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Biomedical subjects

C A Macera

Publications and source records attributed to C A Macera.

88 records · Page 5Linked to original sources
PubMed1989

Predicting lower-extremity injuries among habitual runners.

This prospective study of 583 habitual runners used baseline information to examine the relationship of several suspected risk factors to the occurrence of running-related injuries of the lower extremities that were severe enough to affect running habits, cause a visit to a health professional, or require use of medication. During the 12-month follow-up period, 252 men (52%) and 48 women (49%) reported at least one such injury. The multiple logistic regression results identified that running 64.0 km (40 miles) or more per week was the most important predictor of injury for men during the follow-up period (odds ratio = 2.9). Risk also was associated with having had a previous injury in the past year (odds ratio = 2.7) and with having been a runner for less than 3 years (odds ratio = 2.2). These results suggest that the incidence of lower-extremity injuries is high for habitual runners, and that for those new to running or those who have been previously injured, reducing weekly distance is a reasonable preventive behavior.

Adolescent↗
PubMed1988

The use of proportional hazards regression in investigating dropout rates in a longitudinal study.

One difficulty with the interpretation of data from longitudinal studies is the bias associated with those who do not complete the study. In a 12-month study on the occurrence of musculoskeletal problems in 966 runners (583 of whom completed the study), a proportional hazards model with time-dependent covariates was used to assess factors associated with dropout at the various stages of the study. This approach allowed examination of baseline factors as well as the effect of change in mileage, the occurrence of a musculoskeletal problem, or the occurrence of another health problem on the rate of dropout. Those most likely to drop out of the study were younger and heavier at baseline and, prior to drop out, were less likely to experience general health problems and more likely to show a 40% decline in weekly running mileage in the month before dropout. Examination of factors associated with dropout is important since factors influencing dropout may also affect the study outcome for the risk factor analysis (a musculoskeletal problem severe enough to be seen by a physician). The results of the dropout analysis can be used to guide in the choice of analytic methods and to aid in the interpretation of the risk factor analyses.

Adult↗
PubMed1988

A mail survey of physical activity habits as related to measured physical fitness.

The associations of self-reported measures of physical activity from a mail survey with an objective measure of physical fitness were investigated. Respondents to a health status survey (n = 12,225), conducted in 1982 by the Institute for Aerobics Research in Dallas, TX, formed the population. From this group, males who also had a clinical examination within 60 days of the return of their questionnaire served as subjects. The study subjects (n = 375, mean age = 47.1 years) completed a maximal physical fitness assessment using a modified Balke protocol. The questionnaire included a section of inquiries concerning leisure time physical activity participation in which subjects were asked to quantitatively recall exercise participation for varying periods of time. Reported exercise participation values were converted to estimates of energy expenditure and combined into overall indices of physical activity participation. Multiple regression analyses were used to determine the individual contributions of the physical activity indices in predicting maximal treadmill performance (physical fitness). Significant predictors of physical fitness were age (beta = -0.34), an index of running, walking, and jogging participation (beta = 0.31), and the response to a question on frequency of sweating (beta = 0.35). The multiple correlation coefficient for these variables in predicting physical fitness was 0.65. These results indicate that exercise behavior can be accurately estimated in large populations by using simple questions in a mail survey.

Adult↗
PubMed1987

Evaluating interrater agreement through "case-control" sampling.

An approach to evaluating interrater agreement is presented that is based on "case-control" sampling scheme, in which individuals are classified by one rating method and stratified prior to being classified by a second rating method. A new estimate of the kappa interrater agreement index that is based on the case-control scheme is also presented. Power and other economic considerations are discussed, indicating that the new approach may be useful in practice.

Biometry↗
PubMed1985

A recommended core book list for public health libraries.

Public health is a multidisciplinary field ranging broadly across the health care spectrum. In light of this diversity the selection of basic reference books and textbooks in the field is a complex task. This paper first defines the components of what is public health and then presents such a list to serve as a guide to the librarian faced with this task.

Bibliographies as Topic↗
PubMedDate not supplied

Moderate leisure-time physical activity: who is meeting the public health recommendations? A national cross-sectional study.

We identified the prevalence of adults who met the 1993 Centers for Disease Control and Prevention and the American College of Sports Medicine moderate physical activity recommendation and the 1996 Surgeon General's Report on Physical Activity and Health energy expenditure guideline for leading a moderately active lifestyle. Participants were 16,890 women and 12,272 men at least 18 years old who were asked in the 1990 National Health Interview Survey about their leisure-time physical activities. About one third of US adults met either recommendation for moderate activity; 32% met the Centers for Disease Control and Prevention and the American Association of Sports Medicine recommendation and 38% met the surgeon general's guideline. Women, ethnic minorities, adults with lower educational attainment, and older adults were least active. Public health efforts are needed to address the issues related to physical inactivity and to provide organized programs to increase moderate physical activity levels in US adults.

Adult↗
PubMedDate not supplied

Clinical feasibility of a free-weight strength-training program for older adults.

BACKGROUND: An emerging trend in the field of gerontology is the recognition that older adults, especially the frail elderly population, can increase their levels of strength and thus improve functional capability. Social acceptance of physical frailty and provision of care and assistance to dependent persons has now turned to helping the frail elderly adults maintain or improve functional independence. METHODS: The purpose of our study was to show the feasibility and effectiveness of a low-cost strength-training program using free weights for increasing strength and functional fitness among older adult volunteers. Participants aged 73 to 94 years were residents of a multilevel care retirement community in Columbia, SC. The strength-training program, led by an instructor, used dumbbells and ankle weights and was conducted in a multipurpose recreation room at the retirement facility. RESULTS: Functional performance measures (timed chair stand, 6-meter walk, stair climb, balance) handgrip strength, and self-assessment of activity level were outcome measures. All 25 participants completed the strength-training program. The average program adherence rate of all participants was 87 percent. No participant injuries or other adverse effects were observed. Functional performance measures improved significantly among program participants, with the greatest improvement in the timed chair stand (33.5 percent improvement) and the stair climb (17.6 percent improvement). CONCLUSION: Free-weight strength-training programs are appropriate for older adults, can be implemented in community settings, and are associated with significant improvement in functional performance.

