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961.
Sven Prevrhal John A. Shepherd Kenneth G. Faulkner Ken W. Gaither Dennis M. Black Thomas F. Lang 《Journal of clinical densitometry》2008,11(2):260-236
Hip structural analysis (HSA) estimates geometrical and mechanical properties from hip dual-energy X-ray absorptiometry (DXA) images and is widely used in osteoporosis trials. This study compares HSA to volumetric quantitative computed tomography (QCT) measurements in the same population. A total of 121 women (mean age 58 yr, mean body mass index 27 kg/m2) participated. Each woman received a volumetric QCT scan and DXA scan of the left hip. QCT scans were analyzed with in-house software that directly computed geometric and mechanical parameters at the neck and trochanteric regions. DXA HSA was performed with an implementation by GE/Lunar. Pair-wise linear regression of HSA variables was conducted by method to site matched QCT variables for bone density, cross-sectional area, and cross-sectional moment of inertia (CSMI) of the femur neck. HSA correlated well with QCT (r2 = 0.67 for neck bone mineral density [BMD] and 0.5 for CSMI) and standard DXA at the neck (r2 = 0.82 for BMD). HSA and volumetric QCT compared favorably, which supports the validity of a projective technique such as DXA to derive geometrical properties of the proximal hip. 相似文献
962.
963.
Background Research suggests that gain-framed messages are generally more effective than loss-framed messages at promoting preventive
health behaviors. Virtually all previous studies, however, have examined prevention behaviors that require regular and repeated
action to be effective. Little is known about the utility of message framing for promoting low-frequency prevention behaviors
such as vaccination. Moreover, few studies have identified mediators of framing effects.
Purpose We investigated whether behavioral frequency (operationalized as the number of shots required) moderated the effect of framed
health messages on women’s intentions to receive the human papillomavirus (HPV) vaccine. We also sought to identify mediators
of framing effects.
Method Undergraduate women (N = 237) were randomly assigned to read an HPV vaccination booklet that varied by message frame (gain vs. loss) and behavioral
frequency (one shot vs. six shots).
Results We observed a frame-by-frequency interaction such that the loss-framed message led to greater vaccination intentions than
did the gain-framed message but only among participants in the one-shot condition. Perceived susceptibility to HPV infection
mediated the observed framing effects.
Conclusions This study provides an important exception to the commonly observed gain-framed advantage for preventive health behaviors.
Loss-framed appeals appear to be particularly effective in promoting interest in low-frequency prevention behaviors such as
HPV vaccination.
Portions of this article were presented at the annual meeting of the Society of Behavioral Medicine, San Francisco, March
2005. 相似文献
964.
Unmet needs for services for older adults with mental illness: comparison of views of different stakeholder groups. 总被引:1,自引:0,他引:1
Lawrence A Palinkas Viviana Criado Dahlia Fuentes Sally Shepherd Hans Milian David Folsom Dilip V Jeste 《The American journal of geriatric psychiatry》2007,15(6):530-540
OBJECTIVE: The authors assessed the need for mental health services among older adults in San Diego County, California, by determining what needs were not being addressed by existing services, what services were necessary to address these needs, and how much consensus there was among different stakeholders with respect to the problems and solutions related to service delivery. METHODS: Semistructured interviews were conducted with 23 health care and social service providers and administrators, 16 services consumers and other older adults (55 years of age and older), and 19 caregivers/family members and patient/client advocates. This was followed by four focus groups comprised of 18 providers and administrators, six focus groups comprised of 50 consumers and other older adults, and five focus groups comprised of 39 caregivers (family members and advocates). RESULTS: The unmet needs fell into three categories: mental health services, physical health services, and social services. Two interrelated themes were identified by participants: 1) the need for age-appropriate and culturally appropriate services to overcome barriers to mental health services access, use, and quality; and 2) the interrelations between unmet needs that address prevention as well as treatment of mental illness, including socialization and social support, transportation, housing, and physical health care. Differences in stakeholder assessment of unmet needs were associated with respective roles in delivery and use of mental health services. CONCLUSION: Age-appropriate and culturally appropriate solutions that address both prevention and treatment may represent the best strategies for addressing the challenges of mental illness and are most likely to be endorsed by all three groups of stakeholders. 相似文献
965.
