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At least 955 records · Page 53Linked to original sources
PubMed2005

Modifying physical activity in a multiethnic sample of low-income women: one-year results from the IMPACT (Increasing Motivation for Physical ACTivity) project.

BACKGROUND: Ethnic minorities or those with low socioeconomic status (SES) are at increased risk of cardiovascular disease, type 2 diabetes, and all-cause mortality, compared to higher SES Whites. National surveys also indicate that low-income, ethnic minority women have the highest rates of inactivity in the United States. PURPOSE: This study (the Increasing Motivation for Physical ACTivity or IMPACT study) promoted adoption and maintenance of physical activity (PA) in sedentary, low-income women participating in federally funded job training programs. METHODS: The study consisted of 2 months of weekly 1-hr classes, then random assignment to 10 months of either home-based telephone counseling for PA plus information and feedback via mailed newsletters (Phone + Mail Counseling condition) or just the mailed newsletters (Mail Support condition). The IMPACT intervention included behavior change strategies for PA as well as discussions related to motivational readiness for PA change. Participants completed surveys and physiological assessments at baseline after the classes ended (i.e., at 10 weeks) and at 6 and 12 months postbaseline. Seventy-three percent of randomized participants (n = 72) were Latina, with a mean age of 32 +/- 10 years. More than half the women had not completed high school, and 73% had an annual income less than 20,000 dollars. RESULTS: After 10 months of a home-based intervention, women in the phone + mail counseling condition had significantly greater increases in estimated total energy expenditure compared to women in the mail support condition (p < .05). CONCLUSIONS: Regular PA counseling delivered via the telephone and through the mail appears effective for encouraging regular PA among low-income women transitioning from welfare or job training to the workforce.

Adolescent↗
PubMed2000

Response rate comparisons of e-mail- and mail-distributed student evaluations.

BACKGROUND: The proliferation of electronic information delivery systems has led to increasing use of e-mail as a rapid method of gathering information. Little research has been conducted on the use of e-mail for collecting curriculum evaluations. PURPOSE: To compare e-mailed and mailed educational evaluations for 4th-year medical students. METHODS: Curriculum evaluations were sent to 4th-year medical students who were randomly assigned to receive the survey either by mail or e-mail. RESULTS: Mailed evaluations yielded a higher return rate, fewer number of students omitting items, and shorter responses to an open-ended question than evaluations completed via e-mail. CONCLUSIONS: Although the findings have limited generalizability because of low response rates and small sample sizes, the results suggest caution when using e-mail to collect curriculum evaluations from 4th-year medical students.

Clinical Clerkship↗
PubMed1998

An epidemiologic study of multiple sclerosis in Northern Ireland.

We wanted to establish the point prevalence of MS in Northern Ireland. Northern Ireland has been a known high-risk area for MS since the original work of Allison and Millar in 1951. Studies demonstrated a rising prevalence in 1951 of 41 (95% CI, 37 to 44), in 1961 of 57 (95% CI, 53 to 61), and in 1986 of 104 (95% CI, 85 to 128)/10(5) population for probable/early probable and latent disease. We surveyed four districts (area 2,030 km2, population 151,000). Case sources included Regional Neurology Service records, postal survey of general medical practitioners, hospital databases, MS charities, and MS respite facilities. We used the Poser and Allison and Millar criteria in diagnosis. From a provisional list of 402 patients, 254 (177 female, 77 male, ratio 2.3:1) were identified with definite or probable disease by the Poser criteria, prevalence 168.2/10(5) (95% CI, 147.5 to 188.9/10(5)) with 34 suspected patients and an overall prevalence 190.7/10(5) (95% CI, 168.7 to 212.7/10(5)). We interviewed and examined over 87% of these 288 patients. There were 246 patients classified as probable/early probable and latent by Allison and Millar, prevalence 162.9/10(5) (95% CI, 142.6 to 183.3/10(5)). Seventy-six probable or definite patients had onset between 1985 and 1992 (estimated incidence, 6.5/10(5)/yr). Age range of prevalent patients was 18 to 79 years (mean +/- SD, 49.2 +/- 13.3 years). Mean age at onset was 31.6 +/- 10.1 years. Overall, 12.5% had primary progressive disease and 20% had benign MS. Northern Ireland has an extremely high and rising MS prevalence. This may reflect a true increase in disease incidence or may be explained by increasing survival, improved case ascertainment, increased disease awareness, or improved laboratory and radiologic diagnosis.

