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Biomedical subjects

P M Dubbert

Publications and source records attributed to P M Dubbert.

34 records · Page 2Linked to original sources

Weight gain associated with decreases in smoking rate and nicotine intake.

The mechanisms involved in the weight gain associated with smoking cessation are not well known. This study employed a single-subject design to investigate changes in weight following systematic reductions in smoking rate and cigarette nicotine content. Although there were no changes in the subject's caloric intake or physical activity, a weight gain of 3.6 kg was observed after 4 months of reduced rate and nicotine intake. These results suggest that weight change during smoking reduction and cessation may be primarily due to changes in factors other than caloric intake or activity.

Body Weight↗

Increasing handwashing in an intensive care unit.

The present study provides the first systematic evaluation of strategies for increasing handwashing of hospital staff. Nursing staff on two intensive care units (ICUs) were observed over a 3-month period. After baseline observations, two interventions were implemented on the experimental unit: changing to an emollient handwashing agent, and providing feedback to staff about the frequency of handwashing. Feedback focused on the previous day's handwashing following completed patient contacts, interrupted patient contacts, and critical procedures. No increase in handwashing was observed following introduction of the emollient soap. However, when feedback was provided on the experimental ICU, handwashing following completed patient contacts (the major dependent measure) increased to 92%, and was significantly higher than handwashing on the control unit. Follow-up observations suggested that compliance on the experimental unit appeared to return to baseline levels.

Cross Infection↗

Cardiovascular reactivity to psychological stress in aerobically trained versus untrained mild hypertensives and normotensives.

Cardiovascular reactivity to video game and mental arithmetic stressors was compared among three groups of men: aerobically trained mild hypertensives, untrained mild hypertensives, and a comparison group of untrained normotensives. Relative to the untrained hypertensives, the trained hypertensives reacted to the video game with marginally smaller systolic blood pressure and diastolic blood pressure, but there were no significant differences between these groups in reactivity during the mental arithmetic task. Comparisons between each hypertensive group and the normotensive group showed that blood pressure (BP) reactivity of normotensives during the video game was generally similar to that of trained hypertensives but smaller than that of untrained hypertensives. These results indicate that aerobic training, which has been found to reduce resting BP in mild hypertensives, may also exert a favorable impact in reducing cardiovascular reactivity of hypertensives during some stressful situations.

Adult↗

Riboflavin as a tracer of medication compliance.

Three experiments were conducted to evaluate the accuracy of urine ultraviolet fluorescent tests for riboflavin, which has been used as a tracer for medication compliance in several clinical drug trials. Observer accuracy in discriminating riboflavin-positive or negative urine samples was found to vary with the method of observation, dose of riboflavin, observer experience, and time postingestion. The results showed that, while the 5-mg dose used in previous clinical trials was too small to permit reliable assessment of compliance, larger doses of riboflavin could produce nearly 100% accuracy for minimally trained observers who used a matching-to-sample observation procedure. The findings are discussed in terms of the potential clinical and research applications of this type of simple but reliable compliance assessment procedure.

Adult↗

Toward a behavioral assessment of anticipatory symptoms associated with cancer chemotherapy.

A tripartite assessment of nine patients experiencing either pretreatment nausea and vomiting, pretreatment nausea or posttreatment nausea and vomiting only was conducted. Three consistent patterns of response emerged: (1) patients with pretreatment nausea and vomiting reported elevated levels of nausea and anxiety and demonstrated increased levels of physiological arousal; (2) patients with pretreatment nausea reported elevated levels of nausea and anxiety but showed no evidence of increased physiological arousal; and (3) patients with posttreatment symptoms only evidenced low levels on all measures. These data are consistent with the hypothesis that a continuum of responses exists in patients undergoing chemotherapy ranging from no pre- or posttreatment symptoms to pretreatment nausea and vomiting.

Adolescent↗

The influence of caloric information on cafeteria food choices.

We evaluated the effect of posting caloric information on food purchases at a cafeteria. Purchases of more than 14,300 entrees, vegetables, and salads by 6,970 customers were unobtrusively monitored via the cash register inventory control system during 15 evening observations. A quasi-multiple-baseline design across food groups was used to test the additive effect of labeling the three lowest caloric choices for vegetables, salads, and entrees. A linear logit analysis confirmed that labeling increased the probability of low calorie selections for vegetables and salads, but not for entrees. Observations of meals purchased by a subsample of 413 customers indicated labeling did not change the total caloric content of meals. The number of customers and total sales per evening were unaffected by the labeling intervention. The results suggest that manipulating environmental cues may be an effective method for changing food purchases in a cafeteria, but labeling individual items may not be the best way to decrease total calories purchased.

Journal Article↗

Stress management training in medical school.

It has been widely noted that medical school can be stressful experience for many students and that on completion of their medical education students will enter a profession high in potential stressors. However, very few systematic efforts to teach medical students practical stress management skills have been undertaken. In the study reported here, a group of students volunteered to participate in a six-session program that taught them personal stress management techniques, including self-relaxation training, schedule-planning, priority-setting, leisure time-planning, and cognitive modification techniques. From pretraining to posttraining, the students showed improvement on a variety of measures that included knowledge about stress, self-report inventory scores assessing stress symptoms and life-style, personal ratings of stressful situations, and their daily activity schedules. A control group largely failed to show improvement relative to the stress management training group largely failed to show improvement relative to the stress management training group subjects. The importance of making available to students such specific, behavioral and preventive stress management training is discussed.

Female↗

Health barriers to walking for exercise in elderly primary care.

Health status is acknowledged by nursing theory as a factor in the probability of health behavior changes. Yet few studies have addressed the health-related barriers encountered by chronically ill elderly patients in primary care clinics who are trying to increase their physical activity. This study used self- and interviewer-administered instruments to assess potential barriers to physical activity in a sample of 60- to 80-year-old patients entering a walking program. Pain, fatigue, and mobility and sensory impairments were prevalent and could be significant barriers to participation. The authors present specific suggestions for helping patients overcome these barriers.

Activities of Daily Living↗

Nonpharmacologic approaches to therapy for hypertension.

OBJECTIVE: To provide an overview of nondrug therapeutic modalities for management of hypertension. METHODS: We review four strategies that involve lifestyle changes--weight reduction, moderation of sodium intake, physical activity, and moderation of alcohol consumption--that can potentially have a blood pressure-lowering effect. RESULTS: Several clinical trials have shown that a weight loss of 10 to 20% will significantly decrease blood pressure. An average of 1 to 2 mm Hg reduction in blood pressure may occur per kilogram of weight lost. Although sodium restriction has less effect on blood pressure than does weight reduction, a decrease in sodium intake to <100 mmol/day can yield a mean blood pressure reduction of 3 to 5 mm Hg systolic and 2 to 3 mm Hg diastolic. Exercise regimens have demonstrated convincing antihypertensive effects. In recent randomized studies, the average reduction in blood pressure ranged from 5 to 15 mm Hg for systolic measurements and 5 to 10 mm Hg for diastolic readings. Alcohol consumption has been shown to have one of the strongest associations with blood pressure among the potentially modifiable risk factors for hypertension. An average of 1 mm Hg decrease in blood pressure has been noted per one drink/day reduction in consumption. CONCLUSION: Lifestyle changes that can decrease blood pressure are important because they may not only eliminate the need for drug treatment but also decrease other cardiovascular risk factors.

Journal Article↗