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PubMedDate not supplied

Effects of exercise training on aerobic fitness in children after open heart surgery.

Graded treadmill tests to maximal exercise were given to 24 children 1 year or more after open-heart surgery and to 26 age- and sex-matched controls, before and after 9 weeks of exercise training to test whether or not they could increase their aerobic fitness levels. The corrected cardiac lesions included tetralogy of Fallot, aortic stenosis, transposition of the great arteries and atrioventricular canal (AVC). Maximal exercise variables measured were heart rate (HR), oxygen consumption (VO2), and workload (stage of exercise and time on treadmill). The results of the pretraining tests indicated that the fitness levels of the 24 patients were significantly less than those of the controls. Of the original groups, 9 controls and 12 patients satisfactorily completed the training (jogging) program. The results of the post-training tests indicated that both the patients and controls significantly improved their fitness levels. Specifically, most subjects improved their maximal workload with little or no increase in maximal HR or VO2. In conclusion, children after open-heart surgery for complex congenital heart disease can further improve their work capacity by a dynamic exercise program. After training, they are able to do more work at a given VO2.

Adolescent↗
PubMed1984

Who attends family planning clinics?

Data were obtained from 1,810 consecutive women who attended a central metropolitan (Brisbane) Family Planning Clinic during a 5 week period in 1982. Young women in particular formed the major client group with 32% being under 20 years of age. The client population was skewed towards women of upper socioeconomic status (SES). There was no SES disproportion in the use of oral contraceptives or IUD's. However, diaphragm use occurred disproportionately in women of upper SES groups; postcoital contraception was sought by and limited to, women of SES classes A and B only. The clinic satisfied a need for women with a history of failed or absent contraception and 15% had already had a termination of pregnancy by the time they first presented at the clinic.

Abortion, Induced↗
PubMed1989

Designing interventions to prevent HIV-1 infection by promoting use of condoms and spermicides among intravenous drug abusers and their sexual partners.

This paper summarizes the results of a 2-day workshop to identify the most effective educational strategies to promote use of condoms and spermicides for preventing heterosexual transmission of HIV-1 virus from intravenous drug abusers (IVDA) to their steady, nonintravenous drug abusing (NIVDA) sexual partners. Representatives from health departments, drug abuse treatment centers, academic institutions, service organizations, and the community discussed issues relating to population characteristics, educational strategies and recruitment techniques. A consensus document that identifies the most effective recruitment and intervention strategies was developed. Recruitment issues include locations, recruitment targets, anticipated difficulties, and ethical considerations. The majority of workshop participants agreed that an intervention should target the couple (both IVDA and NIVDA). Intervention concerns encompass obtaining trust, maintaining participation, and identifying guidelines to maximize program impact.

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

Cigarette smoking by adolescent females: implications for health and behavior.

Cigarette smoking rates among teenage females have risen progressively since 1968 until surpassing teenage males in 1979. Psychosocial factors underlying the initiation of smoking include peer pressure, adult role modeling and prosmoking messages in advertising, with smoking potentially representing a desired set of personality characteristics. Regular smoking leads to the development of a dependence process, with cessation often difficult to achieve and maintain. Preventing smoking onset is a responsibility of health professionals and educators. Social psychological approaches teaching social skills and techniques for resisting smoking have been effective in reducing rates of initiation in JHS experimental programs.

Adolescent↗
PubMed1987

Effects of social supports on attitudes and health behaviors of pregnant adolescents.

The influence of social support on maternal attitudes and behaviors was assessed in 57 third-trimester adolescent women attending an urban prenatal clinic. Sociodemographic characteristics, social support, self-esteem, and feelings about pregnancy were measured by questionnaire. The support and influence of the adolescent father was emphasized. Social support was measured as a multidimensional construct derived by a priori and empirical procedures. The outcomes measured were the amount of prenatal care, attendance at scheduled postpartum appointments, and pleasure with the pregnancy. Stepwise multiple-regression analyses were used to assess the contributions of the predictor to criterion variables. Pleasure with pregnancy was positively associated with the receipt of assistance from the adolescent's mother, favorable opinions of friends, and satisfaction with living arrangements. Attendance at postpartum visits was associated with high self-esteem. Notably absent as significant contributors were sociodemographic characteristics, receipt of emotional and tangible support from the adolescent father, and expectation of aid from social-assistance programs.

Adolescent↗
PubMed1989

Calculation of survival curves and statistical comparison of two censored populations: a computer program in BASIC.

In experimental aging research the handling of censored data imposes a serious problem in the calculation of survival curves of partly censored populations and the statistical comparison of such populations. The presented computer program combines a method to calculate a corrected survival curve and a test to compare two censored populations. In both methods, the proportion of the animals that survive or die during an interval and the number at risk at the start of that interval is used in the calculation of relative survival or death during that interval. The program is written in an elementary BASIC and will run on practically every computer programmable in BASIC. The presented method can be used for testing the difference between survival characteristics of two animal populations but might also be employed in evaluating the effect of a medical treatment.

Aging↗
PubMed1991

Improving the cost-effectiveness of AIDS health care in San Juan, Puerto Rico.

