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After rehabilitation: an 18-month follow-up of elderly inner-city women.

OBJECTIVE: Elderly inner-city women (n = 125) greater than the age of 60 and living alone and who were consecutively admitted to a large, urban, university-based rehabilitation hospital were followed to (a) examine the power of standardized clinical measures to predict who was living alone 18 months after discharge, (b) determine whether live-alone women at 18 months' follow-up were more independent in instrumental activities of daily living (IADL) than women who were not living alone, and (c) investigate whether women who return home to live alone and have low or declining physical function are at risk for subsequent relocation or death. METHOD: Data from four standardized assessments (physical function, cognition, comorbidity, and depression) and demographic information were gathered during in-patient rehabilitation. Self-report IADL data were collected via telephone interviews at 3, 6, and 18 months' follow-up. RESULTS: Statistical analysis of results showed that physical function, cognition, and comorbidity were significant and independent predictors of living alone at 18 months' follow-up. Women living alone at 18 months reported significantly greater IADL independence than women who were not living alone. Path analysis confirmed that the relationship between the clinical measures and living situation at 18 months was mediated by self-reported IADL functioning. CONCLUSION: Standard clinical data obtained at discharge are useful to identify who can return home to live alone after rehabilitation, but in-home assessment of IADL remains key to understanding the complex skills required to live alone.

Activities of Daily Living↗

Educational rehabilitation of mentally and physically handicapped children in Benin City, Nigeria.

Handicapping diseases have remained major problems associated with immense suffering and superstition in the African setting. There are no accurate vital statistics of the incidence of mental and physical retardation in children in Nigeria, but it is presumed to be higher than in the U.S.A. or Europe. This study shows that provision for education and rehabilitation for handicapped children, such as school accommodation, transportation, teaching aids, specialist teachers etc., attract low priority in the minds of the education planners. In developing countries, the efforts of voluntary organizations to supplement government efforts should be encouraged by the Government and by the public. Intensive health education is needed for the public and also for the teachers who come in contact with handicapped children.

Adolescent↗

Properties of preprocessed sinogram data in x-ray computed tomography.

The accurate determination of x-ray signal properties is important to several computed tomography (CT) research and development areas, notably for statistical reconstruction algorithms and dose-reduction simulation. The most commonly used model of CT signal formation, assuming monoenergetic x-ray sources with quantum counting detectors obeying simple Poisson statistics, does not reflect the actual physics of CT acquisition. This paper describes a more accurate model, taking into account the energy-integrating detection process, nonuniform flux profiles, and data-conditioning processes. Methods are developed to experimentally measure and theoretically calculate statistical distributions, as well as techniques to analyze CT signal properties. Results indicate the limitations of current models and suggest improvements for the description of CT signal properties.

Algorithms↗

Spectral analysis of heart sounds: relationships between some physical characteristics and frequency spectra of first and second heart sounds in normals and hypertensives.

Frequency analysis of heart sounds has been gaining recognition as a possible indicator of several heart and valve diseases, although a comprehensive study of normal heart sounds has not been published. Relating the frequency content of normal heart sounds to certain physical characteristics surrounding the generation of these sounds could lead to a valuable diagnostic tool and give a better understanding of the mechanism of heart sounds production. In this study, the first and second heart sounds from seventy-four normal, and seven hypertensive volunteers were recorded, digitized and analysed using a Fast Fourier Transform algorithm. Statistical analysis was used to relate physical characteristics (sex, blood pressure, and body surface area) of the subjects to the frequency content of normal heart sounds and to compare normal and hypertensive heart sounds. Statistical analysis showed that the major concentration of energy, for both first heart sound (S1) and second heart sound (S2), is below 150 Hertz (Hz) which may indicate that both sounds are caused by vibrations within the same structure, possibly the entire heart. However S2 spectra have greater amplitude than S1 spectra above 150 Hz, which may be due to vibrations within the aorta and pulmonary artery. Relationships observed between body surface area, sex, blood pressure, and the frequency content of heart sounds indicate that as heart size increases, the amplitude of the frequency coefficients above 150 Hz decreases. These observations were more identifiable in the S1 spectra than in the S2 spectra, possibly because the S2 higher frequency components may mask subtle changes in the S2 spectra caused by heart size changes. However, when the changes in heart size are significant, as in hypertension or increased body surface area, trends in the S2 spectra can be observed.

Adolescent↗

Inflammatory, autoimmune, chronic diseases: bad diet and physical inactivity are causes or effects?

It is now well established that most chronic diseases, especially those identified as inflammatory, are statistically correlated with some typical dietary excesses and physical inactivity. But do really these habits cause the diseases, or they result from them? Current opinion favours the first option, but fails to explain why the satisfaction of eating, naturally evolved in our brains to produce health, apparently induces countless millions of people to eat unrestrictedly until becoming mortally sick, whereas trying to keep a theoretically healthy diet is most often a real torture. The inverse explanation makes much more sense: since inflammation produces much heat, calorie-rich diets are required. An inflamed digestive tract lacks digestive power and is easily irritated or damaged by solid objects, therefore requiring a refined, concentrated, low-fibre diet. And inflamed or merely sick organisms are easily exhausted by physical effort, hence physical inactivity. This study confirms that, most probably, the primary causes of inflammatory diseases are always external inflammatory agents, like infectious micro-organisms or toxic substances, of which a particularly ubiquitous example is nicotine. High-calorie/low-fibre diets and physical inactivity are direct consequences of generalised inflammation. Inversely, in most cases, physical exercise and moderation in eating, by themselves, cannot substantially suppress inflammations, but they can prevent them from being further reinforced by the neural reward system. Moreover, diets and exercise causing important suffering will usually do more harm than good, especially to children and young people, not to mention pregnant or nursing women. Only the identification and elimination of the inflammatory agents can efficiently prevent and cure inflammatory diseases, and currently nicotine, absorbed intentionally or passively, from tobacco or other sources, must be considered the chief suspect because of its inflammatory power, ubiquity and addictive properties.

