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51.
Leisure-time physical activity as an estimate of physical fitness: a validation study 总被引:5,自引:0,他引:5
This paper describes a new interview questionnaire for the assessment of leisure-time physical activity (LTPA), and its validation as an alternative estimate of physical fitness. British subjects (77 males, 41 females) provided details of their LTPA over a period of a "typical" 2 weeks, enabling the estimation of the energy expended. Physical fitness was assessed with a battery of measures, the optimal single measure being sub-maximal physical work capacity (PWC). The questionnaire showed LTPA to be stable following test-retest administration (r = 0.86; p less than 0.0001) for total LTPA energy expenditure. Total LTPA was found to be significantly related to PWC (r = 0.48, p less than 0.0001), as were very hard (r = 0.55; p less than 0.0001) and hard LTPA (r = 0.38; p less than 0.0001). Multiple regression analysis with PWC as the dependent variable yielded a multiple correlation of r = 0.87, with significant contributions from very hard and hard LTPA. It is concluded that whilst this questionnaire is both reliable and a valid estimate of physical fitness amongst a population consistent in their leisure-time physical activities, there is scope for its further use within larger populations, allowing for an analysis of the effects of age and gender on the associations so far observed. 相似文献
52.
Carasiti ME Lamb RE Davio M 《Topics in hospital pharmacy management / Aspen Systems Corporation》1991,11(2):6-17
"If it ain't broke, don't fix it" is a classic quote that is still heard. Although health professionals strive for continuous improvement in the understanding, prevention, and treatment of pathology, they commonly ignore the system for health care delivery. DUE provides an effective mechanism for continuous examination of the system and improvement of patient outcome as it relates to drug therapy. The movement toward integration of DUE and clinical profiles will bring the Medical Center closer to realizing the ultimate goal of total quality care. 相似文献
53.
Lamb JM 《Health progress (Saint Louis, Mo.)》1992,73(10):52-5, 57
54.
Randomized controlled trial of supported discharge in patients with exacerbations of chronic obstructive pulmonary disease 总被引:4,自引:0,他引:4 下载免费PDF全文
BACKGROUND: A randomised trial was performed on patients presenting to hospital with an exacerbation of chronic obstructive pulmonary disease (COPD) to compare outcomes in those managed at home with support with those admitted to hospital in the standard manner. METHODS: Over an 18 month period all patients presenting to the Royal Infirmary of Edinburgh on weekdays (n=718) with a diagnosis of an exacerbation of COPD were assessed for inclusion in the trial. Patients with impaired level of consciousness, acute confusion, acute changes on radiography, or an arterial pH of <7.35 or with other serious medical or social reasons for admission were excluded. Patients randomised to home support were discharged with an appropriate treatment package (antibiotics, corticosteroids, nebulised bronchodilators and, if necessary, home oxygen). They were visited by a nurse the following day and thereafter at intervals of 2-3 days until recovery when they were discharged from follow up. Parallel observations were made on patients allocated to normal hospital admission up to the point of discharge. Patients in both groups were assessed at home eight weeks after the initial assessment. RESULTS: Among weekday patients 353 (50%) were considered obligatory admissions, 140 (19%) were admitted because of co-morbidity, 17 (2%) because of poor social circumstances, and 24 (3%) did not consent to the trial. The remaining 184 (26%) were randomised (2:1) either to home support or to a standard hospital admission. The median time to discharge was 7 days for the home support group and 5 days for the admitted group (p<0.01); 25% of the home support group and 34% of the admitted group were readmitted before the final assessment at eight weeks (p>0.05). There were no significant differences between the groups in attendances by GPs and carers or in health status measured eight weeks after the initial assessment. Satisfaction with the service was good. The mean total health service cost per patient was estimated as 877 pounds sterling for the home support group and 1753 pounds sterling for the admitted group. CONCLUSIONS: This study shows that home supported discharge is a well tolerated, safe, and economic alternative to hospital admission for a proportion of patients referred to hospital for admission for an exacerbation of COPD. 相似文献
55.
56.
OBJECTIVES: To investigate maternal knowledge and attitudes about otitis media (OM) risk, to estimate the prevalence of risk factors in the first year of life, and to identify barriers to the reduction of risk factors (eg, formula feeding, day care attendance, and exposure to passive smoke). METHODS: Questionnaires mailed to a systematic sample of 504 Minnesota women >/=18 years old identified through 1994 birth certificates. RESULTS: Eighty percent returned a completed survey. According to maternal report, 29% of infants (age 8 to 13 months) had recurrent OM (>/=3 episodes) and 2% had tympanostomy tubes. Forty-six percent attended day care, 29% had >/=1 smoking parent, and 49% breastfed for =2 months. Women were more knowledgeable about OM signs and symptoms than about risk factors. Mean OM knowledge score (the sum of correct true-false responses) was 7.0 (standard deviation = 1.6). Using multiple linear regression, knowledge score was significantly related to marital status, education, age, area of residence, breastfeeding (months), and number of cigarettes smoked per day by the mother, but not to infant or sibling OM history or day care attendance (R = .23). Infant history of OM (odds ratio, 1.9; 95% confidence interval, 1.1 to 3.2) and white race (odds ratio, 0.3; 95% confidence interval, 0. 1 to 0.8), but not the presence of risk factors, were significantly related to having received clinicians' advice about OM prevention advice. CONCLUSION: OM education and prevention programs should target pregnant women and new mothers with OM risk factors, and those who are young, single, and less educated. 相似文献
57.
