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Biomedical subjects

M Pratt

Publications and source records attributed to M Pratt.

At least 37 records · Page 2Linked to original sources
PubMed1998

Evaluating the BMJ guidelines for economic submissions: prospective audit of economic submissions to BMJ and The Lancet.

CONTEXT: Editorial management of articles on health economics may benefit from guidelines for peer review and revision. OBJECTIVE: To assess whether publication (in August 1996) of the BMJ guidelines on peer review of economics submissions made any difference to editorial and peer review processes, quality of submitted manuscripts, and quality of published manuscripts. DESIGN AND SETTING: Before-after study conducted in the editorial offices of BMJ and The Lancet of the effect of the BMJ guidelines on review and revision of economics submissions, defined as those making explicit comments about resource allocation and/or costs of interventions. MAIN OUTCOME MEASURES: Editorial fate and changes in the quality of submissions. RESULTS: A total of 2982 manuscripts were submitted to the 2 journals during the before periods, 105 (3.5%) of which were economics submissions. Of these, 27 (24.3%) were full economics evaluations, and 78 (75.7%) were other economics submissions. Overall acceptance rate was 11.6% (12/105). During the after period 2077 manuscripts were submitted to the 2 journals, 87 (4.2%) of which were economics submissions. Eighteen (20.7%) were full economics evaluations, and 69 (79.3%) were other economics submissions. Overall acceptance rate was 6.9% (6/87). Although a number of manuscripts could not be traced to determine whether they were economics submissions, there appeared to be little difference between the 2 journals in numbers or editorial fate of the manuscripts. There was no change in the quality of submitted manuscripts, but BMJ editors found the guidelines and checklists useful and sent fewer economics submissions for external peer review in the after phase. CONCLUSIONS: Publication of the guidelines helped the BMJ editors improve the efficiency of the editorial process but had no impact on the quality of economics evaluations submitted or published.

Economics↗
PubMed1998

Relationship of physical activity and television watching with body weight and level of fatness among children: results from the Third National Health and Nutrition Examination Survey.

CONTEXT: Physical inactivity contributes to weight gain in adults, but whether this relationship is true for children of different ethnic groups is not well established. OBJECTIVE: To assess participation in vigorous activity and television watching habits and their relationship to body weight and fatness in US children. DESIGN: Nationally representative cross-sectional survey with an in-person interview and medical examination. SETTING AND PARTICIPANTS: Between 1988 and 1994, 4063 children aged 8 through 16 years were examined as part of the National Health and Nutrition Examination Survey III. Mexican Americans and non-Hispanic blacks were oversampled to produce reliable estimates for these groups. MAIN OUTCOME MEASURES: Episodes of weekly vigorous activity and daily hours of television watched, and their relationship to body mass index and body fatness. RESULTS: Eighty percent of US children reported performing 3 or more bouts of vigorous activity each week. This rate was lower in non-Hispanic black and Mexican American girls (69% and 73%, respectively). Twenty percent of US children participated in 2 or fewer bouts of vigorous activity perweek, and the rate was higher in girls (26%) than in boys (17%). Overall, 26% of US children watched 4 or more hours of television per day and 67% watched at least 2 hours per day. Non-Hispanic black children had the highest rates of watching 4 or more hours of television per day (42%). Boys and girls who watch 4 or more hours of television each day had greater body fat (P<.001) and had a greater body mass index (P<.001) than those who watched less than 2 hours per day. CONCLUSIONS: Many US children watch a great deal of television and are inadequately vigorously active. Vigorous activity levels are lowest among girls, non-Hispanic blacks, and Mexican Americans. Intervention strategies to promote lifelong physical activity among US children are needed to stem the adverse health consequences of inactivity.

Adolescent↗
PubMed1998

Environmental and policy interventions to promote physical activity.