Autoimmune Diseases↗

[The most frequent causes and mechanisms of athletic injuries during organized physical education].

Injuries in physical training activities can be prevented by analyzing the causes and mechanisms of the origin of trauma. An analysis of statistical reports on injuries occurring in organized physical training in the Czechoslovak Socialist Republic showed that the injuries were primarily caused by another person, and, further, by the condition of the training ground. In case of women and children, this order was reversed. With regard to prevention, this finding should lead to purposeful education, exercising a positive influence on the participants of sports activities and, also, to the provision of adequate sports grounds and footwear. As regards the injury mechanisms, involuntary falls prevail. Even in this case, preventive measures can be taken by methods training the fall. The analysis is completed with a diagnostic evaluation and with the localization of injuries. Articular injuries, particularly those in the lower extremities, appear to be the most frequent diagnosis.

Adolescent↗

Research in physical medicine and rehabilitation. IX. Primary data analysis.

The primary statistical analysis is approached from the standpoint of what is required to publish in medical research journals. Descriptive and bivariate statistics cover the majority of medical research articles now published. Statistical guidelines for review of manuscripts are used to develop guidelines for analysis, including specifying the objective, the source of subjects and response rate, differences detectable with the expected sample size, appropriateness of statistics for one and two variables, method of presentation of results and conclusions and calculation of confidence intervals. Common mistakes to avoid include use of standard error of the mean instead of standard deviation, use of standard deviation with skewed data, failure to describe the statistical test used, multiple comparisons and failure to use special forms of t test and chi 2.

Cerebrovascular Disorders↗

Physical facilities of medical school libraries in the United States, 1966-1975: a statistical review.

This paper, based on information received from a questionnaire to which 107 of the present 114 medical school libraries in the U.S. responded, shows the vast growth and expansion of such libraries. The 86 libraries which have been built, expanded, under construction of planned during 1966-1975 represent the greatest expansion in the history of medical school libraries. This "decade of revolution" can be attributed to the evergrowing resources, primary users, and services discussed in this paper. The survey results can also be useful to those institutions planning or remodelling such library facilities in the near future.

Architecture↗

Effect of physical conditioning on measures of thyroid hormone action.

Serum thyroid function tests (T4, T3, rT3 and TSH levels) and measures of peripheral thyroid hormone action (serum dopamine-beta-hydroxylase activity (DBH) and sex hormone binding globulin (SHBG] were determined in 6 women before and one month after initiating an aerobic physical conditioning program. The same measurements were made in a control group of 6 women who did not increase their activity during this time. In physically conditioned subjects, the resting heart rate decreased from 65.1 +/- 3.9 (mean +/- SE) at baseline to 58.0 +/- 2.9 beats per minute after one month (P less than 0.025), indicating an appreciable state of physical conditioning was achieved. However, there were no statistically significant changes in thyroid function test, serum DBH or SHBG levels in either the physically conditioned or the control group. These data indicate that being physically conditioned has a negligible effect on thyroid status.

Adult↗

Changes in physical capacity, heart size and function in patients after myocardial infarction, who underwent a 4-to 6-week physical training program.

From findings in 1,200 coronary patients after myocardial infarction, it was shown that a stationary course of treatment in a rehabilitation center, where a gradually intensifying, individually adapted physical training program is administered, can lead to statistically highly significant improvements in the functional efficiency of the heart, as well as in physical capacity, in a short period of 4-6 weeks. It should be stressed that these positive effects can be demonstrated in the early stages of rehabilitation from infarction, that is, directly following discharge from the hospital, in the same way as in a late course of treatment of the repeated therapy; it is also important to point out that similar favorable results were obtained for older groups as for younger ones under all parameters, within the same time. A 6-week training period is more effective than a 4-week one.

Blood Pressure↗

Minor physical anomalies in schizophrenia.

OBJECTIVE: The study was conducted to evaluate the spread of the minor physical anomalies (MPAs) in patients with schizophrenia and normal subjects, and the relevance of MPAs to sex, age of onset of the disease, birth order, and season of birth. METHODS: Forty two inpatients satisfying the DSM-IV criteria for schizophrenia and 36 normal controls were evaluated for MPAs using the Waldrop scale. Subjects with schizophreniform, schizoaffective and schizotypal personality disorders were excluded from the sample to prevent these from possible confounding of the results. RESULTS: The schizophrenic patients showed significantly more anomalies than the controls. In both male and female patients, there was a higher incidence of anomalies in the region of the head. Significantly higher scores for minor physical anomalies were associated with later position in the birth order. Gender differences were without statistical significance. No relationship was found between minor physical anomalies and age of onset of the disease and birth season. CONCLUSION: The results are consistent with the theory of disturbed craniofacial development in at least one subpopulation of schizophrenic patients and indicate the origins of the disturbance in the early embryonal period. The higher incidence of anomalies in the region of head reflects the complex processes in the morphogenesis of mouth, ears and eyes.

Adult↗