Activities of Daily Living↗
PubMedDate not supplied

Postrace morbidity among runners.

We examined two general measures of morbidity, musculoskeletal problems and respiratory symptoms, among participants of a 42 km race. We compared the morbidity experience of these participants to runners racing shorter distance events (5 km and 10 km) on the same day. Male marathon runners were almost twice as likely (and female marathon runners four times as likely) to report a lower extremity musculoskeletal problem in the month after the race as nonmarathon runners. Although adjusting for other factors did not change the crude odds ratio for either men or women, logistic regression results indicated that the strongest factor associated with lower extremity musculoskeletal problems in the month after the marathon was the report of a musculoskeletal problem in the year before the marathon. Neither male nor female marathon runners reported an excess of respiratory symptoms compared to those who ran shorter distances. However, a report of respiratory symptoms in the month before the race was statistically associated with respiratory symptoms in the month after the race. These results suggest that runners who have had lower extremity musculoskeletal problems in the year before, or those who have recently experienced respiratory symptoms, should use caution when preparing for and recovering from racing events.

Adult↗
PubMedDate not supplied

Runners' health habits, 1985--"the Alameda 7" revisited.

Seven health habits were shown to be associated with longevity in a longitudinal study initiated in Alameda County, CA, in 1965. These habits (drinking moderately, exercising regularly, maintaining desirable weight for height, eating breakfast, not eating snacks, sleeping 7 or 8 hours per day, and never having smoked) were recently examined in a sample of the U.S. population. Subgroups with low income and little education were found to have low frequency of these health habits. In this report, findings on the frequency of these habits in 966 habitual runners in South Carolina are presented separately for men and women and according to age, education, income, and weekly mileage. Subgroups of the runners are surprisingly similar to subgroups of the national sample for several health habits. In addition, among the runners, low-income groups and those with little education have a lower frequency of good health habits relative to the other groups, although these differences are not statistically significant. Overall, about half of the runners practice five or more good health habits. These results indicate that even among healthy runners there is need for improvement in the adoption of health habits thought to be associated with reduced morbidity and mortality.

Adolescent↗
PubMedDate not supplied

Sedentary lifestyle and state variation in coronary heart disease mortality.

Using linear regression, the authors demonstrated a strong association between State-specific coronary heart disease mortality rates and State prevalence of sedentary lifestyle (r2 = 0.34; P = 0.0002) that remained significant after controlling for the prevalence of diagnosed hypertension, smoking, and overweight among the State's population. This ecologic analysis suggests that sedentary lifestyle may explain State variation in coronary heart disease mortality and reinforces the need to include physical activity promotion as a part of programs in the States to prevent heart disease.

Adult↗
PubMedDate not supplied

Health promotion practices among physicians.

Personal belief concerning both the validity of health promotion and the physician's ability to influence patient behavior may affect how much effort a physician spends on health promotion strategies. We assessed these beliefs through a mail survey to physicians practicing in a predominantly rural southern state in 1987 (n = 83) and 1991 (n = 96). Response rates in both studies exceeded 75%. The instrument was obtained from similar studies conducted in Massachusetts in 1981 and Maryland in 1983. Between 1987 and 1991 we found slight improvements in the perceived importance of many health behaviors, but significant improvement was observed in the importance of reducing intake of dietary saturated fat (66% in 1987 to 80% in 1991; P < .05). Less than 10% of the physicians thought they could be "very successful" in modifying patients' behaviors. However, in 1991 physicians perceived that their ability to be "very successful" in helping patients to modify their behavior would increase threefold (8%-24% for exercise; 4%-18% for smoking) if given appropriate support. Although the type of appropriate support was not identified, the credibility of physician's advice in promoting health changes is important. These results suggest that efforts should be made to provide support to physicians who are inclined to discuss health behavior changes with their patients. Medical Subject Headings (MeSH): dietary fats, exercise, patient education, physician's practice patterns, smoking.

Adult↗
PubMedDate not supplied

Blood pressure in Hispanic women: the role of diet, acculturation, and physical activity.

The role of diet, acculturation, and physical activity on systolic and diastolic blood pressure was examined among 1,420 Mexican American, 388 Cuban American, and 542 Puerto Rican women who responded to the Hispanic Health and Nutrition Examination Survey collected in 1982-4. Dietary intake measures included sodium, potassium, calcium, magnesium, fiber, ethanol, and total kilocalories as estimated from 24-hour recall data. Serum sodium/potassium ratio was included as a measure of metabolic function. Acculturation was measured using language preference, speaking, reading and writing. Physical activity included recreational and non-recreational activities. Other correlates included age, education, and body composition. Final models indicated that age and body composition were significantly associated with blood pressure across all three Hispanic subgroups. Among Mexican-American women, acculturation had an impact on both systolic and diastolic blood pressure that was independent of diet, body composition, and physical activity. Furthermore, the dietary intake of specific nutrients such as sodium and potassium did not appear to be as important as the way the individual metabolized those nutrients, as indicated by the serum sodium/potassium ratio. The strong association of body mass index with both systolic and diastolic blood pressure among all three ethnic groups reinforces the need to maintain an appropriate body weight.

Acculturation↗