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At least 613 records · Page 34Linked to original sources
PubMed1990

Muscle function in rheumatoid arthritis. Assessment and training.

The conclusions can be summarized as follows: experienced problems of muscle function were reported in about 80% of RA and OA patients for whom there was involvement of large joints of the lower extremities; RA and OA patients did not differ as to experienced problems of muscle strength, endurance and balance/coordination; problems of muscle function were correlated with functional tests of muscle strength but not with those of endurance and balance/coordination; problems of muscle strength were found to correlate with LE-ADL, whereas problems of endurance and balance/coordination were not found to correlate with the latter; the translated and slightly modified version of the HAQ questionnaire appeared to possess a high degree of reliability and validity in assessing disability in patients with RA under Swedish conditions; a quantitative battery of tests for the evaluation of standing balance on a computerized force platform was found to be satisfactorily reliable and to correlate in healthy subjects with most of the functional tests employed; in healthy subjects, standing balance appeared to be related not only to age but also to sex, males and older age groups showing greater postural sway than females and persons of younger age groups; compared with healthy subjects, RA subjects showed significantly greater postural sway, differences being greatest for those tests representing a relatively high level of difficulty; dynamic training for six weeks appeared to provide RA patients with a greater increase in physical capacity of the lower extremities than did static training, the gains thus obtained still being present after an additional three-month period; the effectiveness of the dynamic training programs did not vary with the degree of supervision of training by a physiotherapist, i.e. of 12 visits or 4 being made at the health care centre; despite the intensity of the dynamic training-program employed with RA patients, no increase in pain experience or disease activity was found during the training-period; during short-term high-intensity training a significant increase in circulating beta-EP was found between the 3rd and 6th weeks of training, no increase in CRF and beta-LPH being present; following a long-term low-intensity training period, a significant increase of CRF and beta-LPH was found, no similar increase being noted for beta-EP.

Arthritis, Rheumatoid↗
PubMed1991

Rehabilitation and biomechanics.

In the area of rehabilitation and biomechanics, several articles divided into five categories, including therapeutic heat, foot and ankle orthotics, exercise in elderly arthritis patients, muscle strengthening in rheumatoid arthritis, and arthroplasty and immobilization are reviewed. Superficial heat was demonstrated to increase intra-articular temperature, and therefore, may be detrimental. On the other hand, local deep microwave hyperthermia appears to have potential therapeutic benefits. The role and effectiveness of foot orthotic devices are reviewed. The problem and treatment of forefoot varus is emphasized. A new technique of measuring subpedal pressure in the shoe is presented, demonstrating reduced foot pressures by certain types of footwear. Rheumatoid arthritis and osteoarthritis wee present in 23% of a nursing home population, but were a substantial factor for placement in only 15%. However, this group had higher pain scores, depended more on wheelchair use, and was more likely to have significant functional limitations. Exciting new data on strengthening the quadriceps in the frail elderly, whose mean age was 90.2 years, are reviewed. The relationship of quadriceps muscle strength and maximum voluntary strength as a function of age and gender and the effects of an endurance training program in 15 physically compromised nursing home residents is discussed. A static and a dynamic training program for rheumatoid arthritis patients were compared. The dynamic group significantly increased muscle strength, endurance, and aerobic capacity as compared to the static group, without any increase in disease activity. The results further showed that a home program was beneficial. Interesting data presented show that using a Cybex isokinetic dynamometer (Lumex, Bayshore, NY) test was reliable for normal control and for rheumatoid arthritis patients who were stronger.(ABSTRACT TRUNCATED AT 250 WORDS)

Biomechanical Phenomena↗
PubMed1992

SQUID: a program for the analysis and display of data from crystallography and molecular dynamics.

SQUID is a flexible computer program that allows the analysis and display of molecular coordinates from crystallography, NMR, and molecular dynamics. The program can also display two-dimensional and three-dimensional data using many graph types, as well as perform array processing of data with numerous intrinsic functions. Graphics are based on the use of "move" and "draw" instructions, allowing easy development of new device drivers, including vector plotters.

Computer Graphics↗
PubMed1998

A dynamic cadaver model of the stance phase of gait: performance characteristics and kinetic validation.