Adolescent↗
PubMed1998

High prevalence of parkinsonism after occupational exposure to lead-sulfate batteries.

Seven of nine postal workers exposed to lead-sulfate batteries over a period of up to 30 years developed parkinsonian symptoms. One of the remaining two showed left-hand bradykinesia and one was not available for examination. The high prevalence and cause of parkinsonism in these patients remains unexplained. Lead intoxication may play a role in the occurrence of parkinsonian symptoms, but involvement of sulfate and other sulfur compounds must also be considered.

Antiparkinson Agents↗
PubMed2005

A review of ENT consultant postal questionnaires.

In recent years, there appears to have been an increase in the number of postal questionnaires being received by ENT consultants. Questionnaires with unsound methodology waste the time of those who send and receive them, as inferences cannot be made from their results. In this study,a review was performed on a sample of 19 questionnaire studies published in two ENT journals between January 1998 and December 2002. Each study was given a 30-point score, based on the quality of its methodology. The average score assigned to each study was 32 percent, suggesting that the quality of methodology was generally poor. These results should serve as a warning to those embarking on and those interpreting research of this kind.

Consultants↗
PubMed1995

Variations in the radiological management of intussusception: results of a postal survey.

A survey of the radiological reduction of intussusception in a selection of British hospitals was performed using a questionnaire. Replies were received from radiologists working in 51 district general hospitals and 25 teaching hospitals or specialist paediatric institutions. Most district general hospitals still use barium as the sole method of reduction of intussusception. Most teaching hospitals and specialist paediatric units have changed to a pneumatic method. The contra-indications, details of patient preparation and technical details of each method varied considerably.

Air Pressure↗
PubMed2005

Effects of ambient ozone exposure on mail carriers' peak expiratory flow rates.

The extent to which occupational exposure to ozone in ambient air can affect lung function remains unclear. We conducted a panel study in 43 mail carriers by measuring their peak expiratory flow rates (PEFRs) twice daily for 6 weeks in 2001. The daily exposure of each mail carrier to O3, particulate matter < 10 microm in aerodynamic diameter (PM10), and nitrogen dioxide was estimated by one air monitoring station in the center of the mail carrier's delivery area. Hourly concentrations of air pollutants during their exposure periods were 6-96 ppb for O3, 11-249 microg/m3 for PM10, and 14-92 ppb for NO2. Linear mixed-effects models were used to estimate the association between air pollution exposures and PEFR after adjusting for subject's sex, age, and disease status and for temperature and humidity. We found that night PEFR and the deviation in night PEFR were significantly decreased in association with 8-hr O3 exposures with a lag 0-2 days and by daily maximum O3 exposures with a lag of 0-1 day in our multipollutant models. By contrast, neither PM10 nor NO2 was associated with a PEFR reduction. Daily 8-hr mean concentrations of O3 had greater reduction effects on PEFR than did daily maximum concentrations. For a 10-ppb increase in the 8-hr average O3 concentration, the night PEFR was decreased by 0.54% for a 0-day lag, 0.69% for a 1-day lag, and 0.52% for a 2-day lag. We found that an acute lung function reduction occurs in mail carriers exposed to O3 concentrations below current ambient air quality standards and occupational exposure limits.

Adult↗
PubMed1999

Biomarkers for exposure to ambient air pollution--comparison of carcinogen-DNA adduct levels with other exposure markers and markers for oxidative stress.

