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Biomedical subjects

B Belza

Publications and source records attributed to B Belza.

8 recordsLinked to original sources

Use of alternative therapies by older adults with osteoarthritis.

OBJECTIVE: To examine the rates of use and expenditures on alternative therapies by adults with osteoarthritis (OA). METHODS: Adults with OA recruited from the community to participate in a randomized clinical trial recorded alternative and traditional health care use on postcard diaries. General and arthritis-specific quality of life was assessed by questionnaires. RESULTS: More than 47% of participants reported using at least one type of alternative care during the 20-week intervention period. Among alternative care consumers, the most commonly used treatments were massage therapy (57%), chiropractic services (20.7%), and nonprescribed alternative medications (17.2%). Four percent of subjects reported using only alternative care during the study period. Expenditures for alternative therapy averaged $1,127 per year, compared with $1,148 for traditional therapies. CONCLUSION: Use of and expenditures for alternative care were high among this cohort of older adults with OA. Clinicians may want to inquire about use of these therapies before recommending treatments for this condition.

Aged↗

Testing the effectiveness of an osteoporosis educational program for nursing students in Thailand.

OBJECTIVE: Osteoporosis, a health problem that is on the rise, has received considerable attention among the health care community and the public. The majority of primary prevention programs for osteoporosis have been focused on women in mid-life. A concern is that young women may not be aware of osteoporosis risk factors and therefore may not be engaging in preventive behaviors. The purpose of this study was to test the effectiveness of an osteoporosis educational program for young women. METHODS: A sample of 100 female undergraduate students who were enrolled in the first year of a nursing program in Thailand were randomly assigned to a control group or an experimental group. Participants in the experimental group participated in a 3-hour osteoporosis educational program (OEP). At entry to and exit from the study, all participants completed the Osteoporosis Knowledge Test, the Osteoporosis Health Belief Scale, and the Osteoporosis Self-Efficacy Scale. RESULTS: The experimental group had higher change scores for knowledge, health belief, and self-efficacy than the control group. The OEP increased knowledge of osteoporosis in these young women. CONCLUSION: These findings indicate the need for further health education concerning the importance of dietary calcium and exercise on osteoporosis prevention in young women.

Adult↗

Economic evaluation of aquatic exercise for persons with osteoarthritis.

OBJECTIVES: To estimate cost and outcomes of the Arthritis Foundation aquatic exercise classes from the societal perspective. DESIGN: Randomized trial of 20-week aquatic classes. Cost per quality-adjusted life year (QALY) gained was estimated using trial data. Sample size was based on 80% power to reject the null hypothesis that the cost/QALY gained would not exceed $50,000. SUBJECTS AND METHODS: Recruited 249 adults from Washington State aged 55 to 75 with a doctor-confirmed diagnosis of osteoarthritis to participate in aquatic classes. The Quality of Well-Being Scale (QWB) and Current Health Desirability Rating (CHDR) were used for economic evaluation, supplemented by the arthritis-specific Health Assessment Questionnaire (HAQ), Center for Epidemiologic Studies-Depression Scale (CES-D), and Perceived Quality of Life Scale (PQOL) collected at baseline and postclass. Outcome results applied to life expectancy tables were used to estimate QALYs. Use of health care facilities was assessed from diaries/questionnaires and Medicare reimbursement rates used to estimate costs. Nonparametric bootstrap sampling of costs/QALY ratios established the 95% CI around the estimates. RESULTS: Aquatic exercisers reported equal (QWB) or better (CHDR, HAQ, PQOL) health-related quality of life compared with controls. Outcomes improved with regular class attendance. Costs/QALY gained discounted at 3% were $205,186 using the QWB and $32,643 using the CHRD. CONCLUSION: Aquatic exercise exceeded $50,000 per QALY gained using the community-weighted outcome but fell below this arbitrary budget constraint when using the participant-weighted measure. Confidence intervals around these ratios suggested wide variability of cost effectiveness of aquatic exercise.

Aged↗

Quantitating physical activity in COPD using a triaxial accelerometer.