OBJECTIVE: This study was undertaken to evaluate the performance of a new dynamic laboratory model of the stance phase of gait. DESIGN: Five cadaver feet were repetitively tested in the apparatus. BACKGROUND: Typical biomechanical investigations of cadaver feet simply place a static load on the tibia. The present system was designed to better simulate the changing in-vivo loading environment of the foot and ankle during gait. METHODS: The device mimics the behavior of the tibia, foot, and ankle from heel-strike to toe-off by reproducing the physiologic actions of five extrinsic foot muscles and physiologic motion at the proximal tibia. To verify its utility, cadaver gait simulations were conducted while measuring applied muscle forces, ground reaction forces, and plantar pressures. RESULTS: Dynamic muscle forces were consistently delivered to within 10% of pre-programmed values. Dynamic measurements of ground reaction forces and plantar pressure were similar to those measured in healthy human subjects. Peak vertical (y), foreaft (x) and medio-lateral (z) forces were 110, 18, and 4% of body weight respectively. Compressive force in the tibial shaft reached 410% of body weight. RELEVANCE: Cadaver studies have greatly enhanced our understanding of normal and pathologic foot function, but are often limited by over-simplified loading conditions. The apparatus presented here accurately reproduces the in-vivo loading environment and provides a powerful investigational tool for the study of foot and ankle function. With this device, musculoskeletal structures can be examined in detail under biomechanical conditions similar to those they experience in life.

Journal Article↗
PubMed1999

Federal surveillance of veterinary drugs and chemical residues (with recent data).

The National Residue Program is a dynamic risk-based program involving many Federal agencies, with the objective of preventing illegal drug residues and chemicals in the food supply. Surveillance is the systematic collection, analysis, and interpretation of residue data for public health action. This consists of assessing the cause(s) of the problem, recommending educational incentives, and intervention of prevention and control measures. The role of residue databases in formulating policy decisions and identifying risk factors for drug residues is discussed. A descriptive analysis, of 5 years (1992-1996) field investigative reports of drug residue occurrence in food animals is presented. The results showed that violative residues occurred predominately in culled dairy cows and bob veal calves.

Animals↗
PubMedDate not supplied

Program evaluation. Part 1: Four generations of theory.

Program evaluation is necessary for understanding and improving educational programs in nursing, but it is frequently surrounded by a climate of unease and perplexity. This first article in a two-part series reviews and evaluates extant models of program evaluation using Guba and Lincoln's four generations of evaluation as a theoretical framework. The second article (November/December 1990) examines the state-of-the-art of program evaluation in nursing education and proposes implementation of a responsive model of program evaluation in schools of nursing. The series aims to foster more dynamic, efficient program analysis, thereby enhancing the effectiveness of nursing's educational programs.

Humans↗
PubMed1995

Observer-based dynamic patient modeling for diagnostic computer programs in long term treatment.

This article shows the dynamic patient model concept, the major argument of which is that the state of the patient could change during the computer aided diagnostic procedure. It introduces the definition of quasi parallel diagnostic systems and quasi parallel sensitive points. A kind of verification procedure can be seen for classical diagnostics, examining diagnostic systems by temporally behavior. The rest of the paper represents an adaptive diagnostic structure, convenient for observing and monitoring a dynamically modeled patient in long term treatment. The basis of the structure shown here is the observer theory presented and applied previously in signal processing.

Diagnosis, Computer-Assisted↗
PubMedDate not supplied

Changing men's attitudes and behavior: the Zimbabwe Male Motivation Project.

A multimedia communication campaign was conducted between 1988 and 1989 to promote family planning among men in Zimbabwe. The campaign consisted of a 52-episode semiweekly radio soap opera, about 60 motivational talks, and two pamphlets about contraceptive methods. Changes over time were measured by comparing a subset of a follow-up survey conducted from October to December 1989 to a baseline survey conducted from April to June 1988. Men exposed to the campaign were also compared to men who were not exposed. The follow-up survey revealed that the campaign reached 52 percent of men aged 18 to 55. Among married Shona-speaking men, use of modern contraceptive methods increased from about 56 percent to 59 percent during the campaign. Condom use increased from about 5 percent to 10 percent. Awareness and current use of modern contraceptives was also higher among men exposed to the campaign, primarily because of their greater awareness of condoms. Men exposed to the campaign were significantly more likely than other men to make the decision to use family planning and to say that both spouses should decide how many children to have.

