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J J Strain

Publications and source records attributed to J J Strain.

At least 145 records · Page 8Linked to original sources
PubMed1993

Total radical-trapping antioxidant potential (TRAP) of plasma: effects of supplementation of young healthy volunteers with large doses of alpha-tocopherol and ascorbic acid.

A randomized, placebo-controlled double-blind supplementation trial was conducted on 32 adults to assess the effect of dl-alpha-tocopherol (1 g/day for 28 days) or ascorbic acid (AA) (1 g/day for 28 days) separately or in combination on the total radical-trapping antioxidant potential (TRAP) of plasma. Subjects were divided into 4 groups of 8 and received the following: Group 1, placebo; Group 2, ascorbic acid; Group 3, alpha-tocopherol; Group 4, alpha-tocopherol and AA. Antioxidant potential was assessed using the TRAP technique (a specific measure of the capacity of the secondary antioxidants, vitamins E, C, reduced thiol compounds and urate in plasma to resist controlled in vitro peroxidation). TRAP values were estimated at baseline and after treatment (day 29). Group means of the antioxidant vitamins at baseline were within normal values for both ascorbic acid (62-82 mumol/l) and alpha-tocopherol (24-29 mumol/l). Despite marked increases post-supplementation in plasma alpha-tocopherol levels in Groups 3 (94%) and 4 (91%) and in AA levels in Groups 2 (82%) and 4 (32%), there were no significant differences (analysis of variance) between the 4 treatment groups for TRAP values on day 29. Paired-t-testing revealed significant (P < 0.01) increases in post-supplementation TRAP values in Groups 2 and 3.

Adolescent↗
PubMed1993

Coronary risk factors in Belfast schoolchildren.

Although Northern Ireland leads the world in terms of coronary heart disease mortality, the prevalence of coronary risk factors in the childhood population is largely unknown. The aims of the present study were to assess the feasibility of collecting this data and to undertake a preliminary investigation of risk factor status. One hundred and three out of 154 first year pupils (67%), mean age 12.3 years from a Belfast secondary school had their height, weight, pubertal status and blood pressure estimated. Blood samples were analysed for serum cholesterol and thiocyanate in 99 children. 31% had elevated cholesterol, 13% had raised blood pressure, 13% were overweight and 5% were identified as smokers. There appeared to be relatively high risk factor levels with at least one risk factor present in 45% of children. No difficulties arose in compliance with the test protocol suggesting that coronary profiling in children on a large-scale is feasible. On the basis of these results, we feel that coronary risk factor status in Northern Irish children needs further evaluation.

Adolescent↗
PubMed1992

Vitamin C and vitamin E--synergistic interactions in vivo?

The synergistic relationship between ascorbic acid (vitamin C) and alpha-tocopherol (vitamin E) in the inhibition of lipid peroxidation has been known for some time and is now well established in vitro systems. The possibility that ascorbic acid may also reduce tocopheroxyl radicals in vivo is a subject of some interest and speculation. Although not all experiments have failed to suggest a synergistic antioxidant interaction, recent data indicate that the postulated synergism between these vitamins might be relatively unimportant compared with other metabolic processes.

Animals↗
PubMed1992

Evaluating psychiatric consultations in the general hospital. Multivariate prediction of concordance.

A study of 316 consultation cases was undertaken to examine the concordance between the psychiatric consultants' recommendations and the consultees' follow-through. Using a model of case concordance (defined as the proportion of all recommendations followed on each case), it was demonstrated that process variables, including who (the referring doctor p < or = 0.07) recommended what (psychosocial ward management p < 0.01, psychosocial diagnostic action p < 0.01, biological diagnostic action p < 0.01, aftercare p < or = 0.02, and number of recommendations p < or = 0.03), and when (timing of consultation p < or = 0.02), were the significant predictors of case concordance rather than clinical or demographic variables.

Comorbidity↗
PubMed1992

A new tool for consultation-liaison funding: modified DRGs to reflect psychiatric comorbidity.

