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Biomedical subjects

D Post

Publications and source records attributed to D Post.

At least 19 recordsLinked to original sources
PubMed2002

Determinants of adolescents' smoking behaviour: a literature review.

A review of studies focused on determinants of adolescents' smoking behaviour (ASB) published between 1990-2000 is presented. Determinants were divided into three groups: individual factors, social factors and societal factors. Individual factors include knowledge, intentions, attitudes, health-related behaviour, personality characteristics and school-related variables. Social factors include smoking behaviour of parents, siblings, peers and significant adults, but also family characteristics, social support, and socio-economic status. Societal factors include restrictions on smoking, tobacco advertisement, and smoking behaviour of adolescents' role model.

Adolescent↗
PubMed2001

Self-reported health problems of Slovak adolescents.

This paper describes self-reported health problems among 2616 Slovak adolescents (52.4% boys, 47.6% girls). Adolescents consider their health as very good in general. They often feel 'vital', and rarely feel depressed or irritated. However, the psychological health of more than 20% of the boys and 40% of the girls was unsatisfactory. Furthermore, a sizeable number suffered from separate physical complaints, chronic diseases or used medical services. Findings are more unfavourable for girls in comparison with boys. Our findings indicate that adolescence is not such a healthy period in human life as is often considered. The Slovak Republic, a Central European country, does not differ in this respect from Western European countries.

Adolescent↗
PubMed2001

[Which objectively assessed limitations in health status, activities of daily living, or in psychological and social spheres are decisive for referral to a nursing home or to a home for the aged].

Which type of limitation is most decisive for a positive indication for a residential home or a somatic or psycho-geriatric nursing home, and to what extent do data on living situation (independent, adapted or intramural) and the social situation (alone or living together) influence this qualification? To obtain an answer to this question three experiments with an integrated, objective and independent assessment-for-care system were set up in the Netherlands. We studied one of them, in the town of Meppel, started in 1996. The study population consisted of all older people living in and around Meppel who had a positive indication for either a residential home, or a somatic or psycho-geriatric nursing home (N = 206 in 1998). Differences in limitations were computed by means of analysis of variance and the types of limitation and their impact on the type of allocated institutions were computed by logistic regression. The limitations only partially explain the types of indication. Indication for a residential home is based on physical limitations. When these increase they become a contra-indication for a residential home and a somatic nursing home indication is given. Mental limitations primarily yield indications for psycho-geriatric nursing homes. Social limitations have a higher incidence among persons with an indication for a somatic nursing home but cannot fully explain this indication. Persons with a residential home indication were significantly more often from an adapted living situation background. The living situation -alone or together-does not have an impact on the indication. We may not conclude that the assessment took place objectively, for, based on the registration it is impossible to conclude for what criteria a person was indicated for a specific type of institution. The objective of assessment, the allocation and distribution of collectively financed care in residential homes and nursing homes based on verifiable assessment methodology could not be realised.

Activities of Daily Living↗
PubMed2000

The effects of patient communication skills training on compliance.

OBJECTIVE: To examine the relationship between communication skills training for patients and their compliance with recommended treatment. DESIGN: A randomized control design was used, with patients nested within physicians. Each physician was audiotaped with 6 patients, 2 patients in each of the 3 intervention conditions: (1) a trained group (n = 50) received a training booklet in the mail 2 to 3 days prior to the scheduled appointment, (2) an informed group (n = 49) received a brief written summary of the major points contained in the training booklet while in the waiting room prior to the scheduled appointment, and (3) an untrained group (n = 51) did not receive any form of communication skills intervention. SETTING: Participants included physicians and patients from 9 different primary care, family practice locations. Two locations were clinics associated with a large, university-based medical school and hospital, while 7 were private practice offices in the community. PARTICIPANTS: The sample included 25 family physicians (averaging 11 years postresidency) and 150 patients. Patients were randomly selected from appointment records and randomly assigned to 1 of 3 intervention conditions. INTERVENTION: A training booklet designed to instruct patients in information seeking, provision, and verification. MAIN OUTCOME MEASURE: Patients' compliance with medications, behavioral treatment (e.g., diet, exercise, smoking cessation), and/or follow-up appointments and referrals. RESULTS: Trained patients were more compliant overall than untrained or informed patients. Training positively influenced compliance with behavioral treatments and follow-up appointments and referrals. CONCLUSION: Training patients in communication skills may be a cost-effective way of increasing compliance and improving the overall health of patients.

