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PubMed2006

Long-term neurodevelopmental outcome and brain volume after treatment for hydrops fetalis by in utero intravascular transfusion.

OBJECTIVE: We tested the hypothesis that long-term neurodevelopmental outcomes of successfully treated fetuses with immune hydrops are similar to their unaffected siblings according to a protocol that addresses the underlying pathophysiologic condition. STUDY DESIGN: Sixteen of 18 consecutive hydropic fetuses (89%) who were treated in a dedicated fetal medicine unit between July 1985 and October 1995 survived. The transfusion protocol used a 2-step correction over a 2 to 4 day interval, combined with umbilical venous pressure measurements to avoid over transfusion and bicarbonate administration to assure a posttransfusion UV pH of >7.30. Survivors were evaluated at a mean age of 10 years. Statistical analyses included t-test, Wilcoxon rank-sum test, Fisher's exact test, and Pearson coefficients. RESULTS: Overall, death or major neurologic morbidity occurred in 4 of 18 of the fetuses (22%) who were treated (2/16 of survivors [12.5%]). Among the survivors, the children with immune hydrops had physical, neurologic, and cognitive outcomes statistically similar to their siblings, except for a measure of visual attention. Two of the children (12%) had major neurologic sequelae. Brain volumes were statistically smaller than unrelated control subjects by 8.8%, but these control subjects were not matched for height at testing or gestational age at birth. Both groups had brain volumes within the normal range. CONCLUSION: Intravascular transfusion of fetuses with profoundly anemic immune hydrops results in high survival rates and favorable long-term neuropsychological outcomes.

Blood Transfusion, Intrauterine↗
PubMed1983

Physical constitution and smoking habits of patients with idiopathic spontaneous pneumothorax.

This is a report on a statistical study comparing the Kaup index and the level of tobacco consumption of patients with idiopathic spontaneous pneumothorax and those of healthy subjects. A statistically significant difference was found between the average Kaup index of the patients with idiopathic spontaneous pneumothorax and that of normal healthy individuals in Japan as published by the Ministry of Health and Welfare. A statistically significant difference was also found in the physical features between 2,433 males with idiopathic pneumothorax and 1,906 healthy males when compared by means of the Kaup index. Again, a statistically significant difference was noted in the level of tobacco consumption between the males with idiopathic pneumothorax and normal males when compared by means of the Brinkmann index. The Kaup index of idiopathic pneumothorax patients was lower than that of healthy subjects, while the level of tobacco consumption of the former was higher. Idiopathic spontaneous pneumothorax is related to thin and tall individuals and the level of tobacco consumption among such patients is higher than among healthy subjects.

Adolescent↗
PubMed2004

Discerning aggregation in homogeneous ensembles: a general description of photon counting spectroscopy in diffusing systems.

In order to discern aggregation in solution, we present a quantum mechanical analog of the photon statistics from fluorescent molecules diffusing through a focused beam. A generating functional is developed to fully describe the experimental physical system as well as the statistics. Histograms of the measured time delay between photon counts are fit by an analytical solution describing the static as well as diffusing regimes. To determine empirical fitting parameters, fluorescence correlation spectroscopy is used in parallel to the photon counting. For expedient analysis, we find that the distribution's deviation from a single Poisson shows a difference between two single fluor monomers or a double fluor aggregate of the same total intensities. Initial studies were performed on fixed-state aggregates limited to dimerization. However preliminary results on reactive species suggest that the method can be used to characterize any aggregating system.

Biophysics↗
PubMed1992

The effects of psychological distress and psychological well-being on use of medical services.

In this study, the authors determined whether mental health status affects the use of general medical services, with and without adjustment for the correlated effects of general health perceptions and physical health status on such use. Data were used from the RAND Health Insurance Experiment, which has information on up to 5 years of use of medical services by a nonelderly, civilian, general population. Health status and other covariates were assessed by self-administered questionnaires at enrollment. In the absence of statistical control for general and physical health status, worse mental health status-whether assessed by a global self-report measure or its two component parts, psychological well-being and psychological distress-significantly increased the use of both inpatient and outpatient general medical services. After controlling for general health perceptions, physical health status, demographic factors, and insurance plan coverage, the effects of mental health status on use are reduced, but not eliminated. Psychological distress and psychological well-being retained independent effects on total medical expenses.

Activities of Daily Living↗
PubMed2005

Validation of the Korean version of the oswestry disability index.