Funding for consultation-liaison (C-L) psychiatry remains an overriding obstacle to its implementation and practice. Several methods have been described to access funds for this subspecialty of psychiatry, but none has been enacted as a policy by third party payers to reimburse adequately for the service. In addition, although the consultation portion of the effort can be reimbursed in part in some cases through fee for services, the liaison portion is dependent on the donation of psychiatry time or the largesse of the host department. The efforts at Stanford to capitalize on the findings that psychiatric and medical comorbidity results in prolonged length of hospital stay and increased health resource utilization suggest that specific DRGs would be important patient groups to screen and charge for psychiatric services. Furthermore, DRGs that are accompanied by a high frequency of psychiatric comorbidity are a "target" for an additional funding aliquot to assess and manage the patient's psychiatric status.

Cost Control↗
PubMed1992

Prevalence of mental disorders in newly admitted medical inpatients with AIDS.

The authors evaluated 42 newly admitted medical inpatients with acquired immune deficiency syndrome (AIDS) using DSM-III-R criteria and obtained quantitative ratings of psychiatric morbidity using standard instruments. A current Axis I disorder was present in 61.9% of the patients. Organic mental disorders predominated (47.6% of all patients) and were more common in the most severely ill patients. Major depressive syndrome was rarer than expected (9.5%). Recent physical disability was correlated with repeated hospitalizations, and trends were found suggesting correlation of recent physical disability with increased anxiety and cognitive impairment. This study, using actual patient evaluations, suggests predictors of psychiatric morbidity in this setting and argues for routine psychiatric screening of medical inpatients with AIDS.

AIDS Dementia Complex↗
PubMed1992

Validation of estimates of energy intake by weighed dietary record and diet history in children and adolescents.

Energy intakes assessed by 7-d weighted dietary records (EI-WDRs) and diet histories (EI-DHs) were compared with concurrent estimates of total energy expenditure (TEE) by the doubly labeled water method in 78 subjects aged 3-18 y. EI-WDRs were not obtained from the 3- and 5-y-old subjects. EI-WDRs in the 7- and 9-y-old children were 108 +/- 25% (n = 12) and 97 +/- 15% (n = 12), respectively, of corresponding TEE values showing good agreement. However in the 12-, 15-, and 18-y-old subjects EI-WDR averaged 89 +/- 12% (n = 12), 78 +/- 18% (n = 12), and 73 +/- 25% (n = 10), respectively, of corresponding TEE values. The difference was greater than or equal to 20% in 13 adolescents. Mean EI-DHs were 114 +/- 19% (3 y), 111 +/- 19% (5 y), 111 +/- 23% (7 y), 106 +/- 9% (9 y), 114 +/- 17% (12 y), 101 +/- 21% (15 y), and 98 +/- 21% (18 y) of TEE estimates. Differences were significant in the 3-, 9-, and 12-y-old subjects. Results suggest that 7-d EI-WDRs tend to underestimate food intake of adolescents. Although EI-DHs were biased towards overestimation in most age groups and individual measurements lacked precision, EI-DHs were more representative of habitual intake than were EI-WDRs.

Adolescent↗
PubMed1992

Daily energy expenditure in free-living children: comparison of heart-rate monitoring with the doubly labeled water (2H2(18)O) method.

Total energy expenditure (TEE) was measured simultaneously in 36 free-living children aged 7, 9, 12, and 15 y over 10-15 d by the doubly labeled water (DLW) method and for 2-3 separate days by heart-rate (HR) monitoring. The 95% confidence limits of agreement (mean difference +/- 2SD) were -1.99 to +1.44 MJ/d. HR TEE discrepancies ranged from -16.7% to +18.8% with 23 values lying within +/- 10% of DLW TEE estimates. Boys and girls spent 462 +/- 108 and 318 +/- 120 min/d, respectively, in total physical activity (P less than 0.01). Time spent in moderate and vigorous physical activity (MVPA) was 68 +/- 37 min/d by younger children (7-9 y) and 34 +/- 24 min/d by older children (12-15 y) (P less than 0.001). Younger boys engaged in MVPA (91 +/- 33 min/d) and vigorous physical activity (VPA) (35 +/- 15 min/d) significantly longer than younger girls (MVPA, 39 +/- 16 min/d, P less than 0.001; VPA, 10 +/- 4 min/d, P less than 0.01) as did older boys (MVPA, 52 +/- 21 min/d; VPA, 30 +/- 18 min/d) compared with older girls (MVPA, 15 +/- 10 min/d; VPA, 8 +/- 5 min/d). HR monitoring provides a close estimation of the TEE of population groups and objective assessment of associated patterns of physical activity.