BACKGROUND: Because most adults in industrialized countries do not meet physical activity guidelines, population-wide interventions are needed. Environmental and policy interventions are based on ecological models of behavior and have the potential to influence entire populations. Ecological models are particularly applicable to physical activity because the behavior must be done in specific physical settings. Cross-sectional data indicate that environmental and policy variables are associated with physical activity behaviors of young people and adults. METHOD: Seven published evaluations of environmental and policy interventions to increase physical activity were reviewed. RESULTS: Two studies showed that placing signs encouraging stair use can be effective. Quasi-experimental evaluations provided limited evidence that broad environmental changes can be effective. Large-scale policy interventions are currently being conducted in several countries. PROPOSED MODEL: A model describing the development of policy and environmental interventions is proposed, in the hope of stimulating more research in this area. Advocacy or planning groups identify and work with agencies that control policies and environments that can be altered to increase physical activity. Educational and policy/environmental interventions are seen as complementary. CONCLUSION: Lack of conceptual models and the inherent difficulties of evaluation have hampered research on environmental and policy interventions. Further research is needed, and practitioners and researchers should work together to evaluate programs.

Adult↗
PubMed1998

Evolution of RPS4Y.

Sequence variation within RPS4Y, a ribosomal protein gene located in the nonpseudoautosomal region of the Y chromosome, was used to elucidate the origin of this gene in primates. Complete coding and additional flanking sequences (949 bp) of the RPS4Y locus were determined in four nonhuman primate species. Phylogenetic reconstruction of RPS4 sequence evolution supports the monophyly of mammalian RPS4 and RPS4Y. Molecular evolutionary rate estimation reveals significantly elevated rates of DNA and protein evolution in RPS4Y compared with its X-chromosome homologs. These rates enable us to estimate the timing of the transposition of RPS4X to the Y chromosome (95% confidence interval, 32 MYA-74 MYA), and this estimate was verified by Southern hybridization analysis of prosimian and simian genomic DNA. These data support a transposition event of ancestral primate RPS4X to the Y chromosome prior to the divergence of Prosimii.

Animals↗
PubMed1997

Cardiovascular disease control efforts among local health departments in Missouri: four-year trends and policy implications.

Knowledge, attitudes, and activities in cardiovascular disease (CVD) control among local health departments in Missouri were surveyed in 1990 and in 1994, following four years of a community-based CVD risk-reduction project. Hypertension screening was rated as the most frequently performed CVD-related activity in 1990 and in 1994. Differences in mean scores between baseline and follow-up surveys showed no significant changes except for cholesterol screening. Respondents preferred individual patient education rather than community-wide approaches to risk reduction. Our findings highlight the need for more emphasis on coalition building and community-based programs for preventing and controlling CVD at the local health department level.

Cardiovascular Diseases↗
PubMed1996

Changes in newspaper coverage of cardiovascular health issues in conjunction with a community-based intervention.

Numerous community-based prevention projects, with significant media components, have been conducted over the past decade. Multiple evaluation strategies have been used to document the effectiveness of these interventions, including intermediate measures of community impact such as assessment of media coverage. As part of the evaluation of a community-based intervention (the Bootheel Heart Health Project), dissemination of information on cardiovascular disease (CVD) was measured through a media content analysis of newspapers. Data were analyzed from 23 newspapers in six rural counties in southeastern Missouri for the period October 1988 through August 1993. An increase was observed in CVD-related coverage in the pre-intervention period (mean articles per month = 31.5) compared with the post-intervention period (mean articles per month = 50.7) (F = 10.2; P = 0.003). In supporting data from a separate randomized risk factor survey of 1510 residents in the same area, respondents reported hearing of heart health coalitions primarily through local newspapers. The current study documents increasing print media coverage of cardiovascular health issues in a high-risk, rural area and shows that media content analysis can be a useful evaluation tool in community-based interventions.

Cardiovascular Diseases↗
PubMed1996

Preventing cardiovascular disease through community-based risk reduction: the Bootheel Heart Health Project.

