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Biomedical subjects

P Patterson

Publications and source records attributed to P Patterson.

At least 55 records · Page 3Linked to original sources
PubMed1998

Community based intervention on adolescent risk taking: using research for community action.

OBJECTIVES: To use research on adolescent risk taking behaviour as an impetus for a community to develop locally based injury prevention strategies. DESIGN: Case study, based on a community action model and formative evaluation. This involved: a community profile on adolescent risk taking behaviour; interviews with service providers; dissemination of research findings to local policy makers; development and implementation of a community action plan to address adolescent risk taking; and assessment of its impact. SETTING: A rural town with a population of 10,195 situated in the North Island of New Zealand. SUBJECTS: School aged adolescents and the safety policies and practices of community organisations involved with adolescents. RESULTS: Risk taking behaviours identified by the community profile included: drink-driving, substance abuse, carrying of weapons with intent to harm, and suicidal ideation. Community members identified that risk taking behaviour associated with alcohol in relation to: (1) violence (self directed and assault) and (2) road related injuries should be the focus of their activities. The strategies identified focused on advocacy, education, legal/regulatory change, and environmental modification. Evaluation conducted six months after intervention identified increased community awareness of the adverse effects of adolescent risk taking and some changes in policies and practice related to adolescent safety. CONCLUSIONS: Providing a community with local information that has high relevance for its members may act as a stimulus for the development of injury prevention initiatives. While this case study illustrated that a comprehensive approach focusing on adolescent risk taking behaviour, rather than on isolated injury problems, may be an appropriate way to highlight escalating adolescent injury rates, it also demonstrates the limitations of a short time frame for a community development project.

Adolescent↗
PubMed1998

Low serum antimycobacterial drug levels in non-HIV-infected tuberculosis patients.

BACKGROUND: Despite the use of directly observed therapy (DOT) by tuberculosis control programs, patient treatment failure, relapse, and acquired drug resistance remain problematic in a small number. We investigated serum drug levels in non-HIV-infected tuberculosis patients who were receiving DOT by the health department and did not respond to treatment as expected. METHODS: The indications for checking levels were as follows: (1) slow clinical response or failure to convert the sputum culture within 12 weeks; (2) treatment failure, early disease relapse < 13 months since being declared cured; (3) relapse, late disease reactivation > or = 13 months since being declared cured; and (4) acquired drug resistance while receiving DOT. Baseline characteristics of control subjects who responded to therapy as expected were compared. Venous blood for analysis was obtained at 2 h after directly observed ingestion and measured by high-performance liquid chromatography. RESULTS: Twenty-four patients receiving daily or twice-weekly standard therapy with isoniazid (INH, 300 or 900 mg) and rifampin (RMP, 600 mg) were identified; 22 had drug levels evaluated at 2 h. For INH, 15 of 22 patients (68%) had levels less than the reported target range. For RMP, 14 of 22 patients (64%) had low levels. Among the 14 patients receiving INH, 900 mg, and RMP, 600 mg, 4 (29%) had very low levels of both. Use of a combination INH/RMP tablet was associated with lower INH levels (p=0.04); however, RMP levels were higher (p<0.02). Alcohol use was associated with significantly higher RMP (p<0.01) serum concentrations. CONCLUSIONS: Important questions remain concerning the utility and timing of serum drug measurements. However, if a patient is not responding to therapy as expected and one is assured that the Mycobacterium tuberculosis organism is susceptible to the drugs given and that the patient is taking the medication as prescribed, drug level monitoring should be considered.

Adult↗
PubMed1998

Injuries in the sport of racewalking.

OBJECTIVE: To examine the nature and incidence of injuries suffered by racewalkers. DESIGN AND SETTING: A total of 682 questionnaires were distributed to racewalkers in the San Diego/Long Beach, CA area, participants in a national qualifying race held in Washington, DC, and subscribers to The Ohio Racewalker. SUBJECTS: Four hundred questionnaires were returned to the investigators, for a return rate of 58.7%. MEASUREMENTS: Questions addressed demographics, exercise patterns, competitive history, walking surfaces, types of footwear normally used for training and competition, and injuries suffered during racewalking. Questionnaire results were tabulated and chi-square analyses were used to test for interrelationships. A stepwise discriminant analysis was used to develop a model for the prediction of injury in racewalking. RESULTS: Racewalking participation peaks in the 30- to 39-year-old age group, while the proportion of injured participants is greatest in those under 30. Most injuries involved the lower extremity, but the "average" racewalker suffered only one serious injury every 51.7 years. Those participants who trained six or seven times per week were most likely to be injured; those who trained three or fewer times per week were least likely to be injured. The percentage of injured participants increased progressively with weekly training mileage. A model based on the data from this investigation correctly predicted membership in either the injured or uninjured group in only 64.1% of cases and is, therefore, of limited use to the researcher or clinician. CONCLUSIONS: Although the rate of injuries in racewalkers is low, more systematic research is necessary before sports medicine professionals can confidently recommend consistently effective injury prevention procedures.

Journal Article↗
PubMed1998

The effectiveness of an interactive computer program versus traditional lecture in athletic training education.