Masking functions constructed from pedestal levels bracketing absolute threshold may exhibit negative masking, particularly when stimuli are defined in terms of amplitude (pressure). Three experimental conditions using 10-ms 1000-Hz tones in quiet, 1000-Hz tones embedded in continuous noise, and 6500-Hz tones in quiet, yielded negative masking when amplitudes were used to define the stimulus, with the greatest amount of negative masking occurring with 6500-Hz tones. Two models were applied to the data: the transduction model, which assumes direct coupling, and the sensory analytical model, which assumes differential coupling. Maximum likelihood estimates were derived to indicate goodness-of-fit, and the Akaike information criterion and Bayesian information criterion were utilised to adjust for model complexity. Overall, both models effectively accounted for the data, though the sensory analytic model provided the best fits to the data and has the added quality of being based on underlying physiological processes. 相似文献
966.
967.
968.
Benjamin P C Wei Robert K Shepherd Roy M Robins-Browne Graeme M Clark Stephen J O'Leary 《Otolaryngology--head and neck surgery》2007,136(4):589-596
OBJECTIVES: The study goals were to examine whether cochlear implantation increases the risk of meningitis in the absence of other risk factors and to understand the pathogenesis of pneumococcal meningitis post cochlear implantation. STUDY DESIGN AND SETTING: Four weeks following surgery, 54 rats (18 of which received a cochleostomy alone, 18 of which received a cochleostomy and acute cochlear implantation using standard surgical techniques, and 18 of which received a cochlear implant) were infected with Streptococcus pneumoniae via three different routes of bacterial inoculation (middle ear, inner ear, and intraperitoneal) to represent all potential routes of bacterial infection from the upper respiratory tract to the meninges. RESULTS: The presence of a cochlear implant reduced the threshold of bacteria required to cause pneumococcal meningitis from all routes of infection in healthy animals. CONCLUSION: The presence of a cochlear implant increases the risk of pneumococcal meningitis regardless of the route of bacterial infection. SIGNIFICANCE: Early detection and treatment of pneumococcal infection such as otitis media may be required, as cochlear implantation may lead to a reduction of infectious threshold for meningitis. 相似文献
969.
Care management of work injuries: results of a 1-year pilot outcome assurance program. 总被引:2,自引:0,他引:2
D H Linz L F Ford M J Nightingale P L Shannon J S Davin C O Bradford C D Shepherd 《Journal of occupational and environmental medicine / American College of Occupational and Environmental Medicine》2001,43(11):959-968
A 1-year pilot study was conducted, linking the efforts of a workers' compensation managed care organization with those of an occupational health clinic and emergency department of manage work-related injuries and associated work disability. Sustained (> 90 day), injury-specific return-to-work outcomes, modified by job title, were compared with loosely managed and well-managed benchmarks. The mean return-to-work outcome, measured as lost workdays (LWDs), was 5.11 +/- 21.0 LWDs for 418 workers. These results exceeded benchmarks for both loosely managed care, 14.0 +/- 17.2 LWDs, P < 0.001 (8.9 fewer LWDs/case), and optimally case-managed care, 6.99 +/- 7.64 LWDs, P = 0.044 (1.9 fewer LWDs/case). An estimate of the value of these saved LWDs to the employers-at $200 per workday was $740,400 for the loosely managed benchmarks and $157,000 for the well-managed benchmarks. The Outcome Assurance Program virtually eliminated typical delays in the diagnosis and medical management of these injured workers. 相似文献
970.
Maria A. Stanley Nicole Shepherd Nichole Duvall Sandra B. Jenkinson Hasnaa E. Jalou Deborah C. Givan Gregory H. Steele Charlene Davis Marilyn J. Bull Donna U. Watkins Randall J. Roper 《American journal of medical genetics. Part A》2019,179(2):177-182
Feeding and swallowing disorders have been described in children with a variety of neurodevelopmental disabilities, including Down syndrome (DS). Abnormal feeding and swallowing can be associated with serious sequelae such as failure to thrive and respiratory complications, including aspiration pneumonia. Incidence of dysphagia in young infants with DS has not previously been reported. To assess the identification and incidence of feeding and swallowing problems in young infants with DS, a retrospective chart review of 174 infants, ages 0–6 months was conducted at a single specialty clinic. Fifty‐seven percent (100/174) of infants had clinical concerns for feeding and swallowing disorders that warranted referral for Videofluroscopic Swallow Study (VFSS); 96/174 (55%) had some degree of oral and/or pharyngeal phase dysphagia and 69/174 (39%) had dysphagia severe enough to warrant recommendation for alteration of breast milk/formula consistency or nonoral feeds. Infants with certain comorbidities had significant risk for significant dysphagia, including those with functional airway/respiratory abnormalities (OR = 7.2). Infants with desaturation with feeds were at dramatically increased risk (OR = 15.8). All young infants with DS should be screened clinically for feeding and swallowing concerns. If concerns are identified, consideration should be given to further evaluation with VFSS for identification of dysphagia and additional feeding modifications. 相似文献