Human exposure to genotoxic compounds present in ambient air has been studied using selected biomarkers in nonsmoking Danish bus drivers and postal workers. A large interindividual variation in biomarker levels was observed. Significantly higher levels of bulky carcinogen-DNA adducts (75.42 adducts/10(8) nucleotides) and of 2-amino-apidic semialdehyde (AAS) in plasma proteins (56.7 pmol/mg protein) were observed in bus drivers working in the central part of Copenhagen, Denmark. In contrast, significantly higher levels of AAS in hemoglobin (55.8 pmol/mg protein), malondialdehyde in plasma (0. 96 nmol/ml plasma), and polycyclic aromatic hydrocarbon (PAH)-albumin adduct (3.38 fmol/ microg albumin) were observed in the suburban group. The biomarker levels in postal workers were similar to the levels in suburban bus drivers. In the combined group of bus drivers and postal workers, negative correlations were observed between bulky carcinogen-DNA adduct and PAH-albumin levels (p = 0.005), and between DNA adduct and [gamma]-glutamyl semialdehyde (GGS) in hemoglobin (p = 0.11). Highly significant correlations were found between PAH-albumin adducts and AAS in plasma (p = 0.001) and GGS in hemoglobin (p = 0.001). Significant correlations were also observed between urinary 8-oxo-7, 8-dihydro-2'-deoxyguanosine and AAS in plasma (p = 0.001) and PAH-albumin adducts (p = 0.002). The influence of the glutatione S-transferase (GST) M1 deletion on the correlation between the biomarkers was studied in the combined group. A significant negative correlation was only observed between bulky carcinogen-DNA adducts and PAH-albumin adducts (p = 0.02) and between DNA adduct and urinary mutagenic activity (p = 0.02) in the GSTM1 null group, but not in the workers who were homozygotes or heterozygotes for GSTM1. Our results indicate that some of the selected biomarkers can be used to distinguish between high and low exposure to environmental genotoxins.

Adult↗
PubMed2003

Effects of sterilizing gamma irradiation on bloodspot newborn screening tests and whole blood cyclosporine and tacrolimus measurements.

Sterilizing irradiation of the US mail has been proposed as a method to prevent delivery of viable anthrax spores. Because newborn screening samples (bloodspots) and cyclosporine and tacrolimus specimens (whole blood) are delivered routinely through the mail, we studied whether sterilizing gamma irradiation could affect these test results. Specimens were exposed to 18 kGy gamma irradiation (100 hours x 18,000 rad/h), a "kill dose" for Bacillus pumilus spore strips. Irradiation had no significant effect on whole blood cyclosporine or tacrolimus results, but it had a degradative effect on bloodspot phenylalanine, hemoglobins, biotinidase, galactose-1-phosphate uridyltransferase, thyroxine, and thyrotropin. Such irradiation potentially could cause false-negative results for the detection of phenylketonuria and likely would lead to an increase in secondary testing for hemoglobin variants, but it is unlikely to lead to false-negative or false-positive results for the remaining newborn screening tests. These experiments cannot rule out possible greater effects by larger doses or other types of irradiation.

Anthrax↗
PubMed2006

Using mail to reach patients seen at an urban health care facility.

Urban American Indians/Alaska Natives (AI/ANs) are highly mobile, and little is known about ways to include them in research or clinical activities. We evaluated postal mailings as a means of reaching patients seen at an urban Indian health care facility (60% of whom were AI/AN) and identified factors associated with receipt of mail. As part of a clinical trial, a Native art calendar was sent via first class mail to 5,633 clients seen at the urban Indian clinic during the prior two years. A multi-step address verification process was conducted, including telephone contacts, Web searches, and in-person visits. Logistic regressions examined the association of client characteristics with accurate addresses. Based on initial mailings and in-person location efforts, we estimated that only 61% of clients actually received the calendars. The multi-step address verification process was significantly less likely to identify working addresses for clients who were AI/AN and clients who were seen more than 3 months before the study. Reaching urban AI/ANs for research activities and health care is difficult. Innovative strategies are needed to locate this highly mobile and understudied population.

Adolescent↗
PubMedDate not supplied

Immunization registry-based recall for a new vaccine.