Adolescent↗
PubMedDate not supplied

Contraceptive use and fertility decline in Chogoria, Kenya.

This article describes the results pertaining to fertility and family planning from a 1985 survey conducted in the catchment area of Chogoria Hospital in central Kenya. Current contraceptive prevalence was found to be quite high, 43 percent as opposed to 17 percent for Kenya as a whole. The total fertility rate of 5.2 births per woman was 2.5 births lower than the national rate. Very few women reported wanting to have large numbers of children or thinking that fate or God should determine family size. Although these data cannot conclusively demonstrate that the family planning program operating in the area has been responsible for reduced fertility there, they do provide some support for this hypothesis.

Adolescent↗
PubMed2001

Is sedation safe during dynamic sleep fluoroscopy of children with obstructive sleep apnea?

OBJECTIVE: Airway compromise is considered a relative contraindication for pediatric sedation. This contraindication presents a paradoxical problem when patients require sedation in preparation for imaging performed to evaluate the cause of airway obstruction. We use dynamic sleep fluoroscopy in the evaluation of children who have obstructive sleep apnea. The purpose of this study was to evaluate the success and safety of a structured sedation program for dynamic sleep fluoroscopy. MATERIALS AND METHODS: Eighty consecutive dynamic sleep fluoroscopic studies were evaluated. The type of sedation used, success rate, complications related to the sedation, and characteristics of the children studied were reviewed. Patients were sedated in accordance with our departmental sedation program guidelines. Findings on fluoroscopy were correlated with episodes of oxygen desaturation or noisy breathing. RESULTS: In all 80 cases, dynamic sleep fluoroscopy was successfully performed. Seventy-two studies were performed, with sedation supervised by the radiologist. Four patients fell asleep without sedation. In four patients, sedation was performed by an anesthesiologist (preprocedural decision). Sixty-four children (80%) had complex medical problems, and 39 (49%) had a history of previous airway surgery. All studies were considered successful. Specific diagnoses were identified in 66 children (83%). No children suffered complications or required tracheal intubation. CONCLUSION: Children with airway compromise who are being evaluated for obstructive sleep apnea can be successfully and safely sedated for dynamic sleep fluoroscopy when a structured sedation program is used.

Child, Preschool↗
PubMed1994

[Intensive back exercises 5 weeks after surgery of lumbar disk prolapse. A prospective, randomized multicenter trial with a historical control group].

An intensive, dynamic rehabilitation program applied to patients who had undergone first time lumbar discectomy was evaluated in a multicentre, clinical trial. Ninety-six patients between 18 and 70 years of age who had been operated within the period September 1989 to May 1990 at the Department of Neurosurgery, Copenhagen County Hospital, Glostrup were consecutively randomized into one of two rehabilitation programs: a) traditional mild, general mobility-improving exercises within pain limits; or b) intensive dynamic back extension and abdominal exercises without low back pain being the limiting factor. Both groups underwent 14 hours of treatment over a period of six weeks, starting five weeks after surgery. Seventy-six patients operated within the period January 1989 to September 1989 formed the historical control group. The results at follow-up at 26 weeks favoured intensive exercises with regard to the patients disability-index and working capabilities. The results are statistically significant. After one year a trend favouring intensive exercises can be observed. No differences in pain or objective measurements were found. A rehabilitation program using intensive exercises without back pain being the limiting factor appears to give the patients increased behavioural support, resulting in improvements in work capacity and reduction in patients' self-rated disability.

Adolescent↗
PubMed2001

Linking population-level risk assessment with landscape and habitat models.

