Life Sciences Commons^™

Acute Effects Of Whole-Body Vibration On Lower Extremity Muscle Performance In Persons With Multiple Sclerosis, Kurt Jackson, Harold Merriman, Paul Vanderburgh, C. Brahler

C. Jayne Brahler

Background and Purpose: Whole-body vibration (WBV) is a relatively new form of exercise training that may influence muscle performance. This study investigated the acute effects of high (26 Hz) and low (2 Hz) frequency WBV on isometric muscle torque of the quadriceps and hamstrings in persons with multiple sclerosis (MS).

Participants and Method: Fifteen individuals (mean age = 54.6 years, SD = 9.6) with MS and Expanded Disability Status Scale (EDSS) scores ranging from 0-6.5 (mean = 4.2, SD = 2.3) participated in this randomized cross-over study. Following baseline measures of isometric quadricep and hamstring torque, subjects were exposed to …

Numerous Test Items In The Complete And Short Forms Of The Bot-2 Do Not Contribute Substantially To Motor Performance Assessments In Typically Developing Children Six To Ten Years Old, C. Brahler, Betsy Donahoe-Fillmore, Sara Mrowzinski, Susan Aebker, Megan Kreill

C. Jayne Brahler

The purposes of the current study were (1) to determine the magnitude of association between individual subtest items and the respective total subtest scores on the four subtests in the Bruininks-Oseretsky Test of Motor Proficiency, second edition (BOT-2) and (2) to review items on the BOT-2 Short Form. The correlation coefficients (r) between ranged from .865 to .071. Several items suffered from a ceiling effect, and four of the eight items on the Short Form for these four subtests had very low associations with their subtest total score. These results raise several issues with the BOT-2 that warrant further investigation.

Dengue: Defining Protective Versus Pathologic Immunity, Alan Rothman

Alan Rothman

Dengue is an expanding public health problem, and an effective vaccine remains elusive. This review discusses how the significant influence of sequential infection with different dengue virus serotypes on the severity of disease can be viewed in terms of beneficial and detrimental effects of heterologous immunity. A more complete understanding of these effects is likely to be critical for predicting optimal vaccine-induced immune responses.

Transgenesis In Animal Agriculture And Zoonotic Disease Resistance, Michael Greger

Michael Greger, M.D.

In 2009, the US Food and Drug Administration (FDA) released guidelines for the commercialization of genetically engineered (GE) farm animals. Numerous applications for approval of transgenic species are currently pending. Anthropocentric concerns raised to date have tended to neglect the impact of the physiological trade-off between production efficiency and immune function. Given animal agriculture's track record of prioritizing productivity - even at the expense of animal health - the incorporation of biotechnological tools to further stress production towards biological limits may continue to undermine immunocompetence. Regulatory schemata to avert adverse public health outcomes are discussed. Given the rising incidence of …

From The Centers For Disease Control And Prevention. Prevalence Of Penicillin-Resistant Streptococcus Pneumoniae--Connecticut, 1992-1993, E. Simpson

E. Hatheway Simpson

To determine the extent of antimicrobial susceptibility testing of Streptococcus pneumoniae and the prevalence of penicillin resistance among pneumococcal isolates from July 1992 through June 1993, in August 1993 the Connecticut Department of Public Health and Addiction Services (DPHAS) surveyed all 44 hospitals with clinical microbiology laboratories in Connecticut. This report summarizes the results of that survey.

Factor Structure Of The Chinese Service Quality Assessment Scale, Siu-Yin Cheung, Eddie Lam, Jia-Wen Shao, Jennifer Mak

Jennifer Y Mak

The quality of service has been the major subject of interest for business and academia. The aims of this study were to investigate the service quality of fitness clubs in Hong Kong and Guangzhou and to examine the underlying factor structure of the Service Quality Assessment Scale (SQAS; Lam, Zhang, & Jensen, 2005) in the Chinese context.