STUDY DESIGN: Validation of a translated, culturally adapted questionnaire. OBJECTIVES: To translate and culturally adapt a Korean version of the Oswestry Disability Index (ODI) and to validate its use in Korean patients. SUMMARY OF BACKGROUND DATA: The ODI is one of the most widely used and validated instruments for measuring disability in spinal disorders. However, no validated Korean version of the index was available at the time our study was initiated. METHODS: The study was carried out in three phases: the first was translation into Korean and cultural adaptation of the questionnaire; the second was a pilot study to assess the comprehensibility of the prefinal version and modification; the third was a reliability and validity study of the final version. The Korean version was tested on 206 patients with lumbar spinal disorders who had undergone operations at the authors' institute. Test-retest reliability, internal consistency, concurrent validity, and construct validity were investigated. Follow-up questionnaires were obtained from 39 patients at the 3-month postoperative follow-up meeting. Differences in the ODI, visual analog scale (VAS), and World Health Organization (WHO) quality of life assessment (WHOQOL-BREF) between preoperative and follow-up questionnaires were evaluated. The correlation of the postoperative ODI with the pain rating on a visual analog scale and WHOQOL-BREF was also analyzed. RESULTS: Test-retest reliability was assessed with 88 patients in a time interval of 48 hours. The intraclass correlation coefficient of test-retest reliability was 0.9167. Reliability estimated by the internal consistency reached a Cronbach's alpha of 0.84. The correlation of the preoperative ODI with the pain rating on a visual analog scale (100 mm) was r = 0.425 (P = 0.0001). The correlation between three of the WHOQOL-BREF domains (physical health, psychological health, and environment) and the ODI was statistically significant. The correlation coefficient between the ODI and physical health domain of the WHOQOL-BREF was r = -0.48 (P < 0.05). The correlations with psychological health and environment domains were low with r = -0.192 and -0.160, respectively, even though statistically significant (P < 0.05). The correlation of the postoperative ODI with the pain rating on a visual analog scale (100 mm) was r = 0.626 (P = 0.0001). The correlation between all four domains of the WHOQOL-BREF and the postoperative ODI was statistically significant. CONCLUSIONS: The results of this study indicate that the Korean version of the ODI is a reliable and valid instrument for the measurement of disability in Korean patients with lower back problems. The authors recommend this Korean version of the ODI for use in future clinical studies in Korea.

Adult↗
PubMed1996

Analysis of change in self-reported physical function among older persons in four population studies.

Change in self-reported physical function was examined using baseline and 5 years of follow-up data between 1982 and 1991 from the four Established Populations for Epidemiologic Studies of the Elderly studies. In East Boston, Massachusetts (n = 3,809), Iowa and Washington Counties, Iowa (n = 3,673), New Haven, Connecticut (n = 2,812), and North Carolina (n = 4,163), noninstitutionalized persons aged 65 years and older were asked a series of questions to assess their physical function: a modified Katz Activities of Daily Living (ADL) scale, three items from the Rosow-Breslau Functional Health Scale, and questions on physical performance, adapted from Nagi, as well as information on demographic, social, and health characteristics. Longitudinal statistical analyses (random effects and Markov transition models) were used to evaluate improvement, stability, and deterioration in functional ability at both an individual and a population level over multiple years of data. The average decline in physical function associated with age was found to be greater than previous cross-sectional studies have suggested, and the rate of decline increased with increasing age. Considerable individual variation was evident. Although many people experienced declines, a smaller but substantial portion experienced recovery. Women reported a greater rate of decline in physical function and were less likely to recover from disability.

Activities of Daily Living↗
PubMed2004

Differentiation of globally unpolarized complex random fields.

Different types of random vector fields can be depolarized in a global sense. They can be physically discriminated by probing the statistical invariance when they are subject to operations such as a change of the reference frame or the introduction of an arbitrary retardance. With use of the observable polarization sphere as a visualization tool, a set of measurements is capable of discriminating between certain types of globally depolarized light, and we discuss the geometric interpretation of the physical invariances.

Journal Article↗
PubMed2003

Physical activity in relation to indices of endothelial function and angiogenesis factors in hypertension: a substudy of the Anglo-Scandinavian Cardiac Outcomes Trial (ASCOT).