Ecological risk assessment at the population level often involves predicting the effects of a particular change in the land-use patterns on the viability of native species. A common method of addressing such questions is modeling the metapopulation dynamics of the species in the landscape. However, the landscape and, as a result, the spatial structure of the metapopulation usually do not remain unchanged, thus the assessment of viability must incorporate the dynamic nature of the landscape. A new link being developed between a metapopulation modeling program (RAMAS) and a landscape dynamics program (LANDIS) will allow the transitional dynamics of the landscape to be incorporated into assessment of viability and threat. This approach combines methods of landscape prediction with those of metapopulation simulation. The link between the landscape model and metapopulation model is provided by statistical models of habitat suitability for the species in focus.

Animals↗
PubMed1982

The demographic impact of the family planning--health services project in Matlab, Bangladesh.

This paper evaluates the demographic impact of the Family Planning-Health Services Project in Matlab Thana of rural Bangladesh. The project was begun by the International Centre for Diarrhoeal Disease Research, Bangladesh in October 1977. Contraceptive services--including pills, condoms, IUDs, sterilization, and injectables--are supplemented by oral rehydration, tetanus toxoid, and other services. About 33 percent of eligible couples are using contraception. Impact is evaluated by direct measurement of birth rates in the treatment and comparison areas. An overall fertility decline of about 25 percent is observed, concentrated among older women. The impact is two-to-three times that of an earlier project that included fewer methods and used lesser trained workers. The study shows that intensive family planning efforts can affect fertility in the absence of socioeconomic changes.

Adolescent↗
PubMedDate not supplied

Reweighting DHS data to serve multiple perspectives.

Information about health and family planning infrastructures is collected through the service availability module (SAM), an important feature of the Demographic and Health Surveys (DHS) conducted in many developing countries. The DHS samples were designed to provide a representative sample of households and women of reproductive age. Using the weights routinely provided with DHS data sets, service accessibility can be described straightforwardly at the individual and household levels. However, without further adjustment, SAM data do not provide a representative picture of service delivery at the community, or primary sampling unit, level, where the data are collected. This report proposes a methodology for reweighting the SAM data, using rural data from the Egypt DHS as an illustration, so that available family planning facilities at this level may be usefully characterized at little additional cost.

Adolescent↗
PubMed2004

Distributed interactive virtual environments for collaborative experiential learning and training independent of distance over Internet2.

Medical knowledge and skills essential for tomorrow's healthcare professionals continue to change faster than ever before creating new demands in medical education. Project TOUCH (Telehealth Outreach for Unified Community Health) has been developing methods to enhance learning by coupling innovations in medical education with advanced technology in high performance computing and next generation Internet2 embedded in virtual reality environments (VRE), artificial intelligence and experiential active learning. Simulations have been used in education and training to allow learners to make mistakes safely in lieu of real-life situations, learn from those mistakes and ultimately improve performance by subsequent avoidance of those mistakes. Distributed virtual interactive environments are used over distance to enable learning and participation in dynamic, problem-based, clinical, artificial intelligence rules-based, virtual simulations. The virtual reality patient is programmed to dynamically change over time and respond to the manipulations by the learner. Participants are fully immersed within the VRE platform using a head-mounted display and tracker system. Navigation, locomotion and handling of objects are accomplished using a joy-wand. Distribution is managed via the Internet2 Access Grid using point-to-point or multi-casting connectivity through which the participants can interact. Medical students in Hawaii and New Mexico (NM) participated collaboratively in problem solving and managing of a simulated patient with a closed head injury in VRE; dividing tasks, handing off objects, and functioning as a team. Students stated that opportunities to make mistakes and repeat actions in the VRE were extremely helpful in learning specific principles. VRE created higher performance expectations and some anxiety among VRE users. VRE orientation was adequate but students needed time to adapt and practice in order to improve efficiency. This was also demonstrated successfully between Western Australia and UNM. We successfully demonstrated the ability to fully immerse participants in a distributed virtual environment independent of distance for collaborative team interaction in medical simulation designed for education and training. The ability to make mistakes in a safe environment is well received by students and has a positive impact on their understanding, as well as memory of the principles involved in correcting those mistakes. Bringing people together as virtual teams for interactive experiential learning and collaborative training, independent of distance, provides a platform for distributed "just-in-time" training, performance assessment and credentialing. Further validation is necessary to determine the potential value of the distributed VRE in knowledge transfer, improved future performance and should entail training participants to competence in using these tools.

Computer Simulation↗