Effects Of Polychlorinated Biphenyl (Pcb) On Response Perseveration And Ultrasonic Vocalization Emission In Rat During Development, Howard Cromwell

Howard Casey Cromwell

The 3 major symptoms of autistic spectrum disorders include 1) social behavioral alterations, 2) problems in communication and 3) higher-order motoric deficits of perseveration and stereotyped movements. Previous work has shown that early developmental exposure to polychlorinated biphenyls (PCBs) alters rat pup social motivation and juvenile rat social recognition/investigation. The present work extends this previous research by examining how perinatal PCB exposure alters motoric functions and communication abilities at different stages of development. Action perseveration was examined using performance measures from a T-maze environment. Communication abilities were evaluated by monitoring ultrasound emission in rat pups during a brief isolation from …

Ankle Plantarflexion Strength In Rearfoot And Forefoot Runners: A Novel Clusteranalytic Approach, Dominik Liebl, Steffen Willwacher, Joseph Hamill, Gert-Peter Brüggemann

Joseph Hamill

The purpose of the present study was to test for differences in ankle plantarflexion strengths of habitually rearfoot and forefoot runners. In order to approach this issue, we revisit the problem of classifying different footfall patterns in human runners. A dataset of 119 subjects running shod and barefoot (speed 3.5 m/s) was analyzed. The footfall patterns were clustered by a novel statistical approach, which is motivated by advances in the statistical literature on functional data analysis. We explain the novel statistical approach in detail and compare it to the classically used strike index of Cavanagh and Lafortune (1980). The two …

Transitions, Risks, And Actions In Coronary Events--Center For Outcomes Research And Education (Trace-Core): Design And Rationale, Molly Waring, Richard Mcmanus, Jane Saczynski, Milena Anatchkova, David Mcmanus, Randolph Devereaux, Robert Goldberg, Jeroan Allison, Catarina Kiefe

Richard H. McManus

Background: Cardiovascular disease continues to cause significant morbidity, mortality, and impaired quality of life, with unrealized health gains from the underuse of available evidence. The Transitions, Risks, and Actions in Coronary Events Center for Outcomes Research and Education (TRACE-CORE) aims to advance the science of acute coronary syndromes by examining the determinants and outcomes of the quality of transition from hospital to community and by quantifying the impact of potentially modifiable characteristics associated with decreased quality of life, rehospitalization, and mortality. Methods and Results: TRACE-CORE comprises a longitudinal multiracial cohort of patients hospitalized with acute coronary syndromes, 2 research projects, …

Transitions, Risks, And Actions In Coronary Events--Center For Outcomes Research And Education (Trace-Core): Design And Rationale, Molly Waring, Richard Mcmanus, Jane Saczynski, Milena Anatchkova, David Mcmanus, Randolph Devereaux, Robert Goldberg, Jeroan Allison, Catarina Kiefe

Richard H. McManus

Background: Cardiovascular disease continues to cause significant morbidity, mortality, and impaired quality of life, with unrealized health gains from the underuse of available evidence. The Transitions, Risks, and Actions in Coronary Events Center for Outcomes Research and Education (TRACE-CORE) aims to advance the science of acute coronary syndromes by examining the determinants and outcomes of the quality of transition from hospital to community and by quantifying the impact of potentially modifiable characteristics associated with decreased quality of life, rehospitalization, and mortality. Methods and Results: TRACE-CORE comprises a longitudinal multiracial cohort of patients hospitalized with acute coronary syndromes, 2 research projects, …

Preventing Paediatric Obesity; Recommendations From A Community-Based Qualitative Investigation, Patricia Tucker, Jennifer Irwin, L. Sangster Bouck, Meizi He, G. Pollett

Trish Tucker

Childhood obesity is on the rise, and interventions targeted at pre-school-aged children are essential for the primary prevention of this disease. Physical activity programming and decreasing screen viewing may be advantageous ways to reduce the early onset of obesity. Parents' perceptions regarding effective tools and programmes to target obesity are needed to develop an efficacious programme. Ten semi-structured focus groups were conducted for this qualitative study. Two experienced moderators facilitated all focus groups which were conducted in local day cares, workplaces and play groups, frequented by parents. All focus groups were audio-recorded and transcribed verbatim. Strategies to ensure trustworthiness of …