Adult↗
PubMed2000

Follow-up study of workers in a nylon carpet yarn plant after remedial actions taken against a contaminated humidification system.

OBJECTIVE: To investigate the effectiveness of remedial actions taken against a contaminated humidification system, after an outbreak of humidifier disease in a nylon carpet yarn plant. METHODS: Two and 6 years after modification, a follow-up investigation of a stratified (age, smoking habits) sample of exposed (n = 75) and non-exposed (n = 56) workers was carried out. Outcome-parameters were: respiratory symptoms, spirometry, skin tests and serology with various humidifier fungi. In addition, the yearly incidence of work-disability because of chronic respiratory disease during the 2 years before, and 11 years after the modification was compared. RESULTS: At follow-up, exposed workers, who remained at the same workplace no longer had significantly more frequent chronic respiratory symptoms. The prevalence of positive serology was still higher (P < 0.05) in exposed workers after 2 years, but at the 6 year follow-up investigation, the difference was no longer significant. Prevalence of positive skin tests after 2 years no longer differed from that of the non-exposed workers. Slopes (ml/years) of the graphs of forced vital capacity (FVC) and one-second forced expiratory volume (FEV1) during the 6 year follow-up after the first investigation did not differ between exposed and non-exposed workers, both before and after adjustment for age, smoking habits and results of skin tests and serology before modification. Before modification, exposed workers with a positive late skin test had a lower FVC than non-exposed workers. After 6 years of follow-up their FVC was still lower, but the difference was no longer significant. There were no indications of selective loss to follow-up. After remedial actions no new cases of humidifier disease occurred. Moreover, the yearly incidence of work-disability in this plant because of chronic respiratory disease, decreased from 1.30% to 0.27% compared with a decrease from 0.30% to 0. 12% in other synthetic fibre plants. CONCLUSION: Follow-up investigation of exposure-effects demonstrated the effectiveness of remedial actions taken against a contaminated humidification system.

Adolescent↗
PubMed2000

Exposure and acute exposure-effects before and after modification of a contaminated humidification system in a synthetic-fibre plant.

OBJECTIVE: Follow-up study of exposure and acute exposure-effects after modification to steam humidification of a contaminated cold water system which had caused an outbreak of humidifier fever in a synthetic-fibre plant. METHODS: Before and after modification of the system aerobiological measurements were performed. Concentrations of fungi and bacteria, in colony forming units (cfu) per m3, were measured by stationary air sampling with an Andersen sampler. Endotoxin levels (pg/m3) were determined by Limulus Amoebocyte Lysate (LAL) assay in pooled dust from personal air sampling. An indication of exposure levels of oil-mist was obtained by monitoring with a direct reading optical photometer. Changes as acute exposure-effects in spirometry and white blood cell count, during an afternoon shift were compared in exposed and non-exposed workers before and after modification. RESULTS: Measured levels of fungi, total bacteria, Gram-negative bacteria and endotoxins both before and after modification were below levels which would be expected to be associated with the exposure-effects. However, after modification, we found that the statistically significant differences in levels of bacteria and endotoxins with a department without humidification no longer existed. Mean oil-mist concentrations were below 1 mg/m3, with short-time peak exposure during certain tasks of up to 5 mg/m3. Before modification, in exposed workers there was significantly more decline of spirometry, and more increase of white blood cell count during the first afternoon shift, compared with non-exposed workers. In exposed workers, the white blood cell count increase was positively associated with decline of spirometry. After modification, differences between exposed and non-exposed workers no longer existed. CONCLUSION: Follow-up investigation of acute exposure-effects demonstrated the effectiveness of remedial actions taken against a contaminated humidification system. Follow-up of exposure-effects in particular is recommended when there is doubt about the interpretation of exposure measurements.

Bacteria↗
PubMed1999

Use of pyrrolidonyl peptidase to distinguish Citrobacter from Salmonella.

