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Biomedical subjects

J Stokes

Publications and source records attributed to J Stokes.

18 recordsLinked to original sources
PubMed1992

Predictors of smoking cessation: the Framingham Study.

The relation of demographic, behavioral, and health-related variables to smoking cessation was studied in 1,178 women and 1,506 men cigarette smokers enrolled in the Framingham Heart Study. Smoking cessation was defined as abstinence from all tobacco products for at least 1 year. Proportional hazard models were used to identify baseline variables associated with long-term cessation. In order to identify factors predictive of cessation in the following 2 years, logistic regression models on person-examination data were used. Recent hospitalization and development of coronary heart disease were predictive of smoking cessation, while diagnosis of cancer or changes in pulmonary function were not. Overall, women were as likely to quit as men; however, women who smoked heavily were the least likely to quit. Secular trends were noted in men only; men were more likely to quit after the release of the 1964 Surgeon General's report on smoking. The relation of illness development and sex to smoking cessation should be considered in developing smoking cessation programs.

Coronary Disease↗
PubMed1992

Psychometric vs. attentional correlates of early onset alcohol and substance abuse.

Adolescent inpatients with a diagnosis of alcohol abuse (n = 28), nonalcohol substance abuse disorders (n = 15), or psychiatric disorders without substance abuse (n = 46) were examined on measures of attentional, intellectual, and personality functioning. High scores on a personality measure, the Substance Abuse Proclivity Scale (SAP), was the best predictor of substance abuse in general. Alcohol abusers were differentiated from other substance abusers by their increased impairment on the Continuous Performance Test. Adolescents with alcohol abuse did not manifest the types of cognitive impairments associated with chronic alcoholism. These data suggest that certain attentional impairments may be associated with early onset alcohol abuse and that earlier conceptions of the role of attentional impairments in risk prediction for alcohol abuse are supported.

Adolescent↗
PubMed1991

Variability of body weight and health outcomes in the Framingham population.

BACKGROUND: Fluctuation in body weight is a common phenomenon, due in part to the high prevalence of dieting. In this study we examined the associations between variability in body weight and health end points in subjects participating in the Framingham Heart Study, which involves follow-up examinations every two years after entry. METHODS: The degree of variability of body weight was expressed as the coefficient of variation of each subject's measured body-mass-index values at the first eight biennial examinations during the study and on their recalled weight at 25 years of age. Using the 32-year follow-up data, we analyzed total mortality, mortality from coronary heart disease, and morbidity due to coronary heart disease and cancer in relation to intraindividual variation in body weight, including only end points that occurred after the 10th biennial examination. We used age-adjusted proportional-hazards regression for the data analysis. RESULTS: Subjects with highly variable body weights had increased total mortality (P = 0.005 for men, P = 0.01 for women), mortality from coronary heart disease (P = 0.009 for men, P = 0.009 for women), and morbidity due to coronary heart disease (P = 0.0009 for men, P = 0.006 for women). Using a multivariate analysis that also controlled for obesity, trends in weight over time, and five indicators of cardiovascular risk, we found that the positive associations between fluctuations in body weight and end points related to mortality and coronary heart disease could not be attributed to these potential confounding factors. The relative risks of these end points in subjects whose weight varied substantially, as compared with those whose weight was relatively stable, ranged from 1.27 to 1.93. CONCLUSIONS: Fluctuations in body weight may have negative health consequences, independent of obesity and the trend of body weight over time.

Adult↗
PubMed1991

Regional obesity and risk of cardiovascular disease; the Framingham Study.

Risk of cardiovascular events was determined over 24 years of surveillance in relation to general adiposity reflected by relative weight and by regional obesity estimated by skinfolds and waist girth per inch of height. Upper quintile values of relative weight, subscapular skinfolds and waist girth were each associated with increased risks of cardiovascular disease in both sexes. Risk of total cardiovascular events increased with the degree of regional, central or abdominal obesity. Mortality from cardiovascular disease was also increased. Increased relative weight and central obesity were both associated with increased risk factors including cholesterol, blood pressure, glucose and uric acid. Changes in weight were mirrored by changes in risk factors with linear trends over a 15 lb range of weight fluctuations. Subscapular skinfold and the ratio of subscapular-to-triceps skinfold, measures of central obesity, were in either sex also associated with an increased probability of coronary attacks in particular. The subscapular skinfold contributed to CHD risk independent of body mass index (BMI). Multivariate analyses taking all the risk factors into account indicate an independent effect of abdominal obesity on stroke, cardiac failure and cardiovascular and all-cause mortality in men. In women, only the subscapular-to-triceps skinfold ratio independently contributes to CHD, cardiovascular and all cause mortality. Regional obesity appears to be an independent contributor to cardiovascular disease at a given level of general adiposity, its effect only partially mediated through promotion of other known risk factors. These data suggest that cardiovascular disease is as closely linked to abdominal as to general adiposity.