Healthy Eating And Physical Activity Challenges And Opportunities In After-School Programs: Providers’ Perspectives, Heather Thomas, L. Fellner, Patricia Tucker, Jennifer Irwin

Trish Tucker

The purpose of this study was to understand after-school program providers’ perspectives of (a) current physical activity and nutrition curriculum, practices, and challenges, and (b) necessary modifications, program suggestions or resource needs to improve the healthy eating and active living practices within their after-school program for children aged 6 to 12 years. This qualitative study targeted a sample of nine after-school program providers in London, Ontario. Data was collected via in-depth interviews and a demographic survey between January and April 2009. Strategies to enhance data trustworthiness were incorporated throughout. After-school program providers identified insufficient healthy eating curriculum and requested interactive, …

Co-Active Life Coaching As A Treatment For Adults With Obesity, Courtney Newnham-Kanas, Jennifer Irwin, Don Morrow

Donald Morrow

This study evaluates the impact of one-on-one coaching on the waist circumference, BMI, self-esteem, self-efficacy, physical activity, and functional health status of adults with obesity. A one-group within- subjects, pre-test post-test study design was used. The study took place at the University of Western Ontario from June-October 2007. A total of 20 men and women aged 35-55, with a BMI ≥ 30 participated in the study. Each engaged in six to eight 35-minute sessions with a Certified Professional Co-Active Coach during which they explored desired changes and how to achieve them. Paired t-tests were used to analyse the pre- and …

Annotated Bibliography Of Life Coaching And Health Research, Courtney Newnham-Kanas, Paul Gorczynski, Don Morrow, Jennifer Irwin

Donald Morrow

No abstract provided.

The Impact Of Co-Active Life Coaching On Female University Students With Obesity, Melissa Van Zandvoort, Jennifer Irwin, Don Morrow

Donald Morrow

The purpose of this qualitative study was to explore the impact of Co-active life coaching on obese female university students. Five obese (BMI ≥ 30kg/m2), female university students received an average of nine weekly, 35-minute, one-on-one sessions with a certified coach. Semi- structured, in-depth interviews before and after participating in the coaching intervention were conducted, and inductive content analysis was utilized. Strategies to enhance data trustworthiness were incorporated throughout. Participants initially reported: struggling with barriers and experiencing pressure from family to lose weight; negative relationships with themselves; feeling self-conscious and remorse for their size and lifestyle choices. At the conclusion …

The Impact Of Co-Active Coaching On Physically Inactive 12 To 14 Year Olds In Ontario, Paul Gorczynski, Don Morrow, Jennifer Irwin

Donald Morrow

This study assessed the impact of life coaching on physical activity participation, self-efficacy, social support, and perceived behavioural control among physically inactive youth between the ages of 12 and 14 years in London, Ontario. The multiple-baseline across participants single case-experimental design study consisted of five 12 to 14 year olds. Six coaching sessions were conducted over two months by a certified professional Co-active coach. Physical activity increased for one participant while the other participants’ physical activity remained unchanged. No significant changes occurred in self-efficacy, social support, and perceived behavioural control with specific regard to becoming more physically active. Results indicted …

Health Promotion Theory In Practice: An Analysis Of Co-Active Coaching, Jennifer Irwin, Don Morrow

Donald Morrow

According to the World Health Organization (1986), “health promotion is the process of enabling people to increase control over, and to improve their own health.” To bring this process and its desired outcomes to fruition, many theories and models for understanding and altering health behaviours have been designed and utilized (Ajzen, 1988; Bandura, 1986; Fishbein & Ajzen; 1975; Freire, 1973, 1974; Jessor & Jessor, 1977; Prochaska, 1979). Practitioners of behaviour change implementation are legion, as therapists, counsellors, social workers and so forth. Coaching (in various iterations such as life coaching, personal coaching, executive coaching) is a recent and growing behavioural …

