Personality correlates of religious commitment: a further verification.
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Catholicism↗
Biomedical subjects
T J Coates
Publications and source records attributed to T J Coates.
The effects of mild diastolic hypertension on the results of tests of cognitive function in adults 22 to 59 years of age.
OBJECTIVE: To test the hypothesis that mild diastolic hypertension (90 to 104 mm Hg) may induce asymptomatic impairment of cognitive function. DESIGN: Cross-sectional. SETTING: Community participants recruited to a university-based ambulatory care center. PARTICIPANTS: Three hundred twelve men and women with untreated essential hypertension and 47 normotensive subjects, 22 to 59 years of age. MEASUREMENTS AND MAIN RESULTS: Cognitive function tests measured reaction time to and accuracy in interpreting predetermined visual stimuli, the ability to acquire, reproduce, and change a set of arbitrary stimulus-response associations, and memory and learning of verbal information. These tests were selected to detect subtle differences in performances as opposed to differentiating neurologically normal persons from brain-damaged persons. After controlling for age, gender, and education, results showed that there was no significant difference between the normotensive and hypertensive subjects in two measures of reaction time to and four measures of accuracy in interpreting predetermined visual stimuli, in the measure of arbitrary stimulus-response associations, or in seven memory and learning variables. Although confidence intervals for the differences between means were wide, clinically significant differences were not likely to be present. Younger age was associated with faster reaction times, fewer errors, and better performance on memory and learning tasks, independent of diastolic blood pressure. CONCLUSIONS: The few detectable effects of untreated mild hypertension on cognitive function reported in the literature may be due to chance and are of questionable clinical significance.
Adult↗
Quitting smoking: reasons for quitting and predictors of cessation among medical patients.
OBJECTIVE: To describe why medical patients quit smoking and the methods they use. DESIGN: Cross-sectional and prospective cohort design. Patient smokers were enrolled in a study of physician counseling about smoking. One year later, 2,581 of the patients were asked about quit attempts and methods used. Of those, 245 former smokers whose quitting had been biologically validated were interviewed about why and how they had quit. SETTING: Offices of internists and family practitioners in private practice and a health maintenance organization. SUBJECTS: Consecutive sample of ambulatory patients who smoked. MEASUREMENTS AND MAIN RESULTS: Baseline questionnaires included demographic data, smoking history, and symptoms and diagnoses related to smoking. After one year, subjects were interviewed about smoking status and methods used in attempting to quit. Cessation was confirmed by biochemical testing. Those who had quit were asked about reasons for quitting. Seventy-seven percent of successful quitters gave health-related reasons for quitting and the quitters ranked "harmful to health" as the most important reason for quitting. In a multivariate analysis, those who had a college education, who had social pressures to quit, and who had greater confidence in being able to quit were more likely to have quit smoking one year later, while those who smoked their first cigarette within 15 minutes of awakening and who had more diagnoses related to smoking were less likely to have quit smoking one year later. Participation in a treatment program and having been counseled by a physician or nurse practitioner were positively related to successful quitting, while use of filters or mouthpieces was negatively related. CONCLUSIONS: Concerns about health are the most common reason patients give for quitting, and addiction is the most important barrier to quitting. Education, social pressure, provider advice, and formal programs, but not over-the-counter devices, appear to increase the chances that smokers will quit.
Adult↗
Training physicians about smoking cessation: a controlled trial in private practice.