BACKGROUND: Immunization recall for specific vaccines may be necessary to "catch up" children with newly available vaccines or recall children after vaccine shortages. The extent to which immunization registry-based recall can increase immunization rates for a new vaccine has not been prospectively studied. OBJECTIVE: To assess the efficacy of letter/telephone recall for immunization with pneumococcal conjugate vaccine (PCV7) in an economically disadvantaged urban population. DESIGN/METHODS: Randomized controlled trial at an inner-city teaching hospital. Using an immunization registry, we randomly assigned children aged 6 weeks to 22 months unimmunized for PCV7 to an intervention group (n = 610) or a control group (n = 624). The intervention consisted of letter and telephone recall for PCV7 vaccination. Two months after intervention, receipt of 1 or more doses of PCV7 was assessed. Intention-to-treat analysis was used. RESULTS: We were unable to successfully contact 42.3% of the intervention subjects by mail and telephone. In the intervention group, 23.0% (140 children) received PCV7 within 2 months compared with 20.2% (126 children) in the control group (P = NS). No intervention effect was evident when children were stratified by age. A large proportion of the study population had Medicaid insurance (51.2%) or were uninsured (28.5%), but response to PCV7 recall did not vary by insurance status. CONCLUSIONS: Letter and telephone recall for PCV7 vaccine did not significantly increase the rate of PCV7 immunization in an inner-city teaching hospital serving a disadvantaged population. The effectiveness of recall appears to have been limited by the inability to reach many subjects by mail and telephone.

Child, Preschool↗
PubMedDate not supplied

A randomized clinical trial of a care recommendation letter intervention for somatization in primary care.

PURPOSE: This paper describes the impact of a care recommendation (CR) letter intervention on patients with multisomatoform disorder (MSD) and analysis of patient factors that affect the response to the intervention. METHODS: One hundred eighty-eight patients from 3 family practices, identified through screening of 2,902 consecutive patients, were classified using somatization diagnoses based on the number of unexplained physical symptoms from a standardized mental health interview. In a controlled, single-crossover trial, patients were randomized to have their primary care physician receive the CR letter either immediately following enrollment or 12 months after enrollment. The CR letter notified the physician of the patient's somatization status and provided recommendations for the patient's care. Patients were followed for 24 months with assessments of functional status at baseline, 12, and 24 months. RESULTS: Longitudinal analysis revealed a 12-month intervention effect for patients with multisomatoform disorder (MSD) of 5.5 points (P < .001) on the physical functioning (PCS) scale of the SF-36. Analysis of scores on the MCS scale of the SF-36 found no significant effect on mental functioning. The intervention was more effective for patients with 1 or more comorbid chronic physical diseases (P = .01). CONCLUSIONS: The CR letter has a favorable impact on physical impairment of primary care patients with MSD, especially for patients with comorbid chronic physical disease. Multisomatoform disorder appears to be a useful diagnostic classification for managing and studying somatization in primary care patients.

Alabama↗
PubMed2004

Effects of processing and storage conditions on amyloid beta (1-42) and tau concentrations in cerebrospinal fluid: implications for use in clinical practice.

BACKGROUND: Reported concentrations of amyloid beta (1-42) (A beta 42) and tau in cerebrospinal fluid (CSF) differ among reports. We investigated the effects of storage temperature, repeated freeze/thaw cycles, and centrifugation on the concentrations of A beta 42 and tau in CSF. METHODS: Stability of samples stored at -80 degrees C was determined by use of an accelerated stability testing protocol according to the Arrhenius equation. A beta 42 and tau concentrations were measured in CSF samples stored at 4, 18, 37, and -80 degrees C. Relative CSF concentrations (%) of the biomarkers after one freeze/thaw cycle were compared with those after two, three, four, five, and six freeze/thaw cycles. In addition, relative A beta 42 and tau concentrations in samples not centrifuged were compared with samples centrifuged after 1, 4, 48, and 72 h. RESULTS: A beta 42 and tau concentrations were stable in CSF when stored for a long period at -80 degrees C. CSF A beta 42 decreased by 20% during the first 2 days at 4, 18, and 37 degrees C compared with -80 degrees C. CSF tau decreased after storage for 12 days at 37 degrees C. After three freeze/thaw cycles, CSF A beta 42 decreased 20%. CSF tau was stable during six freeze/thaw cycles. Centrifugation did not influence the biomarker concentrations. CONCLUSIONS: Repeated freeze/thaw cycles and storage at 4, 18, and 37 degrees C influence the quantitative result of the A beta 42 test. Preferably, samples should be stored at -80 degrees C immediately after collection.