58.
Hansen LA; Malarkey DE; Wilkinson JE; Rosenberg M; Woychik RE; Tennant RW 《Carcinogenesis》1998,19(10):1837-1845
We previously reported that papillomas can arise from the follicular
epithelium of v-Ha-ras transgenic TGxAC mice. Since the viable-yellow
mutation (A(vy)) of the mouse agouti gene which regulates coat color
pigmentation by acting within the micro-environment of the hair follicle
has been shown to function as a tumor promoter in the liver, we
hypothesized that it may also play a role in TGxAC skin tumorigenesis.
Endogenous agouti protein product was detected in the outer root sheath of
anagen hair follicles following plucking of the hair shaft, but not in the
interfollicular epithelium, in TGxAC mice on an FVB/N genetic background.
It was also detected in papillomas from these mice produced by
12-O-tetradecanoylphorbol-13-acetate (TPA) treatment or plucking.
Expression of the A(vy) allele in the v-Ha-ras transgenic TGxAC mouse line
results in an approximately 2-fold increase in papilloma development
compared with controls which did not carry the A(vy) allele following
twice-weekly treatment with 1.25, 2.5 or 5.0 microg TPA. In addition,
TPA-treated, papilloma-bearing F1 mice which carried the A(vy) allele, but
not F1 mice which did not carry the A(vy) allele, exhibited a syndrome of
humoral hypercalcemia mediated by parathyroid hormone-related protein
(PTHrP) that led to weight loss, hypercalcemia and hypophosphatemia. Thus,
we conclude that the A(vy) allele can influence the development of skin
tumors and PTHrP-mediated humoral hypercalcemia in v-Ha-ras transgenic
TGxAC mice.
相似文献
59.
Elliott SP Orejuela F Hirsch IH Lipshultz LI Lamb DJ Kim ED 《The Journal of urology》2000,163(3):792-795
PURPOSE: Azoospermia after electroejaculation in spinal cord injured men may be due to testicular failure or obstruction. These men can initiate pregnancy with assisted reproductive techniques, such as intracytoplasmic sperm injection, but only if sperm are present in the testis biopsy. We analyzed the histopathology of testis biopsies from spinal cord injured men and assessed whether patient factors were predictive of testis biopsy pathology. MATERIALS AND METHODS: A total of 50 paraplegic men undergoing testis biopsy were divided into 2 groups based on normal or abnormal testis histopathology. Patient age, post-injury years, level of lesion, hormonal status and semen analysis results were compared. RESULTS: Spermatogenesis was normal in 28 of the 50 patients. Hypospermatogenesis was exhibited in 15, maturation arrest at the spermatid stage in 6 and maturation arrest at the spermatocyte stage in 1 of the 22 abnormal cases. Nevertheless, mature sperm were identified in 43 of 50 biopsies (normal spermatogenesis and hypospermatogenesis). Men with normal spermatogenesis had better forward progression of sperm and a higher testosterone-to-luteinizing hormone ratio. Otherwise, there was no statistically significant correlation between study variables and testis biopsy results. No factors were predictive of testis biopsy histopathology. CONCLUSIONS: The documentation of mature sperm in 43 of 50 biopsies from spinal cord injured patients suggests that a high rate of sperm retrieval is possible using testicular sperm extraction if sperm cannot be retrieved from the ejaculate. With intracytoplasmic sperm injection techniques the majority of spinal cord injured men retain fertility potential, even if azoospermic following electroejaculation. 相似文献
60.
Danny Rischin Lester Peters Richard Fisher Andrew Macann Jim Denham Michael Poulsen Michael Jackson Lizbeth Kenny Michael Penniment June Corry David Lamb Bev McClure 《Journal of clinical oncology》2005,23(1):79-87
PURPOSE: To select one of two chemoradiotherapy regimens for locally advanced squamous cell carcinoma (SCC) of the head and neck as the experimental arm for the next Trans-Tasman Radiation Oncology Group phase III trial. PATIENTS AND METHODS: One hundred twenty-two previously untreated patients with stage III/IV SCC of the head and neck were randomized to receive definitive radiotherapy (70 Gy in 7 weeks) concurrently with either cisplatin (75 mg/m(2)) plus tirapazamine (290 mg/m(2)/d) on day 2 of weeks 1, 4, and 7, and tirapazamine alone (160 mg/m(2)/d) on days 1, 3, and 5 of weeks 2 and 3 (TPZ/CIS), or cisplatin (50 mg/m(2)) on day 1 and infusional fluorouracil (360 mg/m(2)/d) on days 1 through 5 of weeks 6 and 7 (chemoboost). RESULTS: Three-year failure-free survival rates were 55% with TPZ/CIS (95% CI, 39% to 70%) and 44% with chemoboost (95% CI, 30% to 60%; log-rank P = .16). Three-year locoregional failure-free rates were 84% in the TPZ/CIS arm (95% CI, 71% to 92%) and 66% in the chemoboost arm (95% CI, 51% to 79%; P = .069). More febrile neutropenia and grade 3 or 4 late mucous membrane toxicity were observed with TPZ/CIS, while acute skin radiation reaction was more severe and prolonged with chemoboost. Compliance with protocol treatment was satisfactory on both arms. CONCLUSION: Both regimens are feasible and are associated with significant but acceptable toxicity profiles in the cooperative group setting. Based on the promising efficacy seen in this trial, TPZ/CIS is being evaluated in a large phase III trial. 相似文献