Abdomen↗
PubMed1991

Dietary lipid predictors of coronary heart disease in men. The Framingham Study.

The relationship between dietary lipids and the 16-year incidence of coronary heart disease (CHD) morbidity and mortality was examined in two male cohorts, aged 45 to 55 years (n = 420) and 56 to 65 years (n = 393) from the Framingham Study. Dietary lipids were assessed through a single 24-hour recall at the initiation of follow-up in 1966 to 1969. In the younger cohort, there were significant positive associations between the incidence of CHD and the proportion of dietary energy intake from total fat and monounsaturated fatty acids. The proportion of energy intake from saturated fatty acids had a marginally significant positive association with CHD. The associations remained even after adjustment for cardiovascular disease risk factors, including serum cholesterol level, suggesting that their effects are at least partially independent of other established risk factors. In contrast to the younger cohort, none of the dietary lipids were associated with CHD in the older cohort. Dietary intervention for the prevention of CHD in younger men is supported by these findings.

Adult↗
PubMed1990

Transition from pre-linguistic to linguistic communication in hearing-impaired infants.

This paper examines the development of the ability to signal intentionality in hearing-impaired infants. Four infants were monitored from the time aids were accepted and worn consistently until an expressive vocabulary of ten words was recorded. The focus of the study was the child's developing ability to coordinate attention to both a person and an object. Longitudinal video-taping allowed analysis of the stages and rate at which these infants achieved this pattern of attention. These infants were found to follow a sequence of steps similar to that reported in studies of hearing children. This finding and its possible implications for early identification of hearing impairment are discussed.

Child Language↗
PubMed1990

Cardiovascular risk factors.

Atherosclerosis and its various clinical manifestations are now highly predictable and preventable diseases. Dyslipidemia appears to be a necessary cause, and hypertension and cigarette smoking are both powerful and modifiable contributing causes. Health professionals should incorporate cardiovascular risk assessment and risk factor modification within the context of their delivery of personal health services. Such services probably already have contributed to the decline of cardiovascular mortality, and the current levels of risk factors in the United States population indicate that substantial further reduction should be possibly by creating a smoke-free environment by the year 2000 and by implementing the recommendations of the National Cholesterol and High Blood Pressure Education Programs.

Adult↗
PubMed1989

Blood pressure as a risk factor for cardiovascular disease. The Framingham Study--30 years of follow-up.

Data from 30 years of follow-up of the original Framingham Study cohort of 5,070 men and women aged 30-62 years who were first examined during the period 1948-1952 and who were free of cardiovascular disease reveal that blood pressure is a strong and consistent predictor of the development of coronary heart disease, stroke, transient ischemic attack, and congestive heart failure. Other factors related to blood pressure like obesity, left ventricular hypertrophy as demonstrated on electrocardiograms, and heart enlargement as shown by x-ray radiography made several selective additional independent contributions to risk; heart enlargement by x-ray radiography was the best predictor of congestive heart failure.

Adult↗
PubMed1979

Perception of effort during constant work to self-imposed exhaustion.

The purpose of this study was to describe the pattern of change in effort sense and the value of this pattern in predicting work end-point at relatively high work intensity (80% VO2 max). The patterns of change of various physiological functions were also observed. Two modes of work (walking and running) were compared to ascertain generalizability of results. 26 healthy male volunteers served as subjects. Time to exhaustion (ET) did not differ between walking and running. As work continued during both tasks, significant increases of VE, VE/VO2, VE/VCO2 and HR and a significant decrease of ETCO2 were observed; while VO2 and R remained fairly constant. VO2 and VE during the run were about 5% greater than during the walk; there were no differences in other measures. Ratings of perceived exertion (RPE) from the Borg Scale were identical for both conditions, increasing in a near linear fashion from a value of 12.9 at 25% of total work time to 18.9 at exhaustion. Ratings obtained at 25 and 50% ET were extrapolated to time of exhaustion; the point of intercept corresponded to ratings of perceived exertion for maximal work. At exhaustion, subjects rated perception of respiratory exertion for the walk as less than that for the run; perception of leg exertion was not different for the two conditions. Plasma lactate, epinephrine and norepinephrine concentrations following exercise did not differ between the two conditions. The findings for the walking experiment were essentially replicated in a second investigation involving another 28 subjects. It is concluded that, with the exception of VO2 and some ventilatory parameters, walking and running at the same relative work intensity resulted in comparable perceptual and physiological responses. Psychophysical judgments made early during work were reasonably accurate predictors of exhaustion time.

Adult↗
PubMed1976

Polycystic kidney disease in a patient with the oral-facial-digital syndrome - type I.

Bilateral polycystic kidneys and chronic renal failure were observed in a 48-year-old woman with the classic clinical features of the oral-facial-digital syndrome, Type I (OFD-I). Since this association has been previously reported in two other patients, these findings suggest that polycystic kidneys may be a hitherto unrecognized manifestation of the oral-facial-digital syndrome.

Abnormalities, Multiple↗