Aged↗
PubMed2001

Feasibility of using different approaches for recruiting younger twins to establish a population based twin register in Sri Lanka.

Identifying twins for a population-based register can be achieved through birth records or community surveys. We studied the feasibility and effectiveness of different methods of identifying and recruiting twins to establish a population based register. To trace twins a population survey was carried out using an interviewer administered questionnaire. We also inspected the birth registration certificates at a divisional secretariat reported from a specified hospital between the years of 1985-1997 and compared it to the birth register of this same hospital. To recruit twins a random sample of 75 twin pairs (150 twins) identified at the Divisional Secretariat were contacted through the post and 25 twin pairs (50 twins) were personally visited. The prevalence of twins was 6.5 twins per 1000 people in the area surveyed. The twinning rate at the hospital was 18.92 twins per 1000 births. A discrepancy of 38 multiples births between the hospital labour room records and those registered at the DS was noted. The response from the postal invitation for recruitment was 59% and the response from the personal invitation was 68%. (Difference 9.4% 95% CI; 7.06-11.73). Community survey and systematic inspection of birth records either at the hospital or the birth registration office was an effective method to trace twins. Once traced, personal contact was more effective than the postal invitation for recruitment of younger twins. A cost-effective approach would be to use a postal coverage followed by personal contact for non-responders. The alternative method, community coverage, would have financial implications.

Birth Certificates↗
PubMed1996

Nasal lavage cellularity, grain dust, and airflow obstruction.

To evaluate the clinical utility of nasal lavage (NL), we performed post-work shift NL on 172 grain workers and 78 postal worker control subjects. The grain worker group included a higher percentage of current smokers (25.7% vs 16.7%) and a lower percentage of former smokers (21.15% vs 35.9%) compared with the postal workers. The control subjects included more female workers and were slightly older than the grain workers. Compared with the postal workers, the grain workers were exposed to significantly greater concentrations of total dust (0.1 +/- 0.0 vs 6.8 +/- 1.4 mg/m3; mean +/- SEM) and total endotoxin (4.3 +/- 0.8 vs 2,372.4 +/- 653.8 endotoxin units/m3). NL from gain workers showed a higher concentration of total cells (55,000 +/- 14,000 vs 25,000 +/- 5,000 cells per milliliter; p=0.03), a higher concentration of squamous epithelial cells (17,029.0 +/- 4,177 .0 vs 7,103.7 +/- 1,479.8 cells per milliliter; p=0.03), and a higher concentration of neutrophils (40,058.0 +/- 12,803.2 vs 17,891.0 +/- 3,822.3 cells per milliliter; p=0.10) compared with postal workers. Importantly, these differences in NL cellularity between grain workers and postal workers were observed within the three strata of smokers. To further assess the importance of total cells, squamous epithelial cells, and neutrophils in the NL fluid of grain workers, we investigated the relationship between these cell concentrations and (1) measures of dust and endotoxin exposure during the work shift. (2) spirometric measures of airflow obtained immediately before the NL, and (3) work-related respiratory symptoms. The concentration of total cells, the concentration of squamous epithelial cells, or the concentration of neutrophils in the NL was not associated with ambient levels of dust or endotoxin, with baseline or cross-shift changes in lung function, or with work-related respiratory symptoms. These findings suggest that increased NL cellularity may be seen in workers exposed to high dust levels. However, the NL cellularity does not appear to be associated with ambient concentrations of dusts or endotoxins, with signs of airflow obstruction, or with work-related respiratory symptoms.

Adult↗