BACKGROUND: Hypertension is an important risk factor for cardiovascular disease. The latest guidelines recommend regular physical exercise as initial step or adjunct in the treatment of hypertension. We investigated the association between physical activity and the degree of hypertension, as well as the relation to indices of endothelial damage/dysfunction and angiogenesis. METHODS: We studied 234 patients with hypertension (198 males; mean age 64 years; mean blood pressure 166/90 mmHg), who were compared with 60 age and sex-matched healthy normotensive controls. We assessed the patient's physical activity using the validated Baecke physical activity questionnaire and measured flow-mediated dilatation (FMD) of the brachial artery and von Willebrand factor (vWf) as indices of endothelial damage/dysfunction, whilst angiogenesis was assessed by measurement of plasma vascular endothelial growth factor (VEGF) and its soluble receptor (sFlt-1) both by ELISA. RESULTS: When hypertensive patients were compared with the controls, there was no statistically significant difference in total physical activity score using the Baecke questionnaire although plasma VEGF and vWf levels were higher, but sFlt-1 levels and FMD lower (all P < 0.001). Patients with high physical activity were younger, and had lower mean diastolic blood pressure and 10-year Framingham stroke risk, when compared with those with low physical activity; but indices of endothelial damage/dysfunction and angiogenesis were not significantly different. CONCLUSION: Physical activity scores in hypertensive patients are not significantly different from healthy normotensive controls, and there appears to be no relation to the abnormal processes of endothelial damage/dysfunction and angiogenesis seen in hypertensives.

Angiogenesis Inducing Agents↗
PubMed2001

Effects of antenatal corticosteroid administration on mortality and long-term morbidity in early preterm, growth-restricted infants.

OBJECTIVE: To evaluate the effect of antenatal corticosteroids on mortality, morbidity, and disability or handicap rate in early preterm, growth-restricted infants. METHODS: This case-control study in two tertiary care centers included all live-born singleton infants with growth-restriction due to placental insufficiency, who were delivered by cesarean because of cardiotocographic signs of fetal distress before the beginning of labor at a gestational age of 26-32 weeks during the years 1984-1991. Infants who had been treated antenatally with corticosteroids more than 24 hours and less than 7 days before birth were matched by birth weight, sex, and year of birth with infants whose mothers had been admitted more than 24 hours before delivery but were not treated antenatally with steroids. The main outcome measure was survival without disability or handicap at 2 years corrected age. A sample of 60 case-control pairs would give 81% power to demonstrate 50% increase of this outcome [odds ratio (OR) 3.0] by corticosteroid treatment. Behavior and physical growth were evaluated at school age by questionnaire. RESULTS: The study group and control group consisted of 62 infants each. Survival without disability or handicap at 2 years' corrected age was more frequent in the corticosteroid group [OR 3.2, confidence interval (CI) 1.1, 11.2]. In the long-term follow-up at school age there was a statistically significant negative effect on physical growth (OR 5.1, CI 1.4, 23.8), but no differences in behavior were detected. CONCLUSION: Benefits from antenatal corticosteroids for early preterm, growth-restricted infants appear to outweigh possible adverse effects.

Adrenal Cortex Hormones↗
PubMed1980

The relationship between biographic profile and job role preceptions of the allied health chair: a national study.

The purpose of the study was to construct a professional profile of medical technology and physical therapy baccalaureate chairs to compare male and female respondents in the areas of (1) biographic background, (2) career aspiration, (3) influence in decision making, (4) job-related stress, (5) goals important to role as chair, (6) skills important to role as chair, and (7) perception of ideal power. The response rate to a 1978 national survey was 72%. Statistical analysis on the 25 physical therapy females, 23 physical therapy males, and 20 medical technology female respondents revealed they were comparable in terms of the above variables. The three groups shared a common biographic profile except in the areas of marital status and clinical experience. These chairs exhibited low scholarly productivity and little interest in careers in academic administration or the clinical setting. Rather, they indicated sustained interest in departmental chair status or a return to fulltime faculty status. There was also perceived high participation in decision making, low to moderate job-related stress, and high concern for personal and faculty development. They agreed that selected administrative skills were necessary to their role as chairs. Finally, they reported that a considerable amount of power was necessary to their role as chairs in their institutions. Implications for chair development and recommendations for future research are discussed.

Allied Health Personnel↗
PubMed1996

[Social and familial aspects in physical abuse and sexual abuse experiences in childhood from the viewpoint of young adults. Selected results of the Hamburg Study (1)].

The basic assumption of this investigation is that sexual abuse and physical maltreatment should not be investigated in isolation. Young adults have been asked to participate in a study on body and sexual experiences in childhood. It was tested how sexually abused and/or physically maltreated women and men differentiate from those without this experiences. 23% out of 616 women were classified as sexually abused and 28% as physically maltreated. 4% of the 452 men were allocated as sexually abused and 14% as physical maltreated. Aside from assessing group differences, the main purpose of this study was to test which variables would predict sexual abuse and physical maltreatment in multivariate analysis. In this part of the study, the relevance of socioeconomic and family factors for the statistical prediction of sexual abuse and physical maltreatment in multivariate analysis are presented.