In the routine testing of foods for Salmonella, Citrobacter and other members of the Enterobacteriaceae often produce colonies which are almost indistinguishable from Salmonella on commonly used selective agars. Biochemical confirmation of such colonies can be expensive and time-consuming. It has been suggested that the enzyme pyrrolidonyl peptidase (PYRase) could be used as a rapid test to distinguish Citrobacter colonies (PYRase-positive) from Salmonella (PYRase-negative). Pure cultures of Salmonella, Citrobacter and other Enterobacteriaceae were tested for PYRase activity; all strains of Salmonella tested were PYRase-negative, and all Citrobacter tested were PYRase-positive. Inoculated and naturally contaminated food samples were tested for the presence of Salmonella by a standard cultural method. A PYR test was used to test Salmonella-like colonies isolated on selective agar and potentially, eliminate PYR-positive isolates from further biochemical testing. The test was able to screen out 6% of colonies selected from samples inoculated with Salmonella, and 43% of colonies selected from uninoculated samples.

Bacterial Typing Techniques↗
PubMed1999

Follow up investigation of workers in synthetic fibre plants with humidifier disease and work related asthma.

OBJECTIVE: To investigate the clinical and sociomedical outcome in patients with various clinical manifestations of humidifier disease and work related asthma after removal from further exposure. METHODS: Follow up investigation (range 1-13 years) of respiratory symptoms, spirometry, airway responsiveness, sickness absence, and working situation in patients with (I) humidifier fever (n = 12), (II) obstructive type of humidifier lung (n = 8), (III) restrictive type of humidifier lung (n = 4), and (IV) work related asthma (n = 22). All patients were working at departments in synthetic fibre plants with microbiological exposure from contaminated humidification systems or exposure to small particles (< 1 micron) of oil mist. RESULTS: At follow up patients with work related asthma were less often symptom free (37%, 7/19) than patients with humidifier disease (I, II, III) (67%, 16/24). Mean forced expiratory volume in one second (FEV1) of patients with obstructive impairment had been increased significantly at follow up but still remained below the predicted value. Mean forced vital capacity (FVC) of patients with initially restrictive impairment had returned to normal values at follow up. Airway hyperresponsiveness at diagnosis persisted in patients with obstructive impairment (II + IV 14/17, but disappeared in patients with humidifier fever (3/3) and restrictive type of humidifier lung (2/2). In patients with obstructive impairment (II + IV), FVC and FEV1 at diagnosis were negatively associated with the duration between onset of symptoms and diagnosis and the number of years of exposure. Those with positive pre-employment history of respiratory disease had a lower FEV1 at diagnosis. Sickness absence due to respiratory symptoms decreased in all groups of patients after removal from further exposure, but this was most impressive in patients with the humidifier lung (II, III) and patients with work related asthma (IV). At follow up 83% of the patients were still at work at the same production site, whereas 11% received a disability pension because of respiratory disease. CONCLUSION: In patients with work related respiratory disease caused by exposure from contaminated humidification systems or oil mist, removal from further exposure resulted in clinical improvement, although, especially in those with obstructive impairment, signs persisted. Because of the possibility of transferring patients to exposure-free departments most patients could be kept at work.

Adult↗
PubMed1999

[Consideration of mental symptoms and physical disabilities in deciding upon placement in a residential home versus a nursing home].

This study analysed 235 applications of elderly people for residential home and nursing home care. The applications were submitted to a Dutch municipal care allocation board. Based on the 1994 registration data from this board the impact of physical restrictions and mental problems on the care allocation for residential or nursing homes and connected care was studied. Physical complaints were measured with an adl and an hdl scale (Activities of Daily Living and Household Activities of Daily Living), mental problems were assessed by means of the Reality, Orientation and Restlessness Scales. Persons with an admission allocation for a nursing home (both psychogeriatric and somatic) had the highest scores on all scales; persons allocated to the residential home and related care had significantly lower scores. Above-mentioned scales have been combined into care level categories. Fifty seven persons, however, appeared not to have any physical or mental problems despite a care allocation to the residential home or related care. Contextual problems (housing, social contacts, endurance-capacity of relatives and friends) were particularly decisive in this case. Moderately severe problems, both physical and mental, generally resulted in an allocation to the residential home or related care. Serious problems usually result in allocation to the somatic or the psychogeriatric nursing home. Combined serious problems (75%) tended to result in an allocation to the psychogeriatric nursing home. This study is preliminary to the development of a care allocating instrument.