STUDY OBJECTIVE: To determine the reliability, validity, and stability of a triaxial accelerometer for walking and daily activity measurement in a COPD sample. DESIGN: Cross-sectional, correlational, descriptive design. SETTING: Outpatient pulmonary rehabilitation program in a university-affiliated Veterans Affairs medical center. PARTICIPANTS: Forty-seven outpatients (44 men and 3 women) with stable COPD (FEV(1), 37% predicted; SD, 16%) prior to entry into a pulmonary rehabilitation program. MEASUREMENTS AND RESULTS: Test-retest reliability of a triaxial movement sensor (Tritrac R3D Research Ergometer; Professional Products; Madison, WI) was evaluated in 35 of the 47 subjects during three standardized 6-min walks (intraclass correlation coefficient [rICC] = 0.84). Pearson correlations evaluated accelerometer concurrent validity as a measure of walking (in vector magnitude units), compared to walking distance in all 47 subjects during three sequential 6-min walks (0. 84, 0.85, and 0.95, respectively; p < 0.001). The validity of the accelerometer as a measure of daily activity over 3 full days at home was evaluated in all subjects using Pearson correlations with other indicators of functional capacity. The accelerometer correlated with exercise capacity (maximal 6-min walk, r = 0.74; p < 0.001); level of obstructive disease (FEV(1) percent predicted, r = 0.62; p < 0.001); dyspnea (Functional Status and Dyspnea Questionnaire, dyspnea over the past 30 days, r = - 0.29; p < 0.05); and activity self-efficacy (Activity Self-Efficacy Questionnaire, r = 0.43; p < 0.01); but not with self-report of daily activity (Modified Activity Recall Questionnaire, r = 0.14; not significant). Stability of the accelerometer to measure 3 full days of activity at home was determined by an rICC of 0.69. CONCLUSIONS: This study provides preliminary data suggesting that a triaxial movement sensor is a reliable, valid, and stable measure of walking and daily physical activity in COPD patients. It has the potential to provide more precise measurement of everyday physical functioning in this population than self-report measures currently in use, and measures an important dimension of functional status not previously well-described.

Activities of Daily Living↗

Maintaining health in well older adults: initiatives for schools of nursing and The John A. Hartford Foundation for the 21st century.

In the past century, there has been a substantial increase in the number of older Americans and an increase in their life expectancy at birth. These trends will continue over the next century, marked by further increases in active life expectancy and marked changes in the racial and ethnic composition of the older population. While nursing has traditionally focused on the care of frail older individuals, most older adults--well older adults--enjoy a relatively high level of health and function. In this article, well older adults are defined as those with the physical, mental, social, and spiritual function or resources to meet the needs of everyday living. Recommendations for improving care of well older adults are provided, including reconceptualizing ways of thinking, expanding practice initiatives, building the science of nursing research in geriatrics and gerontology, developing education and training opportunities, and rethinking individual safety within the context of autonomy.

Adult↗

Conducting research in respondents' homes: benefits, problems, and strategies.

In summary, homes are valuable yet underused sites for data collection. Although homes are more frequently used for qualitative research because of the nature of qualitative inquiry requiring few distractions and more reflection, homes also can be used for quantitative studies. One major benefit of collecting data in homes is that of obtaining health-related information when a person is at baseline versus in a crisis situation. With adequate funding, attention to safety, and a mechanism for making and confirming appointments, homes serve as valuable sites for obtaining data.

Adult↗

The impact of fatigue on exercise performance.

The purpose of this paper is to discuss the impact of fatigue on exercise performance. First, fatigue will be defined and distinguished from similar constructs. Second, examples of instruments to measure fatigue in the rheumatic diseases are highlighted. Next, the social implications of fatigue are briefly mentioned. Fourth, methods in which fatigue impacts exercise performance are discussed. Fifth, the prevalence of fatigue in arthritis and its relationship to exercise will be presented. And last, areas of future research and roles of clinicians in managing fatigue relative to exercise performance are proposed.

Exercise↗

Correlates of physical activity in chronic obstructive pulmonary disease.

BACKGROUND: Physical activity is a key dimension of functional status in people with chronic obstructive pulmonary disease (COPD), and the central target of interventions in this group. OBJECTIVES: To determine the relationships among functional performance measured as physical activity, functional capacity, symptom experiences, and health-related quality of life in people with COPD. METHOD: Cross-sectional, descriptive study. Convenience sample of 63 outpatients with COPD studied prior to entry into a pulmonary rehabilitation program. RESULTS: Daily physical activity, as measured by an accelerometer, was strongly associated with maximal distance walked during a 6-minute walk test (r = .60, p < .00), level of airway obstruction (r = .37, p < .01), walking self-efficacy (r = .27, p < .05), and physical health status (r = .40, p < .01). Physical activity was not correlated with self-report of functional status. The only predictor of physical activity was the 6-minute walk test. CONCLUSIONS: Accelerometer measurement of functional performance was most significantly related to walking abilities. This methodology represents a novel approach to measuring an important dimension of functional status not previously well quantified.

Activities of Daily Living↗