OBJECTIVE: To evaluate the effectiveness of an interactive athletic training educational curriculum (IATEC) computer program as compared with traditional lecture instruction. Instructions on assessment of the quadriceps angle (Q-angle) were compared. Dependent measures consisted of cognitive knowledge, practical skill assessment, and attitudes toward the 2 methods of instruction. DESIGN AND SETTING: Sixty-six subjects were selected and then randomly assigned to 3 different groups: traditional lecture, IATEC, and control. The traditional lecture group (n = 22) received a 50-minute lecture/demonstration covering the same instructional content as the Q-angle module of the IATEC program. The IATEC group (n = 20; 2 subjects were dropped from this group due to scheduling conflicts) worked independently for 50 to 65 minutes using the Q-angle module of the IATEC program. The control group (n = 22) received no instruction. SUBJECTS: Subjects were recruited from an undergraduate athletic training education program and were screened for prior knowledge of the Q-angle. MEASUREMENTS: A 9-point multiple choice examination was used to determine cognitive knowledge of the Q-angle. A 12-point yes-no checklist was used to determine whether or not the subjects were able to correctly measure the Q-angle. The Allen Attitude Toward Computer-Assisted Instruction Semantic Differential Survey was used to assess student attitudes toward the 2 methods of instruction. The survey examined overall attitudes, in addition to 3 subscales: comfort, creativity, and function. The survey was scored from 1 to 7, with 7 being the most favorable and 1 being the least favorable. RESULTS: Results of a 1-way ANOVA on cognitive knowledge of the Q-angle revealed that the traditional lecture and IATEC groups performed significantly better than the control group, and the traditional lecture group performed significantly better than the IATEC group. Results of a 1-way ANOVA on practical skill performance revealed that the traditional lecture and IATEC groups performed significantly better than the control group, but there were no significant differences between the traditional lecture and IATEC groups on practical skill performance. Results of a t test indicated significantly more favorable attitudes (P < .05) for the traditional lecture group when compared with the IATEC group for comfort, creativity, and function. CONCLUSIONS: Our results suggest that use of the IATEC computer module is an effective means of instruction; however, use of the IATEC program alone may not be sufficient for educating students in cognitive knowledge. Further research is needed to determine the effectiveness of the IATEC computer program as a supplement to traditional lecture instruction in athletic training education.

Journal Article↗
PubMed1998

A neural net representation of experienced and nonexperienced users during manual wheelchair propulsion.

A neural net approach was used to classify and analyze combinations of the physiological and kinematic responses (the factor patterns) of experienced and novice individuals during wheelchair propulsion, and to determine the key characteristics (individual factors) used in making this determination. A sequence of artificial neural networks (ANN) was developed and used to classify differences between eight nonimpaired controls and seven individuals using wheelchairs, who ranged in age from 24 to 36 years. The subjects propelled a wheelchair on a specially constructed dynamometer at three different velocity levels during which stroke pattern, force, energy, and efficiency data were collected. The data from 10 subjects (5 from each group) were used to train a net, with the data from the remaining 5 subjects used to test the resulting net. The nets correctly classified the training subjects in all 10 cases and correctly classified all 5 test subjects, indicating that the developed networks were able to generalize to new data sets. It was concluded that a minimal net consisting of only three variables, peak VO2 at the high velocity, hand force on the rim at the low velocity, and push angle at the high velocity, could accurately represent the differences between these groups.

Adult↗
PubMed1997

Suicide: qualitative data from focus group interviews with youth.

Suicide is a leading cause of morbidity and mortality among people aged 15-24 years of age. This paper illustrates the use of focus groups with young people to enhance knowledge of ways to address youth suicide. Analysis of the findings identified three themes perceived by participants as being warning signs of a suicidal friend (personality changes, risk-taking behaviour and unusual actions). An important finding, which has implications for the planning of further suicide prevention strategies, was that young people would either cope alone or turn to a friend if they were feeling suicidal. The fact that a lack of knowledge was identified as the major barrier to youth using existing services/resources suggests that health promotion awareness campaigns which provide information on where young people could access help need to be developed. The use of focus groups with young people has provided valuable insights into ways to address youth suicide. We urge other researchers to incorporate similar methodologies.

Adolescent↗
PubMed1997

Risk-taking behaviours in a sample of New Zealand adolescents.

We surveyed the risk-taking behaviour of students aged 16 years and over in two New Zealand high schools, with a particular focus on road safety, substance use, sexual behaviour and personal safety. The questionnaire was completed by 471 students, a participation rate of 99 per cent. We found that seven out of 10 students who had ridden either a bicycle or motorcycle in the previous 12 months had not always worn a helmet; that 56 per cent had driven a car without a licence; and 23 per cent had been involved in a motor vehicle crash. A lifetime incidence of 63 per cent for cigarette smoking, 34 per cent for marijuana use and 78 per cent for alcohol use was found. Forty per cent of the students reported ever having sexual intercourse. During the previous 12 months, 49 per cent of these had not always used contraceptives and 61 per cent reported not always wearing condoms as protection for sexually transmitted diseases. Twenty-five per cent had physically harmed another person and 10 per cent reported carrying a weapon with the intent of harming someone else. This study shows that adolescents are willing to provide information on risk taking and that they are engaging in high levels of health-harming behaviour. Such information is important for designing health promotion programs to address adolescent risk taking.

Accidents, Traffic↗
PubMed1997

Demographic risk factors associated with elevated lead levels in Texas children covered by Medicaid.

This is the first large population-based study of demographic risk factors for elevated lead in Texas children. It summarizes data on 92,900 children covered by Medicaid screened for blood lead during the first 6 months of 1993 in Texas. The highest percentage of elevated lead levels (14.3%) was in children 25-36 months of age, with slightly lower percentages in those younger (13% of 19-24 months) and older (12% of 37-48 months) with blood lead levels greater than 10 micrograms/dl. The group with the highest percentage of elevated blood lead levels was 2-4-year-old African American males (17.3%) making this subgroup 3.5 times higher than the group with the lowest percentage-white girls over age 4 (4.8%). Males had higher blood lead levels for all ages and ethnic groups. Three principal risk factors were found for excessive blood lead in children: ethnicity, gender, and age; this is consistent with the second National Health and Nutrition Examination Survey (NHANES II) and Phase I of the NHANES III results demonstrating ethnicity and income association with lead in children in the United States.

Child↗