Participants' Perceived Utility Of Motivational Interviewing Using Co-Active Life Coaching Skills On Their Struggle With Obesity, Courtney Newnham-Kanas, Don Morrow, Jennifer Irwin

Donald Morrow

The purpose of this qualitative study was to investigate the impact of Motivational Interviewing (MI) using Co-Active Life Coaching skills as a treatment for adults (age, 35–55 years) struggling with obesity. Eight women (BMI≥30) who reside in London, Ontario, received 18 coaching sessions over six months with a Certified Professional Co-Active (CPCC) coach. Participants engaged in semi-structured pre- and post-interviews, along with a focus group six months after the last coaching session. The study's CPCC was also interviewed post-intervention to gain an understanding of what it was like coaching this population. All interviews were analysed using inductive content analysis. Following …

Self-Reported Colorectal Cancer Screening Of Medicare Beneficiaries In Family Medicine Vs. Internal Medicine Practices In The United States: A Cross-Sectional Study, Angela Higgins, Anna Doubeni, Karon Phillips, Adeyinka Laiyemo, Becky Briesacher, Jennifer Tjia, Chyke Doubeni

Chyke A. Doubeni

BACKGROUND: The benefit of screening for decreasing the risk of death from colorectal cancer (CRC) has been shown, yet many patients in primary care are still not undergoing screening according to guidelines. There are known variations in delivery of preventive health care services among primary care physicians. This study compared self-reported CRC screening rates and patient awareness of the need for CRC screening of patients receiving care from family medicine (FPs) vs. internal medicine (internists) physicians. METHODS: Nationally representative sample of non-institutionalized beneficiaries who received medical care from FPs or internists in 2006 (using Medicare Current Beneficiary Survey). The main …

Baseline And Follow-Up Laboratory Monitoring Of Cardiovascular Medications, Jennifer Tjia, Shira Fischer, Marsha Raebel, Daniel Peterson, Yanfang Zhao, Shawn Gagne, Jerry Gurwitz, Terry Field

Jennifer Tjia

BACKGROUND: Laboratory monitoring of medications is typically used to establish safety prior to drug initiation and to detect drug-related injury following initiation. It is unclear whether black box warnings (BBWs) as well as evidence- and consensus-based clinical guidelines increase the likelihood of appropriate monitoring. OBJECTIVE: To determine the proportion of patients newly initiated on selected cardiovascular medications with baseline assessment and follow-up laboratory monitoring and compare the prevalence of laboratory testing for drugs with and without BBWs and guidelines. METHODS: This cross-sectional study included patients aged 18 years or older from a large multispecialty group practice who were prescribed a …

Quality Measurement Of Medication Monitoring In The "Meaningful Use" Era, Jennifer Tjia, Terry Field, Shira Fischer, Shawn Gagne, Daniel Peterson, Lawrence Garber, Jerry Gurwitz

Jennifer Tjia

Objectives: While the 2011 implementation of "meaningful use" legislation for certified electronic health records (EHRs) promises to change quality reporting by overcoming data capture issues affecting quality measurement, the magnitude of this effect is unclear. We compared the measured quality of laboratory monitoring of Healthcare Effectiveness Data and Information Set (HEDIS) medications based on specifications that (1) include and exclude patients hospitalized in the measurement year and (2) use physician test orders and patient test completion. Study Design: Cross-sectional study. Methods: Among patients 18 years and older in a large multispecialty group practice utilizing a fully implemented EHR between January …

Development And Pilot Testing Of Guidelines To Monitor High-Risk Medications In The Ambulatory Setting, Jennifer Tjia, Terry Field, Lawrence Garber, Jennifer Donovan, Abir Kanaan, Marsha Raebel, Yanfang Zhao, Jackie Fuller, Shawn Gagne, Shira Fischer, Jerry Gurwitz

