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Biomedical subjects

Jan Berger

Publications and source records attributed to Jan Berger.

7 recordsLinked to original sources

Fatigue in the U.S. workforce: prevalence and implications for lost productive work time.

OBJECTIVE: The objective of this study was to estimate fatigue prevalence and associated health-related lost productive time (LPT) in U.S. workers. METHODS: Fatigue prevalence, LPT due to fatigue, and LPT for any health-related reason (in hours and dollars) were measured in a national cross-sectional telephone survey of U.S. workers. RESULTS: The 2-week period prevalence of fatigue was 37.9%. Of workers with fatigue, 65.7% reported health-related LPT compared with 26.4% of those without fatigue. Workers with fatigue cost employers 136.4 billion dollars annually in health-related LPT, an excess of 101.0 billion dollars compared with workers without fatigue. Fatigue frequently co-occurs with other conditions and, when present, is associated with a threefold increase, on average, in the proportion of workers with condition-specific LPT. CONCLUSIONS: Fatigue is prevalent in the U.S. workforce. When occurring with other health conditions, it is associated with significantly more condition-specific LPT.

Adolescent↗

The effects of exercise training on fat-mass loss in obese patients during energy intake restriction.

Dietary restriction combined with endurance exercise training represents an effective strategy to promote weight loss and reduce fat mass in obese patients. Exercise programmes without dietary restriction are less efficient. However, addition of exercise to a dietary restriction programme does not induce a greater fat-mass loss than dietary restriction alone. The latter is likely attributed to a compensatory reduction in daily physical activity following the implementation of exercise training. Nonetheless, inclusion of an exercise training programme is important to prevent a decrease in fat-free mass, increase relative visceral fat-mass loss, improve dietary compliance and eventually maintain long-term weight control. Obese male patients with the highest fat mass are most likely to lose the largest amount of fat mass in such lifestyle intervention programmes. Influences of training modalities during energy intake restriction on fat-mass loss are reviewed. The relationship between total energy expenditure during exercise training and overall fat-mass loss has been firmly established. The amount of training forms a more important predictor of fat-mass loss than training intensity. The sort of exercise (e.g. walking, cycling, swimming) plays another important predictor of fat-mass loss in intervention programmes. The implementation of resistance training in such programmes does not augment fat-mass loss but improves body composition by increasing fat-free mass. Further studies are needed to define the optimal interventional programme for obese patients.

Adipose Tissue↗

Rehabilitation in cardiac patients:what do we know about training modalities?

This article discusses the effects of training in cardiac rehabilitation and describes the influence of various training modalities on the evolution of exercise capacity in cardiac patients. Both home- and hospital-based studies are analysed separately. From the collected studies, a very heterogeneous character of the content of the rehabilitation programmes appears. Direct comparison of the effects of the training programmes on exercise capacity remains difficult. Baseline factors for predicting a better training outcome are: low exercise capacity and peripheral oxygen extraction; presence of hibernating myocardium; high myocardial perfusion; low degree of coronary vessel occlusion; working status; and improved feelings of wellbeing. The increased work capacity as a result of rehabilitation is associated with: an increased volume density of skeletal muscle mitochondria; peripheral muscular vasodilatory capacity; cardiac output and a decreased left ventricular end-diastolic pressure; depletion of muscular phosphocreatine levels; and degree of restenosis. Home- and hospital-based interventions induce comparable training effects. More research is needed concerning the training modalities in cardiac rehabilitation. There is an influence of weekly training frequency and programme duration on the training outcome. A higher training frequency and/or duration might induce greater training effects. The evolution of the anaerobic threshold is sensitive to the training intensity and inclusion of strength training, which remains to be established for maximal exercise capacity. However, insufficient information is available on the influence of training session duration on the evolution of exercise capacity.

Cardiac Rehabilitation↗

Cardiac rehabilitation reduces the rate of major adverse cardiac events after percutaneous coronary intervention.

BACKGROUND: Despite multiple publications on effects of rehabilitation in cardiac patients, rehabilitation is not fully known to be of value in post-percutaneous coronary intervention (PCI) patients. AIMS: To investigate the influence of cardiac rehabilitation on the incidence of major adverse cardiac events (MACEs) in post-PCI patients. METHODS: Retrospectively and nonrandomized 140 post-PCI patients (107 males, mean age 62 (7) years) participated in a 3-month rehabilitation program, starting 2 weeks post-PCI, while 83 post-PCI patients (54 males, mean age 68 (8) years) did not and were all followed up for 15 months. Data on cardiac medication prescription and incidence of MACE (including angina pectoris with or without reintervention, restenosis, myocardial infarction, revascularisation with re-PCI or CABG, and death) were collected. The relationship with cardiovascular risk factors including sex, smoking behaviour, obesity, diabetes mellitus, hypertension, familiar predisposition, and hypercholesterolemia was analysed. RESULTS: The incidence of total MACE in the rehabilitation group is significantly lower than in the control group (24% vs. 42%, respectively; P<0.005). The incidence of documented restenosis, angina pectoris with resulting reintervention, all revascularisations, and death is significantly lower in the rehabilitation group, compared with the control group. CONCLUSION: The incidence of MACE and restenosis is significantly lower when PCI patients are included in a cardiac rehabilitation program.

Aged↗

Agreement between insurance claim and self-reported hospital and emergency room utilization data among persons with diabetes.

As part of a retrospective evaluation of a diabetes management program, the agreement between self-reported and insurance claim data on hospitalization and emergency room utilization was examined. Data agreement on hospitalization or emergency room visits between the two collection modes was evaluated through the use of simple agreement proportions and the kappa agreement statistic. A total of 1,230 participant responses were studied. The proportions of patients with hospitalization or emergency room visits were indistinguishable between the self-reported and medical claims data, and kappa statistics also indicated good-to-excellent agreement between data sets. The percentages of participants whose self-reported hospitalization and emergency room utilization exactly matched data derived from insurance claims were high (89.1% and 87.2%, respectively). Furthermore, the kappa statistics of agreement for the number of hospitalizations (0.6366) and emergency room visits (0.5390) indicate good agreement between self-reported and insurance claim data. The results of this study suggest either self-reported or insurance claims data can be used to evaluate the impact of health care interventions on hospital or emergency room utilization.

Aged↗