OBJECTIVES: The purpose of this study was to determine whether a community-based risk reduction project affected behavioral risk factors for cardiovascular disease. METHODS: Community-based activities (e.g., exercise groups, healthy cooking demonstrations, blood pressure and cholesterol screenings, and cardiovascular disease education) were conducted in six southeastern Missouri counties. Evaluation involved population-based, cross-sectional samples of adult residents of the state and the intervention region. Weighted prevalence estimates were calculated for self-reported physical inactivity, cigarette smoking, consumption of fruits and vegetables, overweight, and cholesterol screening. RESULTS: Physical inactivity decreased within the intervention region, that is, in communities where heart health coalitions were developed and among respondents who were aware of these coalitions. In addition, the prevalence rates for reports of cholesterol screening within the past 2 years were higher for respondents in areas with coalitions and among persons who were aware of the coalitions. CONCLUSIONS: Even with modest resources, community-based interventions show promise in reducing self-reported risk for cardiovascular disease within a relatively brief period.

Adolescent↗
PubMed1995

Physical activity and public health. A recommendation from the Centers for Disease Control and Prevention and the American College of Sports Medicine.

OBJECTIVE: To encourage increased participation in physical activity among Americans of all ages by issuing a public health recommendation on the types and amounts of physical activity needed for health promotion and disease prevention. PARTICIPANTS: A planning committee of five scientists was established by the Centers for Disease Control and Prevention and the American College of Sports Medicine to organize a workshop. This committee selected 15 other workshop discussants on the basis of their research expertise in issues related to the health implications of physical activity. Several relevant professional or scientific organizations and federal agencies also were represented. EVIDENCE: The panel of experts reviewed the pertinent physiological, epidemiologic, and clinical evidence, including primary research articles and recent review articles. CONSENSUS PROCESS: Major issues related to physical activity and health were outlined, and selected members of the expert panel drafted sections of the paper from this outline. A draft manuscript was prepared by the planning committee and circulated to the full panel in advance of the 2-day workshop. During the workshop, each section of the manuscript was reviewed by the expert panel. Primary attention was given to achieving group consensus concerning the recommended types and amounts of physical activity. A concise "public health message" was developed to express the recommendations of the panel. During the ensuing months, the consensus statement was further reviewed and revised and was formally endorsed by both the Centers for Disease Control and Prevention and the American College of Sports Medicine. CONCLUSION: Every US adult should accumulate 30 minutes or more of moderate-intensity physical activity on most, preferably all, days of the week.

Adult↗
PubMed1995

Policy as intervention: environmental and policy approaches to the prevention of cardiovascular disease.

This paper describes the evolution of efforts to prevent cardiovascular disease, from individual health education approaches to broader community education efforts and, finally, to comprehensive and integrated programs addressing environmental, policy, and individual behavior change. Policies are divided into two areas: legislation/regulation and organizational policy. Environmental strategies are measures that alter or control the physical or social environment. Dimensions along which these strategies might be implemented are provided. Policy and environmental approaches can be justified on economic, strategic, and theoretical grounds. Experiences from other fields and other countries provide a framework for conceptualizing cardiovascular disease prevention approaches.

Cardiovascular Diseases↗
PubMed1994

Physical activity patterns in American high school students. Results from the 1990 Youth Risk Behavior Survey.

OBJECTIVE: To assess by self-reported participation in vigorous physical activity, the quantity and quality of school physical education, team sports, and television watching among 11,631 American high school students. RESULTS: Of all students in grades 9 through 12, 37% reported engaging in 20 minutes of vigorous physical activity three or more times per week. Participation in vigorous physical activity was higher among boys than girls (P < .01) and higher among white students than among those of other races and ethnic groups (P < .01). Overall, 43.7% of boys and 52% of girls reported that they were not enrolled in physical education classes. Of the students who reported attending physical education class during the past 2 weeks, 33.2% reported exercising 20 minutes or more in physical education class three to five times per week. In contrast, rates of participation in varsity and junior varsity sports remained constant across grade levels, but participation in recreational physical activity programs showed a lesser magnitude and also decreased with advancing grade. More than 70% of students reported spending at least 1 hour watching television each school day, and more than 35% reported watching television 3 hours or more each school day. CONCLUSIONS: Participation in vigorous physical activity and physical education class time devoted to physical activity are substantially below the goals set in Healthy People 2000. As students move toward graduation, we observed disturbing declines in participation in community recreation programs and overall vigorous activity. Students appear to spend considerably more time watching television than participating in physical activity. Public health efforts should focus on increasing the physical activity levels of our youth to enhance their current well-being and to reduce the risks of future chronic disease.

