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Biomedical subjects

J H Price

Publications and source records attributed to J H Price.

At least 181 records · Page 10Linked to original sources
PubMedDate not supplied

Reduction of firearm-related violence through firearm safety counseling. The role of family physicians.

The United States has a greater percentage of households with guns and more acts of violence than any other country in the western world. Suicide is the nation's eighth leading cause of deaths in the United States, of which 60% are caused by firearms. Homicide is the 11th leading cause of deaths among Americans, of which 70% are caused by firearms. Another 1400 deaths each year are caused by unintentional firearm-related injuries. Most of these deaths can, in part, be attributed to inappropriate behaviors (eg, keeping a loaded and inadequately secured firearm in the home). As respected professionals in the community, family physicians have a unique opportunity to promote behaviors in patients that reduce the risk of firearm-related injuries in patients and their families.

Adolescent↗
PubMedDate not supplied

Video microscopy to quantitate the inhomogeneous equilibrium strain within articular cartilage during confined compression.

The objectives of this study were to develop a method to quantitate the displacement and strain fields within articular cartilage during equilibrium confined compression, and to use the method to determine the variation of the equilibrium confined compression modulus with depth from the articular surface in bovine cartilage. The method made use of fluorescently labeled chondrocyte nuclei as intrinsic fiducial markers. Articular cartilage was harvested from the patellofemoral groove of adult bovines and trimmed to rectangular blocks 5 mm long, 0.76 mm wide, and 500 microns deep with the articular surface intact. Test specimens were stained with the DNA binding dye Hoechst 33258, placed in a custom confined compression chamber, and viewed with an epifluorescence microscope equipped for video image acquisition. Image processing was used to localize fluorescing chondrocyte nuclei in uncompressed and compressed (approximately 17%) specimens, allowing determination of the intra-tissue displacement profile. Strain was determined as the slope of linear regression fits of the displacement data in four sequential 125-microns-thick layers. Equilibrium strains varied 6.1-fold from the articular surface through 500 microns of cartilage depth, with the greatest compressive strain in the superficial 125-microns layer and the least compressive strain in the two deepest 125-microns layers. Thus, the four successive 125-microns layers have moduli that are 0.44 (superficial), 1.07, 2.39, and 2.67 (deep) times the apparent modulus for a 500-microns thick cartilage sample assumed to be homogeneous.

Animals↗
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Reducing firearm injuries: the role of local public health departments.

OBJECTIVE: The purpose of this study was to gather data regarding local public health departments' involvement in activities to prevent firearm-related morbidity and mortality. METHODS: A questionnaire was sent to local public health departments serving cities with populations > or =60,000 to assess their perceptions of the magnitude of the firearm injury problem in their jurisdictions and the activities in which they were engaged to reduce firearm-related injuries. RESULTS: Almost half (49.7%) of respondents said that their departments had not seriously thought about being involved in activities to reduce firearm-related injuries, and fewer than one in five (17.8%) reported that their departments were involved in such activities. Respondents identified three barriers to involvement in activities to reduce firearm injuries: limited financial resources (62.7% of respondents), lack of expertise (50.8%), and not enough time (47%). CONCLUSIONS: Despite the extent of firearm injuries in the US, systematic collection of local data on firearm morbidity and mortality to help guide policy development is lacking.

Female↗
PubMedDate not supplied

The large loop excision of the transformation zone cut or blend thermal artefact study: a randomized controlled trial.

The objective of this randomized controlled trial was to determine whether the pure cut setting results in less thermal artefact than the traditional blend setting when performing a large loop excision of the transformation zone (LLETZ). Forty-nine consenting women were randomized to undergo an LLETZ procedure using either the pure cut or the blend setting. Two histopathologists, who were blind to the randomization, examined the specimens and then graded and measured the degree of thermal artefact. No significant difference was noted at the epithelial margin. At the deep stromal margins, in the blend group, the mean thickness of thermal artefact was 0.382 mm (95% CI, 0.350-0.414) and in the cut group 0.325 mm (95% CI, 0.297-0.353). This was statistically significant. No significant difference was detected in terms of grading of thermal artefact, the presence of dysplasia at the specimen margins, or in positive follow-up smears. Although there was less thermal artefact at the deep stromal margin, cautery at this margin does not generally interfere with pathological assessment of the specimen and the pure cut setting does not produce a clinically significant decrease in the degree of thermal artefact.

Adult↗
PubMedDate not supplied

the management of vulval intraepithelial neoplasia in Northern Ireland.

In this study, we present the findings of a regional retrospective audit of all cases of vulval intraepithelial neoplasia (VIN) diagnosed in Northern Ireland (NI) over an 11-year period (1989-1999). During the period of the study, there were 97 cases of VIN. Cases of VIN were treated by many different clinicians at 14 hospitals. The commonest symptom at presentation was pruritus vulvae. The most common histopathologic diagnosis was VIN III (73%). In 52% of the cases, there was multifocal VIN, and in 43%, there was involvement of other sites such as the cervix, vagina, or anal region. The most common initial treatment was surgical excision, but a multitude of different treatments were performed initially. During the study period, 18 of 90 patients (20%) for whom follow-up was available developed invasive vulval squamous carcinoma. Most of the vulval cancers were superficially invasive, but three patients died of vulval cancer during the study period. This study illustrates that in NI, VIN is treated at many institutions by a multitude of clinicians. Management seems largely dependent on personal clinician preference and has been haphazard with little central coordination and organized strategy. VIN should be managed by clinicians with expertise in this field and who are treating significant numbers of patients according to evidence-based protocols.