Activities of Daily Living↗
PubMed1999

Polychromatic percepts during hypergravity.

Future helmet mounted systems and cockpit displays will rely on color graphics and information that high performance aircraft pilots will need to discern and understand. Color in displays may help reduce pilot workload. The effect of high G and reduced eye level blood pressure on field-of-view has been study extensively. The effect of high sustained acceleration on color vision, however, is unknown. Research on visual contrast sensitivity, night vision, and visual acuity under acceleration in a human centrifuge has demonstrated changes in vision. We began by having normal color vision subjects view a magnified color aerial map and describe what they saw as we slowly ramped up the G profile from baseline (1.4 G) at 0.1G/sec until they experienced almost complete blackout. At that point subjects began straining and the centrifuge was rapidly decelerated. Several subjects described the river fading away before much else happened. Then the yellow and green features of the terrain faded together. Reds and dark blues appeared to change to black but remained legible until the entire image also faded to black. Computer types call the color of a river on a map cyan. So a display was created that resembled a device know as a "light bar" that is routinely used in centrifuge research. It consisted of a 45 degree wide square projection of green dots in the periphery and a red dot in the center on a white background. Due to our new curiosity about cyan we added dots halfway between the green and red that were cyan. We then ran several people through the same slow onset ramp until near blackout. Several reported that the cyan disappeared completely, significantly before the green. Then the green disappeared, and finally the central red dot. For those who experience it, it is a very useful and repeatable early end point where vision is affected but still available. Next we borrowed a color wheel from the hypobaric chamber and taped it to the wall of the cab. Several subjects reported discomforting angular optical vection due to torsional nystagmus. Thus, a vertical bar arrangement of colors was selected that minimized disruption from involuntary eye movements.

Aerospace Medicine↗
PubMed1998

['Public health status and perspectives' 1997. VII. Health care needs and health care consumption].

In the 'Public health status and forecasts' 1997 attention is given to the relationship between health status and health care. The theme report 'Health care need and health care consumption' integrates information about both phenomena and about waiting lists in the different sectors of health care. It is difficult to quantify the need for health care, because statements about need always imply a judgment by parties involved. In the literature need for health care is often operationalized by historical data on health care consumption or by health status indicators. At the national level only limited quantitative information is available to support policy on waiting lists and waiting times. The data are seldom disease-specific. Changes in size and distribution (by age and sex) of the population will increase health care cost over the period 1994-2015 in the Netherlands by 0.9-1.0% per year. More detailed demographic projections, however, indicate that there are large disease-specific differences.

Age Distribution↗
PubMed1998

A genetically engineered strain of Saccharopolyspora erythraea that produces 6,12-dideoxyerythromycin A as the major fermentation product.

The erythromycin producer, Saccharopolyspora erythraea ER720, was genetically engineered to produce 6,12-dideoxyerythromycin A, a novel erythromycin derivative, as the major macrolide in the fermentation broth. Inspection of the biosynthetic pathway for erythromycin would suggest that production of this compound could be achieved simply through the disruption of two genes, that encoding the erythromycin C-6 hydroxylase (eryF) and that encoding the erythromycin C-12 hydroxylase (eryK). The double mutant, however, was found to produce a mixture of 6,12-dideoxyerythromycin A and the precursor, 6-deoxyerythromycin D. Complete conversion to the desired product (to the limit of detection by TLC) was achieved by inserting an additional copy of the eryG gene, encoding the erythromycin 3"-O-methyltransferase and driven by the ermE* promoter, into the S. erythraea chromosome.

Bacterial Proteins↗
PubMed1998

Teenagers: mental health and psychological issues.

Adolescence is a developmental period marked by multiple challenges and demands which create a heightened vulnerability to the development of emotional disorders. Primary care physicians are in an ideal position to intervene in the early stages and prevent the tragic consequences which can occur with an untreated mental health disorder. This article reviews the assessment and treatment of adolescent mental health in the primary care medical setting. Knowledge of these disorders and their manifestations in the primary care environment will enable clinicians to provide higher quality medical care and will reduce the potential for continual life disruptions into the adult years.