Adolescent↗
PubMed1993

Documented need for more effective diagnosis and treatment of familial hypercholesterolemia according to data from 502 heterozygotes in Utah.

A project to help Utah residents with heterozygous familial hypercholesterolemia (FH) identified affected individuals by collecting detailed questionnaires from: (1) very high-risk persons in computer files of screening data (very high cholesterol levels, very early coronary artery disease, and strong positive family history); (2) confirmed FH index cases from a university lipid clinic; and (3) relatives of any confirmed FH cases. Questionnaires were received from 2,143 persons identifying 101 living index cases and 502 relatives meeting the criteria for the diagnosis of FH. Finding new FH heterozygotes was about one fourth as expensive by tracing relatives of confirmed FH cases by evaluating very high-risk persons. Of those meeting criteria for the diagnosis of heterozygous FH, only 31% reported being told by their physicians that they had FH, only 42% indicated that they were taking a cholesterol-lowering prescription medication, and only 23% had reasonably controlled cholesterol levels (below the 90th percentile). However, the data also suggest that good control is achievable in motivated patients. Among 106 FH heterozygotes who were early responders to a second follow-up questionnaire, 79% were taking prescription medications, of whom 49% had achieved cholesterol levels below the 90th percentile, and 17% even achieved cholesterol levels below the 50th percentile. We conclude that most patients with heterozygous FH are not diagnosed and not adequately treated. We demonstrated how many of these persons needing help could be identified efficiently by tracing relatives of known index cases.

Adolescent↗
PubMed1993

Contact dermatitis from beryllium in dental alloys.

An increasing number of metals with the potential to cause allergic contact dermatitis have found their way into dental alloys for economic and practical reasons. 2 patients are reported who developed gingivitis adjacent to the Rexillium III alloy in their dental prostheses. Patch testing demonstrated positive reactions to beryllium sulfate, a component of the alloy. Components of dental alloys and the mechanism of the contact dermatitis are discussed.

Adult↗
PubMed1991

An investigation of the safety of the blood reinfusion step used with tunneled venous access devices in children with cancer.

Infection has been identified as the most serious potential complication of the indwelling catheter. As a result, the primary nursing goal using the catheters is to prevent infection. Nurses must frequently manipulate the catheters when securing blood specimens and are concerned that this manipulation may serve as a source of infection for the immunocompromised pediatric oncology patient. One particular step in catheter manipulation during blood sampling is blood reinfusion, ie, residual blood in the catheter is withdrawn and set aside while a second sample is collected for laboratory analysis but is subsequently returned to the patient through the catheter. The purpose of this study was to examine this nursing procedure for its potential of contaminating the blood sample that was to be reinfused, or for the potential of reinfusing a sample that contained preexisting pathogens independent of the procedure itself. An experimental design was used with 21 patients randomly assigned to an experimental group (unclean procedure to exaggerate the potential to incur pathogens during the process), and 21 randomly assigned to a control group (usual clean procedure followed with the reinfusion sample). The usual blood sampling procedure was altered for all participants as the typical amount of blood that normally constitutes the reinsertion sample was not reinserted, but was instead used to complete certain microbial analyses. Of the 42 participants, 17 were male and 25 were female; 35 were white and seven were black; 22 were diagnosed with leukemias and 20 with solid tumors. The age range for participants was 2 to 20 years (mean = 9.4 years, SD = 4.8).(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