Adolescent↗
PubMed2004

Hematite (Fe2O3) acts by oxydative stress and potentiates benzo[a]pyrene genotoxicity.

Since epidemiological studies have implicated the co-exposition of iron oxides and polycyclic aromatic hydrocarbons as potential etiological factors involved in the excess of mortality from lung cancer in miners, experimental studies have been performed to investigate the role of iron on benzo[a]pyrene (B[a]P)-induced lung pathogenesis. We demonstrated previously that in vivo damage was higher when B[a]P was coated onto hematite than when B[a]P was administered alone. In order to determine the role of (i) different cell types and (ii) adsorption of hematite in this potentiation, in vitro studies were developed. The Comet assay was first used to measure DNA damage in four isolated cell types from Sprague-Dawley rats at 1, 2, 4, 8 and 24h after in vitro treatment with hematite (Fe2O3) or B[a]P or B[a]P coated onto hematite. For the two treatments with B[a]P, no damage was observed in alveolar macrophages, but significant increases in damage were seen in lymphocytes, hepatocytes and lung cells (where the effects of B[a]P coated onto hematite were stronger than those of B[a]P alone). In a second part of the study, the Comet assay was conducted with lung cells to measure the in vitro effect of (i) the coating and (ii) the role of the physical properties of Fe2O3. A statistically significant increase in damage was observed for the coating of B[a]P onto Fe2O3 compared (i) with their simple addition and (ii) with the coating of B[a]P onto graphite used as an inert compound. This study showed that (i) Fe2O3/B[a]P acts essentially in lung cells, (ii) the coating is a primordial step and (iii) the physical properties of Fe2O3 play a very minor role, which suggests another mechanism of action to explain the higher toxicity. Hence, our data may contribute to explain the excess of mortality in epidemiological studies and overall why exposures to B[a]P coated onto Fe2O3 resulted in higher toxicity in rodents compared to exposure to B[a]P alone.

Animals↗
PubMed2000

Stalking by former intimates: verbal threats and other predictors of physical violence.

Scant empirical research has been conducted on the relationship between threats and violence. The purpose of this analysis is to assess the link between verbal threats of violence and actual physical violence against former intimate victims of stalking. The researcher interviewed 187 female former intimate stalking victims, asking respondents about various characteristics of their experiences. Responses to questions pertaining to threats; history of violence; stalkers' drug and alcohol use; frequency of phone calls, "following," and letters during stalking; and victims' age and education were analyzed as possible predictors of three violence-related dependent variables: (a) whether or not violence occurred, (b) the number of violent incidents during stalking, and (c) physical injury during stalking. The results of linear and logistic regression models reveal that, regardless of the measure of violence, there is an independent, moderate, and statistically significant correlation between verbal threats and subsequent violence. Regression coefficients for drug abuse and alcohol abuse were also statistically significant, but only in predicting physical injury during stalking.

Adolescent↗
PubMed2006

Physical and mental function and incident low back pain in seniors: a population-based two-year prospective study of 1387 Danish Twins aged 70 to 100 years.

STUDY DESIGN: Prospective cohort study. OBJECTIVES: To investigate whether physical performance, grip strength, cognitive function, and depression symptomatology are risk factors for incident low back pain (LBP) over a 2-year period in seniors. SUMMARY OF BACKGROUND DATA: LBP is common in the older age groups, but little is known about predictors of LBP in this age group. METHODS: Data from the 2001 and 2003 data collection from the population-based Longitudinal Study of Aging Danish Twins formed the basis of this analysis. Participants free from LBP at baseline (no LBP during the past month, N = 1387) were included and interview data on overall physical function, and assessment of grip strength, overall cognitive function, and depression at baseline were obtained. LBP status at follow-up was assessed using a modified version of the Standardized Nordic Questionnaire. Logistic regression was used to assess the associations between the baseline risk factors and LBP at follow-up. RESULTS: A total of 1387 persons 70 to 100 years of age at baseline were included in the analyses. Of the initially LBP-free individuals, 7% had experienced LBP more than 30 days out of the past year, 7% had altered or decreased their physical activities due to LBP, and 11% had received treatment for LBP at follow-up. Good overall physical function (being among the top 50%) at baseline was protective for LBP of more than 30 days duration and for diminishing physical activities due to LBP and for care seeking due to LBP. High depression scores (being among the top 25%) were strongly associated with altering or decreasing daily activities because of LBP. Grip strength and overall cognitive performance at baseline were associated with lower incidence of LBP and decreasing activities due to LBP at follow-up; however, these associations were not statistically significant. CONCLUSION: Poor overall physical function and depression symptomatology are associated with LBP and consequences of LBP in persons 70 years of age and older.