STUDY OBJECTIVE: To test the hypotheses that physicians in private practice who receive a continuing education program (entitled "Quit for Life") about how to counsel smokers to quit would counsel smokers more effectively and have higher rates of long-term smoking cessation among their patients. DESIGN: Randomized trial with blinded assessment of principal outcomes. SETTING: Private practices of internal medicine and family practice. SUBJECTS: Forty-four physicians randomly assigned to receive training (24) or serve as controls (20) and consecutive samples of smokers visiting each physician (19.6 patients per experimental and 22.3 per control physician). INTERVENTIONS: Physicians received three hours of training about how to help smokers quit. Physicians and their office staffs were also given self-help booklets to distribute to smokers and were urged to use a system of stickers on charts as reminders to counsel smokers about quitting. MEASUREMENTS AND MAIN RESULTS: Based on telephone interviews with patients, physicians in the experimental group were more likely to discuss smoking with patients who smoked (64% vs. 44%), spent more time counseling smokers about quitting (7.5 vs. 5.2 minutes), helped more smokers set dates to quit smoking (29% vs. 5% of smokers), gave out more self-help booklets (37% vs. 9%), and were more likely to make a follow-up appointment about quitting smoking (19% vs. 11% of those counseled) than physicians in the control group. One year later, the rates of biochemically confirmed, long-term (greater than or equal to 9 months) abstinence from smoking were similar among patients in the experimental (3.2%) and control (2.5%) groups (95% confidence interval for the 0.7% difference: -1.7 to +3.1%). CONCLUSIONS: The authors conclude that this continuing education program substantially changed the way physicians counseled smokers, but had little or no impact on rates of long-term smoking cessation among their patients. There is a need for more effective strategies to help physicians help their patients to quit smoking.
Clinical Competence↗
The AIDS epidemic: a model for developing intervention strategies for reducing high-risk behavior in gay men.
The authors convened a conference at the University of California, San Francisco, to provide a framework for developing health education programs to reduce high-risk sexual activity associated with the acquired immunodeficiency syndrome (AIDS). Operating on a consensus model, four groups of experts defined the sexual behaviors that place an individual at high risk for AIDS, the principles of health psychology that can be applied to health education programs for reducing high-risk sexual activity among gay men, the health education and media strategies that might be used, and the factors unique to gay men that need to be considered. We hope that these reports will not only provide a foundation for the discussion of health education strategies for reducing the risk of AIDS, but will also prove useful to local, regional, and national organizations in developing such programs.
Acquired Immunodeficiency Syndrome↗
Human immunodeficiency virus prevention: applying the lessons learned.
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Female↗
Ethnicity and smoking: differences in white, black, Hispanic, and Asian medical patients who smoke.
To describe differences in the attitudes and behaviors of white, black, Hispanic, and Asian medical patients who smoke, we surveyed 2,835 patients of primary care physicians who participated in a controlled trial on smoking cessation. White smokers smoked more cigarettes per day, were more addicted to cigarettes, had more smoking-related symptoms and illnesses, and were more likely to relate smoking to their symptoms and illnesses. Black smokers found less pleasure in smoking, expressed the least concern about the health risks of smoking, but reported the greatest desire to quit and most confidence that they could quit. Hispanic and Asian smokers more often wanted to quit to keep their children from being exposed to smoking. We conclude that a single approach to helping patients quit smoking is less likely to be effective than one tailored to the ethnic differences among those patients.
Adolescent↗
The effectiveness of smoking cessation advice given during routine medical care: physicians can make a difference.
Physicians may be hesitant to advise their patients to give up cigarette smoking partly because they doubt their own effectiveness. The three studies cited in this paper indicate that physicians can help their patients quit smoking if they briefly explain the benefits of quitting and provide concrete advice on how to go about it. This advice is effective primarily with light smokers. If smokers require medical care at least as frequently as nonsmokers and if physicians advise them (during routine care) to quit smoking, some 38 of the 54 million smokers could be reached in a single year. Further research is needed in areas such as physician motivation and the provision of information on smoking.
Adult↗
Reported changes in the sexual behavior of men at risk for AIDS, San Francisco, 1982-84--the AIDS Behavioral Research Project.