Adolescent↗
PubMed1992

Dietary behaviour and health in Northern Ireland: an exploration of biochemical and haematological associations.

STUDY OBJECTIVE: The aim was to determine the relationships between dietary behaviour and biochemical and haematological measures. DESIGN: This was a cross sectional population study. SETTING: The study took place in the general community within Northern Ireland. SUBJECTS: 522 randomly selected adults aged 18-64 years took part (65% of the eligible sample). MEASUREMENTS AND MAIN RESULTS: Four dietary behaviours were identified using principal components analysis from 7 d weighed dietary records described in terms of mean intake of 41 food groups. Haematological and biochemical analyses were carried out on non-fasting blood samples. Social, personal, and lifestyle information was ascertained through interviewer administered questionnaires. Partial correlations controlled for age and smoking behaviour were calculated. There were significant negative associations between iron status measures and the "traditional" behaviour, while the "meat and two veg" behaviour showed positive associations. There were positive associations between the "cosmopolitan" and "convenience" behaviours and folate status in women. White cell count and platelet levels in women were negatively associated with the "traditional" and "cosmopolitan" behaviours. Total cholesterol levels showed significant negative associations with the "cosmopolitan" behaviour in women and HDL cholesterol levels were positively associated with the "cosmopolitan", "convenience" and "meat and two veg" behaviours. CONCLUSIONS: Through a multivariate approach to dietary assessment it is possible to identify food combinations that cluster and interact to influence biochemical and haematological indices of health status.

Adolescent↗
PubMed1991

Predictors of physician nonadherence to chemotherapy regimens.

Physician nonadherence to cancer treatment regimens may diminish treatment efficacy and compromise clinical research. The influence of clinical, demographic, and psychosocial patient characteristics on physician adherence to breast cancer chemotherapy was investigated, as was the role of the clinician's attitudes concerning the chemotherapy. One hundred seven women recently diagnosed with breast cancer were followed for 26 weeks of treatment. Fifty-six (52%) of the patients experienced unjustified modification for at least one chemotherapeutic agent. Stepwise multiple regression revealed independent contributions of increased patient age, treatment setting (clinic versus academic or community private practice), and stage of disease to physician nonadherence. Regimen complexity, delay in seeking treatment, and presence of psychiatric disorder did not contribute, in general, to unjustified regimen modifications. Patient psychological and psychiatric factors, however, did influence prescribing behavior for vincristine. Physician awareness of factors contributing to unnecessary treatment modifications may reduce the frequency of such behaviors.

Age Factors↗
PubMed1991

Patterns of referral from consultation-liaison to social work services.

Despite their importance, the nature and context of referral patterns among mental health disciplines in the general hospital has not been sufficiently explored. This study focuses on consultation-liaison (C-L) psychiatry patterns of referral to social work services (SWS). From a structured data base of 1170 consults, it was observed that C-L referred 24% of the cases seen by psychiatry. Psychiatry was more likely to refer those who are: female (p = less than 0.05), living with others (p = less than 0.05), described as less urgent (p = less than 0.05), diagnosed with personality disorders (p = less than 0.01), under greater psychosocial stress (Axis IV) (p = less than 0.001), and evaluated as having better functional status (Axis V) (p = less than 0.001). Regression analysis revealed that four variables had the greatest impact on differentiating those C-L referred to SWS from the "others": 1) constant observation recommended (log -586, p = 0.0001); 2) type of psychiatric management (log -573, p = 0.0001); 3) Medicaid insurance (log -564, p = 0.0001); and 4) original referral for the consultation was the refusal of tests or medical treatment (log -559, p = 0.002).

Anxiety Disorders↗
PubMed1991

Health service delivery and research outcomes of a common departmental structure for psychiatric consultation-liaison and social work services at a university hospital.