Adolescent↗
PubMed1998

Socio-economic differences in health risk behavior in adolescence: do they exist?

Socio-economic differences in risk behaviors in adolescence can be seen as a prelude to the re-emergence of socio economic health differences in adulthood. We studied whether or not socio-economic differences in health risk behaviors are present in male and female adolescents in The Netherlands. The relation between socio-economic status (SES) and health risk behaviors was examined, by testing both the main and interaction effects of SES and gender on separate health risk behaviors on one hand, and on the behaviors cumulatively on the other. The data were derived from 1984 adolescents in the four northern provinces of The Netherlands. SES was measured by means of the educational level and the occupational status of both parents. Four health risk behaviors were included in this study: smoking, alcohol consumption, soft drug use, and (no) physical exercise. We found that the relationships between SES and health risk behaviors are not as linear as is often found in adulthood. Our findings can be characterised overall by an absence of relationship between SES and health risk behaviors. The only exception applies to sport, which is linearly related to SES. Adolescents in the lower SES groups engage in sport less than adolescents in the higher SES groups. There was an irregular relationship between the father's occupational status and the adolescents' smoking and drinking. Adolescents in the highest, lowest and middle of the six SES groups have the highest rates of health risk behaviors. All observed relationships are similar for both male and female adolescents. A relationship between gender and the separate health risk behaviors was found only for alcohol consumption and drug use. For both male adolescents showed higher rates of risk behavior. Males also scored higher on the cumulative health risk behaviors than their female counterparts. The findings of this study do not support the hypothesis of latent differences in adolescence.

Adolescent↗
PubMed1997

The clinical spectrum of humidifier disease in synthetic fiber plants.

In a synthetic fiber production site with recirculating cold water humidification systems and small-size-particle (> 0.1 mu < 1 mu) oil mist exposure, humidifier disease was diagnosed in several workers. The patients could be divided into three groups illustrating the clinical spectrum of humidifier disease: humidifier fever (toxic inhalation fever) (12 patients): an asthma-like syndrome (8 patients); and allergic alveolitis (4 patients). Natural challenge at the work place, monitored by parameters such as peak-flow, spirometry, blood leucocyte count, and body temperature, provided important diagnostic information. In patients with chronic allergic alveolitis, a gradual recovery during an exposure-free period indicated a work-related causation, more than changes during challenge in normal work. In some patients, the fungus Sporothrix schenckii, hitherto unknown as a sensitizer, may have been at least one of the causative antigens. Measured levels of viable fungi (< or = 100 CFU/m3) and endotoxin (64 pg/m3) in air samples were much lower than those at which health effects usually are reported. Small-size-particle oil mist exposure may have underestimated the exposure to microorganisms, but otherwise an adjuvant role to this type of co-exposure might also be postulated. In contrast to allergic alveolitis, the asthma-like syndrome appeared to be more common in patients with a history of atopy and of smoking.

Adult↗
PubMed1997

Step treadmill exercise training and blood pressure reduction in women with mild hypertension.

Stepping as an exercise modality has gained increasing popularity. The step treadmill is an exercise machine which simulates actual stair-climbing. The purpose of this study was to determine the effectiveness of a 16-week supervised aerobic step treadmill exercise training protocol in reducing resting blood pressure in women with unmedicated mild hypertension. During the training protocol, subjects exercised during a self-selected appointment three times a week on the step treadmill, increasing from 20 minutes up to 60 minutes per session, at a target heart rate corresponding to 70-80% heart rate reserve for 16 weeks. Utilizing paired t-test analysis, mean resting systolic blood pressure decreased from 142.2 +/- 9.1 to 132.7 +/- 8.2 mm Hg (p < .01) and mean resting diastolic blood pressure decreased from 93 +/- 4.9 to 87.4 +/- 5.4 mm Hg (p < .01) during the 16-week protocol. Mean maximal oxygen uptake was significantly increased, whereas mean body weight did not change significantly over the 16-week period. Large scale trials are needed to further delineate the effectiveness of stepping as a health care intervention in adults with unmedicated mild hypertension, especially in women.

Adult↗