We surveyed 454 men in November 1983 and in May 1984 regarding their sexual practices during the month before the survey. In the 1983 survey, we also asked for reports about sexual behavior during the same month 1 year prior to the survey. The sample consisted of men recruited as they left bath-houses and bars, men who had not used bars or baths for meeting sexual partners for 2 months prior to the November 1983 survey, and men in committed primary relationships with another man. We found substantial changes in reported sexual behavior with persons other than a primary partner. The average number of male partners declined from 6.3 in November 1982 to 3.9 in May 1984. Receptive anal intercourse without condom declined from 1.9 to 0.7, oral-anal contact declined from 1.1 to 0.3, and swallowing semen declined from 2.8 to 0.7 in terms of the number of times that the respondent engaged in the act in the last month. These same changes did not occur in relation to sex with a primary partner. Only one variable, namely, increased length of time since the first homosexual experience, distinguished persons maintaining few sexual partners from those increasing the number of sexual partners from November 1983 to May 1984. Four variables distinguished those retaining high numbers of sexual partners from those lowering the number of sexual partners, namely, ability to remember a visual image of AIDS deterioration, age, relationship status, and length of time since first homosexual experience.
Acquired Immunodeficiency Syndrome↗
Who plans to be tested for HIV or would get tested if no one could find out the results?
We analyzed the characteristics of individuals at risk for HIV who have not been tested but who (1) planned to be tested, or (2) would get tested "if no one other than you (the respondent) could find out your results." Data were from the 1991 National AIDS Behavioral Surveys, a probability sample of the U.S. population. Logistic regression was used to analyze the correlates of testing behavior among the 41% of individuals in high-prevalence cities who had HIV risk factors (n = 3,175). Of this group, 7% planned to be tested and 30% would get tested "if no one other than you could find out the results." Minorities and individuals with less education and without insurance were more likely to plan to be tested (versus previously tested), and individuals with less education and lower incomes were more likely to be willing to be tested "if no one other than you could find out the results" (versus previously tested). We conclude that a variety of options to increase testing rates should be explored, including accessible testing services, policies and procedures to increase perceptions of testing privacy, and home testing.
AIDS Serodiagnosis↗
Demographic characteristics of heterosexuals with multiple partners: the National AIDS Behavioral Surveys.
In a study of risk behavior among heterosexuals, 9% of a national sample and 12% of a sample drawn from high-risk cities report having two or more sexual partners in the year before the survey. In both samples, sex with multiple partners is most common among men, younger people and the unmarried. Multivariate analyses show that racial and ethnic differences in the proportion of respondents with multiple partners vary by marital status. The results indicate that many heterosexuals are failing to protect themselves against sexually transmitted diseases: Among respondents with multiple partners, only 18% of men and 22% of women always use condoms with their primary partner, and 28% of men and 32% of women always use them with secondary partners. These proportions do not increase significantly with the number of partners; in general, almost half of men and women with multiple partners never use condoms.
Acquired Immunodeficiency Syndrome↗
Predictors of follow-through on plans to be tested for HIV.
INTRODUCTION: Fewer than 40% of people in the United States with HIV risk factors have been tested. However, almost 40% of untested individuals with HIV risk factors in high AIDS prevalence cities stated in the 1991 National AIDS Behavioral Surveys (NABS) that they (1) "planned to be tested" or (2) "would get tested if no one could find out." METHODS: We used longitudinal data from the 1991 and 1992 NABS (n = 5,543), which are nationally representative telephone surveys. We assessed whether untested individuals were tested one year later, and we used logistic regressions to address two research questions: What are the predictors of testing among untested individuals? What are the predictors of testing among untested individuals who "planned to be tested" or "would get tested if no one could find out?" RESULTS: We found that 30% of individuals who "planned to be tested," 16% of individuals who "would get tested if no one could find out," and 11% of persons with no intentions to be tested had been tested one year later (P < .001). In regression analyses, risk factors and higher education were key predictors of testing. CONCLUSIONS: It is encouraging that 30% of individuals who plan to be tested did get tested within one year. Further research, however, needs to examine testing barriers for the 70% of individuals who do not follow through on testing plans. The results provide important information for targeting testing programs, developing effective public policies, and addressing the debate over issues such as name reporting and the availability of home HIV tests.
AIDS Serodiagnosis↗