Jennifer Tjia

OBJECTIVES: To develop guidelines to monitor high-risk medications and to assess the prevalence of laboratory testing for these medications among a multispecialty group practice. STUDY DESIGN: Safety intervention trial. METHODS: We developed guidelines for the laboratory monitoring of high-risk medications as part of a patient safety intervention trial. An advisory committee of national experts and local leaders used a 2-round Internet-based Delphi process to select guideline medications based on the importance of monitoring for efficacy, safety, and drug-drug interactions. Test frequency recommendations were developed by academic pharmacists based on a literature review and local interdisciplinary consensus. To estimate the potential …

Disparities In Combination Drug Therapy Use In Older Adults With Coronary Heart Disease: A Cross-Sectional Time-Series In A Nationally Representative Us Sample, Jennifer Tjia, Becky Briesacher, Dawei Xie, Jason Fu, Robert Goldberg

Jennifer Tjia

BACKGROUND: Despite evidence of effective combination drug therapy for secondary prevention of coronary heart disease (CHD), older adults with this condition remain undertreated.

OBJECTIVE: To describe time trends (1992-2003) in the adoption of combination cardiac drug therapies (beta-blockers [beta-adrenoceptor antagonists], ACE inhibitors or angiotensin II type 1 receptor antagonists [angiotensin receptor blockers; ARBs], and lipid-lowering agents) among older adults in the US with CHD and to identify factors associated with not using combination therapy.

METHODS: The study took the form of a cross-sectional time-series. The study population consisted of a nationally representative sample of adults aged >or=65 years with CHD …

Long-Term Trends In Short-Term Outcomes In Acute Myocardial Infarction, Hoa Nguyen, Jane Saczynski, Joel Gore, Molly Waring, Darleen Lessard, Jorge Yarzebski, George Reed, Frederick Spencer, Shu-Xia Li, Robert Goldberg

Jorge L. Yarzebski

BACKGROUND: The objectives of this study were to examine the magnitude of, and 20-year trends in, age differences in short-term outcomes among men and women hospitalized with acute myocardial infarction (AMI) in central Massachusetts.

METHODS: The study population consisted of 5907 male and 4406 female residents of the Worcester, MA, metropolitan area hospitalized at all greater Worcester medical centers with AMI between 1986 and 2005.

RESULTS: Overall, among both men and women, older patients were significantly more likely to have developed atrial fibrillation, heart failure, and to have died during hospitalization and within 30 days after admission compared with patients …

Efficacy Of A Family Practice-Based Lifestyle Intervention Program To Increase Physical Activity And Reduce Clinical And Physiological Markers Of Vascular Health In Patients With High Normal Blood Pressure And/Or High Normal Blood Glucose (Snac): Study Protocol For A Randomized Controlled Trial, Robert Petrella, Kuni Aizawa, Kevin Shoemaker, Tom Overend, Leonard Piché, Mauricio Marin, Sheree Shapiro, Sophie Atkin

Leonard Piché

BACKGROUND: Previous interventions to increase physical activity and reduce cardiovascular risk factors have been targeted at individuals with established disease; less attention has been given to intervention among individuals with high risk for disease nor has there been determination of the influence of setting in which the intervention is provided. In particular, family practice represents an ideal setting for the provision and long-term maintenance of lifestyle interventions for patients at risk (ie high-normal blood pressure or impaired glucose tolerance).

METHODS/DESIGN: The Staged Nutrition and Activity Counseling (SNAC) study is a randomized clustered design clinical trial that will investigate the effectiveness …

Body Mass Index, Treatment Practices, And Mortality In Patients With Acute Heart Failure, Timothy Fitzgibbons, Olga Hardy, Darleen Lessard, Joel Gore, Jorge Yarzebski, Robert Goldberg

Jorge L. Yarzebski

OBJECTIVES: Obesity is associated with an increased risk of heart failure (HF). Among patients presenting with acute HF, however, differences in clinical characteristics, treatment regimens, and short-term prognosis of varying weights are largely unknown, particularly from a broader population-based perspective. METHODS: A total of 3722 patients admitted with acute HF to 11 greater Worcester (Massachusetts, USA) hospitals during 1995 and 2000 were categorized as being lean (n = 216), normal weight (n = 1465), overweight (n = 1007), or obese (n = 1034) at the time of hospitalization. RESULTS: Obese patients with decompensated HF were significantly younger (mean age = …