Convincing evidence exists that psychosocial factors have a major impact on both outcome and costs in the medical/surgical services in general hospitals. This paper describes the Human Services Department's impact on social work and consultation-liaison psychiatry, using a data-based management system across five specialties: 1) social work; 2) consultation-liaison psychiatry; 3) supportive care (hospice); 4) home care (home health discharge planning); and 5) pastoral care, which offers opportunities for research and quality assurance monitoring. Time spent in service delivery was used to estimate the cost per hour: 1) pastoral care $96; 2) social work $36; 3) consultation-liaison psychiatry $59; 4) home care $49. Referral to social work was preferred for a range of family and discharge planning services. Consultation-liaison services were preferred for depression, paranoid behavior, and management problems. Referral overlap was noted for "coping with diagnosis" for social work and consultation-liaison psychiatry. Using a computerized data base format for documenting the referral process, work accomplished, and time spent among those services providing mental health care in the general hospital permits the observation of redundancy of services delivered and their costs.

Chicago↗
PubMed1991

Psychiatric aspects of head and neck surgery. Part II: Body image and psychiatric intervention.

Surgery of the head and neck leads to profound changes of body image, including disfigurement and difficulties with verbalization. The psychologic importance of alterations in these areas will be discussed as well as their effect on the conduct of psychiatric treatment. Psychiatric intervention in this population demands an active approach and special preparation for the therapeutic encounter is necessary.

Body Image↗
PubMed1991

Psychiatric aspects of head and neck surgery. Part I: New surgical techniques and psychiatric consequences.

Individuals who undergo head and neck surgery experience extreme stressors that go beyond those which occur with the usual surgical patient. This paper will review the literature and discuss the psychiatric consequences of otolaryngeal surgery. In addition, new head and neck surgical techniques, which offer special challenges to the patient as well as to the psychiatric consultant, will be examined. Tracheostomy, which occurs as a result of head and neck surgery, is of particular importance with regard to postoperative adaptation and is a significant complication that must be reckoned with.

Adaptation, Psychological↗
PubMed1991

Serum total free radical trapping ability in acute myocardial infarction.

Serum total free radical trapping abilities (TRAP experimental) were measured in 15 patients with acute myocardial infarction (AMI) and compared to sex- and age-matched controls. TRAP experimental values were significantly lower (p less than 0.01) in the AMI group. Theoretical trapping abilities were also calculated and compared with experimentally derived values. In the AMI group there was no significant difference between the experimental and calculated TRAP, but in the control group experimental values were significantly higher (p less than 0.01) than calculated values. In the control group regression analysis revealed that alpha-tocopherol and ascorbate taken together most closely explained the radical trapping ability of sera, with a regression equation: TRAP experimental = 562.9 + 2.082 (alpha-tocopherol + ascorbate). In the AMI group no relationship between the serum antioxidants and TRAP experimental was observed.

Acute Disease↗
PubMed1991

Potential contribution of leisure activity to the energy expenditure patterns of sedentary populations.

Total daily energy expenditure (TEE) by the doubly-labelled (2H218O) water method and basal metabolic rate (BMR) by indirect calorimetry were measured in thirty-two healty free-living adults in Northern Ireland. Habitual physical activity patterns in occupational and discretionary activities were assessed by interview questionnaire. Expressed as a multiple of BMR the TEE values for the sixteen males (1.88 (SD 0.28), range 1.44-2.57) and sixteen females (1.77 (SD 0.16), range 1.50-2.06) were compatible with current Department of Health and Social Security (DHSS; 1979) and Food and Agriculture Organization/World Health Organization/United Nations University (FAO/WHO/UNU; 1985) estimates of energy requirements. The results suggest that discretionary physical activity is now emerging as an equally important determinant of energy expenditure in the UK as the occupational classifications currently used as the basis of DHSS (1979) and FAO/WHO/UNU (1985) recommendations for energy requirements. Therefore, realistically achievable inputs of recreational exercise can have a significant impact in counteracting low levels of energy expenditure which are associated with modern lifestyles and are implicated as a risk factor for coronary heart disease and obesity.

Adult↗