHg/year faster among male migrants than among male nonmigrants, and about 0.4 mmHg/year faster among female migrants than among female nonmigrants. These findings have clear implications for the health of migrants.

Adolescent↗
PubMed1984

Hospital utilization: an epidemiologic perspective on possible future trends.

Like the noted Mr. Holmes, epidemiologists work with details. This article focuses upon the use of detailed epidemiologic data to explore potential changes in hospital service utilization during the next decade. Although epidemiologists share with Mr. Holmes a commitment to inductive reasoning based on specific data, only a fictional detective would claim infallibility. In practice, data describing human populations are limited, inferences fragile, and changes always possible. These cautions need to be kept in mind when estimating future trends.

Demography↗
PubMed1983

Elevation of systolic and diastolic blood pressure associated with migration: the Tokelau island migrant study.

Cross-sectional univariate and multivariate analyses estimated differences between the blood pressure of adult Tokelauan migrants to New Zealand and non-migrants still living on three Polynesian atolls. Response rates were 97 and 99% in the two locations. Among males, the difference between migrants and non-migrants after adjustment for significant covariates was 7.2 mmHg systolic pressure (p less than 0.001) and 8.1 mmHg diastolic pressure (p less than 0.001). Among females, adjusted systolic pressure was not significantly higher in migrants compared to non-migrants (1.8 mmHg, p = 0.065) and diastolic pressure was only 3.0 mmHg higher (p less than 0.001). Body mass is significantly correlated with blood pressure in this study group; nonetheless, differences in body mass explain only a small proportion of the observed migrant/non-migrant differential in blood pressure. Estimates of blood pressure differences preceding migration are also reported. These indicate that blood pressure was neither consistently nor significantly higher among those who subsequently migrated. This report provides compelling evidence linking Westernization and the development of chronic disease.

Adolescent↗
PubMed1976

Gallium-67 scanning for carcinoma of the lung.

Gallium-67 citrate scanning was prospectively evaluated in 55 patients who had lung lesions suspected to be primary carcinoma on chest x-ray films and in whom subsequent histologic diagnosis was obtained. Of 47 patients with histologically proved carcinoma of the lung, 44 (94 per cent) had a positive 67Ga scan. No patient with a positive scan had a benign lesion, so that the positive scan accuracy rate was 100 per cent. All 8 patients with a benign lesion and 3 patients with a malignant lesion had negative scans, for a negative scan accurary rate of 72 per cent for benign lesions. These results give statistical validity for the usefulness of the 67Ga scan in diagnosing carcinoma of the lung (p less than 0.001). Tumor cell type had little effect on the sensitivity of 67Ga scan. The 67Ga scan was equally useful in the evaluation of peripheral and central lesions. There was little difference amount T1, T2, and T3 classified lesions in their ability to take up 67Ga. The 67Ga scan was competitive with mediastinoscopy in assessing mediastinal lymph node metastases and provides a noninvasive method of assessing hilar lymph node metastases. There was a good correlation between the clinical staging of patients with lung cancer based on a chest x-ray film and 67Ga scanning and the staging after surgical treatment based on the histology of the resected specimens.

Gallium Radioisotopes↗
PubMedDate not supplied

AIDS-related knowledge, attitudes, and precautionary behaviors among emergency medical professionals.

AIDS-related knowledge, attitudes, and precautionary behaviors were assessed among a random sample of Michigan-licensed emergency medical service (EMS) professionals between June and August 1988. Of 2,000 mailed questionnaires, 1,020 were returned (51 percent response), and 997 of the returned questionnaires were used in the final analysis. Survey results indicated that most respondents were able to correctly identify the transmission routes of the human immunodeficiency virus (HIV), but many respondents had misconceptions about nonviable routes, the incidence of HIV infection among health care workers, and some aspects of the natural history of HIV. More than half of the respondents (56.6 percent) believed that their chances of becoming infected with HIV were "somewhat high" or "very high," although the number of documented HIV seroconversions due to occupational HIV exposures in health care settings is low. Although only six respondents (0.6 percent) reported that they had refused treatment to patients known or suspected to be infected with HIV, 25 percent felt that EMS professionals should be allowed to refuse treatment under such circumstances. Potential exposures to HIV were assessed through respondents' reports of three activities in the 6 months prior to the survey. For each activity, use of universal precautions recommended by the Centers for Disease Control was also assessed. In general, few respondents reported the consistent use of precautions. While the majority of those attempting resuscitations (86.9 percent) reported that they always use a protective device, only 36.7 percent of those treating bleeding patients reported that they always wear gloves, and only 21.9 percent of those using needles reported that they do not recap them after use.

Acquired Immunodeficiency Syndrome↗