Adult↗
PubMedDate not supplied

Assets as predictors of suicide attempts in African American inner-city youths.

OBJECTIVE: To assess whether developmental assets and risk-taking behaviors, as measured by the Search Institute instrument, were related to attempted suicide in African American, inner-city youth. METHODS: Survey of 336 African American, inner-city youths. RESULTS: Significant odds ratios were found for 4 asset questions and for 11 risk-taking behavior questions by attempted suicide behavior. The odds ratios ranged from 2.4 to 6.4 in magnitude. The percent of variation in suicide-attempt behavior explained by the asset questions (14.6% and 19.6%) was explained by the risk-taking behavior/high-risk behavior pattern questions. CONCLUSIONS: The risk-taking behavior items were better predictors of suicide behavior than were the developmental asset items for the African American youth.

Adolescent↗
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Patients' expectations of the family physician in health promotion.

This study evaluated patients' perceptions of the family practice physician's role in providing health promotion services. We distributed a questionnaire to a convenience sample of 450 patients (mean age = 40.4 years, SD = 15.8); 382 responded, yielding an 85% response rate. At least 70% of the respondents believed physicians should counsel all patients concerning yearly Pap smears, breast self-exams, and smoking cessation. A sizeable minority believed physicians should teach sex education to teens (41%), discuss social support systems with patients (41%), and discuss home-safety issues with patients (42%). The topics patients least wanted physicians to discuss were financial problems (32%) and seat-belt usage (31%). These patients thought physicians should refer them to other professionals for dental care (33%), marital problems (21%), and financial problems (20%). At least half of the respondents thought physicians should help in the following areas only if requested to do so by the patient: sexual problems (58%), sleeping difficulties (54%), and marital problems (53%). Chi-square analyses were conducted to examine differences in beliefs based on age, sex, educational level, and preventive health orientation of the respondent. We found significant differences based upon these demographic variables; however, interaction effects among the demographic variables also exist.

Adolescent↗
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Pediatricians' perceptions and practices regarding childhood obesity.

A 42-item Likert format questionnaire examining pediatricians' perceptions and practices concerning childhood obesity was distributed to a national random sample of 500 physicians. The overall response rate was 68%. The majority of pediatricians believed physicians are obligated to counsel parents of obese children regarding the health risks of obesity (83%), that normal weight is important to the health of children (67%), and that physicians should be role models by maintaining their normal weight (59%). However, 70% of these pediatricians believed designing programs and counseling children about weight loss was difficult, 22% felt competent in prescribing weight loss programs for children, and only 11% agreed that counseling children and parents on weight loss is professionally gratifying. At least one-half of the respondents recommended the following weight loss programs/techniques to their patients: (1) decreasing caloric consumption (84%), (2) seeing a dietitian/nutritionist (78%), (3) joining Weight Watchers (66%), (4) aerobic exercise (60%), and (5) behavior modification programs (55%). These pediatricians received most of their weight control information from medical journals (70%) and past experience (68%). We also assessed belief and attitudes concerning the effect of childhood obesity, the role obesity plays in selected diseases, and the etiology of childhood obesity.

Attitude of Health Personnel↗
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Family practice physicians' perceptions and practices regarding health promotion for the elderly.

This study assessed 321 family practice physicians' perceptions and practices regarding health promotion in the elderly; specifically, whether health promotion is perceived to be beneficial for this segment of the population. A random sample of 250 male and 250 female members of the American Academy of Family Physicians was surveyed. The internal reliability of the questionnaire was assessed, yielding a Cronbach alpha of .84. Respondents were 46% male and 54% female, and 67% of them had completed a residency program. Three-fourths (77%) of the respondents were between 25 and 50 years of age. The majority believed that health promotion counseling is of value to patients of all ages (88%) and that medical schools should devote more attention to preventive medicine (69%). These physicians identified lack of third-party payment, lack of sufficient staff, lack of competence in prescribing prevention programs for the elderly, and finding counseling the elderly about preventive health issues not professionally gratifying as barriers to health promotion of the elderly. All health promotion practices but one listed on the questionnaire were perceived as important by at least half the physicians. Until compensation for health promotion is available and physicians perceive themselves as competent concerning health promotion in the elderly, it is likely their clinical practices and recommendations will lag behind their favorable attitudes toward the topic.

Adult↗
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Family practice physicians' beliefs, attitudes, and practices regarding obesity.

This study examined 318 family practice physicians' beliefs, attitudes, and practices regarding obese patients. Most physicians surveyed were aware of the health effects of obesity and that normal weight is important to the health of their patients. Beliefs, attitudes, and practices differed significantly based on the physicians' sex, weight, years in practice, and belief that counseling patients on weight loss is professionally gratifying and that most obese patients can lose significant amounts of weight. A notable number of respondents held negative or stereotypical attitudes toward obese patients (i.e., obese patients lack self-control, are lazy and sad). The most commonly recommended weight loss techniques were decreasing caloric consumption (92 percent), participating in Weight Watchers (84 percent), consulting a dietitian/nutritionist (76 percent), and aerobic exercise (75 percent). The two sources of weight control information most frequently cited were past experience (73 percent) and medical journals (71 percent). The results of this survey indicate that there is considerable room for improvement in the beliefs, attitudes, and practices of family physicians regarding obese patients.

Adult↗