In an era of decreasing availability of funds and increasing demand, the AIDS epidemic threatens to overwhelm health-care services in some countries. We describe a comprehensive model for the treatment of AIDS in San Juan, Puerto Rico, and compare it with traditional hospital-based services. Given the existing allocation of funds, the comprehensive model emphasised prevention, education, surveillance, early detection, and outpatient care to reduce hospital care. In 1987, the last year of the traditional system, there were 95 admissions of AIDS patients to hospital, and in 1988, the first year of the comprehensive model, there were 100 admissions. The mean length of stay of AIDS inpatients was reduced from 22.3 days in 1987 to 11.3 days in 1988, a 46.8% reduction (p = 0.001). The annual mean (SE) cost of inpatient care per AIDS patient fell from $15,118 (1699) in 1987 to $3869 (659) in 1988. Savings were used to improve non-hospital services, including outreach, education, emergency and outpatient care, laboratory and epidemiological services, and research, and to introduce an employee incentive scheme. Management strategies that reduce the length of inpatient care and provide less costly treatment alternatives can improve AIDS health care in developing nations.

Acquired Immunodeficiency Syndrome↗
PubMed1989

School-based clinic use and other factors affecting adolescent contraceptive behavior.

Adolescent risk taking, preventive behavior, and contraceptive use were investigated using a self-administered questionnaire in a sample of 260 inner-city high school students targeted by a school-based health clinic. Multivariate models consisting of individual and environmental variables significantly predicted sexual activity and contraceptive use. Older age at first intercourse, higher number of welfare benefits received by the household (including Medicaid, food stamps, and free or reduced price lunch), and use of the school-based clinic were significant positive predictors of more frequent contraceptive use by adolescents. Results of our study suggest that programs may be having some success in encouraging and enabling sexually active adolescents to use contraception and to use it more consistently. Rigorous program evaluations should help program planners and policy makers design and refine adolescent pregnancy-prevention efforts.

Adolescent↗
PubMed1988

A focus group study of sexually active black male teenagers.

This is a report of a focus group study conducted by the National Institute for Adolescent Pregnancy and Family Services at Temple University. It presents in detail how the study was carried out and relevant findings from the transcripts of sessions held with a group of sexually active teenage males, including excerpts from the transcripts. Also included are the characteristics of the participants and a summary of the services they requested from a model adolescent pregnancy prevention and care program.

Adolescent↗
PubMed1984

Effects of beta 1-selective and nonselective beta-adrenoceptor blockade during exercise conditioning in healthy adults.

The interaction of beta 1-selective (cardioselective) and nonselective beta-adrenoceptor blockade with exercise conditioning was investigated in 30 healthy adult persons. A double-blind protocol was used and the effects of atenolol (100 mg/day), propranolol (80 mg twice daily), and placebo were studied by treadmill testing (Bruce protocol) before and after a 2-month supervised program of dynamic exercise. Exercise tolerance was assessed by time and work performed to exhaustion. Subjects who received propranolol, but not those who received atenolol or placebo, showed an acutely impaired exercise tolerance after drug administration but before training (-8 +/- 4%, p less than 0.05). All 3 groups showed significantly improved exercise capacity following training after drug treatment had been discontinued (atenolol, 22 +/- 6% improvement; propranolol, 13 +/- 6%; placebo, 10 +/- 3%). However, when tested while still receiving medication, subjects who received propranolol failed to show significant improvement in exercise capacity. In contrast, patients who received atenolol and placebo improved significantly. The data indicate that enhancement of maximal work capacity by exercise conditioning can occur despite administration of either beta 1-selective or nonselective beta-adrenoceptor antagonists. However, the fatiguing effects of propranolol that were evident when work performance during propranolol therapy was compared with work performance while not receiving propranolol before the training program persists after training and may limit the net improvement in work capacity induced by exercise conditioning compared with the pretraining state.

Adult↗
PubMed1991

The Quality Assurance Project: introducing quality improvement to primary health care in less developed countries.

Persistently excessive morbidity and mortality rates in less developed countries (LDCs) served by primary health care systems suggest that the quality of services is inadequate. The PRICOR project, sponsored by the United States Agency for International Development, has designed and implemented methods for quality assessment and problem solving in LDC health systems. After developing comprehensive lists of essential activities and tasks, similar to practice parameters, for seven child survival interventions, PRICOR supported comprehensive quality assessment studies in twelve LDC countries. The studies, yielding over 6000 observations of health worker-client encounters, indicated highly prevalent, serious program deficiencies in areas including diagnosis, treatment, patient education and supervision. To facilitate corrective action, PRICOR assisted managers in conducting operations research to resolve priority problems revealed by the assessments. The recently initiated Quality Assurance Project is building on PRICOR techniques in designing and implementing sustainable continuous quality improvement programs for LDC health systems.

Acute Disease↗
PubMedDate not supplied

Initiating a vasectomy training clinic in a family practice residency.

The development of and initial experience with a vasectomy training clinic in a family practice residency program are presented. A literature review and faculty consensus resulted in the acceptance of a standardized technique in which the ends of the vas are cauterized and not tied. An appropriate time block per patient to allow for counseling and for teaching of the technique was 90 minutes. Patients were recruited by instituting reduced charges and advertising through the local Planned Parenthood office and county health service. A partial prepayment was required to reduce broken appointments. Review of the first 50 cases indicates a good resident experience, an appropriately low complication rate, and no failures.

Family Practice↗