Changes Over Time In The Use Of Aspirin In Patients Hospitalized With Acute Myocardial Infarction (1975 To 1997): A Population-Based Perspective, Elizabeth Jackson, Ramya Sivasubramian, Frederick Spencer, Jorge Yarzebski, Darleen Lessard, Joel Gore, Robert Goldberg

Jorge L. Yarzebski

OBJECTIVE: The purpose of this study was to examine 2 decade-long trends in the use of aspirin and associated outcomes in patients hospitalized with acute myocardial infarction. BACKGROUND: Aspirin has been shown to be beneficial in the secondary prevention of AMI. However, little is known about changes over time in the use of aspirin in patients hospitalized with AMI and associated outcomes, particularly from a more generalizable population-based perspective. METHODS: We examined trends in aspirin use and hospital and long-term outcomes in 9336 metropolitan Worcester, Mass, residents hospitalized with validated AMI in all area hospitals between 1975 and 1997. RESULTS: …

Thirty-Year Trends (1975-2005) In The Magnitude, Patient Characteristics, And Hospital Outcomes Of Patients With Acute Myocardial Infarction Complicated By Ventricular Fibrillation, Robert Goldberg, Jorge Yarzebski, Frederick Spencer, Juan Zevallos, Darleen Lessard, Joel Gore

Jorge L. Yarzebski

Limited contemporary data are available describing the incidence rates, hospital prognosis, and factors associated with the occurrence of ventricular fibrillation (VF) in patients hospitalized with acute myocardial infarction (AMI). The objectives of our study were to examine 3-decade-long trends (1975 to 2005) in the magnitude, predictors, and hospital case-fatality rates associated with VF in residents of a large New England metropolitan area hospitalized at all area medical centers with an uncomplicated AMI. The study population consisted of 7,472 residents of the Worcester (Massachusetts) metropolitan area hospitalized with an uncomplicated AMI in 15 annual periods from 1975 to 2005. The overall …

Temporal Trends (1975 Through 1990) In The Incidence And Case-Fatality Rates Of Primary Ventricular Fibrillation Complicating Acute Myocardial Infarction. A Communitywide Perspective, David Chiriboga, Jorge Yarzebski, Robert Goldberg, Joel Gore, Joseph Alpert

Jorge L. Yarzebski

BACKGROUND: As part of a population-based study of acute myocardial infarction, we examined changes over time in the incidence and in-hospital case-fatality rates of primary ventricular fibrillation complicating acute myocardial infarction. METHODS AND RESULTS: Patients with validated acute myocardial infarction hospitalized at 16 hospitals in the Worcester, Mass, metropolitan area between 1975 and 1990 comprised the study sample. During the 15-year study period, 5.1% of patients developed primary ventricular fibrillation in the setting of uncomplicated acute myocardial infarction, with this rate remaining relatively constant over time. Both age- and multivariable-adjusted analyses showed no significant trend in the incidence rates of …

Temporal Trends And Associated Factors Of Inpatient Cardiac Rehabilitation In Patients With Acute Myocardial Infarction: A Community-Wide Perspective, Frederick Spencer, Bobak Salami, Jorge Yarzebski, Darleen Lessard, Joel Gore, Robert Goldberg

Jorge L. Yarzebski

PURPOSE: Cardiac rehabilitation (CR) has been shown to be an important therapeutic intervention after the development of acute myocardial infarction (AMI), but historically has been underused. Inpatient CR often represents cardiac patients' first exposure to risk factor modification education and acts as a gateway to outpatient programs. METHODS: The authors performed a longitudinal study of the use of inpatient CR in 5204 Worcester residents hospitalized with validated AMI in seven 1-year periods between 1986 and 1997. RESULTS: The overall rate of referral to inpatient CR was 68%, with a slight decline in use to less than 60% in the authors' …