Activities of Daily Living↗
PubMed2004

Obesity and physical inactivity in rural America.

CONTEXT AND PURPOSE: Obesity and physical inactivity are common in the United States, but few studies examine this issue within rural populations. The present study uses nationally representative data to study obesity and physical inactivity in rural populations. METHODS: Data came from the 1998 National Health Interview Survey Sample Adult and Adult Prevention Module. Self-reported height and weight were used to calculate body mass index. Physical inactivity was defined using self-reported leisure-time physical activity. Analyses included descriptive statistics, chi 2 tests, and logistic regression. FINDINGS: Obesity was more common among rural (20.4%, 95% CI 19.2%-21.6%) than urban adults (17.8%, 95% CI 17.2%-18.4%). Rural residents of every racial/ethnic group were at higher risk of obesity than urban whites, other factors held equal. Other predictors of obesity included being male, age 25-74, lacking a high school diploma, having physical limitations, fair to poor health, and a history of smoking. Proportionately more rural adults were physically inactive than their urban peers (62.8% versus 59.3%). Among rural residents, minorities were not significantly more likely to be inactive than whites. Males and younger adults were less likely to be inactive. Rural adults who were from the Midwest and South, had less than a high school education, had fair to poor health, and currently smoked were more likely to be inactive compared to their respective referent group. CONCLUSIONS: The high prevalence of obesity and inactive lifestyles among rural populations call for research into effective rural interventions.

Adolescent↗
PubMed1998

Determinism and mass-media portrayals of genetics.

Scholars have expressed concern that the introduction of substantial coverage of "medical genetics" in the mass media during the past 2 decades represents an increase in biological determinism in public discourse. To test this contention, we analyzed the contents of a randomly selected, structured sample of American public newspapers (n=250) and magazines (n=722) published during 1919-95. Three coders, using three measures, all with intercoder reliability >85%, were employed. Results indicate that the introduction of the discourse of medical genetics is correlated with both a statistically significant decrease in the degree to which articles attribute human characteristics to genetic causes (P<.001) and a statistically significant increase in the differentiation of attributions to genetic and other causes among various conditions or outcomes (P<. 016). There has been no statistically significant change in the relative proportions of physical phenomena attributed to genetic causes, but there has been a statistically significant decrease in the number of articles assigning genetic causes to mental (P<.002) and behavioral (P<.000) characteristics. These results suggest that the current discourse of medical genetics is not accurately described as more biologically deterministic than its antecedents.

Genetic Determinism↗
PubMedDate not supplied

[Validity and reproducibility of a questionnaire on physical activity and non-activity for school children in Mexico City].

OBJECTIVE: To assess the validity and reproducibility of a self-reported questionnaire on physical activity and inactivity, developed for children aged 10-14 in Mexico City. MATERIAL AND METHODS: Between May and December 1996, a self-reported physical activity and inactivity questionnaire was developed and applied twice to a sample of 114 students aged 10 to 14, from a low and middle income population of Mexico City. The children's mothers completed the same questionnaire, and two 24-hour recalls of physical activity were used for comparison. Statistical analysis consisted of central tendency and dispersion measures and Pearson's correlation coefficient. RESULTS: Correlations between hours per day spent in physical activity and inactivity from the children's questionnaire and the 24-hour recall data, were 0.03 for moderate activity, 0.15 for vigorous activity, and 0.51 (p = 0.001) for watching television, adjusted by age, gender, town, and illness prior to the administration of the questionnaire. Compared to the 24-hour recall data, the questionnaire overestimated the time spent watching television, reading or participating in vigorous activity, and underestimated the time engaged in moderate activity. Statistically significant (p < 0.05) six-month reproducibility values were observed for watching television (r = 0.53), sleeping (r = 0.40), moderate (r = 0.38), and vigorous activity (r = 0.55). CONCLUSIONS: Among children of Mexico City aged 10-14, the questionnaire showed acceptable validity in estimating the time watching television, and acceptable reproducibility of the time watching television, vigorous and moderate activity.

Adolescent↗